CN107242889B - Purse-string suture cutting closer - Google Patents
Purse-string suture cutting closer Download PDFInfo
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- CN107242889B CN107242889B CN201710632250.0A CN201710632250A CN107242889B CN 107242889 B CN107242889 B CN 107242889B CN 201710632250 A CN201710632250 A CN 201710632250A CN 107242889 B CN107242889 B CN 107242889B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3209—Incision instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1132—End-to-end connections
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1142—Purse-string sutures
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Abstract
The invention provides a purse-string suture cutting closer, which belongs to the field of medical instruments for operations and comprises a shell, a clamp body and a cutting knife, wherein the clamp body comprises an upper clamp body and a lower clamp body, a knife pushing groove is formed in the upper clamp body and the lower clamp body along the length direction of the upper clamp body and the lower clamp body, two groups of nail hole groups are formed in the side surface of the lower clamp body facing the upper clamp body, each group of nail hole group comprises a plurality of nail holes which are arranged at intervals, titanium nails are placed in the nail holes, and a nail pusher for driving the titanium nails to be nailed is arranged in the lower clamp body; one group of nail hole groups in the two groups of nail hole groups on the lower clamp body are closed nail hole groups, the other group of nail hole groups are pouched nail hole groups, and pouched nail holes in the pouched nail hole groups form included angles with the push broach grooves; the side surface of the upper clamp body facing the lower clamp body is also provided with a group of pouch nail hole groups. The invention can cut the esophagus or small intestine to be anastomosed and sew two sections of ports obtained after cutting, wherein the sewing of one section of port is closed type sewing, and the sewing of the other end of port is purse type sewing.
Description
Technical Field
The invention relates to the field of medical instruments for operations, in particular to a purse-string suture cutting closer.
Background
In a laparoscopic gastric cancer resection operation, after a stomach is completely cut, the esophagus and the small intestine are required to be anastomosed, the treatment process relates to the cutting and suturing of the esophagus/the small intestine, the purse string suturing and the anastomosis treatment process of the esophagus and the small intestine, wherein in the prior art, the cutting and the suturing can be carried out by adopting a linear cutting closer or a linear cutting stapler, the purse string suturing can be carried out manually or by adopting a purse string forceps, the two processes are carried out separately in the prior art, the workload and the working difficulty of a doctor are increased to a certain extent, and therefore, in order to simplify the anastomosis treatment process of the esophagus and the small intestine, the invention aims to design the purse string suture cutting closer which can combine the cutting, the suturing and the purse string suturing.
Disclosure of Invention
In view of the above, there is a need for a purse string suture cutting closer capable of cutting an esophagus or small intestine to be anastomosed and suturing the ports of two segments obtained after the cutting, wherein the suturing of one segment of the port is a closed suturing and the suturing of the other end of the port is a purse string suturing.
In order to achieve the purpose, the technical scheme adopted by the invention is as follows:
a purse string suture cutting closer for use with a firing device, comprising:
the shell is internally provided with a pushing piece connected with the firing device;
the pliers body is arranged at one end of the shell and comprises an upper pliers body and a lower pliers body which can be mutually opened or closed, the upper pliers body and the lower pliers body are provided with a push cutter groove along the length direction, the side surface of the lower pliers body facing the upper pliers body is provided with two groups of nail hole groups, the two groups of nail hole groups are arranged on two opposite sides of the push cutter groove, each group of nail hole group comprises a plurality of nail holes which are arranged at intervals, titanium nails are placed in the nail holes, and a nail pusher for driving the titanium nails to be nailed is arranged in the lower clamp body;
the cutting knife is slidably arranged in the push knife groove and is connected with the nail pusher and the pushing piece;
in the two groups of nail hole groups on the lower clamp body, one group of nail hole groups are closed nail hole groups, the other group of nail hole groups are pouched nail hole groups, and pouched nail holes in the pouched nail hole groups form included angles with the push broach grooves;
a group of pouch nail hole groups are also formed in the side surface, facing the lower forceps body, of the upper forceps body, the pouch nail hole groups are arranged on one side of the cutter pushing groove, and a closed nail anvil matched with the closed nail hole for use is arranged on the other side of the cutter pushing groove; the upper clamp body is internally provided with the nail pusher;
the upper clamp body and the lower clamp body are internally provided with a pouch nail anvil piece and a nail anvil driving piece; the pouched nail anvil piece comprises two parallel nail anvil rods arranged at intervals, the two nail anvil rods are slidably arranged in the forceps body and are positioned at two ends of the pouched nail hole, and the two nail anvil rods are mutually connected and can slide in the opposite direction or in the opposite direction along the length direction of the pouched nail hole; a plurality of groups of purse-string nail anvils are arranged on the purse-string nail anvil piece at intervals, each group of purse-string nail anvils is matched with one purse-string nail hole for use, each group of purse-string nail anvils comprises two anvil parts, and the two anvil parts are respectively arranged on one opposite side of the two nail anvil rods;
the nail anvil driving piece is arranged in the clamp body in a sliding mode, is connected with the cutting knife and slides along the length direction of the push knife groove under the action of the cutting knife, and enables the two nail anvil rods to move oppositely in the sliding process so that the two anvil rods and the corresponding purse-string nail holes are overlapped, the two anvil rods respectively correspond to the two nail feet of the titanium nail one by one, or the two nail anvil rods are enabled to slide oppositely in the sliding process so that the two anvil rods are located on two sides of the titanium nail respectively after the titanium nail is combined, and the distance between the two anvil rods is not smaller than the length of the titanium nail.
