CN116983039A

CN116983039A - Anastomat

Info

Publication number: CN116983039A
Application number: CN202210446849.6A
Authority: CN
Inventors: 李振华; 杨兵; 潘贞; 林晋生
Original assignee: Wuhan United Imaging Zhirong Medical Technology Co Ltd
Current assignee: Wuhan United Imaging Zhirong Medical Technology Co Ltd
Priority date: 2022-04-26
Filing date: 2022-04-26
Publication date: 2023-11-03

Abstract

The application discloses an anastomat, which comprises a nail anvil and a nail bin, wherein the near end of the nail bin is rotatably connected with the nail anvil; the proximal end of the cartridge is oriented in a first direction toward the distal end thereof, and a clamping gap is formed between the cartridge and the anvil when the cartridge and the anvil are engaged, the clamping gap being at least partially tapered in the first direction. According to the application, the clamping gap between the nail bin and the nail anvil is gradually reduced towards the first direction, so that the clamping force of the distal end of the anastomat is improved, and the problem that the distal end of the anastomat cannot extrude tissues to a proper thickness is avoided.

Description

Anastomat

Technical Field

The application relates to the technical field of suturing instruments, in particular to an anastomat.

Background

At present, in the surgical minimally invasive surgery, an anastomat is often used for suturing and cutting.

The anastomat mainly comprises a nail bin, a nail anvil and a driving rod which is added in, a doctor operates a handle to position the anastomat in vivo, controls the closing of a jaw to squeeze tissues, and pushes the anastomat to finish suturing and cutting operations on the tissues.

As shown in fig. 1, the anvil and the staple cartridge of the current anastomat have flat opposite surfaces, and the staple cartridge have a tendency to press tissues to cause distal stacking of the tissues in the process of clamping the tissues, so that the closing force of the staple cartridge and the staple cartridge at the distal end is far smaller than that of the staple cartridge at the proximal end, which results in that the distal tissues cannot be pressed to a proper thickness, and the forming of the staples is poor.

Disclosure of Invention

In view of the foregoing, it is desirable to provide a stapler that solves the technical problem in the prior art that the closing force of the distal end is smaller than the proximal end during the process of clamping the tissue between the staple cartridge and the anvil.

In order to achieve the technical aim, the technical scheme of the application provides an anastomat, which comprises a nail anvil and a nail bin, wherein the proximal end of the nail bin is rotatably connected with the nail anvil; the direction of the proximal end of the nail bin towards the distal end of the nail bin is a first direction, when the nail bin is anastomosed with the nail anvil, a clamping gap is formed between the nail bin and the nail anvil, and the clamping gap is at least partially gradually reduced along the first direction.

In one embodiment, the clamping gap comprises a proximal gap, an intermediate gap, a distal gap, arranged in sequence along a first direction, at least the distal gap tapering along the first direction.

In one embodiment, an opening is formed around the distal ends of the staple cartridge and anvil, and the proximal gap, the intermediate gap, the distal gap, and the opening are sequentially disposed along a first direction, and the opening gradually increases in size along the first direction.

In one embodiment, the clamping gap formed by the proximal gap, the intermediate gap and the distal gap tapers in the first direction.

In one embodiment, the opposite surfaces of the nail anvil and the nail bin are respectively an extrusion surface and a clamping surface, at least one of the extrusion surface and the clamping surface is a plane, the other is a curved surface, and the curved surface is gradually close to the plane along a first direction and is in arc-shaped arrangement.

In one embodiment, the cross section of the clamping surface perpendicular to the first direction is arc-shaped, and the arc-shaped convex surface faces the extrusion surface.

In one embodiment, the cross-section is a symmetrical arcuate cross-section.

In one embodiment, the opening is flared.

In one embodiment, the device further comprises at least one protrusion arranged on the clamping surface of the staple cartridge and/or the pressing surface of the staple anvil.

In one embodiment, the number of the protrusions is plural, and the protrusions are distributed on the clamping surface at intervals.

Compared with the prior art, the application has the beneficial effects that: according to the application, the clamping gap between the nail bin and the nail anvil is gradually reduced along the first direction, so that the clamping force between the distal end of the nail bin and the nail anvil is improved, the problem that tissues cannot be pressed to a proper thickness due to insufficient clamping force at the distal end of the nail bin is avoided, and the phenomenon of poor nails is avoided.

