WO2023030042A1 - Staple cartridge assembly and surgical instrument - Google Patents

Abstract

A staple cartridge assembly (302) and a surgical instrument The staple cartridge assembly (302) comprises: a staple cartridge body (1) provided with a plurality of staple cavities (12), the staple cavities (12) being provided with staple cavity openings in a staple outlet surface (13) of the staple cartridge body (1), wherein the staple cartridge body (1) is provided with a feed groove (11) allowing for movement of a cutting knife assembly (40), the feed groove (11) extends in a front-rear direction (X) of the staple cartridge assembly (302), two rows of staple cavities (12) are respectively formed at both sides of the feed groove (11), and each row of staple cavities (12) all extend in the front-rear direction (X); a plurality of anastomose staples (4) arranged in the plurality of staple cavities (12), each anastomose staple (4) comprising a base portion (42) and two staple legs (41), the staple legs (41) are respectively connected to two ends of the base portion (42), and the base portion (42) being curved as viewed along the extension direction of the two staple legs (41); and gaskets (3) mounted on the staple outlet surface (13) and covering the staple cavity openings. When the anastomose staples (4) are fired, the anastomose staples (4) are pushed out of the staple cavity openings, and the anastomose staples (4) are separated from the staple outlet surface (13) with the gaskets (3). The staple cartridge assembly (302) can effectively prevent the anastomose staples (4) from crushing tissue, thereby effectively avoiding the risks of bleeding and air leakage.

Description

Staple Cartridge Components and Surgical Instruments

related application

This application is required to be submitted to the China Patent Office on September 1, 2021, the application number is 202111019429.1, and the application name is "Nail Cartridge Components and Surgical Instruments", and it is submitted to the China Patent Office on September 1, 2021, and the application number is 202122093195.7, the priority of a Chinese patent application titled "Nail Cartridge Components and Surgical Instruments", the entire contents of which are incorporated in this application by reference.

technical field

The present application relates to the field of medical instruments, in particular to a staple cartridge assembly and a surgical instrument.

Background technique

The surgical instrument may include an end effector, the end effector includes a staple cartridge seat and an abutment seat, the staple cartridge seat is used to receive the staple cartridge assembly; the staple cartridge assembly includes a staple cartridge main body and staples arranged in the staple cartridge main body, The main body of the staple cartridge is provided with several staple cavities for storing staples. The main body of the staple cartridge includes a top surface, and the top surface is provided with a staple outlet formed by the staple cavity penetrating the top surface.

Once the physician determines that the end effector is gripping the target tissue, the surgical cutting stapler can be fired, thereby severing and stapling the tissue. When suturing, the top surface is in contact with the tissue to be sutured, and the cutting piece in the surgical cutting stapler pushes the wedge-shaped pusher block in the staple cartridge to move, so that the staple driver drives the staples in the staple cartridge to move upwards from the staple cavity. Pierce and suture the target tissue (i.e., staple out).

In the prior art, the staples are directly nailed to the tissue, the contact area between the staples and the tissue is small, the pressure is high, and the tissue is easily damaged, especially for lung surgery, which is prone to the risk of air leakage and bleeding. Moreover, during the forming process of the staples, gaps also exist between the corresponding staple holes and the staples, which may cause air leakage and bleeding. In addition, the width of the staple cartridge assembly used in the prior art is too large, and when the end effector is inserted into the body from the gap between two ribs, the ribs are easily damaged, causing postoperative rib pain in patients.

application content

In order to overcome the above-mentioned defects of the prior art, the present application aims to propose a staple cartridge assembly and a surgical instrument, which can effectively avoid staples from crushing tissue, and effectively avoid risks of bleeding and air leakage.

The application provides a staple cartridge assembly, which includes:

The main body of the staple cartridge is provided with a plurality of nail cavities. The staple cavity has a nail cavity opening on the nail outlet surface of the staple cartridge main body. The main body of the staple cartridge is provided with a knife groove for the movement of the cutter assembly. The front and rear direction of the component extends, and two rows of nail cavities are arranged on both sides of the knife groove, and each row of nail cavities extends along the front and rear direction;

A plurality of staples, a plurality of staples are arranged in a plurality of staple cavities, the staples include a base and two staple legs, each staple leg is respectively connected to one of the two ends of the base, along the extension of the two staple legs Viewed in the direction, the base is curved;

Gasket, the gasket is installed on the nail outlet surface and covers the opening of the nail cavity;

When the staple is fired, the staple is pushed out from the opening of the staple cavity, and the staple is separated from the staple exit surface with the gasket.

In at least one embodiment, the gasket is in the form of a sheet.

In at least one embodiment, the gasket has a thickness to width ratio of 1:5 to 1:20.

In at least one embodiment, the gasket has a thickness to width ratio of 1:8 to 1:15.

In at least one embodiment, the gasket has a thickness of 0.1 mm to 0.5 mm.

In at least one embodiment, a straight line passing through the first gap and the second gap between adjacent staples located on the same side of the tool slot and in the front-to-back direction will always be aligned with at least one staple located on the same side of the tool slot. intersect.

In at least one embodiment, the staple cartridge assembly includes a plurality of shims, and the straight line passing through the third gap and the fourth gap between the shims located on the same side of the knife groove and adjacent in the front-rear direction always aligns with at least one Spacers on the same side of the flutes intersect.

In at least one embodiment, the width of the third gap and the fourth gap between adjacent pads in the front-rear direction is less than 1/15 of the length of a single pad; and/or

The gap between two rows of shims on the same side of the tool slot is less than 1/15 of the width of a single shim.

In at least one embodiment, the base is arc-shaped or V-shaped or W-shaped. Among the two rows of staples on the same side of the knife groove, the two ends of the base of one row of staples are bent toward the other row of staples. Adjacent to the other row of staples, the cross-section of the staple cavity is adapted to the base, thereby guiding the movement of the staples along the thickness of the cartridge assembly.

In at least one embodiment, two rows of nail cavities located on the same side of the knife groove are arranged alternately.

In at least one embodiment, the staple cartridge assembly includes a plurality of spacers, each spacer covers a plurality of staple cavity openings, so that each spacer can pass through a plurality of staples.

