CN115381511A - Trigger mechanism for anastomat - Google Patents

Abstract

The firing mechanism for the stapler provided by the present invention is arranged on the shell of the stapler, the lower part of the shell is a fixed handle, and the front end of the fixed handle is provided with a rotatable movable handle; the inner wall of the shell is provided with a The rotating shaft sliding groove, the rotating shaft of the movable handle is arranged in the rotating shaft sliding groove, the rear end protrusion of the upper rear end of the movable handle is in contact with the blocking surface of the inner wall of the housing; the upper end of the rotating shaft movable groove is close to part, the housing is also provided with a rotatable limit block, the limit block divides the sliding groove of the rotating shaft into two sections; when the movable handle is pressed, the movable handle moves forward and upward along the sliding groove of the rotating shaft, Until the limit block is pushed away and the upper end of the sliding groove of the rotating shaft is reached, the limit block returns to its original position under the action of the limit block reset mechanism, and the movable handle is continuously pressed, and the trigger buckle on the top of the movable handle pushes the push button of the stapler. The blade bar moves forward.

Description

Firing mechanism for stapler

technical field

The invention relates to the field of medical instruments, in particular to a firing mechanism for a stapler.

Background technique

Due to the development of modern science and technology, a cutting stapler that replaces traditional manual suturing has been born; the cutting stapler has the advantages of rapid anastomosis, reliability, and fewer postoperative complications. Its working principle is similar to that of a stapler, that is, the process of stapling and cutting tissues and organs with titanium nails and blades, respectively. Existing cutting staplers are mainly used for cutting and anastomosis of skin, digestive tract, blood vessels, lungs, etc., and are suitable for laparoscopic and open operations. The repair and reconstruction of many lumen-like internal structures (such as urinary tract: including urethra, vesicourethra, ureteral bladder, ureter; intestinal tract, blood vessels, etc.) currently mainly rely on manual anastomosis with wires and the use of endoluminal circular staplers or Multiple linear cutting staplers are used for anastomosis. The endoluminal circular stapler is suitable for end-to-end or end-to-side anastomosis, but requires an additional stoma, so a second anastomosis of the stoma is required, which artificially increases the difficulty, cost, and complications of the operation; and the staples are located in the tissue In the organ cavity, it is not suitable for many tissues and organs that require valgus anastomosis (such as: blood vessels, ureters, etc.); staples located in the cavity are also likely to cause postoperative stenosis, obstruction and many other complications; multiple linear cutting and anastomosis The use of the device increases the difficulty of the anastomosis operation, and the junction of the staples is prone to anastomotic tissue necrosis, anastomotic leakage, bleeding, or postoperative stenosis obstruction.

The existing problems of the prior art will be described in detail below in conjunction with the accompanying drawings.

As shown in FIG. 1 , two lumens to be sutured are formed during the operation, and the ends of the lumens need to be sutured together.

Combined with Figures 2, 3, and 5, it is a commonly used varus anastomosis operation. First, an incision A1 is made on the lumen at the right end, and the stapler with a curved end in Figure 3 is inserted into the lumen. The operation of the stapler The handle is located outside the lumen, pull the two broken ends of the lumen between the circular staple anvil A8 and the circular staple magazine A9, push the staple pusher A11 to fire the staples in the circular staple magazine A10, and place the staples in the lumen The two broken ends are nailed together, and the excess tissue is excised by the annular blade A9, thereby forming a circle of sutured lumen tissue A2 in Fig. 2 . Then take the stapler out of the lumen through the wound A1, and then use the stapler shown in Figure 5 to suture the wound A1. This suturing method has at least three defects: (1) Inverted anastomosis is used to form an inverted suture lumen tissue A2 protruding from the inner wall of the lumen in the lumen, which is easy to cause many complications such as stenosis and obstruction after the operation. (2) An incision A1 needs to be made on the lumen and needs to be anastomosed again. This incision is additionally opened due to the operation, which increases the difficulty of the operation and also increases unnecessary pain for the patient. (3) Use multiple staplers, greatly increasing the cost of surgery.

Combined with Figures 4 and 5, this is the second anastomosis method. Pull the lumen at the right end in Figure 1, place the two broken ends side by side, so that the outer walls of the two lumens stick together, and then use the lumen at the right end as shown in Figure 5. The linear stapler anastomoses the lumen side by side, that is, puts the two lumen walls affixed together between the staple magazine A6 and the anvil A7, and fires the staples in the staple magazine A6 to separate the two segments. The lumen walls of the lumen are anastomosed together, and then an ostomy opening A3 is opened at the anastomosed part, and finally the ends of the two lumens are anastomosed by the linear stapler shown in FIG. 5 . The ostomy port A3 has just become the communicating port of the two sections of the lumen. This anastomotic method has at least three defects: (1) Since the original orientation of a section of the lumen needs to be changed, the lumen is pulled by external force, and this method itself will cause damage to the lumen. (2) After the anastomosis, the flowing content in the lumen moves through the stoma A3, forming a 90-degree turn in the lumen, and the flow is not smooth enough, which is easy to block. (3) Two or more anastomoses are required, which greatly increases the cost and difficulty of the operation.

Figure 6 shows the valgus suture method, in which the two ends are valgus, and a circle of valgus suture lumen tissue A5 is formed after suturing. The advantages of this method are obvious, and the suture point is outside the lumen, without causing Postoperative complications such as stenosis and obstruction. However, in the current operation, this method is limited to manual suturing, and staplers cannot be used. It can be illustrated in conjunction with Figure 3 that if the broken ends of the two sections of the lumen are turned outward on the circular anvil A8 and the circular staple cartridge A10 respectively, and then sutured together, there is no way to separate the stapler from the sutured lumen after suturing. take it down. In order to realize the eversion-type anastomosis of the stapler, the invention patent with the application number of 201510282427X provides an extraluminal anastomosis method. After the lumen is sutured, the annular structure of the staple cartridge and the base is cut off with scissors, thereby removing the staples. Bin and base. However, this method is only an idea, and no detailed structural features are given. There are at least four reasons why it cannot be applied clinically: (1) The operation space is very small, and it is difficult to insert the tissue between the anastomotic ring after suturing. An additional pair of scissors is inserted to cut the ring structure. (2) When using scissors to cut the annular structure, external force needs to be applied. If the operation is not done properly, it will cause secondary damage to the lumen tissue, or even break the lumen. (3) The rigidity of materials that are easy to be cut and damaged by scissors must be insufficient to form sufficient anastomotic traction, which is also destructive to surgical scissors. (4) The anastomosis method of pulling the anvil ring to the proximal end to squeeze the staples is adopted, because the distal end cannot be seen during the operation, which may easily cause tearing of the tissues and organs.

