CN101278853A - forceps stapler - Google Patents

Abstract

The invention relates to a forceps type suture device which consists of four parts of a needle holding device (21), a thread picking up device (1), a thread box (11) and an elastic handle (12). The needle holding device (21) is integrated with the thread picking up device (1) into a whole in V shape by the elastic handle (12), and the elastic handle (12) keeps the needle holding device and the thread picking up device opening in the V shape. The two end teeth (22) of the needle holding device (21) can be locked tightly by a back end pulling screw (16). The eyelet (24) of a suture needle (23) is arranged at a needle pin end. The front end of the outer tube (6) of the thread picking up device (1) is equipped with an outlet pinhole (2) and a thread picking up hook (3). The other end of a thread picking up pull rod (4) is combined with a thin wire rope (8). Winding over the top end of the thread box (11), the thin wire rope (8) is fixed on the top end (13) of the up extending part of the rod of the needle holding device (15). According to the principle, the forceps type suture device can be manufactured into shapes which are the same as that of current various forceps of straight shape, gun shape or knee shape, etc., and is applicable to different operation regions.

Description

forceps stapler

technical field

The invention relates to a medical instrument used in surgery, in particular to a forceps stapler.

Background technique

In surgical operations, it is often encountered that the operation area is located in a deep and narrow cavity, such as the tonsillar fossa, nasal cavity, chest cavity, skull base, etc., and some parts that need to be sutured in endoscopic surgery. These parts are often located in important organs. On or near the area, the tissue is fragile and not resistant to traction. How to suture these parts accurately has been a problem that has always plagued surgeons. Traditional suturing apparatus is made up of needle holder, sewing needle, suture thread, and the eyelet of sewing needle is positioned at the tail end of sewing needle. The suturing process is as follows: the surgeon uses tweezers or hemostatic forceps and other surgical instruments to retract the tissue to expose the surgical field, and the other hand holds the needle holder to hold the suture needle with suture, and inserts the needle from the side of the tissue to be sutured. Release the needle holder after the other side of the tissue to be sutured passes through, and then use the same needle holder to hold the pierced needle point, pull the needle out and at the same time bring the thread out through the tail end of the needle, and remove the needle Finally, the sutures are knotted to complete a suture. This suture technique does not show its disadvantages in the better exposed parts of the surgical field (such as suturing of the skin), but in the deep and narrow cavity, its disadvantages are very obvious: 1. The needle holder is larger The volume makes it difficult to enter some small cavities or block the operator's field of vision; 2. After the needle tip passes through the other side of the tissue to be sutured, an assistant is required to help the operator hold the needle tip, because the Due to the recovery of the tissue after the needle, the needle tip retracts into the tissue and cannot be clamped before the operator clamps the needle tip. However, the help of the assistant brings two problems. First, it is difficult for the assistant to insert another needle because of the narrow operation area. 1. Surgical instruments, and secondly, the inconsistency between the assistant and the operator often causes the tearing of the tissue or the loss of the suture needle; 3. Due to the limited angle range of the needle holder holding the suture needle and the angle range of force when suturing, it is deep and narrow Not all wounds can be sutured in the lacunar surgery area, and some parts that should be sutured have to be abandoned and replaced by packing or compression. Due to the needs of the development of minimally invasive surgery, people have improved various suturing utensils, such as: the patent No. 92232376.3 and the patent No. 200520069505.X disclosed by the Chinese Patent Office all have needle holes at the front end of the sewing needle. The tissue to be sutured is better protected, but only the threading action is completed, and the operator's other hand or the help of an assistant is needed. The patent literature with the application number 200410052745.9 announced by the Chinese Patent Office in January 2006 discloses a surgical automatic stapler, which solves the problem of consistent needle force and reduces tissue damage, but has a complex structure and a large volume. Larger and more operating procedures, it is not suitable for suturing small cavities. In recent years, due to the development of artificial intelligence, tissue engineering and other related disciplines, people have begun to imitate human hands to make smaller instruments (see Maria Siemionow, KaganOzer, Wlodzimierz Siemionow, Robotic assistance inmicrosurgery, Journal of reconstructive microscopy, 2000, (16) 8:643-649, Robot-Assisted Microsurgery, Journal of Reconstructive Microsurgery, 2000, (16) 8:643-649) or designing intelligently controlled needles (see Patrick Sears and Pierre Dupont, A Steerable Needle Technology Using Curved Concentric Tubes, International Conference on Intelligent Robots and Systems, October9-15, 2006, Beijing, China, a controllable needle technology using a curved coaxial tube, International Conference on Intelligent Robots and Systems, October 9-15, 2006, Beijing, China), but they are all limited to the development of the subject itself. These studies are only at the theoretical level, and there is no available equipment yet.

