Disclosure of Invention
In order to solve the problems that in the prior art, when a thoracoscope cutting stitching instrument shears and stitches target tissues, the shearing and extrusion actions of the thoracoscope cutting stitching instrument tend to lead the target tissues to be partially separated from the shearing range of the jaw rods due to extrusion deformation, so that the shearing and stitching of the target tissues are not thorough, the invention provides the thoracoscope cutting stitching instrument which is convenient for fixing the tissue to cut.
The technical scheme adopted by the invention is as follows:
the thoracoscope cutting stitching instrument comprises a holding main body and a supporting rod, wherein one end of the supporting rod is connected to the holding main body, and the other end of the supporting rod is provided with a cutting stitching mechanism;
The cutting suturing mechanism comprises a nail bin and a jaw rod hinged to the nail bin, one end of the nail bin is connected with the supporting rod, the other end of the nail bin is connected with a first nail supporting seat, the first nail supporting seat is hinged to the nail bin through a spring, the inclined direction of the first nail supporting seat is opposite to that of the jaw rod, a second nail supporting seat is arranged on one surface, close to the nail bin, of the jaw rod, and the second nail supporting seat is used for being matched with the first nail supporting seat to form a fixed clamping opening.
Further, a first coupling head is arranged at the end part, close to the second nail propping seat, of the first nail propping seat, a second coupling head is arranged at the end part, close to the first nail propping seat, of the second nail propping seat, the shape of the first coupling head is coupled with the shape of the second coupling head, and a plurality of stitching nails are arranged in the nail bin;
The first coupling head and the second coupling head are used for forming a closed structure when the jaw rod rotates to be parallel to the nail bin to be closed, and fixedly supporting the staples in the stapling process.
Further, a puncture endoscope mechanism is sleeved on the support rod, a double-channel sleeve head is arranged on the puncture endoscope mechanism, and one end of the double-channel sleeve head is connected with a sleeve and an endoscope;
The dual-channel sleeve head and the sleeve are penetrated by the supporting rod and sleeved on the supporting rod, the endoscope is connected to the outer surface of the sleeve in a fitting mode, the sleeve is used for enabling the puncture endoscopic mechanism to enter the chest cavity from the wound through tip puncture, and the endoscope is used for peeping the working state of the cutting and suturing mechanism in the chest cavity.
Further, a two-channel connecting pipe is arranged on the two-channel sleeve head, a first connecting pipe opening is formed in the two-channel connecting pipe, an endoscope connecting wire is arranged in the first connecting pipe opening, one end of the endoscope connecting wire is connected with the endoscope through the inside of the two-channel connecting pipe, and the other end of the endoscope connecting wire is connected with a display screen.
Further, a second pipe connecting opening is further formed in the double-channel connecting pipe, an air pipe is arranged in the second pipe connecting opening and is communicated with the sleeve, and the air pipe is used for externally connecting an air pump and an air supply device to supply air to the chest through the sleeve.
Further, an adjusting bent pipe is connected between the support rod and the cutting and sewing mechanism, the adjusting bent pipe is made of flexible damping materials and is used for allowing the cutting and sewing mechanism to rotate through flexible connection and adjusting the included angle between the cutting and sewing mechanism and the support rod.
Further, a trigger handle is arranged on the holding main body, and a safety switch button and a jaw control button are arranged on the trigger handle, wherein the safety switch button is used for preventing the equipment from being started accidentally in a non-working state, and the jaw control button is used for controlling the opening and closing actions of the jaw rod through an internal driving mechanism and a transmission mechanism.
Further, a rotating wheel is connected between the trigger handle and the supporting rod, the rotating wheel is fixedly connected with the supporting rod, the rotating wheel is rotationally connected with the trigger handle, and the rotating wheel is used for driving the supporting rod to rotate through rotation so as to adjust the rotation angle of the nail bin and the jaw rod.
