Disclosure of utility model
Aiming at the problems of adhesion and friction between a reinforcing repairing piece and a mucous membrane at the inner side of a tissue and no connection relation exists between the reinforcing repairing piece and the end face of a nail anvil component of a circular anastomat and the end face of a nail bin component of the circular anastomat in the prior art, the reinforcing repairing piece is easily warped due to the influence of anastomat in the anastomosis process, and the problem of incapability of accurately attaching an anastomat is solved.
The utility model provides a near-end anastomotic stoma strengthening component which comprises a near-end strengthening piece and a near-end fixing component, wherein the near-end strengthening piece comprises an end face part and a cylindrical surface connecting part, the end face part is a circular ring piece, the top end of the cylindrical surface connecting part is fixed on the bottom surface of the end face part, and the inner side surface of the cylindrical surface connecting part is aligned with the inner annular edge of the end face part. The bottom surface of the end surface part is provided with a plurality of bulges. The bulge is used for being embedded into a bin hole of a single nail in the circular anastomat nail bin. The proximal end fixing component is used for detachably connecting the cylindrical surface connecting part and the nail barrel of the circular anastomat.
The utility model is further arranged that the near-end reinforcing sheet is provided with at least one first incision, the first incision is used for cutting the end face part and the cylindrical surface connecting part along the axial direction of the cylindrical surface connecting part, and two tangent planes at the single first incision can be mutually attached. When the first cuts are plural, all of the first cuts divide the proximal reinforcing sheet into a plurality of portions distributed around the axis of the cylindrical connecting portion. Each portion of the proximal reinforcing sheet is connected to a proximal fixation assembly.
The utility model is further arranged such that the proximal fixation assembly is of a ring-shaped configuration with a single opening, or that the proximal fixation assembly is formed of a plurality of members distributed about the axis of the cylindrical connection.
The utility model is further characterized in that the proximal end fixing assembly comprises a tensioning ring, the tensioning ring comprises a plurality of arc-shaped pieces, a first inserting part and a first inserting groove are arranged on each arc-shaped piece, all arc-shaped pieces are distributed around the axis of the connecting part of the surrounding cylindrical surface, and two adjacent arc-shaped pieces are connected together in an inserting and matching way through the first inserting part and the first inserting groove. The cylindrical surface connecting part is fixedly connected with the tensioning ring, the tensioning ring is tensioned on the inner side of the nail cylinder of the circular anastomat, and the tensioning ring is positioned on the inner side of the annular knife of the circular anastomat.
The utility model further provides that the proximal end fixing assembly can be replaced by a structure comprising a plurality of brackets and buckles, wherein each bracket is fixedly connected with the cylindrical surface connecting part and the circular anastomat. The cylindrical surface connecting portion is provided with a plurality of first buckling grooves distributed around the axis of the cylindrical surface connecting portion, and a buckle penetrating through the top end of the support is clamped in each first buckling groove. The circular anastomat is provided with a plurality of second buckling grooves distributed around the axis of the circular anastomat, and a buckle penetrating through the bottom end of the support is clamped in each second buckling groove.
The utility model is further arranged that the first incision has a plurality of incisions.
The utility model is further arranged that the top of the end face part is provided with a groove, and each protrusion is internally provided with a groove.
The utility model is further arranged such that the vertical distance from the lowest point of the protrusion to the bottom surface of the end face portion is greater than or equal to 0.1mm.
The utility model further provides that the proximal reinforcing sheet is a degradable bio-reinforcing sheet.
The utility model is further arranged such that the thickness of the end face portion is less than or equal to 0.3mm.
The utility model also provides a reinforcing kit which comprises the proximal anastomotic stoma reinforcing component and the distal anastomotic stoma reinforcing component. The distal end reinforcing component comprises a distal end reinforcing sheet and a distal end fixing component, the distal end fixing component comprises an inner fixing piece and an outer fixing piece, the inner fixing piece and the outer fixing piece are detachably connected, and the distal end reinforcing sheet is clamped between the inner fixing piece and the outer fixing piece. The inner fixing piece and the outer fixing piece in the radial direction of the three through holes do not exceed the outer edge of the distal reinforcing piece, and the diameter of the through hole of the outer fixing piece and the diameter of the through hole of the distal reinforcing piece are larger than or equal to the diameter of the through hole of the inner fixing piece. The inner fixing piece is used for detachably connecting a central shaft of the circular anastomat.
