Staple cartridge for a surgical instrument and surgical instrumentTechnical Field
The invention relates to a nail bin for a surgical instrument and the surgical instrument, and belongs to the field of medical instruments.
Background
When the conventional linear cutting anastomat is used for firing, a nail pushing sheet arranged in a nail bin is pushed by a firing push rod to complete the firing action of the titanium nails, meanwhile, the distal end of a cutting knife at the cutting knife rod lags behind the wedge-shaped head part at the distal end of the firing push rod by 3-5mm, when a user operates the firing push rod to complete the firing action, the firing push rod and the cutting knife push rod move simultaneously, and the titanium nails in the nail bin are firstly molded due to the lag relation between the wedge-shaped head part of the nail pushing rod and the cutting knife, and the cutting knife at the rear end of the wedge-shaped head part of the nail pushing rod lags behind 3-5mm to cut the stapled tissues.
However, because the interval between suturing and cutting is short, when the distal wedge-shaped head of the firing push rod acts to push the push plate to extrude the titanium nails to form the B-shaped nails, the cutting action immediately pulls the suturing tissues to cause displacement of the tissues, and the height and consistency of the formed nails are affected. Finally, the phenomena of high nail height discreteness, local bleeding after anastomosis and the like are generated. Simultaneously, the distal end integrated into one piece of cutting knife and the cutting arbor of current structure, the instrument has changed the nail storehouse but unable cutting knife of changing when many times firing, appears tumour cell's planting and transfer easily.
In addition, the existing anastomat is often provided with 2 or 3 rows of stitching nail groups on the nail bin, and a plurality of stitching nails are arranged on the inner side and the outer side of the same position in the firing process to be fired simultaneously. Because of the simultaneous firing, when the inner side and outer side stitching nails contact and stitch the tissues, the surrounding tissues are extruded outwards, so that the stitching effect of the tissues is affected, and the conditions of tissue leakage, wound bleeding and the like are generated.
Based on the above situation, the invention provides the nail bin capable of forming nails by steps at the inner side and the outer side, so that the maximum load of the instrument during operation is effectively reduced, and the safety coefficient of the instrument during use is improved.
Disclosure of Invention
The invention aims to provide a nail bin for a surgical instrument and the surgical instrument, which push a nail pushing sheet by adopting a pushing block with cam groups with different lengths, so that an inner stitching nail is firstly triggered, an outer stitching nail is triggered, and then the stitching nail is triggered, thereby ensuring that the stitching effect of stitching nails is better, avoiding the situations of tissue leakage, wound bleeding and the like, and the mode of stitching nails step by step at the inner side and the outer side effectively reduces the maximum load when the instrument works, and improves the safety factor of the instrument.
The invention provides a nail bin for a surgical instrument, which comprises a nail bin body, a nail arranged in the nail bin body, a nail pushing sheet for pushing the nail and a pushing block for pushing the nail pushing sheet, wherein the pushing block comprises a bottom plate, two first cam groups and two second cam groups, the first cam groups are arranged in parallel, the second cam groups are arranged in parallel, the first cam groups are perpendicular to the bottom plate, the first cam groups are positioned between the two second cam groups, and the end parts of the first cam groups are positioned at the front sides of the end parts of the second cam groups in the moving direction of the pushing block.
Further, the staple cartridge body is provided with a channel for the pushing block to move in the longitudinal direction, the staple cartridge body is provided with an inner stitching cavity and an outer stitching cavity which are symmetrically arranged on the left and right sides by taking the channel as a symmetrical axis in the longitudinal direction, the inner stitching cavity is arranged close to the channel relative to the outer stitching cavity, the staples comprise inner staples arranged in the inner stitching cavity and outer staples arranged in the outer stitching cavity, the first cam group pushes the inner staples to be out, the second cam group pushes the outer staples to be out, the staple cartridge body is provided with a contact surface contacted with a stitched part, a distance d1 is formed between a crown of the inner staples and the contact surface, and a distance d2 is formed between the crown of the outer staples, wherein d1 is smaller than d2.
Further, the ejector pin piece includes the interior ejector pin piece that sets up in interior suture chamber and the outer ejector pin piece that sets up in the outer suture nail, interior ejector pin piece compares the outer ejector pin piece is close to the suture face setting.
Further, the height of the inner push pin sheet is higher than that of the outer push pin sheet.
Further, the stem of the inner staples is longer than the stem of the outer staples.
Further, the nail bin further comprises a frame body fixed at the bottom of the nail bin body and a cover plate covered at the top of the nail bin body, and the cover plate and the frame body are mechanically connected with the nail bin.