Drawings

FIG. 1 is a three-dimensional schematic view of a prior art stapler holding tissue;

FIG. 2 is a three-dimensional schematic view of a prior art stapler from another perspective when clamping tissue;

FIG. 3 is a three-dimensional schematic view of a stapler according to an embodiment of the application;

FIG. 4 is an enlarged partial schematic view at A in FIG. 3;

FIG. 5 is a schematic view of a stapler according to an embodiment of the present application;

FIG. 6 is a schematic view of a stapler according to another embodiment of the present application;

FIG. 7 is a three-dimensional schematic view of a staple cartridge and protrusions in a stapler according to an embodiment of the application;

FIG. 8 is a schematic view of the configuration of the staple cartridge and projections in the stapler according to an embodiment of the application;

fig. 9 is a three-dimensional schematic view of an anvil in a stapler according to an embodiment of the application.

Detailed Description

The following detailed description of preferred embodiments of the application is made in connection with the accompanying drawings, which form a part hereof, and together with the description of the embodiments of the application, are used to explain the principles of the application and are not intended to limit the scope of the application.

As shown in fig. 3 and 5, the present application provides a stapler including an anvil 1 and a cartridge 2 having a proximal end rotatably coupled to the anvil 1, a direction of the proximal end of the cartridge 2 toward a distal end thereof being a first direction, and a clamping gap is formed between the cartridge 2 and the anvil 1 when the cartridge 2 and the anvil 1 are stapled, and the clamping gap is at least partially gradually reduced in the first direction. Through the fact that when the nail bin 2 and the nail anvil 1 clamp tissues, the tissues tend to be piled up towards the distal end of the nail bin 2 due to the fact that the tissues are extruded, so that clamping force between the distal end of the nail bin 2 and the nail anvil 1 is far smaller than that between the proximal end of the nail bin 2 and the nail anvil 1.

Wherein the proximal end of the staple cartridge 2 is the same as the proximal end of the staple cartridge 2, which is rotatably connected to the anvil 1, towards the distal end thereof.

Wherein, one end of the surgical instrument close to the handle is called a proximal end, and the other end is a distal end.

It will be appreciated that the clamping gap may decrease stepwise in the first direction or continuously.

In one embodiment, the proximal end of the anvil 1 is rotatably coupled to the cartridge 2 by a pivot pin 3. The rotary pin 3 may be rotatably inserted into the nail bin 2, or the anvil 1 may be rotatably sleeved on the rotary pin 3.

In one embodiment, two rotating pins 3 are respectively arranged on two sides of the nail bin 2, the two rotating pins 3 are coaxially arranged, two fixing holes are formed in the nail anvil 1 opposite to the two rotating pins 3, and the nail anvil 1 is rotatably sleeved on the rotating pins 3 through the fixing holes.

In one embodiment, the clamping gap comprises a proximal gap, an intermediate gap, a distal gap, arranged in sequence along a first direction, at least the distal gap decreasing gradually along the first direction. By setting the distal end gap to be gradually smaller, the holding force of the distal ends of the anvil 1 and the cartridge 2 can be increased.

It will be appreciated that the ratio of the proximal gap, the intermediate gap, the distal gap and the opening in the first direction may be 20%, 50%, 20%, 10%, and the ratio of the proximal gap, the intermediate gap, the distal gap and the opening in the first direction may be 30%, 35%, 30%, 5%.

In one embodiment, the clamping gap formed by the proximal gap, the intermediate gap and the distal gap tapers in a first direction. By arranging the clamping gap formed by the proximal gap, the intermediate gap and the distal gap to be gradually decreasing in the first direction, a gradual increase of the clamping force from the proximal to the distal end is achieved, avoiding a sudden increase of the clamping force.

It will be appreciated that the proximal gap, the intermediate gap and the distal gap may decrease stepwise in the first direction or may decrease continuously in the first direction.

In one embodiment, the surfaces of the nail anvil 1 opposite to the nail bin 2 are respectively a pressing surface 11 and a clamping surface 21, at least one of the pressing surface 11 and the clamping surface 21 is a plane, the other is a curved surface, and the curved surface is gradually close to the plane along the first direction and is in arc arrangement.

The extrusion surface 11 may be an inclined surface or an arc surface; the clamping surface 21 may be an inclined surface or an arc surface, as shown in fig. 8 (an arrow in fig. 8 is used to illustrate a bending direction of the clamping surface 21), when the pressing surface 11 is a plane, the clamping surface 21 is an arc surface, and along the first direction, the clamping surface 21 gradually approaches the pressing surface 11; when the clamping surface 21 is a plane and the pressing surface 11 is a cambered surface, the pressing surface 11 gradually approaches the clamping surface 21 in the first direction. By the mode, the clamping gap is gradually reduced.

