CN103829987B - Can the straight cuts closer of disposable closed intestinal tube under the mirror of chamber - Google Patents

Abstract

The invention discloses a linear cutting closer which can close the intestinal tract at one time under the endoscope, which belongs to the invention in the field of medical equipment. The rod is connected to the front end of the sheath to form a four-bar linkage mechanism; the front end of the sheath is also provided with a first push rod for pushing and pulling the connecting rod to control the expansion of the nail anvil and the nail cartridge shell by a certain distance, the The first push rod moves back and forth under the control of the control mechanism. Two connecting rods are used to connect the tube sheath and the nail abutment seat, so that the distance between the nail abutment seat and the nail cartridge shell can be opened without extending the length of the nail abutment seat and the nail cartridge case, and at the same time the nail abutment seat The included angle with the staple cartridge shell is small, which will not make the intestinal tube slip off easily during clipping, so as to achieve the purpose of one-time closure of the intestinal tube, thereby improving the operation efficiency and safety.

Description

Laparoscopic linear cutting occluder capable of one-time closure of intestinal tract

technical field

The invention relates to a linear cutting closure, in particular to a linear cutting closure capable of closing intestinal tract at one time.

Background technique

The closer is a device used in medicine to replace manual suturing. The main working principle is to use titanium nails to separate or close the tissue, similar to a stapler. Existing closers can be mainly divided into skin closers, circular closers, linear cutting closers and the like. Among them, the linear cutting closer mainly includes a handle body and an execution head. The execution head includes a push knife, a staple cartridge seat and a nail abutment seat. The handle body is provided with a firing push rod for controlling the push knife, and the handle body is provided with a The trigger assembly that controls the forward and backward movement of the firing push rod. The trigger assembly is generally composed of a rack, a return spring, a safety lock, and the like. The existing laparoscopic linear cutting closer has the following disadvantages: after the nail anvil is opened, the angle between the nail anvil and the staple cartridge is too large, and when clamping the thickened intestinal tube, the anvil and the staple cartridge The inner wall of the seat will form a large forward thrust on the intestinal tube, causing the intestinal tube to slide towards the opening of the actuator head, resulting in the inability to completely clamp the intestinal tube at one time. The opening angle of the anvil in the relatively narrow abdominal space such as the pelvic cavity is limited. Therefore, it is difficult to completely clamp and close and cut a large intestine through the staple cartridge and the anvil at one time using the existing technology. The staples are clipped multiple times to complete the cutting of one intestinal tube. However, the intestinal tube that has been clipped and stapled multiple times is easy to leak due to the uneven distribution of staples, causing anastomotic leakage, intra-abdominal infection and other complications, resulting in serious consequences. There is no better way to solve the above-mentioned shortcoming at present.

Aiming at the shortcomings of the existing linear cutting closers, the inventors have made creative improvements to the linear cutting closers so that they can close the intestinal tract at one time.

Contents of the invention

In view of this, the purpose of the present invention is to provide a linear cutting closure device that can close the intestinal tract at one time under the endoscope. In the case of opening a large distance, the angle between the two will not be very large, so it solves the problem that the angle between the nail cartridge shell and the nail abutment seat on the existing linear cutting closer is large and cannot be used once The sex completely grips the bowel.

The present invention is realized by the following technical means:

The linear cutting closure device capable of one-time closure of the intestinal tract under the endoscope of the present invention comprises a handle, a sheath located at the front end of the handle, an executive head arranged at the front end of the sheath, and a control mechanism for controlling the action of the executive head. It includes a nail abutment base and a staple cartridge assembly, the staple cartridge assembly includes a staple cartridge case, a plurality of nail grooves are arranged side by side on the nail cartridge case, and the nail groove position on the end surface of the nail abutment seat is connected with the staple cartridge case Corresponding to a plurality of closed nail forming grooves, the middle part of the nail cartridge shell and/or the nail abutment seat is provided with pusher grooves along the length direction; the plurality of nail grooves are symmetrically arranged on both sides of the pusher grooves, and the A cutting knife is arranged inside the sheath, and the cutting knife can be inserted into the groove of the pushing knife, and the tail end of the nail abutting seat is connected with the front end of the sheath through two connecting rods arranged side by side to form a four-bar linkage mechanism; The front end of the tube sheath is also provided with a first push rod for pushing and pulling the connecting rod to control the expansion of the nail anvil and the cartridge case by a certain distance, and the first push rod moves back and forth under the control of the control mechanism.

