WO2023030042A1 - 钉仓组件及外科器械 - Google Patents

钉仓组件及外科器械 Download PDF

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Publication number
WO2023030042A1
WO2023030042A1 PCT/CN2022/113621 CN2022113621W WO2023030042A1 WO 2023030042 A1 WO2023030042 A1 WO 2023030042A1 CN 2022113621 W CN2022113621 W CN 2022113621W WO 2023030042 A1 WO2023030042 A1 WO 2023030042A1
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WO
WIPO (PCT)
Prior art keywords
staple
staple cartridge
nail
cartridge assembly
staples
Prior art date
Application number
PCT/CN2022/113621
Other languages
English (en)
French (fr)
Inventor
孙宝峰
杨庆辉
Original Assignee
江苏风和医疗器材股份有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from CN202111019429.1A external-priority patent/CN115137425A/zh
Priority claimed from CN202122093195.7U external-priority patent/CN216060618U/zh
Application filed by 江苏风和医疗器材股份有限公司 filed Critical 江苏风和医疗器材股份有限公司
Publication of WO2023030042A1 publication Critical patent/WO2023030042A1/zh

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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

Definitions

  • the present application relates to the field of medical instruments, in particular to a staple cartridge assembly and a surgical instrument.
  • the surgical instrument may include an end effector, the end effector includes a staple cartridge seat and an abutment seat, the staple cartridge seat is used to receive the staple cartridge assembly;
  • the staple cartridge assembly includes a staple cartridge main body and staples arranged in the staple cartridge main body,
  • the main body of the staple cartridge is provided with several staple cavities for storing staples.
  • the main body of the staple cartridge includes a top surface, and the top surface is provided with a staple outlet formed by the staple cavity penetrating the top surface.
  • the surgical cutting stapler can be fired, thereby severing and stapling the tissue.
  • the top surface is in contact with the tissue to be sutured, and the cutting piece in the surgical cutting stapler pushes the wedge-shaped pusher block in the staple cartridge to move, so that the staple driver drives the staples in the staple cartridge to move upwards from the staple cavity. Pierce and suture the target tissue (i.e., staple out).
  • the staples are directly nailed to the tissue, the contact area between the staples and the tissue is small, the pressure is high, and the tissue is easily damaged, especially for lung surgery, which is prone to the risk of air leakage and bleeding.
  • gaps also exist between the corresponding staple holes and the staples, which may cause air leakage and bleeding.
  • the width of the staple cartridge assembly used in the prior art is too large, and when the end effector is inserted into the body from the gap between two ribs, the ribs are easily damaged, causing postoperative rib pain in patients.
  • the present application aims to propose a staple cartridge assembly and a surgical instrument, which can effectively avoid staples from crushing tissue, and effectively avoid risks of bleeding and air leakage.
  • the application provides a staple cartridge assembly, which includes:
  • the main body of the staple cartridge is provided with a plurality of nail cavities.
  • the staple cavity has a nail cavity opening on the nail outlet surface of the staple cartridge main body.
  • the main body of the staple cartridge is provided with a knife groove for the movement of the cutter assembly.
  • the front and rear direction of the component extends, and two rows of nail cavities are arranged on both sides of the knife groove, and each row of nail cavities extends along the front and rear direction;
  • a plurality of staples a plurality of staples are arranged in a plurality of staple cavities, the staples include a base and two staple legs, each staple leg is respectively connected to one of the two ends of the base, along the extension of the two staple legs Viewed in the direction, the base is curved;
  • Gasket the gasket is installed on the nail outlet surface and covers the opening of the nail cavity;
  • the staple When the staple is fired, the staple is pushed out from the opening of the staple cavity, and the staple is separated from the staple exit surface with the gasket.
  • the gasket is in the form of a sheet.
  • the gasket has a thickness to width ratio of 1:5 to 1:20.
  • the gasket has a thickness to width ratio of 1:8 to 1:15.
  • the gasket has a thickness of 0.1 mm to 0.5 mm.
  • a straight line passing through the first gap and the second gap between adjacent staples located on the same side of the tool slot and in the front-to-back direction will always be aligned with at least one staple located on the same side of the tool slot. intersect.
  • the staple cartridge assembly includes a plurality of shims, and the straight line passing through the third gap and the fourth gap between the shims located on the same side of the knife groove and adjacent in the front-rear direction always aligns with at least one Spacers on the same side of the flutes intersect.
  • the width of the third gap and the fourth gap between adjacent pads in the front-rear direction is less than 1/15 of the length of a single pad
  • the gap between two rows of shims on the same side of the tool slot is less than 1/15 of the width of a single shim.
  • the base is arc-shaped or V-shaped or W-shaped.
  • the two ends of the base of one row of staples are bent toward the other row of staples.
  • the cross-section of the staple cavity is adapted to the base, thereby guiding the movement of the staples along the thickness of the cartridge assembly.
  • two rows of nail cavities located on the same side of the knife groove are arranged alternately.
  • the staple cartridge assembly includes a plurality of spacers, each spacer covers a plurality of staple cavity openings, so that each spacer can pass through a plurality of staples.
  • the plurality of staple cavity openings covered by each spacer includes different rows of staple cavity openings located on one side of the knife groove.
  • a spacer covers a whole row of nail cavities on one side of the knife groove or covers all nail cavities on one side of the knife groove.
  • the spacer includes a first plate portion and a second plate portion, the first plate portion and the second plate portion are staggered along the front-rear direction and the left-right direction of the nail cartridge assembly, and the first plate portion and the second plate portion It is integrally formed, the first plate portion is provided with two through holes for matching with one staple, and the second plate portion is provided with two through holes for matching with the other staple.
  • the staple cartridge assembly includes a plurality of spacers, two or more spacers connected together by a frangible connection.
  • the staple cartridge assembly includes a plurality of gaskets
  • the staple exit surface of the staple cartridge body includes a groove disposed around the opening of the staple cavity
  • the gaskets are installed on the staple exit surface by interference fit with the groove.
  • the shim is glued to the nail exit surface.
  • the spacer has a through hole through which the nail legs pass, and the through hole may be a special-shaped hole opened toward the side of the spacer.
  • a surgical instrument which includes an end effector, and the end effector includes a jaw assembly, and the jaw assembly includes: a nail cartridge seat for installing the nail cartridge assembly; anvil,
  • the end effector also includes an end effector cover capable of being fitted on the staple cartridge seat and/or the nail abutment seat.
  • the end effector also includes a staple bin assembly mounted on the nail bin seat, the nail bin assembly can be a nail bin assembly according to the present application; the end effector cover is set on the nail bin assembly and the nail bin seat .
  • the end effector cover includes a first piece and a second piece, the first piece and the second piece are detachably connected, and the end effector cover is set on the nail cartridge seat and/or Or during the nail abutment seat, the first piece is located between the nail cartridge seat and the nail abutment seat.
  • the first panel may be made of absorbable, dissolvable or degradable material.
  • first sheet and the second sheet are stitched together by thread, the first sheet and the second sheet can be separated by removing the thread, or the first sheet and the second sheet can be easily The disconnected parts are connected together.
  • the end effector sleeve is fitted on the anvil
  • the end effector also includes a staple cartridge assembly mounted on the staple cartridge seat, and the staple cartridge assembly is a staple cartridge assembly according to the present application.
  • the staples and the spacer can be nailed on the tissue together, increasing the contact area between the staple and the spacer and the tissue, making the pressure in the contact area uniform, and avoiding suturing lung tissue and lung tissue.
  • the spacer can also be pressed near the nail hole formed by the staple on the tissue, and by applying pressure to the tissue near the nail hole, it can Reducing the gap between the nail hole and the staples can also prevent bleeding and air leakage from the nail hole.
  • the bases of the staples are curved, such as arc-shaped or V-shaped or W-shaped staples.
  • the staples can be more closely overlapped and arranged to produce a larger volume in the same area. Staple lines of staple coverage to reduce the possibility of tearing, leakage and/or bleeding after the stapling procedure.
  • End effector sleeves can serve a similar effect to spacers. End effector sleeves and spacers can be used together or separately.
  • the present application also provides a stapler comprising the above-mentioned staple cartridge assembly and/or end effector.
  • Fig. 1 shows a schematic structural view of a stapler according to an embodiment of the present application
  • Figure 2 shows an exploded view of an end effector of a stapler according to an embodiment of the present application
  • Figure 3 shows a schematic structural view of a possible staple cartridge assembly
  • Figure 4 shows a top view of a possible staple cartridge assembly
  • Fig. 5 shows a sectional view along line A-A in Fig. 4;
  • Fig. 6 shows a schematic diagram of a distribution state of staples in a possible staple cartridge assembly
  • Fig. 7 shows a schematic structural view of the staple cartridge assembly according to the first embodiment of the present application
  • Figure 8 shows a sectional view along the line B-B in Figure 7;
  • Fig. 9 shows a schematic diagram of the distribution state of the spacers and staples of the staple cartridge assembly according to the first embodiment of the present application
  • Fig. 10 shows a schematic diagram of a stapler used for lung surgery according to the first embodiment of the present application
  • Fig. 11 shows a schematic structural view of staples of a possible staple cartridge assembly according to the present application
  • Fig. 12 shows a schematic structural view of another angle of staples of a possible staple cartridge assembly according to the present application
  • Fig. 13 shows a schematic structural view of another possible staple cartridge assembly according to the present application.
  • Fig. 14 shows a structural schematic diagram of another angle of staples of another possible staple cartridge assembly according to the present application.
  • Fig. 15 shows a schematic diagram of a distribution state of staples of a possible staple cartridge assembly according to the present application
  • Fig. 16 shows a schematic diagram of another possible distribution state of the staples of the staple cartridge assembly according to the present application.
