WO2012040984A1 - Endoscopic surgical cutting stapler with replaceable staple cartridge - Google Patents

Endoscopic surgical cutting stapler with replaceable staple cartridge Download PDF

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Publication number
WO2012040984A1
WO2012040984A1 PCT/CN2010/079796 CN2010079796W WO2012040984A1 WO 2012040984 A1 WO2012040984 A1 WO 2012040984A1 CN 2010079796 W CN2010079796 W CN 2010079796W WO 2012040984 A1 WO2012040984 A1 WO 2012040984A1
Authority
WO
WIPO (PCT)
Prior art keywords
staple cartridge
staple
cutting
pusher
groove
Prior art date
Application number
PCT/CN2010/079796
Other languages
French (fr)
Chinese (zh)
Inventor
张祖仁
袁栋坤
蒋震宇
吉荣
张奕奕
徐维华
虞国安
戴晓东
Original Assignee
常州市康迪医用吻合器有限公司
上海创亿医疗器械技术有限公司
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
Application filed by 常州市康迪医用吻合器有限公司, 上海创亿医疗器械技术有限公司 filed Critical 常州市康迪医用吻合器有限公司
Publication of WO2012040984A1 publication Critical patent/WO2012040984A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07271Stapler heads characterised by its cartridge
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07278Stapler heads characterised by its sled or its staple holder
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07285Stapler heads characterised by its cutter

Definitions

  • the present invention relates to a laparoscopic surgical stapler for use in thoracoscopic surgery, and more particularly to a laparoscopic surgical stapler with a replaceable staple cartridge, which is in the field of medical devices. Background technique
  • the endoscopic sclerotomy stapler is usually used for the anastomosis of the esophagus, stomach, duodenum, small intestine, colon, rectum, appendix, gallbladder, pancreas and spleen in the digestive tract. It is used for cutting and anastomosis of the lungs and trachea in the respiratory tract. It is also used for cutting and anastomosis of the bladder and uterus in the genitourinary system, which can reduce the operation time and improve the quality of surgery.
  • the existing endoscopic surgical cutting staplers have various endoscopic singular cutting staplers as described in U.S. Patent Nos. 20080308602, 20090206124 and 20090206123.
  • the execution head is first inserted into the T body cavity through a puncture needle having an inner diameter of 12 mm to 13 mm, and then the head axial rotation and/or joint rotation is controlled to align the tissue to be cut.
  • the clamping mechanism can be operated to push the slide bar to clamp the anastomotic tissue to be cut between the anvil of the execution head and the staple cartridge.
  • the two ends of the slider are respectively inserted into the anvil of the execution head and the two ends of the staple cartridge, so as to achieve the required clamping thickness between the anvil and the staple cartridge;
  • the skateboard pushes the pusher block, and pushes the staple from the staple cartridge through the stapled forming groove that is clamped to the anastomotic tissue to be cut directly to the anvil, so that the U-shaped staple is bent into a B shape, and the operation of the tissue anastomosis is achieved.
  • the cutting knife on the slide bar cuts the clamped tissue to be cut to achieve the purpose of cutting the tissue.
  • the clamping mechanism is operated to loosen the cut anastomosis tissue, so as to exit the endoscope and the cutting stapler.
  • Endoscopic surgical cutting The clamping mechanism and firing mechanism of the stapler can also utilize other operating mechanisms.
  • the operating mechanism can also have an indicating mechanism.
  • Various operating mechanisms, such as the clamping mechanism and the firing mechanism of the laparoscopic surgical stapler may be manual laparoscopic surgical stapler as in U.S. Patent Nos. 20080308602 and 20090206123, or may be electric mirrors such as U.S. Patents 20090090763 and 20090095790.
  • the surgical cutting stapler can also be a fluid-driven endoscopic cutting stapler as disclosed in U.S. Patents 2,070,125,826 and 20080029577.
  • the existing endoscopic surgical cutting stapler comprises the following components: an anastomosis body, an execution head, an extension tube connecting the stapler body and the execution head, and an operating mechanism for controlling the action of the execution head.
  • the actuator head consists of an actuator, a carriage, a staple cartridge and an anvil. Install the slide bar, staple cartridge and anvil on the actuator.
  • the staple cartridge consists of a staple cartridge shell, a pusher block, a pusher slide, and a staple. There are nail slots, push nail holes and pusher slots in the cartridge housing. The staples are mounted in the staple slots.
  • the pusher block is mounted in the push pin hole. The pusher block can be moved within the pusher hole to push the staple out of the staple slot.
  • the pusher skateboard pushes the staples out of the staple slots by pushing the pusher blocks in the pusher holes.
