Disclosure of Invention
The first aim of the invention is to provide a nail bin cushion block of a endoscope cutting anastomat, which is characterized in that the nail bin cushion block is arranged at the position, close to a nail bin knife groove, of a nail bin assembly; when the nail bin is arranged in the nail bin frame, the upper bottom surface of the nail bin cushion block is contacted with the lower bottom surface of the nail bin, which is close to the nail bin knife slot, of the nail bin, and the lower bottom surface of the nail bin cushion block is contacted with the upper bottom surface of the nail bin frame, which is close to the nail bin knife slot; the technical scheme that when the tissue is clamped between the nail bin assembly and the nail anvil assembly, the nail bin cushion block blocks the nail bin tissue contact surface close to the nail bin knife groove from moving in the direction of the upper bottom surface of the nail bin frame is realized. Because when the nail bin assembly and the nail anvil assembly clamp tissues, the nail bin cushion block blocks the clamped tissues from pressing the nail bin tissues close to the nail bin knife groove to move in the direction of the upper bottom surface of the nail bin frame, the phenomenon that the anastomat stretches out of the nail storage hole to be stuck on the clamped tissues can be avoided, and at the moment, if the nail bin assembly and the nail anvil assembly are opened, the tissues can not bring the anastomat out of the nail storage hole, so that the technical effect that the operation of anastomat for cutting the anastomat by using the endoscope can normally finish the anastomotic tissues is achieved. Because the phenomenon that the tissue of the nail bin close to the cutter slot of the nail bin moves towards the upper bottom surface of the nail bin frame and then is contained is avoided, the tissue which is not contained is extruded from the position between the tissue contact surface of the nail bin and the tissue contact surface of the nail anvil, and the movement of the clamped tissue with the anastomat can not generate larger position deviation of the anastomat arranged in the nail storage hole, when the bottom block of the wedge moves between the lower bottom surface of the nail bin and the upper bottom surface of the nail bin frame, the small structure between adjacent nail storage holes for restraining the anastomat in the nail bin can be prevented from being damaged by the aid of the nail bin cushion block, and the position deviation of the anastomat arranged in the nail storage hole can be prevented, so that the anastomat can be accurately pressed on the forming slot to be formed in a bending mode, and the quality of the bending mode of the anastomat is improved; the surgical operation device is particularly suitable for clamping anastomosed tissues containing anastomotic nails for the second time, is particularly suitable for clamping tough and thick tissues such as anastomosed stomach and the like, and is also particularly suitable for clamping lung tissues such as hard trachea, lung nodules and the like during anastomosis, and achieves the technical effect of ensuring the safety and reliability of the surgical operation.
The second aim of the invention is to provide a nail bin cushion block of the endoscope cutting anastomat, which adopts the technical characteristics that a groove is arranged in the nail bin cushion block and a convex block is arranged in the nail pushing block; the technical characteristics of the accommodating groove are formed by adopting the pushing surface of the bottom block of the inclined wedge, the inclined wedge piece and the guide block; the technical scheme is that when the nail bin cushion block is installed in the nail bin, the convex blocks of the nail pushing block are inserted into the grooves of the nail bin cushion block, and the nail bin cushion block is restrained on the nail pushing block; after the tissue is clamped between the nail bin assembly and the nail anvil assembly, the driving piece pushes the inclined wedge to move forwards, the inclined wedge piece of the inclined wedge pushes the nail pushing block to move upwards in the nail storage hole, so that the convex block of the nail pushing block moves out of the groove of the nail bin cushion block, and then the pushing surface of the bottom block of the inclined wedge pushes the nail bin cushion block to move forwards; meanwhile, the nail bin cushion block is restrained in the accommodating groove of the inclined wedge. Because the lug of the nail pushing block is inserted into the groove of the nail pushing block when the nail pushing block is arranged in the nail bin, the nail pushing block is restrained on the nail pushing block, when the nail bin assembly and the nail anvil assembly clamp tissues, the nail bin block blocks the clamped tissues from being pressed by the clamped tissues to move in the direction of the contact surface of the nail bin tissues close to the nail bin knife groove to the upper bottom surface of the nail bin frame, and the technical effect that the endoscopic cutting anastomat can normally finish the operation of anastomosing tissues is achieved. After tissue is clamped between the nail bin assembly and the nail anvil assembly, the driving piece pushes the inclined wedge to move forwards, the inclined wedge piece of the inclined wedge pushes the nail pushing block to move upwards in the nail storage hole, the convex block of the nail pushing block moves out of the groove of the nail bin cushion block, after that, the push surface of the bottom block of the inclined wedge pushes the nail bin cushion block to move forwards, and meanwhile, the nail bin cushion block is restrained in the accommodating groove of the inclined wedge, so that after the endoscopic cutting anastomat completes the operation of anastomosing tissue, the nail bin cushion block moves forwards to the front part of the nail bin, the hard tissue which is anastomosed by the anastomosing nail makes the nail bin tissue contact surface close to the nail bin knife groove move towards the upper bottom surface of the nail bin frame, the acting force between the hard tissue which is anastomosed by the nail bin tissue contact surface and the nail anvil tissue contact surface can be reduced, and the driving piece can exit the nail bin assembly and the nail anvil assembly with smaller force, and the technical effect that the endoscopic cutting anastomat can normally complete the anastomosing tissue is further achieved.
