CN104434242B - End effector, surgical operating instrument and purse-string forceps - Google Patents
End effector, surgical operating instrument and purse-string forceps Download PDFInfo
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- CN104434242B CN104434242B CN201310438122.4A CN201310438122A CN104434242B CN 104434242 B CN104434242 B CN 104434242B CN 201310438122 A CN201310438122 A CN 201310438122A CN 104434242 B CN104434242 B CN 104434242B
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- staple
- tong arm
- ejector pin
- end effector
- nail
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1142—Purse-string sutures
Abstract
The present invention relates to technical field of medical instruments, a kind of end effector, surgical operating instrument and purse-string forceps are disclosed, carry out the operating process of surgical operation to lumen organization with simplification, reduce operating time, mitigate the wound brought to operation patients.End effector includes：First tong arm and the second tong arm；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, is arranged on the opposite side of the longitudinal direction of the first tong arm and the second tong arm；Cutting mechanism, is arranged between suturing mechanism and purse string suture mechanism；Purse string suture mechanism includes：The the first staple nail kit set on first tong arm, the first staple nail anvil that second tong arm is set when jaw is closed at position corresponding with the first staple nail kit, first staple nail kit, two seam areas for including being internally provided with the first staple upper along the longitudinal direction, and between two seam areas and inside is not provided with the open area of the first staple.
Description
Technical field
The present invention relates to technical field of medical instruments, more particularly to a kind of end effector, a kind of surgical operating instrument
With a kind of purse-string forceps.
Background technology
Gastrointestinal surgery generally needs cut-out closure tissue lumen, and carries out purse string suture at the side tube chamber for disconnecting,
It is used to coordinate the nail anvil for installing round stitching unstrument at purse string suture, is grasped to carry out follow-up suture etc. using round stitching unstrument
Make.
Purse string suture is a kind of common suturing skill in surgical operation, it is known that there are two kinds of sides of main purse string suture
Formula.A kind of mode is to carry out purse string suture by hand, and as shown in Figure 1 a, 1 b, doctor first uses lotus around the otch of lumen organization 59
Bag pin passes through tissue surface with purse wire 58, then tightens up completion purse string suture by purse wire 58.The mode of manual suture is grasped
Make complicated, the more difficult assurance of performance accuracy, and easily seldom adopted in the section's of being out at present operation because off-line causes suture to fail
With.
Another way is to aid in carrying out purse string suture using purse-string forceps.As shown in Figure 2 a, a kind of purse-string forceps are equally profits
With threading a needle（That is pocket pin）Band line（That is purse wire 58）Mode carry out purse string suture.
As shown in Figure 2 b, also a kind of purse-string forceps are to follow closely 57 by pocket purse wire 58 is attached into the surface of lumen organization 59
And purse string suture is carried out, common mode is that percussion pocket follows closely 57 and is pierced into it and is fixed to lumen organization 59, and purse wire
58 are connected with each other between pocket nail 57, or are pressed between lumen organization 59 and pocket nail 57 by pocket nail 57, so that
Purse wire 58 is attached to lumen organization 59, to realize purse string suture.
Generally when being performed the operation to lumen organization, purse string suture is carried out except the remaining end otch to lumen organization is needed
Outward, in addition it is also necessary to its lesion end is cut, is sutured.And existing purse-string forceps unitary function, can be only done the pocket to remaining end
Suture, it is impossible to realize the cutting suture to lesion end.Therefore at least also need to the use of surgical devices such as other staplers
Tool, the operation for changing operating theater instruments is relatively complicated, and this can cause operating time more long, increases operation risk and to operation patients
The pain brought.
And, the 1980s occurs in that endoscope-assistant surgery, and it is a kind of main through endoscope and various imagings
Technology and make surgeon without performing a surgical operation in the case of huge wound is caused to patient.Relative to open surgery
Speech, the endoscope-assistant surgery significant advantage such as have, post-operative recovery small to disorganization fast, so that the trend as development.This
In the case of, the purse-string forceps for endoscope-assistant surgery are occurred in that, the existing purse-string forceps for endoscope-assistant surgery equally exist above-mentioned functions
Single problem.
The content of the invention
First purpose of the invention is to provide a kind of end effector, and surgical operation is carried out to lumen organization with simplification
Operating process, reduces the pain of operating time, operation risk and patient, further can be also used for endoscope-assistant surgery.The end
Actuator includes：First tong arm and the second tong arm, the first tong arm and the second tong arm can in the presence of opening and closing mechanism phase
To motion, so that the jaw that the first tong arm and the second tong arm are formed opens or closes；Suturing mechanism, suturing mechanism is arranged on
The side of the longitudinal direction of one tong arm and the second tong arm；Purse string suture mechanism, purse string suture mechanism is arranged on the first tong arm and
The opposite side of the longitudinal direction of two tong arms；Cutting mechanism, cutting mechanism is arranged between suturing mechanism and purse string suture mechanism；Lotus
Bag suturing mechanism includes：The the first staple nail kit set on first tong arm, the second tong arm is followed closely when jaw is closed with the first staple
The the first staple nail anvil set at the corresponding position of casket, the first staple nail kit is upper along the longitudinal direction to be included being internally provided with the first seam
Two seam areas of nail, and between two seam areas and inside is not provided with the open area of the first staple, the
One staple can be fired by the first staple ejector pin mechanism.
