技术领域technical field
本发明涉及医疗器械技术领域，尤其涉及一种组织闭合装置、组织闭合组件及配有该组织闭合组件的医疗器械。The invention relates to the technical field of medical devices, in particular to a tissue closure device, a tissue closure component and a medical device equipped with the tissue closure component.
背景技术Background technique
在现有的消化道的吻合术中，一般是先使用直线型或者弧线形吻合器对管状器官进行离断吻合，再使用圆管型吻合器进行对离断的组织进行对接吻合。这样，当使用直线型或者弧线形吻合器对管状器官进行离断吻合后，由于吻合口是线状的，这样再使用圆管型吻合器吻合时会存在猫耳朵，有瘘的风险，而且手术成本高。In the existing anastomosis of the digestive tract, it is generally first to use a linear or arc-shaped stapler to separate and anastomose the tubular organ, and then to use a round-shaped stapler to perform butt anastomosis on the severed tissue. In this way, when a linear or arc-shaped stapler is used to anastomose a tubular organ, since the anastomosis is linear, there will be cat ears when the circular stapler is used for anastomosis, and there is a risk of fistula. Surgery costs are high.
发明内容Contents of the invention
本发明的目的在于提供一种组织闭合装置、组织闭合组件及配有该组织闭合组件的医疗器械。The object of the present invention is to provide a tissue closure device, a tissue closure component and a medical device equipped with the tissue closure component.
为实现上述发明目的之一，本发明一实施方式提供一种组织闭合装置，包括底座、与底座配合的压板，以及推钉块，其中所述压板设置为可相对所述底座转动，其包括一打开位置和一闭合位置，当所述压板位于闭合位置时，所述压板和所述底座配合形成一可容置部分管状组织的第一容置空间；所述推钉块包括一初始位置、一钉闭合位置和一拉回位置，所述初始位置位于所述钉闭合位置和所述第一容置空间的近端，所述拉回位置位于所述初始位置和钉闭合位置之间；所述组织闭合装置还包括置钉部，所述置钉部设置于所述底座远端且用于放置切刀，当所述推钉块从钉闭合位置向拉回位置移动时，所述推钉块与所述切刀配合以驱动切刀从所述底座远端向近端移动以切断组织。In order to achieve one of the objectives of the above invention, an embodiment of the present invention provides a tissue closure device, which includes a base, a pressing plate matched with the base, and a nail pushing block, wherein the pressing plate is set to be rotatable relative to the base, which includes a An open position and a closed position, when the press plate is in the closed position, the press plate and the base cooperate to form a first accommodating space that can accommodate part of the tubular tissue; the push nail block includes an initial position, a A nail closed position and a pull-back position, the initial position is located at the proximal end of the nail closed position and the first accommodating space, and the pull-back position is located between the initial position and the nail closed position; the The tissue closure device also includes a nail setting part, which is arranged at the distal end of the base and is used for placing a cutter. When the nail pushing block moves from the nail closing position to the pulling back position, the nail pushing block Cooperate with the cutter to drive the cutter to move from the distal end to the proximal end of the base to cut tissue.
作为本发明实施方式的进一步改进，所述置钉部还用于放置至少一个闭合钉，所述推钉块和所述置钉部设置为可配合地驱使位于置钉部的闭合钉成型的结构，所述推钉块由近端向远端驱动所述闭合钉成型时，所述切刀相对于所述置钉部固定不动，从而不切割组织。As a further improvement of the embodiment of the present invention, the nail setting part is also used to place at least one closing nail, and the nail pushing block and the nail setting part are set to a structure that can cooperatively drive the closing nail located at the nail setting part to form , when the nail pushing block drives the closure nail from the proximal end to the distal end to form, the cutting knife is fixed relative to the nail setting part, so as not to cut tissue.
作为本发明实施方式的进一步改进，所述闭合钉设置为两个，且所述两个闭合钉分别位于所述切刀的两侧。As a further improvement of the embodiment of the present invention, there are two closure nails, and the two closure nails are respectively located on both sides of the cutter.
作为本发明实施方式的进一步改进，所述置钉部设有台阶，以限制所述闭合钉向近端方向移动，当所述推钉块与所述切刀配接并驱动所述切刀向近端移动时，所述闭合钉相对于所述置钉部保持不动。As a further improvement of the embodiment of the present invention, the nail setting part is provided with a step to limit the movement of the closure nail in the proximal direction. When the nail pushing block is matched with the cutter and drives the cutter When the proximal end is moved, the closure nail remains stationary relative to the nail setting portion.
作为本发明实施方式的进一步改进，所述推钉块具有用于所述闭合钉成型的钉成型槽和用于压缩组织的侧壁，所述侧壁高于所述钉成型槽。As a further improvement of the embodiment of the present invention, the nail pushing block has a nail forming groove for forming the closed nail and a side wall for compressing tissue, and the side wall is higher than the nail forming groove.
作为本发明实施方式的进一步改进，所述推钉块位于所述侧壁之间设有中壁，所述中壁低于所述侧壁。As a further improvement of the embodiment of the present invention, the pusher block is provided with a middle wall between the side walls, and the middle wall is lower than the side walls.
作为本发明实施方式的进一步改进，所述中壁具有弧形凹空部。As a further improvement of the embodiment of the present invention, the middle wall has an arc-shaped hollow.
作为本发明实施方式的进一步改进，所述切刀包括用于切断组织的切割部，及分别位于所述切割部的相对两侧且与所述切割部相连接的第一连接部和第二连接部，所述第一连接部和第二连接部可选择地与所述推钉块脱开或配接。As a further improvement of the embodiment of the present invention, the cutter includes a cutting portion for cutting tissue, and a first connecting portion and a second connecting portion respectively located on opposite sides of the cutting portion and connected to the cutting portion part, the first connecting part and the second connecting part can be selectively disengaged from or mated with the push nail block.
作为本发明实施方式的进一步改进，所述切割部上设有用于将底组织切断的戟刃，所述戟刃具有尖端部。As a further improvement of the embodiment of the present invention, the cutting part is provided with a halberd blade for cutting the underlying tissue, and the halberd blade has a tip.
作为本发明实施方式的进一步改进，所述切割部上还设有用于滑动切断侧壁组织的斜刃，所述斜刃沿曲线延伸，且所述斜刃与所述戟刃平滑连接，所述斜刃设置为两个，且所述两个斜刃分布于所述戟刃的两侧。As a further improvement of the embodiment of the present invention, the cutting part is also provided with an oblique blade for slidingly cutting off the side wall tissue, the oblique blade extends along a curve, and the oblique blade is smoothly connected with the halberd blade, the There are two inclined blades, and the two inclined blades are distributed on both sides of the halberd blade.
作为本发明实施方式的进一步改进，所述第一连接部和第二连接部上均设有配接部，所述推钉块具有可选择地与所述配接部配接或脱开的接合部。As a further improvement of the embodiment of the present invention, the first connecting part and the second connecting part are provided with fitting parts, and the pusher block has a joint that can be selectively mated with or disengaged from the fitting parts. department.
作为本发明实施方式的进一步改进，所述配接部为卡扣，所述接合部为突起。As a further improvement of the embodiment of the present invention, the fitting part is a buckle, and the engaging part is a protrusion.
作为本发明实施方式的进一步改进，所述切刀具有配接部，所述推钉块具有可选择地与所述配接部配接或脱开的接合部，当所述推钉块从钉闭合位置向拉回位置移动时，所述配接部与所述接合部配接以使所述推钉块驱动切刀从所述底座远端向近端移动以切断组织，当所述推钉块从初始位置向钉闭合位置移动时，所述配接部与所述接合部脱开。As a further improvement of the embodiment of the present invention, the cutter has a fitting portion, and the nail pushing block has an engaging portion that can be selectively mated with or disengaged from the fitting portion. When the closed position moves to the retracted position, the matching part is matched with the engaging part so that the nail pushing block drives the cutter to move from the distal end of the base to the proximal end to cut off the tissue. The mating portion is disengaged from the engaging portion as the block moves from the initial position to the staple closed position.
作为本发明实施方式的进一步改进，所述配接部为卡扣，所述接合部为突起。As a further improvement of the embodiment of the present invention, the fitting part is a buckle, and the engaging part is a protrusion.
为实现上述发明目的之一，本发明一实施方式提供一种组织闭合组件，其中所述组织闭合组件包括上述任一项技术方案所述的组织闭合装置，以及可装配至所述组织闭合装置的切刀，在闭合过程中，当所述推钉块处于初始位置和由近端向远端移动时，所述切刀与所述推钉块脱开，当所述推钉块处于钉闭合位置和由远端向近端移动时，所述推钉块与所述切刀配合以驱动切刀从所述底座远端向近端移动以切断组织。To achieve one of the objectives of the above invention, an embodiment of the present invention provides a tissue closure assembly, wherein the tissue closure assembly includes the tissue closure device described in any of the above technical solutions, and a tissue closure device that can be assembled to the tissue closure device. The cutting knife, during the closing process, when the nail pushing block is in the initial position and moves from the proximal end to the distal end, the cutting knife is disengaged from the nail pushing block, and when the nail pushing block is in the nail closing position And when moving from the distal end to the proximal end, the nail pushing block cooperates with the cutting knife to drive the cutting knife to move from the distal end of the base to the proximal end to cut tissue.
