Anastomotic stoma reinforcing and repairing assembly, anastomotic device and applicationTechnical Field
The invention relates to the technical field of medical instruments, in particular to an anastomotic stoma strengthening and repairing assembly, an anastomotic device and application.
Background
The anastomat is a medical instrument used in medicine to replace manual suturing, and realizes tissue separation, closing and functional reconstruction of organs by firing and implanting mutually staggered titanium nails into tissues to perform cross suturing. Compared with the traditional manual suturing, the anastomat suturing has the advantages of being simple and convenient to operate, shortening the operation time, reducing the occurrence probability of postoperative complications of patients, improving the operation efficiency and the like, and can be used for completing the anastomosis of difficult parts which are difficult to treat in the traditional manual suturing. Therefore, the anastomat is widely applied to operations such as thoracic surgery, gastrointestinal surgery, hepatobiliary surgery, urinary surgery and the like.
Although the existing anastomat is widely applied to clinical operations at present, the existing repairing sheet is assembled in a sleeve shape with two fixed sides, the repairing sheet is sleeved on the nail box component of the anastomat, the repairing sheet is assembled on the nail box component of the anastomat by virtue of the sleeve elastic support, the assembling process is difficult, the sutures on the two sides are in an unfixed state, and the operation is easy to be interfered. The existing reinforcement repair patch is complex to assemble with the nail bin and the nail anvil of the anastomat, the anastomotic stoma cannot be tightly closed, and bleeding, air leakage or seepage is caused during or after operation due to poor reinforcement effect.
Disclosure of Invention
Aiming at the problems existing in the prior art, the invention provides an anastomotic stoma reinforcing and repairing assembly, an anastomotic device and application.
In order to achieve the above purpose, the technical scheme adopted by the invention is as follows:
The anastomotic stoma reinforcing and repairing assembly is characterized by comprising a repairing piece, a suture and a buckle, wherein one or more free ends of the suture are fixedly connected with the buckle, the buckle is used for fixing the free ends of the suture and is simultaneously fixed on a gun body of an anastomat, after the tissue is clamped by the anastomat or after the tissue is cut and anastomosed by the anastomat, the buckle is disassembled, the suture is pulled out by pulling the buckle, and the repairing piece is separated from the anastomat.
Based on the technical scheme, still further, patch one end is equipped with the recess, and the patch other end is equipped with the convex part, is equipped with a plurality of holes between recess and the convex part, and the suture passes through the hole and alternately wears to establish between recess and convex part.
Based on the technical scheme, the suture comprises a backing, wherein the repair patch and two side edges of the backing are detachably sutured through sutures, the repair patch and the backing are made of degradable materials, and the sutures are absorbable sutures or non-absorbable sutures.
According to the technical scheme, the end part of the backing or the repairing sheet is provided with the end cap, wherein the end edge of the backing is folded towards the other end part of the backing to form the end cap connected with the backing, or both sides of the backing are folded inwards at positions close to the suture at the same time to form the end cap connected with the backing, and the end edge of the repairing sheet is folded towards the other end part of the repairing sheet to form the end cap connected with the repairing sheet, or both sides of the repairing sheet are folded inwards at positions close to the suture at the same time to form the end cap connected with the repairing sheet.
Based on the technical scheme, a guiding structure is formed by extending from the end part of the repairing sheet to the direction away from the end part.
Based on the technical scheme, still further, the buckle includes first semicircle main part, and two free ends of first semicircle main part are equipped with first extension section and second extension section respectively, and first extension section extends along the direction of keeping away from the centre of a circle, and the second extension section extends along the direction of keeping away from the centre of a circle.
According to the technical scheme, the stapler comprises a sleeve component, wherein the sleeve component is detachably fixed on the sleeve component through a suture, the sleeve component is sleeved on a nail box component of the stapler when the stapler is used, and the suture is tightened when the sleeve component is separated from the nail box component, so that the repair patch is tightly attached to the nail box component.
Based on the technical scheme, the sleeve assembly comprises a nail bin sleeve and a nail anvil sleeve, wherein repair pieces are fixed on the nail bin sleeve and the nail anvil sleeve through sutures in a crossed trend respectively, a second poking piece is arranged on the nail anvil sleeve and is of an integrated structure with one end of the nail anvil sleeve, a through hole is formed in the nail anvil sleeve, the second poking piece is arranged at one end of the nail anvil sleeve, a first poking piece is arranged on the nail bin sleeve and is of an integrated structure with one end of the nail bin sleeve, a through hole is formed in the nail bin sleeve, and the first poking piece is arranged at one end of the nail bin sleeve.