In the technical scheme, the suturing mechanism of end effector side can realize the suture of tissue, the pocket of opposite side
Suturing mechanism can realize the purse string suture of tissue, and the cutting mechanism between suturing mechanism and purse string suture mechanism is then capable of achieving
The cutting of tissue, it is seen then that the purse string suture of tube chamber remaining end tissue can be realized using end effector provided by the present invention, with
And the cutting and suture of lesion end tissue, compared with prior art, enormously simplify the behaviour that surgical operation is carried out to lumen organization
Make process, reduce operating time, alleviate the wound brought to operation patients.
Second object of the present invention is to provide a kind of surgical operating instrument, including：Handle and by handle drives as preceding
State the end effector of technical scheme.Because end effector has the effect above, therefore the surgical operating instrument can letter significantly
Change carries out the operating process of surgical operation to lumen organization, reduces operating time, mitigates the wound brought to operation patients.
Third object of the present invention is to provide a kind of purse-string forceps, and the purse-string forceps include：First tong arm and the second tong arm, the
One tong arm and the second tong arm can the relative motion in the presence of opening and closing mechanism so that the first tong arm and the second tong arm institute shape
Into jaw open or close；Purse string suture mechanism, including：The the first staple nail kit set on first tong arm, the second tong arm exists
The the first staple nail anvil set at position corresponding with the first staple nail kit when jaw is closed, the first staple nail kit is along the longitudinal direction
Upper two seam areas for including being internally provided with the first staple, and between two seam areas and inside is not provided with
The open area of the first staple, the first staple can be fired by the first staple ejector pin mechanism.
After the first staple in the first staple nail kit is all fired, the otch and seam area of lumen organization's remaining end
Corresponding part is sewn, and the part that the otch of lumen organization's remaining end is corresponding with open area is not sewn, and realizes
The purse string suture of lumen organization's remaining end, and staple is more firm with the connection of lumen organization, significantly reduces pocket nail de-
Fall the purse string suture risk for causing, therefore, the purse-string forceps substantially increase the security of operation.
Brief description of the drawings
Fig. 1 a are the schematic cross-section of lumen organization's purse string suture；
Fig. 1 b are front view of the lumen organization after purse wire is tightened up；
Fig. 2 a are a kind of existing purse-string forceps purse string suture principle schematic；
Fig. 2 b are existing another purse-string forceps purse string suture principle schematic；
Fig. 3 a are the end effector dimensional structure diagram of the embodiment of the present invention；
Fig. 3 b are the half section structural representation when end effector jaw of the embodiment of the present invention is closed；
Fig. 3 c are the end effector structural representation that jaw opens in operation technique of the embodiment of the present invention；
Fig. 3 d are the cross section structure schematic diagram of end effector jaw closure in operation technique of the embodiment of the present invention；
Fig. 3 e are the internal structure schematic three dimensional views of the end effector of the embodiment of the present invention（Tissue apposition side, staple portion
Divide and fired）；
Fig. 4 be cut, the lumen organization's schematic diagram after tissue apposition and purse string suture；
Fig. 5 a are the schematic three dimensional views that the lumen organization after purse string suture coordinates with circular stapler nail anvil；
Fig. 5 b are the schematic three dimensional views that lumen organization's suture is carried out by circular stapler；
Fig. 6 is the surgical operating instrument structural representation of the embodiment of the present invention.
Reference：
57- pockets nail 58- purse wire 59- lumen organizations
10a- the first tong arm 10b- the second tong arm 11- suturing mechanisms
12- purse string sutures mechanism 13- cutting mechanisms 14- the first staple nail kits
15- circular stapler nail anvil 16- the first staple ejector pin sliding block the first staples of 17-
18- the first staple nail anvil 19- the second staple nail kit the second staples of 20-
21- the second staple ejector pin sliding block 22- the first staple nail pushing device 23- cutter
24- cutter grooves 25- the second staple nail anvil 26- handles
27- end effector 28- slender bodies 29- transmission mechanisms
30- the second staple nail pushing device 31- closure flanges
Specific embodiment
In order that purse string suture, cutting just can be completed with same apparatus and sutured, simplify to needing to carry out purse string suture
Tissue（Particularly lumen organization）The operating process of surgical operation is carried out, the pain of operating time, risk and patient is reduced,
Further can be used in endoscope-assistant surgery, the embodiment of the invention provides 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 suture of tissue, the purse string suture of opposite side
Mechanism can realize the purse string suture of tissue, and the cutting mechanism between suturing mechanism and purse string suture mechanism is then capable of achieving tissue
Cutting, the end effector provided using the embodiment of the present invention or surgical operating instrument can realize tube chamber remaining end tissue
Purse string suture, and the cutting and suture that lesion end is organized, enormously simplify the operation that surgical operation is carried out to lumen organization
Journey, reduces operating time, is yet further useful for endoscope-assistant surgery.To make the object, technical solutions and advantages of the present invention more
It is clear, the present invention is described in further detail by the following examples.
