WO2011069427A1

WO2011069427A1 - Stapling device of digestive tract stapler

Info

Publication number: WO2011069427A1
Application number: PCT/CN2010/079442
Authority: WO
Inventors: 彭阳红; 周乃康
Original assignee: Peng Yanghong; Zhou Naikang
Priority date: 2009-12-10
Filing date: 2010-12-06
Publication date: 2011-06-16
Also published as: CN201701250U

Abstract

A stapling device of digestive tract stapler includes an anvil (Ⅰ),a central shaft, and a cartridge assembly (Ⅱ). The anvil (Ⅰ) consists of an anvil body (3), an anvil cap (1), a connecting rod (4), and retainer clips (2) which are provided with projections on the inner sides. The cartridge assembly (Ⅱ) consists of a cartridge and staples (7), a circular knife (6), a staple driving blade (8), and a cartridge assembly casing. The cutting surface (Ⅲ) of the cartridge assembly (Ⅱ) matches the cutting surface (Ⅲ)of the anvil (Ⅰ). The central shaft consists of the connecting rod (4) and a draw rod (5). The draw rod (5) is positioned in the center of the cartridge assembly (Ⅱ) and provided with grooves. The grooves of the draw rod (5) fit the projections of the retainer clips (2) to prevent the stapling device rotating during operation. The cutting surfaces (Ⅲ) of both the cartridge assembly (Ⅱ)and the anvil (Ⅰ) are elliptic.

Description

Digestive tract stapler kiss cutting device

The invention relates to a digestive tract stapler, in particular to a kiss and cut device of a digestive tract anastomat.

technical background

Anastomotic fistula and anastomotic stenosis are the two most serious complications of esophageal cancer surgery. The wide application of digestive tract anastomat in esophageal cancer surgery has reduced the occurrence of anastomotic leakage to a certain extent, but did not reduce the probability of anastomotic stenosis. Postoperative anastomotic stenosis is closely related to anastomotic diameter, postoperative local inflammation, and scar contraction. The digestive tract anastomosis adopts end-to-side anastomosis, and the esophageal diameter of the anastomotic canal anastomosis is small: the esophageal diameter is small, which is prone to postoperative anastomotic stenosis. There are many reasons for the occurrence of anastomotic leakage. The digestive tract anastomosis uses end-to-side anastomosis in esophageal cancer surgery, which makes the anastomotic and mediastinal tension too important; especially for esophageal cancer, the position is higher. In patients with insufficient gastric volume during operation, the anastomotic tension was greater after anastomosis, and the risk factor for anastomotic leakage increased. A recent study of the "randomized controlled clinical study of esophagogastric valgus plus lateral wall anastomosis for the treatment of anastomotic stenosis" compared the three methods of ectopic valgus plus lateral extension anastomosis, manual suture and instrumental anastomosis The incidence of postoperative anastomotic stenosis showed that the incidence of postoperative anastomotic stenosis was 0, 9.6%, and 19.1%, respectively, and there were significant differences among the three groups. This also suggests that expanding the anastomotic diameter can reduce the occurrence of anastomotic stenosis. The utility model patent CN2091650U discloses an oblique mouth type anastomosis head of a digestive tract anastomat, which is envisaged that the oblique shaft type knife, the nail seat, the knife seat, the nail seat outer casing and the long axis of the digestive tract stapler are both 15° - 45°, the larger anastomotic area after the kiss is cut, and the occurrence of anastomotic stenosis is reduced. However, this concept has the following problems in practice: In the process of esophagus-gastric anastomosis, the principle of "stapler" is adopted. During the use of the stapler, the direction of the anastomosis and the direction of the force are the same, and the nails are perpendicular after the anastomosis. Ordering, uniform force; and utility model In the anastomosis of the inclined surface of the CN2091650U, the angle of the anastomosis and the direction of the force of the nail are at an angle, so that the nail is aligned with the surface of the anastomosis, which is easy to cause uneven force in the ankle nail. The effect is not accurate and it is easy to cause anastomotic leakage. Summary of the invention

The technical problem to be solved by the utility model is to provide an elliptical gastrointestinal anastomat kiss-cutting device, so that the relevant staff can adopt partial side-to-side anastomosis technique in the implementation of esophageal-anastomosis surgery, and reduce from a certain limit. Risk factors for sputum; At the same time, the elliptical kiss cut surface is used to enlarge the anastomotic inner diameter to prevent postoperative anastomotic stricture.

In order to achieve the above objectives, the utility model is implemented by the following technical solutions:

An elliptical digestive tract anastomotic kiss cutting device, comprising an anvil base, a central shaft, and a nail chamber assembly. The abutment is composed of a nail base and a nail cap; the abutment of the nail is elliptical, and the center thereof is a connecting rod; the connecting rod is a hollow rod-shaped device, and a circlip is inserted therein, and the inner side of the circlip is provided with a bulge The nail compartment assembly includes a nail chamber, a suture nail, a ring knife, a push nail piece and a nail box assembly shell ^, the kiss cut surface of the nail chamber assembly matches the kiss cut surface of the nail base, and both are oval, ring cutter and push nail The axial cross section of the piece is elliptical; the central axis is composed of a connecting rod and a tie rod; the pulling rod is located at the center of the nail chamber assembly, and the pulling rod is provided with a groove, and when the esophagus-gastric anastomosis is performed, the groove and the circlip on the pulling rod The convex anastomosis prevents the kiss device from rotating during the operation.

In the above solution, the abutment surface of the anvil base and the nail chamber assembly are oval, and the ratio of the short axis to the long axis is Sinl5°~Sin60°.

