RU61122U1 - Хирургический сшиватель - Google Patents
Хирургический сшиватель Download PDFInfo
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Abstract
Хирургический сшиватель относится к медицинской технике, преимущественно к аппаратам для соединения тканей, и может быть использовано при хирургических операциях для сшивания кожи, а также при иных сходных по значению действиях. Хирургический сшиватель содержит корпус, подвижную рукоятку, подвижную матрицу, накладку матрицы и узел сшивания, элементы соединения которого выполнены с возможностью многократного монтажа. Подвижная рукоятка выполнена с осевым креплением и ручкой и оснащена пружиной возврата и рычагом привода подвижной матрицы. Технический результат - повышение надежности и атравматики при эксплуатации достигается за счет того, что пружина возврата выполнена плоской, размещена в подвижной рукоятке с примыканием средней части на осевое крепление, опиранием одним концом на нижний элемент подвижной рукояти и снабженной на втором конце штифтом, подвижная рукоятка снабжена упором с упорной планкой, снабженной резьбовой втулкой, неподвижная рукоятка снабжена упорной пластиной, направляющая выполнена с продольным пазом и окном, подвижная матрица выполнена в виде плоской пластины с формующим скобу пазом на конце, накладка выполнена в виде плоской пластины с окном и выступами для опоры скобы, узел сшивания снабжен вставкой со скосом, обращенным к кассете, кассета состоит из корпуса, на котором размещена защелка и фиксатор освобождения пружины.
1 н.п. формулы, 10 фигур чертежей
Description
1. Область техники.
Полезная модель относится к медицинской технике, преимущественно к аппаратам для соединения тканей, и может быть использовано при хирургических операциях для сшивания кожи, а также при иных сходных по значению действиях.
2. Уровень техники.
Известен хирургический сшиватель выполненный в виде корпуса с неподвижной рукоятью, содержащий подвижную рукоять, держатель кассеты, кассету и снабженный приводом возврата толкателя скоб. (Пат. RU №216450, 01.10.2001, МПК (7) А 61 В 17/068).
Недостатком устройства является неконструктивное выполнение привода возврата толкателя скоб не обеспечивающее надежность возврата в процессе сшивания.
Наиболее близким к полезной модели по своей целевой сущности и достигаемому результату является хирургический сшиватель, содержащий, корпус, состоящий из несущих элементов в виде направляющей для подвижной матрицы, кронштейна подвижной рукоятки и неподвижной рукоятки, подвижную рукоятку с осевым креплением и ручкой, подвижная рукоятка оснащена пружиной возврата и рычагом привода подвижной матрицы, подвижную матрицу и накладку матрицы, и узел сшивания, включающий кассету, направляющую кассеты и пуансон, элементы соединения узла сшивания выполнены с возможностью многократного монтажа (патент РФ №2104671, кл. А 61 В 14/115).
Недостатком известного сшивателя является низкая надежность сшивателя, обусловленная массивностью держателя узла сшивания и сложность сборки-разборки, что затрудняет его промывку и приводит к снижению уровня асептики операции, сложность конструкции кассеты и возможность зарядки ее только пакетом скоб, из-за того, что невозможно установить скобы поочередно (в россыпь), так как скоба устанавливается полкой в паз кассеты и, не имея удерживающего элемента для скобы, проваливается в паз кассеты; кроме того, при случайном отведении подвижной ручки назад (по часовой стрелке) в процессе применения, возникает опасность выпадения кассеты, в том числе и на операционном поле; толкатель скоб, выполняя одновременно и функцию формирователя скобы и функцию удерживающего элемента, имеет большую степень изношенности
в процессе эксплуатации, что снижает срок службы сшивателя. Следует отметить также, что в данной конструкции рабочий зазор, в который попадает скоба для процесса формирования-сшивания образуется элементом сшивателя и элементом кассеты, что является нецелесообразным, так как за счет предельного сочетания допусков при изготовлении, зазор может быть больше или меньше допустимого и процесс сшивания будет невозможен.
3. Раскрытие полезной модели.
3.1. Задача.
Задачей настоящего полезной модели является повышение надежности и атравматики при эксплуатации за счет упрощения конструкции сшивателя и кассеты, их изготовления, сборки-разборки, обеспечение доступности промывки всех элементов и стерилизации, а также, продление срока службы.
3.2. Отличительные признаки.
