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RU2104671C1 - Surgical suturing device - Google Patents

Surgical suturing device Download PDF

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RU2104671C1
RU2104671C1 RU94029178A RU94029178A RU2104671C1 RU 2104671 C1 RU2104671 C1 RU 2104671C1 RU 94029178 A RU94029178 A RU 94029178A RU 94029178 A RU94029178 A RU 94029178A RU 2104671 C1 RU2104671 C1 RU 2104671C1
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Russia
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pusher
handle
drive
movable
holder
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RU94029178A
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Russian (ru)
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RU94029178A (en
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Виктор Алексеевич Липатов
Николай Николаевич Каншин
Александр Борисович Затюрюкин
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Виктор Алексеевич Липатов
Николай Николаевич Каншин
Александр Борисович Затюрюкин
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Priority to RU94029178A priority Critical patent/RU2104671C1/en
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Abstract

FIELD: medical technics. SUBSTANCE: device that can be, for example, used when suturing together skin in surgical operations contains casing 1 made up of bearing member 2 and immovable handle 3 and is also provided with holder 16 of suture unit. Clip pusher is made in the form of movable plate with stop shelf 5 located on upper end of pusher 4. Drive 6 of pusher 4 is made in the form of movable handle 7 with axial fastening 25. Working end 18 of handle 7 has bearing shoulders 19. Spring 8 is executed in the form of three ribs and is supported by immovable handle 3 through its upper rib and by movable handle 7 of drive 6 through its lower rib. Side rib 17 has bearing shoulders 20 and is supported by bearing shelf 5 of pusher 4. Suture unit 11 is disposed in holder 16 and joining unit members are constructed for multiple mounting, in particular, on rod members 21,22. Detachment of sutured tissue from suturing device is accomplished by displacement of overall device along surgical join. EFFECT: increased reliability and avoided traumatism. 4 cl, 9 dwg

Description

Изобретение относится к медицинской технике, преимущественно к аппаратам для соединения тканей и может быть использовано, например, для сшивания кожи при хирургических операциях. The invention relates to medical equipment, mainly to apparatus for connecting tissues and can be used, for example, for stitching the skin during surgical operations.

Известен хирургический сшиватель, содержащий корпус, толкатель скоб, пружинный привод толкателя скоб и узел сшивания, при этом соединения выполнен с возможностью многократного монтажа (патент СССР N 1184431, МПК A 61 B 17/11, 1985 г.). Known surgical stapler, comprising a housing, a pusher of brackets, a spring drive of the pusher of brackets and a stitching unit, while the connection is made with the possibility of multiple mounting (USSR patent N 1184431, IPC A 61 B 17/11, 1985).

Недостаток известного устройства заключается в том, что взаимное расположение рабочего органа, привода и элементов управления снижает обзорность операционного поля. A disadvantage of the known device is that the relative position of the working body, drive and controls reduces the visibility of the surgical field.

Известен также хирургический сшиватель, являющийся наиболее близким аналогом, содержащий корпус, состоящий из несущего элемента и неподвижной ручки, толкатель скоб в виде пластины с упорной полкой, привод толкателя скоб, выполненный в виде подвижной ручки с пружиной, опирающейся верхним усом на неподвижную ручку корпуса, а нижним усом опирающейся на подвижную ручку привода, узел сшивания и узлы соединения (патент США N 4411378, кл. 227/19, 1983 г.). Also known is a surgical stapler, which is the closest analogue, containing a housing consisting of a supporting element and a fixed handle, a pusher of brackets in the form of a plate with a thrust shelf, a drive of the pusher of brackets made in the form of a movable handle with a spring resting on the fixed handle of the body with a mustache, and with a lower mustache resting on a movable handle of the drive, a stitching unit and connection units (US patent N 4411378, CL 227/19, 1983).

Недостатком данного устройства является невозможность контроля окончательного загиба скобы в процессе сшивания - неконтролируемый загиб скобы или чрезмерное приложение усилия в процессе загибания приводит к разрушению сшивателя и к атравматике при сшивании ввиду отсутствия контролируемой блокировки положения подвижной рукоятки, соответствующего моменту окончательного загиба скоб. The disadvantage of this device is the inability to control the final bending of the bracket during the stitching process - uncontrolled bending of the bracket or excessive application of force during the bending process leads to the destruction of the stapler and to atraumatic stitching due to the absence of a controlled locking of the position of the movable handle corresponding to the moment of the final bending of the staples.

