KR101158067B1 - Tubular organ expansion type pusher - Google Patents

Tubular organ expansion type pusher Download PDF

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Publication number
KR101158067B1
KR101158067B1 KR1020100048623A KR20100048623A KR101158067B1 KR 101158067 B1 KR101158067 B1 KR 101158067B1 KR 1020100048623 A KR1020100048623 A KR 1020100048623A KR 20100048623 A KR20100048623 A KR 20100048623A KR 101158067 B1 KR101158067 B1 KR 101158067B1
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KR
South Korea
Prior art keywords
expansion
shaft
pusher
pressing
head
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KR1020100048623A
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Korean (ko)
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KR20110129154A (en
Inventor
김철웅
장광석
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(주)트리플씨메디칼
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Priority to KR1020100048623A priority Critical patent/KR101158067B1/en
Publication of KR20110129154A publication Critical patent/KR20110129154A/en
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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
    • A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
    • 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
    • A61B2017/1121—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis adapted for performing tissue or graft eversion

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  • Surgical Instruments (AREA)

Abstract

PURPOSE: A tubular organ expansion type pusher is provided to simplify a tubular organ fixing process, thereby rapidly and easily performing an anastomosis process of a tubular organ. CONSTITUTION: A head(12) is inserted to the inside of a tubular organ through one side of the opened tubular organ. A pusher comprises one or more expansion members(22). The expansion member moves the tubular organ to an expansion position for expanding the tubular organ by pressurizing the inner wall of the tubular organ. An opening part(14) for accessing one end of the expansion member is included in the head. The expansion member includes a guide surface moving along one surface of the head. The pusher comprises a connection bar which enables the expansion member to rotate.

Description

TUBULAR ORGAN EXPANSION TYPE PUSHER}

The present invention relates to a pusher, and more particularly to a pusher capable of expanding and encircling a coronary organ (such as a blood vessel).

Coronary organs such as blood vessels or intestines can be connected to each other through the closure of the ends, but this method takes a lot of time and effort, and the acquisition of sophisticated closure techniques requires a long training period.

One of the proposed methods to overcome this disadvantage is anastomosis method using anastomosis ring. For example, the anastomosis ring may be easily attached to the vessel by fixing the anastomosis ring to the end of the vessel, and fastening the anastomosis ring and the anastomosis ring to each other.

However, when the above anastomosis method is actually performed, there are many difficulties in fixing the end of the blood vessel to the anastomosis ring. Briefly describing the process of fixing the end of the blood vessel to the anastomosis ring, the blood vessel is inserted into the internal space of the anastomosis ring, and then the blood vessels (eversion) to the end of the vessel to the fixing pin of the anastomosis ring located outside the vessel Plug in to fix the vessels. At this time, the process of pulling out the end of the blood vessel with a forceps is required, and after such a process is repeated 6-8 times, the end of the blood vessel may be fixed to the anastomosis ring (for details, refer to Korea Patent Publication No. 2009- Disclosed in 0107376). However, since the blood vessel has a thin layer and has elasticity that is easily contracted, it takes a lot of time because the blood vessel is torn and damaged in the process of fixing the blood vessel, or several times fixation using forceps is required.

It is an object of the present invention to provide a pusher that can easily secure the end of the tubular organ to the anastomosis ring.

Another object of the present invention is to provide a pusher that can solve the problem that the coronary organ is damaged when fixed to the anastomosis ring.

Another object of the present invention is to provide a pusher that can easily and quickly anastomulate a tubular organ.

Still other objects of the present invention will become more apparent from the following detailed description and the accompanying drawings.

According to one embodiment of the invention, the pusher is inserted into the interior of the tubular pipe through one side of the open tubular organ; And one or more expansion members appearing through the one side of the head inserted into the tubular organ and moving to an expansion position to press the inner wall of the tubular organ to expand the tubular organ.

The head may have an opening through which one end of the expansion member enters, and the expansion member may have a guide surface moving along one surface of the head positioned on the opening.