The applicant proposed a plan for extracavitary anastomosis in the invention application with the application number 202110022419.7 and the name "A Stapler", but relatively many manual steps are required in actual operation. In order to further simplify the operation of the stapler in the operation, the inventors conducted further research.

Contents of the invention

The purpose of the present invention is to provide an easy-to-operate stapler firing mechanism.

The firing mechanism for the stapler provided by the present invention is arranged on the shell of the stapler. The lower part of the shell is a fixed handle, and the front end of the fixed handle is provided with a rotatable movable handle; The sliding groove of the rotating shaft extending above, the rotating shaft of the movable handle is arranged in the sliding groove of the rotating shaft, the rear end protrusion of the upper rear end of the movable handle is in contact with the blocking surface of the inner wall of the housing; The upper end of the housing is also provided with a rotatable limit block, and the limit block divides the sliding groove of the rotating shaft into two sections; when the movable handle is pressed, the movable handle moves along the sliding groove of the rotating shaft from bottom to Move forward and upward until the limit block is pushed away and reaches the upper end of the sliding groove of the rotating shaft. The limit block returns to its original position under the action of the limit block reset mechanism. Continue to press the movable handle, and the trigger on the top of the movable handle pushes The staple pusher bar of the stapler moves forward.

The movable handle installation method designed by the present invention, before pressing the movable handle, the trigger buckle on the top of the movable handle has no effect on the forward and backward movement of the pusher piece rod. The sliding groove moves forward and upward, so that the trigger buckle can push the nail pusher rod, and the nail pusher rod can drive the ring of the nail pusher to fire the staples, thereby completing the firing action.

Preferably, the sliding groove of the rotating shaft is downwardly arc-shaped, and rises along the arc-shaped sliding groove relatively gently. The sliding groove of the rotating shaft is in an inverted L shape, and the lower part of the inverted L shape is arc-shaped, and the limit block is arranged at a position close to the corner of the inverted L shape, and the limit block moves the arc under the action of the limit block reset mechanism. The shaped part is divided into two sections, and when the limiting block is pushed by an external force, the limiting block enters the inverted L-shaped corner.

Preferably, the trigger button is in the shape of a bird's beak.

Preferably, the limit block reset mechanism is a torsion spring.

In order to give appropriate force feedback when the operator presses the movable handle, the rear upper end of the movable handle of the present invention is provided with a second mounting column, which is located behind the second mounting column, and the inner wall of the housing is provided with a first Mounting posts, the two ends of the return spring are installed on the first mounting post and the second mounting post respectively. In addition, through the traction of the return spring, the movable handle and the fixed handle can maintain a distance suitable for holding.

In order to avoid misoperation, a safety bolt is provided between the fixed handle and the movable handle. The rotating end of the safety bolt is arranged on the movable handle, and the free end of the safety bolt leans against the fixed handle. Remove or remove the safety bolt to press the movable handle.

Preferably, the bottom of the pusher rod has a gap, and when the rotating shaft of the movable handle reaches the upper end of the movable groove of the rotating shaft, the trigger button of the movable handle is inserted into the gap; or the bottom of the pusher rod has a push The protruding part of the nail rod, when the rotating shaft of the movable handle reaches the upper end of the movable groove of the rotating shaft, the trigger button of the movable handle pushes the pushing rod to move forward through the protruding part of the pushing rod.

The rear end of the stapler rod of the stapler of the present invention is provided with a stapler rod push piece, and the staple pusher rod passes through the through hole on the stapler rod pusher piece. Rely on, the trigger button can push the nail push piece rod to move forward relative to the nail cartridge rod push piece. Before pressing the movable handle, if you need to adjust the positions of the staple pusher rod and the staple cartridge rod, you can push the staple pusher rod, and the staple pusher rod will drive the staple cartridge rod to move synchronously through the staple cartridge rod push piece, when the staple cartridge rod Move to the appropriate position, the staple cartridge rod is blocked by the staple anvil ring through the staple cartridge ring, and after the handle is pressed, the trigger button can push the nail pusher rod to move in the through hole relative to the staple cartridge rod push piece and the staple cartridge rod.

Preferably, the push piece rod is provided with a push piece of the push piece, and a connecting spring is arranged between the piece of the push piece of the push piece and the push piece of the cartridge bar, and the push piece of the push piece is connected with the push piece of the cartridge bar. The distance between the push pieces is greater than or equal to the staple height of the staple. When there is no external force, the connecting spring separates the pushing piece of the nail pushing rod from the pushing piece of the staple cartridge rod, so that the distance between the nail pushing piece ring and the nail cartridge ring is maintained.

Preferably, a connecting rod is arranged between the pushing piece of the nail pushing rod and the pushing piece of the staple cartridge rod, one end of the connecting rod is fixed on the pushing piece of the nail pushing rod, and the other end is inserted on the pushing piece of the staple cartridge rod, and The pushing piece can move relative to the staple cartridge rod, and the connecting spring is sheathed on the connecting rod. The connecting rod is not only convenient for installing the connecting spring, but also can play a guiding role.

In the firing mechanism provided by the present invention, after the movable handle is pressed, the trigger buckle reaches the set position along with the movable handle, and the trigger buckle pushes the nail pusher rod to move, which is easy to operate. Before the movable handle is pressed, the trigger button has no contact with the pusher rod, and does not affect other operations on the pusher rod.