The utility model further provides that the inner fixing piece is an elastic fixing piece which is abutted and fixed on the central shaft of the circular anastomat through friction force.
The utility model is further arranged in such a way that a plurality of elastic fastening strips are arranged on the inner side of the inner fixing piece, and all the elastic fastening strips are parallel to the axis of the inner fixing piece and distributed around the axis of the inner fixing piece.
The utility model is further arranged that the distal reinforcing sheet is provided with at least one second incision, the second incision cuts the distal reinforcing sheet along the axial direction of the distal reinforcing sheet, and two tangent planes at the single second incision can be mutually attached. When the second cuts are plural, all of the second cuts divide the distal reinforcing section into portions distributed around the axis of the distal reinforcing section.
The utility model is further arranged that the inner fixing member is provided with at least one third incision, and the third incision cuts the inner fixing member along the axis direction of the inner fixing member. When the third cuts are plural, all of the third cuts divide the inner fixing into portions distributed around the axis of the inner fixing. Two adjacent parts of the inner fixing piece are detachably connected.
The outer fixing member has at least one fourth cutout that cuts the outer fixing member along an axis direction of the outer fixing member. When the fourth cuts are plural, all of the fourth cuts divide the outer fixture into portions distributed about the outer fixture axis.
The present utility model is further configured such that the distal reinforcing section has a plurality of second cutouts, the inner anchor has a plurality of third cutouts, and the outer anchor has a plurality of fourth cutouts.
The utility model is further provided with a second inserting part and a second inserting groove on each part of the inner fixing piece, and two adjacent parts in the inner fixing piece are connected with the second inserting groove in an inserting fit manner through the second inserting part.
The utility model further provides that the distal end reinforcing component further comprises a plurality of buckling pieces, all buckling pieces are distributed around the axis of the inner fixing piece, and pass through the outer fixing piece and the distal end reinforcing piece and are inserted into the inner fixing piece to be clamped with the inner fixing piece.
The utility model further provides that the distal reinforcing sheet is a degradable biological reinforcing sheet.
The utility model is further arranged such that the thickness of the distal reinforcing sheet is less than or equal to 0.3mm.
The utility model also provides a circular anastomat, which comprises the reinforcement sleeve, the nail cylinder, the nail supporting seat and the central shaft. The nail barrel is internally fixed with a nail bin and an annular knife, the nail supporting seat is internally fixed with a nail anvil and a knife anvil, the central shaft is fixedly connected with the nail supporting seat, and the central shaft is fixedly connected or detachably connected with the nail barrel.
The end face part is attached to the end face of the nail bin, and at most one protrusion is embedded into a bin hole of each single nail in the nail bin. The cylindrical surface connecting part is positioned at the inner side of the annular knife and is detachably connected with the nail cylinder through the proximal end fixing component.
The inner fixing piece is detachably connected with the central shaft, and the distal reinforcing sheet is attached to the end face of the nail anvil. When the annular knife abuts against the knife anvil, the distal end fixing assembly is located on the inner side of the annular knife.
The utility model is further arranged that the distance between the outer edge of the inner fixing piece and the inner edge of the knife anvil is more than or equal to 2mm in the radial direction of the knife anvil, and the distance between the outer edge of the outer fixing piece and the inner edge of the knife anvil is more than or equal to 2mm.
The utility model is further arranged that the distance between the outer wall of the cylindrical surface connecting part and the inner wall of the annular knife is more than or equal to 2mm.
In summary, compared with the prior art, the utility model has the advantages that the proximal end reinforcing sheet only has one section of extension part along the axial direction of the circular anastomat on the inner side of the circular anastomat, and the extension part is detachably connected with the circular anastomat through the proximal end fixing component, so that the problems of friction and adhesion between the proximal end reinforcing sheet and tissues are solved, and the possibility of movement and fold formation of the proximal end reinforcing sheet on the circular anastomat is reduced. In addition, the bulge on the proximal reinforcing sheet increases the connection strength between the proximal reinforcing sheet and the nail bin of the circular anastomat, reduces the possibility of edge tilting of the proximal reinforcing sheet in the anastomosis process, ensures that the proximal reinforcing sheet can be accurately attached to an anastomotic stoma, and ensures the reinforcement effect. On the basis, the utility model also provides a reinforcing component, wherein the near-end anastomotic stoma reinforcing component and the far-end anastomotic stoma reinforcing component are both arranged in a split structure, and the reinforcing component is arranged on the existing circular anastomat on the basis of not changing the structure of the existing circular anastomat, so that the structural improvement of the existing circular anastomat can be realized very simply and at low cost.
