技术领域Technical Field
本发明涉及医疗器械技术领域，具体涉及一种外科缝切装置。The present invention relates to the technical field of medical instruments, and in particular to a surgical suturing device.
背景技术Background Art
在外科手术治疗时，常常需要对人体内的一些组织进行缝合和切割。例如，在进行外科手术时，首先将部分组织进行缝合，同时将这部分组织进行切除。又例如，在人体内可能会因各种原因形成一些瘘道，瘘道指的是因脓肿引起的连接于体外与有腔器官之间或两个有腔器官之间的病理性排脓管道。此外，在消化道常见的良性病变肛门直肠瘘，在进行手术治疗时往往最后医生需要手工操作关闭瘘口。又如，对于一些小的脱垂组织的切除等等。因此，需要对瘘口周围组织进行缝合和切割，以实现瘘口关闭。现有技术中出现了一些对组织进行缝合和切割的器械，然而，现有的器械的结构往往比较复杂，灵活性不高。During surgical treatment, it is often necessary to suture and cut some tissues in the human body. For example, during a surgical operation, part of the tissue is first sutured and then removed. For another example, some fistulas may be formed in the human body due to various reasons. Fistulas refer to pathological pus-draining ducts connected between the outside of the body and a cavity organ or between two cavity organs caused by abscesses. In addition, anorectal fistulas, which are common benign lesions in the digestive tract, often require doctors to manually close the fistula during surgical treatment. For another example, for the removal of some small prolapsed tissues, etc. Therefore, it is necessary to suture and cut the tissues around the fistula to achieve fistula closure. In the prior art, there are some instruments for suturing and cutting tissues. However, the structures of the existing instruments are often complex and not very flexible.
发明内容Summary of the invention
针对现有技术中的问题，本发明的目的在于提供一种外科缝切装置，通过驱动组件驱动击发组件完成缝切装置的闭合和击发，对组织进行缝合和切割。In view of the problems in the prior art, the purpose of the present invention is to provide a surgical suturing device, which can complete the closing and firing of the suturing device by driving a firing assembly through a driving assembly to suturing and cutting tissues.
本发明实施例提供一种外科缝切装置，包括：An embodiment of the present invention provides a surgical suturing device, comprising:
中空的壳体，所述壳体的侧壁开设有窗口；A hollow shell, wherein a window is provided on a side wall of the shell;
钉砧，固定于所述壳体的内部；An anvil, fixed inside the shell;
击发组件，位于所述钉砧的近端侧，所述击发组件的内部设置有吻合钉和切刀；A firing assembly is located at the proximal side of the anvil, and an anastomotic staple and a cutter are arranged inside the firing assembly;
驱动组件，所述缝切装置击发时，所述驱动组件推动所述击发组件朝向所述缝切装置的远端侧方向运动，并将所述击发组件中的吻合钉和切刀朝向所述钉砧推出。The driving assembly pushes the firing assembly to move toward the distal end of the suturing device when the suturing device is fired, and pushes the staples and the cutter in the firing assembly toward the staple anvil.
在一些实施例中，初始状态下，所述击发组件位于所述窗口的近端侧，所述驱动组件推动所述击发组件朝向所述缝切装置的远端侧方向运动时，所述击发组件逐渐覆盖所述窗口并将所述击发组件中的吻合钉和切刀朝向所述钉砧推出。In some embodiments, in an initial state, the firing assembly is located on the proximal side of the window, and when the driving assembly pushes the firing assembly toward the distal side of the suturing device, the firing assembly gradually covers the window and pushes the staples and cutter in the firing assembly toward the anvil.
在一些实施例中，所述击发组件包括钉仓和击发块，所述钉砧、所述钉仓和所述击发块依次沿所述缝切装置的轴向方向从远端侧向近端侧方向排列，所述钉仓中设置有所述吻合钉，所述击发块上设置有所述切刀。In some embodiments, the firing assembly includes a nail magazine and a firing block, and the anvil, the nail magazine and the firing block are arranged in sequence along the axial direction of the suturing device from the distal side to the proximal side, the staples are arranged in the nail magazine, and the cutter is arranged on the firing block.
在一些实施例中，所述钉仓的远端侧设置有切刀槽和钉孔，所述击发块的远端侧设置有击发片，所述击发片与所述钉孔的位置相对应，所述切刀与所述切刀槽的位置相对应。In some embodiments, a cutting knife groove and a nail hole are provided on the distal side of the nail magazine, a firing plate is provided on the distal side of the firing block, the firing plate corresponds to the position of the nail hole, and the cutting knife corresponds to the position of the cutting knife groove.
在一些实施例中，所述切刀槽为直线型槽或弧线形槽，所述钉孔均位于所述切刀槽的同一侧。In some embodiments, the cutting groove is a straight groove or an arc-shaped groove, and the nail holes are all located on the same side of the cutting groove.
在一些实施例中，所述钉砧还设有切割配合部，所述切割配合部与所述切刀槽的位置相对应。In some embodiments, the anvil is further provided with a cutting matching portion, and the cutting matching portion corresponds to the position of the cutting knife groove.
在一些实施例中，所述切割配合部为刀砧或为位于所述钉砧的向远端侧延伸的凹槽。In some embodiments, the cutting engagement portion is a knife anvil or a groove extending toward the distal end of the nail anvil.
在一些实施例中，所述钉仓具有第一位置和第二位置，初始状态下，所述钉仓处于所述第一位置，所述缝切装置击发时，所述驱动组件通过所述击发块推动所述钉仓向所述缝切装置的远端侧方向运动至所述第二位置；In some embodiments, the staple cartridge has a first position and a second position. In an initial state, the staple cartridge is in the first position. When the suturing device is fired, the driving assembly pushes the staple cartridge toward the distal side of the suturing device to the second position through the firing block.
所述钉仓位于所述第二位置时，所述驱动组件继续推动所述击发块朝向所述缝切装置的远端侧方向运动，所述击发块将所述钉仓中的吻合钉和所述切刀朝向所述钉砧推出。When the staple cartridge is located at the second position, the drive assembly continues to push the firing block to move toward the distal side of the suturing device, and the firing block pushes the staples in the staple cartridge and the cutter toward the staple anvil.
在一些实施例中，所述击发组件还包括弹性件，所述弹性件的两端分别抵持所述钉仓和所述击发块。In some embodiments, the firing assembly further includes an elastic member, two ends of which respectively abut against the nail magazine and the firing block.
在一些实施例中，所述弹性件位于所述钉仓的内部，所述弹性件的远端侧抵持所述钉仓的远端侧面，所述弹性件的近端侧抵持所述击发块的远端侧面；In some embodiments, the elastic member is located inside the nail magazine, the distal side of the elastic member abuts against the distal side of the nail magazine, and the proximal side of the elastic member abuts against the distal side of the firing block;
所述钉仓位于所述第一位置时，所述击发块至少部分位于所述钉仓的内部，所述弹性件具有一初始压缩量，所述钉仓位于所述第二位置，且所述驱动组件继续推动所述击发块朝向所述缝切装置的远端侧方向运动时，所述击发块压缩所述弹性件以使得所述击发块继续进入所述钉仓的内部。When the nail magazine is located at the first position, the firing block is at least partially located inside the nail magazine, and the elastic member has an initial compression amount. When the nail magazine is located at the second position and the drive assembly continues to push the firing block toward the distal side of the suturing device, the firing block compresses the elastic member so that the firing block continues to enter the interior of the nail magazine.
在一些实施例中，所述驱动组件包括驱动把手，所述驱动把手可旋转地连接至所述壳体，所述驱动把手沿第一方向运动时，所述驱动把手推动所述击发组件朝向所述缝切装置的远端侧方向运动。In some embodiments, the drive assembly includes a drive handle rotatably connected to the housing, and when the drive handle moves along a first direction, the drive handle pushes the firing assembly to move toward the distal side of the slit cutting device.
在一些实施例中，所述驱动把手包括依次排列的击发配合部、枢转部和握持部，所述枢转部可旋转地连接至所述壳体，所述击发配合部与所述击发组件可旋转地连接。In some embodiments, the driving handle includes a firing engagement portion, a pivot portion, and a grip portion arranged in sequence, the pivot portion is rotatably connected to the housing, and the firing engagement portion is rotatably connected to the firing assembly.
在一些实施例中，所述钉砧和所述击发组件均贴近所述壳体的内侧壁设置，所述击发组件与所述枢转部分别位于所述壳体中心线的两侧。In some embodiments, the anvil and the firing assembly are both disposed close to the inner wall of the shell, and the firing assembly and the pivot portion are respectively located on both sides of the center line of the shell.
在一些实施例中，所述壳体的近端侧还设置有固定把手，所述驱动把手的枢转部通过一连接销与所述固定把手可旋转地连接。In some embodiments, a fixed handle is further provided on the proximal side of the shell, and the pivot portion of the driving handle is rotatably connected to the fixed handle via a connecting pin.
在一些实施例中，所述驱动组件还包括第二弹性件，所述驱动把手受到外力而沿第一方向旋转时，所述第二弹性件发生弹性变形，所述驱动把手推动所述击发组件向所述缝切装置的远端侧方向运动，以击发缝切装置，所述外力消除后，所述驱动把手在所述第二弹性件的弹性变形恢复力下，沿第二方向旋转。In some embodiments, the drive assembly also includes a second elastic member. When the drive handle is subjected to an external force and rotates in a first direction, the second elastic member undergoes elastic deformation, and the drive handle pushes the firing assembly to move toward the distal side of the slit cutting device to fire the slit cutting device. After the external force is eliminated, the drive handle rotates in a second direction under the elastic deformation restoring force of the second elastic member.