  • Fig. 17 shows a schematic diagram of a distribution state of gaskets and staples of a staple cartridge assembly according to the present application
  • Fig. 18 shows a schematic diagram of another possible distribution state of gaskets and staples of the staple cartridge assembly according to the present application
  • Fig. 19 shows a schematic structural view of a staple cartridge assembly according to a second embodiment of the present application.
  • Figure 20 shows a sectional view along line C-C in Figure 19;
  • Fig. 21 shows a schematic diagram of the distribution state of the spacers and staples of the staple cartridge assembly according to the second embodiment of the present application
  • Fig. 22 shows an enlarged schematic view of a spacer and staples of a staple cartridge assembly according to a second embodiment of the present application
  • Fig. 23 shows a schematic structural view of an end effector according to an embodiment of the present application.
  • Fig. 24 shows a schematic view of the structure of staples not in contact with the nail abutment seat
  • Fig. 25 shows a schematic structural view of the deformation of the staple when it contacts the anvil.
  • the terms “near”, “rear” and “distal”, “anterior” used herein are relative to the clinician manipulating the stapler.
  • the terms “near” and “rear” refer to the part relatively close to the clinician (or in other words, relatively close to the operating assembly 10 of the stapler, see Fig. 1)
  • the terms “far” and “front” refer to the part relatively far away from the clinician ( In other words, the operating assembly 10 that is relatively far away from the stapler, or the end effector 30 that is relatively close to the stapler, see the part in FIG. 1 ).
  • upper and lower refer to the relative positions of the nail anvil 304 and the cartridge holder 303 of the jaw assembly 301, specifically, the nail anvil 304 is “upper” and the staple cartridge holder 303 is “lower”.
  • staplers can be used in many orientations and positions, so these terms expressing relative positional relationships are not limiting and absolute.
  • the present application provides a stapler, which includes an operating assembly 10 , a shaft assembly 20 extending forward from the operating assembly 10 , and an end end (front end) at one end (front end) of the shaft assembly 20 .
  • the external effector 30 and the cutting blade assembly 40 for performing tissue cutting.
  • the operating assembly 10 includes a housing and a power source module.
  • the power source module includes a manually operated handle by the user connected to the transmission described below.
  • the power source module includes a motor and a power module disposed in the casing, the power module includes a battery for providing the motor with electrical energy required for rotation, and the motor is connected to the transmission device described below.
  • the type of power source module does not limit the scope of protection of this application. In the following, the overall function of the stapler will be described by taking the power source module including the motor and the power supply module as an example.
  • the housing of the operation assembly 10 may include a connected handle housing and a head housing according to the positional relationship, the head housing may accommodate the transmission mechanism, and the handle housing may be held by the user.
  • the shaft assembly 20 may include a mandrel and a sleeve sleeved on the mandrel.
  • the stapler may further include a transmission device connected to the power source module, and the transmission device may include a first transmission mechanism and a second transmission mechanism.
  • the bushing (relative to the operating assembly 10, or relative to the housing of the operating assembly 10) can be driven to move axially through the first transmission mechanism, and the mandrel (relative to the operating assembly 10, or That is, relative to the axial movement of the housing of the operating assembly 10, both the sleeve and the mandrel can move axially forward or backward.
  • End effector 30 can include jaw assembly 301 and staple cartridge assembly 302 .
  • the jaw assembly 301 may include a cartridge base 303 and an abutment base 304 pivotably connected to the cartridge base 303 for operatively supporting the cartridge assembly 302 therein.
  • the nail anvil 304 can selectively move between the open position and the closed position to realize switching between the open state and the closed state, so that the nail anvil 304 cooperates with the staple cartridge assembly 302 to loosen or clamp tissue.
  • One end (front end) of the sleeve is connected to the nail anvil 304, and the other end (rear end) is connected to the first transmission mechanism, which can drive the sleeve to move backward or forward.
  • the backward movement of the sleeve can cause the anvil 304 to pivot upward to open the jaw assembly 301
  • the forward movement of the sleeve can cause the anvil 304 to pivot downward to close the jaw assembly 301 .
  • the cutting knife assembly 40 is connected to the mandrel to be driven by the mandrel to perform a firing action or a knife retracting action.
  • the cutting knife assembly 40 includes a knife bar 401 and a nail pushing plate 402 located at the front end of the knife bar 401 .
  • One end (front end) of the mandrel is located in the casing, and the other end (rear end) is connected to the second transmission mechanism.
  • a portion of cutter assembly 40 is located within the sleeve and is attached to the front end of the mandrel.
  • the nail pushing plate 402 is located in the space formed between the staple cartridge seat 303 and the nail anvil seat 304 .
  • the second transmission mechanism can drive the mandrel to move forward and backward.
  • the forward movement of the mandrel can make the nail pushing plate 402 move forward, pushing the staples 4 of the staple cartridge assembly 302 out to staple the tissue and cut the tissue by the cutting knife of the cutting knife assembly 40 .
  • the rearward movement of the mandrel can cause the cutter assembly 40 to move backward to return to the original position.
  • the stapler uses staples 4 to staple tissues, which is also commonly referred to as stapling or suturing as known to those skilled in the art.
  • the jaw assembly 301 is closed, and the motor drives the jaw assembly 301 to close through the first transmission mechanism to clamp the tissue.
  • the cutting knife assembly 40 fires, and the motor drives the cutting knife assembly 40 forward through the second transmission mechanism to suture and cut the tissue.
  • the cutter assembly 40 retreats, and the motor drives the cutter assembly 40 to retreat through the second transmission mechanism.
  • the jaw assembly 301 is opened, and the motor drives the jaw assembly 301 to open through the first transmission mechanism to loosen the tissue, thereby realizing the stapling and cutting functions of the stapler.
  • a possible staple cartridge assembly 302 may include a staple cartridge main body 1 , a staple pusher 2 , staples 4 and a bracket 5 .
  • the staple cartridge body 1 is provided with a knife groove 11 and a nail cavity 12.
  • the knife groove 11 is used for the movement of the cutter assembly 40 and provides guidance for the movement of the cutter assembly 40. Therefore, the knife groove 11 can also be called a guide groove.
  • the nail cavities 12 are located on the left and right sides of the knife groove 11, and a plurality of nail cavities 12 extending in the front-rear direction X form a row, which can be Multiple rows of nail cavities 12 are arranged on both sides of the knife groove 11 , for example, in the example shown in FIG. 3 and FIG. 4 , three rows of nail cavities 12 are respectively arranged on both sides of the knife groove 11 .
  • the multiple rows of staple cavities 12 can accommodate multiple rows of staples, which can make the width of staples to sew tissue wider.
  • Each staple cavity 12 can be provided with a staple 4 , the staple pusher 2 is located at the bottom of the staple 4 , and the staple pusher 2 is used to push the staple 4 out of the staple cavity 12 .
  • the staple cartridge main body 1 is connected to the bracket 5, and the bracket 5 can block the lower opening of the knife groove 11 and the staple cavity 12, so that the push piece 2 and the staples 4 can be kept in the staple cavity 12.
  • the staple pushing plate 402 drives the staple pushing piece 2 to move toward the staple exit surface 13, so that the staples 4 leave the staple cavity 12, thereby suturing the tissue.
  • FIG. 5 Three states of the staple 4 are shown in FIG. 5 . From right to left, the staple 4 completely leaves the staple cavity 12 after being fired, and the staple 4 partially leaves the staple cavity 12 during the process of being fired. The staples 4 remain unfired within the staple cavities 12 .
  • multiple rows of staples 4 are viewed from a top view, or in other words, after the staples 4 in the staple cartridge assembly 302 are fired and joined to the tissue, multiple rows of staples 4 are formed on the tissue, and the staples 4 in a row are adjacent to each other.
  • the first gap S10 between staples and the second gap S20 between adjacent staples in another row 4 of staples may be connected by a straight channel S. That is, the suture inside and the suture outside (the upper side and the lower side of the two rows of staples in FIG. 6 ) are connected by a straight channel S.
  • the outside of suturing may refer to the side close to the wound, and the inside of suturing may refer to the side away from the wound.
  • blood vessels in lung tissue and pulmonary interstitium may be located in channel S without being fixed by staples 4 , and there is a greater risk of bleeding.
  • the linear channel S also has a greater risk of air leakage.
  • the staple cartridge assembly 302 of the present application may include a staple cartridge main body 1 , a staple pusher 2 , a spacer 3 , staples 4 and a bracket 5 .
  • the staple cartridge main body 1 is provided with a knife groove 11 and a staple cavity 12 .
  • the staple cavity 12 forms a staple cavity opening on the staple exit surface 13 of the staple cartridge body 1 , and when the staples 4 in the staple cavity 12 are fired, the staples 4 are pushed out from the staple cavity opening.
  • the nail cavities 12 can be located on the left and right sides of the knife groove 11, and a plurality of nail cavities 12 extending in the front-rear direction X form a row.
  • Two rows of nail cavities 12 are respectively arranged on both sides of the knife groove 11 .
  • Two rows of nail cavities 12 compared with three rows of nail cavities 12 make the size of the staple cartridge assembly 302 smaller in the left-right direction Y.
  • FIG. 10 it can be understood that when using a stapler to operate on the lung 100 , the end effector 30 is inserted into the body from the gap between two ribs to clamp the lung 100 .
  • the width of the staple cartridge assembly 302 in the left and right direction Y is small, which facilitates the insertion of the end effector 30 into the body from the gap between two ribs, facilitates surgical operations, and reduces the pain of the patient.
  • the staple 4 is arranged in a plurality of staple cavities 12, and the staple 4 includes a base 42 and two staple legs 41 (see, for example, FIGS. 11 to 14 ).