In at least one embodiment, the plurality of staple cavity openings covered by each spacer includes different rows of staple cavity openings located on one side of the knife groove.

In at least one embodiment, a spacer covers a whole row of nail cavities on one side of the knife groove or covers all nail cavities on one side of the knife groove.

In at least one embodiment, the spacer includes a first plate portion and a second plate portion, the first plate portion and the second plate portion are staggered along the front-rear direction and the left-right direction of the nail cartridge assembly, and the first plate portion and the second plate portion It is integrally formed, the first plate portion is provided with two through holes for matching with one staple, and the second plate portion is provided with two through holes for matching with the other staple.

In at least one embodiment, the staple cartridge assembly includes a plurality of spacers, two or more spacers connected together by a frangible connection.

In at least one embodiment, the staple cartridge assembly includes a plurality of gaskets, the staple exit surface of the staple cartridge body includes a groove disposed around the opening of the staple cavity, and the gaskets are installed on the staple exit surface by interference fit with the groove.

In at least one embodiment, the shim is glued to the nail exit surface.

In at least one embodiment, the spacer has a through hole through which the nail legs pass, and the through hole may be a special-shaped hole opened toward the side of the spacer.

Also provided is a surgical instrument, which includes an end effector, and the end effector includes a jaw assembly, and the jaw assembly includes: a nail cartridge seat for installing the nail cartridge assembly; anvil,

Wherein, the end effector also includes an end effector cover capable of being fitted on the staple cartridge seat and/or the nail abutment seat.

In at least one embodiment, the end effector also includes a staple bin assembly mounted on the nail bin seat, the nail bin assembly can be a nail bin assembly according to the present application; the end effector cover is set on the nail bin assembly and the nail bin seat .

In at least one embodiment, the end effector cover includes a first piece and a second piece, the first piece and the second piece are detachably connected, and the end effector cover is set on the nail cartridge seat and/or Or during the nail abutment seat, the first piece is located between the nail cartridge seat and the nail abutment seat.

Optionally, the first panel may be made of absorbable, dissolvable or degradable material.

In at least one embodiment, the first sheet and the second sheet are stitched together by thread, the first sheet and the second sheet can be separated by removing the thread, or the first sheet and the second sheet can be easily The disconnected parts are connected together.

In at least one embodiment, the end effector sleeve is fitted on the anvil,

The end effector also includes a staple cartridge assembly mounted on the staple cartridge seat, and the staple cartridge assembly is a staple cartridge assembly according to the present application.

In this application, by installing a spacer on the main body of the staple cartridge, the staples and the spacer can be nailed on the tissue together, increasing the contact area between the staple and the spacer and the tissue, making the pressure in the contact area uniform, and avoiding suturing lung tissue and lung tissue. When interstitium and other tissues or organs are crushed, the risk of bleeding and air leakage is avoided at the same time; at the same time, the spacer can also be pressed near the nail hole formed by the staple on the tissue, and by applying pressure to the tissue near the nail hole, it can Reducing the gap between the nail hole and the staples can also prevent bleeding and air leakage from the nail hole. In addition, the bases of the staples are curved, such as arc-shaped or V-shaped or W-shaped staples. Compared with conventional straight staples, the staples can be more closely overlapped and arranged to produce a larger volume in the same area. Staple lines of staple coverage to reduce the possibility of tearing, leakage and/or bleeding after the stapling procedure.

End effector sleeves can serve a similar effect to spacers. End effector sleeves and spacers can be used together or separately.

The present application also provides a stapler comprising the above-mentioned staple cartridge assembly and/or end effector.

Description of drawings

Fig. 1 shows a schematic structural view of a stapler according to an embodiment of the present application;

Figure 2 shows an exploded view of an end effector of a stapler according to an embodiment of the present application;

Figure 3 shows a schematic structural view of a possible staple cartridge assembly;

Figure 4 shows a top view of a possible staple cartridge assembly;

Fig. 5 shows a sectional view along line A-A in Fig. 4;

Fig. 6 shows a schematic diagram of a distribution state of staples in a possible staple cartridge assembly;

Fig. 7 shows a schematic structural view of the staple cartridge assembly according to the first embodiment of the present application;

Figure 8 shows a sectional view along the line B-B in Figure 7;

Fig. 9 shows a schematic diagram of the distribution state of the spacers and staples of the staple cartridge assembly according to the first embodiment of the present application;

Fig. 10 shows a schematic diagram of a stapler used for lung surgery according to the first embodiment of the present application;

Fig. 11 shows a schematic structural view of staples of a possible staple cartridge assembly according to the present application;

Fig. 12 shows a schematic structural view of another angle of staples of a possible staple cartridge assembly according to the present application;

Fig. 13 shows a schematic structural view of another possible staple cartridge assembly according to the present application;

Fig. 14 shows a structural schematic diagram of another angle of staples of another possible staple cartridge assembly according to the present application;

Fig. 15 shows a schematic diagram of a distribution state of staples of a possible staple cartridge assembly according to the present application;

Fig. 16 shows a schematic diagram of another possible distribution state of the staples of the staple cartridge assembly according to the present application;

Fig. 17 shows a schematic diagram of a distribution state of gaskets and staples of a staple cartridge assembly according to the present application;

Fig. 18 shows a schematic diagram of another possible distribution state of gaskets and staples of the staple cartridge assembly according to the present application;

Fig. 19 shows a schematic structural view of a staple cartridge assembly according to a second embodiment of the present application;

Figure 20 shows a sectional view along line C-C in Figure 19;

Fig. 21 shows a schematic diagram of the distribution state of the spacers and staples of the staple cartridge assembly according to the second embodiment of the present application;

Fig. 22 shows an enlarged schematic view of a spacer and staples of a staple cartridge assembly according to a second embodiment of the present application;

Fig. 23 shows a schematic structural view of an end effector according to an embodiment of the present application;

Fig. 24 shows a schematic view of the structure of staples not in contact with the nail abutment seat;

Fig. 25 shows a schematic structural view of the deformation of the staple when it contacts the anvil.