在一些实施例中，所述第二弹性件位于所述击发配合部与所述壳体之间或所述握持部与所述壳体之间；所述第二弹性件为至少部分具有弹性的弹片、压簧或拉簧。In some embodiments, the second elastic member is located between the firing mating portion and the shell or between the gripping portion and the shell; the second elastic member is a spring, a compression spring or a tension spring that is at least partially elastic.
在一些实施例中，还包括沿所述缝切装置的轴向方向延伸的导轨，所述钉砧、所述钉仓和所述击发块依次套设于所述导轨上。In some embodiments, it further includes a guide rail extending along the axial direction of the slit cutting device, and the anvil, the nail magazine and the firing block are sequentially sleeved on the guide rail.
在一些实施例中，包括两个所述导轨，所述钉砧、所述钉仓和所述击发块的两侧分别沿从远段侧到近端侧方向套设于所述导轨；In some embodiments, two guide rails are included, and the anvil, the nail magazine and the two sides of the firing block are respectively sleeved on the guide rails along the direction from the distal end side to the proximal end side;
所述钉仓包括位于两侧的套设于所述导轨上的两个钉仓引导部，所述吻合钉和所述切刀均位于所述两个钉仓引导部之间。The staple cartridge comprises two staple cartridge guide parts which are located on both sides and sleeved on the guide rails, and the anastomosis staples and the cutter are both located between the two staple cartridge guide parts.
在一些实施例中，所述壳体的近端侧开设有近端开口，所述击发组件从所述近端开口至少部分进入所述壳体的内部，所述驱动组件与所述击发组件的近端侧相连接。In some embodiments, a proximal opening is provided on the proximal side of the shell, the firing assembly at least partially enters the interior of the shell from the proximal opening, and the drive assembly is connected to the proximal side of the firing assembly.
在一些实施例中，所述壳体的远端侧表面为用于导向的弧形表面，所述弧形表面的远端侧开设有远端开口。In some embodiments, the distal side surface of the shell is an arcuate surface for guiding, and a distal opening is formed on the distal side of the arcuate surface.
本发明所提供的外科缝切装置具有如下优点：The surgical suturing device provided by the present invention has the following advantages:
本发明提供了一种对组织缝合和切割的器械，通过驱动组件驱动击发组件完成缝切装置的击发，通过击发组件中的吻合钉在钉砧处成型而对组织进行缝合，并通过击发组件中的切刀对组织进行切割，使用过程中将外科缝切装置放置于病变位置，将需要缝合和切割的组织拉入到钉砧和击发组件之间，操作驱动组件闭合和击发缝切装置即可，结构精简，操作简单，使用方便。The present invention provides an instrument for suturing and cutting tissues. The firing assembly is driven by a driving assembly to complete the firing of a suturing and cutting device. The anastomotic staples in the firing assembly are formed at the staple anvil to suturing the tissues, and the cutter in the firing assembly is used to cut the tissues. During use, the surgical suturing and cutting device is placed at the lesion position, and the tissue to be sutured and cut is pulled between the staple anvil and the firing assembly. The driving assembly is operated to close and fire the suturing and cutting device. The structure is simple, the operation is simple, and the use is convenient.
附图说明BRIEF DESCRIPTION OF THE DRAWINGS
通过阅读参照以下附图对非限制性实施例所作的详细描述，本发明的其它特征、目的和优点将会变得更明显。Other features, objectives and advantages of the present invention will become more apparent from a reading of the detailed description of non-limiting embodiments made with reference to the following accompanying drawings.
图1是本发明一实施例的外科缝切装置在初始状态下的主视图；FIG1 is a front view of a surgical suturing device in an initial state according to an embodiment of the present invention;
图2是本发明一实施例的外科缝切装置在初始状态下的爆炸图；FIG2 is an exploded view of a surgical stapling device according to an embodiment of the present invention in an initial state;
图3是本发明一实施例的击发组件和钉砧在初始状态下的示意图；3 is a schematic diagram of a firing assembly and anvil in an initial state according to an embodiment of the present invention;
图4和图5是本发明一实施例的钉仓组件与切刀配合的结构示意图；4 and 5 are schematic diagrams of the structure of the nail magazine assembly and the cutter in cooperation with each other according to an embodiment of the present invention;
图6是本发明一实施例的击发块的结构示意图；FIG6 is a schematic diagram of the structure of a firing block according to an embodiment of the present invention;
图7是本发明一实施例的吻合钉的结构示意图；7 is a schematic structural diagram of an anastomotic staple according to an embodiment of the present invention;
图8是本发明一实施例的击发组件和钉砧在初始状态下的俯视图；8 is a top view of a firing assembly and anvil in an initial state according to an embodiment of the present invention;
图9是图8中A1-A1方向的剖视图；FIG9 is a cross-sectional view taken along the A1-A1 direction in FIG8 ;
图10是本发明一实施例的外科缝切装置在击发状态下的立体图；FIG10 is a perspective view of a surgical stapling device in a firing state according to an embodiment of the present invention;
图11是本发明一实施例的驱动把手与固定把手配合的示意图；FIG11 is a schematic diagram of the cooperation between the driving handle and the fixed handle according to an embodiment of the present invention;
图12是本发明一实施例的击发组件和钉砧在击发过程中的示意图；12 is a schematic diagram of a firing assembly and anvil during the firing process according to an embodiment of the present invention;
图13是本发明一实施例的击发组件和钉砧在击发完成时的示意图；13 is a schematic diagram of a firing assembly and anvil when firing is completed according to an embodiment of the present invention;
图14是本发明一实施例的钉仓、钉砧和导轨配合的示意图；14 is a schematic diagram of the cooperation between a nail magazine, a nail anvil and a guide rail according to an embodiment of the present invention;
图15是本发明一实施例的击发组件和钉砧在击发完成时的俯视图；15 is a top view of the firing assembly and the anvil when the firing is completed according to an embodiment of the present invention;
图16是图15中A2-A2方向的剖视图；Fig. 16 is a cross-sectional view taken along the direction A2-A2 in Fig. 15;
图17是本发明一实施例的外科缝切装置在击发完成后复位的主视图。17 is a front view of a surgical stapling device according to an embodiment of the present invention after the firing is completed and reset.
附图标记：Reference numerals:
1 壳体 5 击发块1 Housing 5 Firing block
11 壳体的远端侧 51 击发片11 Distal side of housing 51 Firing piece
111 远端开口 52 击发引导部111 distal end opening 52 firing guide
12 固定把手 54 第一枢转轴12 Fixed handle 54 First pivot axis
122 第一通孔 58 推刀面122 First through hole 58 Pushing surface
13 窗口 59 容纳槽13 Window 59 Receiving slot
15 近端开口 6 传动件15 Proximal opening 6 Transmission element
2 钉砧 7 驱动组件2 Anvil 7 Drive assembly
21 钉砧引导部 71 驱动把手21 anvil guide 71 driving handle
22 钉砧面 711 击发配合部22 nail anvil surface 711 firing matching part
3 钉仓组件 7111 第二枢转轴3 Nail cartridge assembly 7111 Second pivot axis
31 钉仓 712 枢转部31 nail magazine 712 pivoting portion
311 钉仓引导部 7121 第二通孔311 Nail magazine guide 7121 Second through hole
312 钉仓面 713 握持部312 Nail magazine surface 713 Grip part
3121 钉孔 7131 弹性件止挡部3121 nail hole 7131 elastic stopper
313 切刀槽 72 连接销313 Cutter slot 72 Connecting pin
32 第一弹性件 73 第二弹性件32 first elastic member 73 second elastic member
33 吻合钉 731 第二弹性件的第一端33 staple 731 first end of the second elastic member
331 固定端 732 第二弹性件的第二端331 fixed end 732 second end of the second elastic member
332 尖刺端 733 通槽332 spike end 733 slot
4 导轨 9 切刀4 Guide rails 9 Cutter
41 导轨的远端侧 91 切刀的远端侧41 Far side of guide rail 91 Far side of cutter
42 导轨的近端侧 92 切刀的近端侧42 Near side of guide rail 92 Near side of cutter
具体实施方式DETAILED DESCRIPTION
现在将参考附图更全面地描述示例实施方式。然而，示例实施方式能够以多种形式实施，且不应被理解为限于在此阐述的实施方式；相反，提供这些实施方式使得本发明将全面和完整，并将示例实施方式的构思全面地传达给本领域的技术人员。在图中相同的附图标记表示相同或类似的结构，因而将省略对它们的重复描述。Example embodiments will now be described more fully with reference to the accompanying drawings. However, example embodiments can be implemented in many forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that the present invention will be comprehensive and complete and fully convey the concepts of the example embodiments to those skilled in the art. The same reference numerals in the figures represent the same or similar structures, and thus their repeated description will be omitted.