Description of drawings

Figure 1 is a schematic diagram of two sections of the lumen to be anastomosed;

Figure 2 is a schematic diagram of varus anastomosis;

Fig. 3 is a schematic diagram of a stapler for varus anastomosis;

Fig. 4 is a schematic diagram of the second way of lumen anastomosis;

Fig. 5 is a schematic diagram of a stapler for external anastomosis;

Figure 6 is a schematic diagram of valgus anastomosis;

Fig. 7 is a perspective view of the present invention;

Fig. 8 is the right view of the present invention;

Fig. 9 is a left view of the present invention;

Fig. 10 is a schematic diagram of the internal structure of the present invention (remove the right shell);

Fig. 11 is a schematic diagram of the internal structure of the shell of the present invention;

Figure 12 is a partial schematic view of the present invention;

Fig. 13 is a partial exploded view of the present invention;

Figure 14 is a schematic structural view of the drive sleeve;

Figure 15 is an exploded view of the cooperation relationship between the staple cartridge bar, the nail pusher bar, the nail anvil bar, and the unlocking bar;

Figure 16 is a schematic diagram of the positional relationship between the unlocking lever and the anvil lever;

Figure 17 is a partial schematic diagram of the propulsion extension assembly;

Figure 18 is a partial schematic diagram of the propulsion extension assembly II;

Figure 19 is a schematic diagram of unlocking the unlocking lever forward;

Fig. 20 is a schematic diagram of opening the nail anvil ring, the nail bin ring, and the nail pusher ring;

Fig. 21 is a schematic diagram of the staple cartridge ring and the lock;

Figure 22 is an exploded view of the staple cartridge rod;

Figure 23 is an example of a male buckle and a female buckle;

Fig. 24 is another example of male buckle and female buckle;

Figure 25 is a schematic diagram of the connection of three unlocking columns;

Figure 26 is a closed schematic diagram of the nail anvil ring, the nail bin ring, and the nail pusher ring;

Figure 27 is the second schematic diagram of the closure of the nail anvil ring, the nail bin ring, and the nail pusher ring;

Figure 28 is a schematic diagram of the push nail ring and the guard plate;

Fig. 29 is a partial schematic diagram of tissue eversion end-to-end anastomosis (taking intestinal tissue as an example).

In the figure: A1-wound; A2-inverted suture lumen tissue; A3-ostomy opening; A4-end suture lumen tissue; A5-valgus suture lumen tissue; A6-nail cartridge; A7-screw anvil; A8-circular nail anvil; A9-circular blade; A10-circular nail bin; A11-nail pushing seat;

1-anvil ring, 101-anvil guard plate, 102-connecting hinge, 103-first half ring, 104-second half ring;

2-staple bin ring, 201-staples, 202-connecting hinge, 203-first half ring, 204-second half ring, 205-avoidance groove, 206-ring mounting seat;

3-pin push piece ring, 301-ring blade, 302-pin push ring guard plate, 303-connecting hinge, 304-pin push piece, 305-first half ring, 306-second half ring;

4-Advance rod, 401-Nail cartridge rod push piece, 402-Connecting spring, 403-Nail push rod push piece, 404-Position hole, 406-Connecting rod, 407-Protrusion rod protrusion, 408-Drive sleeve , 4081-accommodating groove, 4082-limiting part;

5-adjusting nut, 501-knob, 502-fixed part;

6-movable handle, 601-trigger buckle, 602-movable handle shaft, 603-return spring, 604-safety bolt, 605-limit block, 606-limit block torsion spring, 607-first mounting column, 608-the first Two installation columns, 609-the first installation hole, 610-the second installation hole, 611-the third installation hole, 612-safety bolt torsion spring; 613-rear end protrusion;

7-anvil rod lock, 701-male buckle, 702-female buckle, 703-unlock spring, 704-unlock post;

8-staple bin rod lock, 801-male buckle, 802-female buckle, 803-unlock spring, 804-unlock post, 805-external push spring, 806-male buckle groove, 807-rotation shaft hole;

9-Push nail bar lock, 901-male buckle, 902-female buckle, 903-unlock spring, 904-unlock column;

10 - unlock lever;

11- Unlock the push block;

12-screw pusher rod, 1201-screw pusher rod protrusion;

13-staple bin rod, 1301-indicator;

14-anvil bar, 1402-connecting plate;

15-housing, 1501-fixed handle, 1502-sliding groove of rotating shaft, 1504-dial, 1505-sliding groove upper end, 1506-sliding groove lower end, 1507-blocking surface, 1508-limit block installation point.

Detailed ways

The technical solution of the present invention will be described in detail below with reference to FIGS. 7-29 .

For the sake of clarity, the directional terms we use in the drawings and the following descriptions are relative to the operator holding the stapler handle horizontally with the right hand, that is, the fixed handle is located in the jaw of the right hand, and the other four fingers except the thumb Hold the active handle. Specifically, the terms "proximal" and "rear" refer to a position close to the operator, while the terms "distal" and "anterior" refer to a position remote from the operator. The term "left" refers to the left side of the operator, while the term "right" refers to the right side of the operator; "up" refers to the direction opposite to gravity, and "down" refers to the direction of gravity. Other directional terms can be understood in light of the figures and description below.

The circular cutting stapler provided by the present invention includes: a handle trigger assembly, a pushing extension assembly and an anastomotic cutting assembly.

The handle trigger assembly includes: a stapler shell 15 , a movable handle 6 , and a safety bolt 604 .

As shown in Figures 7, 8, 9, and 10, the lower part of the stapler housing 15 has a fixed handle 1501, and the stapler body is made of relatively lightweight materials such as plastic. The stapler shell 15 is divided into two halves, which are interspersed and mounted together by rivets and screws. The middle of the shell has a concave-convex surface to form an accommodating cavity for fixing and installing various components. The fixed handle 1501 is tilted backward and downward for the operator to hold. According to the evaluation of the overall weight of the stapler, a counterweight can be added to the fixed handle appropriately. A dial 1504 is arranged on the shell of the stapler to indicate the advancing distance of the staple cartridge rod.

