CN104434241B - 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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- CN104434241B CN104434241B CN201310437983.0A CN201310437983A CN104434241B CN 104434241 B CN104434241 B CN 104434241B CN 201310437983 A CN201310437983 A CN 201310437983A CN 104434241 B CN104434241 B CN 104434241B
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- nail
- tong arm
- kit
- purse
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
Abstract
The present invention relates to technical field of medical instruments, disclose a kind of end effector, surgical operating instrument and purse-string forceps, end effector and surgical operating instrument can simplify the operating process of operation, mitigate the wound brought to operation patients, pocket can also further followed closely and is more firmly connected with lumen organization.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：On first tong arm set the first pocket nail nail kit, on the second tong arm set the second pocket nail nail kit, the first pocket nail nail kit and the second pocket nail nail kit pocket nail percussion mouth have make by pocket follow closely nail leg draw in closing-in structure.
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 stapler at purse string suture, is grasped to carry out follow-up identical grade using round stapler
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
It is that purse wire 58 is attached to by the surface of lumen organization 59 by pocket nail 57 and purse string suture is carried out, common mode is percussion lotus
Bag follows closely 57 and is pierced into it and is fixed to lumen organization 59, and purse wire 58 or the interconnection between pocket nail 57, or
It is pressed between lumen organization 59 and pocket nail 57 by pocket nail 57, so as to purse wire 58 is attached into 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.
Shown in Fig. 2 b in the prior art, pocket nail 57 needs to use and purse wire 58 is fixed on into pipe without nail anvil forming technique
The surface of cavity tissue 59, often occurs that pocket follows closely the phenomenon of avulsion using this purse-string forceps, so as to cause purse string suture to fail, this
Also operation risk and the pain brought to operation patients can be increased.
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 operating time, and further pocket nail is difficult avulsion, and the security of operation is higher.
The end effector includes：First tong arm and the second tong arm, the first tong arm and the second tong arm can be in opening and closings
Relative motion in the presence of mechanism, so that the jaw that the first tong arm and the second tong arm are formed opens or closes；Suturing mechanism, seam
Close the side that mechanism is arranged on the longitudinal direction of the first tong arm and the second tong arm；Purse string suture mechanism, purse string suture mechanism is set
In the first tong arm and the opposite side of the longitudinal direction of the second tong arm；Cutting mechanism, cutting mechanism is arranged on suturing mechanism and pocket
Between suturing mechanism；Purse string suture mechanism includes：The the first pocket nail nail kit set on first tong arm, is set on the second tong arm
Second pocket follows closely nail kit, and pocket nail is respectively arranged with the first pocket nail nail kit and the second pocket nail nail kit, and pocket is followed closely by pocket
The pocket nail percussion mouth of the percussion of nail ejector pin mechanism, the first pocket nail nail kit and the second pocket nail nail kit have make by pocket follow closely
Nail leg draw in closing-in structure, the first pocket nail nail kit and the second pocket nail nail kit be provided with positioned at lotus towards the surface of jaw
Purse wire between two nail legs of Bao Ding.
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.
Preferably, the first pocket nail nail kit and the second pocket nail nail kit pocket nail percussion mouth have make by pocket follow closely
Nail leg intersect draw in closing-in structure.The end effector can be such that pocket nail is more firmly connected with lumen organization, significantly
The phenomenon that pocket follows closely easy avulsion is improved, the security of operation is improve.
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, enters one
Step can also be such that pocket nail is more firmly connected with lumen organization, improve the security of operation.
Third object of the present invention is to provide a kind of purse-string forceps, can follow closely pocket and be connected more firm with lumen organization, lotus
Bao Ding is difficult avulsion, substantially increases the security of operation.Purse-string forceps include：First tong arm and the second tong arm, the first tong arm and
Second tong arm can the relative motion in the presence of opening and closing mechanism so that the jaw that the first tong arm and the second tong arm are formed
Open or close；Purse string suture mechanism, including：The the first pocket nail nail kit set on first tong arm, is set on the second tong arm
Second pocket follows closely nail kit, and pocket nail is respectively arranged with the first pocket nail nail kit and the second pocket nail nail kit, and pocket is followed closely by pocket
The pocket nail percussion mouth of the percussion of nail ejector pin mechanism, the first pocket nail nail kit and the second pocket nail nail kit have make by pocket follow closely
Nail leg intersect draw in closing-in structure, the first pocket nail nail kit and the second pocket nail nail kit the surface of jaw is provided with position
Purse wire between two nail legs of pocket nail.