作为本发明实施方式的进一步改进，所述组织闭合组件还包括可装配至所述组织闭合装置的闭合钉，在闭合过程中，当所述推钉块位于初始位置时，所述闭合钉的自由端与所述推钉块相对，当所述推钉块位于钉闭合位置时，所述闭合钉的自由端受所述推钉块作用弯折成型。As a further improvement of the embodiment of the present invention, the tissue closure assembly further includes closure nails that can be assembled to the tissue closure device. The end is opposite to the nail pushing block, and when the nail pushing block is at the nail closing position, the free end of the closing nail is bent and shaped by the nail pushing block.
为实现上述发明目的之一，本发明一实施方式提供一种医疗器械，包括器械本体、连接所述器械本体的击发把手，其中所述医疗器械还包括上述任一项技术方案所述的组织闭合装置，所述组织闭合装置可拆装地连接所述器械本体。In order to achieve one of the objectives of the above invention, an embodiment of the present invention provides a medical device, including a device body and a firing handle connected to the device body, wherein the medical device also includes the tissue closure described in any one of the above technical solutions device, the tissue closure device is detachably connected to the instrument body.
与现有技术相比，本发明的有益效果在于：设有切刀，且当所述推钉块从钉闭合位置向拉回位置移动时，所述推钉块与所述切刀配合以驱动切刀从所述底座远端向近端移动以切断组织。该发明操作简单、使用方便，进一步减少了手术成本。Compared with the prior art, the present invention has the beneficial effect that: a cutting knife is provided, and when the nail pushing block moves from the nail closing position to the pull-back position, the nail pushing block cooperates with the cutting knife to drive A knife moves proximally from the distal end of the base to sever tissue. The invention is simple in operation and convenient in use, and further reduces operation cost.
附图说明Description of drawings
图1是本发明一实施方式中医疗器械的立体示意图；Fig. 1 is a three-dimensional schematic diagram of a medical device in an embodiment of the present invention;
图2是本发明一实施方式中组织闭合组件的立体示意图，此时压板处于闭合位置；Fig. 2 is a three-dimensional schematic diagram of the tissue closure assembly in an embodiment of the present invention, at this time the pressing plate is in the closed position;
图3是本发明一实施方式中组织闭合组件的另一立体示意图，此时去除护片，且压板处于闭合位置；Fig. 3 is another three-dimensional schematic view of the tissue closure assembly in an embodiment of the present invention, at this time, the protective sheet is removed, and the pressing plate is in the closed position;
图4是本发明一实施方式中组织闭合组件的立体分解图；Fig. 4 is a three-dimensional exploded view of the tissue closure assembly in one embodiment of the present invention;
图5是本发明一实施方式中组织闭合组件的另一立体示意图，此时压板处于打开位置；Fig. 5 is another perspective view of the tissue closure assembly in an embodiment of the present invention, at this time the pressing plate is in the open position;
图6a是本发明一实施方式中组织闭合组件的推钉块处于初始位置的剖视图；Fig. 6a is a cross-sectional view of the nail pushing block of the tissue closure assembly in an initial position according to an embodiment of the present invention;
图6b是本发明一实施方式中组织闭合组件的推钉块由初始位置向钉闭合位置运动过程中的剖视图；Fig. 6b is a cross-sectional view of the nail pushing block of the tissue closure assembly moving from the initial position to the nail closing position in one embodiment of the present invention;
图6c是本发明一实施方式中组织闭合组件的推钉块到达钉闭合位置的剖视图；Fig. 6c is a cross-sectional view of the nail pushing block of the tissue closure assembly reaching the nail closing position in one embodiment of the present invention;
图6d是本发明一实施方式中组织闭合组件的推钉块由钉闭合位置向拉回位置运动过程中的剖视图；Fig. 6d is a cross-sectional view of the nail pushing block of the tissue closure assembly moving from the nail closing position to the retracting position in one embodiment of the present invention;
图7是本发明一实施方式中推钉块的立体示意图；Fig. 7 is a three-dimensional schematic diagram of a push nail block in an embodiment of the present invention;
图8是本发明一实施方式中切刀的立体示意图；Fig. 8 is a three-dimensional schematic diagram of a cutter in an embodiment of the present invention;
图9a是本发明一实施方式中闭合钉的立体示意图；Fig. 9a is a schematic perspective view of a closure nail in an embodiment of the present invention;
图9b是图9a所示的闭合钉的主视图；Figure 9b is a front view of the closure nail shown in Figure 9a;
图9c是图9a所示的闭合钉弯折后的立体示意图；Fig. 9c is a schematic perspective view of the closed nail shown in Fig. 9a after being bent;
图10a是本发明第二实施方式中闭合钉的立体示意图；Fig. 10a is a schematic perspective view of a closure nail in a second embodiment of the present invention;
图10b是图10a所示的闭合钉的主视图；Figure 10b is a front view of the closure nail shown in Figure 10a;
图11a是本发明第三实施方式中闭合钉的主视图；Figure 11a is a front view of a closure nail in a third embodiment of the present invention;
图11b是图11a所示的闭合钉弯折后的主视图；Figure 11b is a front view of the closure nail shown in Figure 11a after being bent;
图12a是本发明第四实施方式中闭合钉的主视图；Figure 12a is a front view of a closure nail in a fourth embodiment of the present invention;
图12b是图12a所示的闭合钉弯折后的主视图；Figure 12b is a front view of the closure nail shown in Figure 12a after being bent;
图13a是本发明第五实施方式中闭合钉的主视图；Fig. 13a is a front view of a closure nail in a fifth embodiment of the present invention;
图13b是图13a所示的闭合钉弯折后的主视图。Figure 13b is a front view of the closure nail shown in Figure 13a after being bent.
具体实施方式Detailed ways
以下将结合附图所示的具体实施方式对本发明进行详细描述。但这些实施方式并不限制本发明，本领域的普通技术人员根据这些实施方式所做出的结构、方法、或功能上的变换均包含在本发明的保护范围内。The present invention will be described in detail below in conjunction with specific embodiments shown in the accompanying drawings. However, these embodiments do not limit the present invention, and any structural, method, or functional changes made by those skilled in the art according to these embodiments are included in the protection scope of the present invention.
为清楚地表达本发明内所描述的位置与方向，以器械操作者作为参照，靠近操作者的一端为近端，远离操作者的一端为远端。拉回位置为闭合钉达到闭合位置后，由远端向近端运动过程中初始位置与钉闭合位置中间的位置。In order to clearly express the positions and directions described in the present invention, the operator of the instrument is used as a reference, the end close to the operator is the proximal end, and the end far away from the operator is the distal end. The pull-back position is the middle position between the initial position and the closed position of the nail in the process of moving from the distal end to the proximal end after the closing nail reaches the closed position.
如图1所示，本发明公开了一种医疗器械的实施方式，医疗器械可用于消化道的吻合手术中，其包括器械本体10，枢轴连接于器械本体10的击发把手12，以及可拆装地连接器械本体10的组织闭合装置14。一般地，组织闭合装置14设置于器械本体10的远端。As shown in FIG. 1 , the present invention discloses an embodiment of a medical device. The medical device can be used in the anastomosis operation of the digestive tract, which includes a device body 10, a firing handle 12 pivotally connected to the device body 10, and a detachable The tissue closure device 14 is groundedly connected to the instrument body 10. Generally, the tissue closure device 14 is disposed at the distal end of the instrument body 10 .
器械本体10的结构，可沿用现有的直线型或弧线形吻合器的器械本体结构，也可以单独设计，可以理解的是，该器械本体10的结构只要能够配合组织闭合装置14工作即可。在以下说明中，将以现有的直线型或弧线型吻合器的器械本体结构作为本实施方式中的器械本体10结构进行说明。The structure of the instrument body 10 can follow the instrument body structure of the existing linear or arc-shaped stapler, or can be designed separately. It can be understood that the structure of the instrument body 10 can be used as long as it can cooperate with the tissue closure device 14 to work. . In the following description, the structure of the instrument body 10 in this embodiment will be described using the instrument body structure of a conventional linear or curved stapler.
另外，在本发明还公开了一种组织闭合组件的实施方式，组织闭合组件包括了组织闭合装置14以及可装配至组织闭合装置14的闭合钉16。组织闭合装置14和闭合钉16的结构和使用方式将在下述进行详细说明。In addition, the present invention also discloses an embodiment of a tissue closure assembly, which includes a tissue closure device 14 and a closure staple 16 that can be assembled to the tissue closure device 14 . The structure and usage of the tissue closure device 14 and closure staples 16 will be described in detail below.
如图2、图3、图4和图5所示，组织闭合装置14包括连接部18，底座20、与底座20配合的压板22、推钉块24，以及置钉部26。As shown in FIG. 2 , FIG. 3 , FIG. 4 and FIG. 5 , the tissue closure device 14 includes a connecting portion 18 , a base 20 , a pressing plate 22 matched with the base 20 , a nail pushing block 24 , and a nail setting portion 26 .
其中，连接部18用于连接器械本体10。底座20设置于连接部18的远端，其可以和连接部18一体成形。Wherein, the connecting portion 18 is used for connecting the instrument body 10 . The base 20 is disposed on the distal end of the connecting portion 18 , and can be integrally formed with the connecting portion 18 .
本优选实施例中，压板22可枢轴的连接底座20，以使压板22可相对底座20转动。其中，置钉部26设置于底座20的远端。In this preferred embodiment, the pressing plate 22 is pivotally connected to the base 20 so that the pressing plate 22 can rotate relative to the base 20 . Wherein, the nail setting portion 26 is disposed at the distal end of the base 20 .