In one embodiment, the cross section of the clamping surface 21 perpendicular to the first direction is arc-shaped, and the convex surface of the arc faces the pressing surface 11. When both the clamping surface 21 and the pressing surface 11 are planar, as shown in fig. 2, stress concentration occurs at the corners of the edges of the clamping surface 21, resulting in tissue pinching. According to the application, the cross sections of the clamping surface 21 and the first direction which are mutually perpendicular are arc-shaped, so that the gap between the clamping surface 21 and the edge of the extrusion surface 11 is increased, the tissue fluid can be conveniently discharged to two sides, and possible sharp points are avoided, and the tissue is prevented from being clamped.

In one embodiment, as shown in fig. 6, the clamping surface 21 is a symmetrical arcuate cross-section. The clamping surface 21 is arranged to be a symmetrical arc-shaped section, so that both sides of the clamping surface 21 are bent in a direction away from the nail anvil 1, stress concentration on both sides of the clamping surface 21 is avoided, and tissue is prevented from being clamped.

As shown in fig. 5, in one embodiment, the distal ends of the staple cartridge 2 and the anvil 1 are formed with openings around them, and the proximal gap, the intermediate gap, the distal gap, and the openings are sequentially arranged in the first direction, and the openings gradually increase in size in the first direction.

By arranging the openings with gradually increased sizes along the first direction at the tail ends of the staple cartridge 2 and the staple anvil 1, the stress concentration at the tail ends can be avoided, and the tissue clamped injury caused by the stress concentration of the anastomat can be avoided.

It will be appreciated that the opening may be horn-shaped, fan-shaped, etc.

In one embodiment, the opening is flared. Through the distal end of nail storehouse 2 and nail anvil 1 encirclement form horn-shaped opening, along the opening increase gradually of first direction, when nail storehouse 2 and nail anvil 1 centre gripping tissue, the opening that nail storehouse 2 and nail anvil 1 encirclement formed the basal portion of centre gripping tissue, the opening that increases gradually can adapt to the basal portion of subassembly enlarged tissue, can avoid pressing from both sides the tissue outside the anastomotic region.

In one embodiment, the distal end face of the anvil 1 is gradually moved away from the staple cartridge 2 in a first direction to form an arcuate transition surface, and the distal end face of the staple cartridge 2 is gradually moved away from the anvil 1 in the first direction to form an arcuate transition surface. By the arrangement, the end surfaces of the distal ends of the nail anvil 1 and the nail bin 2 are surrounded to form the horn-shaped opening.

As shown in fig. 7 and 9, in one embodiment, the clamping surface 21 of the staple cartridge 2 is provided with a plurality of staple storage slots 22, the plurality of staple storage slots 22 are distributed along the array of the clamping surface 21, the clamping surface 21 of the anvil 1 is provided with a plurality of forming slots 12 corresponding to the staple storage slots 22, and the forming slots 12 are arranged in a one-to-one correspondence with the staple storage slots 22.

In one embodiment, a notch 23 is formed in the proximal end of the staple cartridge 2, which is recessed away from the anvil 1 relative to the entire surface of the anvil 1, and the bottom surface of the notch 23 is a plane, and the bottom surface is connected to the clamping surface 21 by an inclined surface. By forming the notch 23, the rotating nail anvil 1 can be prevented from being clamped at the end part of the proximal end of the nail bin 2, so that the nail anvil 1 and the nail bin 2 can be attached more tightly, and the gap between the nail anvil 1 and the nail bin 2 after being closed can be reduced; secondly, the gap between the proximal end of the nail bin 2 and the nail anvil 1 is increased, so that the gap between the proximal end of the nail bin 2 and the nail anvil 1 is larger than the clamping gap in closing, and the phenomenon that tissues are clamped and injured due to the fact that tissues inserted into the proximal end of the nail bin 2 are continuously extruded in the rotating process of the nail anvil 1 is avoided.

In one embodiment, the anvil 1 is provided with a wire slot 13 in a first direction, the wire slot 13 extending through the anvil 1 in the first direction, the cartridge 2 is provided with a cutting slot 24 opposite the wire slot 13, and the cutting slot 24 extends from the proximal end to the distal end of the cartridge 2 but not through the distal end of the cartridge 2. The cutting groove 24 is used for accommodating a cutting edge of a cutting knife, and when the cutting knife cuts tissue, the cutting edge of the cutting knife penetrates through the cutting groove 24 and is immersed into the wire groove 13, so that the tissue of a patient is cut.