The invention aims at realizing the following technical scheme:
the execution assembly of the endoscopic cutting anastomat comprises a nail bin assembly and a nail anvil assembly. A driver is installed in the actuator assembly. The driving piece is provided with a cutting knife. The laparoscopic cutting stapler may be a straight laparoscopic cutting stapler or an arcuate laparoscopic cutting stapler. The nail bin assembly is provided with a nail bin, a nail bin frame, an inclined wedge and a nail bin knife slot in the front-back direction. The nail bin is arranged on the nail bin frame. The inclined wedge is provided with a bottom block. The lower bottom surface of the bottom block rests on the upper bottom surface of the cartridge frame. The bottom block can move back and forth between the lower bottom surface of the nail bin and the upper bottom surface of the nail bin frame. A plurality of nail storage holes are arranged on the nail bin tissue contact surface of the nail bin in a staggered way. And installing the anastomat and the nail pushing block in the nail storage hole. Staples are mounted on top of the pusher block. A plurality of concave forming grooves are arranged on the nail anvil tissue contact surface of the nail anvil component in a staggered way. The anvil assembly has anvil pockets in a fore-and-aft direction. The driving member pushes the cutter to move along the cartridge knife slot and the anvil knife slot. After tissue is clamped between the nail bin assembly and the nail anvil assembly, the forming groove on the nail anvil assembly corresponds to the position of the anastomat in the nail bin, the driving part pushes the inclined wedge to move forwards, the inclined wedge pushes the nail pushing block to move upwards in the nail storage hole, the nail pushing block pushes the anastomat to puncture the tissue to press against the forming groove to form the anastomat after being bent, and the driving part pushes the cutting knife to move forwards along the nail bin knife groove and the nail anvil knife groove to cut the tissue between the nail bin knife groove and the nail anvil knife groove.
And a nail bin cushion block is arranged at the position, close to the nail bin knife groove, of the nail bin assembly. The single side of the nail bin assembly, which is close to the nail bin knife slot, can be provided with the nail bin cushion block, and the left side and the right side of the nail bin assembly, which is close to the nail bin knife slot, can be provided with the nail bin cushion block. When the nail bin is installed in the nail bin frame, the upper bottom surface of the nail bin cushion block is contacted with the lower bottom surface of the nail bin, which is close to the nail bin knife slot, of the nail bin, and the lower bottom surface of the nail bin cushion block is contacted with the upper bottom surface of the nail bin frame, which is close to the nail bin knife slot. When tissue is clamped between the cartridge assembly and the anvil assembly, the cartridge spacer blocks movement of the cartridge tissue contacting surface adjacent the cartridge knife channel in a direction toward the upper bottom surface of the cartridge frame.
The nail bin cushion block is provided with a groove. The nail pushing block is provided with a convex block. When the nail bin cushion block is installed in the nail bin, the convex blocks of the nail pushing block are inserted into the grooves of the nail bin cushion block, and the nail bin cushion block is restrained on the nail pushing block. The first technical scheme is as follows: the front and rear sides of the nail bin cushion block are respectively provided with a front groove and a rear groove. The two nail pushing blocks adjacent to the nail bin cushion block are respectively a front nail pushing block and a rear nail pushing block. When the nail bin cushion block is installed in the nail bin, the protruding blocks of the front nail pushing block are inserted into the front grooves of the nail bin cushion block, the protruding blocks of the rear nail pushing block are inserted into the rear grooves of the nail bin cushion block, and the nail bin cushion block is restrained on two adjacent nail pushing blocks. The second technical proposal is as follows: the middle of the nail bin cushion block is provided with a groove. When the nail bin cushion block is installed in the nail bin, the convex blocks on the front side and the rear side of the nail pushing block are inserted into the grooves of the nail bin cushion block together, so that the nail bin cushion block is restrained on the nail pushing block. The third technical scheme is as follows: the middle of the nail bin cushion block is provided with a first groove, and one side of the nail bin cushion block is provided with a second groove. The two nail pushing blocks adjacent to the nail bin cushion block are a first nail pushing block and a second nail pushing block respectively. When the nail bin cushion block is arranged in the nail bin, the convex blocks on the front side and the rear side of the first nail pushing block are inserted into the first groove of the nail bin cushion block together, the convex blocks on one side of the second nail pushing block are inserted into the second groove of the nail bin cushion block, and the nail bin cushion block is restrained on the two adjacent nail pushing blocks. The fourth technical scheme is as follows: the nail bin cushion block is provided with a front groove, a middle groove and a rear groove; the three nail pushing blocks adjacent to the nail bin cushion block are respectively a front nail pushing block, a middle nail pushing block and a rear nail pushing block. When the nail bin cushion block is installed in the nail bin, the convex blocks on the front side and the rear side of the middle nail pushing block are inserted into the middle groove of the nail bin cushion block together, the convex blocks on the rear side of the front nail pushing block are inserted into the front groove of the nail bin cushion block, the convex blocks on the front side of the rear nail pushing block are inserted into the rear groove of the nail bin cushion block, and the nail bin cushion block is restrained on the adjacent three nail pushing blocks.
The front end of the bottom block of the inclined wedge can be provided with a pushing surface, and the side surface can be provided with an inclined wedge piece. The nail bin is provided with an inclined wedge groove. The inclined wedge piece of the inclined wedge is inserted into the inclined wedge groove of the nail bin. After the tissue is clamped between the nail bin assembly and the nail anvil assembly, the driving piece pushes the inclined wedge to move forwards, the inclined wedge piece of the inclined wedge pushes the nail pushing block to move upwards in the nail storage hole, the protruding block of the nail pushing block moves out of the groove of the nail bin cushion block, and then the pushing surface of the bottom block of the inclined wedge pushes the nail bin cushion block to move forwards.
The wedge may have a guide block therein. When the nail bin is arranged in the nail bin frame, the guide block of the inclined wedge is inserted into the knife groove of the nail bin. After the tissue is clamped between the nail bin assembly and the nail anvil assembly, the driving piece pushes the inclined wedge to move forwards, and the inclined wedge plate of the inclined wedge pushes the nail pushing block to move upwards in the nail storage hole, so that the protruding block of the nail pushing block moves out of the groove of the nail bin cushion block; simultaneously, the guide block of the inclined wedge and the inclined wedge piece block the nail bin cushion block from moving leftwards and rightwards; thereafter, the push surface of the bottom block of the wedge pushes the cartridge head block forward.