As shown in Fig. 3 a to Fig. 3 d, the end effector of the embodiment of the present invention, including：
First tong arm 10a and the second tong arm 10b, the first tong arm 10a and the second tong arm 10b can be in opening and closing mechanisms
The lower relative motion of effect, so that the jaw that the first tong arm 10a and the second tong arm 10b are formed opens or closes；
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 longitudinal direction of the first tong arm 10a and the second tong arm 10b
Opposite side；
Cutting mechanism 13, cutting mechanism 13 is arranged between suturing mechanism 11 and purse string suture mechanism 12；
Purse string suture mechanism 12 includes：
The the first staple nail kit 14 set on first tong arm 10a, the second tong arm 10b is followed closely when jaw is closed with the first staple
The the first staple nail anvil 18 set at the corresponding position of casket 14, the first staple nail kit 14 is upper along the longitudinal direction to be included being internally provided with
Two seam areas of the first staple 17, and between two seam areas and inside is not provided with opening for the first staple 17
Mouth region domain, the first staple 17 can be fired by the first staple ejector pin mechanism.
In various embodiments of the present invention, away from the side of user when " distally " refers to that the apparatus is operated, " nearside " then refers to
Near the side of user when the apparatus is operated." advance " points to the direction motion away from user, and " retrogressing " is then pointed to and leaned on
The direction motion of nearly user.The end effector that the embodiment of the present invention is provided can coordinate drive mechanism to use, by driving
Mechanism provides driving force.The specific constructive form of drive mechanism is not limited, for example, can directly by existing stapler front end
End effector unload, the end effector that the embodiment of the present invention is provided is loaded onto, by the driving of existing stapler
Mechanism is opening and closing mechanism, suturing mechanism, purse string suture mechanism and cutting mechanism provide driving force.In addition it is also possible to be this
The other design driven mechanism of end effector that inventive embodiments are provided.
The end effector that the embodiment of the present invention is provided according to function can be divided into opening and closing mechanism, suturing mechanism,
Purse string suture mechanism and the part of cutting mechanism four.Wherein, opening and closing mechanism is used to realize two tong arm institutes of end effector
The opening and closing of the jaw of formation, can drive jaw to open and be placed in one with by lumen organization to be performed the operation, so when using
Rear-guard movable clamp port closure clamps lumen organization to carry out the surgical actions such as purse string suture, cutting, suture, and works as surgical action
After end, jaw can be driven to open to discharge tissue again.Cutting mechanism is used to realize the cutting function to organizing, can be by
The lesion end of lumen organization and remaining end cutting are separated.Suturing mechanism is used for suture function of the realization to tissue, can be in tube chamber
The incision at lesion tissue end is sutured.Purse string suture mechanism is used to realize the purse string suture function to organizing, can manage
The incision of cavity tissue remaining end carries out purse string suture, and the nail anvil of round stitching unstrument is installed to coordinate in subsequent operation, uses
Round stitching unstrument carries out the operation such as suturing.
In the present embodiment, after the incision of lumen organization's remaining end carries out purse string suture (as shown in Figure 4), by tube chamber
The excision of the lesion at lesion tissue end utilizes lumen organization's elasticity in itself, as shown in figure 5 a and 5b, makes round stitching unstrument
Enter the inside of the remaining end of lumen organization 59 at the opening that nail anvil 15 passes through the remaining end of lumen organization 59, and coordinate round stitching unstrument
The end end suture of lumen organization is realized, because the technology is well known to those skilled in the art, therefore is no longer described in detail here.
This tetrameric structure will be respectively further described below.
In the end effector of the embodiment of the present invention, opening and closing mechanism, suturing mechanism, purse string suture mechanism and cutting
At least both can synchronously be driven in mechanism；Can also opening and closing mechanism, suturing mechanism, purse string suture mechanism and cut
Cutting mill structure is 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 to turn
Dynamic movable tong arm；Or, the first tong arm 10a is non-rotatable fixed tong arm, and the second tong arm 10b is rotatable adjustable clamp
Arm；Or, the second tong arm 10b is non-rotatable fixed tong arm, and the first tong arm 10a is rotatable activity tong arm.Either
Only one of which activity tong arm or two are movable tong arm, as long as the pincers that two tong arms can form two tong arms by driving
Mouth opening and closing.