Further, the length of the connecting rod on the side close to the actuator head among the two connecting rods is greater than or equal to the length of the connecting rod on the side away from the actuator head.

Further, the control mechanism includes a firing assembly for impacting the staples in the nail slot for stapling, a second push rod for pushing the cutting knife forward to cut tissue, and a firing assembly and the first push rod respectively. The trigger assembly connected with the rod is arranged on the handle.

Further, the firing assembly includes a nail pushing block arranged at the bottom of the nail groove, a nail pushing plate arranged in the tube sheath and capable of moving forward and inserted into the nail cartridge shell, the head of the nail pushing plate is set as a slope When the slope moves forward, it can be inserted into the back of the nail pushing block to force the pushing nail block to move to the top of the nail groove; the trigger assembly includes a first trigger and a first return spring for controlling the return of the first trigger. A third push rod is arranged inside the tube sheath, one end of the third push rod is connected to the pusher plate, and the other end of the third push rod abuts against the top of the first trigger.

Further, the head of the first push rod abuts against one of the two connecting rods, and one of the two connecting rods is connected to the first push rod through an elastic element.

Further, the head of the first push rod abuts against one of the two connecting rods, and a torsion spring is provided at the hinge between one of the two connecting rods and the sheath.

Further, the handle is also provided with a button for locking the position of the first push rod, and the first push rod is snap-fitted with the button after it is in place.

Further, the trigger assembly further includes a second trigger and a second return spring for controlling the return of the second trigger, and the tail end of the first push rod abuts against the top of the second trigger.

Further, the tail end of the second push rod exposes the handle, and the tail end of the second push rod is provided with a handle that is convenient for people to press, and a handle for locking the second push rod is also provided on the handle. position safety lock.

The present invention has the following beneficial effects:

1) The straight-line cutting closer that can close the intestinal canal at one time under the endoscope of the present invention, the tail end of the upper abutment seat is connected with the front end of the tube sheath through two connecting rods arranged side by side to form a four-bar linkage mechanism; the tube sheath The front end of the front end is also provided with a first push rod for pushing and pulling the connecting rod to control the expansion of the nail anvil and the staple cartridge case by a certain distance, and the first push rod moves back and forth under the control of the control mechanism. Two connecting rods are used to connect the tube sheath and the nail abutment seat, so that the distance between the nail abutment seat and the nail cartridge shell can be opened without extending the length of the nail abutment seat and the nail cartridge case, and at the same time the nail abutment seat The included angle with the staple cartridge shell is small, which will not make the intestinal tube slip off easily during clipping, so as to achieve the purpose of one-time closure of the intestinal tube, thereby improving the operation efficiency and safety.

2) The handle is exposed from the tail end of the second push rod in the linear cutting closer that can close the intestinal canal at one time under the endoscope of the present invention, and the tail end of the second push rod is provided with a handle that is convenient for people to press , the handle is also provided with a safety lock for locking the position of the second push rod. The action of the cutting knife is independently controlled by the second push rod instead of the trigger mechanism, which further improves the safety of the operation.

Description of drawings

The present invention will be further described below in conjunction with the accompanying drawings and embodiments.