  • the base 42 is curved, which enables the staples to be more closely overlapped than conventional straight staples, resulting in a staple with greater staple coverage on the same area thread to reduce the possibility of tearing, leaking and/or bleeding after the stapling step. See below for a more detailed description of staples.
  • the contact area with the tissue is increased, the tissue is prevented from being crushed, and the effect of preventing blood seepage and air leakage is effectively realized.
  • the spacer 3 can be installed on the nail outlet surface 13 and cover the nail cavity opening of the nail cavity 12 .
  • the pads 3 are configured as a straight line passing through the third gap S1 and the fourth gap S2 between the pads 3 adjacent in the front-rear direction X (refer to FIG.
  • the solid line L1 and dotted line L2) in 9 must intersect with at least one gasket 3, in other words, the third gap S1 and the fourth gap S2 of the adjacent gasket 3 in the front-rear direction X extend from one side of the anastomotic area The passage to the other side of the anastomotic area cannot be non-linear.
  • the spacer 3 can increase the contact area between the staple 4 and the tissue, thereby reducing the pressure of the staple 4 on the tissue, effectively avoiding the risk of the staple 4 crushing the tissue due to the large suturing force, thereby reducing the risk of bleeding and air leakage .
  • the spacer 3 can also be pressed near the staple hole formed by the staple 4 on the tissue. By applying pressure to the tissue near the staple hole, the gap between the staple hole and the staple 4 can be reduced, thereby avoiding bleeding and leakage. gas.
  • the third gap S1 and the fourth gap S2 may hardly exist.
  • the width of the third gap S1 and the fourth gap S2 may be less than 1/15 of the length of a single spacer 3 , more preferably, less than 1/25 of the length of a spacer 3 .
  • the gap between two rows of shims 3 on the same side of the cutting groove 11 may be less than 1/15 of the width of a single shim 3 , more preferably, less than 1/25 of the width of a single shim 3 .
  • the staple exit surface 13 of the staple cartridge main body 1 can include a groove arranged around the opening of the staple cavity, and the gasket 3 can be installed on the staple exit surface 13 by interference fit with the groove, and the staple 4 can be pushed out of the staple by the push piece 2 When the cavity 12 is opened, the staple 4 can leave the main body 1 of the staple cartridge with the spacer 3 .
  • the spacer 3 can also be pasted on the staple exit surface 13 of the staple cartridge main body 1 or the groove of the staple exit surface 13, and when the staple pusher 2 pushes the staple 4 out of the staple cavity 12, the anastomosis The staple 4 can leave the staple cartridge main body 1 with the spacer 3 .
  • the spacer 3 can be, for example, a rectangular sheet, and the surface of the spacer 3 facing the outside of the nail cavity 12 can be a plane, so that the smooth plane of the spacer 3 can contact the tissue during the operation.
  • the spacer 3 can be provided with a through hole 33 through which the staple leg 41 of the staple 4 can pass through, for example, the staple leg 41 can pass through the through hole 33 during the firing process of the staple 4 .
  • the side of the gasket 3 facing the base 42 of the staple 4 may also be a plane. In this way, the surface of the spacer 3 is flat, the area to be pressed with the tissue is large, the configuration is simple, and the cost is low.
  • a plurality of spacers 3 can be formed by cutting or trimming sheet-shaped raw materials.
  • the staple legs 41 of the staple 4 can be engaged (for example, through elastic deformation) in the through hole 33, and in order to facilitate the clamping of the staple legs 41, the through hole 33 can be, for example, an L-shaped special-shaped hole. .
  • the staple legs 41 of the staple 4 can be inserted into the special-shaped hole from the side of the spacer 3 through the opening of the special-shaped hole, and then the staple 4 is released.
  • the staple legs 41 are used so that the staple 4 is clamped in the through hole 33 of the washer 3 by the tension of the two staple legs 41 . In this way, the staple 4 and the washer 3 can be put into the staple cavity 12 together (in the state where they are assembled).
  • the assembly process can be simplified.
  • the through hole 33 may also be a through hole that does not open on the side of the gasket 3 , such as, but not limited to, a circular hole.
  • the thickness of the gasket 3 can be as thin as possible, for example, the thickness of the gasket 3 can be 0.1 mm to 0.5 mm.
  • the ratio of the thickness to the width W of the gasket 3 may be 1:5 to 1:20, preferably 1:8 to 1:15.
  • FIG. 9 shows the width W of the substantially rectangular spacer 3 .
  • FIG. 17 shows the width W of a rectangular sheet-shaped gasket 3 whose long side is a convex arc, and the width W may be the maximum width of the gasket shown in the figure.
  • FIG. 18 shows the width W of the strip-shaped gasket 3 bent in an arc shape.
  • Figure 22 shows a spacer 3 corresponding to a plurality of staples 4, the width W of the spacer 3 can be the width of the part of the spacer corresponding to one (or a row) of staples 4, or in other words The width of the first plate portion 31 or the second plate portion 32 mentioned above.
  • the gasket 3 will remain in the human body after the operation, and the gasket 3 can be (but not limited to) made of absorbable, soluble or degradable materials or materials that are not easily reacted in the human body.
  • the absorbable material can be polyglycolic acid, and the pad 3 made of the absorbable material can disappear after being bonded with the tissue for a period of time.
  • the material that does not easily react in the human body may be a metal material, and an example of the metal material may be titanium alloy.
  • the shape of the gasket 3 is not limited to a rectangle.
  • the gasket 3 is formed into a rectangular piece whose long side is a protruding arc. side.
  • the spacers 3 are formed in a curved, especially arc-shaped, elongated sheet shape, and the curved convex sides are located on two sides of the spacers 3 in two rows that are far away from each other.
  • each staple cavity 12 can be provided with a staple 4
  • the staple pushing piece 2 is located at the bottom of the staple 4
  • the staple pushing piece 2 is used to push the staple 4 out of the staple cavity 12 .
  • the staple cartridge main body 1 is connected to the bracket 5, and the bracket 5 can block the lower opening of the knife groove 11 and the staple cavity 12, so that the push piece 2 and the staples 4 can be kept in the staple cavity 12.
  • the pusher plate 402 drives the pusher plate 2 to move toward the staple exit surface 13, so that the staples 4 leave the staple cavity 12, thereby suturing the tissue.
  • the staple 4 in the staple cavity 12 is fired to leave the staple cavity 12 , and the staple legs 41 abut against the staple seat 304 to bend, thereby suturing the tissue.
  • Two suturing areas can be respectively formed on both sides of the knife groove 11, and the nail pushing plate 402 moves forward along the knife groove 11 to cut the tissue from the middle of the two suturing areas.
  • FIG. 8 Three states of the staple 4 are shown in FIG. 8 , from right to left, the staple 4 completely leaves the nail cavity 12 after being fired; the staple 4 partially leaves the staple cavity 12 during the process of being fired; the staple The staple 4 remains in the staple cavity 12 unfired.
  • the staple 4 may include a staple leg 41 and a base 42.
  • the two staple legs 41 are connected to two ends 422 of the base 42 (see FIGS. 15 and 16 ).
  • the free ends of the two staple legs 41 can form sharp nail points, and the nail points make it easy for the staple 4 to penetrate into human tissue.
  • the two nail legs 41 are parallel to each other (including substantially parallel), and the nail legs 41 are substantially perpendicular to the base 42 .
  • the parallel (including substantially parallel) of the staple legs 41 is only intended to express the overall shape of the staple 4, in fact, the two staple legs 41 can be slightly opened at their distal ends (the end away from the base 42), thereby anastomosis
  • the nail 4 is a flared U-shape.
  • the two staple legs 41 can be slightly compressed, so that the staple 4 can be installed in the staple cavity 12 by the tension of the staple legs 41, so that the staple 4 is not easy to dislodge from the staple cavity 12. drop.
  • the base 42 is curved, more specifically, viewed along the extending direction of the two nail legs 41, the base 42 is curved, for example, the base 42 can be arc-shaped or V-shaped or W-shaped .
  • the cross-section of the nail chamber 12 can be adapted to the base 42, thereby guiding the staple 4 to move along the thickness direction of the staple cartridge assembly 302, where the cross-section of the nail chamber 12 can be adapted to the base 42, including the diameter of the nail chamber 12.
  • the cross section matches the base 42, for example, the cross section of the nail chamber 12 that accommodates the staples 4 is also arc-shaped or V-shaped or W-shaped;
  • the cross-section can also be rectangular, elliptical, etc.
  • a straight line passing through the first gap S10 and the second gap S20 between the adjacent staples 4 in the front-rear direction X must intersect with at least one staple 4, in other words, through the first gap S10 and the second gap S20 of the adjacent staples 4 in the front-rear direction X, one side of the staple cartridge assembly 302 in the left-right direction (or anastomosis
  • the channel extending from one side of the region) to the other side in the left-right direction Y of the staple cartridge assembly 302 (or called the other side of the stapling region) cannot be non-linear. In this way, the inside of the suture and the outside of the suture cannot be connected through a straight channel, and for lung surgery, the risk of bleeding and air leakage is reduced.
  • the two ends 422 of the base 42 of one row of staples 4 bend toward the middle part 421 of the other row of staples 4 Or bent (than the middle part of the base 42 of the row of staples 4) closer to the other row of staples.
  • the two ends 422 of the bases 42 of two adjacent rows of staples 4 are close to each other and staggered in the front-rear direction X (that is, in the front-rear direction X).
  • the second gap S2 between the adjacent staples 4 is staggered in the front-back direction X, so that the inside of the suture and the outside of the suture cannot be easily communicated, and for lung surgery, the risk of bleeding and air leakage can be reduced.