Furthermore, the two anvil rods are connected with each other through a first spring part, and in a natural state of the first spring part, the distance between the two anvil rods and the distance between the two anvils are not smaller than the length of the pouch nail hole.
Furthermore, the two anvil rods are connected through a gear and rack set structure, one end, close to the shell, of each anvil rod is provided with a rack structure and a gear structure meshed with the rack structure, and the gear structures on the two anvil rods are meshed with each other.
Furthermore, the nail anvil driving piece is positioned on one side of the pouch nail anvil piece and contacts and extrudes one of the two nail anvil rods close to the push knife groove along with the sliding process of the cutting knife so as to drive the two nail anvil rods to slide oppositely, and at the moment, the nail anvil driving piece is positioned between the pouch nail anvil piece and the push knife groove; the end face of one end of the nail anvil driving piece, which is far away from the shell, is an inclined face, and the inclined face inclines towards the side where the pouch nail anvil piece is located.
Further, the anvil drive includes a tapered member and a pressure member; the reducing piece is arranged in the pliers body and arranged between the two anvil rods and the shell, one end, facing the anvil rods, of the reducing piece is provided with a horn-shaped reducing port, the reducing port is used for accommodating one ends of the two anvil rods, the opening size of the reducing port is reduced from one side of the two anvil rods to the side where the shell is located, the maximum opening size of the reducing port is not smaller than the distance between the two anvil rods when the titanium nail is removed, and the minimum opening size is equal to the distance between the two anvil rods when the titanium nail is removed; the convergent piece passes through the extruded piece and connects the cutting knife, the extruded piece is located broach groove place side, and with the convergent piece is detachable connection, the extruded piece can break away from or connect from the one end that the convergent mouth was seted up to the convergent piece, works as when the extruded piece breaks away from the convergent piece, the one end that the cutting knife was kept away from to the extruded piece is located between anvil rod and the broach groove, two anvil rods are entangled to the convergent piece, and two anvils overlap rather than corresponding purse-string nail hole part.
Furthermore, titanium nail plates are slidably mounted in the upper clamp body and the lower clamp body, a plurality of nail grooves are formed in one side face of each titanium nail plate at intervals, and the titanium nails in the purse-string nail holes are placed in the nail grooves.
Further, the titanium nail plates are slidably mounted in the corresponding forceps bodies through second springs.
Furthermore, the nail pusher for driving the titanium nails in the purse nail holes to be nailed is a pressure plate piece, the side surface of the pressure plate piece facing the titanium nail plate is an inclined surface, and the inclined surface inclines towards the side where the purse nail holes are located; when the cutting knife drives the pressing plate to move, the titanium nail plate drives the titanium nails to move towards the sides of the pouch nail holes and to be nailed together under the action of the inclined surface of the pressing plate.
Furthermore, the closed nail holes and the cutter pushing grooves are arranged in parallel, the included angle formed by the purse nail holes and the cutter pushing grooves is 90 degrees, and the purse nail anvil is arranged on the two nail anvil rods.
Further, the purse string suture cutting closer: also comprises a purse-string suture; the purse-string suture is connected with the upper forceps body and the lower forceps body simultaneously, traverses each purse-string nail hole and is positioned between two nail feet of the titanium nail in the purse-string nail hole; the purse-string suture line is detachably connected with the upper forceps body and the lower forceps body.