The pushing surface of the bottom block of the inclined wedge, the inclined wedge piece and the guide block can form an accommodating groove. After the tissue is clamped between the nail bin assembly and the nail anvil assembly, the driving piece pushes the inclined wedge to move forwards, and the pushing surface of the inclined wedge pushes the nail bin cushion block to move forwards; at the same time, the nail bin cushion block is restrained in the accommodating groove of the inclined wedge.
The side surface of the nail bin knife slot of the nail bin can be provided with a nail bin supporting piece. After the nail bin is installed in the nail bin frame, an upper supporting part in the front-rear direction is formed on the side face of the nail bin knife slot of the nail bin. The upper supporting part is positioned between the upper edge of the nail bin supporting piece and the nail bin tissue contact surface of the nail bin. The lower edge of the nail bin supporting piece is contacted with the upper bottom surface of the nail bin cushion block. The lower bottom surface of the nail bin cushion block is contacted with the upper bottom surface of the nail bin frame. When tissue is clamped between the nail bin assembly and the nail anvil assembly, the upper supporting part of the side face of the nail bin knife slot is blocked from moving towards the upper bottom face of the nail bin frame by the nail bin supporting piece and the nail bin cushion block, so that the nail bin tissue contact face close to the nail bin knife slot is blocked from moving towards the upper bottom face of the nail bin frame.
Drawings
FIG. 1 is an external view showing an opening of an actuator assembly of a first endoscopic cutting stapler of the present invention;
FIG. 2 is an external view showing the closing of an actuator assembly of the laparoscopic cutting stapler of FIG. 1;
FIG. 3 is an exterior view showing the anvil assembly of FIG. 1;
FIG. 4 is a top view of the cartridge assembly of FIG. 2 illustrating the mounting of the cartridge head of the first embodiment;
FIG. 5 is a cross-sectional view taken along line 5-5 of FIG. 4;
FIG. 6 is an exterior view showing the cartridge bay of FIG. 5;
FIG. 7 is an exterior view showing the cartridge assembly of FIG. 4 with the cartridge frame removed;
FIG. 8 is an exterior view showing the staple cartridge of FIG. 7;
FIG. 9 is an enlarged exterior view showing the mounting of the cartridge sled of the first embodiment of FIG. 7 on the pusher block;
FIG. 10 is an enlarged exterior view of the cartridge head block of the first embodiment of FIG. 9;
FIG. 11 is an enlarged view showing the staples and pusher blocks of FIG. 7;
FIG. 12 is an enlarged view showing the wedge of FIG. 7;
FIG. 13 is a front view showing the driving member of FIG. 7;
FIG. 14 is a top plan view of the actuator assembly of FIG. 2 illustrating pushing away of the wedges to restrain the staple cartridge pad of the first embodiment;
FIG. 15 is a section view taken at 15-15 of FIG. 14;
fig. 16 is a partial enlarged view showing a region a of fig. 15;
FIG. 17 is a partial exterior view showing the part of FIG. 14 removed;
FIG. 18 is a partial exterior view showing the wedge of FIG. 17 after completion of staple ejection;
FIG. 19 is an external view showing an opening of an actuator assembly of a second endoscopic cutting stapler of the present invention;
FIG. 20 is an external view showing the closing of the actuator assembly of the laparoscopic cutting stapler of FIG. 19;
FIG. 21 is an exterior view showing the anvil assembly of FIG. 19;
FIG. 22 is a top view of the cartridge assembly of FIG. 20 illustrating the mounting of the cartridge spacer of the first embodiment;
FIG. 23 is a sectional view taken along line 23-23 of FIG. 22;
FIG. 24 is a section view taken at 24-24 of FIG. 22;
FIG. 25 is an exterior view showing the cartridge bay of FIG. 24;
FIG. 26 is an exterior view showing the cartridge assembly of FIG. 22 with the cartridge frame removed;
fig. 27 is a partial enlarged view showing a region B of fig. 26;
FIG. 28 is an exterior view showing the staple cartridge of FIG. 26;
FIG. 29 is an enlarged view showing the staples and pusher blocks of FIG. 26;
FIG. 30 is an enlarged view showing the wedge of FIG. 26;
FIG. 31 is a front view showing the driving member of FIG. 19;
FIG. 32 is a top plan view of the actuator assembly of FIG. 20 illustrating pushing away of the wedges to restrain the staple cartridge pad of the first embodiment;
FIG. 33 is a cross-sectional view taken along line 33-33 of FIG. 32;
fig. 34 is a partial enlarged view showing a region C of fig. 33;
FIG. 35 is an enlarged view of the wedge and cartridge sled of the first embodiment of FIG. 34 after completion of staple ejection;
FIG. 36 is an exterior view showing the mounting of the cartridge spacer of the second embodiment to a staple cartridge;
fig. 37 is a partial enlarged view showing a region D of fig. 36;
FIG. 38 is an enlarged exterior view of the cartridge pad of the second embodiment of FIG. 37;
FIG. 39 is an exterior view showing the mounting of the cartridge head block of the first embodiment and the cartridge head block of the second embodiment to a staple cartridge;
FIG. 40 is an exterior view showing the mounting of a cartridge spacer of a third embodiment to a staple cartridge;
fig. 41 is a partial enlarged view showing an area E of fig. 40;
FIG. 42 is an enlarged exterior view of the cartridge pad of the third embodiment of FIG. 41;
FIG. 43 is an exterior view showing the mounting of the cartridge spacer of the fourth embodiment to a staple cartridge;
fig. 44 is a partial enlarged view showing an area F of fig. 43;
FIG. 45 is an enlarged exterior view of the cartridge head block of the fourth embodiment of FIG. 44;
FIG. 46 is a top view of the cartridge assembly illustrating the mounting of the cartridge buttress and the cartridge pad of the first embodiment;
FIG. 47 is a section view taken at 47-47 of FIG. 46;
FIG. 48 is a section view taken at 48-48 of FIG. 46;
FIG. 49 is an exterior view showing the cartridge assembly of FIG. 46 with the cartridge frame removed;
FIG. 50 is a top view of the cam wedge, cartridge buttress and cartridge sled of FIG. 49 illustrating a first embodiment;
FIG. 51 is a cross-sectional view taken through 51-51 of FIG. 50;
Fig. 52 is a cross-sectional view taken through 52-52 of fig. 50.