  • the staple cartridge assembly 302 of the second embodiment of the present application is similar in structure to the staple cartridge assembly 302 of the first embodiment, and the same or similar parts will not be described again, and the same reference numerals will be used to indicate them.
  • the staple cartridge assembly 302 may include a staple cartridge body 1 , a staple pusher 2 , a spacer 3 , staples 4 and a bracket 5 .
  • the staple cartridge main body 1 is provided with a nail cavity 12
  • the gasket 3 can be installed on the nail exit surface 13 of the staple cartridge main body 1 , and the gasket 3 covers the staple cavity opening on the nail exit surface 13 side of the staple cavity 12 .
  • Each spacer 3 can cover multiple staple cavity openings, so that each spacer 3 can allow multiple staples 4 to pass through.
  • Each spacer 3 can cover a plurality of different rows of adjacent nail cavities 12 (or in other words, cover a plurality of different rows of adjacent nail cavity openings), for example, each spacer 3 covers two nail cavities 12, the two The staple cavities 12 are different rows of staple cavities 12 .
  • a plurality of staple cavities (or claims, staple cavities) 12 covered by each spacer 3 may include a Nail cavities 12 of different rows.
  • one spacer 3 can also cover a whole row of nail cavities 12 on one side of the knife groove 11 or cover all the nail cavities 12 on one side of the knife groove 11 .
  • one side of the flute 11 may only have one or two shims 3 .
  • the gasket 3 may include a first plate portion 31 and a second plate portion 32, the first plate portion 31 is provided with two through holes 33 for matching with staples 4, the second plate portion 32 There are two through holes 33 for matching with another staple 4 .
  • the first plate portion 31 is passed by one staple 4 of one row, and the second plate portion 32 is passed by one staple 4 of the other row.
  • the first plate portion 31 and the second plate portion 32 are staggered along the front-rear direction X and the left-right direction Y, and the first plate portion 31 and the second plate portion 32 may be integrally formed.
  • a plurality of gaskets 3 may be connected together, and the plurality of gaskets 3 are connected through a breakable connection, for example, the breakable connection may be multiple Connecting parts arranged at intervals (for example, connecting parts with dotted line or dotted line structure).
  • the connecting portion can be disconnected, and the gasket 3 connected together can be torn into multiple pieces.
  • multiple spacers 3 can be connected together (that is, one spacer 3 corresponds to multiple staples 4, or even all staples 4 in the entire staple cartridge), preferably, at this time, Pad 3 is made of absorbable, soluble or degradable material.
  • the cutting steps during the formation of the spacer 3 can be reduced, and the spacer 3 can be quickly and accurately installed on the staple exit surface 13 of the staple cartridge main body 1, which can The production and assembly costs of the spacer 3 and the cartridge assembly 302 are reduced.
  • the nail anvil 304 can be sleeved with an end effector sleeve 6, and the end effector sleeve 6 can include a first piece 61 and a second piece 62 , the first piece 61 is located between the staple cartridge seat 303 and the nail anvil 304 , and the first piece 61 is opposite to the nail exit surface 13 .
  • the first sheet 61 may be made of absorbable, dissolvable or degradable material, an example of which may be polyglycolic acid.
  • the second piece 62 can be located on the side and the top of the nail anvil 304 .
  • the first sheet portion 61 and the second sheet portion 62 can form an elongated sleeve shape, which is sleeved on the nail abutment seat 304 .
  • the surface of the nail anvil 304 facing the nail outlet surface 13 is the nail abutment surface, and the nail abutment surface is formed with a nail abutment seat groove 3041, after the staple 4 is fired and the staple leg 41 penetrates the tissue, the staple leg 41 can be pressed against the The nail seat groove 3041 is bent to make the staple 4 be stapled to the tissue.
  • the staple leg 41 can pass through the first piece 61, and the staple leg 41 can be pressed against the nail seat groove 3041 to be bent, so that the staple 4 and the first piece 61 are stapled together on the tissue .