Explanation of reference signs

10. Operation component; 20. Shaft component; 30. End effector; 301. Jaw component; 302. Nail cartridge component; 303. Nail cartridge seat; , cutting knife assembly; 401, knife rod; 402, nail pushing plate; 1, main body of the staple bin; 11, knife feeding groove; 12, nail cavity; 13, nail exit surface; 31, the first board part; 32, the second board part; 33, the through hole; 4, the staple; 41, the nail leg; 42, the base; 421, the middle part; 422, the end; 5, the bracket; 6, End effector sleeve; 61, first piece; 62, second piece; 100, lung; S, channel; S10, first gap; S20, second gap; S1, third gap; S2, second gap Four gaps; X, front-back direction; Y, left-right direction; L0, straight line (dashed line); L1, straight line (solid line); L2, straight line (dashed line).

Detailed ways

In order to make the purpose, technical solution and advantages of the present application clearer, the present application will be further described in detail below in conjunction with the accompanying drawings and embodiments. It should be understood that the specific embodiments described here are only used to explain the present application, not to limit the present application. Based on the embodiments in this application, all other embodiments obtained by persons of ordinary skill in the art without making creative efforts belong to the scope of protection of this application.

It should be understood that the terms "near", "rear" and "distal", "anterior" used herein are relative to the clinician manipulating the stapler. The terms "near" and "rear" refer to the part relatively close to the clinician (or in other words, relatively close to the operating assembly 10 of the stapler, see Fig. 1), and the terms "far" and "front" refer to the part relatively far away from the clinician ( In other words, the operating assembly 10 that is relatively far away from the stapler, or the end effector 30 that is relatively close to the stapler, see the part in FIG. 1 ). The terms "upper" and "lower" refer to the relative positions of the nail anvil 304 and the cartridge holder 303 of the jaw assembly 301, specifically, the nail anvil 304 is "upper" and the staple cartridge holder 303 is "lower". However, staplers can be used in many orientations and positions, so these terms expressing relative positional relationships are not limiting and absolute.

In this application, unless otherwise specified and limited, terms such as "connected" and "connected" should be interpreted in a broad sense, for example, it can be a fixed connection, a detachable connection, or a movable connection , or integrated; it can be directly connected or indirectly connected through an intermediary, it can be the internal communication of two elements or the interaction relationship between two elements such as butting. Those of ordinary skill in the art can understand the specific meanings of the above terms in this application according to specific situations.

(first embodiment)

As shown in FIGS. 1 and 2 , the present application provides a stapler, which includes an operating assembly 10 , a shaft assembly 20 extending forward from the operating assembly 10 , and an end end (front end) at one end (front end) of the shaft assembly 20 . The external effector 30 and the cutting blade assembly 40 for performing tissue cutting.

The operating assembly 10 includes a housing and a power source module. In one embodiment, the power source module includes a manually operated handle by the user connected to the transmission described below. In another embodiment, the power source module includes a motor and a power module disposed in the casing, the power module includes a battery for providing the motor with electrical energy required for rotation, and the motor is connected to the transmission device described below. The type of power source module does not limit the scope of protection of this application. In the following, the overall function of the stapler will be described by taking the power source module including the motor and the power supply module as an example.

The housing of the operation assembly 10 may include a connected handle housing and a head housing according to the positional relationship, the head housing may accommodate the transmission mechanism, and the handle housing may be held by the user.

The shaft assembly 20 may include a mandrel and a sleeve sleeved on the mandrel. The stapler may further include a transmission device connected to the power source module, and the transmission device may include a first transmission mechanism and a second transmission mechanism. The bushing (relative to the operating assembly 10, or relative to the housing of the operating assembly 10) can be driven to move axially through the first transmission mechanism, and the mandrel (relative to the operating assembly 10, or That is, relative to the axial movement of the housing of the operating assembly 10, both the sleeve and the mandrel can move axially forward or backward.

End effector 30 can include jaw assembly 301 and staple cartridge assembly 302 . The jaw assembly 301 may include a cartridge base 303 and an abutment base 304 pivotably connected to the cartridge base 303 for operatively supporting the cartridge assembly 302 therein. The nail anvil 304 can selectively move between the open position and the closed position to realize switching between the open state and the closed state, so that the nail anvil 304 cooperates with the staple cartridge assembly 302 to loosen or clamp tissue.

One end (front end) of the sleeve is connected to the nail anvil 304, and the other end (rear end) is connected to the first transmission mechanism, which can drive the sleeve to move backward or forward. The backward movement of the sleeve can cause the anvil 304 to pivot upward to open the jaw assembly 301 , and the forward movement of the sleeve can cause the anvil 304 to pivot downward to close the jaw assembly 301 .

The cutting knife assembly 40 is connected to the mandrel to be driven by the mandrel to perform a firing action or a knife retracting action. Specifically, the cutting knife assembly 40 includes a knife bar 401 and a nail pushing plate 402 located at the front end of the knife bar 401 .

One end (front end) of the mandrel is located in the casing, and the other end (rear end) is connected to the second transmission mechanism. A portion of cutter assembly 40 is located within the sleeve and is attached to the front end of the mandrel. During the suturing and cutting process, the nail pushing plate 402 is located in the space formed between the staple cartridge seat 303 and the nail anvil seat 304 . The second transmission mechanism can drive the mandrel to move forward and backward. When the staple cartridge assembly 302 is installed, the forward movement of the mandrel can make the nail pushing plate 402 move forward, pushing the staples 4 of the staple cartridge assembly 302 out to staple the tissue and cut the tissue by the cutting knife of the cutting knife assembly 40 . The rearward movement of the mandrel can cause the cutter assembly 40 to move backward to return to the original position.

It can be understood that the stapler uses staples 4 to staple tissues, which is also commonly referred to as stapling or suturing as known to those skilled in the art.

The following briefly introduces the process of (electric) stapler suturing and cutting tissue.

The jaw assembly 301 is closed, and the motor drives the jaw assembly 301 to close through the first transmission mechanism to clamp the tissue.