Contents of the invention

The present invention fully considers and overcomes various shortcomings in current similar or related devices at home and abroad. Its purpose is to realize the precise suturing in the deep and narrow operation area by this invention.

For this reason, the present invention provides a kind of tweezers type stapler, wherein, described tweezers type stapler comprises needle holder, thread picker, thread box and elastic handle, and described needle holder and thread picker are thin rods shape, and connected as a whole in a V shape through the elastic handle, the needle holder and the thread picker are kept V-shaped by the elastic handle, and there is a thread between the needle holder and the thread picker A box with a built-in bobbin in the box.

The above-mentioned tweezers-type suturer realizes the functions of holding the needle and picking up the thread through two simple pull rod transmission structures. The principle can be made into the same shape as the current tweezers such as straight, gun-shaped or knee-shaped according to the needs, and different types of sewing needles are used to be suitable for different operation areas. This design fully considers the doctor's previous operating habits. Its shape and operation are basically the same as the current various tweezers. The doctor only needs to point at the part to be sutured and knead to complete the suture. The threading is cumbersome, continuous suturing is possible, the operation is simple, and the efficiency is improved. The thick, short and high-strength structure of this design can also be used for suturing skin and other parts. Since the nurse does not need threading, the efficiency of the entire operation can be improved. Because the design is compact and easy to carry, it can be operated by one person and the operation is simple, so it is also suitable. For grass-roots military hospitals or health teams where medical personnel are in short supply.

Description of drawings

The invention will be described below with reference to the accompanying drawings, in which:

Fig. 1 is the overall schematic diagram of tweezers type stapler of the present invention;

Figure 2 is a longitudinal section view of the wire box;

Figure 3 is a cross-sectional view of the shaft in the wire box;

Fig. 4 is a schematic diagram of the first embodiment of the needle holder;

Fig. 5 schematically shows the cross-section of the front end of Embodiment 1 of the needle holder of the present invention;

Fig. 6 is a schematic diagram of Embodiment 2 of the needle holder of the present invention;

Fig. 7 is the schematic diagram of straight sewing needle;

Fig. 8 is a schematic diagram of a curved suture needle.

Fig. 9 is an implementation principle diagram of Embodiment 1 of the wire picker of the present invention.

Fig. 10 is a schematic diagram of Embodiment 2 of the wire picker of the present invention.

FIG. 11 is a schematic longitudinal section view of the wire picker shown in FIG. 10 .

Fig. 12 is a schematic diagram of the implementation of the gun-shaped forceps stapler.

Fig. 13 is a schematic diagram of the implementation of the knee forceps stapler.

Fig. 14 is a schematic diagram of another implementation of the forceps stapler.

Fig. 15 is a schematic view of the appearance of the forceps stapler.

