CN101779977B - 外科线形切割缝合器的钉仓 - Google Patents
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Abstract
一种外科线形切割缝合器的钉仓,实现缝合钉的钉梁被推钉块的约束钩约束在推钉槽内,推钉块的两个侧面为圆柱面,钉槽从钉仓壳的端面延伸到安装在钉仓壳的推钉孔内的推钉块的推钉槽处,既可以防止钉仓内的缝合钉和推钉块被丢失,又可以防止缝合钉成形失常,还可以减少推钉块的推钉座在推钉孔内移动时的阻力,并且容易提高加工精度,从而使得操作更省力、更安全,加工更方便。
Description
技术领域
本发明涉及到用于代替外科手术中采用手术刀和针线徒手切割缝合操作的外科线形切割缝合器的钉仓,特别涉及到在开放性外科手术中使用的外科线形切割缝合器的钉仓,也特别涉及到在腹腔镜外科手术和胸腔镜外科手术中使用的腔镜外科线形切割缝合器的钉仓。
背景技术
各种外科线形切割缝合器用于代替外科手术中采用手术刀和针线徒手切割缝合的操作,在外科手术中主要被用于缝合人体消化道器官和呼吸道器官,可以减少手术时间,提高手术质量。它们通常被用于消化道中食管、胃、十二指肠、小肠、结肠和直肠等形成新的通道的端端、端侧及侧侧吻合手术和关闭切除的切割缝合手术,也被用于呼吸道中肺和气管等切割缝合手术。它们特别适用于显露和操作困难的器官和组织的切割缝合手术,也特别适用于在腹腔镜外科和胸腔镜外科中的切割缝合手术。
现有的各种外科线形切割缝合器有美国专利20060016853、20070045379、20070194082、20080116244、20080169327和20090095790中介绍的外科线形切割缝合器和腔镜外科线形切割缝合器。外科线形切割缝合器和腔镜外科线形切割缝合器既可以是直线形切割缝合器,也可以是曲线形切割缝合器。在使用外科线形切割缝合器时,操作夹紧机构,使执行头的钉砧与钉仓之间达到所需的夹紧厚度,以便将待切割缝合组织夹紧在钉砧和钉仓之间。待切割缝合组织被夹紧后,即可操作击发机构通过推钉板推动推钉块将缝合钉从钉仓内推出穿透被夹紧的待切割缝合组织直抵钉砧上的缝合钉成形槽,使U形缝合钉弯曲成B形,达到将组织缝合的手术目的,同时推出切割刀切割被夹紧的待切割缝合组织,达到将组织切割的手术目的。完成切割缝合操作后,操作夹紧机构,松开已切割缝合组织,以便退出外科线形切割缝合器。
外科线形切割缝合器的执行头的组成部分包括:钉仓和钉砧。钉仓由钉仓壳、推钉块和缝合钉组成。钉仓壳内有钉槽、推钉孔和推刀槽。缝合钉呈U形,由两个钉腿、一个钉梁和两个钉尖组成。钉腿的一端分别与钉梁连接、另一端分别为钉尖。缝合钉可采用不锈钢丝、钽丝、钛丝或其它具有类似性能的金属丝制造。缝合钉的两个钉腿插在钉槽内。缝合钉的钉梁坐在推钉块的上边上。推钉块可在推钉孔内移动以便将缝合钉从钉槽内推出。钉砧的端面上有与钉仓内的缝合钉位置对应的缝合钉成形槽和与钉仓内的推刀槽位置对应的切割槽。钉仓的钉槽排列在钉仓的推刀槽的两侧,钉砧的缝合钉成形槽相应排列在钉砧的切割槽的两侧。钉仓的钉槽和钉砧的缝合钉成形槽可以根据外科手术对切割缝合的需要,分别排列成两排、三排、四排、五排或六排。推钉板和切割刀既可以安装在钉仓内,也可以安装在外科线形切割缝合器的其它部件内。推钉板依靠斜面推动推钉块将缝合钉从钉仓的钉槽内推出。根据推钉块推出缝合钉时的受力变化,现有的推钉板的斜面的前半段的斜角较大,后半段的斜角较小。切割刀在钉仓的推刀槽内移动。