A thoracoscopic cutting stapler control method for facilitating fixed tissue resection, comprising the steps of:
S100, controlling one end of a holding main body of the cutting stitching instrument to serve as a supporting part, operating the cutting stitching instrument to enable a cutting stitching mechanism at the other end to move to the vicinity of a target object position under the drive of a supporting rod, and carrying out traction fixation on the target object through positioning;
S200, acquiring target information through an endoscope, transmitting the target information to a display screen, and adjusting the self-rotation angle of the cutting stitching instrument and the angle of an included angle between the cutting stitching instrument and a supporting rod based on the position and the angle of a target object, so that the opening end of the cutting stitching instrument is matched with the position and the angle of the target object;
S300, operating a jaw control button on the holding main body to start a driving mechanism, controlling the driving mechanism to transmit power through a transmission mechanism in the cutting stitching instrument, enabling a jaw rod of the cutting stitching instrument to be opened in a rotating angle under the drive of the transmission mechanism, controlling the holding main body to push the cutting stitching mechanism to move to two sides of a target object, and adjusting the position of the cutting stitching mechanism to enable the target object to be enclosed in a clamping opening;
S400, operating a jaw control button on the holding main body to start a driving mechanism, controlling a jaw rod to rotate towards the direction of one side of the nail bin, enabling a first coupling head to be in contact with a second coupling head to be closed, pressing a target object to be attached to a first nail supporting seat, a second nail supporting seat and the nail bin, controlling a start cutting sliding block to slide in the nail bin to push a stitching nail to stitch the target object, cutting the stitched position through a cutting knife arranged on the cutting sliding block until the target object is completely separated from the position, and controlling a cutting stitching instrument to retract to the initial position.
The specific method for controlling the jaw rod to rotate towards the direction of the side where the nail bin is located and enabling the first coupling head to be contacted and closed with the second coupling head in S400 is that the cutting stitching instrument is hinged with the opening and closing of the nail bin through the jaw rod, the rotation plane position of the jaw rod is kept unchanged in the process of rotating towards the nail bin, the free end of the jaw rod is firstly contacted with the free end of the first coupling head in the rotating process and kept in sliding contact with the end of the first coupling head, then the jaw rod is controlled to continuously rotate to press down the first coupling head, the first nail abutting seat is enabled to rotate around the end connected with the spring under pressure control until the coupling end of the first coupling head is contacted with the coupling end of the second coupling head on the jaw rod, the coupling action is completed through shape matching, the central lines of the first nail abutting seat and the second nail abutting seat are controlled to be mutually overlapped to be in the same straight line position, and finally the position of the jaw rod is adjusted to enable the jaw rod to be mutually parallel with the nail bin, and the control process is completed.
The beneficial effects of the invention are as follows:
According to the cutting stitching instrument and the control method thereof, the first nail supporting seat hinged through the spring and the second nail supporting seat connected with the jaw rod are arranged in the cutting stitching mechanism, the jaw rod rotates Zhang Kaishi, the first nail supporting seat rotates and ejects under the action of the pre-stress of the spring, so that a closed clamping opening is formed by surrounding the first nail supporting seat, the second nail supporting seat and the nail bin, in the process that the cutting stitching mechanism pushes a cut target object into the clamping opening, the first nail supporting seat can be extruded by the target object to rotate around the spring and be pressed to one side of the nail bin to give off a moving path space, after the target object completely enters the clamping opening, the first nail supporting seat rebounds under the tensile force of the spring to enable the path space in the withdrawing direction to be closed, and therefore when the jaw rod is closed, even if the jaw rod is extruded and deformed, the target object is always limited by the closed clamping opening formed among the first nail supporting seat, the second nail supporting seat and the nail bin, the closed clamping opening can not be extruded, the whole and thorough treatment of the target object tissue can be achieved through one-time cutting stitching operation, the processing efficiency is greatly improved, and the secondary time delay effect is avoided.
Detailed Description
The invention will now be described in detail with reference to the drawings and examples.