Detailed Description
By way of example, the preferred embodiment of the cartridge spacer of the endoscopic cutting stapler of the present invention is set forth below in connection with the accompanying drawings. It should be appreciated that some or all of the figures are schematic illustrations of preferred embodiments of the invention, and that the actual dimensions of the illustrated parts are not depicted. The foregoing and other objects and advantages of the invention will be more clearly understood upon reference to the detailed description of the preferred embodiment. In the drawings and the following description, the term "posterior" refers to a location proximal to a laparoscopic cutting stapler operator, and the term "anterior" refers to a location distal to the laparoscopic cutting stapler operator; the term "left" refers to the left side of the laparoscopic cutting stapler operator, while the term "right" refers to the right side of the laparoscopic cutting stapler operator; the term "upper" refers to above the laparoscopic cutting stapler operator, while the term "lower" refers to below the laparoscopic cutting stapler operator. Other positional and directional terms may be understood from the drawings and the following description. In order to highlight the figures and descriptions of the cartridge spacer and related components of the endoscopic cutting stapler of the present invention, other components are not described in detail in the drawings. For the structure, installation, use and action of the parts of various endoscopic cutting staplers, reference is made to the patents cited in this specification and to other documents related thereto, and reference is also made to the "multipurpose endoscopic surgical instrument" of the chinese patent invention (application No. 201911292988.2).
Fig. 1-18 illustrate a first embodiment of a cartridge sled according to the present invention in a first endoscopic cutting stapler.
In the actuating assembly 1 of the endoscopic cutting stapler (not shown) there is a cartridge assembly 2 and an anvil assembly 3 (see fig. 1 and 2). A driver 4 is installed in the actuator assembly 1. The driving member 4 is provided with a cutter 5 (see fig. 13). The cartridge assembly 2 has a cartridge 6, a cartridge holder 7, wedges 8, and a cartridge knife slot 9 in a front-to-rear direction (see fig. 4-7). The cartridge 6 is mounted on a cartridge holder 7. The inclined wedges 8 have bottom blocks 10 (see fig. 12). The lower bottom surface 11 of the bottom block 10 rests against the upper bottom surface 12 of the cartridge bay 7 (see fig. 5). The bottom block 10 is movable back and forth between a lower bottom surface 13 of the cartridge 6 and an upper bottom surface 12 of the cartridge bay 7. Adjacent three rows of staple storing holes 15 are staggered on one side of the cartridge knife channel 9 on the cartridge tissue contacting surface 14 of the cartridge 6 (see fig. 4). Staples 16 and pusher blocks 17 are installed in the staple storage holes 15 (see fig. 7 and 11). Staples 16 are mounted on top of push block 17. The anvil assembly 3 has anvil pockets 18 (see fig. 3) in a front-to-rear direction. One side of the anvil knife channel 18 on the anvil tissue contacting surface 19 of the anvil assembly 3 is staggered with adjacent three rows of concave shaped channels 20. The driver 4 pushes the cutter 5 along the cartridge pocket 9 and the anvil pocket 18. When tissue is clamped between the cartridge assembly 2 and the anvil assembly 3 (see fig. 14-18), the forming grooves 20 on the anvil assembly 3 correspond to the positions of the staples 16 in the cartridge 6, the driving member 4 pushes the inclined wedges 8 to move forwards, the inclined wedges 8 push the staple pushing blocks 17 to move upwards in the staple storage holes 15, the staple pushing blocks 17 push the staples 16 to pierce the tissue and press the formed tissue to bend on the forming grooves 20, and then the tissue between the cartridge knife grooves 9 and the anvil knife grooves 18 is cut by the forward movement of the cutting knife 5 along the cartridge knife grooves 9 and the anvil knife grooves 18.
As shown in fig. 4 and 5, fig. 15 and 16, three cartridge pads 21 are mounted at a single side of the cartridge 6 of the cartridge assembly 2 adjacent the cartridge pocket 9. When the cartridge 6 is mounted in the cartridge holder 7, the upper bottom surfaces 22 of the three cartridge pads 21 are in contact with the lower bottom surfaces 13 of the cartridge 6, which are adjacent to the cartridge pocket 9, respectively, and the lower bottom surfaces 23 of the three cartridge pads 21 are in contact with the upper bottom surfaces 12 of the cartridge holder 7, which are adjacent to the cartridge pocket 9, respectively. When tissue is clamped between the cartridge assembly 2 and the anvil assembly 3, the three cartridge spacer blocks 21 block the cartridge tissue contacting surface 14 adjacent the cartridge knife channel 9 from moving in the direction of the upper bottom surface 12 of the cartridge frame 7.
As shown in fig. 9 and 10, the cartridge block 21 has front and rear recesses 24 and 25, respectively, on both front and rear sides thereof. The two push pins 17 adjacent to the cartridge pad 21 are a forward push pin 26 and a rearward push pin 27, respectively. When the cartridge spacer 21 is installed in the cartridge 6, the projections 28 of the forward push staple block 26 and the projections 29 of the rearward push staple block 27 are inserted into the forward recess 24 and the rearward recess 25 of the cartridge spacer 21, respectively, restraining the cartridge spacer 21 to the forward push staple block 26 and the rearward push staple block 27.
