Disclosure of Invention
Aiming at the problems in the prior art, the invention aims to provide a firing assembly and a circular tube type anastomat, wherein in the nail forming process of the anastomat, the movement of a nail anvil to the far end side is compensated through the structural change of a pull piece, and the nail forming effect is improved.
The embodiment of the invention provides a firing assembly, which is used for a circular tube type anastomat, and comprises an anastomat body and a nail anvil assembly, wherein the nail anvil assembly comprises a nail anvil positioned at the distal end side of the anastomat body and a nail anvil shaft positioned at the proximal end side of the nail anvil, the firing assembly comprises a nail pushing rod, a pulling piece and a nail anvil pulling rod, one side of the nail pushing rod is provided with a boss, the nail pushing rod is provided with an initial position and a firing position, and the distal end side of the pulling piece is connected with the nail anvil shaft through the nail anvil pulling rod;
When the nail pushing rod moves from the initial position to the firing position, the boss is in contact with the pull tab and pushes the pull tab up in a direction away from the axis of the anastomat, so that the pull tab generates a pulling force towards the proximal end side of the anastomat on the nail anvil pull rod.
Optionally, the boss is integrally provided with the ejector pin stem.
Optionally, a positioning groove is formed in one side of the nail pushing rod, a pin shaft is arranged in the positioning groove, and the top end of the pin shaft protrudes out of the surface of the nail pushing rod to form the boss.
Optionally, the distal side of the boss is a transition surface, and in a direction perpendicular to the axis of the stapler, a distance from the proximal side of the transition surface to the axis is greater than a distance from the distal side of the transition surface to the axis.
Optionally, the pull tab includes a first connection section, a middle section, and a second connection section sequentially arranged from a proximal end side to a distal end side of the pull tab, and a width of the middle section is greater than a width of the first connection section.
Optionally, when the ejector pin pole is in the initial position, the boss is located one side of the first linkage segment of pull tab, when the ejector pin pole is in the firing position, the boss with the interlude contact of pull tab and with the interlude jack-up of pull tab to the direction of keeping away from the axle center of anastomat.
Optionally, two bosses are disposed on the ejector pin rod, and when the ejector pin rod is located at the initial position, the two bosses are located at two sides of the first connecting section of the pull tab respectively.
Optionally, the anastomat further comprises an adjusting shaft in the anastomat body, the proximal side of the pull tab is connected with the adjusting shaft, the nail pushing rod is in the initial position, and the boss has relative movement along the extending direction of the first connecting section relative to the pull tab when the pull tab moves along the axial direction of the anastomat under the action of the adjusting shaft.
Optionally, a transition section with smooth transition of the side surface is arranged between the middle section of the pull tab and the first connecting section.
Optionally, a central groove is formed in the pull tab, when the ejector pin rod is in the initial position, the boss enters the central groove of the pull tab, and when the ejector pin rod moves from the initial position to the firing position, the boss is separated from the distal end side of the central groove and is in contact with the inner side surface of the pull tab.
Optionally, the anastomat further comprises an adjusting shaft in the anastomat body, the proximal end side of the pull tab is connected with the adjusting shaft, the central groove extends along the axial direction of the anastomat, the nail pushing rod is in the initial position, when the pull tab moves along the axial direction of the anastomat under the action of the adjusting shaft, the boss is in the central groove, and the boss has relative movement along the extending direction of the central groove relative to the pull tab.
The embodiment of the invention also provides a circular tube type anastomat, which comprises the firing assembly.
The embodiment of the invention also provides a circular tube type anastomat, which comprises the firing assembly.
The firing assembly and the circular tube type anastomat provided by the invention have the following advantages:
the invention provides a firing assembly for a tubular anastomat, which is characterized in that in the process of forming staples of the anastomat, the interaction of a staple pushing rod and a pulling piece causes structural change of the pulling piece, a pulling force towards the proximal end side of the anastomat is given to the distal end side of the pulling piece, and the pulling force received by the pulling piece is transmitted to a staple anvil shaft through the staple anvil pulling rod, so that the movement of the staple anvil towards the distal end side is compensated, the gap variation between the staple anvil and a staple bin assembly is reduced as much as possible, and the staple forming effect is improved.