The pusher further includes a connecting bar to which one side of the expansion member is connected so that the expansion member is rotatable, and the expansion member can be moved to the expansion position by rotating as the guide surface moves along the one surface of the head. have.

The pusher is connected to the rear end of the expansion member, the expansion shaft for moving along the longitudinal direction to move the expansion member to the expansion position; A pressing shaft connected to the rear end of the head and generally parallel with the expansion shaft, and moving along the longitudinal direction to move the head toward the tubular organ; And a body disposed to surround the expansion shaft and the pressing shaft, the body providing a moving space between the expansion shaft and the pressing shaft.

The pusher may further include a pressing button connected to a rear end of the expansion shaft, and the pressing shaft may be disposed to surround the expansion shaft and may protrude from an inner circumferential surface of the pressing shaft to limit a movement of the pressing button.

One of the pressing shaft and the body may have one or more fixing protrusions protruding from the opposing surface, and the other of the pressing shaft and the body may have one or more fixing grooves recessed from the opposing surface to insert the fixing protrusion. have.

The expansion member may be provided with a non-slip protrusion formed on one surface in contact with the inner wall of the tubular engine.

The head has an opening formed in the one side, the expansion member may be an elastic rod that appears through the opening and moves to the expansion position by the elastic force upon appearance.

The expansion member may be an open ring, and the pusher may further include a pressing member inserted into an inner circumferential surface of the ring to expand an outer diameter of the ring.

The pusher further comprises one or more forceps provided outside of the ring, the forceps pressing the outer wall of the head and the tubular tube surrounding the ring against the ring such that the ring is released from the interior of the tubular organ. Can be prevented.

According to the present invention can be easily fixed to the anastomosis ring by extending the end of the coronary organs, it is possible to solve the problem of damage to the coronary organs when fixed to the anastomosis ring. In addition, by simplifying the process of fixing the tubular organs it is possible to easily and quickly anastomosis.

1 is a view schematically showing a pusher according to an embodiment of the present invention.
FIG. 2 is a cross-sectional view illustrating the pusher shown in FIG. 1. FIG.
3 is a perspective view illustrating the support bar and the expansion shaft shown in FIG. 2.
4 is a perspective view illustrating the expansion member illustrated in FIG. 2.
5A to 5D are views showing the operation of the pusher shown in FIG. 2.
6 and 7 are diagrams showing a modification of the pusher shown in FIG. 2.
8 to 10 are views showing another modified example of the pusher shown in FIG. 2.
11 and 12 illustrate a pusher according to another embodiment of the present invention.
13 to 15 are views showing the pusher according to another embodiment of the present invention.
16-18 is a figure which shows the operation | movement of the pusher shown in FIG.

Hereinafter, preferred embodiments of the present invention will be described in more detail with reference to FIGS. 1 to 18. The embodiments of the present invention can be modified in various forms, and the scope of the present invention should not be construed as being limited to the embodiments described below. The embodiments are provided to explain the present invention to a person having ordinary skill in the art to which the present invention belongs. Accordingly, the shape of each element shown in the drawings may be exaggerated to emphasize a more clear description.

On the other hand, it will be described below by taking a blood vessel as an example, the technical spirit and scope of the present invention is not limited to this, it can be applied to other coronary organs of the human body other than the blood vessel. For example, coronary organs include organs with tubular structures, such as fallopian tubes, bile ducts, intestines, parotid glands, urethra and ureters, finishing, pancreatic ducts, total hepatic ducts, bile ducts, fallopian tubes, lymphatic vessels, and the like. In addition, the present invention can be applied to various kinds of surgery requiring anastomosis of coronary organs such as blood vessels such as liver, kidney, pancreas, heart transplant.

1 is a view schematically showing a pusher according to an embodiment of the present invention, Figure 2 is a cross-sectional view showing a pusher shown in FIG. As shown in FIGS. 1 and 2, the pusher includes a head 12, a pressing shaft 18, a body 30, and a pressing button 48. The body 30 has a long cylindrical shape, and the head 12 is located at the front end of the body 30. The head 12 has a hemispherical front end and a plurality of openings 14 are formed in the front end. The openings 14 are located radially along the circumference with respect to the central axis parallel to the longitudinal direction of the body 30, and the expansion members 22 described below are each projected through the openings 14. The head 12 has a display line 16 formed on the outer circumferential surface, and preferably inserts the end of the blood vessel to the display line 16 before the pusher (or the expansion member 22) is operated.