Compared with the prior art, the invention has the following beneficial effects:
1. the invention is an improvement on the basis of the existing linear cutting closer, which mainly aims at the part of a clamp body, in particular to an improvement on a nail hole group at two sides of a push knife groove on the clamp body, wherein one side of the push knife groove is reserved with the original structural form capable of forming a closed suture incision, namely, a closed nail hole is arranged on a lower clamp body, corresponding titanium nails, a nail pusher and the like are arranged on the lower clamp body, a nail anvil matched with the closed nail hole of the lower clamp body is arranged on the upper clamp body, and the other side of the push knife groove is improved into a pouch nail hole arranged on both the upper clamp body and the lower clamp body, so that the open pouch suture incision of esophagus/small intestine is realized through a bidirectional opening form.
2. In the structure part forming the pouch type suture incision, the pouch nail anvil is arranged in the forceps body, the pouch nail anvil piece and the nail anvil driving piece are arranged to enable the titanium nails in the pouch nail holes to be smoothly nailed into the tube wall/intestinal wall of the esophagus/small intestine, and the nails can be smoothly removed after the stapling is finished.
3. The purse-string suture cutting closer designed by the invention can realize the integrated operation of cutting, closed suture and open purse-string suture, thus reducing the workload of doctors in the operation to a certain extent and saving the operation time of the doctors, therefore, the invention has better practicability and convenience.
Drawings
FIG. 1 is a cross-sectional inside view of a purse string suture cutting shutter according to a first embodiment of the present invention.
Fig. 2 is a top view of the lower jaw body of fig. 1.
FIG. 3 is a perspective view of the purse nail anvil of FIG. 2 without the purse nail holes being obstructed.
FIG. 4 is a perspective view of the inner portion of the purse-string anvil of FIG. 2 with the purse-string nail holes overlapping.
Fig. 5 is a partial inside view of the body portion of the caliper of fig. 1.
Fig. 6 is a schematic view of the purse-string anvil of fig. 5 with one of the anvil stems removed.
Fig. 7 is an internal structural view of the side of the pouched nail hole in the directionbase:Sub>A-base:Sub>A in fig. 2 when the upper and lower jaw bodies are closed.
Fig. 8 is a schematic structural view of the upper caliper body portion of fig. 7.
FIG. 9 is a partial top view of the lower jaw body in a second embodiment of the invention, wherein the purse anvil does not obscure the purse nail hole.
FIG. 10 is a partial top plan view of the lower jaw body in a second embodiment of the present invention, wherein the purse anvil partially overlaps the purse nail hole.
Description of the main elements
In the figure: the device comprises a shell 1, a pushing piece 11, an upper clamp body 2, shells 21 and 31, a lower clamp body 3, a cutting knife 4, a knife pushing groove 41, a purse string suture 5, a closed nail hole 6, a purse string nail hole 7, a nail pusher 8, a nail pushing connecting piece 81, a purse string anvil 9, an anvil rod 91, a first spring piece 92, a rack structure 93, a gear structure 94, a purse string anvil 10, a branch anvil 101, an anvil driving piece 20, a tapered piece 201, a tapered opening 2011, an extrusion piece 202, a titanium nail plate 30, a nail groove 301, a second spring 302 and a titanium nail 40.
The following detailed description will further illustrate the invention in conjunction with the above-described figures.
Detailed Description
Referring to fig. 1 to 6, in a preferred embodiment of the present invention, a purse-string suture cutting closer can be used with a firing device, and comprises a housing 1, a forceps body, a cutting blade 4 and a purse-string suture 5. The shell 1 is provided with a pushing piece 11 connected with the firing device, and one end of the pushing piece is provided with a clamp body. The forceps body comprises an upper forceps body 11 and a lower forceps body 3 which can be mutually opened or closed, and a push knife groove 41 is formed in the length direction of the upper forceps body 11 and the lower forceps body 3; two groups of nail hole groups are arranged on the side surface of the lower clamp body 3 facing the upper clamp body 11, the two groups of nail hole groups are arranged on the two opposite sides of the cutter pushing groove 41, each group of nail hole groups comprises a plurality of nail holes arranged at intervals, titanium nails 40 are placed in the nail holes, and a nail pusher 8 for driving the titanium nails 40 to be nailed is arranged in the lower clamp body 3. The cutting knife 4 is slidably arranged in the knife pushing groove 41 and is connected with the nail pusher 8 and the pushing piece 11, the jaw is closed in the process that the pushing piece 11 is driven by the trigger device to move, the cutting knife 4 is driven by the pushing piece 11 to slide, and the esophagus/small intestine is cut in the sliding process or the nail pusher 8 is pushed to staple the titanium nails 40 on the esophagus/small intestine.