  • the first sheet portion 61 can prevent tissue bleeding and air leakage.
  • the first sheet part 61 and the second sheet part 62 can be stitched together by thread, after the first sheet part 61 is stapled to the tissue, the first sheet part 61 and the second sheet part 62 can be separated by removing the thread, and the second sheet part 61 can be separated.
  • the two pieces 62 are taken out from the body.
  • first sheet part 61 and the second sheet part 62 can also be connected by a breakable connection part, for example, the breakable connection part can be a plurality of connection parts arranged at intervals (for example, a connection part with a dotted line or a dotted line structure).
  • first piece 61 and the second piece 62 do not have to be made of the same material.
  • the function of the end effector sleeve 6 is similar to that of the spacer 3.
  • the end effector sleeve 6 can increase the contact area between the staple 4 and the tissue, avoiding the staple 4 from crushing the tissue under a large suture force, thereby reducing bleeding , The risk of air leakage.
  • the end effector sleeve 6 can be sleeved on the nail abutment seat 304 .
  • the end effector cover 6 can alternatively or additionally be sleeved on the nail cartridge seat 303 on which the staple cartridge assembly 302 is installed, for example, the end effector cover 6 can be sleeved on the The staple cartridge holder 303 with the staple cartridge assembly 302 installed without the spacer 3 .
  • end effector 30 is not limited to the form shown in the drawings, for example, the end effector 30 can also be curved or circular as in some prior art. In this way, the nail-exiting surface 13 can also be curved or annular.

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Abstract

一种钉仓组件(302)及外科器械。钉仓组件(302)包括：钉仓主体(1)，其设置有多个钉腔(12)，钉腔(12)在钉仓主体(1)的出钉面(13)具有钉腔开口，其中，钉仓主体(1)设置有供切割刀组件(40)运动的走刀槽(11)，走刀槽(11)沿钉仓组件(302)的前后方向(X)延伸，在走刀槽(11)的两侧各设置有两排钉腔(12)，每排钉腔(12)均沿前后方向(X)延伸；多个吻合钉(4)，多个吻合钉(4)设置在多个钉腔(12)内，吻合钉(4)包括基部(42)和两个钉腿(41)，每个钉腿(41)分别连接于基部(42)的两端部中的一个，沿两个钉腿(41)的延伸方向观察，基部(42)是弯曲的；垫片(3)，垫片(3)安装于出钉面(13)并且覆盖钉腔开口；在吻合钉(4)被击发时，吻合钉(4)从钉腔开口被推出，并且吻合钉(4)带着垫片(3)与出钉面(13)分离。钉仓组件(302)能够有效避免吻合钉(4)压伤组织，有效地避免渗血、漏气风险。

Description

钉仓组件及外科器械
相关申请
本申请要求于2021年9月1日提交至中国专利局、申请号为202111019429.1，申请名称为“钉仓组件及外科器械”，以及于2021年9月1日提交至中国专利局、申请号为202122093195.7，申请名称为“钉仓组件及外科器械”的中国专利申请的优先权，其全部内容通过引用结合在本申请中。
技术领域
本申请涉及医疗器械领域，具体涉及一种钉仓组件及外科器械。
背景技术
外科器械可以包括端部执行器，端部执行器包括钉仓座和抵钉座，钉仓座用于接收钉仓组件；钉仓组件包括钉仓主体和设置在钉仓主体内的吻合钉，钉仓主体内设置有若干用于收纳吻合钉的缝钉腔，钉仓主体包括顶端面，顶端面上设有由缝钉腔贯穿顶端面形成的出钉口。
一旦医生确定端部执行器夹持了目标组织，就可以击发外科切割吻合器，从而切断并缝合组织。缝合时，顶端面与被缝合组织接触，外科切割吻合器内的切割件推动钉仓内的楔形推钉块运动，从而使吻合钉驱动器驱动钉仓内的吻合钉从缝钉腔内向上运动，刺穿并缝合目标组织(即吻合钉出钉)。
现有技术中，吻合钉直接钉在组织上，吻合钉与组织的接触面积较小，压强较大，容易使组织损伤，特别是对于肺部的手术，容易出现漏气、渗血的风险。并且，吻合钉在成形过程中，相应的钉孔和吻合钉之间也存在缝隙，可能导致漏气、渗血。另外，现有技术采用的钉仓组件宽度过大，通过端部执行器从两根肋骨之间的缝隙***体内时，容易损伤肋骨，造成患者术后肋骨疼痛。
申请内容
为了克服现有技术的上述缺陷，本申请旨在提出一种钉仓组件及外科器械，能够有效避免吻合钉压伤组织，有效地避免渗血、漏气风险。
本申请提供一种钉仓组件，其包括：
钉仓主体，其设置有多个钉腔，钉腔在钉仓主体的出钉面具有钉腔开口，其中，钉仓主体设置有供切割刀组件运动的走刀槽，走刀槽沿钉仓组件的前后方向延伸，在走刀槽的两侧各设置有两排钉腔，每排钉腔均沿前后方向延伸；
多个吻合钉，多个吻合钉设置在多个钉腔内，吻合钉包括基部和两个钉腿，每个钉腿分别连接于基部的两端部中的一个，沿两个钉腿的延伸方向观察，基部是弯曲的；
垫片，垫片安装于出钉面并且覆盖钉腔开口；
在吻合钉被击发时，吻合钉从钉腔开口被推出，并且吻合钉带着垫片与出钉面分离。
在至少一个实施方式中，垫片呈片状。
在至少一个实施方式中，垫片的厚度与宽度的比值为1∶5至1∶20。
在至少一个实施方式中，垫片的厚度与宽度的比值为1∶8至1∶15。
在至少一个实施方式中，垫片的厚度为0.1毫米至0.5毫米。
在至少一个实施方式中，通过位于走刀槽同侧且在前后方向上相邻的吻合钉之间的第一间隙和第二间隙的直线总会与至少一个位于走刀槽同侧的吻合钉相交。
在至少一个实施方式中，钉仓组件包括多个垫片，通过位于走刀槽同侧且在前后方向上相邻的垫片之间的第三间隙和第四间隙的直线总会与至少一个位于走刀槽同侧的垫片相交。
在至少一个实施方式中，在前后方向上相邻的垫片之间的第三间隙和第四间隙的宽度小于单个垫片的长度的1/15；和/或
走刀槽的同一侧的两排垫片之间的间隙小于单个垫片的宽度的1/15。
在至少一个实施方式中，基部为弧形或V字形或W字形，在走刀槽的同侧的两排吻合钉中，一排吻合钉的基部的两端部向另一排吻合钉弯曲而靠近该另一排吻合钉，钉腔的横截面与基部相适应，从而引导吻合钉沿钉仓组件的厚度方向移动。
在至少一个实施方式中，位于走刀槽的同侧的两排钉腔交错设置。
在至少一个实施方式中，钉仓组件包括多个垫片，每个垫片覆盖多个钉腔开口，从而每个垫片可供多个吻合钉穿过。
在至少一个实施方式中，每个垫片覆盖的多个钉腔开口包括位于走刀槽的一侧的不同排的钉腔开口。
在至少一个实施方式中，一个垫片覆盖走刀槽的一侧的一整排钉腔或覆盖走刀槽的一侧的全部钉腔。
在至少一个实施方式中，垫片包括第一板部和第二板部，第一板部和第二板部沿前后方 向和钉仓组件的左右方向错开，第一板部和第二板部是一体形成的，第一板部设置有两个与一个吻合钉配合的通孔，第二板部设置有两个与另一个吻合钉配合的通孔。
在至少一个实施方式中，钉仓组件包括多个垫片，两个或更多个垫片通过易断连接部连接在一起。
在至少一个实施方式中，钉仓组件包括多个垫片，钉仓主体的出钉面包括围绕钉腔开口设置的凹槽，垫片通过与凹槽过盈配合而安装于出钉面。
在至少一个实施方式中，垫片粘贴于出钉面。
在至少一个实施方式中，垫片具有供钉腿穿过的通孔，通孔可以为朝向垫片的侧方开放的异形孔。
还提供一种外科器械，其包括端部执行器，端部执行器包括钳口组件，钳口组件包括：用于安装钉仓组件的钉仓座；以及能相对于钉仓座打开和闭合的抵钉座，
其中，端部执行器还包括能够套装于钉仓座和/或抵钉座的端部执行器套。
在至少一个实施方式中，端部执行器还包括安装于钉仓座的钉仓组件，钉仓组件可以为根据本申请的钉仓组件；端部执行器套套装于钉仓组件和钉仓座。
在至少一个实施方式中，端部执行器套包括第一片部和第二片部，第一片部与第二片部可分离地连接，在端部执行器套套装于钉仓座和/或抵钉座时，第一片部位于钉仓座和抵钉座之间。
可选地，第一片部可以由可吸收、可溶解或可降解的材料制成。
在至少一个实施方式中，第一片部和第二片部通过线缝合在一起，通过拆除线能够使第一片部和第二片部分离，或者第一片部和第二片部通过易断连接部连接在一起。