As shown in fig. 8, 12 and 14-18, the bottom block 10 of the inclined wedge 8 has a guide block 30 at the front, a pushing surface 31 at the front, and inclined wedge pieces 32 at the sides. The nail bin 6 is provided with an inclined wedge groove 33. The guide block 30 of the inclined wedge 8 is inserted into the cartridge knife slot 9, and the inclined wedge piece 32 of the inclined wedge 8 is inserted into the inclined wedge slot 33 of the cartridge 6. After the tissue is clamped between the nail bin assembly 2 and the nail anvil assembly 3, the driving piece 4 pushes the inclined wedge 8 to move forwards, and the inclined wedge piece 32 of the inclined wedge 8 pushes the front nail pushing block 26 and the rear nail pushing block 27 to move upwards in the nail storage hole 15, so that the protruding blocks 28 and 29 of the front nail pushing block 26 and the rear nail pushing block 27 move out of the front groove 24 and the rear groove 25 of the nail bin cushion block 21 respectively; simultaneously, the guide block 30 and the inclined wedge piece 32 of the inclined wedge 8 block the nail bin cushion block 21 from moving leftwards and rightwards; thereafter, the push surface 31 of the bottom block 10 of the wedge 8 pushes the cartridge head block 21 forward. The push surface 31 of the bottom block 10 of the wedge 8, the wedge 32 and the guide block 30 may form a receiving groove 34. After the tissue is clamped between the nail bin assembly 2 and the nail anvil assembly 3, the driving piece 4 pushes the inclined wedges 8 to move forwards, and the pushing surface 31 of the inclined wedges 8 pushes the nail bin cushion block 21 to move forwards; at the same time, the cartridge spacer 21 is constrained within the receiving slot 34 of the wedge 8.
Because the cartridge cushion block 21 prevents the clamped tissue from pressing the cartridge tissue contact surface 14 close to the cartridge knife slot 9 to move towards the upper bottom surface 12 of the cartridge frame 7 when the cartridge assembly 2 and the anvil assembly 3 clamp the tissue, the staples 16 can be prevented from extending out of the staple storage holes 15 to be stuck on the clamped tissue, and at the moment, if the cartridge assembly 2 and the anvil assembly 3 are opened, the tissue can not bring the staples 16 out of the staple storage holes 15, so that the technical effect that the endoscopic cutting stapler can normally finish the operation of anastomosing the tissue is achieved. Because the phenomenon that the tissue which is received more after the tissue contact surface 14 of the nail cartridge close to the nail cartridge knife slot 9 moves towards the upper bottom surface 12 of the nail cartridge frame 7 is avoided, the tissue which is not received more is extruded from the position between the tissue contact surface 14 of the nail cartridge and the tissue contact surface 19 of the nail anvil, and the movement of the clamped tissue with the anastomat 16 can not generate larger position deviation of the anastomat 16 arranged in the nail storage hole 15, when the bottom block 10 of the inclined wedge 8 moves between the lower bottom surface 13 of the nail cartridge 6 and the upper bottom surface 12 of the nail cartridge frame 7, the nail cartridge cushion block 21 can not only avoid damaging the tiny structure 35 (see figure 8) between the adjacent nail storage holes 15 restraining the anastomat 16 in the nail cartridge 6, but also avoid the position deviation of the anastomat 16 arranged in the nail storage holes 15, so that the anastomat 16 can accurately resist the forming groove 20 to bend and form, and the bending forming quality of the anastomat 16 is improved; the surgical operation device is particularly suitable for clamping anastomosed tissues containing anastomotic nails for the second time, is particularly suitable for clamping tough and thick tissues such as anastomosed stomach and the like, and is also particularly suitable for clamping lung tissues such as hard trachea, lung nodules and the like during anastomosis, and achieves the technical effect of ensuring the safety and reliability of the surgical operation.
Because the lugs 28 and 29 of the nail pushing blocks 26 and 27 are inserted into the grooves 24 and 25 of the nail pushing blocks 21 when the nail cartridge cushion block 21 is installed in the nail cartridge 6, the nail cartridge cushion block 21 is restrained on the nail pushing blocks 26 and 27, when the nail cartridge assembly 2 and the nail anvil assembly 3 clamp tissues, the nail cartridge cushion block 21 stops the clamped tissues from pressing the nail cartridge tissue contact surface 14 close to the nail cartridge knife slot 9 to move towards the upper bottom surface 12 of the nail cartridge frame 7, and the technical effect that the endoscopic cutting anastomat can normally finish the operation of anastomotic tissues is achieved. Since the driver 4 pushes the wedge 8 to move forward after clamping the tissue between the cartridge assembly 2 and the anvil assembly 3, the wedge pieces 32 of the wedge 8 push the push blocks 26 and 27 to move upward in the nail storage holes 15, so that the projections 28 and 29 of the push blocks 26 and 27 move out of the grooves 24 and 25 of the cartridge pad 21, and thereafter the push surface 31 of the bottom block 10 of the wedge 8 pushes the cartridge pad 21 to move forward, and at the same time, the cartridge pad 21 is restrained in the accommodating groove 34 of the wedge 8, so that after the cavity mirror cutting stapler completes the operation of stapling the tissue, the cartridge pad 21 moves forward all the way to the front part of the cartridge 6, the hard tissue which has been stapled by the staples 16 moves in the direction of the upper bottom surface 12 of the cartridge frame 7, so that the force of the stapled tissue which has been stapled by the staples 16 on the hard tissue contact surface 12 of the cartridge and the anvil tissue contact surface 19 can be reduced, and the driver 4 can withdraw from the cartridge assembly 2 and the anvil assembly 3 to achieve the normal technical effect of cutting the tissue.
Fig. 19-35 illustrate a first embodiment of a cartridge sled according to the present invention in a second endoscopic cutting stapler.