Detailed Description
Example embodiments will now be described more fully with reference to the accompanying drawings. However, the exemplary embodiments can be embodied in many different forms and should not be construed as limited to the embodiments set forth herein, but rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the concept of the exemplary embodiments to those skilled in the art. The same reference numerals in the drawings denote the same or similar structures, and thus a repetitive description thereof will be omitted.
In order to solve the technical problems in the prior art, the invention provides a firing assembly for a circular tube type anastomat and the circular tube type anastomat comprising the firing assembly. The anastomat comprises an anastomat body, an operating handle movably connected with the anastomat body and an anvil component matched with the anastomat body. The nail anvil assembly comprises a nail anvil positioned at the far end side of the anastomat body and a nail anvil shaft positioned at the near end side of the nail anvil, and the anastomat body comprises a nail bin assembly arranged at the far end side of the body and a knob arranged at the near end side of the body. The firing assembly comprises a nail pushing rod, a pulling piece and a nail anvil pulling rod positioned at the far end side of the pulling piece, wherein the nail pushing rod is provided with an initial position and a firing position, the initial position refers to the position of the nail pushing rod when the operating handle is not held, and the firing position refers to the position of the nail pushing rod when the operating handle is held and then the nail pushing rod is pushed to move towards the far end side of the anastomat so as to push out the anastomat. The distal side of the pull tab is connected to the proximal side of the anvil pull rod and to the anvil shaft through the anvil pull rod, and the proximal side of the pull tab is connected to the knob through an adjustment shaft.
In the tumor operation process, after tumor tissues are removed by separation, an anvil shaft of the anvil assembly penetrates out of a pouch of residual tissues and is configured at the far end side of the anastomat body, the knob is rotated, the anvil is pulled to move towards the near end side of the anastomat by the adjusting shaft, the pull piece, the anvil pull rod and the anvil shaft, the distance between the anvil and the staple cartridge assembly is gradually reduced to reach a proper distance, and then the state can be reached, at the moment, an operating handle is held, the operating handle pushes the staple pushing rod to move from the initial position to the firing position, and the staple pushing rod drives the staple pushing piece to push staples in the staple cartridge assembly, so that the forming of the staples on the surface of the anvil is realized, and the firing of the anastomat is realized.
When the stapler is fired, the anvil is subjected to the extrusion force of the tissue to the distal end side of the stapler and the pushing force of the staples to the distal end side of the stapler, and then the axial movement is generated. The amount of the movement of the anvil is the flexibility of the anvil assembly, and the flexibility is caused by various reasons, such as fit clearances of various parts (including the anvil assembly, the pull tab, the screw rod, the knob) and the like in the anastomat, the rigidity of the material and the like. In consideration of the problems of difficulty and cost of changing the fit clearance between the nail anvil and the nail bin assembly and the rigidity change of the material, the invention compensates the flexibility of the nail anvil assembly by using structural characteristics under the condition of not increasing the cost by structurally improving the firing assembly so as to reduce the influence of the axial movement of the firing mechanism on the distance between the nail bin and the nail anvil during firing.
Specifically, a boss is arranged on one side of the nail pushing rod. When the nail pushing rod moves from the initial position to the firing position, the boss is in contact with the pulling piece and pushes the pulling piece up in the direction away from the axis of the anastomat, so that the pulling piece generates a pulling force towards the proximal end side of the anastomat on the nail anvil shaft, the pulling force can compensate the pushing force of tissues and the anastomat on the nail anvil shaft towards the distal end side of the anastomat, the axial shifting amount of the nail anvil during the firing of the anastomat is reduced as much as possible, the gap variation between the nail anvil and the nail bin assembly is reduced as much as possible, and the nail forming effect is improved. Here, in the stapler, the inner side and the outer side are the inner side with respect to the axis of the stapler, and the side away from the axis is the outer side.