本发明提供了一种外科缝切装置，包括：中空的壳体，所述壳体的侧壁开设有窗口；钉砧，固定于所述壳体的内部；击发组件，位于所述钉砧的近端侧，所述击发组件的内部设置有吻合钉和切刀；驱动组件，所述缝切装置击发时，所述驱动组件推动所述击发组件朝向所述缝切装置的远端侧方向运动，并将所述击发组件中的吻合钉和切刀朝向所述钉砧推出。The present invention provides a surgical suturing device, comprising: a hollow shell, a side wall of which is provided with a window; an anvil fixed inside the shell; a firing assembly located on the proximal side of the anvil, wherein staples and a cutter are arranged inside the firing assembly; and a driving assembly, wherein when the suturing device is fired, the driving assembly pushes the firing assembly to move toward the distal side of the suturing device and pushes the staples and the cutter in the firing assembly toward the anvil.
该外科缝切装置可以用于组织缝合和切割。首先将外科缝切装置放置于病变位置，将需要缝合和切割的组织通过所述侧壁的窗口拉入到所述壳体内部，使得所述组织位于所述钉砧和所述击发组件之间，然后通过驱动组件驱动击发组件朝向缝切装置的远端侧运动而与钉砧夹紧组织，实现缝切装置闭合，并通过击发组件中的吻合钉在钉砧处成型而对组织进行缝合，同时通过所述切刀对组织进行切割，实现了组织缝合和切割，结构精简，操作简单，使用方便。本发明通过一套驱动组件既可以实现钉砧和击发组件之间的闭合以夹紧组织，又可以实现驱动吻合钉推出成型并驱动切刀推出切割组织，即采用一套驱动组件即可以实现缝切装置闭合和击发，结构更加精简。The surgical suturing device can be used for tissue suturing and cutting. First, the surgical suturing device is placed at the lesion position, and the tissue to be sutured and cut is pulled into the shell through the window of the side wall, so that the tissue is located between the anvil and the firing assembly, and then the firing assembly is driven by the driving assembly to move toward the distal side of the suturing device to clamp the tissue with the anvil, so as to close the suturing device, and the staples in the firing assembly are formed at the anvil to suturing the tissue, and the tissue is cut by the cutter, so as to achieve tissue suturing and cutting, with a simple structure, simple operation and convenient use. The present invention can achieve the closure between the anvil and the firing assembly to clamp the tissue, and can also drive the staples to push out the formation and drive the cutter to push out the cut tissue, that is, the suturing device can be closed and fired by using a set of driving assemblies, and the structure is more simple.
下面结合附图详细介绍本发明各个具体实施例的外科缝切装置的结构，可以理解的是，各个具体实施例不作为本发明的保护范围的限制。The structures of surgical suturing devices according to various specific embodiments of the present invention will be described in detail below in conjunction with the accompanying drawings. It should be understood that the various specific embodiments are not intended to limit the protection scope of the present invention.
如图1～9所示，本发明提供了一种外科缝切装置，包括：中空的壳体1，所述壳体1的侧壁开设有窗口13；钉砧2，固定于所述壳体1的内部；击发组件，位于所述钉砧2的近端侧，所述击发组件的内部设置有吻合钉和切刀9；驱动组件7，所述缝切装置击发时，所述驱动组件7推动所述击发组件朝向所述缝切装置的远端侧方向运动，并将所述击发组件中的吻合钉和切刀9朝向所述钉砧2推出。所述壳体1为管状或近似于管状的形状，且在初始状态下，所述钉砧2和所述击发组件位于所述窗口13的两端，这样，在消化道组织的吻合过程中，缝切装置贴合组织的自然生长形态，所述窗口13贴近待吻合的组织，更易于把待吻合的组织拉入位于所述壳体1侧壁的所述窗口13中，在吻合过后的组织更接近于人体组织的自然形态，不会造成术后的异物感等不适。As shown in Figs. 1 to 9, the present invention provides a surgical suture device, comprising: a hollow shell 1, a window 13 is provided on the side wall of the shell 1; an anvil 2 fixed inside the shell 1; a firing assembly located at the proximal side of the anvil 2, wherein the firing assembly is provided with staples and a cutter 9; and a driving assembly 7. When the suture device is fired, the driving assembly 7 pushes the firing assembly to move toward the distal side of the suture device and pushes the staples and the cutter 9 in the firing assembly toward the anvil 2. The shell 1 is tubular or approximately tubular, and in the initial state, the anvil 2 and the firing assembly are located at both ends of the window 13. In this way, during the anastomosis of the digestive tract tissue, the suture device conforms to the natural growth form of the tissue, and the window 13 is close to the tissue to be anastomosed, so that it is easier to pull the tissue to be anastomosed into the window 13 located on the side wall of the shell 1. The tissue after anastomosis is closer to the natural form of human tissue, and will not cause discomfort such as foreign body sensation after surgery.
在采用该缝切装置对组织进行缝合和切割时，首先将外科缝切装置放置于病变位置，例如，将外科缝切装置经肛门放入到直肠内部，以对直肠中的组织进行缝合和切割。在其他的实施方式中，外科缝切装置也可以用于消化道其他位置的组织缝合和切割，均属于本发明的保护范围之内。When the suturing device is used to suturing and cutting tissue, the surgical suturing device is first placed at the lesion site, for example, the surgical suturing device is placed into the rectum through the anus to suturing and cutting the tissue in the rectum. In other embodiments, the surgical suturing device can also be used for suturing and cutting tissue at other locations of the digestive tract, all of which fall within the scope of protection of the present invention.
在外科缝切装置放置到位之后，可以使用手术钳等工具将需要缝合和切割的组织通过所述侧壁的窗口13拉入到所述壳体1内部，使得所述组织进入到所述钉砧2和所述击发组件之间，然后通过驱动组件7驱动击发组件朝向缝切装置的远端侧运动而与钉砧2夹紧组织，即实现了缝切装置的闭合，然后驱动组件7可以进一步驱动击发组件中的吻合钉在钉砧2处成型而对组织进行缝合，同时驱动击发组件中的切刀9，实现了组织切割。因此，本发明采用一套驱动组件7即可以实现缝切装置闭合和击发，结构更加精简。After the surgical suturing device is placed in place, surgical forceps and other tools can be used to pull the tissue to be sutured and cut into the housing 1 through the window 13 of the side wall, so that the tissue enters between the nail anvil 2 and the firing assembly, and then the firing assembly is driven by the driving assembly 7 to move toward the distal end of the suturing device to clamp the tissue with the nail anvil 2, that is, the closure of the suturing device is achieved, and then the driving assembly 7 can further drive the staples in the firing assembly to form at the nail anvil 2 to suture the tissue, and at the same time drive the cutter 9 in the firing assembly to achieve tissue cutting. Therefore, the present invention can achieve the closure and firing of the suturing device by using a set of driving assemblies 7, and the structure is more streamlined.
在该实施例中，初始状态下，所述击发组件位于所述窗口13的近端侧，所述驱动组件推动所述击发组件朝向所述缝切装置的远端侧方向运动时，所述击发组件逐渐靠近所述钉砧2，并且逐渐覆盖所述窗口13并将所述击发组件中的吻合钉和切刀9朝向所述钉砧2推出。In this embodiment, in the initial state, the firing assembly is located on the proximal side of the window 13. When the driving assembly pushes the firing assembly toward the distal side of the suturing device, the firing assembly gradually approaches the anvil 2, gradually covers the window 13, and pushes the staples and cutter 9 in the firing assembly toward the anvil 2.
如图3～9所示，在该实施例中，所述击发组件包括钉仓组件3和击发块5，从所述缝切装置的远端侧方向到近端侧方向，所述钉砧2、所述钉仓组件3和所述击发块5依次沿所述缝切装置的轴向方向依次排列，所述钉仓组件3包括钉仓31，所述钉仓31中设置有所述吻合钉33。而且所述击发块5的远端侧设有与所述吻合钉对应的击发片51以及切刀9，所述击发片51和所述切刀9至少部分位于所述钉仓31中，所述吻合钉位于所述击发片的远端侧，所述切刀9的位置与所述钉仓31的切刀槽313相对应。As shown in FIGS. 3 to 9 , in this embodiment, the firing assembly includes a staple cartridge assembly 3 and a firing block 5. From the distal end to the proximal end of the suturing device, the nail anvil 2, the staple cartridge assembly 3 and the firing block 5 are sequentially arranged in the axial direction of the suturing device. The staple cartridge assembly 3 includes a staple cartridge 31, and the staple cartridge 31 is provided with the staples 33. Moreover, a firing plate 51 and a cutter 9 corresponding to the staples are provided at the distal end of the firing block 5. The firing plate 51 and the cutter 9 are at least partially located in the staple cartridge 31. The staples are located at the distal end of the firing plate. The position of the cutter 9 corresponds to the cutter groove 313 of the staple cartridge 31.