In the implement assembly 41 of the endoscopic cutting stapler (not shown) there is a cartridge assembly 42 and an anvil assembly 43 (see fig. 19 and 20). A driver 44 is installed in the actuator assembly 41. The driving member 44 has a cutter 45 (see fig. 31). The cartridge assembly 42 has a cartridge 46, a cartridge holder 47, wedges 48, and a forward-rearward directed cartridge knife slot 49 (see fig. 22-25). The cartridge 46 is mounted on a cartridge holder 47. The wedges 48 have bottom blocks 50 (see fig. 30). The lower bottom surface 51 of the bottom block 50 rests against the upper bottom surface 52 of the cartridge bay 47 (see fig. 23 and 24). The bottom block 50 is movable back and forth between a lower bottom surface 53 of the cartridge 46 and an upper bottom surface 42 of the cartridge frame 47. Two sides of cartridge knife channel 49 on cartridge tissue contacting surface 54 of cartridge 46 are staggered with respect to adjacent three rows of staple storing apertures 55 (see FIG. 22). Staples 56 and pusher blocks 57 are installed in the staple storage holes 55 (see fig. 26 and 29). Staples 56 are mounted on top of push block 57. The anvil assembly 43 has a forward and rearward anvil pocket 58 (see fig. 21) therein. The anvil tissue contacting surface 59 of anvil assembly 43 has three adjacent rows of concave forming grooves 60 staggered on each side of anvil knife channel 58. The driver 44 urges the cutter 45 to move along the cartridge pocket 49 and anvil pocket 58. When tissue is clamped between cartridge assembly 42 and anvil assembly 43 (see fig. 20, 32-34), forming slot 60 on anvil assembly 43 corresponds to the position of staples 56 in cartridge 46, driver 44 pushes wedge 48 forward, wedge 48 pushes staple block 57 upward in staple storage aperture 55, staple block 57 pushes staples 56 against forming slot 60 to form the stapled tissue after bending, driver 44 pushes cutter 45 forward along cartridge knife slot 49 and anvil knife slot 58 to cut the tissue between cartridge knife slot 49 and anvil knife slot 58.
As shown in fig. 22-24, 33 and 34, four left cartridge blocks 61 and four right cartridge blocks 62 are mounted to the left and right sides of the cartridge 46 of the cartridge assembly 42 adjacent the cartridge knife slot 49, respectively. When the cartridge 46 is mounted in the cartridge housing 47, the upper bottom surfaces 63, 64 of the four left cartridge blocks 61 and the four right cartridge blocks 62 are in contact with the lower bottom surfaces 53, 53 of the cartridge 46, respectively, proximate the cartridge pocket 49, and the lower bottom surfaces 65, 66 of the four left cartridge blocks 61, 62 are in contact with the upper bottom surfaces 52, respectively, of the cartridge housing 47, proximate the cartridge pocket 49. When tissue is clamped between cartridge assembly 42 and anvil assembly 43, four left cartridge blocks 61 and four right cartridge blocks 62 block movement of cartridge tissue contacting surface 54 adjacent cartridge knife channel 49 in the direction of upper bottom surface 52 of cartridge frame 47.
As shown in fig. 26 and 27, the left cartridge block 61 has front and rear recesses 67 and 68, respectively, on both front and rear sides thereof. The two push blocks 57 adjacent the left cartridge block 61 are a forward push block 69 and a rearward push block 70, respectively. When the left cartridge spacer 61 is installed in the cartridge 46, the projections 71 of the forward push staple block 69 and the projections 72 of the rearward push staple block 70 are inserted into the forward recess 67 and the rearward recess 68, respectively, of the left cartridge spacer 61, restraining the left cartridge spacer 61 against the forward push staple block 69 and the rearward push staple block 70. The right cartridge block 62 has front and rear recesses 73 and 74, respectively, on both front and rear sides. The two push blocks 57 adjacent the right cartridge pad 62 are a forward push block 75 and a rearward push block 76, respectively. When the right cartridge spacer 62 is installed within the cartridge 46, the projections 77 of the forward push staple block 75 and the projections 78 of the rearward push staple block 76 are inserted into the forward recess 73 and the rearward recess 74 of the right cartridge spacer 62, respectively, restraining the right cartridge spacer 62 to the forward push staple block 75 and the rearward push staple block 76.
As shown in fig. 26 to 28, 30 and 32 to 35, the bottom block 50 of the inclined wedge 48 has a guide block 79 in the middle, push surfaces 80 and 81 at the front end, and inclined wedge pieces 82 and 83 at both sides. The cartridge 46 has sloped wedges 84 and 85 therein. Guide block 79 of wedge 48 is inserted into cartridge knife slot 49 and wedges 82 and 83 of wedge 48 are inserted into wedges 84 and 85, respectively, of cartridge 46. After clamping tissue between cartridge assembly 42 and anvil assembly 43, driver 44 pushes wedge 48 forward, and wedges 82 and 83 of wedge 48 push forward and backward staple blocks 69, 70, 75 and 76, respectively, upward within magazine 55 such that lugs 71 and 72 of forward and backward staple blocks 69 and 70 move out of forward and backward recesses 67 and 68, respectively, of left cartridge pad 61, and lugs 77 and 78 of forward and backward staple blocks 75 and 76 move out of forward and backward recesses 73 and 74, respectively, of right cartridge pad 62; meanwhile, the guide block 79 and the inclined wedge piece 82 of the inclined wedge 48 block the left cartridge cushion block 61 from moving in the left-right direction, and the guide block 79 and the inclined wedge piece 83 of the inclined wedge 48 block the right cartridge cushion block 62 from moving in the left-right direction; thereafter, the push surface 80 of the bottom block 50 of the wedge 48 pushes the left cartridge head block 61 forward and the push surface 81 of the bottom block 50 of the wedge 48 pushes the right cartridge head block 62 forward. The push surface 80 of the bottom block 50 of the wedge 48, the wedge 82 and the guide block 79 form a left receiving slot 86. The push surface 81 of the bottom block 50 of the inclined wedge 48, the inclined wedge 83 and the guide block 79 form a right receiving groove 87. After tissue is clamped between the cartridge assembly 42 and the anvil assembly 43, the driving member 44 pushes the inclined wedges 48 to move forward, the push surface 80 of the bottom block 50 of the inclined wedges 48 pushes the left cartridge pad 61 to move forward, and the push surface 81 of the bottom block 50 of the inclined wedges 48 pushes the right cartridge pad 62 to move forward; at the same time, the left cartridge spacer 61 is restrained within the left receiving slot 86 of the wedge 48 and the right cartridge spacer 62 is restrained within the right receiving slot 87 of the wedge 48.