Задача, решаемая настоящим изобретением, заключается в устранении указанных недостатков и в получении следующего технического результата - повышение надежности работы сшивателя и обеспечение атравматики в процессе сшивания при возможности повторного использования узла сшивания и его дозаправки в процессе сшивания. The problem solved by the present invention is to eliminate these drawbacks and to obtain the following technical result - improving the reliability of the stapler and providing atraumatic during the stitching process with the possibility of reuse of the stitching unit and its refueling in the stitching process.

Указанный технический результат достигается тем, что в хирургическом сшивателе, содержащем корпус, состоящий из несущего элемента и неподвижной ручки, толкатель скоб в виде подвижной пластины с упорной полкой, привод толкателя скоб, выполненный в виде подвижной ручки с осевым креплением и с пружиной, опирающейся верхним усом на неподвижную ручку корпуса, а нижним усом опирающейся на подвижную ручку привода, узел сшивания и узлы соединения, корпус снабжен держателем узла сшивания, упорная полка пластины толкателя скоб размещена на верхнем торце толкателя, пружина привода толкателя выполнена в виде трех усов, боковой ус которой опирается на упорную полку пластины толкателя, рабочий конец подвижной ручки и боковой ус пружины привода выполнены с опорными плечиками, узел сшивания размещен в держателе, элементы соединения выполнены с возможностью многократного монтажа. The specified technical result is achieved by the fact that in a surgical stapler containing a housing consisting of a supporting element and a fixed handle, a pusher of brackets in the form of a movable plate with a stop shelf, a drive of the pusher of brackets made in the form of a movable handle with axial fastening and with a spring supported by the upper mustache on the fixed handle of the case, and the lower mustache resting on the movable handle of the drive, the stitching unit and the connection nodes, the body is equipped with a holder of the stitching unit, the thrust shelf of the plate of the pusher of brackets is located on the top m the end of the pusher, the spring of the drive of the pusher is made in the form of three whiskers, the lateral whisker of which is supported by the thrust plate of the pusher plate, the working end of the movable handle and the side mustache of the spring of the drive are made with support arms, the stitching unit is placed in the holder, the connection elements are made for multiple installation .

Кроме того, в нижней части несущего элемента корпуса и на свободном конце неподвижной ручки установлены штыревые элементы со шляпкой. Несущий элемент корпуса снабжен пазом и фиксирующей лункой осевого крепления подвижной ручки, средняя и верхняя части несущего элемента корпуса снабжены окнами, средняя и верхняя части пластины толкателя снабжены пазами и элементами жесткости, узел сшивания состоит из наковальни П-образного профиля с рабочим и монтажными выступами и съемной кассеты с рабочим в верхней части и направляющими в нижней части пазами, толкатель выполнен с пазом в нижней части с боковыми торцами на рабочем конце. In addition, pin elements with a cap are installed in the lower part of the carrier element of the housing and on the free end of the fixed handle. The housing supporting element is provided with a groove and a fixing hole for the axial fastening of the movable handle, the middle and upper parts of the housing supporting element are provided with windows, the middle and upper parts of the pusher plate are provided with grooves and stiffeners, the stitching unit consists of a U-shaped anvil with working and mounting protrusions and a removable cassette with a working in the upper part and grooves guiding in the lower part, the pusher is made with a groove in the lower part with side ends at the working end.

Изобретение иллюстрируется чертежами, где на фиг. 1 представлен общий вид хирургического сшивателя; на фиг. 2 - корпус хирургического сшивателя; на фиг. 3 - толкатель; на фиг. 4 - наковальня; на фиг. 5 - пружина; на фиг. 6 - подвижная ручка; на фиг. 7 - осевое крепление; на фиг. 8 - кассета со скобами; на фиг. 9 - положение скобы при загибе. The invention is illustrated by drawings, where in FIG. 1 shows a general view of a surgical stapler; in FIG. 2 - the body of the surgical stapler; in FIG. 3 - pusher; in FIG. 4 - anvil; in FIG. 5 - spring; in FIG. 6 - movable handle; in FIG. 7 - axial mount; in FIG. 8 - cassette with brackets; in FIG. 9 - the position of the bracket when bending.