When pocket nail is pierced into lumen organization by percussion, the nail leg intersection of pocket nail is drawn in, is connected more firm with lumen organization
Lean on, be difficult to deviate from from lumen organization, therefore, the purse-string forceps substantially increase the security of purse string suture.
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 end effector jaw closure schematic diagram of the embodiment of the present invention；
Fig. 3 c for the embodiment of the present invention end effector after operation technique jaw open schematic diagram；
Fig. 4 is the structural representation of the first tong arm in the embodiment of the present invention；
Fig. 5 a are the internal structure schematic three dimensional views of the end effector of the embodiment of the present invention（Tissue apposition side, staple is not
Fired）；
Fig. 5 b 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. 6 a are the internal structure schematic three dimensional views of the end effector of the embodiment of the present invention（Purse string suture side, pocket nail
Do not fired）；
Fig. 6 b are the cross section structure schematic diagram of the end effector of the embodiment of the present invention（Pocket nail is not fired）；
Fig. 6 c are the internal structure schematic three dimensional views of the end effector of the embodiment of the present invention（Purse string suture side, pocket nail
Part is fired）；
Fig. 6 d are the cross section structure schematic diagram of the end effector of the embodiment of the present invention（Pocket nail is fired）；
Fig. 7 is the percussion process schematic of pocket nail in one embodiment of the invention；
Fig. 8 be cut, the 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：
57- pockets nail 58- purse wire 59- lumen organizations
10a- the first tong arm 10b- the second tong arm 11- suturing mechanisms
The first pockets of 12- purse string sutures mechanism 13- cutting mechanisms 14a- follow closely nail kit
The pockets of 14b- second nail nail kit 56- closing-in structures 17a- tightens up groove
15- line card 16- pockets nail ejector pin sliding block 17- pocket nail nail pushing devices
18- staple nail anvil 19- staple nail kit 20- staples
21- staple ejector pin sliding block 22- staple nail pushing device 23- cutter
24- cutter groove 25- closure flange 26- handles
27- end effector 28- slender bodies 29- transmission mechanisms
571- nail leg 572- crowns
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.
With reference to shown in Fig. 3 a to Fig. 3 c and Fig. 6 b, 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 pocket nail nail kit 14a set on first tong arm 10a, the second pocket nail nail set on the second tong arm 10b
Pocket nail 57 is respectively arranged with casket 14b, the first pocket nail nail kit 14a and the second pocket nail nail kit 14b, pocket nail 57 is by pocket
The pocket nail percussion mouth of the percussion of nail ejector pin mechanism, the first pocket nail nail kit 14a and the second pocket nail nail kit 14b have make by
The closing-in structure 56 that the nail leg 571 of pocket nail 57 is drawn in, the first pocket nail nail kit 14a and the second pocket follow closely nail kit 14b towards pincers
The surface of mouth is provided with the purse wire 58 between two nail legs 571 of pocket nail 57.
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 stapler is installed to coordinate in subsequent operation, uses
Round stapler coincide and waits operation.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 follow closely ejector pin with the staple ejector pin bar for firing staple, for firing the pocket of pocket nail
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, staple ejector pin bar, knife
Bar or pocket nail ejector pin bar can also be respectively different parts；Closure bar can also be pushed away with staple ejector pin bar, knife bar and pocket nail
In nail rod it is any both be structure as a whole or be that different parts are connected with each other；In addition it is also possible to be that closure bar is pushed away with staple
Nail rod, knife bar and pocket nail ejector pin bar are structure as a whole（Can be described as drive rod）Or for different parts are connected with each other.