Detailed ways

As shown in FIG. 1 , the tweezers type stapler is composed of a needle holder 21 , a thread picker 1 , an elastic handle 12 and a thread box 11 . The thread picker 1 and the needle holder 21 are connected as a whole through the elastic handle 12 in a V shape, and the elastic handle 12 keeps the two open in a V shape. The front end of the outer tube 6 of the thread picker 1 is closed, and the front end of the outer tube 6 Later, there is a pinhole 2 on the lower side, and there is a pick-up hook 3 above the inner side of the front end of the outer tube 6. The front end of the pick-up hook 3 is free, and the rear end forms a joint with the outer wall of the outer tube 6. The arc of the pick-up hook 3 Part of it forms a joint with the pick-up pull rod 4, the other end of the pick-up pull rod 4 is combined with the thin steel wire rope 8 at point 7, the thin steel wire rope 8 goes around the top of the wire box 11 and is fixed on the top 13 of the upward extension of the needle holder rod 15, and the pick-up wire The middle part of pull bar 4 is connected with outer tube 6 by spring 5, and pick-up hook 3 can be opened and closed with the tightening or loosening of pick-up pull bar 4, and spring 5 pulls pick-up pull bar 4 to the front end direction of the pick-up. Wire box 11 is positioned between the outer pipe 6 of thread picker and the needle holder bar 15 tops, and axle bar 10 is arranged in the thread box 11, and bobbin 9 can be contained on the axle bar 10, and thread box 11 below is outlet hole 14. The needle holder 21 is composed of a needle holder tube 17 and a needle holder rod 18. The needle holder rod 15 is located between the needle holder tube 17 and the elastic handle 12 and is interconnected with them. The front end of the needle holder rod 18 is It is two end teeth 22 that can be engaged. The rear ends of the needle holder tube 17 and the needle holder rod 18 are bent to the outside. There is a tension screw 16 at the rear end, which can be driven by forward or reverse rotation of the tension screw 16. The needle-holding rod 18 advances or retreats, thereby causing the end teeth 22 to loosen or engage. Tightening the tightening screw 16 can make the end teeth 22 bite tightly, thereby fixing the sewing needle 23. There is a needle eye 24 at the needle point of the sewing needle 23. The fixed loop 19 on the needle tube 17 reaches the front end of the needle holder and passes through the eyelet 24 at the front end of the sewing needle 23 .

As shown in Figure 2, it is a longitudinal section view of the wire box 11. There is a recess on the top wall 26 of the wire box 11, and the thin steel wire rope 8 can slide in it, and the center of the rear wall 27 protrudes forward. The top of bar 10 has the self-locking block 25 that forms joint with it, and when block 25 is pulled apart, bobbin 9 can be inserted into shaft rod 10, and block 25 resets and can stop bobbin 9 to deviate from. The lower wall of wire box lacks to form outlet hole 14, and front wall lacks to facilitate dismounting spool.

As shown in Figure 3, it is a cross-sectional view of the shaft 10, in which there is a slider 28 lifted by a spring 29, the stopper 25 forms a joint with the top of the shaft 10, and the rear end of the stopper 25 extends outwards into an ellipse, when When the stopper 25 is pulled outward, its rear end can press the slider 28 downward and cause the spring 29 to contract, and the spool can be inserted into the shaft rod 10. When the external pulling force is removed, the spring 29 can be opened to push the slider 28 upward. , push the stopper 25 to reset, and prevent the spool from coming out.

As shown in FIG. 4 , the first embodiment of the needle holder 21 is composed of a needle holder tube 17 and a needle holder pull rod 18 , and the needle holder pull rod 18 is located in the needle holder tube 17 and can be pulled therein. The front end of the needle-holding rod 18 is two elastically opened end teeth 22, the inner surfaces of the two end teeth 22 form a fixed aperture 30, and the aperture 30 determines the fixed position and direction of the sewing needle. The rear end of the needle holder 21 is bent outward, and the needle holding rod 18 has a thread 31 near the rear end. The rear end of the needle holder tube 17 is a circular groove 32, the top of the tension screw 16 is two separate leaves, and the bottom is a disc 33, which is suitable for the circular groove 32. The rotation of the tightening screw 16 can make the needle-holding rod 18 be pulled backward or pushed forward.

As shown in Figure 5, it is a cross-sectional view of the front end of the first embodiment of the needle holder 21, which shows that the cross-section of the needle holder tube 17 is oblate, and the cross-section of the empty tube cavity 34 in it is similar to a rectangle. Such a structure makes The angular position of the two end teeth 22 inside the needle holder tube 17 is fixed.

As shown in Figure 6, the schematic diagram of the second embodiment of the needle holder 21, the sewing needle 23 is fixedly connected with the needle holder tube 17, such a structure can make the front end of the needle holder more slender, so that it is suitable for use in parts with smaller gaps. Suture, the disadvantage of this structure is that the needle cannot be replaced when it becomes blunt, but the needle holder needs to be replaced.