在本发明中，远端侧和近端侧是相对于操作者来说的，距离操作者较近的一端为近端侧，距离操作者较远的一端，即更靠近手术位置的一端为远端侧，沿所述缝切装置的轴心的方向为轴向，即从缝切装置的远端侧到近端侧的方向，或从缝切装置的近端侧到远端侧的方向。在图1的视角中，壳体1的远端侧11即为壳体1的左端一侧，而壳体1的固定把手12位于壳体1的近端侧。图1中S1方向即为由近端侧至远端侧方向，S2方向即为由远端侧至近端侧方向。在本发明中，上下方向是以图1的视角中上下方向来定义的，即在图1中，D1方向为向上的方向。在图14的视角中，导轨4的远端侧41为其左端一侧，导轨4的近端侧42为其右端一侧。在本发明中，对于一个部件来说，内侧和外侧是相对于该部件的轴心来说的，靠近轴心的一侧为内侧，远离轴心的一侧为外侧。In the present invention, the distal side and the proximal side are relative to the operator, the end closer to the operator is the proximal side, the end farther from the operator, that is, the end closer to the surgical site is the distal side, and the direction along the axis of the suturing device is the axial direction, that is, the direction from the distal side to the proximal side of the suturing device, or from the proximal side to the distal side of the suturing device. In the perspective of Figure 1, the distal side 11 of the shell 1 is the left side of the shell 1, and the fixed handle 12 of the shell 1 is located on the proximal side of the shell 1. The S1 direction in Figure 1 is the direction from the proximal side to the distal side, and the S2 direction is the direction from the distal side to the proximal side. In the present invention, the up and down directions are defined by the up and down directions in the perspective of Figure 1, that is, in Figure 1, the D1 direction is the upward direction. In the perspective of Figure 14, the distal side 41 of the guide rail 4 is its left side, and the proximal side 42 of the guide rail 4 is its right side. In the present invention, for a component, the inner side and the outer side are relative to the axis of the component, the side close to the axis is the inner side, and the side far from the axis is the outer side.
如图1和图2所示，在该实施例中，所述壳体1的近端侧设置有固定把手12，所述驱动组件7包括驱动把手71，所述驱动把手71可旋转地连接至所述壳体1的固定把手12，所述驱动把手71沿第一方向运动时，所述驱动把手71推动所述击发块5朝向所述缝切装置的远端侧方向运动。如图2所示，所述驱动把手71包括依次排列的击发配合部711、枢转部712和握持部713，所述枢转部712可旋转地连接至所述固定把手12，所述击发配合部711与所述击发块5的近端侧可旋转地连接。在该实施例中，所述固定把手12与所述缝切装置的轴向方向成一定角度，方便操作者握持，也不会对壳体1的近端开口15形成遮挡，操作者可以更方便地从近端开口15处观察壳体1的内部。在其他可替代的实施方式中，所述固定把手12也可以沿所述缝切装置的轴向方向延伸设置，或采用其他的形状和/或其他的与壳体1的连接方式，均属于本发明的保护范围之内。As shown in Fig. 1 and Fig. 2, in this embodiment, a fixed handle 12 is provided on the proximal side of the housing 1, and the drive assembly 7 includes a drive handle 71, and the drive handle 71 is rotatably connected to the fixed handle 12 of the housing 1. When the drive handle 71 moves in a first direction, the drive handle 71 pushes the firing block 5 to move toward the distal side of the slit cutting device. As shown in Fig. 2, the drive handle 71 includes a firing matching portion 711, a pivoting portion 712 and a gripping portion 713 arranged in sequence, and the pivoting portion 712 is rotatably connected to the fixed handle 12, and the firing matching portion 711 is rotatably connected to the proximal side of the firing block 5. In this embodiment, the fixed handle 12 is at a certain angle to the axial direction of the slit cutting device, which is convenient for the operator to hold, and will not block the proximal opening 15 of the housing 1, so that the operator can more conveniently observe the interior of the housing 1 from the proximal opening 15. In other alternative embodiments, the fixed handle 12 may also be extended along the axial direction of the slitting device, or may adopt other shapes and/or other connection methods with the housing 1, all of which fall within the protection scope of the present invention.
如图2所示，在该实施例中，所述缝切装置还包括一传动件6，所述传动件6的两端分别可旋转地连接于所述击发块5的近端侧和所述驱动把手71的击发配合部711。如图1所示，所述钉砧2和所述击发组件均贴近所述壳体1的内侧壁设置，以增大所述壳体1内的视野和操作空间，所述击发组件与所述枢转部712位于所述壳体1中心线的两侧，以获得更高的击发力传递效率。在该实施例中，所述击发组件位于所述壳体1中心线的上侧，所述枢转部712位于所述壳体1中心线的下侧。在另一可替代的实施方式中，也可以所述击发组件位于所述壳体1中心线的下侧，所述枢转部712位于所述壳体1中心线的上侧等，均属于本发明的保护范围之内。如图8所示，击发块5的近端侧设置有第一枢转轴54，所述传动件6的一端通过开孔套设于第一枢转轴54上，且所述传动件6可绕所述第一枢转轴54旋转。如图2所示，所述击发配合部711设置有第二枢转轴7111，所述传动件6的另一端通过开孔套设于所述第二枢转轴7111，且所述传动件6可绕所述第二枢转轴7111旋转。As shown in FIG2 , in this embodiment, the slit cutting device further includes a transmission member 6, and the two ends of the transmission member 6 are rotatably connected to the proximal side of the firing block 5 and the firing matching portion 711 of the driving handle 71, respectively. As shown in FIG1 , the anvil 2 and the firing assembly are both arranged close to the inner side wall of the shell 1 to increase the field of view and operating space in the shell 1, and the firing assembly and the pivot portion 712 are located on both sides of the center line of the shell 1 to obtain a higher firing force transmission efficiency. In this embodiment, the firing assembly is located on the upper side of the center line of the shell 1, and the pivot portion 712 is located on the lower side of the center line of the shell 1. In another alternative embodiment, the firing assembly can also be located on the lower side of the center line of the shell 1, and the pivot portion 712 can be located on the upper side of the center line of the shell 1, etc., all of which are within the protection scope of the present invention. As shown in FIG8 , a first pivot shaft 54 is provided at the proximal side of the firing block 5, one end of the transmission member 6 is sleeved on the first pivot shaft 54 through an opening, and the transmission member 6 can rotate around the first pivot shaft 54. As shown in FIG2 , a second pivot shaft 7111 is provided at the firing matching portion 711, the other end of the transmission member 6 is sleeved on the second pivot shaft 7111 through an opening, and the transmission member 6 can rotate around the second pivot shaft 7111.
如图1和图2所述，所述驱动组件7还包括第二弹性件73，在缝切装置击发过程中，第二弹性件73发生弹性变形，在缝切装置击发完成后，操作者松开驱动把手71时，所述驱动把手71在第二弹性件73的弹性变形恢复力作用下可以自动回弹至初始位置，实现缝切装置的复位。具体地，所述壳体1的近端侧设置有固定把手12，所述第二弹性件73为至少部分具有弹性的弹片，例如可以为金属薄片、塑料薄片、橡胶薄片等。所述第二弹性件73设置于所述驱动把手71的握持部713与所述固定把手12之间，具体地，所述第二弹性件73的第一端731和第二端732分别抵持于所述固定把手12和所述驱动把手71的握持部713。在其他可替代的实施方式中，所述第二弹性件73也可以设置于所述固定把手12与所述驱动把手71的击发配合部711之间，也可以设置于所述壳体1的侧壁与所述驱动把手71的击发配合部711或握持部713之间，均属于本发明的保护范围之内。在其他可替代的实施方式中，所述第二弹性件73也可以采用压簧、拉簧、扭簧等弹性结构。As shown in FIG. 1 and FIG. 2 , the driving assembly 7 further includes a second elastic member 73. During the firing process of the slit cutting device, the second elastic member 73 undergoes elastic deformation. After the firing of the slit cutting device is completed, when the operator releases the driving handle 71, the driving handle 71 can automatically rebound to the initial position under the elastic deformation recovery force of the second elastic member 73, thereby resetting the slit cutting device. Specifically, a fixed handle 12 is provided at the proximal end of the housing 1. The second elastic member 73 is a spring sheet that is at least partially elastic, such as a metal sheet, a plastic sheet, a rubber sheet, etc. The second elastic member 73 is provided between the gripping portion 713 of the driving handle 71 and the fixed handle 12. Specifically, the first end 731 and the second end 732 of the second elastic member 73 are respectively abutted against the fixed handle 12 and the gripping portion 713 of the driving handle 71. In other alternative embodiments, the second elastic member 73 may also be disposed between the fixed handle 12 and the firing matching portion 711 of the driving handle 71, or between the side wall of the housing 1 and the firing matching portion 711 or the gripping portion 713 of the driving handle 71, all of which are within the protection scope of the present invention. In other alternative embodiments, the second elastic member 73 may also be an elastic structure such as a compression spring, a tension spring, or a torsion spring.
图2中示出了该实施例中驱动把手71与壳体1配合的结构。具体地，所述固定把手12的侧壁开设有第一通孔122，所述驱动把手71的枢转部712开设有第二通孔7121，所述驱动组件7还包括连接销72，所述连接销72穿设于所述第一通孔122和所述枢转部712中，所述枢转部712可以绕所述连接销72旋转。如图1和图2所示，所述驱动把手71上设置有弹性件止挡部7131，所述弹性件止挡部7131沿所述驱动把手71的长度方向延伸，所述第二弹性件73的第二端732抵持于所述弹性件止挡部7131，且可沿所述弹性件止挡部7131的延伸方向运动。FIG2 shows the structure of the driving handle 71 and the housing 1 in this embodiment. Specifically, the side wall of the fixed handle 12 is provided with a first through hole 122, the pivoting portion 712 of the driving handle 71 is provided with a second through hole 7121, and the driving assembly 7 further includes a connecting pin 72, which is inserted into the first through hole 122 and the pivoting portion 712, and the pivoting portion 712 can rotate around the connecting pin 72. As shown in FIG1 and FIG2, an elastic member stopper 7131 is provided on the driving handle 71, and the elastic member stopper 7131 extends along the length direction of the driving handle 71, and the second end 732 of the second elastic member 73 abuts against the elastic member stopper 7131 and can move along the extension direction of the elastic member stopper 7131.