Incorporated by reference to shown in Fig. 3 c, Fig. 5 a and 5b, in one particular embodiment of the present invention, cutter 23 and knife bar are one
Body 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
It is not shown）, the distal end portion for closing bar is fixed with closure flange parallel to cut direction in movable tong arm away from the side of jaw
25；When bar advance is closed, the promotion activity tong arm of closure flange 25 turns to jaw closure, and when bar retrogressing is closed, stage clip is pushed away
Dynamic activity tong arm turns to jaw opening.Explanation is needed exist for, the stroke that closure flange 25 is walked when jaw is closed is simultaneously
Need not be 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. 4, Fig. 5 a and Fig. 5 b, cutting mechanism may include cutter 23, cutter 23 can be in push broach
Moved between suturing mechanism and purse string suture mechanism in the presence of mechanism, by group sutured respectively and purse string suture
Knit cutting to separate, push broach mechanism can be push broach bar or miscellaneous part, and cutter 23 and push broach mechanism can be also may be used for one
Being split（Now, cutter 23 are arranged on the distally of push broach mechanism）.First tong arm and the second tong arm are provided with receiving and cut
The cutter groove 24 of the motion of cutter 23（As shown in Figure 4）, provide guiding with the motion for cutter 23, make cutting movement it is more steady,
Accurately.
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 5 a and 5b, suturing mechanism may be provided at two sides of the longitudinal direction of tong arm, a pincers
Arm sets staple nail anvil 18, and another tong arm sets staple nail kit 19, and staple 20 is set in staple nail kit 19, and staple 20 can be along vertical
It is set to direction a row or multi-row, staple 20 can be fired by staple ejector pin mechanism.Staple ejector pin for firing staple 20
Mechanism may include staple ejector pin bar (in the embodiment, the knife bar of cutter 23 is used as staple ejector pin bar), staple ejector pin sliding block 21
With staple nail pushing device 22.Percussion process can be staple ejector pin bar distad lengthwise movement and drive staple ejector pin sliding block 21, stitch
The ramp effect of nail ejector pin sliding block 21 makes its transverse movement in staple nail pushing device 22, then by staple nail pushing device 22 by staple 20
Release staple nail kit 19, through lumen organization 59 and compress staple nail anvil 18, staple 20 is molded in the presence of staple nail anvil 18
It is B shape, so as to complete suture.
The row of staple 20 is not limited, but at least should be a row, more preferably at least two rows, so, can be in the disease of lumen organization
Becoming end carries out at least twice suture, greatly reduces the risk of suture failure.When staple 20 it is longitudinally disposed for it is multiple rows of when, can be with
Multiple staple nail pushing devices 22 in front of one promotion of staple ejector pin sliding block 21 are only set.
When the knife bar of cutter 23 is used as staple ejector pin bar, the position of cutter 23 may be configured as relative to staple ejector pin
Sliding block 21 is more rearward（I.e. closer to nearside）So that first suture and cut afterwards, can so reduce outside the interior tissue of lesion end
Stream, improves the success rate of operation.In one embodiment, staple ejector pin sliding block 21 is cut the knife bar promotion of knife 23, in cutter
Before 23 blade cuts to tissue, the inclined-plane of staple ejector pin sliding block 21 has promoted the staple nail pushing device 22 in front will to stitch
Nail 20 is fired, that is, first by lumen organization's suture in front, therefore, cutter 23 are always just cut after tissue apposition
Cut.
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.As shown in Figure 6 b, second set on the first pocket nail nail kit 14a and the second tong arm 10b for being set on the first tong arm 10a
Pocket follows closely nail kit 14b positions when jaw is closed and relatively, can so obtain preferable purse string suture effect.
As shown in Fig. 6 a to Fig. 6 d, pocket nail ejector pin mechanism includes：Pocket follows closely ejector pin bar, and for each pocket nail
Pocket nail ejector pin sliding block 16 and pocket nail nail pushing device 17 set by nail kit；Nail kit is followed closely for each pocket, when pocket nail is pushed away
Nail rod distad zigzag tread patterns pocket nail ejector pin sliding block 16 when, the laterally driven pocket nail ejector pin in inclined-plane of pocket nail ejector pin sliding block 16
Device 17, makes pocket follow closely nail pushing device 17 and pocket nail 57 is released into pocket nail percussion mouth.
