The purpose of this invention is to provide a kind of novel anastomose esophagus stomach operating theater instruments, use this apparatus not leave over suture material at the anastomotic stoma place, anastomotic stoma is coincide tight, thereby helps preventing the generation of fistula of operative incision and anastomotic stricture.
The present invention is achieved in that
It by body, handle, throw-out collar mechanism, put pipe (stay pipe) mechanism and form, put pipe and work asynchronously with throw-out collar.
Using this apparatus to carry out the ultimate principle that elastic force ring is pricked in the esophagogastric cavity is that esophageal wall and coat of the stomach are pricked on the intracavity stay pipe (referring to Fig. 2) with the latex ring.Because the elastic force effect of latex ring makes esophageal wall closely paste mutually with coat of the stomach, therefore prick the position anastomotic stoma and heal gradually like this at ring.Prick below the position owing to degeneration, necrosis take place ischemia at ring.The latex ring has been attached on the stay pipe after healing is finished, because action of gravity and esophagus, gastric peristalsis make stay pipe and slough drop to gastric by anastomotic position thereupon, excretes with stool at last.
The invention will be further described below in conjunction with drawings and Examples:
In Fig. 1, the body of this setting-ring instrument is made up of device body 24, device head 9, and device is as tubular, and there is fixed handle its rear end.The front end of device head 9 is the ladder tubulose, and the rear end is a conical pipe, and conical pipe one end connects with device body 24, and present embodiment is that device head 9 is installed back spot welding, polishing with device body 24.
The throw-out collar mechanism of setting-ring instrument is made up of throw-out collar 5, ejector sleeve 10, back-moving spring 12, slide block 13,flexible handle 21, bumper bar 20, spring leaf 18.Slide block 13, back-moving spring 12, ejector sleeve 10 are contained in the body intracavity, thread connection is used with slide block 13 in ejector sleeve 10 cover upper reset springs 12 backs, throw-out collar 5 is enclosed within the ladder tube outside of device head 9, and it connects with ejector sleeve 10 by screw 8, and screw 8 can slide in the slotted eye of device head 9.Flexible handle 21 is fixed on the device body 24 by branchia shaft screw 22, and the plush copper offlexible handle 21 upper ends can drive slide block 13 and move.Spring leaf 18 and bumper bar 20 are fixed on the fixed handle by screw 19 and bearing pin 14 respectively, when bumper bar 20 is positioned at safety position, and lockingflexible handle 21.
Its pipe (stay pipe) mechanism of putting lays head by fixed bar 11, stay pipe and forms, and stay pipe is laid and is made up of sleeve 28, X-shaped support 29, half-cylindrical fixed block 4, spring 6.Leaded 1 of sleeve 28 front end, rear end connect with fixed bar 11 usefulness screws 7.X-shaped support 29 and half-cylindrical fixed block 4 are fixed in the sleeve 28 by bearing pin 3, and the solid pipe button 2 of X-shaped support front end is inserted in the inner groove ofstay pipe 26 by the hole of sleeve 28, and the rear end of X-shaped support is supported by spring 6, and has contact to expose outside telescopic hole.When ejector sleeve 10 travels forward, can press the contact of X-shaped support, and compression spring 6 makes the stay pipe inner groove deviate from the solid pipe button 2 of X-shaped support, thereby reach throw-out collar and put stay pipe synchronous working.Fixed bar 11 rear ends connect with adjusting nut 16, and device body 24 back seats are equipped with hollow nut 15.Be with ring washer 17 on the adjusting nut 16 being in, skid off backward to prevent adjusting nut near the left side of hollow nut 15.At the fixed bar postmedian one tangent plane is arranged, have a positioning block 23 to match in the left side of slide block 13, rotate to prevent fixed bar with above-mentioned tangent plane.
Can load onto collar awl 27 at device head 9 front ends of setting-ring instrument, it is shaped as the umbrella taper, and several (4-6) guide grooves are arranged on the male cone (strobilus masculinus).The external diameter of collar awl and the internal diameter of device head 9 are for movingly.The latex ring can be used the conical surface guider head 9 front end places of ring pawl along collar awl, put the latex ring after, again at throw-out collar 5 front end sleeve upper jackets 25.Collar awl can take off the latex ring after first-class.
This implement body parts are by 1Cr 13 rustless steel manufacturings.Stay pipe is by the nylon 1010 manufacturing, and the latex ring is made by the medical infusion latex tubing.
Below in conjunction with Fig. 3 the using method of this apparatus is made brief description:
After the esophageal neoplasm excision, with silkthread stomach tube 31 and lead riser 1 are coupled together, earlier the fixed bar 11 that stay pipe is housed is pushed in theesophagus 32 again, with the lotus colo(u)r streak esophagus is tied on the fixed bar, make the stay pipe lower edge just on this line.Onstomach 33, wear an aperture, make the tail end of fixed bar enter gastral cavity, and stretch out fromcardia 34 broken ends of fractured bone through the aperture of stomach.Carrying stomach again makes it near the esophagus broken ends of fractured bone.And then stretch into setting-ring instrument main body 35(except that fixed bar) from the cardia broken ends of fractured bone of stomach, on push away the setting-ring instrument main body, make it near the esophagus broken ends of fractured bone, rotate adjusting nut 16 this moment, make fixed bar to giving allocation (being side opening 30 centers of fixed bar tail end) to adjusting nut 16, put intra-annular flexible handle with holding this moment, just the latex ring can be placed anastomose esophagus stomach position (see figure 2).33 is stomach among Fig. 2, and 36 is the latex ring.