在至少一个实施方式中，端部执行器套套装于抵钉座，
端部执行器还包括安装于钉仓座的钉仓组件，钉仓组件为根据本申请的钉仓组件。
本申请通过在钉仓主体上安装垫片，可以使吻合钉与垫片一起钉在组织上，增加吻合钉和垫片与组织的接触面积，使接触面积内压力均匀，避免缝合肺组织、肺间质等组织或器官时压伤组织，同时避免渗血、漏气风险；同时，垫片还可以压在吻合钉在组织上形成的钉孔附近，通过对钉孔附近的组织施压，可以减小钉孔和吻合钉之间的缝隙，也可以避免钉孔发生渗血、漏气的现象。另外，吻合钉的基部是弯曲的，如基部为弧形或V字形或W字形的吻合钉，相较于常规的直线钉能使得吻合钉更紧密地重叠布置，在相同区域上产生具有更大钉覆盖率的钉线，以减少在吻合步骤之后撕裂、渗漏和/或渗血的可能性。
端部执行器套可以起到与垫片类似的效果。端部执行器套和垫片可以一起使用或单独使 用。
本申请还提供包括上述钉仓组件和/或端部执行器的吻合器。
附图说明
图1示出了根据本申请的一个实施方式的吻合器的结构示意图；
图2示出了根据本申请的一个实施方式的吻合器的端部执行器的***图；
图3示出了一种可能的钉仓组件的结构示意图；
图4示出了一种可能的钉仓组件的俯视图；
图5示出沿图4中的A-A线的剖视图；
图6示出了一种可能的钉仓组件的吻合钉的分布状态示意图；
图7示出了根据本申请的第一实施方式的钉仓组件的结构示意图；
图8示出沿图7中的B-B线的剖视图；
图9示出了根据本申请的第一实施方式的钉仓组件的垫片和吻合钉的分布状态示意图；
图10示出了根据本申请的第一实施方式的吻合器用于肺部手术的示意图；
图11示出了根据本申请的一种可能的钉仓组件的吻合钉的结构示意图；
图12示出了根据本申请的一种可能的钉仓组件的吻合钉的另一角度的结构示意图；
图13示出了根据本申请的另一种可能的钉仓组件的吻合钉的结构示意图；
图14示出了根据本申请的另一种可能的钉仓组件的吻合钉的另一角度的结构示意图；
图15示出了根据本申请的一种可能的钉仓组件的吻合钉的分布状态示意图；
图16示出了根据本申请的另一种可能的钉仓组件的吻合钉的分布状态示意图；
图17示出了根据本申请的一种可能的钉仓组件的垫片和吻合钉的分布状态示意图；
图18示出了根据本申请的另一种可能的钉仓组件的垫片和吻合钉的分布状态示意图；
图19示出了根据本申请的第二实施方式的钉仓组件的结构示意图；
图20示出沿图19中的C-C线的剖视图；
图21示出了根据本申请的第二实施方式的钉仓组件的垫片和吻合钉的分布状态示意图；
图22示出了根据本申请的第二实施方式的钉仓组件的垫片和吻合钉的放大示意图；
图23示出了根据本申请的一个实施方式的端部执行器的结构示意图；
图24示出了吻合钉未接触抵钉座的结构示意图；
图25示出了吻合钉接触抵钉座而变形的结构示意图。
附图标记说明
10、操作组件；20、杆身组件；30、端部执行器；301、钳口组件；302、钉仓组件；303、钉仓座；304、抵钉座；3041、抵钉座槽；40、切割刀组件；401、刀杆；402、推钉板；1、钉仓主体；11、走刀槽；12、钉腔；13、出钉面；2、推钉片；3、垫片；31、第一板部；32、第二板部；33、通孔；4、吻合钉；41、钉腿；42、基部；421、中间部；422、端部；5、托架；6、端部执行器套；61、第一片部；62、第二片部；100、肺部；S、通道；S10、第一间隙；S20、第二间隙；S1、第三间隙；S2、第四间隙；X、前后方向；Y、左右方向；L0、直线(虚线)；L1、直线(实线)；L2、直线(虚线)。
具体实施方式
为了使本申请的目的、技术方案及优点更加清楚明白，以下结合附图及实施例，对本申请进行进一步详细说明。应当理解，此处所描述的具体实施例仅用以解释本申请，并不用于限定本申请。基于本申请中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本申请保护的范围。
需要理解的是，本文所用术语“近”、“后”和“远”、“前”是相对于操纵吻合器的临床医生而言的。术语“近”、“后”是指相对靠近临床医生(或者说，相对靠近吻合器的操作组件10，参见图1)的部分，术语“远”、“前”则是指相对远离临床医生(或者说，相对远离吻合器的操作组件10，或相对靠近吻合器的端部执行器30，参见图1)的部分。术语“上”“下”以钳口组件301的抵钉座304和钉仓座303的相对位置为参考，具体的，抵钉座304在“上”，钉仓座303在“下”。然而，吻合器可以在许多方向和位置使用，因此这些表达相对位置关系的术语并不是受限和绝对的。
在本申请中，除非另有明确的规定和限定，“相连”、“连接”等术语应做广义理解，例如，可以是固定连接，也可以是可拆卸地连接，还可以是可运动地连接，或成一体；可以是直接相连，也可以通过中间媒介间接相连，可以是两个元件内部的连通或两个元件的相互作用关系如抵接。对于本领域的普通技术人员而言，可以根据具体情况理解上述术语在本申请中的具体含义。
(第一实施方式)
如图1和图2所示，本申请提供一种吻合器，该吻合器包括操作组件10、自操作组件10向前延伸的杆身组件20、设在杆身组件20一端(前端)的端部执行器30以及用于执行组织切割的切割刀组件40。
操作组件10包括壳体和动力源模块。在一个实施方式中，动力源模块包括用户手动操作的手柄，连接到下述传动装置。在另一个实施方式中，动力源模块包括设置在壳体内的电机和电源模块，电源模块包括电池，用于为电机提供旋转所需电能，电机连接到下述传动装置。动力源模块的类型不限制本申请的保护范围。下面，以动力源模块包括电机和电源模块为例描述吻合器的整体功能。
操作组件10的壳体按照位置关系可以包括相连的手柄壳体和头部壳体，头部壳体可以收容传动机构，手柄壳体可供用户握持。
杆身组件20可以包括芯轴及套设于芯轴的套管。吻合器可以还包括与动力源模块连接的传动装置，传动装置可以包括第一传动机构和第二传动机构。可以通过第一传动机构驱动套管(相对于操作组件10，或者说，相对于操作组件10的壳体)沿轴向移动，可以通过第二传动机构驱动芯轴(相对于操作组件10，或者说，相对于操作组件10的壳体)沿轴向移动，套管和芯轴均可以沿轴向向前或向后移动。
端部执行器30可以包括钳口组件301和钉仓组件302。钳口组件301可以包括钉仓座303和可枢转地连接于钉仓座303的抵钉座304，钉仓座303用于可操作地支撑位于其中的钉仓组件302。抵钉座304可在打开位置和闭合位置之间选择性地运动，实现在打开状态和闭合状态之间的切换，从而抵钉座304和钉仓组件302配合而松开或夹紧组织。
套管的一端(前端)连接于抵钉座304，另一端(后端)连接于第一传动机构，第一传动机构可驱动套管向后或向前移动。套管的向后移动可使得抵钉座304向上枢转以打开钳口组件301，套管的向前移动可使得抵钉座304向下枢转以闭合钳口组件301。
切割刀组件40与芯轴连接以被芯轴驱动执行击发动作或退刀动作。具体的，切割刀组件40包括刀杆401以及位于刀杆401前端的推钉板402。
芯轴的一端(前端)位于套管内，另一端(后端)连接于第二传动机构。切割刀组件40的一部分位于套管内且与芯轴的前端连接。在缝合和切割过程中，推钉板402位于钉仓座303和抵钉座304之间形成的空间内。第二传动机构可驱动芯轴向前和向后运动。当安装了钉仓组件302时，芯轴的向前移动可使得推钉板402向前移动，推动钉仓组件302的吻合钉4出钉来缝合组织并由切割刀组件40的切割刀切割组织。芯轴的向后移动 可使得切割刀组件40向后移动，以恢复至初始位置。
可以理解，吻合器使用吻合钉4来钉合组织，如本领域技术人员所知地，这通常也被称为吻合或缝合。
下面简单介绍(电动)吻合器缝合切割组织的过程。
钳口组件301闭合，电机通过第一传动机构驱动钳口组件301闭合而夹紧组织。
切割刀组件40击发，电机通过第二传动机构驱动切割刀组件40前进而缝合和切割组织。
切割刀组件40退刀，电机通过第二传动机构驱动切割刀组件40后退。
钳口组件301打开，电机通过第一传动机构驱动钳口组件301打开而松开组织，从而实现吻合器的缝合和切割功能。
如图2至图6所示，一种可能的钉仓组件302可以包括钉仓主体1、推钉片2、吻合钉4和托架5。
钉仓主体1设置有走刀槽11和钉腔12，走刀槽11供切割刀组件40运动并为切割刀组件40的运动提供导向，因此，走刀槽11还可以被称为引导槽。在钉仓组件302的左右方向Y(还可以被称为宽度方向)上，钉腔12位于走刀槽11的左右两侧，沿前后方向X延伸的多个钉腔12形成为一排，可以在走刀槽11的两侧各设置有多排钉腔12，例如，在图3和图4所示的示例中，走刀槽11的两侧各设置有三排钉腔12。多排钉腔12可以容纳多排吻合钉，可以使吻合钉缝合组织的宽度较宽。
每个钉腔12内可以设有一个吻合钉4，推钉片2位于吻合钉4的底部，推钉片2用于将吻合钉4推出钉腔12。钉仓主体1和托架5连接，托架5可以堵住走刀槽11和钉腔12的下部开口，使推钉片2和吻合钉4能够保持在钉腔12内。
在切割刀组件40向前运动时，推钉板402击发推钉片2向出钉面13运动，使吻合钉4离开钉腔12，从而缝合组织。
在图5中示出了吻合钉4的三种状态，从右至左依次为吻合钉4被击发后完全离开钉腔12，吻合钉4在被击发的过程中部分地离开钉腔12，吻合钉4未被击发而保持在钉腔12内。
参见图6，俯视观察多排吻合钉4，或者说，在钉仓组件302中的吻合钉4被击发接合于组织后，在组织上形成多排吻合钉4，一排吻合钉4中相邻吻合钉之间的第一间隙S10和另一排吻合钉4中相邻吻合钉之间的第二间隙S20可以由直线的通道S连接。即，缝合内部和缝合外部(图6中两排吻合钉的上侧和下侧)通过直线的通道S连接。 可以理解，缝合外部可以是指靠近创口的一侧，缝合内部可以是指远离创口的一侧。
上述钉仓组件302用于肺部手术时，存在如下问题。
(i)如图4所示的三排吻合钉使得钉仓组件302的宽度大，端部执行器30从两根肋骨之间的缝隙***体内时，容易造成肋骨疼痛。
(ii)钉孔处容易出现渗血、漏气现象。
(iii)吻合钉的基部与组织的接触面积小，压强大，容易损伤组织，渗血、漏气。
参照图6，肺部组织、肺间质中的血管，例如毛细血管，可能位于通道S而没有被吻合钉4所固定，存在较大的渗血风险。而且对于肺部手术来说，由于肺部组织中存在空气，直线形的通道S还存在较大漏气风险。
如图7至图9所示，为解决上述问题，本申请的钉仓组件302可以包括钉仓主体1、推钉片2、垫片3、吻合钉4和托架5。