如图2所示，所述第二弹性件73的第二端732具有翘起部，所述翘起部可以相比于所述第二弹性件73的主体部分向上翘起或向下翘起，所述翘起部抵持于所述驱动把手71的所述弹性件止挡部7131朝向所述固定把手12的一侧，所述第二端732的翘起部结构形状还可以是其他的例如圆弧面，以减小其与所述弹性件止挡部7131的摩擦力。进一步地，所述第二弹性件73的第二端732开设有通槽733，所述通槽733沿所述第二弹性件73的长度方向延伸。通过设置所述通槽733，所述第二弹性件73在靠近所述驱动把手71的一侧的更容易产生弹性变形，更方便操作者握持驱动把手71时压缩第二弹性件73变形。As shown in FIG. 2 , the second end 732 of the second elastic member 73 has a tilting portion, and the tilting portion can tilt upward or downward compared to the main body of the second elastic member 73, and the tilting portion abuts against the side of the elastic member stopper 7131 of the driving handle 71 facing the fixed handle 12. The tilting portion of the second end 732 can also be in other shapes, such as an arc surface, to reduce the friction between it and the elastic member stopper 7131. Further, the second end 732 of the second elastic member 73 is provided with a through slot 733, and the through slot 733 extends along the length direction of the second elastic member 73. By providing the through slot 733, the second elastic member 73 is more likely to be elastically deformed on the side close to the driving handle 71, and it is more convenient for the operator to compress and deform the second elastic member 73 when holding the driving handle 71.
如图2所示，所述壳体1的近端侧开设有近端开口15，所述击发组件从所述近端开口15进入所述壳体1的内部，以及使用手术钳等外科工具，对待吻合的组织进行操作。操作者也可以通过近端开口15看到缝切装置的内部。在该实施例中，所述钉砧2和所述钉仓组件3均位于所述壳体1的内部的上方，所述窗口13开设于所述壳体1的上表面，且所述窗口13的位置与所述钉砧2的位置相对应，方便将所述需要缝切的组织通过所述窗口13拉入到所述钉砧2与所述钉仓组件3之间。在其他可替代的实施方式中，所述窗口13也可以设置于所述壳体1的侧壁的其他位置，而不限于图2中示出的位置。As shown in FIG2 , a proximal opening 15 is provided on the proximal side of the shell 1, and the firing assembly enters the interior of the shell 1 from the proximal opening 15, and uses surgical tools such as surgical forceps to operate on the tissue to be anastomosed. The operator can also see the interior of the suturing device through the proximal opening 15. In this embodiment, the anvil 2 and the staple cartridge assembly 3 are both located above the interior of the shell 1, and the window 13 is provided on the upper surface of the shell 1, and the position of the window 13 corresponds to the position of the anvil 2, so that the tissue to be sutured can be pulled between the anvil 2 and the staple cartridge assembly 3 through the window 13. In other alternative embodiments, the window 13 can also be provided at other positions of the side wall of the shell 1, not limited to the position shown in FIG2 .
如图2所示，在该实施例中，所述壳体1的远端侧表面开设有远端开口111，所述远端开口111避免在所述缝切装置放置入组织时，缝切装置的远端与组织腔体之间形成密闭的空间，避免消化道内部正常的分泌的气体或液体及内容物造成的影响此外，由于所述钉砧2和所述钉仓组件3均靠近所述壳体1的内侧上表面设置，而且所述钉砧2和所述钉仓组件3均为占位很小的壁状结构更方便操作者观察壳体1的内部，以及提供了更大的操作空间。在该实施例中，所述远端开口111位于所述壳体1的远端侧表面的中部，即所述远端开口111与所述缝切装置的轴心对齐，且为一个圆形的开口。在其他可替代的实施方式中，所述远端开口111也可以开设于其他位置，也可以为其他形状，例如所述远端开口111为设置在远端侧壁的至少两个贯通远端侧壁的圆形、或者椭圆形开口，均属于本发明的保护范围之内。As shown in FIG. 2 , in this embodiment, a distal opening 111 is provided on the distal side surface of the housing 1. The distal opening 111 prevents the distal end of the suturing device from forming a closed space with the tissue cavity when the suturing device is placed into the tissue, thereby avoiding the influence of the normal secretion of gas or liquid and contents in the digestive tract. In addition, since the anvil 2 and the staple cartridge assembly 3 are both arranged close to the inner upper surface of the housing 1, and the anvil 2 and the staple cartridge assembly 3 are both wall-like structures with a small footprint, it is more convenient for the operator to observe the interior of the housing 1, and a larger operating space is provided. In this embodiment, the distal opening 111 is located in the middle of the distal side surface of the housing 1, that is, the distal opening 111 is aligned with the axis of the suturing device, and is a circular opening. In other alternative embodiments, the distal opening 111 may also be opened at other positions or in other shapes, for example, the distal opening 111 is at least two circular or elliptical openings that penetrate the distal side wall and are arranged on the distal side wall, all of which are within the scope of protection of the present invention.
如图1和图2所示，所述壳体1的远端侧表面可以为用于导向的弧形表面，即所述壳体1的远端侧直径小于其主体部分的直径，而使得其远端侧形成一个近似圆锥形的导向部，可以更方便地引导壳体1穿过肛门插入到直肠的内部，或引导壳体1更容易地进入消化道的其他病变部位，同时保护粘膜层不受到损伤。As shown in Figures 1 and 2, the distal side surface of the shell 1 can be an arcuate surface for guiding, that is, the distal side diameter of the shell 1 is smaller than the diameter of its main part, so that the distal side forms an approximately conical guiding portion, which can more conveniently guide the shell 1 through the anus to be inserted into the rectum, or guide the shell 1 to more easily enter other lesions in the digestive tract, while protecting the mucosal layer from damage.
如图3～5所示，所述钉仓31的远端侧为钉仓面312，钉仓面312中设置有切刀槽313和多个钉孔3121，所述钉孔3121可以排成一排或排成多排，所述钉孔可以排成一排或排成多排，当所述钉孔3121为至少两排时，可以彼此交错设置，即在内圈的所述钉孔3121与在外圈的所述钉孔3121沿直径方向的投影有重合。如图5示出了在初始状态下，切刀9的位置与钉仓31的位置关系，其中省去了击发块5。图6示出了击发块5与切刀9配合的结构，其中省去了切刀9。切刀9是固定安装于所述击发块5的远端侧的容纳槽59中的，所述容纳槽59的底面为与所述切刀9相配合的推刀面58。所述击发块5的远端侧设置有击发片51和切刀9，所述击发片51与所述钉孔3121的位置相对应，用于在缝切装置击发时将吻合钉穿过所述钉孔3121推出。所述推刀面58位于所述切刀9的近端侧92。所述击发块5向远端侧方向运动时，带动所述切刀9同步向远端侧方向运动。如图7所示，所述吻合钉33包括固定端331和尖刺端332，所述吻合钉33的固定端331固定于所述钉仓31的内侧。所述缝切装置击发时，所述击发块5的击发片51推动所述吻合钉33的尖刺端332穿过钉孔3121，刺破组织后到达钉砧2，在钉砧2的钉砧面22成型，且所述固定端311从所述钉仓31脱离而固定在组织上，实现对组织的吻合。图7中的吻合钉的形状和结构仅为示例，在其他可替代的实施方式中，所述吻合钉可以采用其他的形状和结构，均属于本发明的保护范围之内。例如，在另一可替代的实施方式中，所述吻合钉为“B”字形钉，所述吻合钉包括两侧的两个可刺破组织的钉脚，吻合钉在钉砧上成型时，吻合钉的两个钉腿抵压在钉砧的钉槽上弯曲变形使吻合钉成类“B”字形状。所述钉砧2还设置有切割配合部，所述切割配合部与所述切刀槽313的位置相对应，在缝切装置击发时，通过所述切割配合部与所述切刀9的配合，有利于提高切刀9对组织的切割效果。所述切割配合部可以为刀砧或为位于所述钉砧2的向远端侧延伸的凹槽。具体地，所述刀砧可以采用固定设于所述钉砧2上相应位置的硬性塑料薄片，或者硅胶片等现有技术中公开的方式。As shown in FIGS. 3 to 5 , the distal side of the nail magazine 31 is a nail magazine surface 312, in which a cutting knife groove 313 and a plurality of nail holes 3121 are arranged. The nail holes 3121 can be arranged in one row or in multiple rows. When the nail holes 3121 are arranged in at least two rows, they can be arranged alternately with each other, that is, the projections of the nail holes 3121 in the inner circle and the nail holes 3121 in the outer circle along the diameter direction overlap. FIG. 5 shows the position relationship between the position of the cutter 9 and the nail magazine 31 in the initial state, in which the firing block 5 is omitted. FIG. 6 shows the structure of the firing block 5 cooperating with the cutter 9, in which the cutter 9 is omitted. The cutter 9 is fixedly installed in the receiving groove 59 on the distal side of the firing block 5, and the bottom surface of the receiving groove 59 is a pusher surface 58 cooperating with the cutter 9. The firing piece 51 and the cutter 9 are provided at the distal end of the firing block 5. The firing piece 51 corresponds to the position of the nail hole 3121 and is used to push the staple through the nail hole 3121 when the suture cutting device is fired. The pusher surface 58 is located at the proximal side 92 of the cutter 9. When the firing block 5 moves toward the distal side, it drives the cutter 9 to move toward the distal side synchronously. As shown in FIG7 , the staple 33 includes a fixed end 331 and a spike end 332. The fixed end 331 of the staple 33 is fixed to the inner side of the staple magazine 31. When the suture cutting device is fired, the firing piece 51 of the firing block 5 pushes the spike end 332 of the staple 33 through the nail hole 3121, pierces the tissue and reaches the staple anvil 2, is formed on the staple anvil surface 22 of the staple anvil 2, and the fixed end 311 is detached from the staple magazine 31 and fixed on the tissue to achieve the staple anastomosis of the tissue. The shape and structure of the staple in FIG. 7 are only examples. In other alternative embodiments, the staple can adopt other shapes and structures, all of which belong to the protection scope of the present invention. For example, in another alternative embodiment, the staple is a "B"-shaped staple, and the staple includes two nail feet on both sides that can pierce the tissue. When the staple is formed on the anvil, the two nail legs of the staple are pressed against the nail groove of the anvil and bent and deformed to make the staple into a "B" shape. The anvil 2 is also provided with a cutting matching part, and the cutting matching part corresponds to the position of the cutting knife groove 313. When the suturing device is fired, the cutting matching part cooperates with the cutting knife 9, which is conducive to improving the cutting effect of the cutting knife 9 on the tissue. The cutting matching part can be a knife anvil or a groove extending toward the distal side of the anvil 2. Specifically, the knife anvil can be a hard plastic sheet fixedly arranged at a corresponding position on the anvil 2, or a silicone sheet or other methods disclosed in the prior art.