The embodiment 1 is a thoracoscope cutting suture device convenient for fixed tissue excision, as shown in figures 1-3, comprising a holding main body 1 and a support rod 2, wherein one end of the support rod 2 is connected to the holding main body 1, and the other end of the support rod 2 is provided with a cutting suture mechanism 3;
The cutting stitching mechanism 3 comprises a nail bin 31 and a jaw rod 32 hinged to the nail bin 31, one end of the nail bin 31 is connected with the supporting rod 2, the other end of the nail bin 31 is connected with a first nail supporting seat 33, the first nail supporting seat 33 is hinged to the nail bin 31 through a spring 34, the inclined direction of the first nail supporting seat 33 is opposite to that of the jaw rod 32, a second nail supporting seat 35 is arranged on one surface, close to the nail bin 31, of the jaw rod 32, and the second nail supporting seat 35 is used for being matched with the first nail supporting seat 33 to form a fixed clamping opening 36.
The cutting and stapling mechanism 3 of this embodiment is provided with a first nail supporting seat 33 hinged by a spring 34 and a second nail supporting seat 35 connected with a jaw rod 32, when the jaw rod 32 rotates Zhang Kaishi, the first nail supporting seat 33 rotates and ejects under the action of the prestress of the spring 34, so that a closed clamping opening is formed by enclosing the first nail supporting seat 33, the second nail supporting seat 35 and the nail bin 31, when the cutting and stapling mechanism 3 advances a cut target object to bring the cut target object into the clamping opening, the first nail supporting seat 33 can be pressed by the target object to rotate around the spring 34 and be pressed to one side of the nail bin 31 to give off a moving path space, after the target object completely enters the clamping opening, the first nail supporting seat 33 rebounds under the tension of the spring 34 to make the path space in the withdrawal direction closed, and therefore, when the jaw rod 32 is closed, the target object is always limited by the closed clamping opening formed among the first nail supporting seat 33, the second nail supporting seat 35 and the nail bin 31 even if the target object is extruded and deformed, the target object is not extruded out of the clamping opening, the cutting and stapling operation can be carried out once, thereby realizing the complete cutting and stapling operation, the effect and the complete tissue treatment is avoided.
In the use of the thoracoscope cutting stitching instrument, the thoracoscope cutting stitching instrument is matched with a plurality of auxiliary instruments for cooperative use, for example, a positioning needle 5 is adopted to enter the chest, a claw-shaped fixing piece is arranged at the end part of the positioning needle 5 to perform hooking auxiliary fixing on target tissues 6 shown in fig. 5, so that the target tissues 6 are in a certain tightening state, the operation of the cutting stitching instrument is further facilitated, meanwhile, the artificial pneumothorax 7 is formed by inflating the chest before the cutting stitching instrument and other instruments enter, and the relevant operation and the internal condition detection of the instruments can be facilitated.