Хирургический сшиватель содержит корпус 1, состоящий из несущего элемента 2 и неподвижной ручки 3, толкатель 4 скоб, выполненный в виде подвижной пластины с упорной полкой 5, привод 6 толкателя 4, выполненный в виде подвижной ручки 7 с пружиной 8, опирающейся верхним усом 9 на неподвижную ручку 3, а нижним усом 10 - на узел 11 сшивания и узлы соединения 12 - 15. Корпус 1 снабжен держателем 16 узла 11 сшивания ля размещения съемных и несъемных элементов узла 11 сшивания. Упорная полка 5 толкателя 4 скоб размещена на верхнем торце толкателя 4, пружина 8 подвижной ручки 7 снабжена боковым усом 17, который опирается на упорную полку 5. Рабочий конец 18 подвижной ручки 7 и боковой ус 17 выполнены с опорными плечиками 19, 20, что обеспечивает блокировку положения подвижной ручки 7, соответствующего моменту окончательного загиба скоб, а также обеспечивает фиксированное положение толкателя 4 как в процессе сшивания, так и при перезарядке. Узел 11 сшивания, размещенный в держателе 16, соединен с возможность многократного монтажа для обеспечения атравматики в процессе сшивания при возможности повторного использования узла сшивания и его дозаправки в процессе сшивания. The surgical stapler contains a housing 1 consisting of a supporting element 2 and a fixed handle 3, a pusher 4 of brackets made in the form of a movable plate with a stop shelf 5, a drive 6 of the pusher 4, made in the form of a movable handle 7 with a spring 8, supported by an upper mustache 9 on the fixed handle 3, and the lower mustache 10 - to the stitching unit 11 and the connection units 12 to 15. The housing 1 is provided with a holder 16 of the stapling unit 11 for accommodating removable and non-removable elements of the stapling unit 11. The thrust shelf 5 of the pusher 4 brackets is located on the upper end of the pusher 4, the spring 8 of the movable handle 7 is provided with a lateral mustache 17, which rests on the thrust shelf 5. The working end 18 of the movable handle 7 and the lateral mustache 17 are made with supporting shoulders 19, 20, which provides locking the position of the movable handle 7, corresponding to the moment of the final bending of the staples, and also provides a fixed position of the pusher 4 both in the process of stitching and when reloading. The stitching unit 11, located in the holder 16, is connected with the possibility of multiple installation to provide atraumatic during the stitching process, if the stitching unit can be reused and refilled in the stitching process.

Один из вариантов обеспечения разъемности соединения устройства заключается в следующем: в нижней части несущего элемента 2 и на свободном конце неподвижной ручки 3 установлены штыревые элементы 21, 22. Штыревой элемент 21 образует узел соединения несущего элемента 2 корпуса 1 и толкателя 4, а штыревой элемент 22 образует узел соединения неподвижной ручки 3 с пружиной 8. Несущий элемент 2 корпуса 1 снабжен пазом 23 и фиксирующей лункой 24 осевого крепления 25 подвижной ручки 7. Средняя и верхняя части несущего элемента 2 снабжены окнами 26, 27, а средняя и верхняя части толкателя 4 снабжены окнами 28, 29. Держатель 16 узла 11 сшивания выполнен в виде двух параллельных пластин 30 с монтажными пазами 31 в нижней части и элементами жесткости 32, 33, 34. Узел 11 сшивания состоит из наковальни 35 П-образного профиля с рабочим 36 и монтажными 37 выступами и съемной кассеты 38 со скобами с рабочим 39 в верхней части и направляющими 40 в нижней части пазами. Толкатель 4 выполнен с пазом 41 в нижней части с боковыми торцами 42 на рабочем конце 43. такое выполнение обеспечивает кроме блокировки возможность визуального контроля в процессе сшивания. One of the options for ensuring the releasability of the connection of the device is as follows: in the lower part of the carrier 2 and on the free end of the fixed handle 3, pin elements 21, 22 are installed. The pin element 21 forms a connection node of the carrier element 2 of the housing 1 and the pusher 4, and the pin element 22 forms a junction of the fixed handle 3 with the spring 8. The supporting element 2 of the housing 1 is provided with a groove 23 and a fixing hole 24 of the axial fastening 25 of the movable handle 7. The middle and upper parts of the supporting element 2 are provided with windows 26, 27, and the middle the upper parts of the pusher 4 are provided with windows 28, 29. The holder 16 of the stitching unit 11 is made in the form of two parallel plates 30 with mounting grooves 31 in the lower part and stiffeners 32, 33, 34. The stitching unit 11 consists of an anvil 35 of a U-shaped profile with worker 36 and mounting 37 protrusions and a removable cartridge 38 with brackets with worker 39 in the upper part and guides 40 in the lower part of the grooves. The pusher 4 is made with a groove 41 in the lower part with side ends 42 at the working end 43. This embodiment provides, in addition to blocking, the possibility of visual inspection during the stitching process.

Устройство работает следующим образом. The device operates as follows.