As shown in FIGS. 10 , 11 , 12 and 13 , the upper end of the movable handle 6 is installed in the cavity of the housing 15 . A first mounting hole 609 , a third mounting hole 611 , and a second mounting hole 610 are respectively provided at the rear upper end, the front upper end, and the middle of the movable handle 6 . The inner wall of the casing 15 is provided with a sliding groove 1502 for the rotating shaft, which extends from bottom to obliquely upward, and is preferably an arc-shaped groove. The movable handle rotating shaft 602 runs through the third installation hole 611, and the two ends of the movable handle rotating shaft 602 are inserted in the rotating shaft sliding groove 1502, and can slide in the rotating shaft sliding groove. Close to the position of the upper end 1505 of the sliding groove of the rotating shaft sliding groove 1502, a rotatable limiting block 605 is also installed in the casing, and the limiting block 605 closes the rotating shaft sliding groove 1502 under the action of the torsion spring 606 of the limiting block; When the position block encounters an external force, the limit block 605 can rotate counterclockwise, thereby releasing the sealing of the sliding groove of the rotating shaft. The sliding groove 1502 of the rotating shaft is preferably in an inverted L shape, so that the limit block 605 can be installed at the position of the limit block installation point 1508 above. When there is no external force, the limit block 605 will close the bottom. Bit block 605 is turned counterclockwise to the corner of the inverted L shape.

The front upper end of the movable handle 6 is also provided with a trigger catch 601 extending toward the top of the housing. The trigger catch 601 is in the shape of a bird's beak, and its top is oblique to the rear. The second installation column 608 runs through the first installation hole 609, and the first installation column 607 is arranged inside the casing. Two return springs 603 are respectively located on both sides of the movable handle 6, and their ends are respectively installed on the first installation column and the second installation column. On the column, the return spring 603 exerts a backward active force on the movable handle 6, pulling the movable handle to move backward and downward, so as to avoid the movable handle from becoming too high.

The safety bolt 604 is installed on the movable handle through the rotating shaft, and the end of the rotating shaft is inserted in the second mounting hole 610. A safety bolt torsion spring 612 is installed on the rotating shaft. Under the action of the safety bolt torsion spring 612, the free end of the safety bolt 604 pushes On the fixed handle 1501. Only when the abutment between the safety bolt 604 and the fixed handle is released, the movable handle 6 can be pulled, thereby avoiding misoperation.

The working process of the handle trigger assembly is described in detail below:

In the initial state, the movable handle rotating shaft 602 is located at the lower end 1506 of the sliding groove, the rear end protrusion 613 of the movable handle 6 contacts the blocking surface 1507 on the fixed handle, and the free end of the safety bolt 604 leans against the fixed handle. During operation, first remove the safety bolt 604 or pull it downwards, hold the fixed handle, and squeeze the movable handle backward to make it move closer to the fixed handle. Due to the blocking of the blocking surface 1507, the movable handle 6 is squeezed forward and upward, As a result, the rotating shaft 602 of the movable handle moves from the lower end 1506 of the sliding groove to the upper end 1505 of the sliding groove. As shown in Figure 12, when the movable handle shaft 602 reaches the limit block 605, push the limit block 605 to rotate counterclockwise, from the dotted line position in Figure 12 to the solid line position, until the movable handle shaft 602 reaches the upper end of the sliding groove At 1505, the external force acting on the limit block 605 disappears, and the limit block 605 returns to its original position under the action of the limit block torsion spring 606, blocking the moving route of the movable handle rotating shaft 602, so that the movable handle rotating shaft 602 is constrained at the upper end 1505 of the sliding groove. After the movable handle rotating shaft 602 reaches the upper end 1505 of the sliding groove, continue to press the movable handle 6 (either continuously or first loosen and then press), and the firing of the staples can be realized.

The propelling extension assembly includes an adjusting nut 5 , a propelling rod 4 , a nail pusher rod 12 , a staple bin rod 13 , an anvil rod 14 , and an unlocking rod 10 .

As shown in Figures 10, 11, 13, 15, and 16, the adjustment nut 5 is fixedly arranged at the end of the stapler, and the rear end of the adjustment nut 5 is a knob 501, which is rotated by the operator during the operation. Fitted in the shell of the stapler, the knob 501 can rotate relative to the fixing part 502 of the adjusting nut 5 . The push rod 4 is set in the shell of the stapler, the rear end of the push rod 4 is located in the adjustment nut 5, the push rod 4 is threadedly connected with the knob of the adjustment nut 5, and the push rod 4 is driven forward or retracted by rotating the knob of the adjustment nut 5 .

Nail anvil bar 14, nail bin bar 13, and the rear ends of stapler bar 12 are all located in the stapler shell 19, along the direction from the left side to the right side of the stapler, followed by nail anvil bar 14, nail bin bar 13, and pusher bar. Nail piece bar 12. Nail anvil bar 14, nail bin bar 13, nail pusher sheet bar 12 are all elongated, and each bar all selects the stronger (as metal) material of rigidity to make. The rear end of nail anvil bar 14 is installed on the front end of the stapler body and cannot move. The front ends of the nail pusher bar 12, the nail bin bar 13, and the nail anvil bar 14 are respectively connected with the nail pusher ring 3, the nail bin ring 2, and the nail anvil ring 1. The end of the staple cartridge rod 13 is provided with a staple cartridge rod pusher 401, and the staple cartridge rod pusher 401 is provided with a through hole (not shown in the figure), through which the staple pusher rod 12 extends toward the tail of the stapler. . The bottom of the end of the pusher rod 12 is provided with a notch or a protruding part 1201 of the pusher rod. When the knob of the rotation adjustment nut 5 drives the push rod 4 to move forward, the push rod 4 drives the nail pusher bar 12, and the nail pusher bar 12 drives the nail bin bar 13 to move forward through the nail bin bar pusher 401. When the staple cartridge rod 13 moves to a designated position, the staple cartridge ring 2 contacts the anvil ring 1, and the movable handle 6 is pulled, and the movable handle rotating shaft 602 moves in the rotating shaft sliding groove 1502 . When the rotating shaft 602 of the movable handle reaches the upper end 1505 of the slide groove, the top of the trigger catch 601 is inserted into the gap at the end of the pusher piece rod 12 or behind the protruding part 1201 of the pusher piece rod, and the movable handle 6 is pulled, and the trigger catch passes through The notch or the protrusion 1201 of the pusher rod drives the pusher rod 12 to move forward. It should be pointed out that when the staple cartridge rod 13 has not moved to the specified position, the staple cartridge ring 2 is not in contact with the anvil ring 1, and the staple push piece rod 12 can be driven by the friction force between the staple cartridge rod push piece 401 The staple cartridge bar pusher and the staple cartridge bar move forward together; when the staple cartridge ring 2 is in contact with the anvil ring 1, due to the blocking of the anvil ring, a relative movement occurs between the staple pusher bar 12 and the staple cartridge bar pusher 401. Move, that is, the staple cartridge rod and the staple cartridge rod push piece remain stationary, and the staple push piece rod moves forward through the through hole of the staple cartridge lever push piece, thereby driving the staple push piece ring 3 to fire the staples in the staple cartridge ring.