As shown in FIG. 7 , the sewing needle 23 is straight, and the needle eye 24 is at the front end of the sewing needle 23 .

As shown in FIG. 8 , the sewing needle 23 is arc-shaped, and the needle eye 24 is at the front end of the sewing needle 23 .

As shown in Fig. 9, it is the principle diagram of the first embodiment of the thread picker 1. When the suture needle 23 passes through the tissue and passes through the needle hole 2 forward, the suture 20 is brought out thereupon, and the suture 20 passes through the needle eye 24 and is divided into two strands, which are respectively located on the upper and lower sides of the sewing needle 23. Due to the linkage of the whole device, the thread picking hook 3 is opened backward along with the thread picking pull bar 4; when the sewing needle 23 moves back , due to the backlog of the tissue, before the eye of the needle retreats into the tissue, the suture 20 is loosely bent, and at the same time, the thread pick-up lever 4 is pushed forward, so that the thread pick-up hook 3 is closed forward, and the suture 20 passes through the strand above the suture needle 23 and the gap between the sewing needle 23, after the sewing needle 23 withdraws from the pinhole 2, the strand of the suture 20 above the sewing needle 23 is hooked by the pick-up hook 3.

As shown in Figure 10 is a schematic diagram of the second embodiment of the thread picker 1, the thread pick-up rod 4 is located in the outer tube 6, the front end of the thread pick-up rod 4 is a triangular piece 35, the tip of the triangular piece 35 points forward, and the needle hole 2 is located Slightly below the triangular piece 35.

As shown in Figure 11, it is a schematic diagram of the longitudinal section of the second embodiment of the thread picker, showing that the sewing needle 23 is located in the needle hole 2, slightly below the thread pick-up rod 4 and the triangle piece 35, so that the triangle piece 35 can just pass through the seam The needle 23 and the suture are located in the gap between the strands above the needle.

As shown in Figure 12, it is a schematic diagram of the implementation of the gun-like tweezers type stapler, that is, on the basis of Figure 1, the rear end of the outer tube 6 of the thread picker and the needle holder bar 15 are processed into a S-like shape, and the needle holder 21. The rear end is straight, and the rest of the structure and principle are the same as in Figure 1, so that the entire suturing device forms a gun shape, which is suitable for deeper operation areas and reduces the occlusion of the operator's vision.

As shown in Figure 13, it is a schematic diagram of the implementation of the knee-shaped forceps type stapler, that is, on the basis of Figure 1, the rear end of the outer tube 6 of the thread picker and the needle holder bar 15 are processed into a knee shape, and the needle holder 21 The rear end is straight, and the rest of the structure and principle are the same as in Figure 1, so that the entire suturing device forms a knee shape, which is suitable for the narrower operation area of the lacunar operation area and reduces the occlusion of the operator's field of vision.

As shown in Figure 14, it is another implementation of the tweezers-type suturing device. The inner and outer walls of the rear end of the outer tube 6 of the thread picker are hollowed out to form a fork 36, and the corresponding position of the needle holder bar 15 is directed toward the There is a fork 37 protruding from the inner side, the front end structure of the wire picker is as shown in Figure 9, the wire pick-up pull rod 4 is combined with the thin steel wire rope 8 at the point 7 below the fork opening 36, and the rear of the thin steel wire rope 8 is fixed at the point 38 at the rear end of the wire picker .

Figure 15 is a schematic diagram of the appearance of the tweezers-type stapler, and its appearance is basically the same as that of the current common tweezers.

The specific working conditions of the present invention are described below.

Before the operation begins, the instrument nurse selects a tweezers-type stapler of suitable specifications, places the rear end of the corresponding sewing needle 23 in the aperture 30 of the end tooth 22 of the needle holder, and tightens the tension screw 16 at the rear of the needle holder to make it The needle-holding rod 18 is pulled back, the two end teeth 22 of the needle-holder engage, so that the sewing needle 23 is fixed on the needle-holder 21; the stopper 25 at the top of the shaft 10 is pulled away, so that the shaft 10 passes through the spool 9, loosen the stopper 25 to make it automatically restore to complete the installation of the spool; pull the thread end of the spool 9 to pull out the suture 20, pass through the thread outlet hole 14 of the thread box 11, and pass through the fixed coil on the needle holder tube 17 19. Arrive at the front end of the needle holder, pass through the needle eye 24 at the front end of the sewing needle 23 from bottom to top, that is, one strand of the free end of the suture 20 is above the sewing needle 23, and threading is completed. The stapler is assembled ready for use.

