WO2008011754A1 - A surgical stapler - Google Patents

Abstract

A surgical stapler comprises an anastomosing head, a connecting bent tube, a positioning and adjusting mechanism, and a firing mechanism. The anastomosing head is provided with a means that applies inner anastomoses to organic tissues by the firing mechanism firing and radially shooting staples.

Description

 Surgical stapler

 The invention relates to a binding device used in surgical anastomosis surgery, in particular to a surgical binding device which adopts radial emission to perform internal anastomosis, and belongs to the technical field of medical instruments.

technical background

 A surgical stapler is a medical device that is often used in the surgical operation of physiological tissues such as the intestines. The difference in performance of the instrument plays a vital role in the overall surgical effect. In the prior art, the firing direction of the nails is basically the same as the axial direction of the tissue, and the following three ways are specifically:

 First, the axial internal anastomosis. As shown in Figure 1, the two segments la and lb are introverted, forming an anastomotic ring 2 inside the tissue. This is a more traditional method of anastomosis. There are a variety of corresponding kissing devices. The advantage is that the body bleeding during the operation can be discharged along with the contents, and the body tissue is easier to heal after the operation. The disadvantages are: the operation needs to open the door near the anastomosis; after the operation, the anastomosis ring stays in the inner cavity of the tissue, which narrows the internal passage of the tissue, which is not conducive to the removal of the postoperative instrument, which is easy to cause surgical complications, and is not conducive to the postoperative body. The tissue recovery function brings obvious side effects to the patient. Third, this method of anastomosis is not conducive to postoperative examination.

Second, the axial external anastomosis. As shown in Fig. 2, the two-stage tissue la and lb are everted, and an anastomotic ring 2 is formed outside the tissue. Related patents are US6769594 and US6769590. This match The advantages of the method are: no need to open the card during operation, convenient postoperative examination, internal passage of the intestinal tract and other tissues are not affected, and the postoperative instruments are convenient to take out; the biggest disadvantage is: the body bleeding during the operation will enter the body fluid , can not be discharged.

 Third, the expansion within the anastomosis. Chinese patent application 00819331 is one of the more representative ones of this type of anastomosis. The binding surface of the binding device is wave-shaped. After the anastomosis, the two tissues la and lb are partially expanded to form an anastomosis ring 2 with a relatively large diameter. Figure 3 shows. This method of anastomosis is an improvement of the traditional axial internal anastomosis method, which partially overcomes the shortcomings of the conventional method, so that the internal passage of the tissue after surgery is not significantly reduced, which facilitates the removal of the device and the recovery of the function of the body after surgery. The disadvantages are: the body tissue of the anastomosis is always in a tight state, which is not conducive to postoperative tissue healing; the surgical instrument manufacturing is more complicated; postoperative examination is still inconvenient.

Summary of the invention

 The object of the present invention is to overcome the technical defects of the prior art axial augmentation anastomosis, and to provide a surgical binding instrument for performing anastomosis by radial emission, which has the advantages of multiple matching methods in the prior art, and more Improve the surgical results.

 The object of the present invention is achieved by the following technical solution - a surgical stapler comprising an anastomosis head, a connecting elbow, a positioning adjustment mechanism, and a firing mechanism, wherein the anastomosis head portion is provided with a firing mechanism and a radial emitting staple The body organization implements an internal anastomotic device.

 The object of the present invention can also be further achieved by the following technical measures:

In the above surgical stapler, the anastomosis head is composed of two parts, a firing head and a fuselage head. The two are movably connected by a matching firing head rod located at the axial position of the firing head and a firing head lever located at the axial center position of the main body portion; the outer ring of the firing head rod is provided with a firing head firing rod The outer ring of the firing head rod is provided with a fuser firing rod, the annular cutter used for the anastomosis and the staple cartridge for storing the staple are located inside the firing head; the front end of the fuselage head is a stepped circular tubular inner cavity structure The inner diameter of the outer tube is larger than the diameter of the annular cutter, and the inner wall of the outer tube is provided with a nail forming groove.

 Further, in the above surgical stapler, the nail grooves on the staple cartridge are arranged in a ring shape in a plane perpendicular to the axis of symmetry of the firing head, and the passage of each nail groove extends outward in a radial direction; The position and number of the nail forming grooves are identical to the nail grooves on the staple cartridge.