The structure of the stapling and firing assembly in two embodiments of the present invention is described in detail below with reference to FIGS. 1-9. Fig. 1 to 5 show the structure of a firing assembly according to a first embodiment of the present invention, and fig. 6 to 9 show the structure of a firing assembly according to a second embodiment of the present invention.
As shown in fig. 1, the stapler comprises a stapler body and an anvil assembly 1, wherein the anvil assembly 1 comprises an anvil 11 positioned at the distal end side of the stapler body and an anvil shaft 12 positioned at the proximal end side of the anvil, and the distal end side of the stapler body is provided with a cartridge assembly 2. The cartridge assembly 2 comprises a push plate. The inside of the anastomat body is provided with a nail pushing rod 3, pull sheets 4 and 5 and a nail anvil pull rod 7 positioned at the distal end side of the pull sheets. In this embodiment, the tabs 4,5 are provided with two tabs, a first tab 4 and a second tab 5, the two tabs 4,5 having the same function and structure and being arranged in overlapping relation, the first tab 4 being described below as an example. In other embodiments, the number of tabs may be modified, such as having only one tab, or having three tabs, etc. In the view of fig. 1 to 4, the distal side 32 of the ejector pin 3 is the left side in the drawing, the proximal side 31 of the ejector pin 3 is the right side in the drawing, the distal side 32 of the ejector pin 3 is close to the cartridge assembly 2, the proximal side 31 of the ejector pin 3 is linked with an operation handle, and when in firing, the operation handle pushes the ejector pin 3 to move to the distal side, and the staples in the cartridge assembly 2 are pushed by the ejector pin sheet. The distal end side 42 of the first pull tab 4 is the left end in the drawing, the proximal end side 41 of the first pull tab 4 is the right end in the drawing, the distal end side 42 of the first pull tab 4 is connected with the proximal end side of the anvil pull rod 7, the proximal end side 41 of the first pull tab 4 is connected with a knob (not shown in the drawing) through an adjusting shaft 6, and when the knob rotates, the first pull tab 4 and the second pull tab 5 can be driven to move along the axial direction of the anastomat through the adjusting shaft 6, and then the anvil 11 is driven to approach or be far away from the cartridge assembly 2 through the anvil pull rod 7 and the anvil shaft 12.
To compensate for the flexibility of the anvil assembly 1, the amount of play of the anvil 11 during the firing of the stapler is reduced, as shown in fig. 2, a boss 33 is provided on one side of the ejector pin 3, and during the firing of the stapler, the ejector pin 3 moves from the initial position to the firing position, the boss 33 contacts with the inner side surface of the first pull tab 4 and pushes up the pull tabs 4,5 away from the axis of the stapler, so that the pull tabs 4,5 generate a pulling force on the anvil pull rod 7 toward the proximal side of the stapler, and the pulling force compensates for the tissue received by the anvil 11 and the pushing force of the staples toward the distal side. In this embodiment, the inner side surface of the first pull tab 4 is a side surface of the first pull tab 4 facing the axis direction of the stapler, and the opposite side is an outer side surface of the first pull tab 4.
In this embodiment, as shown in fig. 2, the boss 33 is provided integrally with the ejector pin 3. The distal side of the boss 33 is a first transition surface 331, and the proximal side of the first transition surface 331 is closer to the pull tab 4,5 than the distal side of the transition surface, i.e. the distance from the proximal side of the first transition surface 331 to the axis is greater than the distance from the distal side of the first transition surface 331 to the axis in the direction perpendicular to the axis. The surface of the first transition surface 331 may be a slant surface or a cambered surface. When the ejector pin 3 moves from the initial position to the firing position, the first transition surface 331 of the boss 33 first contacts the inner side surface of the first pull tab 4, so that the pull tabs 4,5 can be smoothly ejected by the boss 33.