When suturing is required during the operation, the operator single-hands the tweezers-type suturing device, such as ordinary tweezers, and aligns it with the part to be sutured, so that the needle holder 21 and the thread picker 1 are located on both sides of the tissue to be sutured, and gently pinch them to make the two sides close together. When the front end of the person is close, when the sewing needle 23 passes through the tissue and passes through the needle hole 2 forward, the suture 20 is brought out thereupon, and the suture 20 is divided into two strands due to passing through the needle eye 24, which are respectively located at the ends of the sewing needle 23. At the upper and lower sides, at the same time of this process, because the needle holder approaches inwards, the top 13 of the needle holder rod 15 pulls the thin steel wire rope 8 outwards, so that the pick-up pull rod 4 is pulled back, and then the pick-up hook is pulled in 3 directions. When the sewing needle 23 retreats, due to the backlog of the tissue, the suture 20 is loose and bent before the needle eye 24 retreats into the tissue, and as the sewing needle 23 retreats, the top 13 of the needle holder rod 15 returns to its original position , the pick-up pull bar 4 is pushed forward under the retracting force of the spring 5, so that the pick-up hook 3 is closed forward, and the thread 20 passes through the thread 20 which is located on the needle 23 (i.e., the thread of the free end) and the needle 23, after the sewing needle 23 withdraws from the pinhole 2, the strand of the suture 20 above the sewing needle 23 (that is, the strand at the free end) is hooked by the thread pick-up hook 3, and the sewing needle 23 returns to its original position. , the suture remains in the tissue. During the process of taking out the stapler from the cavity, due to the backlog of tissue and the pulling of the thread picker 1, the suture 20 will continue to be pulled out of the thread box 11 for a certain distance, and the suture will be cut at a suitable distance outside the needle eye 24, and the suture will The free end also comes out of the pick-up for knotting. The remaining suture is still threaded in the eye of the needle, and the next suture can be performed without rethreading.

After the operation is over, the instrument nurse rotates the tightening screw 16 in the opposite direction, pushes the needle-holding rod 18 forward, and the two end teeth 22 are opened due to the elastic effect, removes the sewing needle 23, pulls the stopper 25, and removes the spool 9, Clean instruments and sterilize them for later use.

The specific working conditions of another implementation of the tweezers-type stapler shown in Figure 14 are as follows: when the needle 23 passes through the tissue and passes through the needle hole 2 forward, the needle holder is moved closer to the inside. The fork 37 on the needle bar 15 withstands the thin wire rope 8 and pushes outwards, so that the thread pick-up pull bar 4 is pulled back, and then the triangular piece 35 is retreated to the rear of the needle hole 2; Backlog, before the eye of the needle retreats into the tissue, the suture 20 is loose and bent, and at the same time, the fork 37 moves backward, and the thread pick-up lever 4 is pushed forward under the retracting force of the spring 5, so that the triangular piece 35 passes through the suture 20 and is positioned at the seam. The gap between the strand above the needle 23 (i.e. the strand at the free end) and the needle 23, after the needle 23 exits the pinhole 2, the suture 20 is located at the strand above the needle 23 (i.e. the strand at the free end) Then hooked by the triangular piece 35, after the suture needle 23 returns to its original position, the suture stays in the tissue. All the other processes and steps are the same as above.

The corresponding needle type of this kind of suture device is fixed, and if different types of suture needles are used, such as curved suture needles, the corresponding type of suture device should be replaced so that the position and direction of the needle hole 2 are compatible with the suture needle used.

Although the invention has been described herein with reference to the disclosed structure, the invention is not limited to the details described and the application intends to cover all changes or modifications which come within the purpose of improvement or within the scope of the appended claims.