Drawings
FIG. 1 is a schematic structural view of a proximal anastomosis reinforcing component in embodiment 1;
FIG. 2 is a schematic diagram showing the grooves in embodiment 1;
FIG. 3 is a schematic view of the proximal anastomosis reinforcing assembly of example 1 mounted on a staple cartridge in a circular stapler;
FIG. 4 is a schematic cross-sectional view of the proximal anastomosis reinforcing element of example 1 mounted on a staple cartridge in a circular stapler;
FIG. 5 is an enlarged partial schematic view showing the relative positional relationship of the grooves and staples in example 1;
FIG. 6 is a schematic structural view of a proximal anastomosis reinforcing component in embodiment 2;
FIG. 7 is a schematic view of the proximal anastomosis reinforcing assembly of example 2 mounted on a staple cartridge in a circular stapler;
FIG. 8 is a schematic cross-sectional view of the proximal anastomosis reinforcing element of example 2 mounted on a staple cartridge in a circular stapler;
FIG. 9 is a schematic view of the bottom structure of the distal end stoma reinforcement component in embodiment 3;
FIG. 10 is a schematic top view of the distal stoma strengthening component of example 3;
fig. 11 is a schematic view showing the bottom structure of the distal stoma reinforcement component in embodiment 4;
fig. 12 is a schematic top view of the distal stoma reinforcement component of example 4;
FIG. 13 is a schematic view showing the overall structure of the circular stapler of embodiment 5;
FIG. 14 is a schematic view of an exploded view of the circular stapler of example 5 with the firing handle removed;
FIG. 15 is a schematic view showing the partial structure of the relative positions of the inner fixing member, the outer fixing member and the anvil in embodiment 5;
FIG. 16 is an enlarged partial view showing the relative positions of the cylindrical connecting portion and the annular cutter in example 5;
FIG. 17 is a schematic view of a circular stapler according to embodiment 6;
FIG. 18 is a schematic view of the cartridge of example 6 with the central shaft detached.
The device comprises a proximal end anastomotic stoma reinforcing component, a proximal end reinforcing sheet, a 111, a terminal surface part, a 112, a cylindrical connecting part, a 113, a bulge, a 114, a first incision, a 115, a groove, a 12, a proximal end fixing component, a 121, an arc-shaped piece, a 1211, a first inserting part, a 1212, a first inserting groove, a 122, a bracket, a 123, a buckle, a 2, a distal end anastomotic stoma reinforcing component, a 21, a distal end reinforcing sheet, a 211, a second incision, a 22, a distal end fixing component, a 221, an inner fixing piece, a 2211, an elastic fastening strip, a 2212, a third incision, a 2213, a second inserting part, a 2214, a second inserting groove, a 222, an outer fixing piece, a 2221, a fourth incision, a 223, a buckling piece, a 3, a nail barrel, a 31, a nail cabin, a 311, a bin hole, a 32, an annular knife, a 4, a nail seat, a 41, a nail anvil, a 42, a knife anvil, a 5, a central shaft, a 6 and an anastomat.
Detailed Description
The technical solutions of the present utility model will be clearly described below with reference to the accompanying drawings, and it is obvious that the described embodiments are not all embodiments of the present utility model, and all other embodiments obtained by a person skilled in the art without making any inventive effort are within the scope of protection of the present utility model.
It should be noted that, the positional or positional relationship indicated by the terms such as "center", "upper", "lower", "horizontal", "left", "right", "front", "rear", "lateral", "longitudinal", etc. are based on the positional or positional relationship shown in the drawings, are merely for convenience of describing the present utility model and simplifying the description, and do not indicate or imply that the apparatus or element to be referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present utility model.
The far end and the near end in the utility model are the near end which is the end nearer to the doctor and the far end which is the far end from the doctor according to the position of the instrument when the doctor operates.