In the present invention, one of the two groups of nail hole groups on the lower jaw body 3 is a group of closed nail holes 6, the closed nail holes 6 in the group of closed nail holes 6 are preferably arranged in parallel with the push-out broach slots 41, and the other group of nail hole groups is a group of purse nail holes 7, the purse nail holes 7 in the group of purse nail holes 7 are arranged at an angle to the push-out broach slots 41, i.e., the purse nail holes 7 in the group of purse nail holes 7 are arranged at an angle to the closed nail holes 6 in the group of closed nail holes 6, rather than being arranged in parallel as in the conventional method. In addition, the side surface of the upper clamp body 11 facing the lower clamp body 3 is also provided with a group of purse-string nail holes 7, the group of purse-string nail holes 7 is arranged at one side of the push broach slot 41, the other side of the push broach slot 41 is provided with a nail anvil matched with the closed nail hole 6, and the upper clamp body 11 is also internally provided with a nail pusher 8.
Further, a pouched anvil member 9 and an anvil driving member 20 are slidably mounted in the upper and lower forceps bodies 11 and 3. The pouched nail anvil 9 comprises two parallel nail anvil rods 91 arranged at intervals, the two nail anvil rods 91 are slidably mounted in the forceps body and are positioned at two ends of the pouched nail hole 7, and the two nail anvil rods 91 are connected with each other and can slide in the opposite direction or in the opposite direction along the length direction of the pouched nail hole 7; a plurality of groups of purse-string nail anvils 10 are arranged on the purse-string nail anvil 9 at intervals, each group of purse-string nail anvils 10 is matched with one purse-string nail hole 7 for use, each group of purse-string nail anvils 10 comprises two anvil parts 101, and the two anvil parts 101 are respectively arranged on one side of the two nail anvil rods 91 which are opposite. The anvil driving component 20 is slidably mounted in the forceps body, connected to the cutting knife 4, and slides along the length direction of the push knife groove 41 under the action of the cutting knife 4, and in the sliding process, the two anvil rods 91 slide oppositely to enable the two anvil components 101 and the corresponding purse-string nail holes 7 to have overlapping portions, and meanwhile, the two anvil components 101 are respectively in one-to-one correspondence with the two nail feet of the titanium nail 40, or in the sliding process, the two anvil rods 91 slide oppositely to enable the two anvil components 101 to be respectively located at the two sides of the titanium nail 40 after the nailing of the titanium nail 40 is finished, and the distance between the two anvil components is not less than the length of the titanium nail 40.
The purse-string suture 5 is connected with the upper forceps body 11 and the lower forceps body 3 simultaneously, traverses each purse-string nail hole 7 and is positioned between two nail feet of the titanium nail 40 in the purse-string nail hole 7, so that the purse-string suture 5 can be positioned between the titanium nail 40 and the esophagus/small intestine when the titanium nail 40 is sutured; preferably, the purse-string suture 5 is detachably connected with the upper forceps body 11 and the lower forceps body 3, so that the purse-string suture 5 is separated from the forceps bodies along with the titanium nail 40 after the cutting and suturing are finished.
In conclusion, the invention partially improves the clamp body on the basis of the traditional linear cutting closer. Wherein, one side of the push broach slot 41 is reserved with the original structural form which can form a closed suture incision, namely, the lower forceps body 3 is provided with a closed nail hole 6 and is provided with a corresponding titanium nail 40, a corresponding nail pusher 8 and the like, the upper forceps body 11 is provided with a nail anvil which is matched with the closed nail hole 6 of the lower forceps body 3 for use, and the other side of the push broach slot 41 is improved into a state that the upper forceps body 11 and the lower forceps body 3 are both provided with a pouch nail hole 7, so that the open pouch suture incision of the esophagus/small intestine is realized through a bidirectional opening form; in addition, the purse-string suture 5 is arranged, so that the purse-string suture end is in a purse shape, and the anastomosis treatment in the later period is facilitated.