The cutting knife assembly 40 fires, and the motor drives the cutting knife assembly 40 forward through the second transmission mechanism to suture and cut the tissue.

The cutter assembly 40 retreats, and the motor drives the cutter assembly 40 to retreat through the second transmission mechanism.

The jaw assembly 301 is opened, and the motor drives the jaw assembly 301 to open through the first transmission mechanism to loosen the tissue, thereby realizing the stapling and cutting functions of the stapler.

As shown in FIGS. 2 to 6 , a possible staple cartridge assembly 302 may include a staple cartridge main body 1 , a staple pusher 2 , staples 4 and a bracket 5 .

The staple cartridge body 1 is provided with a knife groove 11 and a nail cavity 12. The knife groove 11 is used for the movement of the cutter assembly 40 and provides guidance for the movement of the cutter assembly 40. Therefore, the knife groove 11 can also be called a guide groove. In the left-right direction Y (also referred to as the width direction) of the staple cartridge assembly 302, the nail cavities 12 are located on the left and right sides of the knife groove 11, and a plurality of nail cavities 12 extending in the front-rear direction X form a row, which can be Multiple rows of nail cavities 12 are arranged on both sides of the knife groove 11 , for example, in the example shown in FIG. 3 and FIG. 4 , three rows of nail cavities 12 are respectively arranged on both sides of the knife groove 11 . The multiple rows of staple cavities 12 can accommodate multiple rows of staples, which can make the width of staples to sew tissue wider.

Each staple cavity 12 can be provided with a staple 4 , the staple pusher 2 is located at the bottom of the staple 4 , and the staple pusher 2 is used to push the staple 4 out of the staple cavity 12 . The staple cartridge main body 1 is connected to the bracket 5, and the bracket 5 can block the lower opening of the knife groove 11 and the staple cavity 12, so that the push piece 2 and the staples 4 can be kept in the staple cavity 12.

When the cutting knife assembly 40 moves forward, the staple pushing plate 402 drives the staple pushing piece 2 to move toward the staple exit surface 13, so that the staples 4 leave the staple cavity 12, thereby suturing the tissue.

Three states of the staple 4 are shown in FIG. 5 . From right to left, the staple 4 completely leaves the staple cavity 12 after being fired, and the staple 4 partially leaves the staple cavity 12 during the process of being fired. The staples 4 remain unfired within the staple cavities 12 .

Referring to FIG. 6 , multiple rows of staples 4 are viewed from a top view, or in other words, after the staples 4 in the staple cartridge assembly 302 are fired and joined to the tissue, multiple rows of staples 4 are formed on the tissue, and the staples 4 in a row are adjacent to each other. The first gap S10 between staples and the second gap S20 between adjacent staples in another row 4 of staples may be connected by a straight channel S. That is, the suture inside and the suture outside (the upper side and the lower side of the two rows of staples in FIG. 6 ) are connected by a straight channel S. It can be understood that the outside of suturing may refer to the side close to the wound, and the inside of suturing may refer to the side away from the wound.

When the above-mentioned staple cartridge assembly 302 is used in lung surgery, there are the following problems.

(i) The three rows of staples shown in FIG. 4 make the staple cartridge assembly 302 wide, and when the end effector 30 is inserted into the body from the gap between two ribs, it is easy to cause rib pain.

(ii) Bleeding and air leakage are prone to occur at the nail holes.

(iii) The contact area between the base of the staple and the tissue is small, the pressure is strong, and it is easy to damage the tissue, ooze blood, and leak air.

Referring to FIG. 6 , blood vessels in lung tissue and pulmonary interstitium, such as capillaries, may be located in channel S without being fixed by staples 4 , and there is a greater risk of bleeding. Moreover, for lung surgery, due to the presence of air in the lung tissue, the linear channel S also has a greater risk of air leakage.

As shown in FIGS. 7 to 9 , in order to solve the above problems, the staple cartridge assembly 302 of the present application may include a staple cartridge main body 1 , a staple pusher 2 , a spacer 3 , staples 4 and a bracket 5 .

The staple cartridge main body 1 is provided with a knife groove 11 and a staple cavity 12 . The staple cavity 12 forms a staple cavity opening on the staple exit surface 13 of the staple cartridge body 1 , and when the staples 4 in the staple cavity 12 are fired, the staples 4 are pushed out from the staple cavity opening. In the left-right direction Y of the staple cartridge assembly 302, the nail cavities 12 can be located on the left and right sides of the knife groove 11, and a plurality of nail cavities 12 extending in the front-rear direction X form a row. In the example shown in FIG. 7, Two rows of nail cavities 12 are respectively arranged on both sides of the knife groove 11 . Two rows of nail cavities 12 compared with three rows of nail cavities 12 make the size of the staple cartridge assembly 302 smaller in the left-right direction Y. As shown in FIG. 10 , it can be understood that when using a stapler to operate on the lung 100 , the end effector 30 is inserted into the body from the gap between two ribs to clamp the lung 100 . The width of the staple cartridge assembly 302 in the left and right direction Y is small, which facilitates the insertion of the end effector 30 into the body from the gap between two ribs, facilitates surgical operations, and reduces the pain of the patient.

The staple 4 is arranged in a plurality of staple cavities 12, and the staple 4 includes a base 42 and two staple legs 41 (see, for example, FIGS. 11 to 14 ). One, viewed along the extension direction of the two staple legs 41, the base 42 is curved, which enables the staples to be more closely overlapped than conventional straight staples, resulting in a staple with greater staple coverage on the same area thread to reduce the possibility of tearing, leaking and/or bleeding after the stapling step. See below for a more detailed description of staples. At the same time, through the structure of the gasket described later, the contact area with the tissue is increased, the tissue is prevented from being crushed, and the effect of preventing blood seepage and air leakage is effectively realized.