如美国专利20070045379和20070194082中所介绍的,外科线形切割缝合器和腔镜外科线形切割缝合器的钉仓内的U形缝合钉的两个钉腿插在钉槽内,缝合钉的钉梁坐在推钉块的上边上,推钉块和推钉孔相配合的两个侧面呈棱形,推钉孔贯通钉仓,推钉块在推钉孔内移动以便将缝合钉从钉槽内推出。这两种式样的外科线形切割缝合器的钉仓的令人不满意处是,由于U形缝合钉的两个钉腿插在钉槽内,缝合钉的钉梁坐在推钉块的上边上,使得U形缝合钉在朝向钉槽口的方向无任何约束,又由于推钉孔贯通钉仓,推钉块又可在推钉孔内移动,在装配、检验、包装、消毒、运输和外科手术使用过程中,外科线形切割缝合器的钉仓内的几十只缝合钉或推钉块中有可能会丢失几只,只要丢失一只缝合钉或推钉块,则在该位置处没有将组织缝合,会发生出血和泄漏等手术事故,因此在每一过程中应该认真检查钉仓内的几十只缝合钉和推钉块,不可丢失一只,实际上仅在装配和检验过程中可以实施,在包装、消毒和运输过程中无法实施,在外科手术使用过程中即使发现也无法添加适用的缝合钉或推钉块。这两种式样的外科线形切割缝合器的钉仓的另一令人不满意处是,由于在推钉块将缝合钉从钉仓内推出穿透被夹紧的待切割缝合组织的同时切割刀切割被夹紧的待切割缝合组织,U形缝合钉在朝向钉槽口的方向又无任何约束,因此被切开的组织收缩时牵拉缝合钉,使缝合钉的位置偏移,造成缝合钉无法正确地直抵钉砧上的缝合钉成形槽,使U形缝合钉无法正确地弯曲成B形,则在该位置处没有将组织正确地缝合,会发生出血和泄漏等手术事故。这两种式样的外科线形切割缝合器的钉仓的再一令人不满意处是,推钉块和推钉孔相配合的两个侧面呈棱形,由于推钉块和推钉孔的棱形侧面仅有0.3mm至0.8mm宽,其加工精度难以保证,因此,为了保证推钉块在推钉孔内定位正确,在推钉块的两个侧面加工有0.3mm左右宽的长筋条,装配时将长筋条***钉槽内,这种结构既增加了加工难度,又大大增加了推钉块在推钉孔内移动时的阻力,并且在推钉板依靠斜面推动推钉块将缝合钉从钉仓内推出的过程中,推钉块侧向受力,推钉块的棱形侧面呈锲状挤压钉槽,钉槽发生弹性变形,进一步增加了推钉块在推钉孔内移动时的阻力。
为了防止钉仓内的几十只缝合钉和推钉块在装配、检验、消毒、运输和外科手术使用过程中被丢失,美国专利7055730和20080116244中介绍的外科线形切割缝合器和美国专利20090095790中介绍的腔镜外科线形切割缝合器,采用在钉仓的上表面盖上一块在使用时移去的防护板,在钉仓的下底面装上一块衬板。这两种式样的外科线形切割缝合器的钉仓的令人不满意处一是需要增加零件;二是只能保证在装配、检验、包装、消毒和运输过程中钉仓内的缝合钉和推钉块不会丢失,但不能保证在这些过程中钉仓内的缝合钉不移位,也不能保证在外科手术使用过程中钉仓内的缝合钉不会丢失。