Furthermore, in order to smoothly nail the titanium nail 40 at the pouch type suture incision into the tube wall/intestinal wall of the esophagus/small intestine and smoothly take off the nail after the stapling is finished, the pouch nail anvil 10 is arranged in the forceps body, two nail anvil rods 91 of the pouch nail anvil 9 which can slide mutually are used as supports, and then the nail anvil driving piece 20 is used as a trigger piece, so that when the titanium nail 40 needs to be stapled, two nail feet 101 of the pouch nail anvil 10 are partially overlapped with the pouch nail hole 7, two nail feet of the titanium nail 40 in the pouch nail hole 7 are abutted against the two nail anvils 101 under the action of the nail pusher 8 and are nailed into the tube wall/intestinal wall of the esophagus/small intestine between the two nail anvils 101 under the action of the nail anvil 101, when the titanium nail 40 needs to be separated from the forceps body after the stapling of the titanium nail 40 is finished, the two nail anvil rods 91 are deviated from each other under the action of the driving piece 20 until the two nail anvils 91 and the two nail anvil rods 101 are respectively positioned at two ends of the pouch nail hole 7 and do not shield the titanium nail 40, and the titanium nail can be separated from the pouch nail 40 after the titanium nail is stapled and the titanium nail 40 is separated from the staple hole 7, so as to realize the stapling.
Further, in the present invention, the two anvil rods 91 are connected to each other by the first spring member 92, and in a natural state of the first spring member 92, a distance between the two anvil rods 91 and a distance between the two anvil rods 101 are not smaller than a length of the purse-string nail hole 7, so that the two anvil rods 91 slide by elastic deformation of the first spring member 92 after the end of the stapling of the titanium nail 40, thereby facilitating the two anvil rods 91 to be easily reset to a position where the purse-string nail hole 7 is not blocked. Preferably, the purse-string anvil 10 is arranged on two anvil rods 91, that is, the purse-string anvil 10 and the anvil rods 91 are integrated into a whole, and in the present invention, the shape of the structure of the purse-string anvil 10 contacting the side of the titanium staple 40 is not limited, and preferably, a curved surface structure with a radian is adopted. More preferably, the side of the purse-string nail anvil 10 contacting the titanium nail 40 is provided with a limiting groove, and the limiting groove is arranged along the sliding direction of the nail foot of the titanium nail 40 when the titanium nail 40 is nailed, so as to limit the moving range and moving direction of the titanium nail 40 through the arrangement of the limiting groove, thereby ensuring that the titanium nail 40 moves according to a predetermined track, and improving the nailing effect of the titanium nail 40.
Referring to fig. 3 or fig. 4, in the present embodiment, the two anvil rods 91 are connected by a rack and pinion structure, a rack structure 93 and a gear structure 94 engaged with the rack structure 93 are disposed at one end of each anvil rod 91 close to the housing 1, and the gear structures 94 on the two anvil rods 91 are engaged with each other to connect the two anvil rods 91; in the present invention, the gear rack set is configured to drive the two anvil rods 91 to slide relative to each other under the triggering of the anvil driver 20 by using the transmission function between the gear rack sets. In addition, the anvil driving member 20 in this embodiment is located at one side of the pouched anvil member 9, and contacts and presses one of the two anvil rods 91 close to the knife pushing groove 41 during the sliding process with the cutting knife 4 to make the two anvil rods 91 slide oppositely, at this time, the anvil driving member 20 is located between the pouched anvil member 9 and the knife pushing groove 41, the two anvils 101 are overlapped with the pouched nail hole 7, the titanium nail 40 can be stapled, the first spring member 92 is in a compressed state, and when the pressing force of the anvil driving member 20 on the anvil rods 91 is removed, that is, the anvil driving member 20 is separated from the anvil rods 91, the two anvil rods 91 can be reset under the action of the first spring member 92; specifically, an end surface of the anvil driving member 20 facing away from the housing 1 is a slanted surface which is slanted toward the side of the pouched anvil member 9 to urge the two anvil rods 91 to slide toward each other by the slanted surface.
In this embodiment, the initial positions of the two anvil rods 91 are located at two ends of the pouch nail hole 7, and the two anvil members 101 are not overlapped with the pouch nail hole 7 and do not shield the pouch nail hole 7, when the titanium nail 40 needs to be stapled, the two anvil members 101 are driven to move in opposite directions by the extrusion force of the anvil driving member 20, when the titanium nail 40 needs to be undocked, the anvil driving member 20 is disengaged from the anvil rods 91, and at this time, the two anvil members are reset by the first spring member 92.