 Further, in the above surgical stapler, the nail groove on the staple cartridge forms 1 to 4 radial emission rings in a direction parallel to the axis of symmetry of the firing head; the most preferred solution is to form 2 to 3 radial directions. The firing ring and the position of the nail groove of the adjacent launching ring are staggered to ensure that the shape of the anastomotic ring is regular and the sealing effect is good after the operation.

 Further, in any of the above surgical binding devices, a ring anvil may be embedded in the stepped circular tubular inner cavity from the outer to the inner second round tube at the front end of the fuselage head, and the inner diameter of the annular anvil may be The outer diameter and the outer diameter are respectively smaller than and larger than the diameter of the annular cutter, so that the circular cutter can enter the interior of the softer anvil after the tissue is cut during the operation, thereby ensuring the surgical effect.

In addition, in the above surgical stapler, the outer ring tube at the front end of the fuselage head can adopt a diastolic structure with a finely tunable diameter so that the body tissue can be better seated and fitted. The invention provides an internal anastomosis for the body tissue by a radial firing staple Compared with the various staplers in the prior art, the present invention overcomes the defects of the internal matching method and overcomes the defects of the present invention, and solves the long-standing desire of the present invention. solved problem. After the operation, the body tissues such as the intestines are basically in a state similar to that before surgery, and the internal passages are not significantly reduced, which is convenient for the removal of the postoperative instruments, and also facilitates the postoperative healing of the tissue, thereby greatly improving the surgical effect.

DRAWINGS

 Fig. 1 is a schematic view showing the effect of the prior art axial internal anastomosis.

 Fig. 2 is a schematic view showing the effect of the prior art axial external anastomosis.

 Fig. 3 is a schematic view showing the effect of the prior art expansion and internal anastomosis.

 Figure 4 is a schematic view of the effect of the present invention after surgery.

 FIG. 5 is a schematic structural view of an anastomosis head portion of a surgical stapler according to the present invention. Figures 6-1 to 6-6 are schematic views of the surgical procedure for performing an anastomosis operation using the surgical stapler provided by the present invention.

 The meanings of the reference numerals are: la, lb tissue; 2 anastomosis ring; 3 nail forming groove; 4 anvil; 5 fuselage head; 6 firing head firing putter; 7 body firing putter; 8 firing head pull rod; 9 shot head; 10 cutter; 11 staples; 12 shots.

Detailed ways

The technical solutions and features of the present invention are described in detail below with reference to the accompanying drawings. Similar to the prior art, the surgical stapler provided by the present invention comprises: an anastomosis head, a connecting elbow, a positioning adjustment mechanism and a firing mechanism, wherein the structure of the anastomosis head portion is as shown in FIG. 5. It consists of two parts, a firing head 12 and a fuselage head 5, which are moved by a matching firing head rod 9 located at the axial position of the firing head 12 and a firing head lever 8 located at the axial center of the body body portion. connection. A firing head firing pusher 6 is provided on the outer ring of the firing head bar 9, and a body firing pusher 7 is provided on the outer ring of the firing head lever 8. The annular cutter 10 used for the anastomosis and the staple cartridge 11 for storing the staples are all located inside the firing head 12. The front end of the fuselage head 5 is a stepped circular tubular inner cavity structure, the outer diameter of the outer ring pipe is larger than the diameter of the annular cutter 10, and the nail forming groove 3 is provided on the inner wall of the outer ring pipe.

 The staple grooves on the staple cartridge 11 are arranged in a ring shape in a plane perpendicular to the axis of symmetry of the firing head 12, and the passage of each of the staple grooves extends radially outwardly so as to be parallel to the axis of symmetry of the firing head 12. Two radial launching rings are formed on the top, and the positions of the staple slots of adjacent firing rings are staggered.

 On the other hand, the number of the nail forming grooves 3 and the position of each of the nail forming grooves 3 on the inner wall of the stepped circular tubular inner ring outer tube at the front end of the body head 5 are all the nails on the staple cartridge 11 The slots are consistent.

 In order to ensure the surgical effect, a ring-shaped anvil 4 is embedded in the stepped circular tubular inner cavity at the front end of the fuselage head 5 from the outside to the inside of the second circular tube, and the inner and outer diameters of the annular anvil 4 are respectively smaller than Greater than the diameter of the annular cutter 10.

In order to ensure that the body organization can be better positioned and matched, the outer ring of the front end of the fuselage head 5 The round tube has a diastolic structure that allows it to be fine-tuned in diameter. The large diameter is used when the tissue is in place, and the tissue is compressed by the contraction after the position is placed, and then an anastomosis operation is performed.