The nail bin comprises a nail bin body, a cutting knife holder body and a cutting knife, wherein the cutting knife is arranged on the cutting knife holder body, the nail bin body is provided with a far end and a tail end which are oppositely arranged, the tail end is connected with a connecting part of a surgical instrument, the cutting knife holder body is arranged at the far end, the cutting knife holder body comprises a side plate and a clamping part which is in clamping fit with a pulling knife rod, and an elastic piece which drives the cutting edge of the cutting knife to not protrude out of the cutting knife holder body is formed on the side plate.
Further, a rotating shaft is arranged on the side plate, the cutting knife is sleeved on the rotating shaft, and the elastic piece is a torsion spring sleeved on the rotating shaft.
Further, the catching portion is formed on the side plate.
Further, the side plates are two oppositely arranged, and a butt joint groove for accommodating the cutting knife is formed between the two side plates.
Further, the clamping part is an elastic buckle formed by bending from the side plate to the butt joint groove.
The invention also provides a surgical instrument which comprises the nail bin for the surgical instrument, a nail anvil assembly butted with the nail bin, a handle for connecting the nail anvil assembly and the nail bin, and a closing compression bar and a driving assembly which are arranged on the handle.
The handle is characterized in that the handle is internally provided with a nail pushing rod and a broach rod, the nail pushing rod is connected with the driving assembly, the broach rod is arranged at the front end of the nail pushing rod, the broach rod is provided with a clamping groove matched with the elastic buckle, and when the driving assembly drives the nail pushing rod to move towards the far end, the nail pushing rod drives the broach rod to move towards the far end, so that the elastic buckle is buckled into the clamping groove.
Compared with the prior art, the nail bin for the surgical instrument and the surgical instrument have the beneficial effects that the pushing block with the cam groups with different lengths is adopted to push the nail pushing sheet, wherein the first cam group is longer than the second cam group, namely, the end part of the first cam group is positioned at the front side of the end part of the second cam group, so that the inner stitching nail is firstly fired, the outer stitching nail is then fired, the stitching effect of the stitching nail is better, and the situations of tissue leakage, wound bleeding and the like are avoided. Meanwhile, the mode of forming nails step by step at the inner side and the outer side is adopted, so that the maximum load of the instrument during working is effectively reduced, and the safety coefficient of the instrument is improved.
In addition, the nail bin for the surgical operation instrument and the surgical operation instrument are characterized in that the cutting knife is arranged at the far end of the nail bin, after the stitching nails are fired, the broach rod and the cutting knife holder body are pulled back to the near end for cutting, namely, after the fired stitching nails are completely molded, tissue cutting is performed, the stability of the stitching nail molding process is ensured, and therefore the purposes of uniform stitching nail forming height and form and bleeding and leakage of the stitching openings are achieved.
The foregoing description is only an overview of the present invention, and is intended to provide a better understanding of the present invention, as it is embodied in the following description, with reference to the preferred embodiments of the present invention and the accompanying drawings.
Drawings
FIG. 1 is a schematic view of a cartridge according to one embodiment of the present invention;
FIG. 2 is a schematic view of the structure of a cartridge body in a cartridge according to an embodiment of the present invention;
FIG. 3 is a schematic view of the pusher block in the cartridge of one embodiment of the present invention;
FIGS. 4 and 5 are schematic views of the structure of a cutter holder block in a cartridge according to an embodiment of the present invention;
fig. 6 and 7 are schematic structural views of a surgical instrument according to an embodiment of the present invention.
Detailed Description
The following describes in further detail the embodiments of the present invention with reference to the drawings and examples. The following examples are illustrative of the invention and are not intended to limit the scope of the invention.
In the description of the present invention, it should be noted that the directions or positional relationships indicated by the terms "center", "upper", "lower", "left", "right", "front", "rear", "axial direction", "inner", "outer", etc. are based on the directions or positional relationships shown in the drawings, are merely for convenience of describing the present invention and simplifying the description, and do not indicate or imply that the devices or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
In the description of the present invention, unless explicitly stated or limited otherwise, the terms "mounted," "connected," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected, mechanically connected, electrically connected, directly connected, indirectly connected via an intervening medium, or in communication between two elements. The specific meaning of the above terms in the present invention will be understood in specific cases by those of ordinary skill in the art.
In addition, the technical features of the different embodiments of the present invention described below may be combined with each other as long as they do not collide with each other.
Referring to fig. 1 to 5, a cartridge for a surgical instrument according to an embodiment of the present invention includes a cartridge body 1, staples 10 disposed in the cartridge body 1, a pusher plate 11 for pushing the staples 10, a pusher block 2 for pushing the pusher plate 11, and a frame 12 fixed to a bottom of the cartridge body 1. When the cartridge is not in use, a cover plate (not shown) may be covered on the top of the cartridge body 1 to prevent dust and the like from entering the cartridge. In this embodiment, the frame 12 and the cover are connected to the cartridge body 1 by a common mechanical connection, such as a snap connection, a threaded connection, etc. The cartridge body 1 has opposite distal and distal ends (in the present invention, the proximal end is the direction of arrow a, the distal end is opposite to a), the distal end is advanced into the tissue to be stapled relative to the distal end, and the cover is removed after the cartridge is mounted on a surgical instrument, as illustrated in fig. 1.