The anastomat comprises an anastomat, an anastomat reinforcing and repairing assembly and a connecting rod, wherein the anastomat comprises a nail bin, a nail anvil and a connecting rod, the nail bin sleeve is sleeved on the nail bin, the nail anvil sleeve is sleeved on the nail anvil, the connecting rod is clamped with a buckle, in the use process, a suture line is pre-fastened, a first pulling piece is pulled to enable the nail bin sleeve to be in a separation state with a repairing piece and the nail bin, a second pulling piece is pulled to enable the nail anvil sleeve to be in a separation state with the repairing piece and the nail anvil, and the nail anvil to be in a separation state, so that the repairing piece is enabled to be clung to the acting surfaces of the nail bin and the nail anvil.
The application of the anastomotic device comprises the anastomat applied to the tissues and used for performing cutting, separating and anastomosis actions on the tissues, and an anastomotic stoma reinforcing and repairing assembly used for reinforcing the tissues.
Compared with the prior art, the invention has the following beneficial effects:
(1) The patch has the function of reinforcing tissues, has good biocompatibility, can be completely degraded, has a thin thickness, does not influence the use of the anastomat, does not increase excessive operations in the use process, and can effectively reduce postoperative bleeding and air leakage.
(2) The repair assembly is matched with the anastomat for temporary installation before operation, and the sleeve assembly and the buckle installation process are matched with each other, so that the operation is rapid. The repairing piece is formed by combining a repairing piece, a backing and a suture, and is bound on the sleeve component in advance, when the repairing piece is used, the sleeve component is used as an intermediate medium, the auxiliary repairing piece is fixed on a nail box component of the anastomat, after the sleeve component is pulled out, the suture is tightened to enable the repairing piece to be adhered to the nail box component, the suture is fixed on a link rod of a gun body of the anastomat through a buckle, the possible interference in operation is avoided, and meanwhile the buckle can be used as a handle for separating the suture after the operation is completed.
(3) Compared with the existing mode of stitching the reinforcing repair piece and the elastic material together by using the stitching to enable the sleeve to be elastic, the method for taking out the stitching and the elastic material from the two sides during evacuation is adopted, and compared with the mode of taking out the stitching and the elastic material from the two sides during evacuation, the method for taking out the stitching and the elastic material from the sleeve is high in safety, low in risk and high in effectiveness. The invention combines the repairing piece with the suture, is convenient to assemble, has no falling risk in the using process, and is simple and easy to operate when being separated.
Drawings
FIG. 1 is a schematic view of a structure with rectangular protrusions according to the present invention;
FIG. 2 is a schematic view of a suture structure with semicircular protrusions according to the present invention;
FIG. 3 is a schematic view of another suture construction assembled from a repair patch, suture and backing of the present invention;
FIG. 4 is a schematic view of the end cap of the present invention folded inwardly along both sides of the patch;
FIG. 5 is a schematic view of the cartridge sleeve of the present invention;
FIG. 6 is a schematic view of the structure of the anvil sleeve of the present invention;
FIG. 7 is a schematic view of a buckle with two layers according to the present invention;
FIG. 8 is a schematic view of a buckle with a single layer structure according to the present invention;
FIG. 9 is a schematic view of the anastomosis device of the present invention;
FIG. 10 is a schematic view of the magazine assembly of the butt-joint gun body of the stapling apparatus of the present invention;
The device comprises the following components of 1, a repair sheet, 2, a suture, 3, a nail bin sleeve, 4, a first pulling sheet, 5, a nail anvil sleeve, 6, a second pulling sheet, 7, a first semicircular main body, 8, a second semicircular main body, 9, a first extension section, 10, a second extension section, 11, a third extension section, 12, a convex part, 13, a groove, 14, a link rod, 15, a nail bin, 16, a nail anvil, 17, a perforation, 18, a butt end, 19, a backing, 20, a communication hole, 21, an end cap, 22 and a buckle.
Detailed Description
The invention is further illustrated and described below with reference to the drawings and detailed description. The technical features of the embodiments of the invention can be combined correspondingly on the premise of no mutual conflict.