The opening and closing mechanism of end effector of the invention can opening using the end effector of existing stapler
Open the various technical schemes of close mechanism to realize, for example, bushing type opening and closing scheme, I-shaped beam type opening and closing scheme
Deng.
For example, opening and closing mechanism may include to close bar, closure bar distal end portion is provided with closure flange, the first tong arm and the
Be provided with stage clip between two tong arms, when bar longitudinal distal motion by driving is closed, closure flange engage the first tong arm and/
Or the second closing face on tong arm so that tong arm overcomes the elastic force of stage clip and closes, and when closing bar and retracting, jaw can be in stage clip
Reset response under open.When bar longitudinal distal motion by driving is closed, closure flange can only engage the first tong arm
Or the second closing face on tong arm, but in order to obtain the stress of relatively balance, it is preferred that closure flange engage simultaneously the first tong arm and
Closing face on second tong arm.
Wherein, closure bar can with for fire the first staple the first staple ejector pin bar, percussion the second staple second
Staple ejector pin bar or for drive the knife bar of cutter be structure as a whole or be different parts be connected with each other；Closure bar, first
Staple ejector pin bar, the second staple ejector pin bar or knife bar can also be respectively different parts；Closure bar can also be pushed away with the first staple
In nail rod, knife bar and the second staple ejector pin bar it is any both be structure as a whole or be that different parts are connected with each other；Additionally,
Can be that closure bar is structure as a whole with the first staple ejector pin bar, knife bar and the second staple ejector pin bar（Can be described as drive rod）Or
For different parts are connected with each other.
Incorporated by reference to shown in Fig. 3 a and Fig. 3 e, in one particular embodiment of the present invention, cutter 23 are one with knife bar
Structure and as the closure bar of opening and closing mechanism, stage clip is provided between the first tong arm 10a and the second tong arm 10b（In figure not
Show）, the distal end portion for closing bar is fixed with closure flange 31 parallel to cut direction in movable tong arm away from the side of jaw；
When bar advance is closed, the promotion activity tong arm of closure flange 31 turns to jaw closure, and when bar retrogressing is closed, stage clip promotes work
Movable pliers turn to jaw opening.Explanation is needed exist for, the stroke that closure flange 31 is walked when jaw is closed simultaneously is not required to
It is very big.
Cutting mechanism：
The cutting mechanism of end effector of the invention can be using the cutting of the end effector of existing stapler
The various technical schemes of mechanism are realized.
For example, with reference to shown in Fig. 3 a, cutting mechanism may include cutter 23, cutter 23 can be in the effect of push broach mechanism
Under between suturing mechanism and purse string suture mechanism move, by tissue sutured respectively and purse string suture cutting point
Can be push broach bar or miscellaneous part from, push broach mechanism, cutter 23 and push broach mechanism can be that one can also be split
's（Now, cutter 23 are arranged on the distally of push broach mechanism）.First tong arm and the second tong arm are provided with receiving cutter 23 and transport
Dynamic cutter groove 24（As shown in Figure 3 a, due to viewing angles reason, not shown in the cutter groove figure of the second tong arm 10b）, think cutting
The motion of knife 23 provides guiding, makes cutting movement more steady, accurate.
Suturing mechanism：
The suturing mechanism of end effector of the invention can be using the sewing machine of the end effector of existing stapler
The various technical schemes of structure are realized.
For example, as shown in Figure 3 a, and combine shown in Fig. 3 d and Fig. 3 e, suturing mechanism may be provided at two longitudinal direction sides of tong arm
To side, tong arm sets the second staple nail anvil 25, and another tong arm sets the second staple nail kit 19, the second staple nail kit
Second staple 20 is set in 19, and the second staple 20 can be set to a row or multi-row along the longitudinal direction, and the second staple 20 can be by
Two staple ejector pin mechanisms fire.The second staple ejector pin mechanism for firing the second staple 20 may include the second staple ejector pin bar
(in the embodiment, the knife bar of cutter 23 is used as the second staple ejector pin bar), the second staple ejector pin sliding block 21 and the second staple are pushed away
Nail device 30.Percussion process can be the second staple ejector pin bar distad lengthwise movement and drive the second staple ejector pin sliding block 21,
The ramp effect of two staple ejector pin sliding blocks 21 makes its transverse movement in the second staple nail pushing device 30, then by the second staple ejector pin
Second staple 20 released the second staple nail kit 19 by device 30, through lumen organization 59 and compress the second staple nail anvil 25, the second seam
Nail 20 is shaped to B shape in the presence of the second staple nail anvil 25, so as to complete suture.
The row of the second staple 20 is not limited, but at least should be a row, more preferably at least two rows, so, can be in lumen organization
Lesion end carry out at least twice suture, greatly reduce suture failure risk.When the second staple 20 is longitudinally disposed for many
During row, the multiple second staple nail pushing devices 30 in front of a promotion of the second staple ejector pin sliding block 21 can be only set.