Example 1
As shown in fig. 1-5, the proximal anastomosis reinforcing component in embodiment 1 of the utility model comprises a proximal reinforcing sheet 11 and a proximal fixing component 12, wherein the proximal reinforcing sheet 11 comprises an end surface portion 111 and a cylindrical surface connecting portion 112, the end surface portion 111 is a circular ring sheet, the top end of the cylindrical surface connecting portion 112 is fixed on the bottom surface of the end surface portion 111, and the inner side surface of the cylindrical surface connecting portion 112 is aligned with the inner circular edge of the end surface portion 111. The bottom surface of the end surface portion 111 has a plurality of projections 113. The protrusions 113 are used for being embedded into the cartridge holes 311 of the single staples in the circular stapler cartridge 31. The proximal end fixing assembly 12 is used for detachably connecting the cylindrical surface connecting part 112 and the nail barrel 3 of the circular anastomat. In this embodiment, the protrusions 113 are distributed in accordance with the single-cartridge holes 311 of the circular stapler, so that each single-cartridge hole 311 is embedded with one protrusion 113, and the protrusions 113 are distributed annularly around the center line of the cylindrical surface connecting portion 112.
In this embodiment, the proximal reinforcing sheet 11 has a section of extension portion along the axial direction of the circular stapler only on the inner side of the circular stapler, and the section of extension portion is detachably connected with the circular stapler through the proximal fixing component 12, which solves the problems of friction and adhesion between the proximal reinforcing sheet 11 and tissues, and reduces the possibility of the proximal reinforcing sheet 11 moving on the circular stapler and forming wrinkles. In addition, the protrusions 113 on the proximal reinforcing sheet 11 in this embodiment increase the connection strength between the proximal reinforcing sheet 11 and the circular stapler nail bin 31, reduce the possibility of edge tilting of the proximal reinforcing sheet 11 in the anastomosis process, enable the proximal reinforcing sheet 11 to accurately fit the anastomosis opening, and ensure the reinforcement effect.
Specifically, the vertical distance from the lowest point of the protrusion 113 to the bottom surface of the end surface portion 111 in this embodiment is greater than or equal to 0.1mm.
Specifically, the proximal reinforcing sheet 11 has at least one first notch 114, where the first notch 114 cuts the end surface portion 111 and the cylindrical connecting portion 112 along the axial direction of the cylindrical connecting portion 112, and two cut surfaces at the single first notch 114 may be attached to each other. When the first slits 114 are provided in plural, all of the first slits 114 divide the proximal reinforcing sheet 11 into plural portions distributed around the axis of the cylindrical connecting portion 112. Each portion of the proximal reinforcing sheet 11 is connected to a proximal fixation assembly 12. The arrangement of the first incision 114 ensures that the proximal reinforcing sheet 11 can have a certain expansion amount under the action of the tension of the tissue on the basis of reinforcing the tissue, thereby facilitating the circular anastomat to be taken out of the anastomat, reducing the risk of tearing the anastomat in the process of taking out the circular anastomat from the anastomat, and improving the success rate of the operation. In addition, the central shaft 5 of the circular anastomat can enter and exit the proximal reinforcing sheet 11 from the first incision 114, so that the proximal reinforcing sheet 11 can be conveniently assembled and disassembled on the prior circular anastomat on the basis of not changing the structure of the prior circular anastomat.
Specifically, the proximal fixation assembly 12 is a ring-shaped structure with a single opening, or the proximal fixation assembly 12 is formed of a plurality of members distributed about the axis of the cylindrical connection 112. The central shaft 5 of the circular anastomat can enter and exit the proximal end fixing assembly 12 from the opening of the proximal end fixing assembly 12 or the pore between two adjacent components in the proximal end fixing assembly 12, so that the proximal end fixing assembly 12 can be disassembled and assembled on the prior circular anastomat on the basis of not changing the structure of the prior circular anastomat.
Specifically, the first cutout 114 has a plurality, and all of the first cutouts 114 are optimally distributed uniformly about the axis of the cylindrical connecting portion 112. The first cutouts 114 are provided in two in this embodiment.
Specifically, the top of the end surface 111 is provided with a groove 115, and each protrusion 113 is provided with a groove 115, so that when the protrusions 113 are pushed out from the hole 311 of the nail bin 31 of the circular anastomat, the protrusions 6 deform and are smoothly pulled out from the hole 311, thereby ensuring the fitting effect of the proximal reinforcing sheet 11 and the anastomotic stoma. Meanwhile, the grooves 115 enable the protrusions 113 to be pressed and formed on the end face portion 111 through a die, and machining difficulty of the protrusions 113 on the end face portion 111 is reduced.