进一步地，置钉部26与底座20一体成型且置钉部26的内侧底壁与底座20的内侧底壁通过弧面或斜面平滑过渡。Further, the nail setting portion 26 is integrally formed with the base 20 , and the inner bottom wall of the nail setting portion 26 and the inner bottom wall of the base 20 smoothly transition through an arc or an inclined surface.
在本实施方式中，置钉部26的横截面设置为U型。In this embodiment, the cross-section of the nail setting portion 26 is set to be U-shaped.
进一步地，压板22包括一打开位置和一闭合位置，例如压板22枢轴转动的两个极限位置或接近极限位置（因机械配合出现的误差导致的），当压板22位于闭合位置时，压板22和底座20可配合形成一用于容置部分管状组织的第一容置空间30，该第一容置空间30为两端开口的空腔。在手术时，可在打开位置时纳入管状组织（例如肠道等），在闭合位置部分管状组织位于压板22和底座20之间。Further, the pressure plate 22 includes an open position and a closed position, for example, two limit positions of the pivot rotation of the pressure plate 22 or close to limit positions (caused by errors in mechanical fit). When the pressure plate 22 is in the closed position, the pressure plate 22 It can cooperate with the base 20 to form a first accommodating space 30 for accommodating part of the tubular tissue, and the first accommodating space 30 is a cavity with two ends open. During surgery, tubular tissue (such as intestinal tract, etc.) can be included in the open position, and part of the tubular tissue is located between the platen 22 and the base 20 in the closed position.
在本发明一实施方式中，置钉部26形成有一第二容置空间32，第二容置空间32和第一容置空间30连通，即第二容置空间32的开口朝向推钉块24，其中，第二容置空间32的高度大于第一容置空间30的高度，即是底座20到压板22的距离小于第二容置空间32开口的口径。In one embodiment of the present invention, the nail setting portion 26 forms a second accommodating space 32, and the second accommodating space 32 communicates with the first accommodating space 30, that is, the opening of the second accommodating space 32 faces the nail pushing block 24. , wherein the height of the second accommodating space 32 is greater than the height of the first accommodating space 30 , that is, the distance from the base 20 to the pressing plate 22 is smaller than the opening diameter of the second accommodating space 32 .
进一步地，置钉部26还可用于放置至少一个闭合钉16。推钉块24和置钉部26设置为可配合地驱使位于置钉部26内的闭合钉16成型的结构。Further, the nail setting portion 26 can also be used to place at least one closure nail 16 . The nail pushing block 24 and the nail setting portion 26 are configured to cooperatively drive the closure nail 16 inside the nail setting portion 26 to form.
另外，组织闭合组件还包括装配至组织闭合装置14的切刀31，置钉部26设置于底座20远端且用于放置切刀31。In addition, the tissue closure assembly further includes a cutter 31 assembled to the tissue closure device 14 , and the nail setting portion 26 is disposed at the distal end of the base 20 and is used for placing the cutter 31 .
如图4所示，本优选实施例中，置钉部26一次能放入两个闭合钉16。具体的，两个闭合钉16分别位于切刀31的两侧。这样，可以同时对组织形成两个集束荷包。当然，也可以设置成，置钉部26一次只能放入一个闭合钉16，或放入两个以上的闭合钉16。相应地，第二容置空间32包括至少一个置钉槽（未图示），置钉槽可由置钉部26内壁形成，也可设置于置钉部26的内壁上。As shown in FIG. 4 , in this preferred embodiment, the nail setting portion 26 can put two closure nails 16 at a time. Specifically, the two closure nails 16 are respectively located on both sides of the cutter 31 . In this way, two bundled wallets can be formed on the organization at the same time. Of course, it can also be set that the nail setting portion 26 can only put one closing nail 16 at a time, or put more than two closing nails 16 . Correspondingly, the second accommodating space 32 includes at least one nail-setting slot (not shown in the figure), and the nail-setting slot can be formed by the inner wall of the nail-setting portion 26 or can be arranged on the inner wall of the nail-setting portion 26 .
进一步地，组织闭合装置14还包括钉匣，钉匣与置钉部26的置钉槽连通，钉匣中设有推钉结构（例如复位弹簧），以将钉匣中的闭合钉16填装至置钉槽中，即可实现当置钉槽中无闭合钉16时（例如击发完毕，组织被取出后），自动将下一颗闭合钉16填装到置钉槽321中。Further, the tissue closure device 14 also includes a nail box, the nail box communicates with the nail setting groove of the nail setting part 26, and a nail pushing structure (such as a return spring) is provided in the nail box to fill the closing nails 16 in the nail box. In the nail slot, it can be realized that when there is no closing nail 16 in the nail slot (for example, after the firing is completed and the tissue is taken out), the next closing nail 16 is automatically filled into the nail slot 321.
进一步地，钉匣设置于置钉部26内，如设置于与置钉部26开口相对的置钉部26的本体内。当然，该钉匣也可以活动连接置钉部26，以方便更换和填装闭合钉16。Further, the nail magazine is arranged in the nail setting part 26 , for example, in the body of the nail setting part 26 opposite to the opening of the nail setting part 26 . Of course, the nail box can also be flexibly connected to the nail part 26 to facilitate replacement and filling of the closing nail 16 .
另外，在底座20的远端还设有护片44（参见图5），这样，在纳入组织及医生在调整位置时，不会接触到闭合钉16和切刀31，从而不会造成伤害。其中，初始时，护片44包覆在远端缺口处，当推钉块24从初始位置向钉闭合位置移动的过程中，随着组织的压缩，护片44被收紧并被挤压到邻近置钉部26的远端。本优选实施例中，护片44的材料为弹性薄膜。In addition, a shield 44 is provided at the far end of the base 20 (see FIG. 5 ), so that when the tissue is taken in and the doctor is adjusting the position, the closing nail 16 and the cutter 31 will not be touched, thereby causing no injury. Wherein, initially, the protective sheet 44 is covered at the notch at the distal end, and when the nail pushing block 24 moves from the initial position to the nail closed position, as the tissue is compressed, the protective sheet 44 is tightened and squeezed to the Adjacent to the distal end of the nail setting portion 26 . In this preferred embodiment, the material of the protective sheet 44 is an elastic film.
再者，推钉块24的具体形状不做限定，只要其能配合置钉部26驱使闭合钉16成型完成对组织的闭合即可。在一种方式中的推钉块24的远端端面设置为平面状的成型槽，如此，当推钉块24由初始位置向钉闭合位置移动的过程中（如6c所示），设于第一容置空间30内的管状组织逐渐向第二容置空间32收拢，并最终全部容纳于第二容置空间32内。可以理解的是，在手术时，当推钉块24处于初始位置时，无论第一容置空间30内和第二容置空间32内均放置有管状组织，还是仅在第一容置空间30内放置有管状组织，当推钉块24由初始位置向钉闭合位置运动过程中，设于第一容置空间30的管状组织都将被推进第二容置空间32内，以便在推钉块24到达钉闭合位置时，对第二容置空间32内收拢的管状组织打集束荷包。Furthermore, the specific shape of the nail pushing block 24 is not limited, as long as it can cooperate with the nail setting part 26 to drive the closure nail 16 to form and complete the closure of the tissue. In one mode, the distal end surface of the pusher block 24 is set as a planar shaped groove, so that when the pusher block 24 moves from the initial position to the nail closed position (as shown in 6c), it is set at the second The tubular tissues in the first accommodating space 30 gradually converge toward the second accommodating space 32 , and are finally all contained in the second accommodating space 32 . It can be understood that, during the operation, when the pusher block 24 is in the initial position, regardless of whether there are tubular tissues placed in the first accommodating space 30 and the second accommodating space 32, or only in the first accommodating space 30 Tubular tissue is placed inside, and when the nail pushing block 24 moves from the initial position to the nail closed position, the tubular tissue set in the first accommodation space 30 will be pushed into the second accommodation space 32, so that the nail pushing block When 24 reaches the closed position of the nail, the bundled purse is applied to the gathered tubular tissue in the second accommodating space 32 .
在另一种方式中的推钉块24的远端端面可设置为弧形的成型槽。如此，当推钉块24从初始位置向钉闭合位置运动过程中，成型槽的弧形端部首先与闭合钉16接触，并在推钉块24持续的移动中给闭合钉16的开放端施加压力，使闭合钉16的开放端弯折，对收拢的管状组织打集束荷包。其中，成型槽可形成第三容置空间34，以容置部分管状组织，当推钉块24到达钉闭合位置时，第三容置空间34可在组件闭合装置的轴向上封闭第二容置空间32，增加了管状组织的收容空间大小。可以理解的是，第三容置空间34实为第一容置空间30的一部分。In another manner, the distal end surface of the nail pushing block 24 may be configured as an arc-shaped shaped groove. In this way, when the pusher block 24 moves from the initial position to the nail closing position, the arc-shaped end of the forming groove first contacts the closing nail 16, and applies force to the open end of the closing nail 16 during the continuous movement of the pushing block 24. The pressure makes the open end of the closure nail 16 bend, and the bundled purse is played on the gathered tubular tissue. Wherein, the forming groove can form a third accommodating space 34 to accommodate part of the tubular tissue. When the pusher block 24 reaches the nail closing position, the third accommodating space 34 can close the second accommodating space 34 in the axial direction of the component closing device. The placement space 32 increases the size of the accommodation space for the tubular tissue. It can be understood that the third accommodating space 34 is actually a part of the first accommodating space 30 .