As shown in fig. 3, the first pull tab 4 includes a first connection section 44, an intermediate section 43, and a second connection section 45 arranged in this order from the proximal end side 41 to the distal end side 42 of the first pull tab 4, and the intermediate section 43 may have a width greater than that of the first connection section 44, and further, the intermediate section 43 may have a width greater than that of the second connection section 45. As shown in fig. 4, when the ejector pin 3 is in the initial position, the boss 33 is located at one side of the first connecting section 44 of the first pull tab 4, and since the second pull tab 5 is overlapped with the first pull tab 4 and has the same structure, the boss 33 is also located at one side of the first connecting section of the second pull tab 5. In this embodiment, two bosses 33 are provided on the ejector pin bar 3, the two bosses 33 being provided on both sides of the first connecting section of the pull tabs 4,5, respectively. However, the present invention is not limited thereto, and it is within the scope of the present invention to provide only one boss 33 or to provide a plurality of bosses 33.
As shown in fig. 5, since the staple pushing rod 3 is located at the initial position before firing, the boss 33 is located at one side or two sides of the first connecting end 44 of the first pull tab 4, and the boss 33 is not in contact with the inner side surface of the first pull tab 4, so that the first pull tab 4 and the second pull tab 5 cannot be lifted. When the ejector pin lever 3 moves from the initial position to the firing position, that is, in the direction a in fig. 5, the boss 33 moves relatively to the first pull tab 4 in the distal end side direction of the stapler, and the boss 33 enters the range of the intermediate section of the first pull tab 4, thereby coming into contact with the inner side surface of the intermediate section 43 of the pull tab and pushing up the intermediate sections of the pull tabs 4,5 in the direction away from the axial center S of the stapler. After the anastomat is completely fired, the nail pushing rod 3 returns to the initial position from the firing position, at the moment, the bosses 33 return to the two sides of the first connecting section 44 again, so that the bosses are not contacted with the inner side surface of the first pull tab 4, and the first pull tab 4 and the second pull tab 5 recover to a flat state after losing the external jacking acting force.
In this embodiment, the ejector pin 3 is in the initial position and the tabs 4,5 have a relative movement in the direction of extension of the first connecting section 44 when moved in the axial direction of the stapler by the adjustment shaft 6. Therefore, when the ejector pin rod 3 is at the initial position, the boss 33 of the ejector pin rod 3 is not contacted with the inner side surface of the first pull tab 4, and the axial movement of the pull tabs 4 and 5 is not affected, the anvil 11 can be driven to be far away from or close to the staple cartridge assembly 2 by the adjusting shaft 6, the pull tabs 4 and 5 and the anvil pull rod 7 in sequence normally through the adjusting knob, and the relation between the rotation angle of the knob and the moving distance of the anvil 11 is not changed due to the fact that the boss 33 is additionally arranged, namely, the boss 33 does not affect the original functions of the pull tabs 4 and 5 before the stapler is fired.
In this embodiment, the distal to proximal sides of the first transition surface 331 are smoothly transitioned, the first transition surface 331 forms an angle with the surface of the ejector pin, and the angle may be set relatively gentle at the distal-most side of the first transition surface 331, i.e., an obtuse angle is formed between the first transition surface 331 and the ejector pin 3 at the distal-most side of the first transition surface 331, and further, the angle is preferably 120 ° to 150 °. Before firing, when the ejector pin bar 3 is located at the initial position, even if the boss 33 and the inner side surface of the first pull tab 4 can be partially contacted, the pull tabs 4 and 5 are not influenced to protrude outwards too much to influence the original functions.