Specifically, in this embodiment, the proximal reinforcing sheet 11 is a degradable bio-reinforcing sheet, and the material of the degradable bio-reinforcing sheet includes a completely degradable and absorbable biological material derived from an animal source and/or a completely degradable and absorbable biological material derived from a polymer and/or a biological material synthesized by an animal source and a polymer and completely degradable and absorbable, and the degradable bio-reinforcing sheet can provide sufficient mechanical tension in the process of tissue healing to prevent the surrounding tissue from being damaged by the staples 6, and the degradable biological material automatically degrades after tissue healing, so that no harmful effect is produced by a human body.
Specifically, the thickness of the end surface portion 111 is less than or equal to 0.3mm, so as to ensure that the annular knife 32 of the circular stapler can smoothly cut the end surface portion 111.
In this embodiment, the proximal fixing assembly 12 is composed of a plurality of members distributed around the axis of the cylindrical surface connecting portion 112, specifically, the proximal fixing assembly 12 includes a tension ring, the tension ring includes a plurality of arc-shaped members 121, each arc-shaped member 121 is provided with a first insertion portion 1211 and a first insertion slot 1212, all the arc-shaped members 121 are distributed around the axis of the cylindrical surface connecting portion 112, and two adjacent arc-shaped members 121 are connected together by the insertion fit of the first insertion portion 1211 and the first insertion slot 1212. The cylindrical surface connecting part 112 is fixedly connected with the tensioning ring, the tensioning ring is tensioned on the inner side of the nail cylinder 3 of the circular anastomat, and the tensioning ring is positioned on the inner side of the annular knife 32 of the circular anastomat. The structure design of the insertion connection of the plurality of arc-shaped pieces 121 can realize the disassembly and assembly of the proximal end fixing component 12 on the existing circular anastomat on the basis of not changing the structure of the existing circular anastomat. In this embodiment, two arc-shaped members 121 are provided.
Specifically, the portions of the cylindrical connecting portion 112 formed by cutting through the first incisions 114 correspond to all the arc-shaped members 121 one by one, and each arc-shaped member 121 is fixedly connected with the corresponding portion of the cylindrical connecting portion 112. In this embodiment, each arc-shaped member 121 is fixedly connected to a portion of the corresponding cylindrical surface connecting portion 112 through an adhesive layer.
Preferably, on the basis of the present embodiment, the positions of the tension ring and the nail barrel 3 of the circular anastomat are relatively fixed, and the annular knife 32 and the structure of relatively fixing the annular knife 32 are not contacted with the tension ring and the cylindrical surface connecting portion 112, so as to reduce the interference caused by the movement of the tension ring and the cylindrical surface connecting portion 112 to the annular knife 32. It should be noted that this preferred embodiment is not shown in the drawings.
Example 2
As shown in fig. 6-8, the proximal anastomosis reinforcing element according to embodiment 2 of the present utility model is shown. In this embodiment, the proximal fixing assembly 12 is also formed by a plurality of members distributed around the axis of the cylindrical connecting portion 112, and this embodiment is different from embodiment 1 in that the proximal fixing assembly 12 has a different structure, specifically, the proximal fixing assembly 12 includes a plurality of brackets 122 and a buckle 123, the plurality of brackets 122 are disposed, and each bracket 122 is fixedly connected with the cylindrical connecting portion 112 and the circular stapler. The cylindrical surface connecting portion 112 is provided with a plurality of first fastening grooves distributed around the axis of the cylindrical surface connecting portion 112, and each first fastening groove is internally fastened with a fastener 123 penetrating through the top end of the bracket 122. The circular stapler is provided with a plurality of second fastening grooves distributed around the axis of the circular stapler, and each second fastening groove is internally clamped with a buckle 123 penetrating through the bottom end of the bracket 122. All the brackets 122 are independent, and the disassembly and assembly of the proximal end fixing component 12 on the existing circular anastomat can be realized on the basis of not changing the structure of the existing circular anastomat.