As shown in FIG. 2, the body 30 has an empty shape, and the pressing shaft 18 and the expansion shaft 42 are installed inside the body 30. In addition, the pressing shaft 18 has a hollow shape, and the expansion shaft 42 is provided inside the pressing shaft 18. However, unlike the present embodiment, the relationship between the pressing shaft 18 and the expansion shaft 42 may be changed.

The pressing shaft 18 is connected to the rear end of the head 12 by screwing, and the expansion shaft 42 is integrally fixed to the rear ends of the support bars 44 and 46. As shown in Fig. 2, the pressing shaft 18 has an actuating projection 18a protruding from the inner wall surface, and is operated in a state in which the head 12 is in contact with the front end of the body 30 ('press release position'). The projection 18a maintains a state spaced apart from the rear end of the body 30.

The pressing shaft 18 protrudes from the rear end of the body 30 through the interior of the body 30, and the pressing button 48 is connected to the rear end of the expansion shaft 42 to open the inside of the pressing shaft 18. It protrudes from the rear end of the pressing shaft 18 through. At this time, in the state in which the expansion member 22 is located inside the head 12 ('release position'), the pressing button 48 maintains a state spaced apart from the actuating projection 18a.

3 is a perspective view showing the support bar and the expansion shaft shown in Figure 2, Figure 4 is a perspective view showing the expansion member shown in FIG. The support bar has a plurality of extension bars 44 and a plurality of connecting bars 46. As shown in FIG. 3, the extension bars 44 are arranged in parallel with the expansion shaft 42 to be connected to the front end of the expansion shaft 42, and the connection bars 46 extend the front end of the extension bars 44. Connect to each other to form a hexagon.

As shown in FIG. 4, the expansion member 22 has a finger shape, and a non-slip protrusion 26 is formed on one surface of the tip portion. As shown in FIG. 2, the expansion members 22 may be rotatably installed on the connection bars 46 and may protrude to the outside of the head 12 through the opening 14 during rotation. The non-slip projection 26 is located on the outer surface of the expansion member 22 installed on the connecting bar 46, as will be described later, when the expansion member 22 is rotated, the anti-slip projection 26 is a blood vessel It is in contact with the inner wall surface of the blood vessel to prevent sliding from the expansion member (22).

5A to 5D are views showing the operation of the pusher shown in FIG. 2. As described above, in order to fix the blood vessel to the anastomosis ring, a process of extravasating the blood vessel is required.

First, as shown in FIG. 5A, the head 12 is inserted into the blood vessel B. FIG. In this case, it is preferable to insert the blood vessel B such that the end E of the blood vessel B reaches the display line 16 described above. At this time, the expansion member 22 maintains the state ('expansion release position') accommodated inside the head 12, the head 12 is in contact with the front end of the body 30 ('pressure release position') Keep it.

Then, as shown in Figure 5b, by pressing the pressing button 48 to move the expansion shaft 42 forward, the support bar fixed to the front end of the expansion shaft 42 together with the expansion shaft 42 Move forward. At this time, the expansion member 22 is drawn out to the outside through the opening 14 of the head 12, and the inner surface of the expansion member 22 is extended by one surface in contact with one surface located on the opening 14 Since the withdrawal of the member 22 is guided, the expansion member 22 opens toward the outside as shown in FIG. 5B ('extended position'). As a result, the expansion member 22 pressurizes the inner wall surface of the blood vessel B, and the blood vessel B may be expanded by the expansion member 22. On the other hand, the anti-slip projection 26 is in contact with the inner wall surface of the blood vessel (B), and prevents the blood vessel (B) is slipped along the outer surface of the expansion member (22).