As shown in FIGS. 8 and 9 , the spacer 3 can be installed on the nail outlet surface 13 and cover the nail cavity opening of the nail cavity 12 . Here, preferably, on the same side of the cutting groove 11, the pads 3 are configured as a straight line passing through the third gap S1 and the fourth gap S2 between the pads 3 adjacent in the front-rear direction X (refer to FIG. The solid line L1 and dotted line L2) in 9 must intersect with at least one gasket 3, in other words, the third gap S1 and the fourth gap S2 of the adjacent gasket 3 in the front-rear direction X extend from one side of the anastomotic area The passage to the other side of the anastomotic area cannot be non-linear. The spacer 3 can increase the contact area between the staple 4 and the tissue, thereby reducing the pressure of the staple 4 on the tissue, effectively avoiding the risk of the staple 4 crushing the tissue due to the large suturing force, thereby reducing the risk of bleeding and air leakage . The spacer 3 can also be pressed near the staple hole formed by the staple 4 on the tissue. By applying pressure to the tissue near the staple hole, the gap between the staple hole and the staple 4 can be reduced, thereby avoiding bleeding and leakage. gas.

Here, preferably, the third gap S1 and the fourth gap S2 may hardly exist. For example, the width of the third gap S1 and the fourth gap S2 may be less than 1/15 of the length of a single spacer 3 , more preferably, less than 1/25 of the length of a spacer 3 .

Preferably, there is almost no gap between two rows of shims 3 on the same side of the tool groove 11 . For example, the gap between two rows of shims 3 on the same side of the cutting groove 11 may be less than 1/15 of the width of a single shim 3 , more preferably, less than 1/25 of the width of a single shim 3 .

The staple exit surface 13 of the staple cartridge main body 1 can include a groove arranged around the opening of the staple cavity, and the gasket 3 can be installed on the staple exit surface 13 by interference fit with the groove, and the staple 4 can be pushed out of the staple by the push piece 2 When the cavity 12 is opened, the staple 4 can leave the main body 1 of the staple cartridge with the spacer 3 .

In a possible implementation, the spacer 3 can also be pasted on the staple exit surface 13 of the staple cartridge main body 1 or the groove of the staple exit surface 13, and when the staple pusher 2 pushes the staple 4 out of the staple cavity 12, the anastomosis The staple 4 can leave the staple cartridge main body 1 with the spacer 3 .

As shown in Figures 9 and 11, the spacer 3 can be, for example, a rectangular sheet, and the surface of the spacer 3 facing the outside of the nail cavity 12 can be a plane, so that the smooth plane of the spacer 3 can contact the tissue during the operation. . The spacer 3 can be provided with a through hole 33 through which the staple leg 41 of the staple 4 can pass through, for example, the staple leg 41 can pass through the through hole 33 during the firing process of the staple 4 . The side of the gasket 3 facing the base 42 of the staple 4 may also be a plane. In this way, the surface of the spacer 3 is flat, the area to be pressed with the tissue is large, the configuration is simple, and the cost is low. A plurality of spacers 3 can be formed by cutting or trimming sheet-shaped raw materials.

In a possible implementation manner, the staple legs 41 of the staple 4 can be engaged (for example, through elastic deformation) in the through hole 33, and in order to facilitate the clamping of the staple legs 41, the through hole 33 can be, for example, an L-shaped special-shaped hole. . Specifically, in the state where the staple legs 41 of the staple 4 are slightly close to each other, the staple legs 41 of the staple 4 can be inserted into the special-shaped hole from the side of the spacer 3 through the opening of the special-shaped hole, and then the staple 4 is released. The staple legs 41 are used so that the staple 4 is clamped in the through hole 33 of the washer 3 by the tension of the two staple legs 41 . In this way, the staple 4 and the washer 3 can be put into the staple cavity 12 together (in the state where they are assembled). The assembly process can be simplified.

Of course, the present application is not limited thereto. For example, the through hole 33 may also be a through hole that does not open on the side of the gasket 3 , such as, but not limited to, a circular hole.

In order to save space, under the premise of ensuring the strength of the gasket 3, the thickness of the gasket 3 can be as thin as possible, for example, the thickness of the gasket 3 can be 0.1 mm to 0.5 mm.

The ratio of the thickness to the width W of the gasket 3 may be 1:5 to 1:20, preferably 1:8 to 1:15. FIG. 9 shows the width W of the substantially rectangular spacer 3 . FIG. 17 shows the width W of a rectangular sheet-shaped gasket 3 whose long side is a convex arc, and the width W may be the maximum width of the gasket shown in the figure. FIG. 18 shows the width W of the strip-shaped gasket 3 bent in an arc shape. Figure 22 shows a spacer 3 corresponding to a plurality of staples 4, the width W of the spacer 3 can be the width of the part of the spacer corresponding to one (or a row) of staples 4, or in other words The width of the first plate portion 31 or the second plate portion 32 mentioned above.

The gasket 3 will remain in the human body after the operation, and the gasket 3 can be (but not limited to) made of absorbable, soluble or degradable materials or materials that are not easily reacted in the human body. For example, the absorbable material can be polyglycolic acid, and the pad 3 made of the absorbable material can disappear after being bonded with the tissue for a period of time. For example, the material that does not easily react in the human body may be a metal material, and an example of the metal material may be titanium alloy.

As shown in FIGS. 17 and 18 , in other possible implementations, the shape of the gasket 3 is not limited to a rectangle. For example, in the example shown in FIG. 17 , the gasket 3 is formed into a rectangular piece whose long side is a protruding arc. side. In the example shown in FIG. 18 , the spacers 3 are formed in a curved, especially arc-shaped, elongated sheet shape, and the curved convex sides are located on two sides of the spacers 3 in two rows that are far away from each other.

Here, on the same side of the tool groove 11, it is still satisfied that the straight line passing through the third gap S1 and the fourth gap S2 of the adjacent pads 3 in the front-rear direction X must intersect with at least one pad 3, in other words, through The channel extending from one side of the fitting area to the other side of the fitting area between the third gap S1 and the fourth gap S2 of the adjacent spacers 3 in the front-rear direction X cannot be linear.

As shown in FIG. 8 , each staple cavity 12 can be provided with a staple 4 , and the staple pushing piece 2 is located at the bottom of the staple 4 , and the staple pushing piece 2 is used to push the staple 4 out of the staple cavity 12 . The staple cartridge main body 1 is connected to the bracket 5, and the bracket 5 can block the lower opening of the knife groove 11 and the staple cavity 12, so that the push piece 2 and the staples 4 can be kept in the staple cavity 12.