When the knife bar of cutter 23 is used as the second staple ejector pin bar, the position of cutter 23 may be configured as relative to second
Staple ejector pin sliding block 21 is more rearward（I.e. closer to nearside）So that first suture and cut afterwards, can so reduce in lesion end
Portion's tissue outflow, improves the success rate of operation.In one embodiment, the knife bar that the second staple ejector pin sliding block 21 is cut knife 23 is pushed away
Dynamic, before the blade of cutter 23 cuts to tissue, the inclined-plane of the second staple ejector pin sliding block 21 has promoted front
Second staple nail pushing device 30 fires the second staple 20, that is, first by lumen organization's suture in front, therefore, cutter 23 are total
It is just to be cut after tissue apposition.
Purse string suture mechanism：
Purse string suture mechanism may be provided at two opposite sides of the longitudinal direction of tong arm, that is, relative with suturing mechanism
Side.
Preferably, the first staple 17 sets at least two rows along the longitudinal direction, and specific row is not limited, so, can be
The incision of lumen organization's remaining end carries out at least twice suture with the part corresponding to two seam areas, greatly reduces lotus
Overseam closes the risk of failure.When the first staple 17 it is longitudinally disposed for it is multiple rows of when, a second staple ejector pin can be only set and slided
Multiple first staple nail pushing devices 22 in front of the promotion of block 21.In one embodiment as shown in Figure 4, the first staple 17 is along longitudinal side
To setting three rows.
As shown in Figure 3 d, and shown in combination Fig. 3 a and 3e, the first staple ejector pin mechanism includes：First staple ejector pin bar,
One staple ejector pin sliding block 16 and the first staple nail pushing device 22, when the first staple ejector pin bar distad the first staple of zigzag tread patterns ejector pin
During sliding block 16, the laterally driven first staple nail pushing device 22 in inclined-plane of the first staple ejector pin sliding block 16 makes the first staple nail pushing device 22
First staple 17 is released into the first staple nail kit 14 and the shaping in the presence of the first staple nail anvil 18.
First staple ejector pin mechanism and the second staple ejector pin mechanism can synchronously be driven, the first staple ejector pin bar and second
Staple ejector pin bar is structure as a whole with the knife bar of cutter（First staple ejector pin bar, the second staple ejector pin bar and knife bar can also
For different parts are connected with each other）, the first staple ejector pin sliding block 16 and the second staple ejector pin sliding block 21 are structure as a whole（Or for not
It is connected with each other with part）, for example, when ejector pin sliding block is by zigzag tread patterns, ejector pin sliding block can drive the first staple nail pushing device 22 and
Two staple nail pushing devices 30, make the staple being arranged in the first staple nail kit 14 and the second staple nail kit 19 be fired respectively.Additionally,
First staple ejector pin mechanism and the second staple ejector pin mechanism can be Liang Ge mechanisms that are separate, being driven separately, at this moment
One staple ejector pin bar and the second staple ejector pin bar are respectively different parts, and the first staple ejector pin sliding block and the second staple ejector pin are slided
Block is respectively different parts.
First staple and the second staple can be structure identical parts, additionally, the first staple nail anvil and the second staple nail
Anvil can also be structure identical part, and the first staple nail pushing device and the second staple nail pushing device can also be structure identical portions
Part, the first staple ejector pin sliding block and the second staple ejector pin sliding block can also be structure identical parts.
In the technical scheme of the embodiment of the present invention, closure bar, the first staple ejector pin bar, knife bar and the second staple ejector pin bar
Can be structure as a whole or for different parts are connected with each other to realize synchronous driving, for example, in one embodiment, closure bar,
First staple ejector pin bar, knife bar and the second staple ejector pin bar are structure as a whole, and can be described as drive rod.When using, drive rod is to remote
Lateral movement drives opening and closing mechanism to be driven, first to close tong arm, with the further motion of drive rod, suturing mechanism
Driven with purse string suture mechanism, after the first staple in the first staple nail kit is fired successively, lumen organization's remaining end is cut
Mouth realizes suture, otch and the portion corresponding to open area of lumen organization's remaining end with the part corresponding to two seam areas
Divide unrealized suture, that is, realize the purse string suture of lumen organization's remaining end, the second staple in the second staple nail kit is by successively
Fire to realize the suture of the incision at lumen organization's lesion end, at the same cutter under the promotion of drive rod in suturing mechanism and
Tissue is cut between purse string suture mechanism, so as to complete cutting, suture and purse string suture simultaneously（Cut, group
The lumen organization after suture and purse string suture is knitted as shown in figure 4, wherein, direction shown in arrow is the length direction of lumen organization）,
This is further simplified the operating process that surgical operation is carried out to lumen organization, reduces operating time, so as to further mitigate
To the wound that operation patients bring.Also, because staple can more firmly be connected with lumen organization, substantially improve pocket seam
The reliability of conjunction, improves the security of operation.