As shown in FIG. 5C, when the pressing button 48 moves to contact the protrusion 18a, the expansion member 22 maintains the maximum open state ('maximum expansion position'), and the vessel B is also maximum. It remains extended. At this time, the projection 18a limits the movement of the pressing button 48.

As shown in FIG. 5D, when the pressing button 48 continues to move forward, the pressing shaft 18 is pressurized because the pressing shaft 18 is constrained by the pressing button 48 due to the projection 18a. Move forward with button 48. When the pressing shaft 18 moves, the head 12 coupled to the front end of the pressing shaft 18 moves together, and the blood vessel B inserted on the head 12 also moves forward in a state where it is fully extended. Move. This operation is useful when inserting the blood vessels to the fixing pin of the anastomosis ring in the expanded state of the blood vessel (B). That is, by moving the blood vessel forward toward the fixing pin in the state in which the blood vessel B is expanded, the fixing pins can penetrate the blood vessel B at about the same time, and the blood vessel B can be easily fixed on the fixing pin. have.

According to the above, by expanding the blood vessel (B) by the operation of the pressing button 48, the blood vessel (B) can be moved forward and fixed on the fixing pin. That is, since two processes can be performed through one operation, not only can the blood vessel B be easily fixed on the anastomosis ring, but the blood vessel B can be prevented from being damaged when the blood vessel B is outgoing. In particular, by simplifying the operation it is possible to reduce the time required for anastomosis to the maximum.

6 and 7 are diagrams showing a modification of the pusher shown in FIG. 2. 6 and 7, a plurality of fixing protrusions 34 are formed on the inner circumferential surface of the body 30, and a plurality of fixing grooves 18a are formed on the outer circumferential surface of the pressing shaft 18. When the expansion shaft 42 is moved by the pressing button 48, there is a fear that the pressing shaft 18 moves together with the expansion shaft 42 before the pressing button 48 is in contact with the projection 18a. When the pressure shaft 18 moves together, the blood vessel B, which is not sufficiently expanded, moves toward the fixing pin of the anastomosis ring, which may damage the blood vessel B.

As shown in FIG. 6, the fixing protrusions 34 are respectively inserted into the fixing grooves 18a to prevent the pressing shaft 18 from moving by a small force. When the pressing shaft 18 moves together with the expansion shaft 42 in the state in which the pressing button 48 is in contact with the protrusion 18a, a relatively large force may be applied to the fixing protrusions 34. As shown, the fixing protrusions 34 are inserted away from the fixing grooves 18a and inserted into the fixing grooves 18a in the adjacent positions.

8 to 10 are views showing another modified example of the pusher shown in FIG. 2. As shown in FIG. 8, a front elastic body S1 is provided between the pressing shaft 18 and the body 30, and a rear elastic body S2 is provided between the pressing shaft 18 and the pressing button 48. Can be. The front elastic body S1 and the rear elastic body S2 help the pressing shaft 18 and the pressing button 48 to return to their original positions by the restoring force.

As shown in FIG. 9, when the pressing button 48 is moved, the front elastic body S1 is compressed. At this time, the pressing shaft 18 does not move, and thus the rear elastic body S2 is not compressed.

As shown in FIG. 10, when the pressing button 48 continues to move, as described above, the pressing shaft 18 moves together with the pressing button 48, and the rear elastic body S2 is compressed. Thereafter, when the force applied to the pressing button 48 is removed, the pressing shaft 18 and the pressing button 48 are returned to their original positions by the restoring force of the front elastic body S1 and the rear elastic body S2.

11 and 12 illustrate a pusher according to another embodiment of the present invention. Hereinafter, only contents distinguished from the above-described embodiments will be described.

The head 12 has an empty shape inside and an opening is formed in the front end portion. In addition, the expansion member 22 has a rod shape and is located inside the head 12. The expansion member 22 is an elastic body having a restoring force, and the shape of the expansion member 22 is limited by the opening formed at the front end of the head 12. The front end of the expansion member 22 is provided with a non-slip projection (26). The rear end of the expansion member 22 is connected to the connection bar 46, the connection bar 46 is connected to the front end of the expansion shaft 42.