Referring to FIG. 9 or FIG. 10, in a second embodiment of the present invention, the anvil shaft 91 is not connected to the anvil shaft by a rack and pinion arrangement, but only by a first spring member 92, and the anvil driver 20 includes a tapered member 201 and an extrusion member 202. The tapered piece 201 is installed in the forceps body and arranged between the anvil rods 91 and the shell 1 of the two anvil rods 101, one end, facing the anvil rods 91 of the two anvil rods 101, of the tapered piece 201 is provided with a flared tapered opening 2011, the tapered opening 2011 is used for accommodating one end of the anvil rods 91 of the two anvil rods 101, the opening size of the tapered opening is tapered from one side of the anvil rods 91 of the two anvil rods 101 to the side of the shell 1, wherein the maximum opening size of the tapered opening 2011 is not smaller than the distance between the anvil rods 91 of the two anvil rods 101 when the titanium nail 40 is removed from the nail, and the minimum opening size is equal to the distance between the anvil rods 91 of the two anvil rods 101 when the titanium nail 40 is closed; the reducing piece 201 is connected with the cutting knife 4 through the extruding piece 202, the extruding piece 202 is located at the side of the push knife groove 41 and is detachably connected with the reducing piece 201, the extruding piece 202 can be separated from one end, provided with a reducing port 2011, of the reducing piece 201 or connected with the reducing piece 201, when the extruding piece 202 is separated from the reducing piece 201, one end, far away from the cutting knife 4, of the extruding piece 202 is located between the anvil rod 91 and the push knife groove 41 of the anvil rod 101, the reducing piece 201 sleeves the anvil rod 91 of the two anvil rods 101, and the two anvil rods 101 are partially overlapped with the corresponding purse nail holes 7.
In a second embodiment of the present invention, the movement of the anvil rods 91 toward each other is achieved by the arrangement of the tapered openings 2011 on the tapered member 201, and the movement of the anvil rods 91 away from each other, i.e., the return movement, is achieved by the first spring member 92.
Further, referring to fig. 5-8, in the first embodiment, the second embodiment or other embodiments of the present invention, in order to facilitate the titanium nail 40 to be stably installed in the forceps body and facilitate the subsequent nailing of the titanium nail 40 by the nail pusher 8, a titanium nail plate 30 is slidably installed in each of the upper forceps body 11 and the lower forceps body 3, a plurality of nail grooves 301 are spaced on one side surface of the titanium nail plate 30, and the titanium nail 40 in the purse-string nail hole 7 is placed in the nail groove 301. In the invention, the nail pusher 8 for driving the titanium nails 40 in the purse-string nail holes 7 to be nailed is a pressure plate part, the side surface of the pressure plate part facing the titanium nail plate 30 is an inclined surface which inclines towards the side of the purse-string nail holes 7; when the cutting knife 4 drives the pressing plate piece to move, the titanium nail plate 30 drives the titanium nail 40 to move towards the side where the nail hole 7 of the purse bag is located and to nail under the action of the inclined surface of the pressing plate piece, namely, the pressing plate piece moves forwards along with the cutting knife 4 under the action of the inclined surface of the pressing plate piece, and the titanium nail plate 30 can move towards one side where the nail hole 7 of the purse bag is located, so that the nail of the titanium nail 40 is realized. Preferably, the titanium nail plate 30 of the invention is slidably mounted in the corresponding forceps body through the second spring 302, so that after the pressing plate member is separated from the titanium nail plate 30 through the arrangement of the springs, the titanium nail plate 30 can automatically return to the position of the titanium nail plate 30 before the titanium nail 40 is stapled, and meanwhile, the separation of the titanium nail plate 30 and the titanium nail 40 from each other is facilitated, so that the titanium nail 40 can be separated from the forceps body more easily in the later period.
Referring to fig. 7 or 8, the upper and lower clamp bodies 11 and 3 of the present invention each include a housing 21 and 31, and the pouched anvil 9, the staple pusher 8, the titanium staple plate 30, the anvil driving member 20, etc. are accommodated in the housing 21 and 31. The purse-string nail anvil 9 is positioned between the titanium nail plate 30 and the side face where the purse-string nail hole 7 is positioned, and is close to the side face where the purse-string nail hole 7 is positioned; the second spring 302 connected with the titanium nail plate 30 is also arranged between the titanium nail plate 30 and the side surface where the purse nail hole 7 is positioned, and simultaneously connects the titanium nail plate 30 and the side surface where the purse nail hole 7 is positioned; in addition, the staple pusher 8 and the anvil driving member 20 of the present invention may be connected by a staple pushing connector 81, and both are connected to the cutting blade 4 by the staple pushing connector 81.