It can be Liang Ge mechanisms that are separate, being driven separately that pocket follows closely ejector pin mechanism and staple ejector pin mechanism, at this moment
Pocket follows closely ejector pin bar and staple ejector pin bar is respectively different parts, and pocket nail ejector pin sliding block and staple ejector pin sliding block are respectively not
Same part, additionally, pocket nail ejector pin mechanism and staple ejector pin mechanism can synchronously be driven, as shown in Figure 5 b, pocket nail is pushed away
Nail rod and staple ejector pin bar are structure as a whole with the knife bar of cutter（Pocket nail ejector pin bar, staple ejector pin bar and knife bar can also
For different parts are connected with each other）, pocket nail ejector pin sliding block 16 and staple ejector pin sliding block 21 are structure as a whole（Or be different parts
It is connected with each other）, for example, when ejector pin sliding block is by zigzag tread patterns, the inclined-plane of ejector pin sliding block can the laterally driven pocket nail He of nail pushing device 17
Staple nail pushing device 22, follows closely pocket and is fired respectively with staple.
As shown in figure 4, positioning method of the purse wire 58 in nail kit surface is not limited, it is preferred that the first pocket follow closely nail kit 10a and
Second pocket nail nail kit is respectively arranged with line card 15 towards the surface of jaw, and purse wire 58 is arranged in line card 15.Purse wire is set
Between two nail legs of pocket nail, when pocket nail is pierced into lumen organization by percussion, purse wire is crushed on the crown of pocket nail
And lumen organization between, when pocket nail percussion is finished, when the jaw of end effector opens, purse wire and the first pocket follow closely nail kit
Separated with the second pocket nail nail kit.
In order that purse wire 58 is more smooth, be reliably positioned at nail kit surface, it is preferred that the first pocket nail nail kit 14a
Two neighboring pocket nail 57 between be provided with least two line cards 15；The two neighboring pocket nail of the second pocket nail nail kit 14b
At least two line cards 15 are provided between 57.The particular number of line card 15 can determine according to the arrangement spacing of pocket nail 57, this
In be not especially limited.
Preferably, the pocket nail percussion mouth of the first pocket nail nail kit 14a and the second pocket nail nail kit 14b have make by
The nail leg 571 of pocket nail 57 intersects the closing-in structure 56 for drawing in.With reference to shown in Fig. 6 b, Fig. 6 d and Fig. 7, the first pocket nail nail kit
The closing-in structure 56 of 14a and the second pocket nail nail kit 14b is positioned at the closing in inclined-plane in the outside of two nail legs 571 of pocket nail 57.
When pocket nail nail pushing device 17 promotes pocket nail 57 to pocket nail percussion mouth direction, compressed by closing in inclined-plane, pocket nail 57
Two nail legs 571 be pierced into lumen organization 59 after gradually draw close, then intersect embrace lumen organization 59.In Fig. 7, A is pocket
The width of nail, is also equal to the width that pocket nail nail kit follows closely groove, and B is that pocket follows closely the width for firing mouth, and B<A, C are closing in inclined-plane
Highly.Can be embraced according to correlation experience or experiment adjustment B, C size, two nail legs 571 intersection for making the pocket after percussion follow closely 57
Firmly lumen organization 59, another layer without being pierced into lumen organization 59.
When pocket nail is pierced into lumen organization by percussion, lumen organization is embraced in pocket nail nail leg intersection gathering, with tube chamber group
Knit connection more firm, pocket nail is difficult to deviate from from lumen organization, therefore, the end effector of the embodiment substantially increases hand
The security of art.
Preferably, the middle part of crown 572 of pocket nail 57 is bent to pocket nail percussion mouth, and the shape of crown 572 can be guided
The deformation of pocket nail 57, is conducive to improving the uniformity of pocket nail shaping.
In order to ensure movement travel during pocket nail percussion in nail kit, pocket nail nail pushing device 17 should enter nail kit
Closing-in structure 56.Optionally, the pocket nail nail pushing device 17 is the pocket nail nail pushing device of elastic material, or, the pocket
Nail nail pushing device 17 is offered towards the side of crown 572 of pocket nail 57 and tightens up groove 17a, when pocket nail nail pushing device 17 will
After the pocket nail 57 releases the pocket nail percussion mouth, the pocket nail nail pushing device 17 is located in the closing-in structure 56 and place
In compressive state.