Fig. 1 is the side structure schematic diagram of linear cutting closer of the present invention;

Fig. 2 is a schematic cross-sectional structure diagram of the upper handle part of the linear cutting closer of the present invention;

Fig. 3 is a structural schematic diagram of the execution head part of the linear cutting closer of the present invention;

Figure 4 is an enlarged schematic diagram of area A in Figure 3;

Fig. 5 is a structural schematic diagram of another connection relationship between the first push rod and the connecting rod on the linear cutting closer of the present invention;

Fig. 6 is a schematic diagram of the three-dimensional structure of the execution head on the linear cutting closer of the present invention;

Figure 7 is an enlarged schematic diagram of area B in Figure 6;

Fig. 8 is a three-dimensional schematic diagram of the partial structure of the nail seat on the linear cutting closer of the present invention;

Fig. 9 is a schematic cross-sectional view of the execution head on the linear cutting closer of the present invention when it is in a closed cutting state.

detailed description

The present invention will be described in detail below in conjunction with accompanying drawing:

As shown in Figures 1-9: the endoscopic linear cutting closure device of this embodiment that can close the intestinal canal at one time includes a handle 1, a tube sheath 2 located at the front end of the handle, an actuator head 3 arranged at the front end of the tube sheath 2, and a user. For the control mechanism that controls the action of the execution head 3, the execution head 3 includes a nail abutment seat 31 and a staple cartridge assembly, and the staple cartridge assembly includes a staple cartridge shell 32, and a plurality of nail slots are arranged side by side on the staple cartridge shell 32 33, the end surface of the nail anvil 31 has a plurality of closed nail forming grooves 34 corresponding to the positions of the nail grooves 33 of the nail cartridge case 32, and the middle part of the nail cartridge case 32 and/or the nail anvil 31 is along the length direction A push knife groove 38 is provided on the top; the plurality of nail grooves 33 are symmetrically arranged on both sides of the push knife groove 38, a cutting knife 39 is arranged inside the tube sheath 2, and a blade is provided at the front end of the cutting knife 39, and the The cutting knife 39 can be inserted into the push knife groove 38, and the tail end of the anvil 31 is connected with the front end of the sheath 2 through two connecting rods 35, 36 arranged in parallel front and rear to form a four-bar linkage mechanism. Among the two connecting rods 35, 36, the length of the connecting rod 35 on the side close to the execution head 3 is slightly longer than the length of the connecting rod 36 on the side away from the execution head 3. Of course, the lengths between the two connecting rods can also be made equal. A parallel four-bar linkage mechanism is formed between the two connecting rods, the front end of the tube sheath and the tail of the nail anvil; Expand the first push rod 37 with a certain distance from the staple cartridge case 32, and the first push rod 37 moves back and forth under the control of the control mechanism. Specifically, the following two methods can be used: one is to move the first push rod The head of the rod 37 is against one of the two connecting rods 35, 36, as shown in Fig. When the first push rod 37 is used, the front end of the first push rod presses the connecting rod, so that the connecting rod rotates forward, so that the nail anvil moves forward and downward to clamp the tissue. When the first push rod 37 is withdrawn, the elastic element 44 pulls the lower connecting rod to rotate backward, so that the distance between the nail anvil and the staple cartridge case is enlarged; the head of the other first push rod 37 is pressed against one of the two connecting rods 35, 36 One, as shown in Figure 4, a torsion spring 45 is provided at the hinge between one of the two connecting rods 35, 36 and the sheath 2, and the torsion force of the torsion spring 45 urges the connecting rod to move when it is not subjected to the first push rod. 37 maintains an angle nearly perpendicular to the front end of the tube sheath during the thrust, that is, the state between the nail abutment seat and the nail case remains open, and when the first push rod 37 presses the connecting rod, it can impel the connecting rod to rotate forward so that The nail anvil is closed with the nail cartridge case.

The straight-line cutting closer that can close the intestinal canal at one time under the endoscope of the present invention uses two connecting rods to connect the tube sheath with the nail abutment seat, so that the nail abutment can be opened without extending the length of the nail abutment seat and the nail magazine shell At the same time, the angle between the anvil seat and the staple cartridge shell is small, so that the intestinal tube will not slip off easily during clipping, and the purpose of one-time closure of the intestinal tube can be achieved, which is extremely convenient. Greatly improve the efficiency and safety of surgery.