To sum up, in technical solution of the present invention, the suturing mechanism of end effector side can realize the suture of tissue, another
The purse string suture mechanism of side can realize the purse string suture of tissue, and the cutting mechanism between suturing mechanism and purse string suture mechanism
Then it is capable of achieving the cutting of tissue, it is seen then that the end effector provided using the embodiment of the present invention can realize tube chamber remaining end group
The purse string suture knitted, and the cutting and suture that lesion end is organized, compared with prior art, greatly reduce replacing operating theater instruments
Frequency, simplify the operating process that surgical operation is carried out to lumen organization, reduce operating time, alleviate to operation patients
The wound brought.
It should be noted that in various embodiments of the present invention, the specification of end effector is not limited, can basis
Specific operation needs are designed.For example, when end effector is the end effector with hysteroscope specification, can be with mating cavity
Mirror is used, and operation is had the advantages of safe, surface of a wound is small, pain is few, recovery is fast concurrently.
As shown in fig. 6, the embodiment of the present invention additionally provides a kind of surgical operating instrument, including：Handle 26 and by handle 26
Drive such as the end effector 27 of foregoing any embodiment.
Also include being internally provided with the slender bodies 28 of transmission mechanism 29 in the embodiment, the distally of handle 26 passes through slender bodies
28 are connected with end effector 27, the drive transmission device 29 of handle 26, transmission mechanism 29 so that by driving pass to end perform
Device 27, driving is provided with for its opening and closing, suture, cutting and purse string suture.Surgical operating instrument with the structure can be with
Coordinate hysteroscope to use, operation is had the advantages of safe, surface of a wound is small, pain is few, recovery is fast concurrently.
The surgical operating instrument provided using the embodiment of the present invention can realize the purse string suture of tube chamber remaining end tissue, with
And the cutting and suture of lesion end tissue, compared with prior art, enormously simplify the behaviour that surgical operation is carried out to lumen organization
Make process, reduce operating time, alleviate the wound brought to operation patients, further can be also used for endoscope-assistant surgery.
The embodiment of the present invention additionally provides a kind of purse-string forceps, including：
First tong arm and the second tong arm, the first tong arm and the second tong arm relative in the case where opening and closing mechanism acts on can be transported
It is dynamic, so that the jaw that the first tong arm and the second tong arm are formed opens or closes；
Purse string suture mechanism, including：On first tong arm set the first staple nail kit, the second tong arm when jaw close and
The the first staple nail anvil set at the corresponding position of first staple nail kit, the first staple nail kit goes up set including inside along the longitudinal direction
It is equipped with two seam areas of the first staple, and between two seam areas and inside is not provided with opening for the first staple
Mouth region domain, the first staple can be fired by the first staple ejector pin mechanism.
When the first staple in the first staple nail kit by all fired after, the otch of lumen organization's remaining end with two suture
Realize suture, the otch of lumen organization's remaining end and the unrealized seam in the part corresponding to open area in part corresponding to region
Close, and then realize the purse string suture of lumen organization's remaining end.
First staple ejector pin mechanism includes：First staple ejector pin bar, the first staple ejector pin sliding block and staple nail pushing device, when
Distad described in zigzag tread patterns during the first staple ejector pin sliding block, the inclined-plane of the first staple ejector pin sliding block laterally drives one staple ejector pin bar
Dynamic first staple nail pushing device, makes the first staple nail pushing device that the first staple is released into the first staple nail kit and in the first corresponding seam
It is molded in the presence of nail nail anvil.
Preferably, the first staple is set at least two rows along the longitudinal direction.Beneficial effect in each embodiment is as before, here
Explanation is not repeated.
The purse-string forceps that the embodiment of the present invention is provided, the concrete form of tong arm opening and closing mechanism is not limited, for example, can use
The structure type similar with aforementioned end effector, also can be using the structure type of general surgery pincers, the first tong arm and the second pincers
Arm is hinged, and is closed jaw by manually operated two levers of operator.When using the structure similar with aforementioned end effector
During form, opening and closing mechanism and purse string suture mechanism can synchronously be driven, and at this moment close bar and the first staple ejector pin bar can
To be structure as a whole, or different parts are connected with each other to realize synchronous driving, additionally, opening and closing mechanism and purse string suture mechanism
Can also be driven separately.
Obviously, those skilled in the art can carry out various changes and modification without deviating from essence of the invention to the present invention
God and scope.So, if these modifications of the invention and modification belong to the scope of the claims in the present invention and its equivalent technologies
Within, then the present invention is also intended to comprising these changes and modification.