When the cutter assembly 40 moves forward (the left side in FIG. 8 ), the pusher plate 402 drives the pusher plate 2 to move toward the staple exit surface 13, so that the staples 4 leave the staple cavity 12, thereby suturing the tissue. Referring to FIG. 24 and FIG. 25 at the same time, the staple 4 in the staple cavity 12 is fired to leave the staple cavity 12 , and the staple legs 41 abut against the staple seat 304 to bend, thereby suturing the tissue. Two suturing areas can be respectively formed on both sides of the knife groove 11, and the nail pushing plate 402 moves forward along the knife groove 11 to cut the tissue from the middle of the two suturing areas.

Three states of the staple 4 are shown in FIG. 8 , from right to left, the staple 4 completely leaves the nail cavity 12 after being fired; the staple 4 partially leaves the staple cavity 12 during the process of being fired; the staple The staple 4 remains in the staple cavity 12 unfired.

The staple 4 may include a staple leg 41 and a base 42. The two staple legs 41 are connected to two ends 422 of the base 42 (see FIGS. 15 and 16 ). The free ends of the two staple legs 41 can form sharp nail points, and the nail points make it easy for the staple 4 to penetrate into human tissue. The two nail legs 41 are parallel to each other (including substantially parallel), and the nail legs 41 are substantially perpendicular to the base 42 . When the staple 4 is not fired, the staple 4 is located in the staple cavity 12 , and the tip of the staple does not exceed the staple exit surface 13 of the staple cartridge main body 1 .

It can be understood that the parallel (including substantially parallel) of the staple legs 41 is only intended to express the overall shape of the staple 4, in fact, the two staple legs 41 can be slightly opened at their distal ends (the end away from the base 42), thereby anastomosis The nail 4 is a flared U-shape. When the staple 4 is loaded into the staple cavity 12, the two staple legs 41 can be slightly compressed, so that the staple 4 can be installed in the staple cavity 12 by the tension of the staple legs 41, so that the staple 4 is not easy to dislodge from the staple cavity 12. drop.

As shown in Figures 11 to 14, the base 42 is curved, more specifically, viewed along the extending direction of the two nail legs 41, the base 42 is curved, for example, the base 42 can be arc-shaped or V-shaped or W-shaped . Correspondingly, the cross-section of the nail chamber 12 can be adapted to the base 42, thereby guiding the staple 4 to move along the thickness direction of the staple cartridge assembly 302, where the cross-section of the nail chamber 12 can be adapted to the base 42, including the diameter of the nail chamber 12. The cross section matches the base 42, for example, the cross section of the nail chamber 12 that accommodates the staples 4 is also arc-shaped or V-shaped or W-shaped; The cross-section can also be rectangular, elliptical, etc.

Referring to FIG. 15 , on the same side of the knife groove 11, preferably, a straight line passing through the first gap S10 and the second gap S20 between the adjacent staples 4 in the front-rear direction X (refer to the dotted line L0 in FIG. 15 ) must intersect with at least one staple 4, in other words, through the first gap S10 and the second gap S20 of the adjacent staples 4 in the front-rear direction X, one side of the staple cartridge assembly 302 in the left-right direction (or anastomosis The channel extending from one side of the region) to the other side in the left-right direction Y of the staple cartridge assembly 302 (or called the other side of the stapling region) cannot be non-linear. In this way, the inside of the suture and the outside of the suture cannot be connected through a straight channel, and for lung surgery, the risk of bleeding and air leakage is reduced.

It can be understood that the examples shown in FIG. 9 and FIG. 17 also satisfy this condition.

As shown in Figure 15 and Figure 16, in the two rows of staples 4 on the same side of the knife groove 11, the two ends 422 of the base 42 of one row of staples 4 bend toward the middle part 421 of the other row of staples 4 Or bent (than the middle part of the base 42 of the row of staples 4) closer to the other row of staples. When multiple rows of staples 4 are viewed from above, or in other words, when the staples 4 are stapled to the tissue, the two ends 422 of the bases 42 of two adjacent rows of staples 4 are close to each other and staggered in the front-rear direction X (that is, in the front-rear direction X). overlapping each other in the front-back direction X, or in other words, viewed along the left-right direction Y, shielding each other), so that the first slit S1 between the adjacent staples 4 in one row of staples 4 is the same as that in the other row of staples 4. The second gap S2 between the adjacent staples 4 is staggered in the front-back direction X, so that the inside of the suture and the outside of the suture cannot be easily communicated, and for lung surgery, the risk of bleeding and air leakage can be reduced.

(second embodiment)

The staple cartridge assembly 302 of the second embodiment of the present application is similar in structure to the staple cartridge assembly 302 of the first embodiment, and the same or similar parts will not be described again, and the same reference numerals will be used to indicate them.

As shown in FIGS. 19 to 22 , the staple cartridge assembly 302 may include a staple cartridge body 1 , a staple pusher 2 , a spacer 3 , staples 4 and a bracket 5 . The staple cartridge main body 1 is provided with a nail cavity 12 , and the gasket 3 can be installed on the nail exit surface 13 of the staple cartridge main body 1 , and the gasket 3 covers the staple cavity opening on the nail exit surface 13 side of the staple cavity 12 .

Each spacer 3 can cover multiple staple cavity openings, so that each spacer 3 can allow multiple staples 4 to pass through. Each spacer 3 can cover a plurality of different rows of adjacent nail cavities 12 (or in other words, cover a plurality of different rows of adjacent nail cavity openings), for example, each spacer 3 covers two nail cavities 12, the two The staple cavities 12 are different rows of staple cavities 12 . When the staples 4 are stapled to the tissue, two staples 4 of different rows pass through the spacer 3, and one spacer 3 is fixed by the two staples 4, that is, there are four fixing points for the spacer 3 Fixing is carried out so that the spacer 3 is in full contact with the tissue, and the force is balanced to avoid deflection when the spacer 3 is in contact with the tissue, effectively avoiding bleeding and air leakage.