  • the staple is U-shaped and consists of two staple legs, a nail beam and two nail tips. One end of the nail leg is respectively connected with the nail beam, and the other end is a nail tip. Staples can be made of stainless steel wire, silk, Titanium wire or other wire with similar properties.
  • the two staple legs of the staple are inserted into the staple groove.
  • the staple beam of the staple sits on the upper side of the push block.
  • the end face of the anvil has a staple forming groove corresponding to the position of the staple in the staple cartridge and a cutting groove corresponding to the position of the pusher groove in the staple cartridge.
  • the nail groove and the push nail hole of the staple cartridge shell are arranged on both sides of the pusher groove.
  • the staple forming grooves of the anvil are arranged on both sides of the cutting groove of the anvil. To be arranged in two rows, three rows, four rows, five rows, six rows, seven rows or eight rows.
  • There is a cutting knife on the slide bar that can be moved in the cutting groove of the staple cartridge and the cutting groove of the anvil.
  • the laparoscopic surgical stapler as described in U.S. Patent No. 20090206123, after completion of the cutting and anastomosis operation, replaces the disposable loading device for reuse.
  • the disposable loading device includes a new actuator head and end connector for a staple cartridge.
  • the unsatisfactory aspect of this type of laparoscopic surgical stapler is that several disposable loading devices need to be replaced during the same procedure in the same patient, since the disposable loading device includes an actuator head and end connector, The total cost is quite high.
  • the object of the present invention is to overcome the deficiencies of the prior art and to provide a laparoscopic surgical stapler with a replaceable staple cartridge that is convenient to use and convenient for loading and unloading a staple cartridge.
  • a laparoscopic surgical cutting stapler with a replaceable staple cartridge comprising an anastomosis body, an execution head, an extension tube connecting the anastomosis body and the execution head, and an operating mechanism for controlling the execution of the head movement
  • the execution head is composed of an actuator, a slider, a staple cartridge and an anvil, and the staple cartridge is pushed by the staple cartridge shell.
  • the nail block, the push nail slide plate and the staple nail are composed.
  • the nail cartridge shell has a nail groove, a push nail hole, a slide plate groove and a push knife groove. The staple is installed in the nail groove, and the push nail block is installed in the push nail hole, and the push nail is pushed.
  • the sliding plate is installed in the sliding slot, and the nail groove and the pushing nail hole of the nail housing are arranged on two sides of the pushing knife groove, and the end surface of the anvil has an anastomotic forming groove and a nail storage corresponding to the position of the staple in the staple cartridge a cutting slot corresponding to the position of the pushing slot in the shell, a cutting knife installed in the pushing slot of the nail housing, a curved chute at the proximal end of the nail housing, and an arc-shaped lug on the cutting knife, the nail cartridge Before use, the arcuate projection of the cutting blade is inserted into the arc chute of the cartridge housing such that the cutting edge of the cutting blade is located in the pusher slot of the cartridge housing; when the cartridge is in use, the slider is from the nail The proximal end of the cartridge moves toward the distal end.
  • the slider pushes the cutter, and the arcuate projection of the cutter is pushed out from the arc chute of the cartridge casing, so that the blade of the cutter is pushed from the cartridge casing.
  • the sipe is extended, and then the slider pushes the cutter to move in the pusher slot of the staple cartridge shell, and the pusher skateboard pushes against the inclined plane
  • the staple pushing block bore when the pusher moves anastomotic staple Release butoxy tank.
  • An arcuate chute at the proximal end of the cartridge housing is located on either side of the proximal end of the cartridge housing, and the arcuate projections of the cutter are located on either side of the cutter.
  • the arcuate chute of the cartridge housing has an elastic stop therein; the resilient stopper causes the arcuate projection of the cutter to be constrained within the arcuate chute of the cartridge housing.
  • the cutting blade has a groove at a distal end thereof, and a protruding block is formed at a proximal end of the pusher blade, and a groove of the cutting blade is embedded in the protrusion of the pusher slide to form a partial pivotal connection.
  • An insert is embedded in the proximal end of the staple cartridge housing, and the curved chute is located in the insert.
  • a bump is located at the distal end of the slide bar, and the bump brings the cutter back to the proximal end of the staple cartridge as the slide bar moves from the distal end of the staple cartridge toward the proximal end.