如图4所示，在该实施例中，所述切刀槽313为直线型槽或弧线形槽，所述钉孔3121均位于所述切刀槽313的同一侧，且所述钉孔相对于所述切刀槽靠近所述壳体的内壁设置。且所述切刀9位于远离所述壳体1侧壁的内侧，所述钉孔3121均位靠近所述壳体1侧壁的外侧。As shown in FIG4 , in this embodiment, the cutting knife groove 313 is a straight groove or an arc groove, the nail holes 3121 are all located on the same side of the cutting knife groove 313, and the nail holes are arranged near the inner wall of the housing relative to the cutting knife groove. The cutting knife 9 is located on the inner side away from the side wall of the housing 1, and the nail holes 3121 are all located near the outer side of the side wall of the housing 1.
下面结合图1～17对外科缝切装置的击发过程进行具体描述。如图1～9所示，为该实施例中外科缝切装置在初始状态下(即未击发时)的结构示意图。如图10～16所示，为该实施例中外科缝切装置在击发时的结构示意图。如图17所示，为该实施例的外科缝切装置在击发完成后复位的结构示意图。The firing process of the surgical suturing device is described in detail below in conjunction with FIGS. 1 to 17. FIGS. 1 to 9 are schematic diagrams of the structure of the surgical suturing device in the initial state (i.e., not fired). FIGS. 10 to 16 are schematic diagrams of the structure of the surgical suturing device in the embodiment when fired. FIG. 17 is a schematic diagram of the structure of the surgical suturing device in the embodiment when it is reset after firing.
在该实施例中，在不同的状态下，所述钉仓31具有第一位置和第二位置，所述第二位置位于所述第一位置的远端侧。初始状态下，所述钉仓31位于所述第一位置，所述第一位置位于所述窗口13的近端侧，此时，所述钉仓31可以完全位于所述窗口13的近端侧即不与所述窗口13重合，或者，所述钉仓31部分位于所述窗口13的近端侧即部分与所述窗口13重合，但整体位于所述窗口13的相对近端侧。所述钉仓31从所述第一位置向所述第二位置运动时，所述钉仓31逐渐覆盖所述窗口13。所述击发块5具有第三位置、第四位置和第五位置，所述第四位置位于所述第三位置的远端侧，所述第五位置位于所述第四位置的远端侧。In this embodiment, in different states, the nail magazine 31 has a first position and a second position, and the second position is located at the distal side of the first position. In the initial state, the nail magazine 31 is located at the first position, and the first position is located at the proximal side of the window 13. At this time, the nail magazine 31 can be completely located at the proximal side of the window 13, that is, it does not overlap with the window 13, or the nail magazine 31 is partially located at the proximal side of the window 13, that is, it partially overlaps with the window 13, but the whole is located at the relatively proximal side of the window 13. When the nail magazine 31 moves from the first position to the second position, the nail magazine 31 gradually covers the window 13. The firing block 5 has a third position, a fourth position and a fifth position, and the fourth position is located at the distal side of the third position, and the fifth position is located at the distal side of the fourth position.
如图1～3所示，初始状态下，驱动把手71未被握持，所述钉仓31处于初始的第一位置，所述击发块5位于初始的第三位置。如图4～9所示，在该状态下，所述击发片51不会推动所述钉仓31中的吻合钉向远端侧方向运动，所述吻合钉不会突出于所述钉仓面312，并且所述击发块5不会带动所述切刀9向远端侧方向运动，所述切刀9的远端侧91位于所述切刀槽313的内部，未突出于钉仓面312，不会切割组织。在初始位置时，所述第二弹性件73保证所述驱动组件稳定地停留在一个位置，不会由于外力误击发。As shown in FIGS. 1 to 3, in the initial state, the driving handle 71 is not held, the staple magazine 31 is in the initial first position, and the firing block 5 is in the initial third position. As shown in FIGS. 4 to 9, in this state, the firing piece 51 will not push the staples in the staple magazine 31 to move in the distal direction, the staples will not protrude from the staple magazine surface 312, and the firing block 5 will not drive the cutter 9 to move in the distal direction. The distal side 91 of the cutter 9 is located inside the cutter groove 313, does not protrude from the staple magazine surface 312, and will not cut tissue. In the initial position, the second elastic member 73 ensures that the driving assembly stays stably in one position and will not be fired by mistake due to external force.
如图10和图11所示，沿第一方向(即图10中的S3方向)握持驱动把手71时，驱动把手71沿第一方向旋转，击发配合部711向远端侧方向(即图10中S1方向)推动击发块5，使得击发块5从所述第三位置运动向远端侧方向至所述第四位置，即到达如图12所示的位置，在击发块5从第三位置运动到第四位置的过程中，击发块5和钉仓31是联动的，钉仓31在击发块5的推动作用下同时向远端侧运动至第二位置，此处第二位置即为钉砧2和钉仓31夹紧组织的手术位置，即实现了缝切装置的闭合。此时，所述第二弹性件73被所述驱动把手71压缩而产生压缩变形。此时，所述切刀9的远端侧91虽然随所述击发块5向远端侧方向运动了一段距离，但是仍然位于所述切刀槽313的内部，未与所述钉仓31发生相对位置的变化，而不会突出于所述钉仓面312，也就不会切割组织。As shown in FIGS. 10 and 11 , when the driving handle 71 is held in the first direction (i.e., the S3 direction in FIG. 10 ), the driving handle 71 rotates in the first direction, and the firing matching portion 711 pushes the firing block 5 in the distal direction (i.e., the S1 direction in FIG. 10 ), so that the firing block 5 moves from the third position to the distal direction to the fourth position, i.e., reaches the position shown in FIG. 12 . In the process of the firing block 5 moving from the third position to the fourth position, the firing block 5 and the nail magazine 31 are linked, and the nail magazine 31 simultaneously moves to the distal side to the second position under the pushing action of the firing block 5. Here, the second position is the surgical position where the nail anvil 2 and the nail magazine 31 clamp the tissue, i.e., the closure of the suture cutting device is achieved. At this time, the second elastic member 73 is compressed by the driving handle 71 to produce compression deformation. At this time, although the distal side 91 of the cutter 9 moves a distance toward the distal side along with the firing block 5, it is still located inside the cutter groove 313 and does not change its relative position with the nail magazine 31. It will not protrude from the nail magazine surface 312 and will not cut the tissue.