In the technical scheme of the embodiment of the present invention, closure bar, staple ejector pin bar, knife bar and pocket nail ejector pin bar can be
Integrative-structure is connected with each other to realize synchronous driving for different parts, for example, in one embodiment, closure bar, staple are pushed away
Nail rod, knife bar and pocket nail ejector pin bar are structure as a whole, and can be described as drive rod.When using, drive rod distal motion is carrying out
Drive, opening and closing mechanism is driven first to close tong arm, with the further motion of drive rod, suturing mechanism and purse string suture
Mechanism is driven, and staple is fired to realize suture successively, and pocket nail is pierced into tissue to realize purse string suture by percussion successively, together
When cutter under the promotion of drive rod between suturing mechanism and purse string suture mechanism to tissue cut so that simultaneously complete
Into cutting, suture and purse string suture（Cut, the lumen organization after tissue apposition and purse string suture as shown in figure 8, its
In, direction shown in arrow is the length direction of lumen organization）, this is further simplified the operation that surgical operation is carried out to lumen organization
Process, reduces operating time, so as to further mitigate the wound brought to operation patients.
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.Also, when pocket nail is pierced into lumen organization by percussion, pocket nail nail leg intersection is drawn in, is connected with lumen organization
Connect more firm, be difficult to deviate from from lumen organization, therefore, substantially increase the security of purse string suture.
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 figure 9, 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, and pocket nail can be made more firmly to be connected with lumen organization, improve the safety of operation
Property, the wound brought to operation patients is alleviated, 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：The the first pocket nail nail kit set on first tong arm, sets on second tong arm
Pocket nail is respectively arranged with the second pocket nail nail kit put, the first pocket nail nail kit and second pocket nail nail kit,
The pocket nail is fired by pocket nail ejector pin mechanism, the pocket nail of the first pocket nail nail kit and second pocket nail nail kit
Percussion mouth have make by pocket nail nail leg intersect the closing-in structure for drawing in, first pocket follows closely nail kit and second lotus
Bag nail nail kit is provided with the purse wire between two nail legs of pocket nail towards the surface of jaw.
When pocket nail is pierced into lumen organization by percussion, pocket nail nail leg intersection is drawn in, is connected more firm with lumen organization,
It is difficult to deviate from from lumen organization, therefore, substantially increase the security of purse string suture.
Pocket nail ejector pin mechanism includes：Pocket follows closely ejector pin bar, and for the pocket set by each pocket nail nail kit
Nail ejector pin sliding block and pocket nail nail pushing device；Nail kit is followed closely for each pocket, when pocket follows closely ejector pin bar distad zigzag tread patterns lotus
During bag nail ejector pin sliding block, the laterally driven pocket nail nail pushing device in inclined-plane of pocket nail ejector pin sliding block makes pocket follow closely nail pushing device by pocket
Nail releases pocket nail percussion mouth.
Preferably, the closing-in structure is closing in inclined-plane.The crown middle part of the pocket nail is to pocket nail percussion mouth
Bending.First pocket follows closely nail kit and the second pocket nail nail kit is respectively arranged with line card towards the surface of jaw, and purse wire is arranged in
Line card.At least two line cards are provided between the two neighboring pocket nail of the first pocket nail nail kit, the second pocket follows closely the phase of nail kit
At least two line cards are provided between adjacent two pockets nail.Beneficial effect in each embodiment is as before, be not repeated herein explanation.
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 closing bar and pocket nail ejector pin bar can be with
It is structure as a whole or different parts is connected with each other to realize synchronous driving, additionally, opening and closing mechanism and purse string suture mechanism
Can 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 (23)
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：
The first pocket set on first tong arm (10a) follows closely nail kit (14a), the set on second tong arm (10b)
Two pockets follow closely nail kit (14b), and first pocket is respectively provided with following closely nail kit (14a) and second pocket nail nail kit (14b)
There is pocket to follow closely (57), pocket nail (57) is fired by pocket nail ejector pin mechanism, first pocket follows closely nail kit (14a) and described
Second pocket nail nail kit (14b) pocket nail percussion mouth have make by pocket nail (57) nail leg (571) draw in closing in
Structure (56), first pocket follows closely nail kit (14a) and second pocket is followed closely nail kit (14b) and is provided with towards the surface of jaw
Purse wire (58) between two nail legs (571) of pocket nail (57)；The pocket nail ejector pin mechanism includes：Pocket
Nail ejector pin bar, and follow closely ejector pin sliding block (16) and pocket nail nail pushing device for the pocket set by each pocket nail nail kit
(17)；Nail kit is followed closely for each pocket, distad pocket described in zigzag tread patterns follows closely ejector pin sliding block when pocket nail ejector pin bar
(16) when, the laterally driven pocket in inclined-plane of pocket nail ejector pin sliding block (16) follows closely nail pushing device (17), follows closely the pocket
Pocket nail (57) is released the pocket nail percussion mouth by nail pushing device (17).