Embodiment 2. This embodiment is based on the foregoing embodiment, in this embodiment, as shown in fig. 3, a first coupling head 37 is disposed on an end portion of the first nail supporting seat 33 near the second nail supporting seat 35, a second coupling head 38 is disposed on an end portion of the second nail supporting seat 35 near the first nail supporting seat 33, the shape of the first coupling head 37 is coupled with that of the second coupling head 38, and a plurality of staples are disposed in the staple cartridge 31 in an aligned manner, where the first coupling head 37 and the second coupling head 38 are used to form a closed structure when the jaw lever 32 is rotated to be closed parallel to the staple cartridge 31 and fixedly support the staples during the stapling process. In the use process, the cutting stitching instrument is hinged with the nail bin 31 through the jaw rod 32, the jaw rod 32 is controlled to keep unchanged in the rotation plane position in the process of rotating towards the nail bin 31, the jaw rod 32 is enabled to be in contact with the free end of the first coupling head 37 and keep sliding contact with the end of the first coupling head 37 in the rotation process, the jaw rod 32 is controlled to continuously rotate to push down the first coupling head 37, the first nail supporting seat 33 is enabled to rotate around the end connected with the spring 34 under pressure control until the coupling end of the first coupling head 37 is in contact with the coupling end of the second coupling head 38 on the jaw rod 32 and the coupling action is completed through shape matching, the center lines of the first nail supporting seat 33 and the second nail supporting seat 35 are controlled to coincide with each other to form the same straight line position, and finally the position of the jaw rod 32 is adjusted to enable the jaw rod 32 to be parallel to the nail bin 31, and the control process is completed. The nail propping seat and the coupling head structure thereon of the embodiment enable the target tissue 6 to be fixed in the clamping opening when the cutting and suturing mechanism 3 is closed, the coupling structure can be set to be in a half hollow and half solid shape of the opposite end parts of the first nail propping seat 33 and the second nail propping seat 35 respectively, and can be coupled to form a smooth integral shape after being mutually attached, for example, the upper half part and the lower half part of two square coupling heads or the round coupling heads are mutually coupled to form an integral body, and specific coupling structure setting can be set according to requirements. The coupling structure of the embodiment enables the cutting and sewing mechanism 3 to be stronger in integrity and more stable in use after closing.
In the embodiment, as shown in fig. 1 and 4, a puncture endoscope mechanism 4 is sleeved on a supporting rod 2, a dual-channel sleeve head 41 is arranged on the puncture endoscope mechanism 4, two communicable channels are arranged in the dual-channel sleeve head 41 and are used for respectively connecting an instrument (such as an endoscope 43) needing to enter the chest cavity and an instrument (such as a display screen 47) staying outside for operation or observation, one end of the dual-channel sleeve head 41 is connected with a sleeve 42 and the endoscope 43, the inner diameter of the sleeve 42 is slightly larger than the diameter of the supporting rod 2, the sleeve 42 can be stably sleeved on the supporting rod 2 and partially stretches into the chest cavity along with the supporting rod 2, the dual-channel sleeve head 41 is the same as the sleeve 42 and is penetrated by the supporting rod 2, the endoscope 43 is in fit connection with the outer surface of the sleeve 42 so as to be stably fit on the sleeve 42 without being inclined when entering the chest cavity, and the sleeve 42 is used for enabling the puncture endoscope mechanism 4 to enter the chest cavity from the tip puncture. Preferably, the end surface of the tip of the sleeve 42 and the end surface of the endoscope 43 are set to have the same inclination and the end surfaces are located in the same plane, so that the contact surface of the sleeve 42 and the endoscope 43 is smoother when the sleeve and the endoscope 43 contact the wound when the sleeve and the endoscope enter along the support rod 2.
As a preferred embodiment, a dual-channel connection pipe 44 is provided on the dual-channel casing head 41, a first connection pipe orifice 45 is provided on the dual-channel connection pipe 44, an endoscope connection wire 46 is provided in the first connection pipe orifice 45, one end of the endoscope connection wire 46 is connected with the endoscope 43 through the inside of the dual-channel connection pipe 44, and the other end of the endoscope connection wire 46 is connected with a display screen 47. The double-channel connecting pipe 44 is also provided with a second connecting pipe orifice 48, an air pipe is arranged in the second connecting pipe orifice 48 and communicated with the sleeve 42, and the air pipe is used for externally connecting an air pump and an air supply device to supply air into the chest through the sleeve 42. The auxiliary instrument for assisting in completing the cutting and suturing operation is integrated on the puncture endoscopic mechanism 4 of the cutting and suturing device, can enter the chest cavity along with the supporting rod 2 to work, is stronger in integrity and higher in convenience, overcomes the defect that a plurality of wounds are required to be formed when various auxiliary instruments are used or one wound with a larger size is required to be formed in the prior art, greatly reduces the size of the surgical wound, can control the length of the surgical wound to be less than or equal to 1.5cm, is smaller than the wound with the size of at least 3cm in the prior art, remarkably improves the speed of postoperative recovery of a patient, and reduces the recovery difficulty.