In one embodiment, the cross section of the wire slot 13 perpendicular to the first direction is T-shaped; the cross section of the cutting groove 24 perpendicular to the first direction is T-shaped, the cutting groove 24 penetrates through the proximal end of the nail bin 2, and when the nail bin 2 and the nail anvil 1 are closed, the cross section of the groove formed by combining the cutting groove 24 and the wire groove 13 perpendicular to the first direction is I-shaped.

As shown in fig. 4 and 7, in one embodiment thereof, at least one protrusion 4 is further included provided on the clamping surface 21 of the staple cartridge 2, the protrusion 4 being configured to prevent the clamped tissue from sliding relative to the clamping surface 21. Because the clamping surface 21 and the extruding surface 11 of the nail bin 2 and the nail anvil 1 for clamping tissues are relatively smooth, the tissues possibly slide relative to the clamping surface 21 and the extruding surface 11 in the clamping process, and the bulges 4 are arranged on the clamping surface 21, so that the bulges 4 can provide extrusion force in the process of clamping the tissues by the clamping surface 21 and the extruding surface 11, the sliding of the tissues relative to the clamping surface 21 can be reduced, and the anastomosis is more accurate.

In one embodiment, the number of the protrusions 4 is plural, and the protrusions 4 are spaced apart from each other on the holding surface 21. By providing a plurality of spaced apart protrusions 4, the protrusions 4 may simultaneously contact the tissue when the tissue is clamped by the stapler, increasing the number of protrusions 4 pressing against the tissue, and further limiting the sliding of the tissue relative to the clamping surface 21.

It will be appreciated that the projections 4 may be cylindrical, bar-like, block-like, etc.

In one embodiment, a plurality of protrusions 4 are circumferentially arranged on the clamping surface 21 at the notch of the nail storage groove 22. When the anastomotic nail in the nail storage groove 22 passes through the tissue and is inserted into the forming groove 12, the bulge 4 positioned at the notch of the nail storage groove 22 can play a limiting role on the tissue, so that the tissue is prevented from sliding relative to the clamping surface 21, and the occurrence of wrinkles at the anastomotic site is avoided.

The specific working procedure of the application is as follows: the gap for clamping the tissue is formed by the nail anvil 1 and the nail bin 2, the tissue is placed in the clamping gap, the nail anvil 1 and the nail bin 2 are closed to anastomose the tissue, and when the anastomoses, the anastomoses positioned in the nail storage groove 22 penetrate through the tissue to enter the forming groove 12 and anastomoses in a B shape in the forming groove 12, so that the suturing of the tissue is realized.

The present application is not limited to the above-mentioned embodiments, and any changes or substitutions that can be easily understood by those skilled in the art within the technical scope of the present application are intended to be included in the scope of the present application.

Claims

1. An anastomat is characterized by comprising a nail anvil and a nail bin with a proximal end rotatably connected with the nail anvil; the direction of the proximal end of the nail bin towards the distal end of the nail bin is a first direction, when the nail bin is anastomosed with the nail anvil, a clamping gap is formed between the nail bin and the nail anvil, and the clamping gap is at least partially gradually reduced along the first direction.

2. The stapler of claim 1, wherein the grip gap comprises a proximal gap, an intermediate gap, a distal gap arranged in sequence along a first direction, at least the distal gap tapering along the first direction.

3. The stapler of claim 2, wherein the cartridge and anvil have openings formed around their ends, the proximal gap, intermediate gap, distal gap, and the openings being sequentially disposed in a first direction, the openings increasing in size in the first direction.

4. The stapler of claim 3, wherein a grip gap defined by the proximal gap, the intermediate gap, and the distal gap tapers in the first direction.

5. The stapler of claim 3, wherein the surfaces of the anvil opposite the staple cartridge are respectively a pressing surface and a clamping surface, at least one of the pressing surface and the clamping surface is a plane, and the other is a curved surface, and the curved surface is gradually close to the plane along a first direction and is arranged in an arc shape.

6. The stapler of claim 5, wherein the gripping surface is arcuately disposed in a cross section perpendicular to the first direction, the arcuately convex surface facing the pressing surface.

7. The stapler of claim 6, wherein the cross-section is a symmetrical arcuate cross-section.

8. A stapler according to claim 3, wherein the opening is flared.

9. The stapler of claim 5, further comprising at least one protrusion disposed on a clamping surface of the cartridge and/or a pressing surface of the anvil.

10. The stapler of claim 9, wherein the number of protrusions is plural, and the protrusions are spaced apart from the clamping surface.