In this embodiment, all the brackets 122 are uniformly distributed around the axis of the cylindrical connecting portion 112, and the top end and the bottom end of each bracket 122 are respectively connected with a buckle 123. In this embodiment, four brackets 122 are provided.
Example 3
The present embodiment provides a reinforcement kit comprising the proximal stoma reinforcement component of embodiment 1 or embodiment 2, and the distal stoma reinforcement component. As shown in fig. 9-10, the distal reinforcing component comprises a distal reinforcing sheet 21 and a distal fixing component 22, the distal fixing component 22 comprises an inner fixing piece 221 and an outer fixing piece 222, the inner fixing piece 221 and the outer fixing piece 222 are detachably connected, the distal reinforcing sheet 21 is clamped between the inner fixing piece 221 and the outer fixing piece 222, and the supporting strength of the distal reinforcing component to the distal reinforcing sheet 21 is improved through the large-area surface contact between the distal reinforcing sheet 21 and the inner fixing piece 221 and the outer fixing piece 222, so that the possibility of edge warping when the distal reinforcing sheet 21 moves in a body is reduced. The inner fixing piece 221 is used for detachably connecting the central shaft 5 of the circular anastomat.
Specifically, the distal reinforcing sheet 21, the inner fixing member 221 and the outer fixing member 222 all have through holes for accommodating the central shaft 5 of the circular stapler, and the axes of the through holes of the three are collinear, so that the supporting force provided by the distal reinforcing component is uniformly distributed on the distal reinforcing sheet 21 in a ring shape. The distal reinforcing sheet 21, the inner fixing member 221 and the outer fixing member 222 are all annular in this embodiment.
Specifically, the radially inner fixing member 221 and the radially outer fixing member 222 of the three through holes do not protrude beyond the outer edge of the distal reinforcing sheet 21, so as to leave a contact space between the distal reinforcing sheet 21 and the staples 6 and the annular knife 32 in the circular stapler. The outer diameters of the inner fixing member 221 and the outer fixing member 222 in this embodiment are smaller than the outer diameter of the distal reinforcing section 21.
Specifically, the diameter of the through hole of the outer fixing piece 222 and the diameter of the through hole of the distal reinforcing piece 21 are larger than or equal to the diameter of the through hole of the inner fixing piece 221, so as to avoid interference between the outer fixing piece 222 and the distal reinforcing piece 21 on the connection between the central shaft 5 of the circular stapler and the inner fixing piece 221. The inner diameters of the outer fixing member 222 and the distal reinforcing sheet 21 in this embodiment are greater than or equal to the inner diameter of the inner fixing member 221.
Specifically, the inner fixing member 221 is an elastic fixing member, and is fixed on the central shaft 5 of the circular stapler by friction force. The inner fixing member 221 in this embodiment is a medical silica gel fixing member.
Specifically, the distal reinforcing component further includes a plurality of fasteners 223, all of the fasteners 223 are distributed around the axis of the inner fixing piece 221, and the fasteners 223 penetrate through the outer fixing piece 222 and the distal reinforcing piece 21 and are inserted into the inner fixing piece to be clamped with the inner fixing piece, so that the distal reinforcing piece 21, the inner fixing piece 221 and the outer fixing piece 222 are tightly connected together.
Specifically, the distal reinforcing sheet 21 is a degradable bio-reinforcing sheet, and the material of the degradable bio-reinforcing sheet includes a completely degradable and absorbable biological material derived from an animal source and/or a completely degradable and absorbable biological material derived from a polymer and/or a biological material synthesized by an animal source and a polymer and completely degradable and absorbable, and the degradable bio-reinforcing sheet can provide sufficient mechanical tension in the process of tissue healing to prevent the surrounding tissues from being damaged by the staples 6, and the degradable biological material automatically degrades after the tissue healing, so that the harmful effects of a human body can be avoided.
Specifically, the thickness of the distal end reinforcing sheet 21 is less than or equal to 0.3mm, so as to ensure that the annular knife 32 of the circular stapler can smoothly cut the distal end reinforcing sheet 21.
Example 4
As shown in fig. 11-12, this embodiment provides a reinforcing sleeve, which is different from embodiment 3 in that a plurality of fastening strips 2211 are disposed on the inner side of the inner fixing member 221 in this embodiment, all the fastening strips 2211 are parallel to the axis of the inner fixing member 221 and distributed around the axis of the inner fixing member 221, so as to increase the elastic deformation amount of the inner fixing member 221 and widen the size range of the central shaft 5 to which the inner fixing member 221 can be connected. In this embodiment all the elastic fastening strips 2211 are evenly distributed around the axis of the inner fixing member 221.
