CN1389180A - 具有增强充填器轴的套针 - Google Patents

具有增强充填器轴的套针 Download PDF

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CN1389180A
CN1389180A CN02121621A CN02121621A CN1389180A CN 1389180 A CN1389180 A CN 1389180A CN 02121621 A CN02121621 A CN 02121621A CN 02121621 A CN02121621 A CN 02121621A CN 1389180 A CN1389180 A CN 1389180A
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plugger
axle
tip
handgrip
far
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CN1232227C (zh
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M·特森顿
R·胡赫斯
S·库雷施
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Ethicon Endo Surgery Inc
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Ethicon Endo Surgery Inc
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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
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3454—Details of tips
    • A61B2017/3456—Details of tips blunt
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3454—Details of tips
    • A61B2017/346—Details of tips with wings

Abstract

按照本发明,提供了一种用于穿透身体组织的、包括一个手把和一根轴的充填器。此轴有一固定在手把上的近端和一从近端延伸而来的远端。此手把和轴是用整体模压成型的聚合物制成的。有一个用比模压成型聚合物的刚性更好的材料制成的、基本上是刚性的增强构件沿此轴设置。

Description

具有增强充填器轴的套针
技术领域
本发明总的来说与外科器械有关，更特别是，与提供通向腹腔通路的套针装置有关。按照本发明的套针装置有一大大增强的充填器轴，此轴增加了刚性以克服穿透期间不希望产生的偏斜。
背景技术
套针是一种用于通向腹腔的外科器械。套针通常包括两个主要部件：一根插管和一个充填器。为了穿透皮肤，外科医生须在套针插入处开一小切口。然后，把套针的远端插入组织。充填器在它的远端有一个尖头或刃口。通过对充填器近端施加压力，迫使尖头经由组织，直至到达诸如腹腔之类的目标位置。经由充填器开出的穿孔，把此插管插入，并撤出充填器，留下插管作为进入腹腔的通路。
因为套针带有锋利的刀刃，所以对组织或器官的无意刺伤仍是人们所担心的。有关套针设计和制造的首要技术挑战之一是使套针具有更安全的性能。特别地，重要的是需要研制一种能够尽量减少非故意刺伤组织或器官可能性的安全套针。曾研制了一种在充填器上带有一防护套的套针，以减少非故意刺伤的可能性。使防护套在延伸位置上偏斜，从而遮盖住了充填器的穿透尖头。当外科医生要用套针穿透组织时，防护套便缩回，并露出了穿透尖头。只要持续地施加压力，防护套便能始终保持在缩回的位置。在外科医生完全刺透了体壁后，即可卸压，防护套便又回到它遮盖住穿透尖头的伸出位置。因此，能够避免非故意地刺伤体腔内的人体组织和器官。在1998年1月20日颁布的Stephens等人的美国专利5,709,671中披露了一种具有防护套的套针的实例，本文在此引用作为参考。
尽管已经设计出了众多用以防止非故意刺伤的套针，但是仍然明显地存在着改进的余地。尽管已有若干防护机构被置入了这些器械，然而，还是存在对人体器官的非故意刺伤的担心。因此，人们又研制出了另外一些防止外科操作期间意外刺伤组织和器官的机构。在套针设计方案上的一个研究成果是在穿透时同时使用显影技术。披露了穿透时可使用显影技术的外科穿透器械的一个专利实例是在1993年12月21日颁布的Riek等人的美国专利5,271,380，本文在此引用作为参考。根据此专利的介绍，有一种穿透器械包括一中空圆柱形套管和一固定在套管远端的影象元件。在一优选实施例中，它有一锥形无刃穿透尖头，以促进器械进入身体组织的徙前术。当穿透到达体腔时，无刃充填器分离而不是切割组织。以这种方式，就不需要使用防护套或其他机构来保护组织或器官，免遭插入期间的非故意刺伤了。
采用光学无刃充填器的徙前术可以减少对安全的担心，并减少了使用早期套针所遇到的非故意的组织刺伤；然而，仍然存在改进的余地。现有技术的那些套针，在组装光学无刃充填器时采用了需要各种技术的大量元件，因而产生了一些制造上的难题。例如，制造商在组装充填器时，采用粘结的方法或使用现有技术中已知的其他机械手段把穿透尖头固定到充填器轴上。不仅装配这些大量的元件是一个难题，而且装配所有这些元件的成本昂贵。