Claims (13)
1. a kind of end effector, it is characterised in that including：
First tong arm (10a) and the second tong arm (10b), first tong arm (10a) and second tong arm (10b) can opened
Relative motion in the presence of close mechanism is opened, so that the pincers that first tong arm (10a) and second tong arm (10b) are formed
Mouth opens or closes；
Suturing mechanism (11), the suturing mechanism (11) is arranged on first tong arm (10a) and second tong arm (10b)
The side of longitudinal direction；
Purse string suture mechanism (12), the purse string suture mechanism (12) is arranged on first tong arm (10a) and second pincers
The opposite side of the longitudinal direction of arm (10b)；
Cutting mechanism (13), the cutting mechanism (13) is arranged on the suturing mechanism (11) and the purse string suture mechanism (12)
Between；
The purse string suture mechanism (12) includes：
On first tong arm (10a) set the first staple nail kit (14), second tong arm (10b) when jaw close and
The the first staple nail anvil (18) set at the corresponding position of the first staple nail kit (14), the first staple nail kit (14) edge
Longitudinal direction includes being internally provided with two seam areas of the first staple (17), and between two seam areas and interior
Portion is not provided with the open area of the first staple, and first staple (17) can be fired by the first staple ejector pin mechanism；It is described
First staple (17) sets at least two rows along the longitudinal direction；The first staple ejector pin mechanism includes：First staple ejector pin bar,
One staple ejector pin sliding block (16) and the first staple nail pushing device (22), when described in the first staple ejector pin bar distad zigzag tread patterns
During the first staple ejector pin sliding block (16), the laterally driven first staple ejector pin in inclined-plane of the first staple ejector pin sliding block (16)
Device (22), make the first staple nail pushing device (22) by first staple (17) release the first staple nail kit (14) and
It is molded in the presence of the first staple nail anvil (18).
2. end effector as claimed in claim 1, it is characterised in that the suturing mechanism (11) includes：
On first tong arm (10a) set the second staple nail kit (19), second tong arm (10b) when jaw close and
The the second staple nail anvil (25) set at the corresponding position of the second staple nail kit (19), in the second staple nail kit (19)
The second staple (20) is provided with, second staple (20) can be fired by the second staple ejector pin mechanism, wherein：
The second staple ejector pin mechanism includes：Second staple ejector pin bar, the second staple ejector pin sliding block (21) and the second staple are pushed away
Nail device (30), when the second staple ejector pin sliding block (21) described in the second staple ejector pin bar distad zigzag tread patterns, described the
The laterally driven second staple nail pushing device (30) in inclined-plane of two staple ejector pins sliding block (21), makes the second staple nail pushing device
(30) second staple (20) is released into the second staple nail kit (19) and in the effect of the second staple nail anvil (25)
Lower shaping.
3. end effector as claimed in claim 2, it is characterised in that the first staple nail ejector pin bar and the second staple are pushed away
Nail rod is that integrative-structure or different parts are connected with each other, and the first staple ejector pin sliding block (16) and the second staple ejector pin are slided
Block (21) is that integrative-structure or different parts are connected with each other.
4. end effector as claimed in claim 1, it is characterised in that the cutting mechanism (13) includes：Can be in push broach
The cutter (23) moved between the suturing mechanism (11) and the purse string suture mechanism (12) in the presence of mechanism.
5. end effector as claimed in claim 4, it is characterised in that first tong arm (10a) and second tong arm
(10b) has the cutter groove (24) for accommodating cutter (23) motion.
6. end effector as claimed in claim 1, it is characterised in that first tong arm (10a) and second tong arm
(10b) is rotatable activity tong arm；Or, first tong arm (10a) is non-rotatable fixed tong arm, described second
Tong arm (10b) is rotatable activity tong arm；Or, second tong arm (10b) is non-rotatable fixed tong arm, described the
One tong arm (10a) is rotatable activity tong arm.
7. end effector as claimed in claim 6, it is characterised in that the opening and closing mechanism includes closure bar, described
Closure bar distal end portion is provided with closure flange, and pressure is provided between first tong arm (10a) and second tong arm (10b)
Spring, when closure bar longitudinal distal motion by driving, the closure flange (31) engage the first tong arm (10a) and/
Or second closing face on tong arm (10b) and make the jaw overcome the elastic force of the stage clip and close, when the closure bar is returned
When moving back, the jaw can open under the reset response of the stage clip.
8. the end effector as described in any one of claim 1~7, it is characterised in that
The opening and closing mechanism, the suturing mechanism (11), the purse string suture mechanism (12) and the cutting mechanism (13)
In at least both synchronously driven；Or,
The opening and closing mechanism, the suturing mechanism (11), the purse string suture mechanism (12) and the cutting mechanism (13)
It is driven separately.
9. end effector as claimed in claim 8, it is characterised in that the end effector is the end with hysteroscope specification
End actuator.
10. a kind of surgical operating instrument, it is characterised in that including：Handle (26) and by the handle (26) drive such as right
It is required that the end effector (27) described in 1~9 any one.