Технический результат, обеспечивающий выполнение поставленной задачи - повышение надежности и атравматики при эксплуатации достигается за счет того, что пружина возврата выполнена плоской, размещена в подвижной рукоятке с примыканием средней части на осевое крепление, опиранием одним концом на нижний элемент подвижной рукояти и снабженной на втором конце штифтом, подвижная рукоятка снабжена упором с упорной планкой, снабженной резьбовой втулкой, неподвижная рукоятка снабжена упорной пластиной, направляющая выполнена с продольным пазом и окном, подвижная матрица выполнена в виде плоской пластины с формующим скобу пазом на конце, накладка выполнена в виде плоской пластины с окном и выступами для опоры скобы, узел сшивания снабжен вставкой со скосом, обращенным к кассете, кассета состоит из корпуса, на котором размещена защелка и фиксатор освобождения пружины.
Кроме того матрица подвижная и накладка может крепиться к направляющей корпуса соединительными винтами, а направляющая корпуса, подвижная матрица и накладка имеют соосное сквозное взаимное расположение окон для размещения и работы рычага привода подвижной матрицы.
3.3. Краткое описание чертежей.
Полезная модель иллюстрируется чертежами, где
на фиг.1 изображен хирургический сшиватель, вид сбоку:
на фиг.2 изображен хирургический сшиватель, вид сверху;
на фиг.3 - вид но стрелке А на фиг.2;
на фиг.4 - вид сбоку на фиг.3;
на фиг.5 - фрагмент вида фиг.3 по «Б», увеличено;
на фиг.6 - вид по стрелке В на фиг.5;
на фиг.7 - вид по стрелке Г на фиг.1;
на фиг.8 - вид по стрелке Д на фиг.5;
на фиг.9 - изображена кассета, вид сверху, сбоку, в разрезе;
на фиг.10 - изображены стадии сшивания.
где поз.1 - корпус сшивателя; поз.2 - направляющая матрицы, поз.3 - неподвижная рукоятка, поз.4 - упорная пластина, поз.5 - кронштейн подвижной рукоятки, поз.6 - вставка, поз.7 - направляющая кассеты, поз.8 - штифт, поз.9 - рукоятка подвижная, поз.10 - ручка подвижной рукоятки, поз.11 - упорная планка, поз.12 - рычаг, поз.13 - резьбовая втулка, поз.14 - резьбовая втулка, поз.15 - упор, поз.16 - матрица подвижная, поз.17 - паз. поз.18 - узел сшивания, поз.19 - накладка матрицы, поз.20 - паз, поз.21 - пуансон, поз.22 - кассета, поз.23 - пружина, поз.24 - центрирующий винт, поз.25 - винт неподвижный, поз.26 - винт съемный, поз.27 - втулка, поз.28 - винт крепления рукоятки подвижной, поз.29 - защелка, поз.30 - корпус кассеты, поз.31 - крышка, поз.32 - фиксатор крышки кассеты; поз.33 - фиксатор освобождения пружины матрицы, поз.34 - толкатель скоб, поз.35 - подающая пружина, поз.36 - оси, поз.37 - рабочий паз, поз.38 - фиксатор защелки, поз.39 - скос фиксатора, поз.40 - выступы, поз 41 - скоба, поз.42 - ось, поз.43 - выступы матрицы, поз.44 - сшиваемая кожа, поз.45 - дно направляющей, поз.46 - выемка.
4. Осуществление полезной модели.
Хирургический сшиватель содержит корпус (1), подвижную рукоятку (9), подвижную матрицу (16), накладку матрицы (19) и узел сшивания (18), элементы соединения которого выполнены с возможностью многократного монтажа.
Корпус сшивателя (1) состоит из несущих элементов в виде направляющей матрицы (2) для подвижной матрицы, кронштейна (5) подвижной рукоятки и неподвижной рукоятки (3).
Направляющая матрицы выполнена с продольным пазом и окном. Неподвижная рукоятка снабжена упорной пластиной (4).
Подвижная рукоятка (9) выполнена с осевым креплением (27, 28) и ручкой подвижной рукоятки (10). Подвижная рукоятка оснащена пружиной возврата (23) и рычагом (12) привода подвижной матрицы. Пружина возврата (23) выполнена плоской, размещена в подвижной рукоятке с примыканием средней части на осевое крепление, опиранием одним концом на нижний элемент подвижной рукояти и снабжена на втором конце штифтом (8). Подвижная рукоятка снабжена упором (15) с упорной планкой (11), снабженной резьбовой втулкой (13).
Подвижная матрица выполнена в виде плоской пластины с формующим скобу пазом на конце. Накладка подвижной матрицы выполнена в виде плоской пластины с окном и выступами для опоры скобы.