钉仓主体1设置有走刀槽11和钉腔12。钉腔12在钉仓主体1的出钉面13形成钉腔开口，钉腔12中的吻合钉4被击发时，吻合钉4从钉腔开口被推出。在钉仓组件302的左右方向Y上，钉腔12可以位于走刀槽11的左右两侧，沿前后方向X延伸的多个钉腔12形成为一排，在图7所示的示例中，在走刀槽11的两侧各设置有两排钉腔12。两排钉腔12相比于三排钉腔12使钉仓组件302可以在左右方向Y上尺寸较小。如图10所示，可以理解，使用吻合器对肺部100进行手术时，端部执行器30从两根肋骨之间的缝隙***体内夹持肺部100。钉仓组件302的左右方向Y上的宽度较小，方便端部执行器30从两根肋骨之间的缝隙***体内，方便进行手术操作，减少患者的痛苦。
吻合钉4设置在多个钉腔12内，吻合钉4包括基部42和两个钉腿41(参见例如图11至图14)，每个钉腿41分别连接于基部42的两端部中的一个，沿两个钉腿41的延伸方向观察，基部42是弯曲的，相较于常规的直线吻合钉能够使得吻合钉更紧密地重叠布置，在相同区域上产生具有更大钉覆盖率的钉线，以减少在吻合步骤之后撕裂、渗漏和/或渗血的可能性。关于吻合钉更为详细的描述参见下文。同时，通过后述的垫片的结构，增大与组织的接触面积，避免压伤组织，有效地实现避免渗血、漏气的效果。
如图8和图9所示，垫片3可以安装于出钉面13并且覆盖钉腔12的钉腔开口。这里，优选地，在走刀槽11的同一侧，垫片3被构造成，通过在前后方向X上相邻的垫片3之间的第三间隙S1和第四间隙S2的直线(参照图9中的实线L1和虚线L2)必然与至少一个垫片3相交，换言之，通过在前后方向X上相邻的垫片3的第三间隙S1、第四间隙S2由吻合区域的一侧延伸到吻合区域的另一侧的通道不可能是非直线状的。垫片3可 以增大吻合钉4与组织的接触面积，从而减小吻合钉4对组织的压强，有效避免较大缝合力使吻合钉4压伤组织的风险，进而降低渗血、漏气风险。垫片3还可以压在吻合钉4在组织上形成的钉孔附近，通过对钉孔附近的组织施压，可以减小钉孔和吻合钉4之间的缝隙，从而避免发生渗血、漏气。
这里，优选地，第三间隙S1和第四间隙S2可以几乎不存在。例如，第三间隙S1和第四间隙S2的宽度可以小于单个垫片3的长度的1/15，更优选地，小于垫片3的长度的1/25。
优选地，走刀槽11同一侧的两排垫片3之间几乎不存在间隙。例如，走刀槽11的同一侧的两排垫片3之间的间隙可以小于单个垫片3的宽度的1/15，更优选地，小于单个垫片3的宽度的1/25。
钉仓主体1的出钉面13可以包括围绕钉腔开口设置的凹槽，垫片3可以通过与凹槽过盈配合而安装于出钉面13，在推钉片2将吻合钉4推出钉腔12时，吻合钉4可以带着垫片3脱离钉仓主体1。
在一种可能的实施方式中，垫片3也可以粘贴于钉仓主体1的出钉面13或者出钉面13的凹槽，在推钉片2将吻合钉4推出钉腔12时，吻合钉4可以带着垫片3脱离钉仓主体1。
如图9和图11所示，垫片3可以为例如矩形的片状，垫片3的朝向钉腔12的外部的表面可以为平面，实施手术时可以使垫片3的光滑的平面接触组织。垫片3可以设置有可以使吻合钉4的钉腿41穿过的通孔33，例如在吻合钉4击发的过程中钉腿41可以穿过通孔33。垫片3的朝向吻合钉4的基部42的一侧也可以为平面。这样，垫片3的表面平整，与组织的压合面积大，构型简单、成本低，可以通过切割或裁切片状原材来形成多个垫片3。
在一种可能的实施方式中，吻合钉4的钉腿41可以(例如，通过弹性变形)卡接于通孔33，为了方便钉腿41卡接，通孔33可以是例如L形的异形孔。具体地，可以在使吻合钉4的钉腿41彼此略靠近的状态下，从垫片3的侧方通过异形孔的开口将吻合钉4的钉腿41装入异形孔，然后释放吻合钉4的钉腿41，使吻合钉4通过两个钉腿41的张力卡接在垫片3的通孔33中。这样，可以将吻合钉4和垫片3一起(在二者装配的状态下)装入钉腔12。可以简化装配过程。
当然，本申请不限于此，例如，通孔33也可以是不在垫片3的侧方开口的通孔，例如，但不限于圆孔。
为了节省空间，在保证垫片3的强度的前提下，垫片3的厚度可以尽量的薄，例如垫片3的厚度可以为0.1毫米至0.5毫米。
垫片3的厚度与宽度W的比值可以为1∶5至1∶20，优选地，为1∶8至1∶15。图9示出了大致长方形的垫片3的宽度W。图17示出了一个长边为凸出的圆弧的矩形片状的垫片3的宽度W，该宽度W可以是图示垫片的最大宽度。图18示出了呈圆弧形弯曲的长条片状的垫片3的宽度W。图22示出了对应于多个吻合钉4的垫片3，该垫片3的宽度W可以是该垫片的对应于一个(或一排)吻合钉4的部分的宽度，或者说是后述的第一板部31或第二板部32的宽度。
手术后垫片3会留在人体内，垫片3可以(但不限于)由可吸收、可溶解或可降解的材料或不易在人体内发生反应的材料制成。例如可吸收材料可以是聚乙醇酸，可吸收材料制成的垫片3可以在和组织接合一段时间后消失。例如不易在人体内发生反应的材料可以为金属材料，该金属材料的示例可以是钛合金。
如图17和图18所示，在其他可能的实施方式中，垫片3的形状不限于矩形。例如，在图17所示的示例中，垫片3形成为一个长边为凸出的圆弧的矩形片状，优选地，该凸出的圆弧位于两排垫片3的彼此远离的两侧。在图18所示的示例中，垫片3形成为弯曲的、特别是圆弧形弯曲的长条片状，该弯曲的凸出侧位于两排垫片3的彼此远离的两侧。
这里，在走刀槽11的同一侧，仍满足，通过在前后方向X上相邻的垫片3的第三间隙S1、第四间隙S2的直线必然与至少一个垫片3相交，换言之，通过在前后方向X上相邻的垫片3的第三间隙S1、第四间隙S2由吻合区域的一侧延伸到吻合区域的另一侧的通道不可能是直线状的。
如图8所示，每个钉腔12内可以设有一个吻合钉4，推钉片2位于吻合钉4的底部，推钉片2用于将吻合钉4推出钉腔12。钉仓主体1和托架5连接，托架5可以堵住走刀槽11和钉腔12的下部开口，使推钉片2和吻合钉4能够保持在钉腔12内。
在切割刀组件40向前(图8中的左侧)运动时，推钉板402击发推钉片2向出钉面13侧运动，使吻合钉4离开钉腔12，从而缝合组织。同时参照图24和图25，钉腔12中的吻合钉4被击发而离开钉腔12，钉腿41抵接抵钉座304而发生弯曲，从而将组织缝合。可以在走刀槽11两侧分别形成两个缝合区域，推钉板402沿走刀槽11向前运动使组织从两个缝合区域中间被切开。
在图8中示出了吻合钉4的三种状态，从右至左依次为吻合钉4被击发后完全离开钉腔12；吻合钉4在被击发的过程中部分地离开钉腔12；吻合钉4未被击发保持在钉腔 12内。
吻合钉4可以包括钉腿41和基部42，两个钉腿41连接于基部42的两端部422(参照图15、图16)，钉腿41和基部42的连接部分可以通过圆角过渡。两个钉腿41的自由端可以形成尖锐的钉尖，钉尖使吻合钉4容易刺入人体组织。两个钉腿41相互平行(包括大致平行)，钉腿41与基部42大致垂直。吻合钉4未被击发时，吻合钉4位于钉腔12内，且钉尖不超过钉仓主体1的出钉面13。
可以理解，钉腿41相互平行(包括大致平行)只是想表达吻合钉4的整体形状，实际上，两个钉腿41可以在其远端(远离基部42的那端)略微张开，从而吻合钉4呈扩口的U字形。在将吻合钉4装入钉腔12中时，两个钉腿41可以略微地被压缩，从而吻合钉4可以依靠钉腿41的张力安装于钉腔12，从而吻合钉4不易从钉腔12掉落。
如图11至图14所示，基部42是弯曲的，更具体地，沿两个钉腿41的延伸方向观察，基部42是弯曲的，例如基部42可以为圆弧形或V字形或W字形。相应地，钉腔12的横截面可以与基部42相适应，从而引导吻合钉4沿钉仓组件302的厚度方向移动，此处钉腔12的横截面可以与基部42相适应包括钉腔12的横截面与基部42相匹配，例如，容纳吻合钉4的钉腔12的横截面也是圆弧形或V字形或W字形；也包括钉腔12的横截面能够容纳基部42，如，钉腔12的横截面也可以为矩形、椭圆形等。
参照图15，在走刀槽11的同一侧，优选地，通过在前后方向X上相邻的吻合钉4之间的第一间隙S10和第二间隙S20的直线(参照图15中的虚线L0)必然与至少一个吻合钉4相交，换言之，通过在前后方向X上相邻的吻合钉4的第一间隙S10、第二间隙S20由钉仓组件302的左右方向上的一侧(或称吻合区域的一侧)延伸到钉仓组件302的左右方向Y上的另一侧(或称吻合区域的另一侧)的通道不可能是非直线状的。这样可以使缝合内部和缝合外部不能通过直线的通道连接，对于肺部手术来说，降低渗血、漏气的风险。
可以理解，图9和图17所示的示例也满足这一情况。
如图15和图16所示，在走刀槽11的同侧的两排吻合钉4中，一排吻合钉4的基部42的两端部422向另一排吻合钉4的中间部421弯曲或弯折而(比该一排吻合钉4的基部42的中间部)靠近该另一排吻合钉。在俯视观察多排吻合钉4，或者说在吻合钉4被钉在组织时，两排相邻的吻合钉4的基部42的两端部422彼此靠近且在前后方向X上错开(即，在前后方向X上彼此重叠，或者说，沿左右方向Y观察，彼此遮挡)，使一排吻合钉4中的相邻吻合钉4之间的第一缝隙S1和另一排吻合钉4中的相邻吻合钉4之 间的第二缝隙S2在前后方向X上错开，使缝合内部和缝合外部不能容易地连通，对于肺部手术来说，可以降低渗血、漏气的风险。
(第二实施方式)
本申请的第二实施方式的钉仓组件302与第一实施方式的钉仓组件302结构相似，对于它们相同或相似的部分不再赘述，并且使用相同的附图标记表示。
如图19至图22所示，钉仓组件302可以包括钉仓主体1、推钉片2、垫片3、吻合钉4和托架5。钉仓主体1设置有钉腔12，垫片3可以安装于钉仓主体1的出钉面13，垫片3覆盖在钉腔12的出钉面13侧的钉腔开口。
每个垫片3可以覆盖多个钉腔开口，从而每个垫片3可供多个吻合钉4穿过。每个垫片3可以覆盖多个不同排的相邻钉腔12(或者说，覆盖多个不同排的相邻钉腔开口)，例如每个垫片3覆盖两个钉腔12，这两个钉腔12是不同排的钉腔12。在吻合钉4被钉合于组织时，不同排的两个吻合钉4穿过垫片3，由两个吻合钉4对一个垫片3进行固定，也就是有4个固定点对垫片3进行固定，使垫片3与组织充分接触，受力均衡，避免垫片3与组织接触时发生偏转，有效避免渗血、漏气的现象。
每个垫片3覆盖的多个钉腔(或称，缝钉腔)12(这里的多个不限于例如图20至图22所示的两个)可以包括位于走刀槽11的一侧的不同排的钉腔12。
另外，一个垫片3还可以覆盖走刀槽11的一侧的一整排钉腔12或覆盖走刀槽11的一侧的全部钉腔12。换言之，走刀槽11的一侧可以仅具有一个或两个垫片3。