Referring to FIG. 11 , the present invention also sets a push piece 403 on the push piece rod 12 parallel to the push piece 401 of the cartridge bar. The push piece rod moves synchronously with the push piece of the push rod. Along the length direction of the nail pusher rod, the staple cartridge rod push piece 401 and the nail pusher rod push piece 403 are connected through a connecting rod 406 , and a connecting spring 402 is sleeved on the connecting rod 406 . Wherein, the end of the connecting rod 406 is fixedly connected with the nail pusher rod push piece 403, and the other end passes through the hole on the staple cartridge rod push piece 401, and can move back and forth in the hole. The distance between the staple cartridge rod push piece 401 and the staple push rod push piece 403 is determined by the staple height of the staple, generally greater than 5mm, preferably equal to the staple height of the staple, or greater than the staple height, as long as the trigger button drives the push When the nail piece bar 12 moves forward, it is enough to fire the staples. By arranging this structure, before the firing, the connecting spring separates the push piece of the staple cartridge rod from the push piece of the staple push rod, so that a certain distance is maintained between the push piece ring 3 and the staple cartridge ring 2. When the handle fires the staples, it can provide some feedback to the operator.

In the above description about the driving relationship between the pusher rod 4 and the pusher rod 12, the pusher rod 4 can only drive the pusher rod 12 forward, but cannot pull the pusher rod 12 backward. An improved structure will now be described in conjunction with FIGS. 11, 13, and 14. A driving sleeve 408 is arranged inside the stapler shell, the rear end of the pusher rod 12 is passed through the driving sleeve 408 , and the protrusion 1201 of the pusher rod extends out of the driving sleeve 408 . The rear end of the driving sleeve 408 is also provided with a receiving groove 4081, and the front end of the receiving groove is provided with a stopper 4082. The flange is stuck on the limiting part 4082 . When the push rod 4 moves backward, through the cooperation of the protruding part 407 of the push rod and the limit part 4082, the drive sleeve is driven, and then the push piece rod is driven to move backward. It should be pointed out that the driving sleeve 408 can be regarded as an independent component assembled with the pusher rod 12, or can be used as a part of the pusher rod 12, and those skilled in the art can make corresponding adjustments based on realizing this function , For example, the receiving groove structure shown in FIG. 14 is set at the end of the pusher rod.

In order to allow the operator to visually see whether the staple cartridge rod has moved to the designated position when the knob of the adjusting nut is rotated during the operation, that is, the staple cartridge ring abuts against the nail anvil ring, the present invention uses the nail cartridge rod Or an indicator 1301 is set on the staple cartridge rod push piece 401, and the indicator 1301 cooperates with the dial 1504 to indicate the moving distance.

13,16,17, the unlocking lever 10 is inserted in the slotted hole of the anvil bar 14, and the slotted hole plays a guiding role. At the end of the nail anvil rod 14, the bottom of the nail anvil rod is provided with a long groove for avoiding the position, and the end of the unlocking rod is exposed from the long groove for avoiding the position. The unlocking projection 11 drives the unlocking rod 10 to move in the anvil rod 14 . As shown in Figure 18, the unlocking bar can also be arranged outside the anvil bar, and the effect of the unlocking bar can also be realized; in order to move stably, a guide ring (not shown) can be set outside the anvil bar, and the unlocking bar can be passed through through the guide ring. In addition, preferably, a whole guide ring is set along the length direction of the unlocking lever, so that it not only plays a guiding role, but also plays a role similar to that of the anvil bar, that is, when the unlocking lever moves in a limited space, the The forward force on the unlocking lever is more easily converted into a force perpendicular to the direction of the lever body, thereby pushing the unlocking column more effectively.

15, 20-28, the anastomotic cutting assembly of the present invention includes: an anvil ring 1, a staple bin ring 2, a nail pusher ring 3, and an annular blade 301. Staples are installed on the staple bin ring 2.

The nail anvil ring 1, the nail bin ring 2, and the nail pusher ring 3 are all in the shape of a ring, which is designed in the present invention to be composed of two semi-ring structures to form a ring structure, which is mainly combined with Figs. The cartridge ring is shown to illustrate how the two ring halves are spliced together and how the rings are closed and opened. The staple bin ring 2 includes a first half-ring 203 and a second half-ring 204. The staple bin ring 2 is integrally located on one side of the front end of the staple bin rod. One end of the second half-ring 204 is connected to the front end of the nail bin rod 13. The other end of the half-ring 204 is connected with one end of the first half-ring 203, and the first half-ring 203 can rotate relative to the connecting point. FIG. To connect, it is foreseeable that the hinge 202 can also be replaced with a rotating shaft. As shown in Figure 22, the connecting ends of the two half-rings are provided with a rotating shaft hole 807, and the rotating shaft can be installed in the rotating shaft hole to realize rotation. The present invention is provided with the nail cartridge rod lock 8, specifically, at the end where the second half ring 204 is connected with the nail cartridge rod, the second half ring 204 is provided with a female buckle 802, and the corresponding end of the first half ring 203 is There is a male buckle 801 at the bottom, and the male buckle 801 can be buckled into the female buckle 802 to realize the first half ring and the second half ring to form a nail bin ring, and the male buckle 801 can be pushed out of the female buckle to release the two halves. Locking between the rings. In the present invention, a through hole is provided on the end of the second half ring 204 and the staple cartridge rod, and an unlocking column 804 is inserted into the through hole. The unlocking column is perpendicular to the length direction of the staple cartridge rod, and the unlocking column 804 is pushed in the direction of the male buckle 801. Use the unlocking post to push the pin out of the box. An unlocking spring 803 is sleeved on the unlocking post 804 , and the unlocking post is reset under the action of the unlocking spring 803 after the external force applied to the unlocking post disappears. The male buckle 801 is preferably an elastic arm made of elastic material. It can be seen from Figures 21 and 22 that two layers of staples 201 are provided on the cartridge ring. The ends of the two half-rings are L-shaped. In the splicing part, one of the half-rings is thicker and the other is thinner, so that staples can be placed on the thicker part, so that the splicing part also has staples, avoiding the The problem of anastomosis omission occurs during anastomosis. The height and length of the staples can be different, and they can be non-absorbable metal nails or absorbable nails, which can be configured according to needs.