可以理解的是，当推钉块24的成型槽设置成不同形状时，所成型的钉的形状也随之变化，例如：也可以通过设定，闭合后形成类似“B”字形的钉。It can be understood that when the forming grooves of the nail pushing block 24 are set in different shapes, the shape of the formed nails will also change accordingly. For example, it can also be set to form a nail similar to a "B" shape after closing.
推钉块24包括一初始位置和一钉闭合位置，初始位置位于钉闭合位置和第一容置空间30的近端（如6a所示）。一般地，当推钉块24位于初始位置时，其对压板22的近端不发生作用，此时压板22打开，可以纳入待手术的管状组织；当推钉块24从初始位置向钉闭合位置移动时，其可作用于压板22的近端靠近底座20，到达压板22的闭合位置，其工作原理可参直线型或弧线形吻合器中工字刀和钉仓、钉砧的配合结构，在此不再赘述。The nail pushing block 24 includes an initial position and a nail closing position, and the initial position is located between the nail closing position and the proximal end of the first accommodating space 30 (as shown in 6 a ). Generally, when the nail pushing block 24 is in the initial position, it does not act on the proximal end of the pressing plate 22, and the pressing plate 22 is opened at this moment, and the tubular tissue to be operated can be included; When moving, it can act on the proximal end of the pressing plate 22 close to the base 20 to reach the closed position of the pressing plate 22. Its working principle can refer to the matching structure of the I-shaped knife, the nail bin and the nail anvil in the linear or arc-shaped stapler. I won't repeat them here.
进一步地，推钉块24还包括一拉回位置，具体的，初始位置位于钉闭合位置和第一容置空间的近端（参见图6a），拉回位置位于初始位置和钉闭合位置之间（参见图6d）。本发明的拉回位置为钉闭合位置向初始位置方向运动过程中的位置，也就是由远端向近端移动过程中的位置。Further, the pusher block 24 also includes a pull-back position, specifically, the initial position is located between the nail closed position and the proximal end of the first accommodating space (see FIG. 6a ), and the pull-back position is located between the initial position and the nail closed position (see Figure 6d). The pull-back position of the present invention is the position during the movement of the closed position of the nail towards the initial position, that is, the position during the movement from the distal end to the proximal end.
进一步参照图6c和6d，当推钉块24从钉闭合位置向拉回位置移动时，推钉块24与切刀31配合以带动切刀31从底座20远端向近端移动以切断组织，当推钉块24到达拉回位置时，切刀31正在切割组织或者已切断组织，最终推钉块回到初始位置以打开所述压板22。Referring further to Figures 6c and 6d, when the nail pushing block 24 moves from the nail closed position to the retracted position, the nail pushing block 24 cooperates with the cutter 31 to drive the cutter 31 to move from the distal end of the base 20 to the proximal end to cut off the tissue, When the nail pushing block 24 reaches the retracted position, the cutting knife 31 is cutting tissue or has severed the tissue, and finally the nail pushing block returns to the initial position to open the pressing plate 22 .
再者，切刀31可选择地与推钉块24脱开或配接，其中如图6a，初始位置时，推钉块24与切刀31脱开，钉闭合位置时，推钉块24与切刀31配接。具体的，初始位置时，推钉块24位于底座20的近端，而切刀31位于底座20的远端并被置于置钉部26，此时切刀31与推钉块24脱开。钉闭合位置时，推钉块24移动到底座20的远端，此时推钉块24推动闭合钉闭合成型，且推钉块24与位于置钉部26的切刀31配接。然后，推钉块24从钉闭合位置向拉回位置移动，此时推钉块24驱动切刀31从底座20远端向近端移动，从而切断组织。具体地，切刀31具有配接部40，推钉块24具有可选择地与配接部40配接或脱开的接合部42，当推钉块24从钉闭合位置向拉回位置移动时，配接部40与接合部42配接以使推钉块24带动切刀31从底座20远端向近端移动以切断组织，当推钉块24从初始位置向钉闭合位置移动时，配接部40与接合部42脱开。进一步的，配接部40为卡扣，接合部42为突起。Furthermore, the cutter 31 can be selectively disengaged or mated with the nail pushing block 24, wherein as shown in Figure 6a, in the initial position, the nail pushing block 24 is disengaged from the cutting knife 31, and when the nail is in the closed position, the nail pushing block 24 and Cutter 31 is matched. Specifically, in the initial position, the nail pushing block 24 is located at the proximal end of the base 20 , while the cutting knife 31 is located at the far end of the base 20 and placed on the nail setting portion 26 , and the cutting knife 31 is disengaged from the nail pushing block 24 at this time. When the nail is in the closed position, the nail pushing block 24 moves to the far end of the base 20. At this time, the nail pushing block 24 pushes the closing nail to close and form, and the nail pushing block 24 is matched with the cutter 31 located at the nail setting part 26. Then, the nail pushing block 24 moves from the nail closing position to the retracting position, at this time, the nail pushing block 24 drives the cutter 31 to move from the distal end of the base 20 to the proximal end, thereby cutting the tissue. Specifically, the cutting knife 31 has a mating portion 40, and the nail pushing block 24 has an engaging portion 42 that can be selectively mated with or disengaged from the fitting portion 40. When the nail pushing block 24 moves from the nail closed position to the retracted position , the matching part 40 is matched with the joint part 42 so that the nail pushing block 24 drives the cutter 31 to move from the distal end of the base 20 to the proximal end to cut off the tissue. When the nail pushing block 24 moves from the initial position to the nail closed position, the matching The connecting portion 40 is disengaged from the engaging portion 42 . Further, the fitting part 40 is a buckle, and the engaging part 42 is a protrusion.
本优选实施例中，在初始位置时，推钉块24与切刀31脱开，此时击发仅进行钉闭合成型形成荷包的操作；当闭合钉16击发闭合形成荷包后，推钉块24与切刀31配合以驱动切刀31从底座20远端向近端移动，再进行切割已经形成荷包的组织，且在切割时荷包在闭合装置的作用下保持不动。这种先闭合后切割的方式一方面保证了手术的安全性，避免在荷包没有形成的情况下切割组织的风险；同时，把钉闭合成型与切割分开进行，也减小了器械的击发力，提高了器械的可靠性；在荷包固定状态下切割组织，可以保证按设计规格保持唇边；而且操作简单、使用方便，进一步减少了手术成本。In this preferred embodiment, when in the initial position, the push nail block 24 is disengaged from the cutter 31, and at this time, the firing only performs the operation of nail closing and forming to form a purse; when the closing nail 16 is fired and closed to form a purse, the push nail block 24 and The cutter 31 cooperates to drive the cutter 31 to move from the distal end of the base 20 to the proximal end, and then cuts the tissue that has formed a purse, and the purse remains motionless under the action of the closing device during cutting. This method of closing first and then cutting ensures the safety of the operation on the one hand and avoids the risk of cutting tissue when the purse is not formed; at the same time, the nail closing and cutting are separated, which also reduces the firing force of the instrument , improving the reliability of the device; cutting the tissue in the fixed state of the purse can ensure that the lip is maintained according to the design specifications; and the operation is simple and easy to use, which further reduces the operation cost.
如图7所示，本优选实施例中，推钉块24具有钉成型槽43，所述钉成型槽43的两侧分别设有用于压缩组织的侧壁46，侧壁46高于钉成型槽43设置，即侧壁位于更靠近与置钉槽的一侧，也就是侧壁46位于钉成型槽43的远端，所述侧壁46为薄壁。这样，实现了先压缩组织，然后闭合钉16再成型，从而确保组织完全收入闭合钉16内，同时薄壁状的侧壁46可以保证对组织有足够的压缩，获得较大的压缩比。其中，与切刀31（参见图6d）配接的接合部42设置于侧壁46。As shown in Figure 7, in this preferred embodiment, the nail pushing block 24 has a nail forming groove 43, and the two sides of the nail forming groove 43 are respectively provided with side walls 46 for compressing tissue, and the side walls 46 are higher than the nail forming groove. 43 is set, that is, the side wall is positioned closer to the side of the nail placement groove, that is, the side wall 46 is positioned at the far end of the nail forming groove 43, and the side wall 46 is thin-walled. In this way, the tissue is compressed first, and then the closure nail 16 is reshaped, thereby ensuring that the tissue is completely received in the closure nail 16, and the thin-walled side wall 46 can ensure sufficient compression of the tissue and obtain a larger compression ratio. Wherein, the joint portion 42 mated with the cutter 31 (see FIG. 6 d ) is provided on the side wall 46 .
进一步的，推钉块24的所述两侧壁46之间设有中壁48，其中中壁48低于侧壁46，即中壁48位于所述钉成型槽43的近端。这样，中壁48低于侧壁46的空间部分，即对两侧壁之间进行挖空，形成了组织在受到压缩时的一个逃逸空间，减少了中壁48与组织的接触面积，更加有利于侧壁46压缩组织，从而减小击发力。具体的，中壁48具有弧形凹空部，以减少与组织的接触面积。Further, a middle wall 48 is provided between the two side walls 46 of the nail pushing block 24 , wherein the middle wall 48 is lower than the side wall 46 , that is, the middle wall 48 is located at the proximal end of the nail forming groove 43 . In this way, the middle wall 48 is lower than the space part of the side wall 46, that is, hollows out between the two side walls, forming an escape space for the tissue when compressed, reducing the contact area between the middle wall 48 and the tissue, and more effective Facilitates sidewall 46 compressing tissue, thereby reducing firing force. Specifically, the middle wall 48 has an arc-shaped hollow to reduce the contact area with the tissue.