为了防止被切开的组织收缩时牵拉缝合钉造成缝合钉的位置偏移,使缝合钉无法正确成形,美国专利20060180633中介绍的外科线形切割缝合器采用两个钉腿一个长、一个短的U形缝合钉,当推钉块将缝合钉从钉仓内推出时,位于前方的长的钉腿先穿透被夹紧的待切割缝合组织直抵钉砧上的缝合钉成形槽弯曲后钩住待切割缝合组织,以防止被切开的组织收缩时牵拉缝合钉造成缝合钉的位置偏移。这种式样的外科线形切割缝合器的钉仓的令人不满意处一是两个钉腿一个长、一个短的U形缝合钉的成形质量较差;二是U形缝合钉有方向性,给加工和装配带来许多困难,一旦装配的方向错误,产生的效果正好相反;三是长的钉腿加大了U形缝合钉的尺寸,使得推钉块和推钉板的尺寸也随着增加,钉仓的尺寸更是双重增加,减少了外科线形切割缝合器的手术适用范围。
因此外科线形切割缝合器的钉仓还需改进。
由上述显然可以看出,现在已经设计了大量不同式样的外科线形切割缝合器的钉仓,并且新的外科线形切割缝合器的钉仓的研制工作仍在继续,以便对每年世界上大量使用的外科线形切割缝合器的钉仓作进一步的改进,使得使用时更方便、更准确、更省力、更安全,装配检验时更便利,生产成本更低。
发明内容
本发明的目的在于提出一种外科线形切割缝合器的钉仓,实现缝合钉的钉梁被推钉块的约束钩约束在推钉槽内,既可以防止钉仓内的几十只缝合钉和推钉块在装配、检验、消毒、运输和外科手术使用过程中被丢失,又可以防止推钉块将缝合钉从钉仓内推出穿透被夹紧的待切割缝合组织直抵钉砧上的缝合钉成形槽的过程中缝合钉偏斜所造成的缝合钉成形失常,从而避免因没有将组织正确缝合而发生出血和泄漏的手术事故。
本发明的另一目的在于提出一种外科线形切割缝合器的钉仓,实现推钉块的两个侧面为圆柱面,钉槽从钉仓壳的端面延伸到安装在钉仓壳的推钉孔内的推钉块的推钉槽处,既可以进一步防止钉仓内的几十只缝合钉和推钉块在装配、检验、消毒、运输和外科手术使用过程中被丢失,又可以减少推钉块的推钉座在推钉孔内移动时的阻力,并且容易提高加工精度。
目前,公知的外科线形切割缝合器的钉仓由钉仓壳、推钉块和缝合钉组成。钉仓壳内有钉槽、推钉孔和推刀槽。缝合钉呈U形,由两个钉腿、一个钉梁和两个钉尖组成。缝合钉的两个钉腿的一端分别与钉梁连接、另一端分别为钉尖。缝合钉的两个钉腿插在钉槽内。缝合钉的钉梁坐在推钉块的上边上。推钉块在推钉孔内移动时可将缝合钉从钉仓的钉槽内推出。钉仓的钉槽排列在钉仓的推刀槽的两侧。
本发明的任务是通过下述技术方案实现的:
本发明的外科线形切割缝合器的钉仓内的推钉块由推钉槽和推钉座组成。推钉块的推钉槽的上边上有约束钩。缝合钉的钉梁被推钉块的约束钩约束在推钉槽内。推钉块的推钉座在推钉孔内移动时通过推钉块的推钉槽将缝合钉从钉仓的钉槽内推出。推钉块的推钉槽上的约束钩可以由呈倾斜的U形的推钉槽的单侧上边形成,也可以为推钉槽的单侧上边上的凸块。推钉块的推钉槽上的约束钩部分伸入缝合钉沿钉仓内的钉槽移动的途径内。推钉块的两个侧面可以为圆柱面。推钉孔的两个侧面为与推钉块的两个圆柱面的侧面相配的圆柱面。既可以两个推钉块由夹在推钉块之间的一个底座联成整体,也可以三个推钉块由分别夹在推钉块之间的两个底座联成整体。
本发明的外科线形切割缝合器的钉仓内的钉槽从钉仓壳的推钉孔的上端面延伸到安装在钉仓壳的推钉孔内的推钉块的推钉槽处。