所述击发块5在第四位置时，继续沿第一方向握持驱动把手71，驱动把手71驱动击发块5继续向远端侧方向运动至第五位置，即如图13所示的击发块5的位置，此时所述击发块5又向远端侧运动了一定距离。在所述击发块5从第四位置向第五位置运动的过程中，击发块5与钉仓31不再联动，钉仓31的位置保持在第二位置不变。如图15和图16所示，击发块5的远端侧继续进入到钉仓31的内部，而使得击发块5的远端侧可以将钉仓31内部的吻合钉朝向钉砧2方向推出，并带动所述切刀9朝向钉砧2方向运动，穿过所述切刀槽313而到达所述钉砧2的切割配合部，实现缝切装置的击发。因此，本发明通过一个驱动把手71即可以实现缝切装置的闭合和击发。此时，所述第二弹性件73进一步被所述驱动把手71压缩而产生更大的压缩变形。When the firing block 5 is in the fourth position, the driving handle 71 is continued to be held in the first direction, and the driving handle 71 drives the firing block 5 to continue to move toward the distal side to the fifth position, that is, the position of the firing block 5 as shown in FIG. 13 , at which time the firing block 5 moves toward the distal side by a certain distance. In the process of the firing block 5 moving from the fourth position to the fifth position, the firing block 5 and the nail magazine 31 are no longer linked, and the position of the nail magazine 31 remains unchanged at the second position. As shown in FIG. 15 and FIG. 16 , the distal side of the firing block 5 continues to enter the interior of the nail magazine 31, so that the distal side of the firing block 5 can push the staples in the nail magazine 31 toward the direction of the nail anvil 2, and drive the cutter 9 to move toward the direction of the nail anvil 2, pass through the cutter groove 313 and reach the cutting matching part of the nail anvil 2, so as to realize the firing of the suturing device. Therefore, the present invention can realize the closing and firing of the suturing device through a driving handle 71. At this time, the second elastic member 73 is further compressed by the driving handle 71 to produce a greater compression deformation.
如图14所示，在该实施例中，所述外科缝切装置还包括沿所述缝切装置的轴向方向延伸的导轨4，所述钉砧2、所述钉仓组件3和所述击发块5从所述缝切装置的远端侧到近端侧方向依次套设于所述导轨4上。所述导轨4可以对所述钉仓组件3和所述击发块5轴向方向运动进行引导和限定，保持所述钉仓组件3和所述钉砧2在轴向方向对齐，从而保证所述钉仓组件3中的吻合钉推出后能够在钉砧2的钉砧面22上的对应位置成型。所述导轨4的远端侧41可以固定于所述壳体1的内部，所述钉砧2固定于所述壳体1的内部，从而保持所述导轨4和所述钉砧2相对于壳体1的位置稳定性，但本发明不限于此。As shown in FIG. 14 , in this embodiment, the surgical suturing device further includes a guide rail 4 extending in the axial direction of the suturing device, and the anvil 2, the staple cartridge assembly 3 and the firing block 5 are sequentially sleeved on the guide rail 4 from the distal end side to the proximal end side of the suturing device. The guide rail 4 can guide and limit the axial movement of the staple cartridge assembly 3 and the firing block 5, and keep the staple cartridge assembly 3 and the anvil 2 aligned in the axial direction, thereby ensuring that the staples in the staple cartridge assembly 3 can be formed at the corresponding positions on the anvil surface 22 of the anvil 2 after being pushed out. The distal end 41 of the guide rail 4 can be fixed to the inside of the housing 1, and the anvil 2 is fixed to the inside of the housing 1, thereby maintaining the positional stability of the guide rail 4 and the anvil 2 relative to the housing 1, but the present invention is not limited thereto.
如图14所示，在该实施例中，所述外科缝切装置包括两个所述导轨4，所述钉砧2、所述钉仓31和所述击发块5的两侧分别套设于所述导轨4。在其他可替代的实施方式中，所述导轨4也不限于设置两个，也可以设置为一个或多个，均属于本发明的保护范围之内。所述钉砧2的两侧分别具有一个钉砧引导部21，套设于两个导轨4上，两个钉砧引导部21之间为钉砧面22。如图14所示，所述钉仓31包括两个钉仓引导部311，分别套设于两个导轨4上，两个钉仓引导部311之间为所述钉仓面312。所述击发块5的两侧分别设置有击发引导部52，分别套设于两个导轨4上。As shown in FIG. 14 , in this embodiment, the surgical suture device includes two guide rails 4, and the anvil 2, the nail magazine 31 and the two sides of the firing block 5 are respectively sleeved on the guide rails 4. In other alternative embodiments, the guide rails 4 are not limited to being set at two, and can also be set at one or more, all of which fall within the scope of protection of the present invention. The two sides of the anvil 2 are respectively provided with an anvil guide 21, which is sleeved on the two guide rails 4, and the anvil surface 22 is between the two anvil guides 21. As shown in FIG. 14 , the nail magazine 31 includes two nail magazine guides 311, which are respectively sleeved on the two guide rails 4, and the nail magazine surface 312 is between the two nail magazine guides 311. The firing block 5 is provided with firing guides 52 on both sides, which are respectively sleeved on the two guide rails 4.
如图17所示，在缝切装置击发完成后，操作者松开驱动把手71，即所述驱动把手71的握持力消除，此时在所述第二弹性件73的弹性变形恢复力作用下，所述驱动把手71从击发位置沿第二方向(即图17中的S4方向)旋转，回弹到其初始位置，实现了缝切装置的复位，所述第二方向与所述第一方向相反。进一步地，由于所述驱动把手71与所述击发组件可旋转地连接，所述驱动把手71沿第二方向旋转时，带动所述击发组件整体向缝切装置的近端侧方向运动，实现钉仓31返回至第一位置。As shown in FIG. 17 , after the suturing device is fired, the operator releases the driving handle 71, that is, the gripping force of the driving handle 71 is eliminated. At this time, under the elastic deformation recovery force of the second elastic member 73, the driving handle 71 rotates from the firing position along the second direction (i.e., the S4 direction in FIG. 17 ), rebounds to its initial position, and the suturing device is reset. The second direction is opposite to the first direction. Furthermore, since the driving handle 71 is rotatably connected to the firing assembly, when the driving handle 71 rotates along the second direction, the firing assembly as a whole is driven to move toward the proximal side of the suturing device, and the staple cartridge 31 is returned to the first position.
如图5～9以及图14～16所示，在该实施例中，所述击发组件还包括第一弹性件32，所述第一弹性件32的两端分别抵持所述钉仓31和所述击发块5。所述第一弹性件32位于所述钉仓31的内部，所述第一弹性件32的远端侧抵持所述钉仓31的远端侧面的内侧，所述第一弹性件32的近端侧抵持所述击发块5的远端侧面。As shown in FIGS. 5 to 9 and 14 to 16, in this embodiment, the firing assembly further comprises a first elastic member 32, and the two ends of the first elastic member 32 respectively abut against the nail magazine 31 and the firing block 5. The first elastic member 32 is located inside the nail magazine 31, the distal end side of the first elastic member 32 abuts against the inner side of the distal end side of the nail magazine 31, and the proximal end side of the first elastic member 32 abuts against the distal end side of the firing block 5.
如图5～9以及图14～16所示，在该实施例中，所述第一弹性件32包括两个压簧，所述两个压簧分别设置于所述钉仓31的两个钉仓引导部311中，并且分别套设在两个所述导轨4上。所述击发块5的击发引导部52的远端侧面和所述钉仓31的远端侧面之间设置有所述第一弹性件32。As shown in FIGS. 5 to 9 and 14 to 16, in this embodiment, the first elastic member 32 includes two compression springs, which are respectively disposed in the two nail magazine guides 311 of the nail magazine 31 and respectively sleeved on the two guide rails 4. The first elastic member 32 is disposed between the distal side surface of the firing guide 52 of the firing block 5 and the distal side surface of the nail magazine 31.
初始状态下(即图3和图9的状态)，所述钉仓31处于所述第一位置，所述击发块5处于所述第三位置，此时，所述第一弹性件32可以处于未被压缩的状态，也可以处于具有一定初始压缩量的状态，此时握持所述驱动把手71，所述驱动把手71给所述击发块5的推力不足以克服所述第一弹性件32抵抗变形的力，因此所述钉仓31与所述击发块5通过所述第一弹性件32实现联动，所述击发块5推动所述钉仓31同步向钉砧2侧运动，所述击发块5运动至第四位置，所述钉仓31运动至第二位置(即图12的状态)。此时，由于所述钉仓31和所述钉砧2一起夹紧组织，继续握持驱动把手71时，会受到组织对钉仓31继续向远端侧方向运动的阻力，因此，需要增大驱动把手71的握持力，驱动把手71给击发块5的推力变大而克服所述第一弹性件32抵抗变形的力，压缩所述第一弹性件32变形，此时所述钉仓31不再向远端侧方向运动，而所述击发块5继续向远端侧运动至第五位置(即图13和图16的状态)。所述击发片51与所述钉仓31中的吻合钉接触并将所述吻合钉朝向钉砧2推出，且所述击发块5带动所述切刀9向钉砧2运动，实现缝切装置的击发。In the initial state (i.e., the state of Figures 3 and 9), the nail magazine 31 is in the first position, and the firing block 5 is in the third position. At this time, the first elastic member 32 can be in an uncompressed state or in a state with a certain initial compression amount. At this time, holding the driving handle 71, the thrust of the driving handle 71 to the firing block 5 is not enough to overcome the force of the first elastic member 32 resisting deformation. Therefore, the nail magazine 31 and the firing block 5 are linked through the first elastic member 32, and the firing block 5 pushes the nail magazine 31 to move synchronously toward the anvil 2 side, the firing block 5 moves to the fourth position, and the nail magazine 31 moves to the second position (i.e., the state of Figure 12). At this time, since the staple cartridge 31 and the anvil 2 clamp the tissue together, when the driving handle 71 is continued to be held, the tissue will resist the staple cartridge 31 from continuing to move toward the distal side. Therefore, it is necessary to increase the holding force of the driving handle 71, and the driving handle 71 pushes the firing block 5 to increase and overcome the force of the first elastic member 32 resisting deformation, compressing the first elastic member 32 to deform. At this time, the staple cartridge 31 no longer moves toward the distal side, and the firing block 5 continues to move toward the distal side to the fifth position (i.e., the state of Figures 13 and 16). The firing piece 51 contacts the staples in the staple cartridge 31 and pushes the staples toward the anvil 2, and the firing block 5 drives the cutter 9 to move toward the anvil 2 to achieve the firing of the suture cutting device.