进一步参见图6b和6c，本优选实施例中，推钉块24从初始位置到钉闭合位置的运动过程中，推钉块24和置钉部26驱动闭合钉16成型，此时切刀31相对于置钉部26固定不动，从而不切割组织。当推钉块24到达钉闭合位置时，闭合钉16已经闭合对组织打集束荷包，同时推钉块24与切刀31配接。参见图6d，当推钉块24从钉闭合位置向拉回位置的运动过程中，即由远端向近端运动的过程中，推钉块24与切刀31配接并驱动切刀31移动以切割形成荷包后的组织，此时闭合钉16相对于置钉部26保持不动。这样，在推钉块24回退的过程中进行切断组织，操作非常简单。另外，初始位置时，切刀31位于底座20的远端，当闭合钉16闭合以对组织打集束荷包后，切刀31才在推钉块24的驱动下运动以切割打结后的组织，从而使得闭合钉16未成形时，切刀31不伤害组织。Referring further to Figures 6b and 6c, in this preferred embodiment, during the movement of the nail pushing block 24 from the initial position to the nail closing position, the nail pushing block 24 and the nail setting part 26 drive the closing nail 16 to form, and at this time, the cutter 31 is opposite to each other. The nail-setting portion 26 is fixed so as not to cut the tissue. When the nail pushing block 24 reaches the nail closing position, the closing nail 16 has been closed to bundle the tissue, and the nail pushing block 24 is mated with the cutter 31 at the same time. Referring to Fig. 6d, when the nail pushing block 24 is moving from the nail closing position to the retracting position, that is, in the process of moving from the distal end to the proximal end, the nail pushing block 24 is matched with the cutter 31 and drives the cutter 31 to move To cut the tissue behind the purse bag, at this time, the closure nail 16 remains still relative to the nail setting portion 26 . In this way, the tissue is cut off during the retraction process of the nail pushing block 24, and the operation is very simple. In addition, at the initial position, the cutting knife 31 is located at the far end of the base 20. After the closing nail 16 is closed to bundle the tissue, the cutting knife 31 moves under the drive of the nail pushing block 24 to cut the knotted tissue. Therefore, when the closing nail 16 is not formed, the cutting knife 31 does not damage the tissue.
具体地，置钉部26（参见图6d）设有台阶（未图示），从而限制闭合钉16向近端方向移动。这样，在保持荷包不动的过程中进行切割，会使切割后的唇边按计划切割，不会造成损坏荷包或者使唇边过窄而造成的手术失败，同时保证切割后唇边宽度的一致性。优选地，切刀31距荷包的距离为3mm~5mm,即唇边的宽度为3mm~5mm。这样既保证荷包的可靠性；又能保证荷包的体积不是很大，方便后续手术过程中进入管型吻合器中进行组织的重建。Specifically, the nail setting portion 26 (see FIG. 6 d ) is provided with a step (not shown), so as to limit the movement of the closure nail 16 in the proximal direction. In this way, when the purse is cut while keeping the purse still, the cut lip will be cut according to the plan, which will not cause damage to the purse or make the lip too narrow to cause operation failure, and at the same time ensure that the lip width after cutting is consistent sex. Preferably, the distance between the cutter 31 and the purse is 3mm~5mm, that is, the width of the lip is 3mm~5mm. This not only ensures the reliability of the purse, but also ensures that the volume of the purse is not too large, so that it is convenient to enter the tubular stapler for tissue reconstruction during subsequent operations.
如图8所示，切刀31包括用于切断组织的切割部56，及分别位于切割部56的相对两侧且与切割部56相连接的第一连接部58和第二连接部60。切割部56上设有用于将底壁组织切断的戟刃54，戟刃54具有尖端部。进一步的，切割部56上还设有用于滑动切断侧壁组织的斜刃52。具体的，斜刃52设置为两个，且两个斜刃52分布于戟刃54的两侧。戟刃54用于把荷包底壁组织从中心切断为两段，进一步提高离断性能。具体地，戟刃54具有尖端部。从而将组织穿刺，确保将组织离断。As shown in FIG. 8 , the cutter 31 includes a cutting portion 56 for cutting tissue, and a first connecting portion 58 and a second connecting portion 60 respectively located on opposite sides of the cutting portion 56 and connected to the cutting portion 56 . The cutting part 56 is provided with a halberd blade 54 for cutting the bottom wall tissue, and the halberd blade 54 has a tip. Further, the cutting portion 56 is also provided with an oblique edge 52 for slidingly cutting off the side wall tissue. Specifically, there are two inclined blades 52 , and the two inclined blades 52 are distributed on both sides of the halberd blade 54 . The halberd blade 54 is used to cut the purse bottom wall tissue into two sections from the center, further improving the breaking performance. Specifically, the halberd blade 54 has a tip portion. Thereby, the tissue is punctured to ensure that the tissue is severed.
本优选实施例中，斜刃52沿曲线延伸，且斜刃52与戟刃54平滑连接。斜刃52与戟刃54形成类似于“W”形刀，即“W”形刀中部为戟刃，两侧为斜刃。另外，斜刃52与戟刃54形成凹入部，便于切刀31移动过程中，与集束荷包接触并切断组织。优选地，在切刀31的移动过程中，戟刃54先接触到集束荷包把其中心离断，接下来，斜刃52也接触到集束荷包并切割，进而斜刃52和戟刃54一起切断组织。In this preferred embodiment, the inclined edge 52 extends along a curve, and the inclined edge 52 is smoothly connected with the halberd edge 54 . The inclined blade 52 and the halberd edge 54 form a knife similar to a "W" shape, that is, the middle part of the "W" shape knife is a halberd edge, and both sides are oblique blades. In addition, the inclined blade 52 and the halberd blade 54 form a concave portion, which is convenient for the cutter 31 to contact with the bundled purse and cut off the tissue during the moving process. Preferably, during the movement of the cutting knife 31, the halberd blade 54 first touches the bundled purse to break its center, and then the oblique blade 52 also touches the bundled purse and cuts it, and then the oblique blade 52 and the halberd blade 54 cut off together organize.
本优选实施例中，第一连接部58和第二连接部60可选择性地与推钉块24配接或脱开。也就是说，配接部40设于第一连接部58和第二连接部60上。具体的，切割部56和配接部40分别位于第一连接部58和第二连接部60相对的两端。另外，斜刃52分别与第一连接部58和第二连接部60成钝角。In this preferred embodiment, the first connecting portion 58 and the second connecting portion 60 can be selectively mated with or disengaged from the pusher block 24 . That is to say, the mating portion 40 is disposed on the first connecting portion 58 and the second connecting portion 60 . Specifically, the cutting portion 56 and the mating portion 40 are respectively located at opposite ends of the first connecting portion 58 and the second connecting portion 60 . In addition, the beveled edge 52 forms an obtuse angle with the first connecting portion 58 and the second connecting portion 60 , respectively.
本优选实施例中，可以是第一连接部58和第二连接部60上均设置有卡槽（未图示），切割部56固定设于卡槽中。另外，切割部56、第一连接部58和第二连接部60可以焊接在一起。当然，切割部56、第一连接部58和第二连接部60之间也可以采用一体成型。In this preferred embodiment, both the first connecting portion 58 and the second connecting portion 60 may be provided with a slot (not shown), and the cutting portion 56 is fixedly arranged in the slot. In addition, the cutting part 56, the first connection part 58 and the second connection part 60 may be welded together. Of course, the cutting part 56 , the first connecting part 58 and the second connecting part 60 can also be integrally formed.
如图9a、图9b和图9c所示，本优选实施例还公开了一种用于组织闭合组件14的闭合钉16，其中组织闭合组件包括组织闭合装置，闭合钉16可装配至组织闭合装置，且组织闭合装置可被操作地使闭合钉16弯折成型。另外，组织闭合装置只要设计成，当操作击发把手12，能驱动组织闭合装置动作以促使闭合钉16弯折成型即可，在此不再详细赘述。以下重点对闭合件16进行详细描述。As shown in Figure 9a, Figure 9b and Figure 9c, this preferred embodiment also discloses a closure nail 16 for the tissue closure assembly 14, wherein the tissue closure assembly includes a tissue closure device, and the closure nail 16 can be assembled to the tissue closure device , and the tissue closure device can be operated to bend the closure nail 16 into shape. In addition, the tissue closure device only needs to be designed so that when the firing handle 12 is operated, the tissue closure device can be driven to make the closure nail 16 bend and formed, and details will not be repeated here. The following description will focus on the closure member 16 in detail.
闭合钉16包括基部62、与基部62相连接的连接部64、与连接部64相连接的第一侧部66和第二侧部68，其中第一侧部66和第二侧部68分别位于连接部64的两侧，且第一侧部66和第二侧部68之间形成开口，基部62构成供器械通过的封闭通道70。The closure nail 16 includes a base 62, a connecting portion 64 connected to the base 62, a first side 66 and a second side 68 connected to the connecting portion 64, wherein the first side 66 and the second side 68 are respectively located at Two sides of the connection part 64, and an opening is formed between the first side part 66 and the second side part 68, and the base part 62 constitutes a closed channel 70 through which instruments pass.