Because the left cartridge spacer 61 and the right cartridge spacer 62 block the movement of the cartridge tissue contacting surface 54 pressed by the clamped tissue to the direction of the upper bottom surface 52 of the cartridge holder 47 when the cartridge assembly 42 and the anvil assembly 43 clamp tissue, the staples 56 are prevented from extending out of the staple storage holes 55 to be stuck on the clamped tissue, and at this time, if the cartridge assembly 42 and the anvil assembly 43 are opened, the tissue does not bring the staples 56 out of the staple storage holes 55, thereby achieving the technical effect that the endoscopic cutting stapler can normally complete the operation of stapling the tissue. Because the phenomenon that the tissue which is more contained after the tissue contact surface 54 of the nail bin close to the nail bin knife groove 49 moves towards the upper bottom surface 52 of the nail bin frame 47 is avoided, the tissue which is not more contained is extruded from the position between the tissue contact surface 54 of the nail bin and the tissue contact surface 59 of the nail anvil, and the movement of the clamped tissue which is penetrated with the anastomat 56 does not generate larger position deviation of the anastomat 56 arranged in the nail storage hole 55 is avoided, when the bottom block 50 of the inclined wedge 48 moves between the lower bottom surface 53 of the nail bin 46 and the upper bottom surface 52 of the nail bin frame 47, the left nail bin cushion block 61 and the right nail bin cushion block 62 can avoid damaging the tiny structure 88 between the adjacent nail storage hole 55 which is used for restraining the anastomat 56 in the nail bin 46, and also avoid the position deviation of the anastomat 56 arranged in the nail storage hole 55, so that the anastomat 56 can be accurately pressed on the forming groove 70 to bend and form, and the bending forming quality of the anastomat 56 is improved; the surgical operation device is particularly suitable for clamping anastomosed tissues containing anastomotic nails for the second time, is particularly suitable for clamping tough and thick tissues such as anastomosed stomach and the like, and is also particularly suitable for clamping lung tissues such as hard trachea, lung nodules and the like during anastomosis, and achieves the technical effect of ensuring the safety and reliability of the surgical operation.
Because the projections 71, 72, 77 and 78 of the forward and rearward push blocks 69, 70, 75 and 76 are inserted into the recesses 67, 68, 73 and 74 of the cartridge blocks 61 and 62, respectively, when the cartridge blocks 61 and 62 are mounted in the cartridge 46, respectively, the cartridge blocks 61 and 62 are restrained on the forward and rearward push blocks 69, 70, 75 and 76, respectively, the cartridge blocks 61 and 62 block movement of the clamped tissue in a direction toward the upper bottom surface 52 of the cartridge frame 47 by the cartridge tissue contacting surface 54 adjacent to the cartridge knife slot 49 when the cartridge assembly 42 and anvil assembly 43 clamp tissue, achieving the technical effect that the endoscopic cutting stapler can normally complete the operation of stapling tissue. Because the driver 44 pushes the wedges 48 forward after clamping tissue between the cartridge assembly 42 and the anvil assembly 43, and thereafter the wedges 82 and 83 of the wedges 48 push the forward push block 69, the rearward push block 70, the forward push block 75 and the rearward push block 76, respectively, upward within the staple storage aperture 55 such that the projections 71, 72, 77 and 78 of the forward push block 69, the rearward push block 70, the forward push block 75 and the rearward push block 76, respectively, move out of the recesses 67, 68, 73 and 74 of the cartridge blocks 61 and 62, respectively, and thereafter the push surfaces 80 and 81 of the bottom block 50 of the wedges 48 push the cartridge blocks 61 and 62, respectively, forward, while the cartridge blocks 61 and 62 are constrained within the receiving slots 86 and 87 of the wedges 48, respectively, after the endoscopic cutting stapler has completed its operation of stapling tissue, the cartridge blocks 61 and 62 are all moved forward to the front of the cartridge 46, and the stapled hard tissue of the staple 56 has moved out of the recesses 67, such that the anvil assembly is moved forward against the anvil assembly 54, thereby reducing the force of the anvil assembly, which is in contact with the anvil assembly 54, and the anvil assembly, thereby further contacting the tissue of the anvil assembly 52, and reducing the force of the anvil assembly, which is normally contacting the anvil assembly 44.
FIGS. 36-38 illustrate a second embodiment of a staple cartridge pad of the present invention in a second type of laparoscopic cutting stapler. The left cartridge block 61 and the right cartridge block 62 of the first embodiment in the second endoscopic cutting stapler are replaced with the left cartridge block 90 and the right cartridge block 91 of the second embodiment in the second embodiment.
As shown in fig. 36-38, a recess 92 is provided in the middle of the left cartridge block 90. A recess 93 is provided in the middle of the right cartridge block 91. When the left cartridge spacer 90 and the right cartridge spacer 91 are installed in the cartridge 46, the bosses 95 and 96 on the front and rear sides of the left push block 94 are inserted together into the recess 92 of the left cartridge spacer 90, restraining the left cartridge spacer 90 to the left push block 94; the projections 98 and 99 on the front and rear sides of the right push block 97 are inserted together into the recess 93 of the right cartridge block 91 to restrain the right cartridge block 91 to the right push block 97.
Other technical features, aspects and effects not described or illustrated in the cartridge pad of the second embodiment may be referred to in the description and illustration of the cartridge pad of the first embodiment in a second endoscopic cutting stapler.
FIG. 39 is a schematic diagram depicting a specific embodiment of the left and right cartridge pods 61, 62 of the first embodiment and the left and right cartridge pods 90, 91 of the second embodiment of the present invention installed in the cartridge 46 in a second type of endoscopic cutting stapler.