In the present invention, the cartridge body 1 is provided with a channel 13 for moving the pushing block 2 in the longitudinal direction, the cartridge body 1 is symmetrically provided with an inner stitching chamber 14 and an outer stitching chamber 15 about the channel 13 as a symmetry axis in the longitudinal direction, the inner stitching chamber 14 is disposed close to the channel 12 relative to the outer stitching chamber 15, and the pushing plate 11 includes an inner pushing plate (not shown) disposed in the inner stitching chamber 14 and an outer pushing plate (not shown) disposed in the outer stitching chamber 15. The staples 10 include an inner staple (not shown) disposed within the inner staple chamber 14 and an outer staple (not shown) disposed within the outer staple chamber 15, the inner and outer staples being mounted to the inner and outer staple pusher plates, respectively. During suturing, the outer staples are used to suture the area adjacent the tissue stoma, and the inner staples are used to suture the area inside the tissue relative to the outer staples. The staple pusher 11 of the present invention is of conventional construction and the manner in which the staples 10 are installed is conventional and will not be described herein.
In the present invention, the pushing block 2 includes a bottom plate 21, two parallel first cam groups 22 and two parallel second cam groups 23 perpendicular to the bottom plate 21, and a limiting block 24 perpendicular to the bottom plate 21, where the two first cam groups 22 are located between the two second cam groups 23, and the limiting block 24 is located between the two first cam groups 22. In the moving direction of the pushing block 2, the end of the first cam group 22 is located at the front side of the end of the second cam group 23. The nail bin body 1 is further provided with a plurality of sliding grooves 16 for accommodating the first cam group 22 and the second cam group 23, the first cam group 22 and the second cam group 23 can move relative to the sliding grooves 16, and the limiting blocks 24 are arranged in the grooves 12 to prevent the pushing blocks 2 from cooperating and shaking in a deviation moving direction when the pushing blocks 2 move relative to the nail bin body 1. The first cam group 22 pushes the inner nail pushing sheet to fire so as to lead the inner stitching nails to be discharged, and the second cam group 23 pushes the outer nail pushing sheet to fire so as to lead the outer stitching nails to be discharged. Because the end of the first cam set 22 is located at the front side of the end of the second cam set 23, when the pushing block 2 moves towards the distal end, the inner pushing nail sheet is pushed to fire, so that the inner stitching nails in the inner stitching cavity 14 are ensured to be ejected faster than the outer stitching nails.
Further, the cartridge body 1 has a contact surface 110 contacting the portion to be stapled, a distance d1 is formed between the crown of the inner staple and the contact surface 110, and a distance d2 is formed between the crown of the outer staple and the contact surface 110, wherein d1 is smaller than d2, i.e. the fixed rod of the inner staple is disposed closer to the contact surface 110 than the rod of the outer staple. In particular, in this embodiment, the inner pusher is positioned closer to the stapling surface 110 than the outer pusher, although in other embodiments, the inner stapling cavity 14 may be positioned higher than the outer stapling cavity 15 by using an inner staple having a longer shaft, or a combination of both.
In the invention, a cutting knife rest body 3 and a cutting knife 30 arranged on the cutting knife rest body 3 are also arranged in the nail bin body 1, and the cutting knife rest body 3 is arranged at the far end. Specifically, the cutter holder body 3 includes a side plate 31 and a clamping portion 32 that is in clamping fit with the broach rod, a rotating shaft 33 is disposed on the side plate 31, and the cutter 30 is sleeved on the rotating shaft 33. The side plate 31 is further provided with an elastic member 34 for driving the blade (not shown) of the cutter 30 not to protrude from the cutter holder body 3, and the elastic member 34 is preferably a torsion spring fitted over the rotation shaft 33. In this embodiment, the clamping portion 32 is formed on the side plate 31, the side plate 31 is two opposite side plates, and a docking slot 311 for accommodating the cutter 30 is formed between the two side plates 31. The holding portion 32 is an elastic buckle formed by bending from the side plate 31 into the abutting groove 311.