使用光学无刃充填器的许多外科医生开始使用这种充填器时不借助影象装置。这些外科外医生发现他们在施行外科操作中单凭触觉反馈也很自在。
外科医生的这种选择及减少制造上的麻烦和成本的愿望导致对一种整体实心塑料无刃充填器的研制。整体实心塑料无刃充填器能够使用诸如注塑成型之类常规的塑料加工方法，因此减少了制造和装配成本。采用注塑成型时，这种整体实心塑料充填器有一根直的注塑成型塑料轴。然而，试验表明，穿透组织所需要的力大到足以引起模压成型的充填器轴产生不容许的偏斜，特别是对于小直径的装置，更是如此。(轴的)这种挠性在组织穿透期间是成问题的。本发明将克服充填器轴的偏斜问题。
发明内容
按照本发明，提供了一种用于穿透身体组织的、包括一个手把和一根轴的充填器。此轴有一固定在手把上的近端和一从近端延伸而来的远端。此手把和轴是用整体模压成型的聚合物制成的。有一个用比模压成型聚合物的刚性更好的材料制成的、基本上是刚性的增强构件沿此轴设置。
附图说明
图1为一包括本发明充填器的套针组件的透视图；
图2为示出了分离的充填器和套管的套针的分解透视图；
图3为本发明充填器的平面图；
图4为充填器的穿透尖头的放大图；
图5为把图4所示穿透尖头旋转90°后的放大图；
图6为本发明充填器增强轴的优选实施例沿图5的6-6线所取的剖面图；
图7为本发明充填器增强轴的、可供替用的第二实施例沿图5的6-6线所取的剖面图；以及
图8为本发明充填器增强轴的、可供替用的第三实施例沿图5的6-6线所取的剖面图。
具体实施方式
在本说明中，用参考数字来标明本发明器械的各个部件和元件。在各附图中所标注的相同数字表示此外科穿透器械的相同部件或元件。在本说明中，“近侧的”或“在近侧”是指此器械、部件或元件朝向使用者延伸的那部分。相反，“远侧的”或“在远侧”是指此器械、部件或元件远离使用者向外延伸的那部分。
现参阅图1和图2，图中示出了带有本发明的充填器20和插管8的套针2。如图2所示，充填器20被插入并穿过活门10，并且被插入套管壳体14和套管12。在插入过程中，与活门操纵杆18相连的内活门(图中未示出)是打开的。密封件10最好是一种围绕在轴22周围并能阻止任何流体或气体从插管8泄漏的隔膜活门。把轴22完全插入插管8后，由手把26把壳套24锁定在套管壳体14上。充填器20的穿透尖头32和轴22的远端部分从套管12向远端延伸。
在使用本发明的装置实际施行外科操作中，外科医生用手术刀在外科操作中图1所示套针2所在位置处开一个小切口。然后，将套针2的远端插入由小切口显露出来的组织中。在套针2插入组织后，将套针2围绕其轴线来回摆动以促进穿透。在穿透尖头32上的分离器34和36有助于在摆动期间分离组织，促进套针2进入腹腔的徙前术。
在完成进入腹腔的穿透后，通过按压按钮51和按钮52(图中未示出)将手把26从套管壳体14上松开，从而把充填器20从插管8中取出。在取出充填器20时，与活门操纵杆18相连的内活门(图中未示出)关闭，因而能阻止任何流体或气体从插管8泄漏。如果需要，还可以经由活栓16，通过套管12有选择地输送诸如二氧化碳之类的增压气体。现在能够经由插管8将诸如直线吻合器、抓取器、夹钳、观测镜等外科器械，插入到需要施行外科操作处实施操作了。
现在再参阅图1和图2，插管8包括套管12和套管壳体14。套管12从套管壳体14向远端延伸。套管壳体14包括活栓16、活门操纵杆18和密封件10。
如图3所示，充填器20有一轴22，此轴有一近端42固定在手把26上，还有一远端44则由此向外延伸。手把26和轴22是用整体模压成型的聚合物制成的。轴22最好包括一个在它的远端44用模压成型与轴22制成一体的锥形穿透尖头32。尖头32包括从穿透尖头32向外延伸的第一和第二分离器34和36。手把26有一固定在轴22的近端42上的帽盖46。帽盖46扣在手把26上，并用压配合将其固定。
现在参阅图4和图5，穿透尖头32在远端44处被整体模压成型在轴22上。穿透尖头32有一圆形底座40和一从底座40在远端延伸的钝头38。底座40位于邻近轴22的远端44处。第一和第二分离器34和36分别具有通常为平直的、直线外缘的表面。第一和第二分离器34和36中的每一个从邻近底座40处向穿透尖头32的钝头38纵向延伸。第一和第二分离器34和36相互间隔约180°，都位于钝头38的近端。
再参阅图3，轴22还包括一设置于其上的增强构件30。在图6所示的实施例中，构件30是一根用不锈钢、钛或现有技术中已知的、合适的任何其他材料制成的刚性增强中空管。采用象注塑成型那样的制造方法，在形成轴22和手把26时，能够把聚碳酸脂之类的聚合物或现有技术中已知的、合适的任何其他聚合物，注塑成构件30。在本领域技术人员显而易见的其他制造方法也能够用来制造本发明的构件。
图7中示出了本发明的另一个实施例。在此实施例中，与轴22类似的轴122包括一设置在轴122内的增强构件130。构件130是用诸如不锈钢、铝或本领域技术人员显而易见的任何其他类似材料之类增强材料制成的一根实心圆柱形杆。采用象注塑成型那样的制造方法，可以围绕构件130把轴122和手把126(图中未示出)整体模压成型为一个构件。
图8示出了与图7所示实施例类似的又一个可供替换的实施例，图中轴222包括一设置于其内的构件230。构件230与构件130类似，但是它的横断面是十字形的。由本领域技术人员可以看到，除了圆形和十字形的横断面外，其它许多合适的横断面的形状也能够用于本发明。
虽然本文已经示出和说明了本发明的若干特定的实施例，但是本领域技术人员可明显知道可采用其它实施例，而不偏离本发明的精神和范围。在说明本发明中使用的术语只是用于说明的，但是并不限于这些术语。