In order that the above objects, features and advantages of the invention will be readily understood, a more particular description of the invention will be rendered by reference to the appended drawings. In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present invention. The present invention may be embodied in many other forms than described herein and similarly modified by those skilled in the art without departing from the spirit of the invention, whereby the invention is not limited to the specific embodiments disclosed below. The technical features of the embodiments of the invention can be combined correspondingly on the premise of no mutual conflict.
In the description of the present invention, it will be understood that when an element is referred to as being "connected" to another element, it can be directly connected to the other element or be indirectly connected with intervening elements present. In contrast, when an element is referred to as being "directly connected" to another element, there are no intervening elements present.
Example 1
As shown in fig. 1-2, the present embodiment provides an anastomotic stoma reinforcement repair assembly, which comprises a repair sheet 1, a suture 2 and a buckle 22, wherein one or more free ends of the suture 2 are fixedly connected with the buckle 22, the buckle 22 fixes the free ends of the suture 2 and is simultaneously fixed on a gun body of an anastomat, after the anastomat clamps tissues or after the anastomat completes cutting and anastomosis, the buckle 22 is detached, the suture 2 is pulled out by pulling the buckle 22, and the repair sheet 1 is separated from the anastomat. Wherein the suture line 2 is an absorbable suture line 2 or a non-absorbable suture line 2, when the absorbable suture line 2 is selected, the suture line 2 is made of PGA, and when the non-absorbable suture line 2 is selected, the suture line 2 is made of PA.
In this embodiment, a groove 13 is formed at one end of the patch 1, a protrusion 12 is formed at the other end of the patch 1, a plurality of holes are formed between the groove 13 and the protrusion 12, and the suture 2 is crossed and threaded between the groove 13 and the protrusion 12 through the holes. The groove 13 structure can solve the problem that the patch on the market needs to be cut after being used, the convex portion 12 structure can extend for the patch 1, the cross trend can be set according to the positions of a plurality of actually arranged holes in order to fit the stapling device nail box assembly structure, the holes are circular holes or elliptical holes, the holes are asymmetrically distributed, and the circle centers of the holes are 1mm-5mm away from the edge of the patch 1. Furthermore, the patch 1 is made of degradable materials, preferably, the patch 1 is made of biological patches of the submucosa of the small intestine of the pig, SIS raw materials of the patch can be completely degraded within 180 days, the patch is more environment-friendly, and the patch 1 can be suitable for nail bins 15 of different types. It should be noted that the protrusion 12 may be provided to provide guidance during assembly, and the shape of the protrusion 12 may be rectangular, semicircular, etc., as illustrated in fig. 1 when the shape of the protrusion 12 is rectangular, and in fig. 2 when the shape of the protrusion 12 is semicircular. When the convex portion 12 is provided on the patch 1, the convex portion 12 and the backing 19 are arranged in a mutually independent structure, and cannot be provided on the backing 19 since the convex portion 12 functions to add guidance to the entire structure when loading.
In some embodiments, the anastomotic stoma reinforcement repair assembly further includes a backing 19, and the repair patch 1 is detachably sewn to both sides of the backing 19 by the suture thread 2, for example, referring to fig. 3, the suture thread 2 on the backing 19 and the repair patch 1 is sewn in a straight line on both sides of the backing 19 and the repair patch 1, respectively. Wherein the back lining 19 is a degradable material, preferably, the back lining 19 is an SIS patch, and the material is small intestinal mucosa layer of pig which is subjected to decellularization treatment. Further, as shown in fig. 3, the middle portion of the patch 11 has a rectangular shape, and the recess 13 is not provided, so that the anastomosis can be realized.
In some embodiments, an end cap 21 is provided at the end of the backing 19, wherein the end edge of the backing 19 is folded toward the other end of the backing 19 to form the end cap 21 attached to the backing 19, or both sides of the backing 19 are folded inwardly toward the suture 2 simultaneously to form the end cap 21 attached to the backing 19. Specifically, the end cap 21 is shaped to fit the cartridge assembly and the magazine assembly of the stapler, preferably any one of a trapezoid, a semicircle and a triangle, and is used for positioning during auxiliary loading to prevent the patch 1 from rotating during use.