A plurality of staple cavities (or claims, staple cavities) 12 covered by each spacer 3 (the multiples here are not limited to two as shown in FIGS. 20 to 22 for example) may include a Nail cavities 12 of different rows.

In addition, one spacer 3 can also cover a whole row of nail cavities 12 on one side of the knife groove 11 or cover all the nail cavities 12 on one side of the knife groove 11 . In other words, one side of the flute 11 may only have one or two shims 3 .

As shown in Fig. 21 and Fig. 22, the gasket 3 may include a first plate portion 31 and a second plate portion 32, the first plate portion 31 is provided with two through holes 33 for matching with staples 4, the second plate portion 32 There are two through holes 33 for matching with another staple 4 . The first plate portion 31 is passed by one staple 4 of one row, and the second plate portion 32 is passed by one staple 4 of the other row. The first plate portion 31 and the second plate portion 32 are staggered along the front-rear direction X and the left-right direction Y, and the first plate portion 31 and the second plate portion 32 may be integrally formed.

In a possible implementation, when the staple 4 is not fired, a plurality of gaskets 3 may be connected together, and the plurality of gaskets 3 are connected through a breakable connection, for example, the breakable connection may be multiple Connecting parts arranged at intervals (for example, connecting parts with dotted line or dotted line structure). When the staple 4 is fired, the connecting portion can be disconnected, and the gasket 3 connected together can be torn into multiple pieces.

In another possible implementation, multiple spacers 3 can be connected together (that is, one spacer 3 corresponds to multiple staples 4, or even all staples 4 in the entire staple cartridge), preferably, at this time, Pad 3 is made of absorbable, soluble or degradable material.

As shown in FIG. 21 , when multiple staples 4 pass through one spacer 3 , the area of the spacer 3 is increased, thereby increasing the area of the spacer 3 in contact with the tissue. In this way, for lung surgery, bleeding and air leakage can be effectively avoided. In addition, this also facilitates the installation of the spacer 3 to the cartridge main body 1 .

In addition, when a spacer 3 is passed through by multiple staples 4, the cutting steps during the formation of the spacer 3 can be reduced, and the spacer 3 can be quickly and accurately installed on the staple exit surface 13 of the staple cartridge main body 1, which can The production and assembly costs of the spacer 3 and the cartridge assembly 302 are reduced.

As shown in Figures 23 to 25, in a possible implementation, the nail anvil 304 can be sleeved with an end effector sleeve 6, and the end effector sleeve 6 can include a first piece 61 and a second piece 62 , the first piece 61 is located between the staple cartridge seat 303 and the nail anvil 304 , and the first piece 61 is opposite to the nail exit surface 13 . The first sheet 61 may be made of absorbable, dissolvable or degradable material, an example of which may be polyglycolic acid. The second piece 62 can be located on the side and the top of the nail anvil 304 . The first sheet portion 61 and the second sheet portion 62 can form an elongated sleeve shape, which is sleeved on the nail abutment seat 304 .

The surface of the nail anvil 304 facing the nail outlet surface 13 is the nail abutment surface, and the nail abutment surface is formed with a nail abutment seat groove 3041, after the staple 4 is fired and the staple leg 41 penetrates the tissue, the staple leg 41 can be pressed against the The nail seat groove 3041 is bent to make the staple 4 be stapled to the tissue.

After the staple 4 is fired, the staple leg 41 can pass through the first piece 61, and the staple leg 41 can be pressed against the nail seat groove 3041 to be bent, so that the staple 4 and the first piece 61 are stapled together on the tissue . The first sheet portion 61 can prevent tissue bleeding and air leakage. The first sheet part 61 and the second sheet part 62 can be stitched together by thread, after the first sheet part 61 is stapled to the tissue, the first sheet part 61 and the second sheet part 62 can be separated by removing the thread, and the second sheet part 61 can be separated. The two pieces 62 are taken out from the body. In addition, the first sheet part 61 and the second sheet part 62 can also be connected by a breakable connection part, for example, the breakable connection part can be a plurality of connection parts arranged at intervals (for example, a connection part with a dotted line or a dotted line structure).

It can be understood that the first piece 61 and the second piece 62 do not have to be made of the same material.

The function of the end effector sleeve 6 is similar to that of the spacer 3. The end effector sleeve 6 can increase the contact area between the staple 4 and the tissue, avoiding the staple 4 from crushing the tissue under a large suture force, thereby reducing bleeding , The risk of air leakage. The end effector sleeve 6 can be sleeved on the nail abutment seat 304 . In addition, the end effector cover 6 can alternatively or additionally be sleeved on the nail cartridge seat 303 on which the staple cartridge assembly 302 is installed, for example, the end effector cover 6 can be sleeved on the The staple cartridge holder 303 with the staple cartridge assembly 302 installed without the spacer 3 .

It can be understood that the end effector 30 is not limited to the form shown in the drawings, for example, the end effector 30 can also be curved or circular as in some prior art. In this way, the nail-exiting surface 13 can also be curved or annular.

It should be understood that although this description is described according to implementation modes, not each implementation mode only contains an independent technical solution, and this description in the description is only for clarity, and those skilled in the art should take the description as a whole, and each The technical solutions in the embodiments can also be properly combined to form other embodiments that can be understood by those skilled in the art.

The series of detailed descriptions listed above are only specific descriptions of the feasible implementation modes of the application, and they are not intended to limit the protection scope of the application. Any equivalent implementation mode or All changes should be included within the scope of protection of this application.