本发明的外科线形切割缝合器既可以在钉仓内安装推钉板和切割刀,也可以在外科线形切割缝合器的其它部件内安装推钉板和切割刀。推钉板依靠斜面推动推钉块可将缝合钉从钉仓的钉槽内推出。钉仓的钉槽可以根据外科手术对切割缝合的需要,排列成两排、三排、四排、五排或六排。切割刀可在推刀槽内移动。
具体实施方法及其附图说明
下面用举例方式,结合附图陈述本发明的外科线形切割缝合器的钉仓的最佳实施例。本发明的范围将在权利要求中指出。应当认识到某些或全部附图都是为了说明本发明的最佳实施例的说明简图,而并未描绘出所示部分的真实尺寸。参考最佳实施例的详细叙述,将会更加清楚地理解达到本发明上述的和其它的目的和优点的实际方式。
本发明的外科线形切割缝合器既可以在钉仓内安装推钉板和切割刀,也可以在外科线形切割缝合器的其它部件内安装推钉板和切割刀。推钉板依靠斜面推动推钉块可将缝合钉从钉仓的钉槽内推出。切割刀可在推刀槽内移动。为了突出钉仓的图形及其说明,在附图中对外科线形切割缝合器、钉砧、推钉板和切割刀不作详细介绍。有关各种外科线形切割缝合器、钉砧、推钉板和切割刀的结构、安装、用途和动作过程可参考本说明书中引用的美国专利。
图1是表示本发明实施例的外科线形切割缝合器的钉仓的外观立体图;
图2是表示图1的外科线形切割缝合器的钉仓从上端面方向的俯视图;
图3是表示图2的外科线形切割缝合器的钉仓的B-B剖视图;
图4是表示图2的外科线形切割缝合器的钉仓的C局部放大视图;
图5是表示图3的外科线形切割缝合器的钉仓的D局部放大视图;
图6是表示图2的外科线形切割缝合器的钉仓被移去后的U形缝合钉的钉梁坐在推钉块的上边上、推钉板预备推动推钉块的放大立体图;
图7是表示图2的外科线形切割缝合器的钉仓中的推钉块的放大正视图;
图8是表示图7的推钉块的放大侧视图;
图9是表示图2的外科线形切割缝合器的钉仓中的推钉板推动推钉块将缝合钉从钉仓内推出直抵钉砧上的缝合钉成形槽后,使U形缝合钉被弯曲成B形的外观立体图(图中未显示钉砧和钉砧上的缝合钉成形槽);
图10是表示图9的外科线形切割缝合器的钉仓被移去后的推钉板推动推钉块将缝合钉从钉仓内推出直抵钉砧上的缝合钉成形槽后,使U形缝合钉被弯曲成B形的放大立体图(图中未显示钉砧和钉砧上的缝合钉成形槽);
图11是表示本发明实施例的外科线形切割缝合器的钉仓中的另一种推钉块的放大立体图。
下面结合图1至图10对本发明实施例的外科线形切割缝合器的钉仓的各零部件进行描述,说明各零部件及其装配位置、动作过程和作用。
外科线形切割缝合器的钉仓1由钉仓壳2、推钉块3和缝合钉4组成。钉仓壳2内有钉槽5、推钉孔6和推刀槽7。缝合钉4呈U形,由两个钉腿8和9、一个钉梁10和两个钉尖11和12组成。钉腿8和9的一端分别与钉梁10连接、另一端分别为钉尖11和12。缝合钉4的两个钉腿8和9插在钉槽5内。缝合钉4的钉梁10坐在推钉块3的上边13上。推钉板25依靠斜面26推动推钉块3在推钉孔6内移动时可将缝合钉4从钉槽5内推出。钉仓1的钉槽5排列在钉仓1的推刀槽7的两侧各两排。