The end of the second half-ring 204 can be integrally formed with the cartridge rod 13, or a separate installation structure can be adopted. As shown in FIG. 22 , the end of the second half ring 204 is provided with a ring mounting seat 206 , and the ring mounting seat 206 is inserted into the through hole on the cartridge rod 13 and then fastened with screws. The unlocking post is inserted into the through hole of the ring mount 206 . Due to the high requirements for disinfection in the operation, the stapler is a disposable consumable device, and the cost is very high. The present invention designs a split installation structure so that the stapler ring, the pusher ring, the anvil ring and the stapler body (including the stapler) rod, nail pusher rod, and nail anvil rod) are separated, and the staple bin ring, nail pusher ring, and nail anvil ring are used as disposable consumable equipment, and the others can continue to be sterilized, which greatly saves costs and reduces operating expenses.

What Fig. 23 shows is another structure of the male buckle and the female buckle. The end of the first half ring 203 is provided with a male buckle groove 806, the male buckle 801 is a sphere, and is installed in the male buckle groove 806 through an externally pushed spring 805, a part of the sphere is exposed outside the male buckle groove, and the exposed part of the ball is Buckle into the female buckle 802 to realize splicing and locking, and use the unlocking column 804 to push the ball out of the female buckle to realize separation.

What Fig. 24 shows is another structure of the male buckle and the female buckle. The first half-ring 203 is provided with a hook-shaped male buckle 801, and the second half-ring 204 is provided with a hook-shaped female buckle 802. The two hook-shaped structures are used to achieve locking, and the unlocking column is used to push the female buckle 802 outward to realize separate. The female buckle 802 is preferably made of elastic material.

The above schematically illustrates the three structural forms of the male buckle and the female buckle. Other applicable structural forms that realize the locking of the two half rings and can be unlocked by means of the unlocking column can all be applied to the present invention. For example, replace the push-out spring and ball shown in Figure 23 with a bolt, insert the bolt into the female buckle to achieve locking, and the unlocking column pushes the bolt out of the female buckle to unlock the lock.

The nail anvil ring and the nail pusher ring are also formed by two half rings. Except that there is no staple, other structures are basically the same as the nail bin ring. Anvil rod locks 7 (comprising male buckles 701 and female buckles 702), Push pin rod lock 9 (comprising male buckle 901, female buckle 902). One end of one of the half rings of the nail anvil ring and the nail pusher ring is respectively connected with the nail anvil rod and the nail pusher rod. With reference to Figure 27, the staple cartridge ring 2 is located between the anvil ring 1 and the pusher ring 3, the pusher ring 3 is located at the proximal end (that is, close to the operator), and the anvil ring 1 is located at the distal end (that is, away from the surgical operation). By). The nail pusher ring 3 and the anvil ring 1 are respectively provided with a nail pusher 304 corresponding to the staples on the staple bin ring 2 and a nail abutting position (not shown in the figure), and the nail pusher ring 3 is also provided with The annular blade 301 is located on the outer edge of the nail pushing piece 304 . The combined use of the nail pusher, the nail abutment position and the staples is a conventional technique, and will not be repeated here.

20, 27, 28, the second half ring 104 of the anvil ring 1 is connected with the anvil bar 14, and an anvil guard plate 101 is set on the end of the second half ring 104 or the anvil bar 14, and the anvil guard The plate 101 is located on the outside of the anvil ring (the one close to the nail bin ring is the inner side). When the first half ring 103 and the second half ring 104 are spliced and locked, the splicing part is blocked by the anvil guard plate 101 . With reference to Figures 20 and 26, at the junction of the pusher ring 3 and the pusher rod 12, a pusher ring guard 302 is provided on the end of the pusher ring or the pusher rod, and the pusher ring guard 302 is located The outer side of the nail pusher ring (the inner side near the nail bin ring), when the two half rings are spliced and locked, the splicing place is blocked by the nail pusher ring guard plate 302 . Combined with Figures 26, 27, and 29, during the anastomosis operation, the broken end of the intestinal tract is everted, the staple cartridge ring 2 is abutted against the anvil ring 1, and then the pusher piece ring 3 is pushed. The broken ends are anastomosed, and at the same time, the excess everted tissue is removed by the circular blade. Tissue grooves (not shown in the figure) are reserved near the anvil ring and the staple cartridge ring near the anvil rod and the staple cartridge rod, and the excised tissues fall into the tissue grooves. In the process of pushing the pusher ring, due to the existence of the pusher ring guard, the force exerted on the pusher rod 12 can be transmitted to the first half ring (that is, the upper half ring in FIG. 20 ) through the pusher ring guard. half ring), so that the force on the whole push nail piece ring is uniform, and the thrust of the first half ring is avoided from being insufficient. Due to the existence of the anvil guard plate 101, the joint of the anvil ring is blocked from the outside, so as to avoid causing the male buckle and the female buckle to disengage under the action of external force, so that the overall stability of the anvil ring is stressed. Guard plate can adopt metal or other hard materials to make.

15, 17, 19 to illustrate how the present invention realizes the unlocking of the buckle through the unlocking lever 10. Since the unlocking rod is located in the anvil rod 14, the corresponding unlocking columns of the anvil ring, the nail bin ring, and the pusher ring must pass through the corresponding rod body and enter the anvil rod. The unlocking post on the anvil rod enters the anvil rod through the hole on the anvil rod, the unlocking post on the nail bin ring 2 passes through the nail bin rod, and then passes through the avoidance groove on the anvil rod to enter the anvil rod, and pushes the staple ring The unlocking column of 3 passes through the nail pusher bar 15, passes through the escape groove 205 on the staple bin bar 16, and enters the staple anvil bar through the escape groove on the nail anvil bar. The unlocking lever shown in Figure 17 has not yet been pushed to the end of the anvil bar (the ring shown in the figure is opened, and it is actually a locked state as shown in Figure 26 during the operation), when the unlocking The rod is pushed to the position shown in Figure 19, and the unlocking rod 10 pushes the unlocking posts of the nail pusher ring, the staple bin ring, and the nail anvil ring to move from the anvil rod to the direction of the nail pusher rod, and the unlocking post will pass through as described above. Unlock the lock between the male buckle and the female buckle by speaking. As shown in Figure 18, the unlocking levers 10 are all located outside the anvil lever. Correspondingly, the unlocking columns corresponding to the anvil ring, the staple bin ring, and the nail pusher ring must pass through the anvil ring to be pushed by the unlocking lever 10. arrive.