Embodiment 4 this embodiment is based on the previous embodiment, in this embodiment, as shown in fig. 2, an adjusting elbow 21 is connected between the support rod 2 and the cutting and sewing mechanism 3, the adjusting elbow 21 is made of flexible damping material, and the adjusting elbow 21 is used to allow the cutting and sewing mechanism 3 to rotate through flexible connection and adjust the angle of the included angle between the cutting and sewing mechanism 3 and the support rod 2. The flexible damping material in this embodiment may be:
The rubber damping material has excellent damping capacity, and different types of rubber, such as natural rubber, nitrile rubber, polyurethane rubber and the like, have different damping effects according to hardness, density and composition differences. When used for adjusting the bent pipe 21 between the support rod 2 and the cutting and sewing mechanism 3, the excellent damping performance can be utilized to absorb and dissipate vibration energy.
Plastic damping materials, such as polyacrylate, polyurethane, polyvinyl butyral and other plastics, can obviously improve damping performance by adjusting the formula and the processing technology. The adjusting bent pipe 21 can be manufactured according to specific requirements, plays a role in a vibration environment, and reduces the influence of vibration on the support rod 2 and the cutting and sewing mechanism 3.
Fiber composite materials, including carbon fiber, glass fiber, asbestos fiber and other materials compounded with resin and other matrix, can not only strengthen the strength and rigidity of the materials, but also maintain good damping effect. The device is suitable for adjusting the bent pipe 21 with certain requirements on strength and damping performance, and can effectively reduce vibration while bearing certain load.
Based on the above type of flexible damping material, a person skilled in the art may set a transmission mechanism for driving the adjusting elbow 21 to rotate by an adjusting angle in the cutting stapler according to the technique of driving the adjusting elbow 21 of the cutting stapler in the prior art, so as to control the bending degree of the adjusting elbow 21 by the operation of the external holding body 1 part, which is not described in detail in the present invention.
Embodiment 5 this embodiment is based on the previous embodiment, in this embodiment, as shown in fig. 2, a trigger handle 11 is provided on the grip body 1, and a safety switch button 12 and a jaw control button 13 are provided on the trigger handle 11, wherein the safety switch button 12 is used for preventing accidental starting of the apparatus in a non-working state, and the jaw control button 13 is used for controlling the opening and closing action of the jaw lever 32 through an internal driving mechanism and transmission mechanism. As a preferred embodiment, a rotary wheel 14 is connected between the trigger handle 11 and the support rod 2, the rotary wheel 14 is fixedly connected with the support rod 2, the rotary wheel 14 is rotatably connected with the trigger handle 11, and the rotary wheel 14 is used for driving the support rod 2 to rotate through rotation so as to adjust the rotation angle of the nail bin 31 and the jaw rod 32.
The electric cutting stitching instrument of the embodiment ensures the safety of the non-working state by adopting electronic locking through the safety switch, and the jaw control button 13 realizes more stable and accurate opening and closing actions through the electric driving system. The rotary adjusting mechanism is rigidly connected with the supporting rod 2, can flexibly adjust various rotary angles, and is matched with other parts of the cutting stitching instrument to adjust and realize dead-angle-free operation. The structure remarkably improves the operation efficiency, the angle adjustment is quicker, and the suturing quality is more uniform and stable.