2. end effector as claimed in claim 1, it is characterised in that first pocket follows closely nail kit (14a) and described the
Two pockets nail nail kit (14b) pocket nail percussion mouth have make by pocket nail (57) nail leg (571) intersect draw in receipts
Mouth structure (56).
3. end effector as claimed in claim 2, it is characterised in that the closing-in structure (56) is closing in inclined-plane.
4. end effector as claimed in claim 2, it is characterised in that crown (572) middle part of pocket nail (57) to
The pocket nail percussion mouth bending.
5. end effector as claimed in claim 1, it is characterised in that first pocket follows closely nail kit (14a) and described the
Two pockets follow closely nail kit (14b) and are respectively arranged with line card (15) towards the surface of jaw, and the purse wire (58) is arranged in the line
Card (15).
6. end effector as claimed in claim 5, it is characterised in that adjacent the two of first pocket nail nail kit (14a)
Line card described at least two (15) is provided between individual pocket nail (57)；Second pocket follows closely the adjacent of nail kit (14b)
Line card described at least two (15) is provided between two pockets nail (57).
7. end effector as claimed in claim 1, it is characterised in that it is elastic material that the pocket follows closely nail pushing device (17)
Pocket follows closely nail pushing device, or, the pocket is followed closely nail pushing device (17) and is offered towards crown (572) side of pocket nail (57)
Groove (17a) is tightened up, it is described after the pocket follows closely nail pushing device (17), and pocket nail (57) is released into the pocket nail percussion mouth
Pocket follows closely nail pushing device (17) in the closing-in structure (56) and in compressive state.
8. end effector as claimed in claim 1, it is characterised in that the suturing mechanism (11) includes：
On first tong arm (10a) set staple nail anvil (18), second tong arm (10b) when jaw is closed with it is described
The staple nail kit (19) set at the corresponding position of staple nail anvil (18), staple (20) is provided with the staple nail kit (19),
The staple (20) can be fired by staple ejector pin mechanism, wherein：
The staple ejector pin mechanism includes：Staple ejector pin bar, staple ejector pin sliding block (21) and staple nail pushing device (22), when the seam
Distad described in zigzag tread patterns during staple ejector pin sliding block (21), the inclined-plane of the staple ejector pin sliding block (21) laterally drives nail ejector pin bar
Move the staple nail pushing device (22), make the staple nail pushing device (22) by the staple (20) release the staple nail kit (19) and
It is molded in the presence of the staple nail anvil (18).
9. 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.
10. end effector as claimed in claim 9, it is characterised in that first tong arm (10a) and second tong arm
(10b) has the cutter groove (24) for accommodating cutter (23) motion.
11. end effectors 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.
12. end effectors as claimed in claim 11, it is characterised in that the opening and closing mechanism includes closure bar, institute
State closure bar distal end portion and be provided with closure flange (25), set between first tong arm (10a) and second tong arm (10b)
There is stage clip, when closure bar longitudinal distal motion by driving, the closure flange (25) engages 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
During rollback, the jaw can open under the reset response of the stage clip.
13. end effector as described in any one of claim 1~12, 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.
14. end effectors as claimed in claim 13, it is characterised in that the end effector is with hysteroscope specification
End effector.
A kind of 15. surgical operating instruments, 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 1~14 any one.