本优选实施例中，由于闭合钉16的基部62构成了供器械通过的封闭通道70，因此当穿入丝杠等器械时，器械可从封闭通道70中进入，并不会接触到荷包，从而不会施加外力给荷包，进而不会导致荷包因受力而滑脱。因此该闭合钉16不但方便器械进入，而且能避免在器械进入时荷包受力滑脱。In this preferred embodiment, since the base 62 of the closure nail 16 constitutes a closed channel 70 for the instrument to pass through, when the lead screw and other instruments are inserted, the instrument can enter from the closed channel 70 without touching the purse, thereby No external force will be applied to the purse, which will not cause the purse to slip due to force. Therefore, the closure nail 16 not only facilitates the entry of the instrument, but also prevents the purse from slipping under force when the instrument enters.
第一侧部66和第二侧部68在邻近基部62的一侧均设置有棘刺部72。这样，棘刺部72可以刺入组织，从而抓住组织粘膜层，防止了组织滑脱。优选的，棘刺部72向靠近连接部64的方向延伸。当然，棘刺部72也可以设计成向其它方向延伸。Both the first side portion 66 and the second side portion 68 are provided with a spine portion 72 on a side adjacent to the base portion 62 . In this way, the spines 72 can penetrate into the tissue, thereby grasping the tissue mucous layer and preventing the tissue from slipping. Preferably, the thorn portion 72 extends toward the connecting portion 64 . Of course, the spines 72 can also be designed to extend in other directions.
进一步的，第一侧部66和第二侧部68上的棘刺部72设置为复数个。具体的，本优选实施例中，第一侧部66和第二侧部68上均设置3个棘刺部72，且第一侧部66和第二侧部68上的棘刺部72对称设置。当然，第一侧部66和第二侧部68上也可以设置其它数量的棘刺部72。同样，第一侧部66和第二侧部68上的棘刺部72也可以设置成不对称。Further, the spines 72 on the first side portion 66 and the second side portion 68 are provided in plural. Specifically, in this preferred embodiment, three spines 72 are provided on each of the first side 66 and the second side 68 , and the spines 72 on the first side 66 and the second side 68 are arranged symmetrically. Of course, other numbers of spines 72 may also be provided on the first side portion 66 and the second side portion 68 . Likewise, the spines 72 on the first side portion 66 and the second side portion 68 can also be arranged asymmetrically.
另外，第一侧部66和第二侧部68上均设置台阶74，且台阶74和棘刺部72分别位于第一侧部66和第二侧部68相对的两侧。台阶74有利于闭合钉16弯折成型，同时配合置钉部26的台阶（图未示）避免成型后的荷包在切刀31被拉回的过程中移动。In addition, steps 74 are provided on the first side portion 66 and the second side portion 68 , and the steps 74 and the spines 72 are respectively located on opposite sides of the first side portion 66 and the second side portion 68 . The step 74 is conducive to the bending and forming of the closing nail 16, and at the same time cooperates with the step (not shown) of the nail part 26 to prevent the formed purse from moving when the cutter 31 is pulled back.
本优选实施例中，第一侧部66和第二侧部68的自由端均设为倒角，以便闭合钉16在钉成型槽43闭合成型。In this preferred embodiment, the free ends of the first side portion 66 and the second side portion 68 are chamfered so that the closing nail 16 can be closed and formed in the nail forming groove 43 .
在闭合过程中，当推钉块24位于初始位置时，闭合钉16的自由端与推钉块24相对，具体的说，第一侧部66和第二侧部68的自由端与推钉块24相对。当推钉块24位于钉闭合位置时，闭合钉16的自由端包容收拢后的管状组织并受推钉块24作用弯折成型，具体的说，第一侧部66和第二侧部68的自由端容纳收拢后的管状组织并受推钉块24作用弯折，从而形成如图9c所示的闭合后形状。In the closing process, when the nail pushing block 24 is in the initial position, the free ends of the closing nails 16 are opposite to the nail pushing block 24, specifically, the free ends of the first side portion 66 and the second side portion 68 are in contact with the nail pushing block. 24 relative. When the push nail block 24 is at the nail closed position, the free ends of the closure nail 16 contain the gathered tubular tissue and are bent and shaped by the push nail block 24, specifically, the first side portion 66 and the second side portion 68 The free end accommodates the gathered tubular tissue and is bent by the pushing nail block 24 to form a closed shape as shown in FIG. 9c.
优选的，第一侧部66和第二侧部68相平行设置。当然，第一侧部66和第二侧部68也可以设置成不平行而略成一定的角度。Preferably, the first side portion 66 and the second side portion 68 are arranged in parallel. Of course, the first side portion 66 and the second side portion 68 can also be arranged not to be parallel but to form a slightly certain angle.
本优选实施例中，封闭通道70为圆形通道。封闭通道70通常是供圆管型吻合器的丝杠等器械穿入的。当然，封闭通道70也可以设计成其它形状的通道。In this preferred embodiment, the closed channel 70 is a circular channel. The closed channel 70 is usually used for the insertion of instruments such as the lead screw of the circular tubular stapler. Of course, the closed passage 70 can also be designed as a passage of other shapes.
另外，可以理解的是，本优选实施例中，连接部64上也可设有至少一个尖刺部76。这样，当闭合组织后，尖刺部76刺入组织，进一步增大了抓住组织的力度，更好地防止组织在受力时滑脱。当然，本实施方式中也可不在闭合钉16的连接部64设置尖刺部76。In addition, it can be understood that, in this preferred embodiment, at least one spiked portion 76 may also be provided on the connecting portion 64 . In this way, after the tissue is closed, the spiked part 76 penetrates into the tissue, which further increases the force of grasping the tissue, and better prevents the tissue from slipping under force. Of course, in this embodiment, the spiked portion 76 may not be provided on the connecting portion 64 of the closure nail 16 .
进一步的，连接部64上设置两尖刺部76。两尖刺部76同样用于抓住组织，防止组织脱开。具体的，连接部64的中心与封闭通道70的中心定义了一中心线78，连接部64上的两尖刺部76相对于中心线78对称设置。当然，连接部64上的两尖刺部76相对于中心线78也可以设置成不对称。Further, two spikes 76 are disposed on the connecting portion 64 . The two spikes 76 are also used to grasp the tissue and prevent the tissue from detachment. Specifically, the center of the connecting portion 64 and the center of the closed channel 70 define a centerline 78 , and the two spikes 76 on the connecting portion 64 are arranged symmetrically with respect to the centerline 78 . Of course, the two spikes 76 on the connecting portion 64 can also be arranged asymmetrically with respect to the central line 78 .
另外，在压板22（参见图1）处于闭合过程中，当推钉块24（参见图1）位于初始位置时，闭合钉16的第一侧部66和第二侧部68与推钉块24相对，参见图5，当推钉块24处于钉闭合位置时，闭合钉16的第一侧部66和第二侧部68受推钉块24作用弯折成型。In addition, when the pressing plate 22 (see FIG. 1 ) is in the closing process, when the nail pushing block 24 (see FIG. 1 ) is in the initial position, the first side portion 66 and the second side portion 68 of the closing nail 16 and the nail pushing block 24 In contrast, referring to FIG. 5 , when the nail pushing block 24 is in the nail closing position, the first side portion 66 and the second side portion 68 of the closing nail 16 are bent and shaped by the pushing nail block 24 .
进一步参照图3，当操作组织闭合装置给闭合钉16的自由端施加压力，使闭合钉16的自由端弯折时，闭合钉16的第一侧部66和第二侧部68的自由端从各自的台阶74处分别向里弯折，从而对收拢的管状组织形成集束荷包；当然，闭合钉16的第一侧部66和第二侧部68的自由端也可以不设台阶，闭合钉16也会弯折成型。当然，也可以根据需要将组织闭合装置的推钉块24的成型槽43（参见图7）设置成不同形状，这样所成型的闭合钉16的形状也随之变化，例如：也可以通过设定，闭合后形成类似“B”字形的钉。可以理解的是，只要闭合后能将收拢的管状组织打集束荷包即可。With further reference to FIG. 3 , when the tissue closure device is operated to apply pressure to the free ends of the closure nails 16 to bend the free ends of the closure nails 16, the free ends of the first side portion 66 and the second side portion 68 of the closure nails 16 from The respective steps 74 are bent inwards respectively, thereby forming a bundled purse for the gathered tubular tissue; certainly, the free ends of the first side portion 66 and the second side portion 68 of the closing nail 16 can also be provided with no steps, and the closing nail 16 It will also bend into shape. Of course, the forming groove 43 (see FIG. 7 ) of the nail pushing block 24 of the tissue closure device can also be set to different shapes according to needs, so that the shape of the closed nail 16 formed also changes accordingly, for example: it can also be set by setting , form a nail similar to a "B" shape after closing. It can be understood that as long as the gathered tubular tissue can be bundled into a purse after closure.
闭合钉16可以是金属钉，也可以是由其他有一定强度和弹性的其他材料制成。The closure nail 16 can be a metal nail, or can be made of other materials with certain strength and elasticity.