As shown in FIG. 11, when the expansion shaft 42 (or the connecting bar 46) is in the extended release position, the expansion member 22 is accommodated inside the head 12 except for the front end portion. Thereafter, as shown in FIG. 12, when the connecting bar 46 moves by the movement of the expansion shaft 42, the expansion member 22 is drawn out through the opening of the head 12 and the expansion member 22. Since the expansion member 22 is no longer restrained by the opening of the head 12, the expansion member 22 is restored to its original shape by the restoring force, and thus diverges outward. That is, through such a method, the blood vessel B fitted to the head 12 can be expanded, and a plurality of expansion members 22 can be easily controlled. At this time, the expansion member 22 is preferably radiated radially, it is preferable to uniformly press the inner wall of the blood vessel (B) to uniformly press the blood vessel (B).

13 to 15 are views showing the pusher according to another embodiment of the present invention. Hereinafter, only contents distinguished from the above-described embodiments will be described.

Expansion member 22 is installed on the outer peripheral surface of the head, as shown in Figure 14, the expansion member 22 has a ring shape with one side open. The pressing member 44 is installed inside the expansion member 22, and the pressing member 44 has a tapered surface 45. The pressing member 44 moves on the inner side of the expansion member 22, and the inner diameter r1 of the expansion member 22 having elasticity can be increased or decreased by the movement. On the other hand, the pressing member 44 is connected to the pressing shaft 42, the pressing member 44 moves together with the pressing shaft 42.

In addition, the forceps 52 having an elasticity is provided on the outside of the expansion member 22, the forceps 52 extend along the outer circumferential surface of the body 30 and through the opening formed in the body 30 of the body 30 It is connected to the forceps rod 54 installed therein. When the forceps rod 54 moves, the forceps 52 move together, and when the forceps 52 move, the inner surface of the forceps 52 contacts the one surface positioned on the opening of the body 30 by one forceps ( As the 52 moves, the forceps 52 can be spaced apart from the expansion member 22 (or the outer circumferential surface of the head 12).

On the other hand, as shown in Figure 15, the body 30 has a lever groove 31, the operation lever 56 connected to the forceps rod 54 moves along the lever groove 31. The forceps rod 54 is moved by the movement of the operation lever 56.

16-18 is a figure which shows the operation | movement of the pusher shown in FIG. As shown in FIG. 16, when the forceps rod 54 is advanced, the forceps 52 are spaced apart from the expansion member 22 (or the outer circumferential surface of the head 12), and at this time, the head 12 in the blood vessel B is disposed. ), And the head 12 is inserted into the blood vessel B so that the end E of the blood vessel B passes through the expansion member 22.

Then, as shown in FIG. 17, when the forceps rod 54 is reversed, the forceps 52 return to their original positions and are placed outside the expansion member 22, and positioned outside the expansion member 22. The blood vessel B is pressed by elasticity.

Thereafter, as shown in FIG. 18, when the pressing member 44 is advanced, the inner diameter of the expansion member 22 is increased by the pressing member 44 and the outer diameter of the expansion member 22 is also increased. Due to this, the blood vessel B may expand. At this time, as the outer diameter of the expansion member 22 increases, the forceps 52 are opened, and the forceps 52 press the blood vessel B located outside the expansion member 22 by the elastic force. Therefore, the blood vessel B can be prevented from slipping away from the head 12 by the expansion member 22 and the forceps 52. Then, as described above, the blood vessel can be fixed to the fixing pin of the anastomosis ring.

Although the present invention has been described in detail by way of preferred embodiments thereof, other forms of embodiment are possible. Therefore, the technical idea and scope of the claims set forth below are not limited to the preferred embodiments.