Due to the relative displacement along the length direction of the rod body between the staple pusher rod and the staple cartridge rod, and between the staple pusher rod, the staple cartridge rod and the staple anvil rod, when the unlocking post of the staple pusher rod passes through the staple cartridge rod, When entering or passing through the anvil bar, when the unlocking column of the staple cartridge bar enters or passes through the staple anvil bar, it is necessary to set an avoidance groove extending along the length direction of the rod body on the staple cartridge bar and the staple anvil bar (as shown in Figure 15). Position groove 205), so as not to hinder the unlocking posts of the nail pusher ring and the nail bin ring.

As shown in Figure 25, from left to right are the unlocking columns corresponding to the nail pusher ring, nail bin ring, and nail anvil ring. In order to facilitate the smooth push of the unlocking lever to the end of each unlocking column, the present invention uses three The connecting plate 1402 is connected, the end of the connecting plate 1402 is provided with an inclined surface, and the unlocking lever is inserted into the bottom of the connecting plate 1402 through the inclined surface, so that the unlocking column can be easily pushed.

The usage method of the present invention will be described in detail below.

When the anastomat of the present invention is in the initial state, the anvil ring 1, the nail bin ring 2, and the nail pusher ring 3 are perpendicular to the corresponding rod body; the nail anvil ring 1, the nail bin ring 2, and the nail pusher ring 3 are all open loops state, the nail anvil rod lock 7, the staple bin rod lock 8, and the nail pusher rod lock 9 are not locked, and the male buckles 701, 801, 901 are separated from the female buckles 702, 802, 902 (as shown in Figure 20) , the unlocking spring 703, 803, 903 is in the original straight state, so that the unlocking column 704, 804, 904 is in the built-in pop-up state, and the end of the unlocking column is located in the anvil bar (if the unlocking bar is not set in the anvil bar, the end through the anvil bar). The nail bin ring 2, the nail pusher ring 3, and the nail anvil ring 1 keep a certain distance. The unlocking lever 10 is in a retracted state. The free end of the safety bolt 604 leans against the fixed handle, the movable handle rotating shaft 602 of the movable handle 6 is located at the lower end 1506 of the slide groove, and the trigger catch 601 is separated from the gap at the bottom of the pusher piece rod 12 or the protruding part 1201 of the pusher piece rod .

In the following, the intestinal anastomosis is taken as an example, but it is not limited to the intestinal tract, and can be applied to any hollow organs and scenes that can be anastomosed everted. Remove the excess soft tissue around the two ends of the intestinal tract, and suture 1-2 traction wires on the edge of the ends; take out the stapler, the stapler is in the initial state, find a suitable surgical anastomosis site, and insert the male buckles 701, 801, and 901 respectively Female snaps 702, 802, 902 lock synthetic rings. The traction wire at the distal end of the lifting anastomat is penetrated from the outside to the inside by the anvil ring 1, and the intestinal stump at the distal end is everted and fixed on the inner side of the anvil ring 1; similarly, pulling anastomosis The traction wire at the proximal end of the device is penetrated from the outside to the inside by the pusher ring 3 and the staple cartridge ring 2, and the intestinal stump located at the proximal end is everted and fixed on the inner side of the staple cartridge ring 2. After the two broken ends are aligned, turn the knob of the adjusting nut 5 clockwise, and under the interaction between the inner thread of the adjusting nut 5 and the outer thread of the push rod 4, the push rod 4 pushes the nail pusher rod 12 and the nail cartridge rod pusher 401 moves to the far end, the staple cartridge rod pusher 401 drives the staple cartridge rod 13 to move distally, and the staple pusher rod 12 and the staple cartridge rod 13 push the staple pusher ring 3 and the staple cartridge ring 2 to move distally. When the red part of the indicator 1301 appears on the dial 1504, and when the nail bin ring 2 is close to the anvil ring 1 by hand, stop rotating the adjusting nut 5 . Confirm that the two stumps of the intestinal tract are well aligned, evenly distributed, and not detached.

Remove the safety bolt 604 or pull it back and down, squeeze the movable handle 6 backward and down to move closer to the fixed handle 1501, the blocking surface 1507 of the shell 15 blocks the rear end protrusion 613 of the movable handle 6, and move the movable handle 6 forward Squeeze upward, and the rotating shaft 602 of the movable handle moves forward and upward along the sliding groove 1502 of the rotating shaft, and pulls the return spring 603 to give force feedback to the operator during anastomosis.

During the upward movement of the movable handle 6 along the sliding groove of the rotating shaft, the interlocking trigger button 601 moves forward and upward to reach the position of the limit block 605. The limiting block 605 moves forward and upward. When the rotating shaft 602 of the movable handle passes the position of the limiting block 605 smoothly and continues to move forward, the limiting block 605 rebounds to the initial position under the action of the torsion spring 606 of the limiting block, and closes the sliding groove of the rotating shaft again. At this time, the plectrum on the upper end of the trigger catch 601 is just in the gap at the bottom of the pusher rod or behind the protruding part 1201 of the pusher rod. Continue to squeeze the movable handle (it can be pressed continuously, or it can be released first and then pressed), the trigger button 601 pushes the pusher piece rod to move forward, and the pusher piece 403 of the pusher rod pushes the connecting spring 402 to move to the far end, further giving Operator force feedback. The staple pusher rod 12 moves distally relative to the staple cartridge rod 13, and the staple pusher rod 12 pushes the staple pusher ring 3 to move distally relative to the staple cartridge ring 2; the staple pusher 304 pushes the staple 201 to move far away, and Through the tissue, the anastomotic staple 201 is blocked by the anvil ring 1 to form; at the same time, the annular blade 301 penetrates and excises excess peripheral intestinal tissue.