In other embodiments, as shown in fig. 4, an end cap 21 is provided at the end of the patch 1, where the end edge of the patch 1 is folded toward the other end of the patch 1 to form the end cap 21 connected to the patch 1, or two sides of the patch 1 are folded at positions near the suture 2 inwards at the same time to form the end cap 21 integrally connected to the patch 1, where the folded end cap 21 is located at the end of the patch 1, and two sides of the patch 1 are formed with vertical structures. Specifically, the end cap 21 in this position is also shaped to fit the cartridge assembly and magazine assembly of the stapler, preferably any one of a trapezoid, a semicircle and a triangle, which is used to assist in positioning during loading, preventing rotation of the patch 1 during use, i.e. the end cap 21 may limit axial displacement of the patch 1.
In some embodiments, a guiding structure is formed by extending from the end of the patch 1 to a direction away from the end, so that the patch 1 and the end cap 21 are partially overlapped, and the wire structure may be rectangular in shape. During operation, the stapler cartridge assembly, the magazine assembly, pass through the patch 1, smoothly reaching the distal end of the endcap 21.
In some embodiments, the anastomotic stoma reinforcement repair assembly further comprises a sleeve assembly, and the repair sheet 1 is detachably fixed on the sleeve assembly through the suture 2 as shown in fig. 5 and 6, and in use, the sleeve assembly is sleeved on a nail box assembly of the anastomat, and when the sleeve assembly is separated from the nail box assembly, the suture 2 is tightened to enable the repair sheet 1 to be closely attached with the nail box assembly. Specifically, the sleeve assembly comprises a nail bin sleeve 3 and a nail anvil sleeve 5, wherein repair sheets 1 are fixed on the nail bin sleeve 3 and the nail anvil sleeve 5 through crossed sutures 2, a second poking sheet 6 is arranged on the nail anvil sleeve 5, one end of the second poking sheet 6 and one end of the nail anvil sleeve 5 are of an integrated structure, a through hole is formed in the nail anvil sleeve 5, the second poking sheet 6 is arranged at one end of the nail anvil sleeve 5, in the embodiment, the through hole of the nail bin sleeve 33 is larger than that of the nail anvil sleeve 55, a first poking sheet 4 is arranged on the nail bin sleeve 3, one end of the first poking sheet 4 and one end of the nail bin sleeve 3 are of an integrated structure, the inside of the nail bin sleeve 3 is of a through hole, and the first poking sheet 4 is arranged at one end of the nail bin sleeve 3.
In this embodiment, referring to fig. 7, the buckle 22 has a semicircular structure as a whole, and is provided with an opening structure, and the opening angle of the opening is preferably 30 ° -180 °. Specifically, the buckle 22 includes first semicircle main part 7 and second semicircle main part 8, and first semicircle main part 7 and second semicircle main part 8 are concentric, and the one end of first semicircle main part 7 and the one end of second semicircle main part 8 are integrated into one piece structure, and the other end of first semicircle main part 7 and the other end of second semicircle main part 8 are contactless, and reserve perforation 17 between first semicircle main part 7 and the second semicircle main part 8, and in the use, suture 2 passes perforation 17, just the diameter of first semicircle main part 7 is greater than the diameter of second semicircle main part 8, and the structure setting of buckle 22 can effectually fix suture 2 to can regard as the handle when suture 2 is taken out, be convenient for take out the operation. The sleeve component and the buckle 22 may be made of any polymer absorbable or non-absorbable material, and preferably, the sleeve component and the buckle 22 may be made of PP/PE/PA or the like. Wherein, a free end of the first semicircular main body 7 and the second semicircular main body 8 which are integrally formed is provided as a first extension section 9, and the first extension section 9 extends along a direction away from the center of the circle. Specifically, the non-contact free end of the first semicircular body 7 is provided with a second extension section 10 along the direction away from the center of the circle, the non-contact end of the second semicircular body 8 is provided with a third extension section 11 along the direction away from the center of the circle, the second extension section 10 and the third extension section 11 are arranged in parallel, and it should be noted that the opening angle is understood as the angle between the first extension section 9 and the second extension section 10 or the third extension section 11 in the direction close to the center of the circle. Wherein, the first extension section 9, the second extension section 10 and the third extension section 11 are arranged to be conveniently sleeved on the link rod 14 of the anastomat.