In the invention, the groups of the purse-string nail holes 7 on the upper forceps body 11 and the lower forceps body 3 are oppositely arranged, each group of the purse-string nail holes 7 consists of a row of purse-string nail holes 7 which are arranged at intervals along the length direction of the forceps body, and the included angle formed by the purse-string nail holes 7 and the push broach slot 41 is preferably 90 degrees, namely, the purse-string nail holes 7, the push broach slot 41 and the closed nail holes 6 are vertically arranged.
In conclusion, the purse-string suture cutting closer designed by the invention has the advantages that the esophagus/small intestine after being cut and sutured presents the suture incision with one closed end and the purse-string suture incision with one closed end, namely the open suture incision, through the improvement of the clamp body, the suture incision with the purse-string type can be convenient for the nail supporting seat of the anastomat used for the later anastomosis treatment to be placed at the end, so that the integrated operation of cutting closed suture and purse-string open suture can be realized by adopting the purse-string suture cutting closer designed by the invention, the workload of a doctor in the operation can be reduced to a certain extent, the operation time of the doctor is saved, and the practicability and the convenience are better.
The above description is intended to describe in detail the preferred embodiments of the present invention, but the embodiments are not intended to limit the scope of the claims of the present invention, and all equivalent changes and modifications made within the technical spirit of the present invention should fall within the scope of the claims of the present invention.
Claims (8)
1. A purse string suture cutting closer for use with a firing device, comprising:
the shell is internally provided with a pushing piece connected with the firing device;
the pliers body is arranged at one end of the shell and comprises an upper pliers body and a lower pliers body which can be mutually opened or closed, the upper pliers body and the lower pliers body are provided with a push cutter groove along the length direction, the side surface of the lower pliers body facing the upper pliers body is provided with two groups of nail hole groups, the two groups of nail hole groups are arranged on two opposite sides of the push cutter groove, each group of nail hole group comprises a plurality of nail holes which are arranged at intervals, titanium nails are placed in the nail holes, and a nail pusher for driving the titanium nails to be nailed is arranged in the lower clamp body;
the cutting knife is arranged in the push knife groove in a sliding way and is connected with the nail pusher and the pushing piece;
the method is characterized in that:
in the two groups of nail hole groups on the lower clamp body, one group of nail hole groups are closed nail hole groups, the other group of nail hole groups are pouched nail hole groups, and pouched nail holes in the pouched nail hole groups form included angles with the push broach grooves;
a group of pouch nail hole groups are also formed in the side surface, facing the lower forceps body, of the upper forceps body, the pouch nail hole groups are arranged on one side of the cutter pushing groove, and a closed nail anvil matched with the closed nail hole for use is arranged on the other side of the cutter pushing groove; the upper clamp body is internally provided with the nail pusher;
the upper clamp body and the lower clamp body are internally provided with a pouch nail anvil piece and a nail anvil driving piece; the pouched nail anvil piece comprises two parallel nail anvil rods arranged at intervals, the two nail anvil rods are slidably arranged in the forceps body and are positioned at two ends of the pouched nail hole, and the two nail anvil rods are mutually connected and can slide in the opposite direction or in the opposite direction along the length direction of the pouched nail hole; a plurality of groups of purse-string nail anvils are arranged on the purse-string nail anvil piece at intervals, each group of purse-string nail anvils is matched with one purse-string nail hole for use, each group of purse-string nail anvils comprises two anvil branches, and the two anvil branches are arranged on one opposite side of the two nail anvil rods;
the nail anvil driving piece is slidably arranged in the forceps body, is connected with the cutting knife and slides along the length direction of the push knife groove under the action of the cutting knife, and enables the two nail anvil rods to move oppositely in the sliding process so that the two anvil rods and the corresponding purse-string nail holes are overlapped, the two anvil rods are respectively in one-to-one correspondence with the two nail feet of the titanium nail, or enables the two nail anvil rods to slide oppositely in the sliding process so that the two anvil rods are respectively positioned at the two sides of the titanium nail after the titanium nail is combined, and the distance between the two anvil rods is not less than the length of the titanium nail;
the closed nail holes and the cutter pushing grooves are arranged in parallel, the included angle formed by the purse nail holes and the cutter pushing grooves is 90 degrees, and the purse nail anvil is arranged on the two nail anvil rods;
the purse-string suture is also included; the purse-string suture line is connected with the upper forceps body and the lower forceps body simultaneously, traverses each purse-string nail hole and is positioned between two nail feet of the titanium nail in the purse-string nail hole; the purse-string suture line is detachably connected with the upper forceps body and the lower forceps body.