Узел сшивания (18) включает кассету (22), направляющую кассеты (7) и пуансон (21). Узел сшивания снабжен вставкой (6) со скосом, обращенным к кассете. Кассета состоит из корпуса кассеты (30), на котором размещена защелка (29) и фиксатор освобождения пружины матрицы (33).
Выполнение поставленной задачи, достигается за счет того, что в хирургическом сшивателе, содержащем корпус, состоящий из направляющей, имеющей продольный паз и окно, неподвижной рукоятки, кронштейна подвижной рукоятки, вставку, направляющую кассеты, в которой посредством защелки корпуса кассета со скобами фиксируется, упорную пластину, расположенную на неподвижной рукоятке и служащую вместе с упором, расположенном на подвижной рукоятке, ограничителем и дозатором усилия, прилагаемого к подвижной матрице в процессе сшивания тканей, что является непременным условием формирования скобы заданной формы, а также штифт, служащий опорой пружины при сжатии рукояток. При этом, элементы корпуса не имеют закрытых и труднодоступных для промывания пазов и формообразований.
Матрица подвижная и накладка крепятся к направляющей корпуса соединительными винтами, при этом матрица подвижная перемещается между направляющей корпуса и накладкой в процессе работы сшивателя и выполнена в виде плоской пластины, имеющей на конце формующий скобу паз. Накладка также выполнена в виде плоской пластины с окном, имеющей выступы для опоры скобы, попадающей в рабочий паз. Направляющая корпуса, подвижная матрица и накладка имеют соосное сквозное взаимное расположение окон для размещения рычага подвижной рукоятки. Рычаг подвижной рукоятки, входящий в сквозные отверстия этих трех элементов, при сжатии рукояток передает
усилие на подвижную матрицу, которая перемещаясь между направляющей и накладкой, формует скобу на пуансоне.
Вставка и пуансон являются элементами сшивателя и образуют зазор, в который попадает скоба из кассеты в момент освобождения пружины. Кроме того, вставка, имея скос, обращенный к кассете, служит для поднятия фиксатора крышки кассеты, освобождая при этом подающую пружину, которая упирается в толкатель, а толкатель перемещает скобы.
Кассета состоит из корпуса, на котором находится защелка, посредством которой кассета крепится на направляющей кассеты, крышки, имеющей фиксатор для поднятия крышки на скосе вставки для возможности свободного перемещения скоб в зазор между вставкой и пуансоном, и фиксатор для освобождения подающей пружины, которая приводит в движение толкатель скоб для последовательного перемещения их в рабочий зазор. Корпус и крышка кассеты образуют «П»-образный канал, в который скобы могут помещаться как пакетом, так и россыпью, без угрозы их хаотичного перемещения внутри кассеты.
Хирургический сшиватель содержит корпус 1, состоящий из направляющей матрицы 2, неподвижной рукоятки 3 с упорной пластиной 4, кронштейна подвижной рукоятки 5, вставки 6, направляющей кассеты 7, штифта 8, предназначенного для опоры пружины 23, осуществляющей обратный ход подвижной рукоятки, подвижную рукоятку 9, состоящую из ручки подвижной рукоятки 10, упорной планки 11, рычага 12, резьбовой втулки 13, которая вместе с упорной планкой 11 является узлом крепления упора 15, подвижную матрицу 16 в виде подвижной плоской пластины с пазом 17 в нижней части, обращенной к узлу сшивания 18, накладку матрицы 19, выполненную в виде неподвижной плоской пластины, имеющей паз 20 в нижней части, обращенный к узлу сшивания 18 и имеющий одинаковую конфигурацию, но увеличенный в размерах относительно паза 17 подвижной матрицы 16 для создания обзорности при движении подвижной матрицы, процесса формирования скобы и соединения тканей, а также имеющей выступы 40 для опоры скобы в узле сшивания, пуансон 21, на котором формуется скоба 41, центрирующий винт 24, при помощи которого пуансон 21 крепится к направляющей кассеты 5, винт неподвижный 25 и винт съемный 26, которые являются узлами соединения элементов сшивателя, выполненные с возможностью многократного монтажа, узел соединения подвижной рукоятки, состоящий из втулки 27, винта крепления подвижной рукоятки 28
и резьбовой втулки 14, при этом, узлы соединения сшивателя выполнены с возможностью многократного монтажа.