Referring to fig. 6 and 7, the present invention further provides a surgical instrument, including the above-mentioned cartridge for a surgical instrument, an anvil assembly 4 abutting against the cartridge, a handle 5 connecting the anvil assembly 4 and the cartridge, and a closing pressure lever 51 and a driving assembly (not shown) disposed on the handle 5, wherein the closing pressure lever 51 is mounted on the handle 5 through a guide pin 510, and a firing push button 52 connected to the driving assembly and operated is further disposed on the handle 5. The handle 5 is further internally provided with a nail pushing rod 53 and a broach rod 54, the nail pushing rod 53 is connected with the driving assembly, the broach rod 54 and the pushing block 2 are arranged at the front end of the nail pushing rod 53, the broach rod 54 is provided with a clamping groove 541 matched with the elastic buckle 32, and when the driving assembly drives the nail pushing rod 53 to move towards the far end, the nail pushing rod 52 drives the broach rod 54 to move towards the far end, so that the elastic buckle 32 is buckled into the clamping groove 541. In the present invention, the handle 5 includes a cartridge holder side handle 55 and an anvil side handle 56 which are fixedly connected to the cartridge and anvil assembly 4, respectively.
The operating principle of the surgical instrument of the invention is as follows:
The cartridge holder side handle 55 and anvil side handle 56 are aligned with the guide pins and the closure plunger 51 is depressed to effect closure of the jaws (clamping tissue to be stapled through the cartridge and anvil assembly 4). Pushing the proximal firing push button 52 drives the push rod 53 and the broach rod 54 to move simultaneously, and the push rods 53 at two sides push the push plate 11 in the staple cartridge to move vertically downwards through the inclined surface of the distal end head, so that sequential compression deformation of the staples 10 is realized, and finally, B-shaped staples are formed, so that tissues are stapled. Because the draw bar 54 lags behind and is hidden inside the cartridge, it does not contact the tissue between the contact surface 110 and anvil surface 41 during stapling. After the ejector pins 53 are pushed distally to form all of the staples 10 in the cartridge, the pull tool bar 54 contacts the cutter holder block 3 within the distal end of the cartridge. Since the cutter 30 is mounted on the cutter holder body 3 through the rotation shaft 33, the cutter bar 54 rotates and ejects the cutter 30 when being inserted into the butt joint groove 311, and the elastic buckle 32 on the side plate 31 deforms and then buckles the clamping groove 541 of the cutter bar 54. At this point the firing of the staples 10 is completed and the pulling back of the firing button 52 will cause the knife 30, which has been extended from the interior of the knife holder 3, to cut tissue from the distal end to the proximal end. During the cutting process, since the two sides of the elastic buckle 32 in the cutter holder body 3 are held by the side walls of the staple cartridge surface, the elastic buckle cannot deform and separate from the broach rod 54 until the complete cutting process of the tissue is completed. When the cutter 30 has cut tissue and moved to the proximal end of the cartridge, a proximal cartridge step (not shown) retains the cutter holder block 3. While a recess (not shown) in the proximal side of the cartridge allows the resilient catch 32 to deform out of engagement, thereby disengaging the broach rod 54 from the cutter holder body 3. After the cutter bar 54 is separated from the cutter holder body 3, the torsion spring 34 arranged on the rotating shaft 33 enables the cutter 30 to be automatically retracted, so that the cutter 30 exposed outside is prevented from accidentally scratching a user.
In summary, the nail bin for the surgical instrument and the surgical instrument push the nail pushing sheet by adopting the pushing blocks with the cam groups with different lengths, wherein the first cam group is longer than the second cam group, namely, the end part of the first cam group is positioned at the front side of the end part of the second cam group, so that the inner stitching nail is firstly fired, the outer stitching nail is fired, the stitching effect of the stitching nail is better, and the situations of tissue leakage, wound bleeding and the like are avoided. Meanwhile, the mode of forming nails step by step at the inner side and the outer side is adopted, so that the maximum load of the instrument during working is effectively reduced, and the safety coefficient of the instrument is improved.
In addition, the nail bin for the surgical operation instrument and the surgical operation instrument are characterized in that the cutting knife is arranged at the far end of the nail bin, after the stitching nails are fired, the broach rod and the cutting knife holder body are pulled back to the near end for cutting, namely, after the fired stitching nails are completely molded, tissue cutting is performed, the stability of the stitching nail molding process is ensured, and therefore the purposes of uniform stitching nail forming height and form and bleeding and leakage of the stitching openings are achieved.
The technical features of the above-described embodiments may be arbitrarily combined, and all possible combinations of the technical features in the above-described embodiments are not described for brevity of description, however, as long as there is no contradiction between the combinations of the technical features, they should be considered as the scope of the description.
The above examples illustrate only a few embodiments of the invention, which are described in detail and are not to be construed as limiting the scope of the invention. It should be noted that it will be apparent to those skilled in the art that several variations and modifications can be made without departing from the spirit of the invention, which are all within the scope of the invention. Accordingly, the scope of protection of the present invention is to be determined by the appended claims.