如图21和图22所示，垫片3可以包括第一板部31和第二板部32，第一板部31设置有两个与吻合钉4配合的通孔33，第二板部32设置有两个与另一吻合钉4配合的通孔33。第一板部31由一排的一个吻合钉4穿过，第二板部32由另一排的一个吻合钉4穿过。第一板部31和第二板部32沿前后方向X和左右方向Y错开，第一板部31和第二板部32可以是一体形成的。
在一种可能的实施方式中，在吻合钉4未击发时，多个垫片3可以是连接在一起的，多个垫片3通过易断连接部相连，例如易断连接部可以是多个间隔设置的连接部(例如，虚线或点划线结构的连接部)。在击发吻合钉4时，连接部可以断开，连接在一起的垫片3可以被撕开为多片。
在另一种可能的实施方式中，多个垫片3可以连接在一起(即，一个垫片3对应多个吻合钉4，甚至整个钉仓的全部吻合钉4)，优选地，此时，垫片3是由可吸收、可溶 解或可降解的材料制成的。
如图21所示，在一个垫片3供多个吻合钉4穿过时，增大了垫片3的面积，进而增大了垫片3与组织接触的面积。这样，对于肺部手术来说，可以有效避免渗血、漏气的现象。另外，这也便于垫片3安装到钉仓主体1。
另外，在一个垫片3供多个吻合钉4穿过时，可以减少垫片3成形时的切割步骤，便于垫片3快速、对位准确地安装到钉仓主体1的出钉面13，可以减小垫片3和钉仓组件302的生产和组装成本。
如图23至图25所示，在一种可能的实施方式中，抵钉座304可以套设有端部执行器套6，端部执行器套6可以包括第一片部61和第二片部62，第一片部61位于钉仓座303和抵钉座304之间，第一片部61与出钉面13相对。第一片部61可以由可吸收、可溶解或可降解的材料制成，可吸收材料的示例可以是聚乙醇酸。第二片部62可以位于抵钉座304的侧面和上面。第一片部61和第二片部62可以构成长条形的套状，套在抵钉座304上。
抵钉座304的朝向出钉面13的表面为抵钉面，抵钉面形成有抵钉座槽3041，在吻合钉4被击发，钉腿41刺穿组织后，钉腿41可以压抵于抵钉座槽3041而弯曲，使吻合钉4钉合在组织上。
吻合钉4被击发后，钉腿41可以穿过第一片部61，并且钉腿41可以压抵于抵钉座槽3041而弯曲，使吻合钉4和第一片部61一起钉在组织上。第一片部61可以防止组织渗血、漏气。第一片部61和第二片部62可以通过线缝合在一起，在第一片部61钉合在组织后，可以通过拆除线使第一片部61和第二片部62分离，将第二片部62从体内取出。另外，第一片部61和第二片部62还可以通过易断连接部相连，例如易断连接部可以是多个间隔设置的连接部(例如，虚线或点划线结构的连接部)。
可以理解，第一片部61和第二片部62不必由同种材料制成。
端部执行器套6的作用与垫片3相似，端部执行器套6可以增大吻合钉4与组织的接触面积，避免较大缝合力下吻合钉4压伤组织，进而可以降低渗血、漏气的风险。端部执行器套6可以套设于抵钉座304。另外，端部执行器套6还可以替代地或额外地套设于安装有钉仓组件302的钉仓座303，例如端部执行器套6可以套设于如图3至图5所示的不具有垫片3的安装有钉仓组件302的钉仓座303。
可以理解，端部执行器30不限于附图中给出的形式，例如，端部执行器30还可以如一些现有技术那样是弯曲的或环形的。这样，出钉面13也可以是弯曲的或环形的。
应当理解，虽然本说明书按照实施方式加以描述，但并非每个实施方式仅包含一个独立的技术方案，说明书的这种叙述方式仅仅是为清楚起见，本领域技术人员应当将说明书作为一个整体，各实施方式中的技术方案也可以经适当组合，形成本领域技术人员可以理解的其他实施方式。
上文所列出的一系列的详细说明仅仅是针对本申请的可行性实施方式的具体说明，它们并非用以限制本申请的保护范围，凡未脱离本申请技艺精神所作的等效实施方式或变更均应包含在本申请的保护范围之内。

Claims (23)

  1. 一种钉仓组件，其特征在于，包括：
    钉仓主体(1)，其设置有多个钉腔(12)，所述钉腔(12)在所述钉仓主体(1)的出钉面(13)具有钉腔开口，其中，所述钉仓主体(1)设置有供切割刀组件(40)运动的走刀槽(11)，所述走刀槽(11)沿所述钉仓组件的前后方向(X)延伸，在所述走刀槽(11)的两侧各设置有两排所述钉腔(12)，每排所述钉腔(12)均沿所述前后方向(X)延伸；
    多个吻合钉(4)，所述多个吻合钉(4)设置在所述多个钉腔(12)内，所述吻合钉(4)包括基部(42)和两个钉腿(41)，每个所述钉腿(41)分别连接于所述基部(42)的两端部(422)中的一个，沿所述两个钉腿(41)的延伸方向观察，所述基部(42)是弯曲的；
    垫片(3)，所述垫片(3)安装于所述出钉面(13)并且覆盖所述钉腔开口；
    在所述吻合钉(4)被击发时，所述吻合钉(4)从所述钉腔开口被推出，并且所述吻合钉(4)带着所述垫片(3)与所述出钉面(13)分离。
  2. 根据权利要求1所述的钉仓组件，其特征在于，所述垫片(3)呈片状。
  3. 根据权利要求1或2所述的钉仓组件，其特征在于，所述垫片(3)的厚度与宽度(W)的比值为1∶5至1∶20。
  4. 根据权利要求3所述的钉仓组件，其特征在于，所述垫片(3)的厚度与宽度(W)的比值为1∶8至1∶15。
  5. 根据权利要求1或2所述的钉仓组件，其特征在于，所述垫片(3)的厚度为0.1毫米至0.5毫米。
  6. 根据权利要求1所述的钉仓组件，其特征在于，通过位于所述走刀槽(11)同侧且在所述前后方向(X)上相邻的所述吻合钉(4)之间的第一间隙(S10)和第二间隙(S20)的直线总会与至少一个位于所述走刀槽(11)同侧的所述吻合钉(4)相交。
  7. 根据权利要求1所述的钉仓组件，其特征在于，所述钉仓组件包括多个所述垫片(3)，通过位于所述走刀槽(11)同侧且在所述前后方向(X)上相邻的所述垫片(3)之间的第三间隙(S1)和第四间隙(S2)的直线总会与至少一个位于所述走刀槽(11)同侧的所述垫片(3)相交。
  8. 根据权利要求7所述的钉仓组件，其特征在于，在所述前后方向(X)上相邻的 所述垫片(3)之间的所述第三间隙(S1)和所述第四间隙(S2)的宽度小于单个垫片(3)的长度的1/15；和/或
    所述走刀槽(11)的同一侧的两排所述垫片(3)之间的间隙小于单个垫片(3)的宽度的1/15。
  9. 根据权利要求1所述的钉仓组件，其特征在于，所述基部(42)为弧形或V字形或W字形，在所述走刀槽(11)的同侧的两排所述吻合钉(4)中，一排所述吻合钉(4)的基部(42)的两端部(442)向另一排所述吻合钉(4)弯曲而靠近该另一排所述吻合钉(4)，所述钉腔(12)的横截面与所述基部(42)相适应，从而引导所述吻合钉(4)沿所述钉仓组件的厚度方向移动。
  10. 根据权利要求1所述的钉仓组件，其特征在于，位于所述走刀槽(11)的同侧的两排所述钉腔(12)交错设置。
  11. 根据权利要求1所述的钉仓组件，其特征在于，所述钉仓组件包括多个所述垫片(3)，每个所述垫片(3)覆盖多个所述钉腔开口。
  12. 根据权利要求11所述的钉仓组件，其特征在于，每个垫片(3)覆盖的多个所述钉腔开口包括位于所述走刀槽(11)的一侧的不同排的所述钉腔开口。
  13. 根据权利要求11所述的钉仓组件，其特征在于，一个所述垫片(3)覆盖所述走刀槽(11)的一侧的一整排所述钉腔(12)或覆盖所述走刀槽(11)的一侧的全部所述钉腔(12)。
  14. 根据权利要求11所述的钉仓组件，其特征在于，所述垫片(3)包括第一板部(31)和第二板部(32)，所述第一板部(31)和所述第二板部(32)沿所述前后方向(X)和所述钉仓组件的左右方向(Y)错开，所述第一板部(31)和所述第二板部(32)是一体形成的，所述第一板部(31)设置有两个与一个所述吻合钉(4)配合的通孔(33)，所述第二板部(32)设置有两个与另一个所述吻合钉(4)配合的所述通孔(33)。
  15. 根据权利要求1所述的钉仓组件，其特征在于，所述钉仓组件包括多个所述垫片(3)，两个或更多个所述垫片(3)通过易断连接部连接在一起。
  16. 根据权利要求1所述的钉仓组件，其特征在于，所述钉仓组件包括多个所述垫片(3)，所述钉仓主体(1)的出钉面(13)包括围绕所述钉腔开口设置的凹槽，所述垫片通过与所述凹槽过盈配合而安装于所述出钉面(13)。
  17. 根据权利要求1所述的钉仓组件，其特征在于，所述垫片(3)粘贴于所述出钉面(13)。
  18. 根据权利要求1所述的钉仓组件，其特征在于，所述垫片(3)具有供所述钉腿(41)穿过的通孔(33)。
  19. 一种外科器械，其包括端部执行器(30)，所述端部执行器(30)包括钳口组件(301)，所述钳口组件(301)包括：用于安装钉仓组件(302)的钉仓座(303)；以及能相对于所述钉仓座(303)打开和闭合的抵钉座(304)，
    其特征在于，所述端部执行器(30)还包括能够套装于所述钉仓座(303)和/或所述抵钉座(304)的端部执行器套(6)。
  20. 根据权利要求19所述的外科器械，其特征在于，所述端部执行器(30)还包括安装于所述钉仓座(303)的所述钉仓组件(302)，所述钉仓组件(302)为权利要求1至18中任一项所述的钉仓组件；所述端部执行器套(6)套装于所述钉仓组件(302)和所述钉仓座(303)。
  21. 根据权利要求19所述的外科器械，其特征在于，所述端部执行器套(6)包括第一片部(61)和第二片部(62)，所述第一片部(61)与所述第二片部(62)可分离地连接，在所述端部执行器套(6)套装于所述钉仓座(303)和/或所述抵钉座(304)时，所述第一片部(61)位于所述钉仓座(303)和所述抵钉座(304)之间。
  22. 根据权利要求21所述的外科器械，其特征在于，所述第一片部(61)和所述第二片部(62)通过线缝合在一起，通过拆除所述线能够使所述第一片部(61)和所述第二片部(62)分离，或者所述第一片部(61)和所述第二片部(62)通过易断连接部连接在一起。
  23. 根据权利要求19所述的外科器械，其特征在于，所述端部执行器套(6)套装于所述抵钉座(304)，
    所述端部执行器(30)还包括安装于所述钉仓座(303)的钉仓组件(302)，所述钉仓组件(302)为权利要求1至18中任一项所述的钉仓组件。
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