推钉块3由推钉槽14和推钉座15组成。推钉块3的推钉槽14的上边上有约束钩16。缝合钉4的钉梁10被推钉块3的约束钩16约束在推钉槽14内。推钉块3的推钉槽14上的约束钩16由呈倾斜的U形的推钉槽14的单侧上边27形成。推钉块3的推钉槽14上的约束钩16部分伸入缝合钉4沿钉仓壳2内的钉槽5移动的途径内。推钉块3的推钉座15在推钉孔6内移动时通过推钉槽14将缝合钉4从钉槽5内推出。推钉块3的两个侧面17和18为圆柱面。推钉孔6的两个侧面19和20为与推钉块3的两个侧面17和18的圆柱面相配的圆柱面。两个推钉块21和22由夹在推钉块21和22之间的一个底座23联成整体的推钉块3。钉仓1内的钉槽5从钉仓壳2的推钉孔6的上端面24延伸到安装在钉仓壳2的推钉孔6内的推钉块3的推钉槽14处。
图11为本发明实施例的外科线形切割缝合器的钉仓中的另一种推钉块。推钉块30由推钉槽31和推钉座32组成。推钉块30的推钉槽31的上边上有约束钩33。缝合钉4的钉梁10被推钉块30的约束钩33约束在推钉槽31内。推钉块30的推钉槽31上的约束钩33为推钉槽31上边上的凸块34。推钉块30的两个侧面35和36为圆柱面。三个推钉块37、38和39由分别夹在推钉块37、38和39之间的两个底座40和41联成整体的推钉块30。图9的推钉块30用于安装在推刀槽的两侧各排列三排钉槽的钉仓(图中未显示)内,其它各零部件及其装配位置、动作过程和作用与图1至图8中描述的相似。
根据上述详细介绍可知,本发明的外科线形切割缝合器的钉仓具有如下技术效果:
本发明的外科线形切割缝合器的钉仓内的U形缝合钉的钉梁被部分伸入缝合钉沿钉仓壳内的钉槽移动的途径内的推钉块的约束钩约束在推钉槽内,缝合钉的两个钉腿又被约束在钉仓壳的钉槽内,使得缝合钉在朝向钉槽口的钉仓壳的上端面的方向的移动受到推钉块的约束。又由于钉仓内的钉槽从钉仓壳的推钉孔的上端面延伸到安装在钉仓壳的推钉孔内的推钉块的推钉槽处,使得缝合钉和推钉块在朝向钉槽口的钉仓壳的上端面的相反方向的移动受到钉仓壳的钉槽的约束。因此,缝合钉和推钉块只有在朝向钉槽口的钉仓壳的上端面的方向的共同移动未受到钉仓壳的约束。由于推钉块的体积较大,推钉块和推钉孔形状较复杂,推钉块离钉仓壳的上端面的距离又较远,使得推钉块在推钉孔内移动时受到的阻力较大,在无外力直接作用在推钉块上时,质量远小于推钉块的缝合钉很难牵拉推钉块一起脱离钉仓壳,从而可以防止钉仓内的几十只缝合钉和推钉块在装配、检验、消毒、运输和外科手术使用过程中被丢失。另一方面,由于缝合钉在朝向钉槽口的钉仓壳的上端面的方向的移动受到推钉块的约束,只有当推钉板推动推钉块将缝合钉从钉仓内推出直至缝合钉的两个钉腿脱离钉仓壳的钉槽的约束,缝合钉才能脱离推钉块的约束,此时,缝合钉的钉腿已穿透被夹紧的待切割缝合组织、直抵钉砧上的缝合钉成形槽弯曲后钩住待切割缝合组织,从而可以在推钉块将缝合钉从钉仓内推出穿透被夹紧的待切割缝合组织直抵钉砧上的缝合钉成形槽的过程中,防止被切开的组织收缩时牵拉缝合钉偏斜所造成的缝合钉成形失常,避免因没有将组织正确缝合而发生出血和泄漏的手术事故。