Embodiment 6 this embodiment is a thoracoscopic cutting stapler control method for facilitating fixed tissue resection, as shown in FIGS. 1-5, comprising the steps of:
S100, controlling one end of a holding body 1 of the cutting stitching instrument to serve as a supporting part, operating the cutting stitching instrument to enable a cutting stitching mechanism 3 at the other end to move to the vicinity of a target object position under the drive of a supporting rod 2, and carrying out traction fixation on the target object through a positioning needle 5;
s200, acquiring target information through an endoscope 43, transmitting the target information to a display screen 47, and adjusting the self-rotation angle of the cutting stitching instrument and the angle of an included angle between the cutting stitching instrument and the support rod 2 based on the position and the angle of a target object, so that the opening end of the cutting stitching instrument is matched with the position and the angle of the target object;
S300, operating a jaw control button 13 on the holding body 1 to start a driving mechanism, controlling the driving mechanism to transmit power through a transmission mechanism in the cutting stitching instrument, enabling a jaw rod 32 of the cutting stitching instrument to rotate at an angle to be opened under the drive of the transmission mechanism, controlling the holding body 1 to push the cutting stitching mechanism 3 to move to two sides of a target object, and adjusting the position of the cutting stitching mechanism 3 to enable the target object to be enclosed in a clamping opening;
S400, operating the jaw control button 13 on the holding body 1 to start the driving mechanism, controlling the jaw rod 32 to rotate towards the direction of one side of the nail bin 31 and enabling the first coupling head 37 to be contacted and closed with the second coupling head 38, pressing the target object to be attached to the first nail supporting seat 33, the second nail supporting seat 35 and the nail bin 31, controlling the start cutting slider to slide in the nail bin 31 to push the staples to stitch the target object, cutting the stitched position by a cutting knife arranged on the cutting slider until the target object is completely separated from the position, and controlling the cutting stapler to retract to the initial position.
In the control method, a stable space reference system is constructed through the cooperative action of the support rod 2 and the positioning needle 5 in the initial positioning stage, so that the tail end of the instrument always keeps the optimal relative position with the target tissue 6, and the clamping deviation caused by instrument drift is avoided. The endoscope 43 vision system dynamically corrects the instrument angle through real-time image feedback, ensures that the opening and closing plane of the clamping opening and the tissue cutting surface reach ideal contact ratio, and effectively eliminates positioning errors caused by visual angle blind areas. The progressive opening process of the jaw rod 32 adopts a stepwise progressive strategy, ensures that tissues completely enter a clamping range through wide positioning, realizes accurate wrapping through fine adjustment, and realizes logic of 'capturing before tightening', thereby avoiding the phenomenon that the edges of the tissues are extruded and then partially separated from an effective cutting suture area. The cooperation setting of nail storehouse 31 and support the nail seat makes the staple be perpendicular to the tissue plane all the time when the percussion, cooperates the synchronous follow-up motion of cutting knife, forms pressfitting, sews up, the continuous operation flow of cutting, and the process is accomplished in succession through the structure that combines the cutting stitching instrument, has stopped the tissue dislocation risk because of substep operation leads to.
The control method ensures that tissues are in a stable constraint state in the whole suture and cutting process through a mechanical self-locking function of the fully closed state of the clamping opening, converts the operation intention of an operator into an accurate mechanical action sequence through electric driving control, maintains the flexibility of manual judgment, eliminates the uncertainty of manual operation, and finally realizes the dual promotion of tissue treatment thoroughness and operation safety.
Preferably, the specific method of controlling the jaw lever 32 to rotate towards the direction of the side where the staple cartridge 31 is located and enabling the first coupling head 37 to contact and close with the second coupling head 38 in S400 may refer to the technical solution in embodiment 2, and in preparation before operation, the cutting stapler should be operated to check whether the coupling condition of the first coupling head 37 and the second coupling head 38 is well closed, and simultaneously check whether good parallelism between the first staple supporting seat 33 and the second staple supporting seat 35 and the staple cartridge 31 is achieved after the first staple supporting seat 33 and the second staple supporting seat 35 are connected, so as to ensure that good support can be performed on the staples in the staple cartridge 31 and ensure uniformity of the stitching.
The foregoing examples merely illustrate specific embodiments of the invention, which are described in greater detail and are not to be construed as limiting the scope of the invention. It should be noted that it will be apparent to those skilled in the art that several variations and modifications can be made without departing from the spirit of the invention, which are all within the scope of the invention.