Claims (18)

1.一种用于穿透身体组织的充填器，所说的充填器包括：
a.一手把和一轴，所说的轴有一固定在所说的手把上的近端和一由此延伸的远端，所说的手把和所说的轴是用整体模压成型聚合物制成的；和
b.一沿所说的轴设置的、基本上是刚性的增强构件，所说的构件是用一种刚性比所说的模压聚合物的刚性更好的材料制成的。
2.按照权利要求1的充填器，其特征在于，所说的远端其上有一穿透尖头。
3.按照权利要求2的充填器，其特征在于，所说的穿透尖头通常是锥形的。
4.按照权利要求2的充填器，其特征在于，所说的穿透尖头至少有一个分离器由此向外延伸。
5.按照权利要求1的充填器，其特征在于，所说的构件是一围绕所说的轴设置的中空圆柱形管。
6.按照权利要求1的充填器，其特征在于，所说的构件是一镶嵌在所说的轴内部的实心杆。
7.按照权利要求6的充填器，其特征在于，所说的杆是圆柱形的。
8.按照权利要求6的充填器，其特征在于，所说的杆有一十字形的横断面。
9.按照权利要求1的充填器，其特征在于，所说的构件包括一种金属。
10.一种套针，其包括：
a.一包括一管状套管的插管，所说的套管有一近端、一远端和一从其间通过的通道，所说的插管有一固定在所说的套管的所说的近端上的壳体，所说的壳体在其近端有一与所说的套管的所说的通道相通的开口；
b.一能插进所说的插管的充填器，所说的充填器包括一手把和一轴，所说的轴有一固定在所说的手把上的近端和一由此延伸的远端，所说的手把和所说的轴是用整体模压成型聚合物制成的；和
c.一沿所说的轴设置的、基本上是刚性的增强构件，所说的构件是用一种刚性比所说的模压聚合物的刚性更好的材料制成的。
11.按照权利要求10的充填器，其特征在于，所说的远端其上有一穿透尖头。
12.按照权利要求11的充填器，其特征在于，所说的穿透尖头通常是锥形的。
13.按照权利要求11的充填器，其特征在于，所说的穿透尖头至少有一个分离器由此向外延伸。
14.按照权利要求10的充填器，其特征在于，所说的构件是一围绕所说的轴设置的中空圆柱形管。
15.按照权利要求10的充填器，其特征在于，所说的构件是一镶嵌在所说的轴内部的实心杆。
16.按照权利要求15的充填器，其特征在于，所说的杆是圆柱形的。
17.按照权利要求15的充填器，其特征在于，所说的杆有一十字形的横断面。
18.按照权利要求10的充填器，其特征在于，所说的构件包括一种金属。
CNB021216215A 2001-06-01 2002-05-31 充填器和具有增强充填器轴的套针 Expired - Lifetime CN1232227C (zh)

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US09/871,922 US6656198B2 (en) 2001-06-01 2001-06-01 Trocar with reinforced obturator shaft
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DE60200308T2 (de) 2005-05-04
ES2215971T3 (es) 2004-10-16
CA2387945C (en) 2010-02-23
CN1232227C (zh) 2005-12-21
JP4290388B2 (ja) 2009-07-01
US6656198B2 (en) 2003-12-02
EP1262150A3 (en) 2002-12-11
EP1262150A2 (en) 2002-12-04
AU3435702A (en) 2002-12-05
EP1262150B1 (en) 2004-03-31
AU781610B2 (en) 2005-06-02
CA2387945A1 (en) 2002-12-01
JP2003019140A (ja) 2003-01-21
MXPA02005541A (es) 2002-12-09
US20020183775A1 (en) 2002-12-05
DE60200308D1 (de) 2004-05-06

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