具体的，本优选实施例中，当操作组织闭合装置，推钉块24从初始位置向钉闭合位置移动的过程中，推钉块24的钉成型槽43与闭合钉16的第一侧部66和第二侧部68抵接并使其第一侧部66和第二侧部68弯折成型，当推钉块24移动到钉闭合位置时，闭合钉16弯折成型，从而将组织打集束荷包，同时推钉块24的接合部42与切刀31的配接部40配接。当推钉块24从钉闭合位置向拉回位置移动的过程中，推钉块24驱动切刀31从底座20的远端向近端移动，从而将形成荷包后的组织切断。Specifically, in this preferred embodiment, when the tissue closure device is operated and the nail pushing block 24 moves from the initial position to the nail closing position, the nail forming groove 43 of the nail pushing block 24 and the first side portion 66 of the closing nail 16 abut against the second side portion 68 and make the first side portion 66 and the second side portion 68 bend and form, and when the push nail block 24 moves to the nail closing position, the closure nail 16 is bent and formed, thereby bundling the tissue purse, and the engaging portion 42 of the push nail block 24 is mated with the mating portion 40 of the cutting knife 31 at the same time. When the nail pushing block 24 moves from the staple closing position to the retracting position, the nail pushing block 24 drives the cutter 31 to move from the distal end of the base 20 to the proximal end, thereby cutting off the tissue formed into the purse bag.
综上，本发明的组织闭合装置、组织闭合组件、医疗器械，可形成中心收拢的集束荷包，降低后续圆管型吻合器吻合后产生“猫耳朵”和瘘的风险，另外，在闭合组织时，仅需一次操作即可，使用方便，减少了手术成本。再者，在闭合组织后，对组织进行切断，使得闭合钉16未成型时，切刀31不会伤害组织，且同时保证切割后唇边宽度的一致性。To sum up, the tissue closure device, tissue closure assembly, and medical device of the present invention can form a bundled purse that gathers in the center, reducing the risk of "cat ears" and fistula after subsequent anastomosis with a circular stapler. In addition, when closing the tissue , Only one operation is required, easy to use, and reduces the cost of surgery. Furthermore, after the tissue is closed, the tissue is cut so that when the closure nail 16 is not formed, the cutter 31 will not damage the tissue, and at the same time, the consistency of the width of the lip after cutting is ensured.
如图10a和图10b所示，本发明提供的闭合钉16的第二优选实施例，该实施例与第一实施例中闭合钉16的不同是，第一侧部66和第二侧部68上没有设置棘刺，基部62上设有延伸杆80，其中延伸杆80与连接部64位于基部62相对的两侧。具体的，延伸杆80具有尖刺端。As shown in Figure 10a and Figure 10b, the second preferred embodiment of the closure nail 16 provided by the present invention, the difference between this embodiment and the closure nail 16 in the first embodiment is that the first side portion 66 and the second side portion 68 No thorns are provided on the base 62 , and an extension rod 80 is provided on the base 62 , wherein the extension rod 80 and the connecting portion 64 are located on opposite sides of the base 62 . Specifically, the extension rod 80 has a sharp end.
本优选实施例中，延伸杆80设置为三个，其中第一个延伸杆80的延长线通过基部62的中心，其中另外两个延伸杆80相对于第一延伸杆80对称设置。当然，也可以设置其它数量的延伸杆。In this preferred embodiment, there are three extension rods 80 , wherein the extension line of the first extension rod 80 passes through the center of the base 62 , and the other two extension rods 80 are arranged symmetrically with respect to the first extension rod 80 . Of course, other numbers of extension rods can also be provided.
如图11a和图11b所示，本发明提供的闭合钉的第三优选实施例，该实施例与第一实施例中闭合钉16的不同是，该闭合钉84未设置封闭通道，闭合钉84包括第一侧部86、与第一侧部86相对设置的第二侧部88及连接第一侧部86和第二侧部88的底部90。其中第一侧部86和第二侧部88之间形成开口部92，底部90与开口部92相对，且底部90上设有至少一个棘刺。As shown in Figure 11a and Figure 11b, the third preferred embodiment of the closing nail provided by the present invention, the difference between this embodiment and the closing nail 16 in the first embodiment is that the closing nail 84 is not provided with a closed channel, and the closing nail 84 It includes a first side portion 86 , a second side portion 88 opposite to the first side portion 86 , and a bottom portion 90 connecting the first side portion 86 and the second side portion 88 . An opening 92 is formed between the first side 86 and the second side 88 , the bottom 90 is opposite to the opening 92 , and at least one spine is disposed on the bottom 90 .
这样，底部90上的棘刺在闭合钉84闭合时会穿过组织的粘膜层，集束荷包会比较牢固，使得荷包在受外力拖拉时不容易滑脱。Like this, the thorns on the bottom 90 can pass through the mucous membrane layer of the tissue when the closing nail 84 is closed, and the bundled purse can be relatively firm, so that the purse is not easy to slip off when being dragged by an external force.
另外，第一侧部86和第二侧部88的自由端均设为倒角，以便闭合钉84在钉成型槽闭合成型。In addition, the free ends of the first side portion 86 and the second side portion 88 are chamfered so that the closing nail 84 can be closed and formed in the nail forming groove.
一优选实施例中，具体的，底部90上设有第一棘刺94和第二棘刺96，其中第一棘刺94和第二棘刺96对称设置。当然，第一棘刺94和第二棘刺96也可以设置成不对称。In a preferred embodiment, specifically, the bottom 90 is provided with first spines 94 and second spines 96 , wherein the first spines 94 and the second spines 96 are arranged symmetrically. Certainly, the first spine 94 and the second spine 96 may also be arranged asymmetrically.
第一棘刺94和第二棘刺96的长度相同。以第一棘刺94做详细介绍，第一棘刺94的第一端设于底部90，第一棘刺94的第二端为末端，通过第一棘刺94的末端且垂直于第一棘刺94定义了一垂直线97，且当闭合钉84被弯折成型后，第一侧部86的弯折部分98和第二侧部88的弯折部分100均与垂直线97相交。这样，使得集束荷包更加牢固，进一步防止了受外力拖拉时滑脱。The first spine 94 and the second spine 96 have the same length. The first thorn 94 is introduced in detail. The first end of the first thorn 94 is arranged on the bottom 90, and the second end of the first thorn 94 is an end. The vertical line 97 and the bent portion 98 of the first side portion 86 and the bent portion 100 of the second side portion 88 both intersect the vertical line 97 when the closure nail 84 is bent and formed. In this way, the bundled purse is made firmer, further preventing slippage when being dragged by an external force.
另外，由于第一棘刺94和第二棘刺96的长度相同，因此垂直线97也通过第二棘刺96的末端。当然，第一棘刺94和第二棘刺96的长度也可以设置成不相同。优选地，第一棘刺94和第二棘刺96的长度在闭合钉84闭合成型后所围成的空间内，以避免损伤组织。In addition, since the first spine 94 and the second spine 96 have the same length, the vertical line 97 also passes through the end of the second spine 96 . Of course, the lengths of the first spines 94 and the second spines 96 can also be set to be different. Preferably, the lengths of the first thorns 94 and the second thorns 96 are within the space enclosed by the closure nail 84 after being closed and formed, so as to avoid tissue damage.
进一步的，第一侧部86和第二侧部88定义了第一平面，当闭合钉84被弯折成型后，第一侧部86的弯折部分98在第一平面上的投影与第二侧部88的弯折部分100在第一平面上的投影互相交叉。另外，第一侧部86和第二侧部88之间具有中心线102，第一侧部86的弯折部分98在第一平面上的投影与第二侧部88的弯折部分100在第一平面上的投影之间的交叉点位于中心线102上，当然也不是绝对地位于中心线102上。Further, the first side portion 86 and the second side portion 88 define a first plane, and when the closure nail 84 is bent and shaped, the projection of the bent portion 98 of the first side portion 86 on the first plane is the same as that of the second side portion 86. Projections of the bent portions 100 of the side portions 88 on the first plane intersect each other. In addition, there is a center line 102 between the first side portion 86 and the second side portion 88, and the projection of the bent portion 98 of the first side portion 86 on the first plane is the same as the bent portion 100 of the second side portion 88 at the second The point of intersection between the projections on a plane is located on the center line 102 , but certainly not absolutely on the center line 102 .
另外，第一侧部86的弯折部分98在第一平面上的投影和第二侧部88的弯折部分100在第一平面上的投影均位于第一棘刺94和第二棘刺96之外，即第二侧部88的弯折部分100的投影位于第一侧部86与第一棘刺94之间、第一侧部86的弯折部分98的投影位于第二侧部88与第二棘刺96之间。In addition, the projection of the bent portion 98 of the first side portion 86 on the first plane and the projection of the bent portion 100 of the second side portion 88 on the first plane are both located outside the first spine 94 and the second spine 96 , that is, the projection of the bent portion 100 of the second side portion 88 is located between the first side portion 86 and the first spine 94, and the projection of the bent portion 98 of the first side portion 86 is located between the second side portion 88 and the second spine Between 96.
如图12a和图12b所示，本发明提供的闭合钉的第四优选实施例，该实施例与第三优选实施例相比，该实施例中，闭合钉106同样包括第一侧部86、与第一侧部86相对设置的第二侧部88及连接第一侧部86和第二侧部88的底部90。其中第一侧部86和第二侧部88之间形成开口部92，底部90与开口部92相对，且底部90上设有至少一个棘刺。As shown in Fig. 12a and Fig. 12b, the fourth preferred embodiment of the closure nail provided by the present invention, compared with the third preferred embodiment, in this embodiment, the closure nail 106 also includes the first side portion 86, The second side portion 88 opposite to the first side portion 86 and the bottom portion 90 connecting the first side portion 86 and the second side portion 88 . An opening 92 is formed between the first side 86 and the second side 88 , the bottom 90 is opposite to the opening 92 , and at least one spine is disposed on the bottom 90 .