Claims (10)

1. forceps type stitching instrument, it is characterized in that: described forceps type stitching instrument comprises needle holder (21), pick-up (1), line box (11) and elasticity handle (12), described needle holder (21) is thin rod shape with pick-up (1) front end, and connect as a whole by described elasticity handle (12) V-shapedly, described needle holder (21) keeps V-arrangement to open with pick-up (1) by described elasticity handle (12), be line box (11) between described needle holder (21) and the pick-up (1), the built-in bobbin of described line box (11) (9).

2. forceps type stitching instrument according to claim 1, it is characterized in that: described needle holder (21) is made up of the needle holder pipe (17) and the pin pull bar (18) of holding that is positioned at it, one needle holder bar (15) is positioned between described needle holder pipe (17) and the described elasticity handle (12) and with them and interconnects, the described front end of holding pin pull bar (18) has two open end teeth of elasticity (22), the occlusal surface of described two end teeth (22) forms the hole (30) of a fixed admittance suture needle (23), and there is tensioned screw (16) described rear end of holding pin pull bar (18), the below of described tensioned screw (16) is a disk (33), and described disk (33) is complementary with the circular groove (32) of described needle holder pipe (17) rear end.

3. forceps type stitching instrument according to claim 2 is characterized in that: the cross section of described needle holder pipe (17) is for oblate, and the cross section of the blank pipe lacuna (34) in it is a rectangle like,

4. forceps type stitching instrument according to claim 1, it is characterized in that: described needle holder (21) is made up of the needle holder pipe (17) and the pin pull bar (18) of holding that is positioned at it, one needle holder bar (15) is positioned between described needle holder pipe (17) and the described elasticity handle (12) and with them and interconnects, one suture needle (23) is by two end tooth (22) clampings or directly fix with needle holder pipe (17), and the pinprick (24) of described suture needle (23) is at its front end.

5. according to any described forceps type stitching instrument among the claim 2-4, it is characterized in that: what described pick-up (1) had an outer tube (6) and was positioned at it picks up line pull bar (4), the front end of described outer tube (6) is a needle outlet (2), the front end of outer tube (6) has ten line hooks (3), pick up the preceding end dissociative of line hook (3), the lateral wall of rear end and outer tube (6) forms the joint, the radian part of picking up line hook (3) with pick up line pull bar (4) and form the joint, picking up line pull bar (4) other end combines with a seizing wire (8), the upwards top (13) of prolongation of needle holder bar (15) is fixed on the top that described seizing wire (8) is walked around described line box (11), picks up line pull bar (4) middle part and is connected by spring (5) with outer tube (6).

6. according to any described forceps type stitching instrument among the claim 2-4, it is characterized in that: what described pick-up (1) had an outer tube (6) and was positioned at it picks up line pull bar (4), the described front end that picks up line pull bar (4) is triangular plate (35), before the tip of described triangular plate (35) is pointed to, one needle outlet (2) is positioned at the below of described triangular plate (35), for suture needle (23) discrepancy pick-up (1).

7. forceps type stitching instrument according to claim 1, it is characterized in that: have recessed on the roof (26) of described line box (11), one seizing wire (8) can slide within it, be extruded with axostylus axostyle (10) before the mediad of the rear wall (27) of described line box (11), the top of described axostylus axostyle (10) have form the joint with it automatically lock block (25), the lower wall of described line box (11) lacks as forms wire hole (14), antetheca lack as.

8. forceps type stitching instrument according to claim 7, it is characterized in that: the slide block (28) that in the described axostylus axostyle (10) is a spring (29) jack-up, described block (25) forms the joint with described axostylus axostyle (10) top, and described block (25) rear end extend outwards is oval.

9. forceps type stitching instrument according to claim 1, it is characterized in that: described needle holder (21) is made up of the needle holder pipe (17) and the pin pull bar (18) of holding that is positioned at it, one needle holder bar (15) is positioned between described needle holder pipe (17) and the described elasticity handle (12) and with them and interconnects, described pick-up (1) has an outer tube (6), the inside and outside two wall hollow outs of the rear end of described outer tube (6) become discharging hole (36), are extruded with fork (37) to the inside with the position of the corresponding needle holder bar of described discharging hole (36) (15).

10. forceps type stitching instrument according to claim 1 is characterized in that: the profile of described forceps type stitching instrument is straight shape, rifle shape or knee joint shape.

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