Для установки кассеты 38 со скобами подвижная ручка 7 отводится от неподвижной ручки 3, при этом толкатель 4 с помощью упорной полки 5, преодолевая сопротивление бокового уса 17, поднимается вверх. После этого по наковальне 35 подается кассета 38 со скобами до упора в приподнятый толкатель 4 и размещается внутри держателя 16 между параллельными пластинами 30. Затем подвижная ручка 7 опускается и под воздействием бокового уса 17 возвращается в первоначальное нейтральное положение, а толкатель 4 рабочим концом 43 проникает в рабочий паз 39 и фиксирует кассету 38 со скобами от горизонтального перемещения. To install the cassette 38 with brackets, the movable handle 7 is withdrawn from the fixed handle 3, while the pusher 4, using the thrust shelf 5, overcoming the resistance of the side mustache 17, rises. After that, through the anvil 35, the cassette 38 is supplied with brackets all the way into the raised pusher 4 and is placed inside the holder 16 between the parallel plates 30. Then the movable handle 7 is lowered and, under the influence of the side mustache 17, returns to its original neutral position, and the pusher 4 penetrates with the working end 43 into the working groove 39 and fixes the cassette 38 with brackets against horizontal movement.

Для сшивания ткани нажимают на подвижную ручку 7, которая перемещается к неподвижной ручке 3, при этом рабочий конец 18, упираясь в нижний торец окна 29, перемещает толкатель 4 вниз. Рабочий конец 18, перемещаясь в пазу 39, взаимодействует со скобой и загибает ее на рабочем выступе 36 наковальни 35 (фиг. 9). В окне 27 можно наблюдать момент окончательного загиба скоб по контакту рабочего конца 18 с нижним торцем окна 27. После снятия нагрузки с подвижной ручки 7 она под воздействием усов 9, 10 возвращается в исходное нейтральное положение и, взаимодействуя с верхним торцем окна 29, перемещает толкатель 4 вверх до упора в боковой ус 17 пружины 8, который обладая достаточной упругостью, не деформируется и удерживает толкатель 4 в исходном положении, при этом рабочий конец 43 толкателя 4 остается в пазу 39 кассеты 38 со скобами. Скобы внутри кассеты 38 подаются автоматически под действием пружины. Затем цикл сшивания повторяется до полного расхода скоб. To stitch the fabric, press the movable handle 7, which moves to the fixed handle 3, while the working end 18, abutting against the lower end of the window 29, moves the pusher 4 down. The working end 18, moving into the groove 39, interacts with the bracket and bends it on the working ledge 36 of the anvil 35 (Fig. 9). In the window 27, you can observe the moment of the final bending of the staples at the contact of the working end 18 with the lower end of the window 27. After removing the load from the movable handle 7, it under the influence of the mustache 9, 10 returns to its original neutral position and, interacting with the upper end of the window 29, moves the pusher 4 up to the stop in the lateral mustache 17 of the spring 8, which, having sufficient elasticity, is not deformed and holds the pusher 4 in its original position, while the working end 43 of the pusher 4 remains in the groove 39 of the cassette 38 with brackets. The brackets inside the cassette 38 are fed automatically by the action of a spring. Then the stitching cycle is repeated until the staples are completely consumed.

Средством для выведения наковальни 35 из-под спинки скобы является перемещение всего устройства вдоль рабочего выступа 36. Форма рабочего конца 43 позволяет при загибе проколоть края ткани и прочно их соединить. Упираясь в выступ 36 наковальни 35 скоба загибается в закольцованную форму. Съем хирургического сшивателя после наложения скобы и разъединение устройства с наложенной на ткань скобой осуществляется отведением его и в месте с ним рабочего выступа 36 наковальни 35 из-под загнутой скобы. После снятия нагрузки скоба и ткань не могут быть защемлены на выступе 36 наковальни 35, т.к. скоба имеет остаточные деформации, ткань в процессе загиба не примыкает к рабочему выступу 36, а загиб скобы ограничен рабочим концом 43 толкателя 4. The means for removing the anvil 35 from under the back of the bracket is to move the entire device along the working protrusion 36. The shape of the working end 43 allows you to pierce the edges of the fabric when bent and firmly connect them. Resting against the protrusion 36 of the anvil 35, the bracket is bent into a ring shape. Removing the surgical stapler after applying the staples and disconnecting the device with the bracket attached to the fabric is carried out by diverting it and, in place with it, the working protrusion 36 of the anvil 35 from under the bent staple. After removing the load, the bracket and fabric cannot be pinched on the protrusion 36 of the anvil 35, because the bracket has residual deformations, the fabric during bending does not adjoin the working protrusion 36, and the bending of the bracket is limited by the working end 43 of the pusher 4.