12: head 14: opening
18: pressure shaft 22: expansion member
26: non-slip projections 30: the body
42: expansion shaft 46: connecting bar
48: pressing button 52: forceps
54: forceps rod

Claims (10)

A head inserted into the tubular organ through one side of an open tubular organ and having a plurality of openings; And
A plurality of expansion members movable through the openings, each of the expansion members moving to an expansion position for pressing the inner wall of the tubular engine to expand the tubular organ while the head is inserted into the tubular organ;
A plurality of connection bars to which one side of the expansion members are connected so that the expansion members are rotatable; And
Is connected to the connecting bars, including an expansion shaft for moving along the longitudinal direction to move the expansion member to the expansion position,
The expansion member,
The extension shaft is supported by one surface of the head located on the opening when the expansion shaft is moved toward the opening, the guide for moving the expansion members to the expansion position by rotating the expansion members around the connecting bars respectively by the pressure of the one surface A pusher having a face. The method of claim 1,
And the openings are radially located along the circumference with respect to the central axis parallel to the longitudinal direction of the expansion axis. The method of claim 1,
The guide surface is a pusher, characterized in that located on the inner surface of the expansion member connected to the connecting bar. The method of claim 1,
The pusher is,
A pressing shaft connected to the rear end of the head and generally parallel with the expansion shaft, and moving along the longitudinal direction to move the head toward the tubular organ; And
The pusher is disposed to surround the expansion shaft and the pressing shaft, further comprising a body providing a moving space of the expansion shaft and the pressing shaft. The method of claim 4, wherein
The pusher further includes a pressing button connected to the rear end of the expansion shaft,
The pressing shaft is disposed to surround the expansion shaft, the pusher characterized in that it comprises a stopper protruding from the inner peripheral surface of the pressing shaft to limit the movement of the pressing button. The method of claim 5,
The pressing button is in contact with the stopper when the expansion members are in the maximum expansion position for maximum expansion of the tubular organ,
And the pressing shaft is movable by the pressing button at the maximum extended position. The method of claim 5,
The stopper is,
The pusher is spaced apart from the rear end of the body in the state in contact with the front end of the body, the pusher, characterized in that the movement of the pressing shaft in contact with the rear end of the body to limit the movement of the pressing shaft. The method of claim 5,
The pusher is,
A rear elastic body installed between the pressing shaft and the pressing button; And
The pusher further comprises a front elastic body provided between the pressing shaft and the body. The method of claim 4, wherein
One of the pressing shaft and the body has one or more fixing protrusions protruding from the opposite surface,
The pusher, characterized in that the pressing shaft and the other one of the body has one or more fixing grooves recessed from the opposite surface is inserted into the fixing projections. The method of claim 1,
The expansion member is provided with a non-slip projection formed on one surface in contact with the inner wall of the tubular engine.
KR1020100048623A 2010-05-25 2010-05-25 Tubular organ expansion type pusher KR101158067B1 (en)

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KR101158067B1 true KR101158067B1 (en) 2012-06-18

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Publication number Priority date Publication date Assignee Title
US10792472B2 (en) * 2017-02-22 2020-10-06 Covidien Lp Apparatus and associated methodologies for creating a stoma
CN112998794B (en) * 2021-02-25 2022-03-11 首都医科大学附属北京朝阳医院 Rat vein replacement quick-connection anastomosis sleeve

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08107876A (en) * 1994-10-12 1996-04-30 Toray Ind Inc Balloon catheter
JPH09154949A (en) * 1995-11-27 1997-06-17 Med Inst Inc Medical insertion device
KR20030017478A (en) * 2000-03-20 2003-03-03 바이-패스, 인크. An anastomotic connector and graft expander for mounting a graft
KR20090107373A (en) * 2008-04-08 2009-10-13 (주)트리플씨메디칼 Pusher and method of anastomosis using the pusher

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08107876A (en) * 1994-10-12 1996-04-30 Toray Ind Inc Balloon catheter
JPH09154949A (en) * 1995-11-27 1997-06-17 Med Inst Inc Medical insertion device
KR20030017478A (en) * 2000-03-20 2003-03-03 바이-패스, 인크. An anastomotic connector and graft expander for mounting a graft
KR20090107373A (en) * 2008-04-08 2009-10-13 (주)트리플씨메디칼 Pusher and method of anastomosis using the pusher

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