Pushing the unlocking push block 11 forward drives the unlocking lever 10 to move distally, and the unlocking lever 10 squeezes the unlocking posts 704, 804, 904. The unlocking posts 704, 804, 904 squeeze the front male buckles 701, 801, 901, and after hearing three "clicks", consider that the male buckles 701, 801, 901 are separated from the female buckles 702, 802, 902. Rotate the second half-ring 104, 204, 306 outward from the first half-ring 103, 203, 305 by using items such as surgical forceps, and remove the stapler. If the annular blade 301 fails to completely remove the excess intestinal tissue, the operator can use other surgical instruments to remove the excess tissue and send it to the anastomotic stoma for histopathological examination, or to reinforce the suture with sutures.

During the anastomosis, when the safety plug 604 is to be removed, and before the anastomosis is planned, it is found that the alignment of the two ends of the intestinal tract is not good, or the tissue distribution is uneven, or there is shedding; at this time, it is necessary to roll back the pusher rod 12 and the staple cartridge Rod 13, re-alignment of the intestinal stump. Then, the adjusting nut 5 is rotated counterclockwise, and under the interaction between the internal thread of the adjusting nut 5 and the external thread of the advancing rod 4, the advancing rod 4 drives the nail pusher rod, the staple cartridge rod push piece 401, and the staple cartridge rod 13 to move proximally. The staple pusher rod 12 and the staple cartridge rod 13 pull the staple pusher ring 3 and the staple cartridge ring 2 to move proximally. When the operator visually inspects that the distance between the staple cartridge ring 2 and the anvil ring 1 is sufficient, the two stumps of the intestinal tract are readjusted, and the anastomosis process is repeated, which will not be repeated here.

In the present invention, in order to ensure the balance of force transmission during the anastomosis and the reliability of anastomosis, it is suggested that metals and other materials with strong hardness should be selected to design and manufacture corresponding components.

The foregoing is only a preferred embodiment of the present invention, and is not intended to limit the present invention. For those skilled in the art, the present invention can have various modifications and changes; within the spirit and principles of the present invention, Any modifications, equivalent replacements, improvements, etc., should be included within the protection scope of the present invention.

Claims (10)

1. A firing mechanism for a stapler, which is arranged on the shell of the stapler, and the bottom of the shell is a fixed handle, which is characterized in that: the front end of the fixed handle is provided with a rotatable movable handle; the inner wall of the shell is provided with The sliding groove of the rotating shaft extending above the front, the rotating shaft of the movable handle is arranged in the sliding groove of the rotating shaft, the rear end protrusion of the upper rear end of the movable handle is in contact with the blocking surface of the inner wall of the housing; it moves close to the rotating shaft At the upper end of the groove, a rotatable limit block is also arranged in the housing, and the limit block divides the sliding groove of the rotating shaft into two sections; when the movable handle is pressed, the movable handle moves forward along the sliding groove of the rotating shaft Move upward until the limit block is pushed away and reaches the upper end of the sliding groove of the rotating shaft. The limit block returns to its original position under the action of the limit block reset mechanism. Continue to press the movable handle, and the trigger buckle on the top of the movable handle pushes to fit The pusher lever of the pusher moves forward. 2. The firing mechanism for a stapler according to claim 1, characterized in that: the sliding groove of the rotating shaft is in a downward arc shape; or the sliding groove of the rotating shaft is in an inverted L shape, and the lower part of the inverted L shape is arc-shaped, The limit block is set near the inverted L-shaped corner, and the limit block divides the arc into two sections under the action of the limit block reset mechanism. When the limit block is pushed by an external force, , the limit block enters the inverted L-shaped corner. 3. The firing mechanism for a stapler according to claim 1, wherein the trigger button is in the shape of a bird's beak. 4. The firing mechanism for a stapler according to claim 1, 2 or 3, characterized in that: the limiting block reset mechanism is a torsion spring. 5. The firing mechanism for a stapler according to claim 1, 2 or 3, characterized in that: the rear upper end of the movable handle is provided with a second mounting column, which is located behind the second mounting column, and the inner wall of the housing is provided with a second mounting column. There is a first mounting column, and the two ends of the return spring are installed on the first mounting column and the second mounting column respectively. 6. The firing mechanism for a stapler according to claim 1, 2 or 3, characterized in that: a safety bolt is provided between the fixed handle and the movable handle, and the rotating end of the safety bolt is arranged on the movable handle, The free end of the safety bolt abuts against the fixed handle. 7. The firing mechanism for a stapler according to claim 1, 2 or 3, wherein the bottom of the pusher rod has a gap, and when the rotating shaft of the movable handle reaches the upper end of the movable groove of the rotating shaft, the movable handle The trigger buckle of the movable handle is inserted into the gap; or the bottom of the pusher rod has a protrusion of the pusher rod. When the rotating shaft of the movable handle reaches the upper end of the movable groove of the rotating shaft, the trigger catch of the movable handle passes through the pusher The rod protrusion pushes the pusher blade rod to move forward. 8. The firing mechanism for a stapler according to claim 1, 2 or 3, characterized in that: the rear end of the stapler bar of the stapler is provided with a stapler bar pusher, and the stapler bar pushes out from the stapler bar. The through hole on the push piece passes through, and when the stapler staple cartridge ring abuts against the anvil ring, the trigger buckle can push the staple push piece rod to move forward relative to the staple cartridge rod push piece. 9. The firing mechanism for a stapler according to claim 8, characterized in that: the nail pusher rod is provided with a pusher of the nail pusher, and the setting between the pusher of the nail pusher and the pusher of the staple cartridge rod There is a connecting spring, and the distance between the pushing piece of the nail pushing rod and the pushing piece of the staple cartridge rod is greater than or equal to the staple height of the staples. 10. The firing mechanism for a stapler according to claim 9, characterized in that: a connecting rod is arranged between the pushing piece of the nail pushing rod and the pushing piece of the magazine rod, and one end of the connecting rod is fixed on the pushing piece of the pushing rod. The other end is inserted on the push piece of the staple cartridge rod, and can move relative to the push piece of the staple cartridge rod, and the connecting spring is sleeved on the connecting rod.

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