Для снятия кассеты 38 подвижная ручка 7 отводится от неподвижной ручки 3, при этом рабочий конец 43 толкателя 4 выходит за пределы паза 39 кассеты 38, после чего кассета 38 извлекается. To remove the cassette 38, the movable handle 7 is retracted from the fixed handle 3, while the working end 43 of the pusher 4 extends beyond the groove 39 of the cassette 38, after which the cassette 38 is removed.

Для разборки осевое крепление 25 поворачивается и извлекается. Затем вынимается пружина 8, толкатель 4 снимается через окно 28 со штыревого элемента 21. Опорные плечики 19 подвижной ручки 7 и штыревой элемент 21 удерживают толкатель 4 в контакте с корпусом 1. For disassembly, the axial mount 25 is rotated and removed. Then the spring 8 is removed, the pusher 4 is removed through the window 28 from the pin member 21. The support arms 19 of the movable handle 7 and the pin member 21 hold the pusher 4 in contact with the housing 1.

Claims (4)

1. Хирургический сшиватель, содержащий корпус, состоящий из несущего элемента и неподвижной ручки, толкатель скоб в виде подвижной пластины с упорной полкой, привод толкателя скоб, выполненный в виде подвижной ручки с осевым креплением и пружиной, опирающейся верхним усом на неподвижную ручку корпуса, нижним усом опирающейся на подвижную ручку привода, узел сшивания и узлы соединения, отличающийся тем, что корпус снабжен держателем узла сшивания, упорная полка пластины толкателя скоб размещена на верхнем торце толкателя, пружина подвижной ручки привода толкателя выполнена в виде трех усов, боковой ус которой опирается на упорную полку пластины толкателя скоб, рабочий конец подвижной рукоятки и боковой ус пружины привода выполнены с опорными плечиками, узел сшивания размещен в держателе узла сшивания корпуса, элементы соединения выполнены с возможностью многократного монтажа. 1. Surgical stapler containing a housing consisting of a supporting element and a fixed handle, a pusher of brackets in the form of a movable plate with a stop shelf, a drive of the pusher of brackets made in the form of a movable handle with axial fastening and a spring resting on the fixed handle of the case with the upper mustache a mustache resting on a movable handle of the drive, a stitching unit and connection units, characterized in that the housing is equipped with a holder for the stitching unit, the thrust shelf of the pusher plate of the staples is located on the upper end of the pusher, the spring is movable th drive handle of the pusher is made in the form of three whiskers, the lateral whisker of which rests on the thrust shelf of the plate of the pusher of brackets, the working end of the movable handle and the lateral whisker of the drive spring are made with support arms, the stitching unit is placed in the holder of the body stitching unit, the connection elements are made with the possibility of multiple installation. 2. Сшиватель по п.1, отличающийся тем, что в нижней части несущего элемента корпуса и на свободном конце неподвижной ручки установлены штыревые элементы со шляпкой, несущий элемент корпуса снабжен пазом и фиксирующей лункой осевого крепления подвижной ручки, средняя и верхняя части несущего элемента корпуса снабжены окнами, средняя и верхняя части толкателя снабжены пазами. 2. The stapler according to claim 1, characterized in that pin elements with a hat are installed in the lower part of the housing supporting element and on the free end of the fixed handle, the housing supporting element is provided with a groove and a fixing hole for the axial fastening of the movable handle, the middle and upper parts of the housing supporting element equipped with windows, the middle and upper parts of the pusher are provided with grooves. 3. Сшиватель по п.1, отличающийся тем, что держатель узла сшивания корпуса выполнен в виде двух параллельных пластин с монтажными пазами в нижней части и элементами жесткости, узел сшивания состоит из наковальни П-образного профиля с рабочим и монтажными выступами и съемной кассеты с рабочим в верхней части и направляющим в нижней части пазами. 3. The stapler according to claim 1, characterized in that the holder of the body stitching unit is made in the form of two parallel plates with mounting grooves in the lower part and stiffening elements, the stapling unit consists of a U-shaped anvil with working and mounting protrusions and a removable cassette with a worker at the top and guides at the bottom of the grooves. 4. Сшиватель по п.1, отличающийся тем, что толкатель выполнен с пазом в нижней части с боковыми торцами. 4. The stapler according to claim 1, characterized in that the pusher is made with a groove in the lower part with side ends.
RU94029178A 1994-08-03 1994-08-03 Surgical suturing device RU2104671C1 (en)

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