同样，当闭合钉106被弯折成型后，第一侧部86的弯折部分108和第二侧部88的弯折部分110均与垂直线97相交。另外，由于第一棘刺94和第二棘刺96的长度相同，因此垂直线97也通过第二棘刺96的末端。当然，第一棘刺94和第二棘刺96的长度也可以设置成不相同。优选地，第一棘刺94和第二棘刺96的长度在闭合钉84闭合成型后所围成的空间内，以避免损伤组织。Likewise, both the bent portion 108 of the first side portion 86 and the bent portion 110 of the second side portion 88 intersect the vertical line 97 when the closure nail 106 is bent into shape. In addition, since the first spine 94 and the second spine 96 have the same length, the vertical line 97 also passes through the end of the second spine 96 . Of course, the lengths of the first spines 94 and the second spines 96 can also be set to be different. Preferably, the lengths of the first thorns 94 and the second thorns 96 are within the space enclosed by the closure nail 84 after being closed and formed, so as to avoid tissue damage.
第一侧部86和第二侧部88定义了第一平面，该优选实施例与第三实施例的不同是，当闭合钉106被弯折成型后，第一侧部86的弯折部分108在第一平面上的投影远离第二侧部88的弯折部分110在第一平面上的投影。The first side portion 86 and the second side portion 88 define a first plane. The difference between this preferred embodiment and the third embodiment is that when the closure nail 106 is bent and shaped, the bent portion 108 of the first side portion 86 The projection on the first plane is away from the projection of the bent portion 110 of the second side portion 88 on the first plane.
进一步的，第一侧部86的弯折部分108在第一平面上的投影和第二侧部88的弯折部分110在第一平面上的投影均位于第一棘刺94和第二棘刺96之间。Further, the projection of the bent portion 108 of the first side portion 86 on the first plane and the projection of the bent portion 110 of the second side portion 88 on the first plane are both located between the first spine 94 and the second spine 96 between.
底部90上还设有第三棘刺112，第三棘刺112与第一侧部86和第二侧部88之间的中心线102相重合。当然，第三棘刺112也可设置成与第一侧部86和第二侧部88之间的中心线102不重合。进一步的，第一棘刺94的长度和第二棘刺96的长度均大于第三棘刺112的长度。There is also a third spine 112 on the bottom 90 , and the third spine 112 coincides with the centerline 102 between the first side portion 86 and the second side portion 88 . Of course, the third spines 112 can also be arranged not to coincide with the centerline 102 between the first side portion 86 and the second side portion 88 . Further, the length of the first spine 94 and the length of the second spine 96 are both greater than the length of the third spine 112 .
如图13a和图13b所示，本发明提供的闭合钉16的第五优选实施例，该实施例与第四优选实施例相比，该优选实施例中，第一侧部86和第二侧部88定义了第一平面，当闭合钉114被弯折成型后，第一侧部86的弯折部分116在第一平面上的投影同样远离第二侧部88的弯折部分118在第一平面上的投影。As shown in Fig. 13a and Fig. 13b, the fifth preferred embodiment of the closure nail 16 provided by the present invention, compared with the fourth preferred embodiment, in this preferred embodiment, the first side 86 and the second side The portion 88 defines a first plane, and when the closure nail 114 is bent and shaped, the projection of the bent portion 116 of the first side portion 86 on the first plane is also far away from the bent portion 118 of the second side portion 88 in the first plane. Projection on a plane.
底部90上同样设有第一棘刺120和与第一棘刺120相对称设置的第二棘刺122。进一步的，底部90上还设有第三棘刺124，第三棘刺124与第一侧部86和第二侧部88之间的中心线102相重合。当然，第三棘刺124也可设置成与第一侧部86和第二侧部88之间的中心线102不重合。本优选实施例中，第三棘刺124的长度大于第一棘刺120的长度和第二棘刺122的长度。The bottom 90 is also provided with a first spine 120 and a second spine 122 symmetrical to the first spine 120 . Further, the bottom 90 is further provided with a third spine 124 , and the third spine 124 coincides with the center line 102 between the first side portion 86 and the second side portion 88 . Of course, the third spines 124 can also be arranged not to coincide with the center line 102 between the first side portion 86 and the second side portion 88 . In this preferred embodiment, the length of the third spine 124 is greater than the length of the first spine 120 and the length of the second spine 122 .
另外，通过第三棘刺124的末端且垂直于第三棘刺124定义了一垂直线126，当闭合钉114被弯折成型后，第一侧部86的弯折部分116和第二侧部88的弯折部分118均与垂直线126相交。这样，使得集束荷包更加牢固，进一步防止了受外力拖拉时滑脱。In addition, through the end of the third spine 124 and perpendicular to the third spine 124, a vertical line 126 is defined. The bent portions 118 each intersect a vertical line 126 . In this way, the bundled purse is made firmer, further preventing slippage when being dragged by an external force.
进一步的，第一侧部86和第二侧部88上均设有尖刺部128。优选的，第一侧部86上的尖刺部128和第二侧部88上的尖刺部128相互对称设置。具体的，尖刺部128朝靠近底部90的方向延伸。Further, both the first side portion 86 and the second side portion 88 are provided with spikes 128 . Preferably, the spiked portion 128 on the first side portion 86 and the spiked portion 128 on the second side portion 88 are arranged symmetrically to each other. Specifically, the sharp part 128 extends toward the direction close to the bottom 90 .
应当理解，虽然本说明书按照实施方式加以描述，但并非每个实施方式仅包含一个独立的技术方案，说明书的这种叙述方式仅仅是为清楚起见，本领域技术人员应当将说明书作为一个整体，各实施方式中的技术方案也可以经适当组合，形成本领域技术人员可以理解的其他实施方式。It should be understood that although this description is described according to implementation modes, not each implementation mode only contains an independent technical solution, and this description in the description is only for clarity, and those skilled in the art should take the description as a whole, and each The technical solutions in the embodiments can also be properly combined to form other embodiments that can be understood by those skilled in the art.
上文所列出的一系列的详细说明仅仅是针对本发明的可行性实施方式的具体说明，它们并非用以限制本发明的保护范围，凡未脱离本发明技艺精神所作的等效实施方式或变更均应包含在本发明的保护范围之内。The series of detailed descriptions listed above are only specific descriptions for feasible implementations of the present invention, and they are not intended to limit the protection scope of the present invention. Any equivalent implementation or implementation that does not depart from the technical spirit of the present invention All changes should be included within the protection scope of the present invention.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201610642767.3ACN106175861B (en) | 2016-08-08 | 2016-08-08 | Tissue closing device, tissue closure component and the medical instrument equipped with the tissue closure component |
| JP2018532229AJP6580269B2 (en) | 2015-12-22 | 2016-12-22 | Tissue closure device, tissue closure assembly and medical device |
| BR112018012702-7ABR112018012702B1 (en) | 2015-12-22 | 2016-12-22 | TISSUE CLOSURE DEVICE, TISSUE CLOSURE ASSEMBLY AND MEDICAL INSTRUMENT |
| PCT/CN2016/111459WO2017107947A1 (en) | 2015-12-22 | 2016-12-22 | Tissue closure device, tissue closure component, and medical equipment |
| US16/061,641US10835244B2 (en) | 2015-12-22 | 2016-12-22 | Tissue closure device, tissue closure component, and medical instrument |
| RU2018125470ARU2726991C2 (en) | 2015-12-22 | 2016-12-22 | Device for tissue closure, unit for tissue closure and medical instrument |
| EP16877757.1AEP3395265A4 (en) | 2015-12-22 | 2016-12-22 | TISSUE CLOSURE DEVICE, TISSUE CLOSURE ELEMENT, AND MEDICAL EQUIPMENT |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201610642767.3ACN106175861B (en) | 2016-08-08 | 2016-08-08 | Tissue closing device, tissue closure component and the medical instrument equipped with the tissue closure component |
| Publication Number | Publication Date |
|---|---|
| CN106175861A CN106175861A (en) | 2016-12-07 |
| CN106175861Btrue CN106175861B (en) | 2018-11-23 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201610642767.3AActiveCN106175861B (en) | 2015-12-22 | 2016-08-08 | Tissue closing device, tissue closure component and the medical instrument equipped with the tissue closure component |
| Country | Link |
|---|---|
| CN (1) | CN106175861B (en) |
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| US10835244B2 (en) | 2015-12-22 | 2020-11-17 | Touchstone International Medical Science Co., Ltd. | Tissue closure device, tissue closure component, and medical instrument |
| CN111358521B (en)* | 2018-12-25 | 2025-02-28 | 天臣国际医疗科技股份有限公司 | Tissue closure devices and medical devices |
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| Date | Code | Title | Description |
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| CP03 | Change of name, title or address | ||
| CP03 | Change of name, title or address | Address after:215021 No. 278 Dongping Street, Suzhou Industrial Park, Jiangsu Province Patentee after:Tianchen International Medical Technology Co., Ltd Address before:215021 science and Technology Plaza, Jinji Lake Road International Science and Technology Park, Suzhou Industrial Park, Jiangsu, 21A Patentee before:TOUCHSTONE INTERNATIONAL MEDICAL SCIENCE Co.,Ltd. |