Кассета 22, являющаяся по сути контейнером для скоб и содержащая механизм их продвижения к узлу сшивания, состоит из корпуса кассеты 30, имеющего защелку 29 для крепления к направляющей кассеты 7, крышки 31, раскрывающейся поворотом вокруг осей 36 на корпусе кассеты 30, и имеющей два фиксатора, фиксатор крышки кассеты 32 и фиксатор освобождения пружины матрицы 33, которые выполняют функцию удерживания и высвобождения скоб в корпусе кассеты 30 кассеты 22, толкателя скоб 34, один торец которого упирается в скобу 41 и имеет толщину, равную диаметру скобы, другой торец толкателя скобы 34 упирается в подающую пружину 35.
Для зарядки кассеты 22 скобами 41 или пакетом скоб крышка 31 раскрывается, поворачиваясь вокруг осей 36 на корпусе кассеты 30, после зарядки крышка 31 опускается и защелкивается на корпусе кассеты 30 фиксаторами защелки 38.
Узел сшивания (фиг.6) определяется взаимным расположением выступов 40 накладки матрицы 19 и дном 45 направляющей матрицы 2, которые образуют рабочий паз 37 и, в который попадает скоба 41 после прохождения паза 18, образованного вставкой 6 и пуансоном 21.
Сшиватель работает следующим образом.
В транспортируемом состоянии кассеты толкатель скоб 34 зафиксирован в крайнем положении фиксатором освобождения пружины матрицы 33, при этом подающая пружина 35 сжата, а скобы зафиксированы от выпадения фиксатором крышки кассеты 32 крышки 31. Для установки в сшиватель кассета 22 вставляется в направляющую кассеты 7 до упора, при этом кассета фиксируется в сшивателе в защелке 29, а фиксатор крышки кассеты 32, упираясь в скос фиксатора 39 вставки 6 приподнимается вверх и не препятствует свободному перемещению скобы 41. Последовательное перемещение скоб в процессе сшивания осуществляется подающей пружиной 35, которая освобождается поднятием фиксатора освобождения пружины матрицы 33. Первая скоба попадает в «П»-образный паз 18, образованный вставкой 6 и пуансоном 21, затем переходит в рабочий паз 37, образованный выступами 40 накладки матрицы 19 и дном 45 направляющей матрицы 2. Для осуществления процесса сшивания скобой сближенных друг с другом краев кожи 44 нажимают на подвижную рукоятку 9, при этом подвижная рукоятка повернется вокруг оси 42. Рычаг 12 подвижной рукоятки передаст усилие на подвижную матрицу 16. которая в свою очередь выступами 43 упираясь на скобу, обогнет ее вокруг пуансона 21,
в результате чего, проколов сшиваемую кожу 44, концы скобы придут навстречу друг другу в горизонтальном положении, при этом форма скобы из «П»-образной примет форму прямоугольника со скругленными углами и одной почти замкнутой стороной.
Рабочий паз 37, образованный выступами 40 накладки матрицы 19 и дном 45 направляющей матрицы 2 обеспечивает попадание в узел сшивания только одной скобы.
Далее сшиватель отводят назад для извлечения конца пуансона 21 из-под скобы 41, при этом под действием подающей пружины 35 кассеты 22 в рабочий паз 37 попадает следующая скоба. Рабочий цикл завершен.
Claims (3)
1. Хирургический сшиватель, содержащий корпус, состоящий из несущих элементов в виде направляющей для подвижной матрицы, кронштейна подвижной рукоятки и неподвижной рукоятки, подвижную рукоятку с осевым креплением и ручкой, подвижная рукоятка оснащена пружиной возврата и рычагом привода подвижной матрицы, подвижную матрицу и накладку матрицы, и узел сшивания, включающий кассету, направляющую кассеты и пуансон, элементы соединения выполнены с возможностью многократного монтажа, отличающийся тем, что пружина возврата выполнена плоской, размещена в подвижной рукоятке с примыканием средней части на осевое крепление, опиранием одним концом на нижний элемент подвижной рукояти и снабженной на втором конце штифтом, подвижная рукоятка снабжена упором с упорной планкой, снабженной резьбовой втулкой, неподвижная рукоятка снабжена упорной пластиной, направляющая выполнена с продольным пазом и окном, подвижная матрица выполнена в виде плоской пластины с формующим скобу пазом на конце, накладка выполнена в виде плоской пластины с окном и выступами для опоры скобы, узел сшивания снабжен вставкой со скосом, обращенным к кассете, кассета состоит из корпуса, на котором размещена защелка и фиксатор освобождения пружины.
2. Устройство по п.1, отличающееся тем, что матрица подвижная и накладка крепятся к направляющей корпуса соединительными винтами.
3. Устройство по п.1, отличающееся тем, что направляющая корпуса, подвижная матрица и накладка имеют соосное сквозное взаимное расположение окон для размещения и работы рычага привода подвижной матрицы.
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