优选地，在初始状态下，所述第一弹性件32处于具有一定初始压缩量的状态，可以更好地限定所述击发块5和所述钉仓31的初始位置，并且在所述钉仓31从所述第一位置向第二位置运动时，所述击发块5和所述钉仓31更好地配合。如图9所示，在初始状态下，所述钉仓31位于所述第一位置时，所述击发块5至少部分位于所述钉仓31的内部，所述击发片51和所述切刀9均位于所述钉仓31内部，所述第一弹性件32具有一初始压缩量。结合图12、图13和图16可以看出，至所述钉仓31运动至所述第二位置，且所述驱动把手71继续推动所述击发块5朝向所述缝切装置的远端侧方向运动时，所述击发块5可以压缩所述第一弹性件32以使得所述击发块5继续进入所述钉仓31的内部。Preferably, in the initial state, the first elastic member 32 is in a state with a certain initial compression amount, which can better define the initial position of the firing block 5 and the nail magazine 31, and when the nail magazine 31 moves from the first position to the second position, the firing block 5 and the nail magazine 31 are better matched. As shown in FIG9 , in the initial state, when the nail magazine 31 is in the first position, the firing block 5 is at least partially located inside the nail magazine 31, the firing plate 51 and the cutter 9 are both located inside the nail magazine 31, and the first elastic member 32 has an initial compression amount. It can be seen from FIG12 , FIG13 and FIG16 that when the nail magazine 31 moves to the second position and the driving handle 71 continues to push the firing block 5 to move toward the distal side of the suturing device, the firing block 5 can compress the first elastic member 32 so that the firing block 5 continues to enter the interior of the nail magazine 31.
在所述缝切装置击发完成后，所述驱动把手71在所述第二弹性件73的作用下沿第二方向旋转复位时，所述驱动把手71带动所述钉仓组件3向缝切装置的近端侧方向运动回到初始状态的第一位置。同时，在所述驱动把手71沿第二方向旋转复位时，所述第一弹性件32不再受向远端侧方向的推力，在其自身弹性恢复力作用下，向近端侧方向推动所述击发片51，所述击发块5在所述第一弹性件32的作用下相对于所述钉仓31退回到初始状态的所述钉仓31内部的第三位置。在不同的实施方式中，所述第一弹性件32可以是弹簧、金属弹片等结构，也可以是受到外力后可以压缩的柔性材料块，例如橡胶块、硅胶块等，均属于本发明的保护范围之内。After the firing of the suturing device is completed, when the driving handle 71 rotates and resets along the second direction under the action of the second elastic member 73, the driving handle 71 drives the staple cartridge assembly 3 to move toward the proximal side of the suturing device and return to the first position of the initial state. At the same time, when the driving handle 71 rotates and resets along the second direction, the first elastic member 32 is no longer pushed toward the distal side, and under the action of its own elastic restoring force, it pushes the firing piece 51 toward the proximal side, and the firing block 5 retreats relative to the staple cartridge 31 to the third position inside the staple cartridge 31 of the initial state under the action of the first elastic member 32. In different embodiments, the first elastic member 32 can be a structure such as a spring, a metal spring sheet, or a flexible material block that can be compressed after being subjected to an external force, such as a rubber block, a silicone block, etc., all of which fall within the protection scope of the present invention.
在另一可替代的实施方式中，也可以不设置该第一弹性件32，而是在击发块5的远端侧外壁和所述钉仓31的近端侧内壁之间设置摩擦阻尼机构(例如在钉仓31的近端侧内壁或所述击发块5的远端侧外壁设置有橡胶颗粒的摩擦阻尼层)，在初始状态下，握持所述驱动把手71，所述驱动把手71给所述击发块5的推力不足以克服所述摩擦阻尼机构的摩擦力，因此所述钉仓31与所述击发块5通过所述摩擦阻尼机构实现联动，所述击发块5推动所述钉仓31同步向钉砧2侧运动，所述击发块5运动至第四位置，所述钉仓31运动至第二位置(即图12的状态)。此时，由于所述钉仓31和所述钉砧2一起夹紧组织，继续握持驱动把手71时，会受到组织对钉仓31继续向远端侧方向运动的阻力，因此，需要增大驱动把手71的握持力，驱动把手71给击发块5的推力变大而克服所述摩擦阻尼机构的摩擦力，此时所述钉仓31在组织的反作用力下不再向远端侧方向运动，而所述击发块5继续向远端侧运动至第五位置(即图13的状态)。因此，所述击发片51与所述钉仓31中的吻合钉接触并将所述吻合钉朝向钉砧2推出，且所述击发块5带动所述切刀9向钉砧2运动，实现缝切装置的击发。In another alternative embodiment, the first elastic member 32 may not be provided, and a friction damping mechanism may be provided between the distal side outer wall of the firing block 5 and the proximal side inner wall of the nail magazine 31 (for example, a friction damping layer of rubber particles is provided on the proximal side inner wall of the nail magazine 31 or the distal side outer wall of the firing block 5). In the initial state, the driving handle 71 is held, and the thrust of the driving handle 71 to the firing block 5 is insufficient to overcome the friction force of the friction damping mechanism. Therefore, the nail magazine 31 and the firing block 5 are linked through the friction damping mechanism, and the firing block 5 pushes the nail magazine 31 to move synchronously toward the anvil 2 side, the firing block 5 moves to the fourth position, and the nail magazine 31 moves to the second position (i.e., the state of Figure 12). At this time, since the staple cartridge 31 and the anvil 2 clamp the tissue together, when the driving handle 71 is continued to be held, the tissue will resist the staple cartridge 31 from continuing to move toward the distal side. Therefore, it is necessary to increase the holding force of the driving handle 71, and the driving handle 71 pushes the firing block 5 to overcome the friction of the friction damping mechanism. At this time, the staple cartridge 31 no longer moves toward the distal side under the reaction force of the tissue, and the firing block 5 continues to move toward the distal side to the fifth position (i.e., the state of FIG. 13). Therefore, the firing piece 51 contacts the staples in the staple cartridge 31 and pushes the staples toward the anvil 2, and the firing block 5 drives the cutter 9 to move toward the anvil 2, thereby achieving the firing of the suture cutting device.
本发明所提供的外科缝切装置具有如下优点：The surgical suturing device provided by the present invention has the following advantages:
本发明提供了一种对组织缝合和切割的器械，通过驱动组件驱动击发组件完成缝切装置的击发，通过击发组件中的吻合钉在钉砧处成型而对组织进行缝合，并通过击发组件中的切刀对组织进行切割，使用过程中将外科缝切装置放置于病变位置，将需要缝合和切割的组织拉入到钉砧和击发组件之间，操作驱动组件闭合和击发缝切装置即可，结构精简，操作简单，使用方便。The present invention provides an instrument for suturing and cutting tissues. The firing assembly is driven by a driving assembly to complete the firing of a suturing and cutting device. The anastomotic staples in the firing assembly are formed at the staple anvil to suturing the tissues, and the cutter in the firing assembly is used to cut the tissues. During use, the surgical suturing and cutting device is placed at the lesion position, and the tissue to be sutured and cut is pulled between the staple anvil and the firing assembly. The driving assembly is operated to close and fire the suturing and cutting device. The structure is simple, the operation is simple, and the use is convenient.
以上内容是结合具体的优选实施方式对本发明所作的进一步详细说明，不能认定本发明的具体实施只局限于这些说明。对于本发明所属技术领域的普通技术人员来说，在不脱离本发明构思的前提下，还可以做出若干简单推演或替换，都应当视为属于本发明的保护范围。The above contents are further detailed descriptions of the present invention in combination with specific preferred embodiments, and it cannot be determined that the specific implementation of the present invention is limited to these descriptions. For ordinary technicians in the technical field to which the present invention belongs, several simple deductions or substitutions can be made without departing from the concept of the present invention, which should be regarded as falling within the protection scope of the present invention.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011607221.7ACN114680978B (en) | 2020-12-29 | 2020-12-29 | Surgical suture device |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011607221.7ACN114680978B (en) | 2020-12-29 | 2020-12-29 | Surgical suture device |
| Publication Number | Publication Date |
|---|---|
| CN114680978A CN114680978A (en) | 2022-07-01 |
| CN114680978Btrue CN114680978B (en) | 2024-08-09 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202011607221.7AActiveCN114680978B (en) | 2020-12-29 | 2020-12-29 | Surgical suture device |
| Country | Link |
|---|---|
| CN (1) | CN114680978B (en) |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN214907504U (en)* | 2020-12-29 | 2021-11-30 | 天臣国际医疗科技股份有限公司 | Surgical suture cutting device |
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| CN214907504U (en)* | 2020-12-29 | 2021-11-30 | 天臣国际医疗科技股份有限公司 | Surgical suture cutting device |
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| CN114680978A (en) | 2022-07-01 |
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