In this embodiment, a transition section 46 with smooth transition of the side surface is provided between the middle section 43 of the first pull tab 4 and the first connecting section 44, so that smooth transition of the boss 33 from the side surface of the first connecting section 44 to the inner side surface of the middle section 43 is realized. Further, a transition section 46 with smooth transition sides may be provided between the second connecting section 45 and the middle section 43, and two side surfaces of the transition section 46 may be inclined planes or cambered surfaces with smooth transition sides. However, the present invention is not limited thereto, and in other alternative embodiments, the transition section 46 may not be provided between the first connecting section 44 and the intermediate section 43, and between the second connecting section 45 and the intermediate section 43, and may be a straight transition.
In this embodiment, the pull tabs 4,5 are preferably elastic pull tabs 4,5, which can make the pull tabs 4,5 more easily ejected by the boss 33, and the pull tabs 4,5 are further preferably elastic pull tabs 4,5 made of metal sheets, but the present invention is not limited thereto, and other materials such as plastics and the like are also within the scope of the present invention.
Fig. 6 to 9 are schematic structural views of a firing assembly according to a second embodiment of the present invention. This embodiment differs from the first embodiment in that (1) the boss is provided separately from the ejector pin 3, the boss being formed by a pin 35 protruding from the surface of the ejector pin 3. (2) The first tab 4 is provided with a central slot 47 in which the pin 35 is positioned so as not to hinder axial movement of the tabs 4,5 under the action of the knob when the stapler is not fired, said pin 35 being in contact with the inner lateral surface of said tabs 4,5 beyond the distal side of said central slot 47 when fired, so that the tabs 4,5 are ejected.
In this embodiment, as shown in fig. 6, a positioning groove 34 is provided on one side of the pin pushing rod 3, the pin shaft 35 is provided in the positioning groove 34, the top end of the pin shaft 35 protrudes from the surface of the pin pushing rod 3 to form the boss, and the number and the position of the pin shaft 35 can be selected according to the requirement. As shown in fig. 7 to 9, the pull tabs 4 and 5 are provided with a central slot 47, when the pin shaft 35 enters the central slot 47 of the pull tabs 4 and 5 in the initial position of the pin shaft 3, and when the pin shaft 35 moves from the initial position to the firing position, the pin shaft 35 is separated from the distal end side of the central slot 47 and contacts with the inner side surface of the pull tabs 4 and 5, and the pin shaft 35 pushes up the pull tabs 4 and 5 in a direction away from the axis of the stapler, so that the pull tabs 4 and 5 generate a pulling force on the anvil pull rod 7 toward the proximal end side of the stapler. After the anastomat is completely fired, the nail pushing rod 3 returns to the initial position from the firing position, and at the moment, the pin shaft 35 returns to the central groove 47 again, so that the pin shaft is not contacted with the first pull piece 4 any more, and the first pull piece 4 and the second pull piece 5 recover to a flat state after losing the force of jacking outwards.
In the first embodiment, the boss 33 and the ejector pin 3 are integrally formed, and the ejector pin 3 is often a plastic part, the boss 33 is also an integrally formed plastic part, and the plastic part and the metal pull tab 4 are easily worn in the long-term relative sliding friction process, so that the compensation effect is affected. Therefore, the pin 35 which is separately arranged with the nail pushing rod 3 is adopted in the second embodiment, and the pin 35 is preferably a metal pin, and the metal-metal contact mode is adopted to replace the plastic-metal contact mode in the first embodiment, so that the abrasion can be reduced, and the compensation effect is more obvious.
As shown in fig. 8, in order to achieve a smooth transition when the pin 35 is disengaged from the central groove 47, the distal end side surface of the pin 35 is provided with a second transition surface 351, and the second transition surface 351 may be an inclined surface or an arc surface to guide the pin 35 to be smoothly disengaged from the central groove 47. In this example, the pin 35 is a ball pin, and in other alternative embodiments, the pin 35 may be a slow transition angle pin, or have a cam surface, etc. Correspondingly, on the distal side of the central slot 47, a guide surface is also provided to better cooperate with the pin 35.