16. surgical operating instruments as claimed in claim 15, 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 17. 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 pocket nail nail kit set on first tong arm, is set on second tong arm
Second pocket follows closely nail kit, and pocket nail is respectively arranged with the first pocket nail nail kit and second pocket nail nail kit, described
Pocket nail is fired by pocket nail ejector pin mechanism, the pocket nail percussion of the first pocket nail nail kit and second pocket nail nail kit
Mouthful have make by pocket nail nail leg intersect the closing-in structure for drawing in, first pocket nail nail kit and second pocket nail
Nail kit is provided with the purse wire between two nail legs of pocket nail towards the surface of jaw；The pocket follows closely ejector pin machine
Structure includes：Pocket follows closely ejector pin bar, and is pushed away for the pocket nail ejector pin sliding block and pocket nail set by each pocket nail nail kit
Nail device；Nail kit is followed closely for each pocket, distad pocket described in zigzag tread patterns follows closely ejector pin sliding block when pocket nail ejector pin bar
When, the laterally driven pocket nail nail pushing device in inclined-plane of the pocket nail ejector pin sliding block, the pocket is followed closely nail pushing device will be described
Pocket nail releases the pocket nail percussion mouth.
18. purse-string forceps as claimed in claim 17, it is characterised in that the closing-in structure is closing in inclined-plane.
19. purse-string forceps as claimed in claim 17, it is characterised in that the crown middle part of the pocket nail is hit to pocket nail
Hair mouth bending.
20. purse-string forceps as claimed in claim 17, it is characterised in that the first pocket nail nail kit and second pocket nail
Nail kit is respectively arranged with line card towards the surface of jaw, and the purse wire is arranged in the line card.
21. purse-string forceps as claimed in claim 20, it is characterised in that first pocket follows closely the two neighboring described lotus of nail kit
Line card described at least two is provided between Bao Ding；Set between the two neighboring described pocket nail of the second pocket nail nail kit
There is line card described at least two.
22. purse-string forceps as any one of claim 17~21, 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.
23. purse-string forceps as claimed in claim 17, it is characterised in that the pocket nail nail pushing device is followed closely for the pocket of elastic material
Nail pushing device, or, the pocket nail nail pushing device is offered towards the crown side that the pocket is followed closely tightens up groove, when pocket nail
After pocket nail is released pocket nail percussion mouth by nail pushing device, the pocket nail nail pushing device be located in the closing-in structure and
In compressive state.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310437983.0A CN104434241B (en) | 2013-09-23 | 2013-09-23 | End effector, surgical operating instrument and purse-string forceps |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310437983.0A CN104434241B (en) | 2013-09-23 | 2013-09-23 | End effector, surgical operating instrument and purse-string forceps |
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| Publication Number | Publication Date |
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| CN104434241A CN104434241A (en) | 2015-03-25 |
| CN104434241B true CN104434241B (en) | 2017-06-16 |
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| CN201310437983.0A Active CN104434241B (en) | 2013-09-23 | 2013-09-23 | End effector, surgical operating instrument and purse-string forceps |
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Families Citing this family (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107242889B (en) * | 2017-07-28 | 2023-02-28 | 广西壮族自治区人民医院 | Purse-string suture cutting closer |
| 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 |
| CN107307891B (en) * | 2017-07-28 | 2023-03-14 | 广西壮族自治区人民医院 | Purse-string suture cutting closer |
| US11779342B2 (en) | 2020-02-19 | 2023-10-10 | Covidien Lp | Laparoscopic purse string suture device |
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| US5490856A (en) * | 1993-12-14 | 1996-02-13 | Untied States Surgical Corporation | Purse string stapler |
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| CN203564293U (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 |
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| JPH05337120A (en) * | 1992-06-04 | 1993-12-21 | Olympus Optical Co Ltd | Suture instrument |
| CN201445545U (en) * | 2009-06-23 | 2010-05-05 | 扬中金祥乳胶制品有限公司 | Disposable intrauterine compressing device |
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| US4821939A (en) * | 1987-09-02 | 1989-04-18 | United States Surgical Corporation | Staple cartridge and an anvilless surgical stapler |
| US5242457A (en) * | 1992-05-08 | 1993-09-07 | Ethicon, Inc. | Surgical instrument and staples for applying purse string sutures |
| US5490856A (en) * | 1993-12-14 | 1996-02-13 | Untied States Surgical Corporation | Purse string stapler |
| CN1785128A (en) * | 2005-12-14 | 2006-06-14 | 苏州天臣国际医疗科技有限公司 | Purse-string suturing device |
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| CN104434241A (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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