Claims (23)

A staple cartridge assembly, characterized in that it comprises: A staple cartridge main body (1), which is provided with a plurality of staple cavities (12), and the staple cavity (12) has a staple cavity opening on the nail exit surface (13) of the staple cartridge main body (1), wherein the The main body (1) of the staple cartridge is provided with a knife feed groove (11) for the movement of the cutting knife assembly (40). Two rows of the nail cavities (12) are arranged on both sides of the knife groove (11), and each row of the nail cavities (12) extends along the front-rear direction (X); A plurality of staples (4), the plurality of staples (4) are arranged in the plurality of staple cavities (12), the staples (4) include a base (42) and two staple legs (41) , each of the nail legs (41) is connected to one of the two ends (422) of the base (42), viewed along the extending direction of the two nail legs (41), the base (42 ) is curved; A gasket (3), the gasket (3) is installed on the nail outlet surface (13) and covers the opening of the nail cavity; When the staple (4) is fired, the staple (4) is pushed out from the opening of the staple cavity, and the staple (4) carries the washer (3) and the staple ejection Face (13) separates. The staple cartridge assembly according to claim 1, characterized in that, the gasket (3) is in the shape of a sheet. The staple cartridge assembly according to claim 1 or 2, characterized in that the ratio of the thickness to the width (W) of the gasket (3) is 1:5 to 1:20. The staple cartridge assembly according to claim 3, characterized in that the ratio of the thickness to the width (W) of the gasket (3) is 1:8 to 1:15. The staple cartridge assembly according to claim 1 or 2, characterized in that, the thickness of the gasket (3) is 0.1 mm to 0.5 mm. The staple cartridge assembly according to claim 1, characterized in that, through the staples (4) located on the same side of the knife-feeding groove (11) and adjacent in the front-rear direction (X) The straight line of the first gap ( S10 ) and the second gap ( S20 ) always intersects at least one of the staples ( 4 ) located on the same side of the cutting groove ( 11 ). The staple cartridge assembly according to claim 1, characterized in that, the staple cartridge assembly comprises a plurality of the shims (3), which are positioned on the same side of the knife-feeding groove (11) and in the front-rear direction ( X) The straight line between the third gap (S1) and the fourth gap (S2) between the adjacent pads (3) will always be at least one of the same side of the tool slot (11) Gasket (3) intersects. The nail cartridge assembly according to claim 7, characterized in that, the third gap (S1) and the fourth gap between adjacent pads (3) in the front-rear direction (X) The width of the gap (S2) is less than 1/15 of the length of a single spacer (3); and/or The gap between two rows of the pads (3) on the same side of the tool groove (11) is less than 1/15 of the width of a single pad (3). The staple cartridge assembly according to claim 1, characterized in that, the base (42) is arc-shaped or V-shaped or W-shaped, and the two rows of staples on the same side of the knife groove (11) In (4), the two ends (442) of the base (42) of one row of the staples (4) are bent toward the other row of the staples (4) and approach the other row of the staples (4) ), the cross-section of the staple cavity (12) is adapted to the base (42), thereby guiding the staple (4) to move along the thickness direction of the staple cartridge assembly. The staple cartridge assembly according to claim 1, characterized in that two rows of the staple cavities (12) located on the same side of the knife feed groove (11) are arranged alternately. The staple cartridge assembly according to claim 1, characterized in that, the staple cartridge assembly comprises a plurality of spacers (3), and each spacer (3) covers a plurality of openings of the nail cavity. The nail cartridge assembly according to claim 11, characterized in that, the plurality of nail cavity openings covered by each spacer (3) include different rows of the Nail cavity opening. The nail cartridge assembly according to claim 11, characterized in that, one gasket (3) covers a whole row of the nail cavities (12) on one side of the knife groove (11) or covers the All the nail cavities (12) on one side of the tool groove (11). The nail cartridge assembly according to claim 11, characterized in that, the gasket (3) comprises a first plate portion (31) and a second plate portion (32), and the first plate portion (31) and the The second plate part (32) is staggered along the front-rear direction (X) and the left-right direction (Y) of the nail cartridge assembly, and the first plate part (31) and the second plate part (32) are Integrally formed, the first plate part (31) is provided with two through holes (33) matched with one of the staples (4), and the second plate part (32) is provided with two The through hole (33) fitted with the staple (4). The staple cartridge assembly according to claim 1, characterized in that, the staple cartridge assembly comprises a plurality of the spacers (3), and two or more of the spacers (3) are connected by a frangible connection together. The staple cartridge assembly according to claim 1, characterized in that, the staple cartridge assembly comprises a plurality of said gaskets (3), and the nail exit surface (13) of the staple cartridge main body (1) includes A groove is provided at the opening of the nail cavity, and the gasket is installed on the nail outlet surface (13) by interference fit with the groove. The nail cartridge assembly according to claim 1, characterized in that, the gasket (3) is pasted on the nail outlet surface (13). The staple cartridge assembly according to claim 1, characterized in that, the spacer (3) has a through hole (33) through which the staple legs (41) pass. A surgical instrument comprising an end effector (30), the end effector (30) comprising a jaw assembly (301), the jaw assembly (301) comprising: a nail cartridge assembly (302) for installing ) of the staple cartridge seat (303); and an abutment seat (304) that can be opened and closed relative to the staple cartridge seat (303), It is characterized in that, the end effector (30) further includes an end effector cover (6) capable of being sleeved on the nail cartridge seat (303) and/or the nail abutment seat (304). The surgical instrument according to claim 19, characterized in that, the end effector (30) further comprises the staple cartridge assembly (302) mounted on the staple cartridge seat (303), the staple cartridge assembly (302) is the staple cartridge assembly according to any one of claims 1 to 18; the end effector cover (6) is sleeved on the staple cartridge assembly (302) and the staple cartridge seat (303). The surgical instrument according to claim 19, characterized in that, the end effector cover (6) comprises a first piece (61) and a second piece (62), and the first piece (61) It is detachably connected with the second piece (62), and when the end effector cover (6) is set on the staple cartridge seat (303) and/or the nail abutment seat (304), the The first piece (61) is located between the staple cartridge seat (303) and the nail abutment seat (304). The surgical instrument according to claim 21, characterized in that, said first sheet (61) and said second sheet (62) are sewn together by thread, and said first sheet can be made The piece (61) and the second piece (62) are separated, or the first piece (61) and the second piece (62) are connected together by a frangible connection. The surgical instrument according to claim 19, characterized in that, the end effector cover (6) is sleeved on the nail anvil (304), The end effector (30) further includes a staple cartridge assembly (302) installed on the staple cartridge seat (303), and the staple cartridge assembly (302) is the one described in any one of claims 1 to 18 Staple cartridge components.

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