As a further improvement of the above technical solution, the control mechanism includes a firing assembly for striking the staples in the nail groove 33 for stapling, a second push rod 42 for pushing the cutting knife 39 forward to cut tissue and A trigger assembly connected with the firing assembly and the first push rod 37 respectively, the trigger assembly is arranged on the handle 1 . Specifically, the tail end of the second push rod 42 exposes the handle 1, and the tail end of the second push rod 42 is provided with a handle 421 that is convenient for people to press. The safety lock 422 for locking the position of the second push rod 42, specifically, a slot can be opened on the second push rod 42, and a bayonet pin that can be inserted into the slot is provided in the safety lock 422 to The locking of the position of the second push rod 42 is completed, and the safety lock 422 can be provided to prevent the second push rod 42 from moving forward arbitrarily, resulting in miscutting. The straight-line cutting and closing device of the present invention that can close the intestinal canal at one time adopts the second push rod to separately control the action of the cutting knife, which further improves the safety of the operation.

As a further improvement of the above technical solution, the firing assembly includes a nail pushing block 411 arranged at the bottom of the nail groove 33, a nail pushing plate 412 arranged in the tube sheath 2 and capable of moving forward and inserted into the nail cartridge shell 32, The head of the nail pushing plate 412 is set as a slope, and when the slope moves forward, it can be inserted into the back of the nail pushing block 411 to force the nail pushing block 411 to move toward the top of the nail groove 33; the trigger assembly includes a first trigger 431 and the first return spring 432 that controls the return of the first trigger 431. A third push rod 413 is arranged inside the tube sheath 2. One end of the third push rod 413 is connected with the nail push plate 412. The third push rod The end of the other end of 413 abuts against the top of the first trigger 431. Preferably, as shown in FIG. The top of 431 is provided with an input gear, and at the same time, a row of racks is provided on the third push rod 431, and a double gear that meshes with the rack and the input gear respectively is provided between the input gear and the rack. Increase the stroke of the rack; preferably, in order to further ensure the safety of the operation, in this embodiment, the tail of the third push rod 431 extends out of the handle and abuts against the handle 421 at the tail end of the second push rod 42 , when the third push rod 431 is not performing the nail pushing action, even if the safety lock 422 is opened, when the second push rod 42 is pushed, the thrust from the tail end of the third push rod 431 will be encountered, thereby prompting the operator that the nail has not been performed action.

The trigger assembly further includes a second trigger 433 and a second return spring 434 for controlling the return of the second trigger 433 , and the tail end of the first push rod 37 abuts against the top of the second trigger 433 . By arranging the first trigger 431 and the second trigger 433 to respectively control the actions of the nail pushing plate 412 and the connecting rod, it is possible to avoid accidents caused by firing the nail pushing plate 412 when the nail anvil is not closed.

As a further improvement of the above technical solution, the handle 1 is also provided with a button 46 for locking the position of the first push rod 37 , and the first push rod 37 snaps into place with the button 46 . By setting the button 46, the first push rod 37 can maintain the closed state of the nail anvil without the operator having to pull the trigger all the time after the first push rod 37 indirectly pushes the nail anvil to close.

Finally, it is noted that the above embodiments are only used to illustrate the technical solutions of the present invention without limitation. Although the present invention has been described in detail with reference to the preferred embodiments, those of ordinary skill in the art should understand that the technical solutions of the present invention can be carried out Modifications or equivalent replacements without departing from the spirit and scope of the technical solution of the present invention shall be covered by the claims of the present invention.