Specifically, the distal reinforcing section 21 has at least one second slit 211, and the second slit 211 cuts the distal reinforcing section 21 along the axial direction of the distal reinforcing section 21, and two cut surfaces at the single second slit 211 can be mutually attached. When the second slits 211 are provided in plural, all the second slits 211 divide the distal reinforcing sheet 21 into plural portions distributed around the axis of the distal reinforcing sheet 21. The second incision 211 is arranged, so that the distal end reinforcing sheet 21 can ensure that the anastomat has a certain expansion amount under the action of the tension of the tissues on the basis of reinforcing the tissues, thereby facilitating the circular anastomat to be taken out of the anastomat, reducing the risk of tearing the anastomat in the process of taking out the circular anastomat from the anastomat, and improving the success rate of the operation. In addition, the central shaft 5 of the circular stapler can enter and exit the distal end reinforcing sheet 21 from the second incision 211, so that the distal end reinforcing sheet 21 can be conveniently assembled and disassembled on the conventional circular stapler without changing the structure of the conventional circular stapler.
Specifically, the inner fixing member 221 has at least one third slit 2212, and the third slit 2212 cuts the inner fixing member 221 along the axial direction of the inner fixing member 221. When the third cuts 2212 are plural, all of the third cuts 2212 divide the inner fixing member 221 into plural portions distributed around the axis of the inner fixing member 221.
The outer fixing member 222 has at least one fourth cutout 2221, and the fourth cutout 2221 cuts the outer fixing member 222 in the axial direction of the outer fixing member 222. When the number of the fourth slits 2221 is plural, all the fourth slits 2221 divide the outer fixing member 222 into a plurality of portions distributed around the axis of the outer fixing member 222, and two adjacent portions of the inner fixing member 221 are detachably connected.
The central shaft 5 of the circular stapler can pass in and out the inner fixing piece 221 and the outer fixing piece 222 from the third cut 2212 and the fourth cut 2221, so that the distal fixing component 22 can be conveniently assembled and disassembled on the existing circular stapler on the basis of not changing the structure of the existing circular stapler.
By the fastening member 223, each two adjacent portions of the inner fastening member 221 are connected to the same portion of the outer fastening member 222, so that each portion of the inner fastening member 221 is connected to form a ring, and each portion of the outer fastening member 222 is also connected to form a ring.
Specifically, in this embodiment, the two tangential planes at the position of the single third notch 2212 may be mutually attached, and the two tangential planes at the position of the single fourth notch 2221 may be mutually attached, so that the inner fixing member 221 and the outer fixing member 222 are all in a complete ring shape, and the uniformity of the supporting force provided by the distal reinforcing component in the ring direction of the distal reinforcing sheet 21 is further improved.
Specifically, the distal reinforcing section 21 has a plurality of second slits 211, the inner fixing member 221 has a plurality of third slits 2212, and the outer fixing member 222 has a plurality of fourth slits 2221. In this embodiment, the number of the second slit 211, the third slit 2212 and the fourth slit 2221 is two.
Specifically, each part of the inner fixing piece 221 is provided with a second insertion part 2213 and a second insertion groove 2214, and two adjacent parts of the inner fixing piece 221 are connected together through the insertion fit of the second insertion part 2213 and the second insertion groove 2214, so that the connection strength between the parts of the inner fixing piece 221 is improved, and the parts of the inner fixing piece 221 can be firmly clamped on the central shaft 5 of the circular anastomat.
Specifically, in this embodiment, the distal reinforcing sheet 21, the inner fixing member 221 and the outer fixing member 222 are formed by two parts, the two parts of the distal reinforcing sheet 21 and the two parts of the inner fixing member 221 are in one-to-one correspondence, the two parts of the distal reinforcing sheet 21 and the two parts of the outer fixing member 222 are also in one-to-one correspondence, and each part of the distal reinforcing sheet 21 is fixedly connected with the corresponding part of the inner fixing member 221 and the corresponding part of the outer fixing member 222, so as to facilitate rapid disassembly and assembly of the distal anastomat reinforcing assembly on the central shaft of the circular anastomat. In this embodiment, each part of the distal reinforcing section 21 and its corresponding part of the inner fixing member 221 and its corresponding part of the outer fixing member 222 are fixedly connected by an adhesive layer.