In this embodiment, the central slot 47 extends in the axial direction of the stapler, the ejector pin 3 is in the initial position, and the pins 35 are in the central slot 47 with a relative movement in the direction of extension of the central slot 47 when the pull tabs 4,5 are moved in the axial direction of the stapler by the adjustment shaft 6. Therefore, when the ejector pin 3 is at the initial position, the pin shaft 35 of the ejector pin 3 is not in contact with the inner side surface of the first pull tab 4, so that the axial movement of the pull tabs 4 and 5 is not affected, the anvil 11 can be driven to be far away from or close to the staple cartridge assembly 2 through the adjusting shaft 6, the pull tabs 4 and 5, the anvil pull rod 7 and the anvil shaft 12 in sequence normally through the adjusting knob, and the relation between the rotation angle of the knob and the moving distance of the anvil 11 is not changed due to the fact that the pin shaft 35 is additionally arranged, namely, the pin shaft 35 does not affect the original functions of the pull tabs 4 and 5 before the stapler is fired.
The central slot 47 in this embodiment may be a through slot that communicates the inner side and the outer side of the pull tabs 4,5, or a blind slot that is formed on the inner side of the first pull tab 4, or both the first pull tab 4 and the second pull tab 5, or only the first pull tab 4, which falls within the protection scope of the present invention.
The pull tabs 4,5 in this embodiment may also be divided into a first connecting section, a middle section and a second connecting section which are arranged in this order from the proximal side to the distal side. The central slot 47 may be open in the middle section and communicate all the way to the first connecting section, and the extension of the central slot 47 may be determined according to the range of movement of the tabs 4,5 in the axial direction. The central groove 47 may be formed at the central axis of the middle section, or may be offset from the central axis of the middle section, and only needs to correspond to the position of the pin 35.
In order to ensure the balance of the stress of the pull tab, two pins 35 may be symmetrically disposed, and correspondingly, the central slot 47 is also matched with each pin 35, so as to achieve a better compensation effect.
Fig. 1-9 illustrate only exemplary firing assemblies and stapling instrument arrangements in accordance with two embodiments of the present invention. In other embodiments, the two embodiments may be combined with each other, for example, in the first embodiment, a central groove may be formed in the pull tabs 4 and 5, and when the push rod 3 is in the initial position, the boss 33 enters the central groove of the pull tabs 4 and 5, and when the push rod 3 moves from the initial position to the firing position, the boss 33 is separated from the central groove of the pull tabs 4 and 5 and contacts with the inner side surface of the first pull tab 4, so as to jack the first pull tab 4 and the second pull tab 5. In the second embodiment, the pin 35 may be moved to the proximal end side of the ejector pin 3 to a position corresponding to the first connecting section 41, and when the ejector pin is in the initial state, the pin 35 is located on one side of the first connecting section 41 and does not contact the inner side surface of the first pull tab 4, and when the ejector pin 3 is moved from the initial position to the firing position, the pin 35 is moved to the intermediate section 43 of the first pull tab 4, and thereby the first pull tab 4 and the second pull tab 5 are lifted.
The firing assembly and the circular tube type anastomat provided by the invention have the following advantages:
the invention provides a firing assembly for a tubular anastomat, which is characterized in that in the process of forming staples of the anastomat, the interaction of a staple pushing rod and a pulling piece causes structural change of the pulling piece, a pulling force towards the proximal end side of the anastomat is given to the distal end side of the pulling piece, and the pulling force received by the pulling piece is transmitted to a staple anvil shaft, so that the movement of the staple anvil towards the distal end side is compensated, the gap variation between the staple anvil and a staple bin assembly is reduced as much as possible, and the staple forming effect is improved.
The foregoing is a further detailed description of the invention in connection with the preferred embodiments, and it is not intended that the invention be limited to the specific embodiments described. It will be apparent to those skilled in the art that several simple deductions or substitutions may be made without departing from the spirit of the invention, and these should be considered to be within the scope of the invention.