Claims (9)

1. can the straight cuts closer of disposable closed intestinal tube under a chamber mirror, comprise handle (1), be positioned at the pipe sheath (2) of handle front end, be arranged on the Executive Head (3) of pipe sheath (2) front end and the controlling organization for controlling Executive Head (3) action, described Executive Head (3) comprises nail supporting base (31) and nail bin groupware, described nail bin groupware comprises cartridge housing (32), described cartridge housing (32) is set side by side with multiple nail groove (33), the end face of described nail supporting base (31) there is the multiple closed nail forming tank (34) corresponding with nail groove (33) position of cartridge housing (32), the middle part of described cartridge housing (32) and/or nail supporting base (31) offers push broach groove (38) along its length, described multiple nail groove (33) is symmetricly set in the both sides of push broach groove (38), cutter (39) are provided with in described pipe sheath (2), described cutter (39) can be inserted in push broach groove (38), it is characterized in that: two connecting rods (35,36) that described nail supporting base (31) tail end is set up in parallel by front and back are connected to form quadric chain with the front end of pipe sheath (2), the front end of described pipe sheath (2) is also provided with for connecting rod described in push-and-pull (35,36) to control the first push rod (37) that described nail supporting base (31) and cartridge housing (32) launch certain distance, and described first push rod (37) is movable under the control of controlling organization.

2. can the straight cuts closer of disposable closed intestinal tube under the mirror of chamber according to claim 1, it is characterized in that: in described two connecting rods (35,36), be more than or equal to connecting rod (36) length away from Executive Head (3) side near the length of the connecting rod (35) of Executive Head (3) side.

3. can the straight cuts closer of disposable closed intestinal tube under the mirror of chamber according to claim 2, it is characterized in that: described controlling organization comprise a percussion assembly doing the action of nail seam for impacting nail groove (33) interior suturing nail, one for promote cutter (39) travel forward the second push rod (42) of cutting and organizing and respectively with the trigger component of pulling the trigger assembly and the first push rod (37) and being connected, described trigger component is arranged on handle (1).

4. can the straight cuts closer of disposable closed intestinal tube under the mirror of chamber according to claim 3, it is characterized in that: described percussion assembly comprise be arranged at nail groove (33) trench bottom ejector pin block (411), to be arranged in pipe sheath (2) and the nail pushing plate (412) be inserted in cartridge housing (32) can be moved forward, the head of described nail pushing plate (412) is arranged to domatic, and the described domatic back that can be inserted into ejector pin block (411) when travelling forward forces ejector pin block (411) to nail groove (33) top movements; Described trigger component comprises the first trigger (431) and controls first back-moving spring (432) of the first trigger (431) return, the 3rd push rod (413) is provided with in described pipe sheath (2), one end of described 3rd push rod (413) is connected with nail pushing plate (412), and the end abutment of the 3rd push rod (413) other end is at the top of the first trigger (431).

5. can the straight cuts closer of disposable closed intestinal tube under the mirror of chamber according to claim 4, it is characterized in that: the head of described first push rod (37) be against two connecting rods (35,36) one of them, described two connecting rods (35,36) one of them be connected with the first push rod (37) by flexible member (44).

6. can the straight cuts closer of disposable closed intestinal tube under the mirror of chamber according to claim 4, it is characterized in that: the head of described first push rod (37) be against two connecting rods (35,36) one of them, the hinged place of described two connecting rods (35,36) one of them and pipe sheath (2) is provided with torsion spring (45).

7. can the straight cuts closer of disposable closed intestinal tube under the chamber mirror according to claim 5 or 6, it is characterized in that: described handle (1) is also provided with one for locking the button (46) of the first push rod (37) position, described first push rod (37) in place after and button (46) be clasped.

8. can the straight cuts closer of disposable closed intestinal tube under the mirror of chamber according to claim 7, it is characterized in that: described trigger component also comprises the second trigger (433) and the second back-moving spring (434) for controlling the second trigger (433) return, the tail end of described first push rod (37) is connected to the top of described second trigger (433).

9. can the straight cuts closer of disposable closed intestinal tube under the mirror of chamber according to claim 8, it is characterized in that: the tail end of described second push rod (42) exposes described handle (1), the tail end of described second push rod (42) is provided with a shank facilitating people to press (421), described handle (1) is also provided with one for locking the safety lock (422) of the second push rod (42) position.