Example 5
As shown in fig. 13 to 16, the present embodiment provides a circular stapler, which includes the reinforcement sleeve set forth in embodiment 3 or embodiment 4, the nail cartridge 3, the nail support 4, and the central shaft 5;
The nail cartridge 31 and the annular knife 32 are fixed in the nail barrel 3, the nail anvil 41 and the knife anvil 42 are fixed in the nail supporting seat 4, the central shaft 5 is fixedly connected with the nail supporting seat 4, and the central shaft 5 is fixedly connected with the nail barrel 3. One end of the nail cylinder 3 far away from the nail propping seat 4 is connected with a firing handle for controlling the relative movement of the nail cylinder 3 and the nail propping seat 4.
The end face 111 is attached to the end face of the cartridge 31, and at most one protrusion 113 is embedded in the cartridge hole 311 of each single nail in the cartridge 31. The cylindrical connecting portion 112 is located inside the annular knife 32 and is detachably connected to the cartridge 3 by the proximal fixing assembly 12.
The inner fixing piece 221 is detachably connected with the central shaft 5, and the distal reinforcing sheet 21 is attached to the end face of the anvil 41. The distal securing assembly 22 is positioned inside the annular knife 32 when the annular knife 32 abuts the knife anvil 42.
In this embodiment, a protrusion 113 is embedded in a hole 311 of each single nail in the nail cartridge 31.
Specifically, the distance between the outer edge of the inner fixing member 221 and the inner wall of the anvil 42 is greater than or equal to 2mm, and the distance between the outer edge of the outer fixing member 222 and the inner wall of the anvil 42 is greater than or equal to 2mm, so that the inner fixing member 221 and the outer fixing member 222 do not hinder the cutting of the annular cutter 32. In this embodiment, the difference between the outer diameter of the inner fixing member 221 and the inner diameter of the anvil 42 is greater than or equal to 2mm, and the difference between the outer diameter of the outer fixing member 222 and the inner diameter of the anvil 42 is greater than or equal to 2mm.
Specifically, the distance between the outer wall of the cylindrical connecting portion 112 and the inner wall of the annular knife 32 is greater than or equal to 2mm, so as to facilitate installation of the tensioning ring described in embodiment 1, or when the proximal stoma reinforcing component 1 in the reinforcing sleeve is the proximal stoma reinforcing component 1 described in embodiment 2, a gap is formed between the cylindrical connecting portion 112 and the annular knife 32, so as to reduce interference of the cylindrical connecting portion 112 on movement of the annular knife 32. The difference between the outer diameter of the cylindrical connecting portion 112 and the inner diameter of the annular cutter 32 in this embodiment is greater than or equal to 2mm.
This embodiment can be used for annular resection of the superior hemorrhoidal mucosa, C-type resection of the superior hemorrhoidal mucosa, and selective resection of the superior hemorrhoidal mucosa.
Example 6
As shown in fig. 17-18, this embodiment provides a circular stapler, which differs from embodiment 5 in that the central shaft 5 is detachably connected to the cartridge 3. The embodiment can be used for esophagus anastomosis, such as tubular stomach and esophagus, colon-to-esophagus end-side anastomosis, stomach and esophagus anastomosis, such as end-side anastomosis of stomach esophagus after proximal gastric resection, jejunum and esophagus anastomosis, such as end-side anastomosis of jejunum esophagus after total gastric resection, stomach and jejunum anastomosis, such as end-side anastomosis of stomach jejunum after distal gastric resection, ileum-colon anastomosis, such as end-side anastomosis of colon ileum after ascending colon resection, colon-to-colon end-side anastomosis after transverse colon resection, rectum anastomosis, such as sigmoid colon, rectum end-to-rectum end anastomosis after rectal resection, anorectal anastomosis, such as rectocele, proctosia, hemorrhoid above III degree and the like.
The above description is only of the preferred embodiments of the present utility model and is not intended to limit the present utility model, but various modifications and variations can be made to the present utility model by those skilled in the art. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present utility model should be included in the protection scope of the present utility model.