FIGS. 40-42 illustrate a third embodiment of the present invention in a staple cartridge sled specific to a second endoscopic cutting stapler. The left cartridge pad 61 and the right cartridge pad 62 in the second type of laparoscopic cutting stapler of the first embodiment of the second type of laparoscopic cutting stapler are replaced with the left cartridge pad 100 and the right cartridge pad 101 of the third embodiment.
As shown in fig. 40-42, the left cartridge block 100 has a first recess 102 in the middle and a second recess 103 on one side. Two of the push blocks 57 adjacent the left cartridge sled 100 are a left first push block 104 and a left second push block 105, respectively. When the left cartridge spacer 100 is installed in the cartridge 46, the front and rear side projections 106 and 107 of the left first push block 104 are inserted together into the first recess 102 of the left cartridge spacer 100, and the side projection 108 of the left second push block 105 is inserted into the second recess 103 of the left cartridge spacer 100, restraining the left cartridge spacer 100 to the left first push block 104 and the left second push block 105. The right cartridge block 101 has a first recess 109 in the middle and a second recess 110 in one side. Two push blocks 57 adjacent to the right cartridge sled 101 are a right first push block 111 and a right second push block 112, respectively. When the right cartridge spacer 101 is installed in the cartridge 46, the front and rear side projections 113 and 114 of the right first push block 111 are inserted together into the first recess 109 of the right cartridge spacer 101, and the side projection 115 of the right second push block 112 is inserted into the second recess 110 of the right cartridge spacer 101, restraining the right cartridge spacer 101 to the right first push block 111 and the right second push block 112.
Other technical features, aspects and effects not described or illustrated in the cartridge pad of the third embodiment may be referred to in the description and illustration of the cartridge pad of the first embodiment in the second endoscopic cutting stapler.
Fig. 43-45 illustrate a fourth embodiment of a cartridge sled according to the present invention in a second endoscopic cutting stapler. The left and right cartridge pods 61, 62 of the first embodiment in the second endoscopic cutting stapler are replaced with the left and right cartridge pods 120, 121 of the fourth embodiment in the fourth embodiment.
As shown in fig. 43-45, the left cartridge block 120 has a central recess 122, a front recess 123 and a rear recess 124. The three push blocks 57 adjacent the left cartridge sled 120 are a middle push block 125, a front push block 126, and a rear push block 127, respectively. When the left cartridge spacer 120 is installed in the cartridge 46, the front and rear projections 128 and 129 of the middle push block 125 are inserted together into the middle recess 122 of the left cartridge spacer 120, the rear projection 130 of the front push block 126 is inserted into the front recess 123 of the left cartridge spacer 120, and the front projection 131 of the rear push block 127 is inserted into the rear recess 124 of the left cartridge spacer 120, restraining the left cartridge spacer 120 against the middle push block 125, the front push block 126 and the rear push block 127. The right cartridge block 121 has a central recess 132, a front recess 133 and a rear recess 134. The three push blocks 57 adjacent the right cartridge pad 121 are a middle push block 135, a front push block 136 and a rear push block 137, respectively. When the right cartridge spacer 121 is installed in the cartridge 46, the forward and rearward projections 138 and 139 of the middle push block 135 are inserted together into the middle recess 132 of the right cartridge spacer 121, the rearward projection 140 of the forward push block 136 is inserted into the forward recess 133 of the right cartridge spacer 121, and the forward projection 141 of the rearward push block 137 is inserted into the rearward recess 134 of the right cartridge spacer 121, restraining the right cartridge spacer 121 against the middle push block 135, the forward push block 136 and the rearward push block 137.
Other technical features, aspects and effects not described or illustrated in the cartridge pad of the fourth embodiment may be referred to the description and illustration in the cartridge pad of the first embodiment in the second endoscopic cutting stapler.
Fig. 46-52 illustrate yet another embodiment of a cartridge spacer of the first embodiment of the present invention in a second type of laparoscopic cutting stapler wherein the cartridge 46 in the second type of laparoscopic cutting stapler is replaced with a cartridge 150.
As shown in fig. 46 to 52, left and right cartridge support pieces 152 and 153 are provided on both sides of a cartridge knife slot 151 of a cartridge 150, respectively. After the cartridge 150 is mounted in the cartridge holder 47, upper left and right supporting portions 154 and 155 are formed on both sides of the cartridge pocket 151 of the cartridge 150, respectively, in the front-rear direction. The left and right upper support portions 154 and 155 are located between the upper edges 156 and 157 of the left and right cartridge tabs 152 and 153 and the cartridge tissue contacting surface 158 of the cartridge 150. The lower edges 159 and 160 of the left and right cartridge tabs 152 and 153, respectively, are in contact with the upper bottom surfaces 63 and 64 of the left and right cartridge blocks 61 and 62, respectively. The lower bottom surfaces 65 and 66 of the left and right cartridge blocks 61 and 62, respectively, are in contact with the upper bottom surface 52 of the cartridge frame 47. When tissue is clamped between cartridge assembly 161 and anvil assembly 43, left and right cartridge tabs 152 and 153 and left and right cartridge blocks 61 and 62, respectively, block movement of left and right upper support portions 154 and 155 on either side of cartridge knife channel 151 in the direction of upper bottom surface 52 of cartridge frame 47, thereby blocking movement of cartridge tissue contacting surface 158 adjacent cartridge knife channel 151 in the direction of upper bottom surface 52 of cartridge frame 47.
The first embodiment cartridge head block in this embodiment may also be replaced with the second embodiment cartridge head block, the third embodiment cartridge head block, or the fourth embodiment cartridge head block.
The technical characteristics and the technical scheme of the nail bin cushion block of the four embodiments can be implemented in various endoscope cutting anastomat, can be implemented independently or in a crossed manner, and can be implemented in a combined manner so as to achieve the best technical effect.