The utility model has the following advantages:

1. The relative side technique is used to reduce the uneven force of the anastomosis, reduce the tension of the anastomosis and the mediastinum, and reduce the risk factors of sputum from a certain limit;

2. The elliptical design is adopted to increase the anastomosis area and enlarge the anastomosis inner diameter to prevent postoperative anastomotic stricture; 3. Ensure that the dowels are stapled perpendicular to the anastomotic surface, and the binding is true, reducing the probability of occurrence of anastomotic leakage;

4. Mature production process, low consumables and low cost;

5. The operability is strong, the operator is easy to master, and the use is convenient. DRAWINGS

1 is a schematic structural view of a kiss cutting device, including an abutment cap 1, a snap spring 2, a nail base 3, a connecting rod 4, a drawbar 5, a ring cutter 6, a nail chamber and a nail 7, a pusher 8 and a nail Slot 9;

Figure 2 is a side view and an A-direction view of the abutment;

Figure 3 is a side view and a B-direction view of the nail holder cap;

Figure 4 is a front side view of the circlip, the inner side of the circlip is provided with a protrusion;

Figure 5 is a side view and a C-direction view of the abutment body;

Figure 6 is a front side view and a three-dimensional view of the connecting rod;

Figure 7 is a side view and a D-direction view of the nail chamber, the annular knife in the nail chamber assembly;

Figure 8 is a front side view of the tie rod of the staple cartridge assembly;

Figure 9 is a side elevational view and an E-direction view of the push plate in the staple compartment assembly. detailed description

An elliptical digestive tract stapler kiss cutting device is shown in Fig. 1, including an anvil seat I, a central shaft, and a nail chamber assembly II. The abutment is composed of a nail cap 1 and a nail body 3; the abutment III of the abutment is elliptical, and the center thereof is a connecting rod 4; the connecting rod 4 is a hollow rod-shaped device as shown in Fig. 6, and a circlip is inserted therein 2, the inner side of the circlip 2 is provided with a protrusion; the nail compartment assembly comprises a nail compartment and a suture nail 7, a ring cutter 6, a pusher piece 8 and a nail compartment assembly shell ^, a kiss face of the nail compartment assembly and a kiss of the nail seat The facets are matched, all of which are elliptical, and the axial faces of the ring cutter and the pusher nail are elliptical; the central shaft is composed of the connecting rod 4 and the tie rod 5; the pull rod 5 is located at the center of the nail chamber assembly, and the pull rod 5 is provided with a groove for implementation When the esophagus-gastric anastomosis is performed, the groove on the tie rod 5 coincides with the protrusion of the circlip 2, preventing The kiss cutting device rotates during the operation. In the above solution, the axial cross section of the anvil I and the nail chamber assembly II, the nail chamber and the annular knife are elliptical. See the figures 1-3, 5, 7, and 9, and the short and long axes. Than Sinl5°~Sin60

The present invention will be further described in detail below with reference to the accompanying drawings and embodiments:

1. After the stomach and esophagus are freed, according to the diameter of the esophagus, the stapler of the short-diameter abutment is selected, and the esophageal diameter is the short diameter of the nail;

2. Firstly, a full-layer purse-string suture is performed along the esophageal wall with a 7ft silk thread at the predetermined resection of the esophageal site to ensure that the suture surface is substantially parallel to the kiss-cut surface, or slightly smaller than the angle of the kiss-cut surface and the longitudinal axis of the esophagus, and is not ligated;

3. Cut and remove the diseased esophagus, insert the abutment obliquely into the esophageal stump, ensure that the suture surface is substantially parallel to the kiss cut surface, ligature the suture loop and fix it on the center rod of the abutment to prevent the nail base from rotating;

4. Insert the stapler body at the appropriate position on the stomach end, insert the pull rod 5 into the connecting rod 4, and if necessary, rotate the stapler body until the groove of the pull rod 5 matches the circlip protrusion in the center rod and cannot rotate (see 10);

5. Tighten the screw at the end of the stapler body so that the anastomosis of the esophagus and the stomach are close together, and the abutment and the nail compartment are completely tightly fitted;

6. Open the safety gate, close the handle, and perform the operation of esophagus-gastric anastomosis;

7. Exit the stapler.

Claims

Claim

1. A novel type of digestive tract anastomosis kiss cutting device, comprising an abutment seat, a central shaft and a nail chamber assembly; the anvil seat is composed of a nail base and a nail seat cap; the abutment of the nail is oval, and the center thereof The connecting rod is a hollow rod-shaped device, and a circlip is inserted therein, and the inner side of the circlip is provided with a protrusion; the nail chamber assembly includes a nail chamber, a suture nail, a ring knife, a push nail piece and a nail box assembly shell ^ The kiss cut surface of the nail chamber assembly is matched with the kiss face of the anvil seat, and both are elliptical, and the axial cross section of the annular knife and the push nail piece is elliptical; the central shaft is composed of a connecting rod and a tie rod; the pull rod is located in the nail chamber The center of the component, the groove is provided with a groove, and when the esophagus-gastric anastomosis operation is performed, the groove on the pull rod is matched with the protrusion of the circlip to prevent the kiss device from rotating during the operation; the feature is that the abutment And the kiss section of the nail compartment assembly is elliptical.

2 . The novel digestive tract anastomotic kiss cutting device according to claim 1 , wherein the abutment and the nail chamber assembly have an elliptical shape, and the ratio of the minor axis to the major axis is Sinl5. °~Sin60°.

The novel digestive tract anastomat kiss cutting device according to claim 1, wherein the nail deck surface and the annular knife are all elliptical, and the ratio of the short axis to the long axis is Sinl5°~Sin60°. .

The novel digestive tract anastomotic kiss cutting device according to claim 1, wherein the inner side of the circlip is provided with a protrusion.

The novel digestive tract anastomotic kiss cutting device according to claim 1, wherein the pull rod is provided with a groove.