2. The purse string suture cutting closure device of claim 1 wherein: the two anvil rods are connected with each other through a first spring part, and in a natural state of the first spring part, the distance between the two anvil rods and the distance between the two anvil rods are not smaller than the length of the pouch nail hole.
3. The purse-string suture cutting closure device of claim 2, wherein: still through gear rack group structural connection between two anvil poles, the one end that each anvil pole is close to the casing all is provided with rack structure and the gear structure who meshes mutually with this rack structure, and the gear structure on two anvil poles is the intermeshing connection still.
4. The purse string suture cutting closure device of claim 2 wherein: the nail anvil driving part is positioned on one side of the pouch nail anvil part, and contacts and extrudes one of the two nail anvil rods close to the cutter pushing groove along with the sliding process of the cutting knife so as to drive the two nail anvil rods to slide oppositely, and at the moment, the nail anvil driving part is positioned between the pouch nail anvil part and the cutter pushing groove; the end face of one end of the nail anvil driving piece, which is far away from the shell, is an inclined face, and the inclined face inclines towards the side where the pouch nail anvil is located.
5. The purse-string suture cutting closure device of claim 2, wherein: the anvil driving component comprises a reducing component and an extruding component; the reducing piece is arranged in the pliers body and arranged between the two anvil rods and the shell, one end, facing the anvil rods, of the reducing piece is provided with a horn-shaped reducing port, the reducing port is used for accommodating one ends of the two anvil rods, the opening size of the reducing port is reduced from one side of the two anvil rods to the side where the shell is located, the maximum opening size of the reducing port is not smaller than the distance between the two anvil rods when the titanium nail is removed, and the minimum opening size is equal to the distance between the two anvil rods when the titanium nail is removed; the convergent piece passes through the extruded article and connects the cutting knife, the extruded article is located push broach groove place side, and with the convergent piece is detachable connection, the extruded article can be followed the one end that the convergent mouth was seted up to the convergent piece and break away from or connect the convergent piece, work as when the extruded article breaks away from the convergent piece, the one end that the cutting knife was kept away from to the extruded article is located between anvil pole and the push broach groove, two anvil poles are entangled to the convergent piece, and two minutes anvils overlap rather than corresponding lotus nail hole part.
6. The purse-string suture cutting closure device of claim 1, wherein: the titanium nail plate is arranged in the upper clamp body and the lower clamp body in a sliding mode, a plurality of nail grooves are formed in one side face of the titanium nail plate at intervals, and the titanium nails in the purse-string nail holes are placed in the nail grooves.
7. The purse string suture cutting closure device of claim 6 wherein: the titanium nail plates are all slidably mounted in the corresponding forceps bodies through second springs.
8. The purse string suture cutting closure device of claim 6 or 7 wherein: the nail pusher for driving the titanium nails in the purse-string nail holes to be nailed is a pressure plate piece, the side surface of the pressure plate piece facing the titanium nail plate is an inclined surface, and the inclined surface inclines towards the side where the purse-string nail holes are located; when the cutting knife drives the pressing plate to move, the titanium nail plate drives the titanium nails to move towards the sides of the pouch nail holes and to be nailed together under the action of the inclined surface of the pressing plate.
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| CN201710632250.0A CN107242889B (en) | 2017-07-28 | 2017-07-28 | Purse-string suture cutting closer |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201710632250.0A CN107242889B (en) | 2017-07-28 | 2017-07-28 | Purse-string suture cutting closer |
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| CN107242889A CN107242889A (en) | 2017-10-13 |
| CN107242889B true CN107242889B (en) | 2023-02-28 |
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| CN201710632250.0A Active CN107242889B (en) | 2017-07-28 | 2017-07-28 | Purse-string suture cutting closer |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109199500B (en) * | 2018-10-24 | 2023-09-26 | 汕头大学 | Nail pushing device of endoscopic purse-string suture device |
| CN111466981B (en) * | 2019-01-24 | 2021-05-28 | 苏州英途康医疗科技有限公司 | Nail bin assembly and surgical operation instrument |
| CN210019534U (en) * | 2019-01-31 | 2020-02-07 | 汕头大学 | Clamping device of minimally invasive abdominal surgery equipment |
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