In another embodiment, referring to fig. 8, the buckle 22 only includes a first semicircular body 7, two free ends of the first semicircular body 7 are respectively provided with a first extension 9 and a second extension 10, the first extension 9 extends in a direction away from the center of the circle, and the second extension 10 extends in a direction away from the center of the circle. The first semicircular body 7 is provided with a through hole, and in use, the suture thread 2 passes through the communication hole 20.
The repairing component can greatly reduce the assembly of the repairing patch 1, the anastomat nail bin 15 and the nail anvil 16 in the operation process through the preassembling of the sleeve, and reduce the assembly operation difficulty. The fastener 22 fixes the suture line 2 and is clamped on the anastomat link rod 14 at the same time, so that the complexity of the instrument can be effectively reduced, and the reinforcement repair sheet 1 is tightly attached to the anastomat nail bin 15 and the nail anvil 16. Suture 2 is pre-tied with repair patch 1, and repair patch 1 is fixed on the anastomat through suture 2 before operation. After the anastomat is clamped or the anastomat is cut and anastomosed, the suture 2 is separated from the repairing sheet 1, and the suture 2 is withdrawn from the body. Repair patch 1 is preloaded onto the sleeve and can be quickly mounted to the stapler in a predetermined position, and clip 22 securing suture 2 can be bridged to stapler link 14.
Example 2
Based on the anastomotic stoma reinforcing repair assembly provided in embodiment 1, referring to fig. 9 and 10, the embodiment provides an anastomat, which comprises an anastomat, wherein the anastomat comprises a nail bin 15, a nail anvil 16 and a link rod 14, a nail bin sleeve 3 is sleeved on the nail bin 15, a nail anvil sleeve 5 is sleeved on the nail anvil 16, a buckle 22 is clamped on the link rod 14, in the use process, the sleeve assembly corresponds to the nail bin 15 and the nail anvil 16 of the anastomat, after the sleeve assembly is sleeved on the nail bin 15 and the nail anvil 16 of the anastomat, the buckle 22 is clamped on the link rod 14 of the anastomat, at the moment, a pretension suture 2 is performed, a first pulling piece 4 is pulled to enable the nail bin sleeve 3 to be in a separation state with a repair piece 1 and the nail bin 15, and a second pulling piece 6 is pulled to enable the nail anvil sleeve 5 to be in a separation state with the repair piece 1 and the nail anvil 16, and the repair piece 1 is enabled to be tightly adhered to the acting surface of the nail bin 15 and the nail anvil 16.
The installation process of the anastomotic device in the embodiment is as follows:
The method comprises the steps of confirming that the gun body of the anastomat is well packaged, opening the package, confirming that the other part of the butt joint structure of the anastomat is well packaged, opening the package, assembling the butt joint end 18 of the butt joint structure with the gun body of the anastomat according to an indication mark, confirming that the reinforcing repair sheet 1 is well packaged, opening the package, binding the reinforcing repair sheet 1 on a sleeve in advance, and sleeving the nail bin sleeve 3 and the nail anvil sleeve 5 on the nail bin 15 and the nail anvil 16 in the butt joint structure shown in the fig. 9 according to the corresponding directions, so that the repair sheet 1 faces the inside of a flare angle in the butt joint structure. The suture 2 is straightened, the winding is avoided, the free end suture 2 is tightly pressed on the link rod 14 by using the buckle 22, the operation is repeated on the opposite side, the sleeve assembly is grasped, the nail cartridge sleeve 3 and the nail anvil sleeve 5 are pulled upwards, the reinforcing repair sheet 1 is attached to the nail cartridge assembly of the anastomat, the tightness of the suture 2 is adjusted, and the repair sheet 1 is attached to the nail cartridge 15 and the nail anvil 16 of the anastomat. It should be noted that, the anastomat is an existing structure, and is not described too much here, but only the assembly structure and the use principle of the repairing component and the anastomat are embodied.
Example 3
Based on the anastomat device in the embodiment 2 and the anastomotic reinforcing repair component, the embodiment also provides application of the anastomat device, wherein the anastomat is applied to tissues and performs cutting, separating and anastomotic actions on the tissues, and the anastomotic stoma reinforcing repair component is used for reinforcing the tissues.
Finally, it should be noted that the above description is only for illustrating the technical solution of the present invention, and not for limiting the scope of the present invention, and that the simple modification and equivalent substitution of the technical solution of the present invention can be made by those skilled in the art without departing from the spirit and scope of the technical solution of the present invention.