本发明的外科线形切割缝合器的钉仓内的推钉块的两个侧面为圆柱面,推钉孔的两个侧面为与推钉块的两个圆柱面的侧面相配的圆柱面,钉槽从钉仓壳的端面延伸到安装在钉仓壳的推钉孔内的推钉块的推钉槽处。由于推钉块和推钉孔的两个侧面为圆柱面,可以采用通用切削刀具方便地加工成具有很高精度的圆柱面,能够保证推钉块在推钉孔内定位正确,不需要在推钉块的两个侧面加工长筋条,也不需要在对应的位置留有钉槽,因此,这种结构既减少了加工难度,又大大减少了推钉块在推钉孔内移动时的阻力。在推钉板依靠斜面推动推钉块将缝合钉从钉仓内推出的前半段过程中,虽然推钉块侧向受力较大,但是在对应的位置没有钉槽,推钉块的圆柱形侧面没有挤压到钉槽,钉槽不会发生弹性变形,此时推钉块在推钉孔内移动时的阻力较小。在推钉板依靠斜面推动推钉块将缝合钉从钉仓内推出的后半段过程中,此时推钉块侧向受力已很小,虽然在对应的位置有钉槽,推钉块的圆柱形侧面挤压钉槽的力很小,钉槽也不会发生明显的弹性变形,此时推钉块在推钉孔内移动时的阻力也较小。
与现有的各种外科线形切割缝合器的钉仓相比较,本发明的外科线形切割缝合器的钉仓在使用时更方便、更准确、更省力、更安全,装配检验时更便利,生产成本更低。
于是可以看出,上述所陈述的目标,包括由前面说明所显示的那些目标被有效地达到了。这里所述的仅仅是本发明申请的典型的最佳实施形式,可以对上述结构作某些变化也不违背本发明的精神和范围。本发明不局限或被限止于这里所陈述的具体细节,而应保留对所属领域中等技术人员来说是显而易见的任何改进或改型。
Claims (8)
1.一种外科线形切割缝合器的钉仓,其组成部分包括:钉仓由钉仓壳、推钉块和缝合钉组成,上述钉仓壳内有钉槽、推钉孔和推刀槽,上述缝合钉呈U形,缝合钉由两个钉腿、一个钉梁和两个钉尖组成,上述钉腿的一端分别与钉梁连接、另一端分别为钉尖,缝合钉的两个钉腿插在上述钉槽内,缝合钉的钉梁坐在上述推钉块的上边上,推钉块在上述推钉孔内移动时可将缝合钉从上述钉仓的钉槽内推出,钉仓的钉槽排列在钉仓的推刀槽的两侧;
其特征在于:上述钉仓内的推钉块由推钉槽和推钉座组成,上述推钉块的推钉槽的上边上有约束钩,上述缝合钉的钉梁被上述推钉块的约束钩约束在推钉槽内,上述推钉块的推钉座在上述推钉孔内移动时通过推钉槽将缝合钉从上述钉仓内的钉槽内推出。
2.根据权利要求1所述的外科线形切割缝合器的钉仓,其特征是,上述推钉块的推钉槽上的约束钩由呈倾斜的U形的推钉槽的单侧上边形成。
3.根据权利要求1所述的外科线形切割缝合器的钉仓,其特征是,上述推钉块的推钉槽上的约束钩由推钉槽的单侧上边上的凸块形成。
4.根据权利要求1所述的外科线形切割缝合器的钉仓,其特征是,上述推钉块的推钉槽上的约束钩部分伸入上述缝合钉沿上述钉仓内的钉槽移动的途径内。
5.根据权利要求1所述的外科线形切割缝合器的钉仓,其特征是,上述钉槽从上述钉仓壳的推钉孔的上端面延伸到安装在上述钉仓壳的推钉孔内的推钉块的推钉槽处。
6.根据权利要求1所述的外科线形切割缝合器的钉仓,其特征是,上述推钉块的两个侧面为圆柱面,上述推钉孔的两个侧面为与推钉块的两个圆柱面的侧面相配的圆柱面。
7.根据权利要求1所述的外科线形切割缝合器的钉仓,其特征是,上述钉仓内安装有推钉板,上述推钉板依靠斜面推动上述推钉块将上述缝合钉从上述钉仓的钉槽内推出。
8.根据权利要求1所述的外科线形切割缝合器的钉仓,其特征是,上述钉仓内安装有切割刀,上述切割刀可在上述钉仓的推刀槽内移动。
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