 Figures 6-1 to 6-6 illustrate the procedure for performing the surgery using the surgical stapler provided by the present invention, and the surgical results are shown in Fig. 4. The specific process of matching is:

 (1) The firing head 12 and the fuselage are in a separated state, and the tissues la and lb to be anastomosed respectively enclose the firing head 12 and the fuselage head 5, and are subjected to a dash bag processing, as shown in Fig. 6-1;

 (2) The firing head 12 is connected to the firing head rod 8 inside the fuselage by the firing head rod, as shown in Fig. 6-2;

 (3) moving the firing head 12 and the fuselage head 5 by the positioning adjustment mechanism of the body portion of the binding device until the firing head firing the push rod 6 is in contact with the body firing push rod 7, and then adjusting the front end of the body head 5 Press the diameter of the circular tube to compress the tissue, so that the tissue to be anastomosis is in place, see Figure 6-3;

 (4) firing - pushing the body firing push rod 7 through the firing mechanism of the binding device, and then pushing the firing head firing the push rod 6 to perform the firing, and pre-storing the staples along the respective nail grooves in the staple cartridge 11 when firing Radially outwardly diverging, the nail forming groove 3 corresponding to the fuselage head 5 cooperates to align the tissues la and lb; at the same time, the circular cutter 10 rapidly translates in the direction of the anvil 4 until it reaches or partially enters the knife The inside of the anvil 4, thereby cutting off excess tissue, see Figure 6-4;

 (5) separating the firing head 12 from the fuselage head portion 5 by a positioning adjustment mechanism of the binding body portion, as shown in Fig. 6-5;

(6) At the end of the anastomosis process, remove the instrument. Excess tissue removed is also accompanied by instruments Take it out together, see Figure 6-6.

 It should be noted that the surgical stapler provided by the present invention preferably conforms to the normal flow direction of the tissue contents, and the upstream tissue should be treated as la at the time of operation, and the purse is wound around the periphery of the firing head 12; the downstream tissue acts as lb, and The outer periphery of the fuselage head 5 is charged with a purse.

Claims

Rights request A surgical stapler, comprising an anastomosis head, a connecting elbow, a positioning adjustment mechanism, and a firing mechanism, wherein: the anastomosis head is provided with a device for initiating an internal anastomosis of the body tissue by firing the firing mechanism and radially emitting the staple.  2. The surgical stapler according to claim 1, wherein: the anastomosis head is composed of two parts, a firing head [12] and a body head [5], and the two are matched to each other by a firing head [12]. The firing head rod [9] at the axial center position and the firing head lever [8] located at the axial center position of the main body portion are movably connected; the outer ring of the firing head rod [9] is provided with a firing head firing push rod [ 6], the outer ring of the firing head lever [8] is provided with a fuser firing rod [7], the annular cutter [10] used for the anastomosis and the staple cartridge [11] for storing the staples are located at the firing head [12] The front end of the fuselage head [5] is a stepped circular tubular inner cavity structure, the outer diameter of the outer ring circular tube is larger than the diameter of the annular cutter [10], and the inner wall of the outer ring circular tube is provided with a nail. Forming groove [3].  3. The surgical stapler according to claim 2, wherein: the staple grooves on the staple cartridge [11] are arranged in a ring shape in a plane perpendicular to the axis of symmetry of the firing head [12], each The channels of the nail grooves extend radially outwardly; the position and number of the nail forming grooves [3] coincide with the nail grooves on the staple cartridge [11]. 4. The surgical stapler according to claim 3, wherein: the staple groove on the staple cartridge [11] forms 1 to 4 radial emission in a direction parallel to the axis of symmetry of the firing head [12] ring. 5. The surgical stapler according to claim 4, wherein: the staple groove on the staple cartridge [11] forms 2 to 3 radial emission in a direction parallel to the axis of symmetry of the firing head [12] Ring, the position of the nail groove of the adjacent launch ring is staggered.  The surgical stapler according to any one of claims 2 to 5, characterized in that: in the stepped circular tubular inner cavity at the front end of the body head [5], the inside of the second circular tube is embedded from the outside to the inside. The annular anvil [4] has an inner diameter and an outer diameter which are smaller than and larger than the diameter of the annular cutter [10], respectively.  The surgical stapler according to claim 2, wherein the outer ring of the front end of the body head [5] is of a diastolic structure having a finely adjustable diameter.