11. surgical operating instruments as claimed in claim 10, it is characterised in that also including being internally provided with transmission mechanism (29)
Slender bodies (28), the distally of the handle (26) is connected by the slender bodies (28) with the end effector (27), institute
State handle (26) be the opening and closing of the end effector (27) by the transmission mechanism (29), suture, cutting and pocket
Suture provides driving.
A kind of 12. purse-string forceps, it is characterised in that including：
First tong arm and the second tong arm, first tong arm and second tong arm can in the presence of opening and closing mechanism phase
To motion, so that the jaw that first tong arm and second tong arm are formed opens or closes；
Purse string suture mechanism, including：The the first staple nail kit set on first tong arm, second tong arm is closed in jaw
When position corresponding with the first staple nail kit at set the first staple nail anvil, the first staple nail kit is along the longitudinal direction
Upper two seam areas for including being internally provided with the first staple, and between two seam areas and inside is not provided with
The open area of the first staple, first staple can be fired by the first staple ejector pin mechanism；First staple is along longitudinal direction
Direction sets at least two rows；The first staple ejector pin mechanism includes：First staple ejector pin bar, the first staple ejector pin sliding block and
One staple nail pushing device, when the first staple ejector pin bar distad the first staple ejector pin sliding block described in zigzag tread patterns, described
The laterally driven first staple nail pushing device in inclined-plane of one staple ejector pin sliding block, makes the first staple nail pushing device by described first
Staple is released the first staple nail kit and is molded in the presence of the first staple nail anvil.
13. purse-string forceps as claimed in claim 12, it is characterised in that
The opening and closing mechanism and the purse string suture mechanism are synchronously driven；Or, the opening and closing mechanism and described
Purse string suture mechanism is driven separately.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310438122.4A CN104434242B (en) | 2013-09-23 | 2013-09-23 | End effector, surgical operating instrument and purse-string forceps |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310438122.4A CN104434242B (en) | 2013-09-23 | 2013-09-23 | End effector, surgical operating instrument and purse-string forceps |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN104434242A CN104434242A (en) | 2015-03-25 |
| CN104434242B true CN104434242B (en) | 2017-06-16 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201310438122.4A Active CN104434242B (en) | 2013-09-23 | 2013-09-23 | End effector, surgical operating instrument and purse-string forceps |
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| CN (1) | CN104434242B (en) |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107320144B (en) * | 2017-07-28 | 2023-06-13 | 广西壮族自治区人民医院 | Linear purse-string suture cutting closer |
| US11045270B2 (en) * | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
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|---|---|---|---|---|
| US4821939A (en) * | 1987-09-02 | 1989-04-18 | United States Surgical Corporation | Staple cartridge and an anvilless surgical stapler |
| CN201328846Y (en) * | 2008-11-27 | 2009-10-21 | 苏州天臣国际医疗科技有限公司 | Single-ended purse-string suture tool |
| EP2417916A2 (en) * | 2010-08-11 | 2012-02-15 | Tyco Healthcare Group LP | Endoscopic purse string surgical device |
| CN202982106U (en) * | 2012-12-29 | 2013-06-12 | 苏州天臣国际医疗科技有限公司 | Surgical operating instrument |
| CN203564287U (en) * | 2013-09-23 | 2014-04-30 | 瑞奇外科器械(中国)有限公司 | End effector, surgical operating instrument and purse-string forceps |
-
2013
- 2013-09-23 CN CN201310438122.4A patent/CN104434242B/en active Active
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4821939A (en) * | 1987-09-02 | 1989-04-18 | United States Surgical Corporation | Staple cartridge and an anvilless surgical stapler |
| CN201328846Y (en) * | 2008-11-27 | 2009-10-21 | 苏州天臣国际医疗科技有限公司 | Single-ended purse-string suture tool |
| EP2417916A2 (en) * | 2010-08-11 | 2012-02-15 | Tyco Healthcare Group LP | Endoscopic purse string surgical device |
| CN202982106U (en) * | 2012-12-29 | 2013-06-12 | 苏州天臣国际医疗科技有限公司 | Surgical operating instrument |
| CN203564287U (en) * | 2013-09-23 | 2014-04-30 | 瑞奇外科器械(中国)有限公司 | End effector, surgical operating instrument and purse-string forceps |
Also Published As
| Publication number | Publication date |
|---|---|
| CN104434242A (en) | 2015-03-25 |
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Address after: 300457 Tianjin Binhai New Area Economic and Technological Development Zone, Fourth Street, No. 5, block B, floor 4 Patentee after: Tianjin Ricky surgical instruments Limited by Share Ltd Address before: 300457 Tianjin Binhai New Area Economic and Technological Development Zone, Fourth Street, No. 5, block B, floor 4 Patentee before: Reach Surgical Instrument (China) Co.,Ltd. |
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