  • the curved chute has an elastic baffle therein, and the elastic baffle divides the arc chute into a proximal arc chute and a distal arc chute; before the use, the cutting knives of the cutting knives
  • the curved protrusions are respectively inserted into the proximal curved chutes of the inserts, so that the cutting edge of the cutting knife is located in the pushing groove of the nail housing, and the elastic baffle in the curved sliding groove of the insert makes the cutting knife
  • the curved bump is constrained in the proximal curved chute of the insert; when the staple cartridge is in use, the slide rod moves from the proximal end of the staple cartridge to the distal end, first pushing the cutter, in the cutter
  • the elastic baffle in the arc chute is elastically deformed by the pressing of the arcuate lug, so that the arcuate lug of the cutting blade is pushed out from the proximal arc chute of the insert, so that the cutting edge of the cutting blade Extending from the pusher slot of the staple
  • the distal end of the cartridge housing has an elastic hook and a side protrusion
  • the distal end of the actuator has a side groove
  • the elastic hook at the distal end of the cartridge shell and the distal end of the actuator The bottom part of the assembly constitutes a detachable snap structure; when the staple cartridge is mounted on the execution frame, the side projections at the distal end of the staple cartridge housing are inserted into the side grooves at the distal end of the execution frame, and the binding staple cartridges are executed along the edge
  • the elastic hook at the distal end of the nail cartridge shell is elastically deformed and then snapped to the bottom of the distal end of the execution frame to restrain the movement of the staple cartridge along the vertical direction of the execution frame; when the staple cartridge is removed from the execution frame
  • the elastic hook at the distal end of the nail cartridge shell is elastically deformed and is separated from
  • the bottom of the cartridge housing is mounted with a bottom cover, and the two sides of the bottom cover are respectively engaged on both sides of the cartridge housing.
  • a cutting knife with a bump is installed in the pusher slot of the nail cartridge shell, and a curved chute is arranged at the proximal end of the nail cartridge shell, and the elastic hook and the execution frame at the distal end of the nail cartridge shell
  • the bottom portion at the distal end constitutes a detachable snap structure.
  • the resilient hook at the distal end of the cartridge housing is resiliently deformed and disengaged from the bottom of the distal end of the actuator to disengage the cartridge housing from the actuator.
  • the projection of the cutter is restrained in the arc chute of the cartridge housing, and the cutting edge of the cutter is located in the pusher groove of the cartridge housing.
  • the slide bar pushes the cutter to extend the blade edge of the cutter from the pusher slot of the staple cartridge housing.
  • the slide bar brings the cutter back to cause the projection of the cutter to be re-constrained in the arc chute of the cartridge casing, and the blade edge of the cutter is relocated in the pusher slot of the cartridge casing.
  • the cutting angle of the cutter is less than 45. It cannot be moved from the proximal end of the staple cartridge to the distal end under the push of the slide bar, preventing the used staple cartridge from being used again. Therefore, only the staple cartridge with the cutting knife can be replaced on the execution head of the same endoscopic surgical cutting stapler, and the same endoscopic surgical cutting stapler can be used to perform multiple endoscopic laparoscopic surgery, so that the use It is more convenient and safer, more convenient when loading and unloading staples, and lower operating costs.
  • FIG. 1 is a perspective view showing the appearance of a joint between a staple cartridge and an anvil when the joint of the endoscopic surgical cutting stapler with a replaceable staple cartridge is opened;
  • Figure 2 is a perspective view showing the appearance when the joint between the staple cartridge and the anvil is rotated when the joint of the endoscopic surgical cutting stapler of Figure 1 is rotated;
  • Figure 3 is an enlarged perspective view showing the opening of the staple cartridge, the extension tube, the joint and the operating mechanism of the endoscopic surgical cutting stapler of Figure 1 after the removal of the staple cartridge and the anvil;
  • Figure 4 is an enlarged perspective view showing the staple body, the extension tube, the joint and the operating mechanism of the endoscopic surgical cutting stapler of Figure 1 when the staple cartridge and the anvil of the head are opened;
  • Figure 5 is a perspective view showing an enlarged appearance when the collar of the actuator of Figure 4 is removed and the staple cartridge and the anvil are opened;
  • Figure 6 is an enlarged perspective view showing the staple body, the extension tube, the joint and the operating mechanism of the endoscopic surgical cutting stapler of Figure 1 when the staple cartridge and the anvil of the head are closed;
  • Figure 7 is an enlarged perspective view showing the closed state between the staple cartridge and the anvil after the collar of the actuator of Figure 6 is removed;
  • Figure 8 is an enlarged perspective view showing the back side of the execution head of the endoscopic cutting stapler of Figure 1;
  • FIG 9 is an enlarged perspective view showing the staple cartridge of the laparoscopic cutting stapler of Figure 1 taken out;
  • Figure 10 is an enlarged perspective view showing the bottom cover of the staple cartridge of the laparoscopic cutting stapler of Figure 1 removed;
  • Figure 11 is a perspective view showing an enlarged appearance of the cartridge case of Figure 10;
  • Figure 12 is an enlarged perspective view showing the slider in the actuator of Figure 1 before pushing the cutter, the pusher block, the pusher slide and the staple;
  • Figure 13 is a perspective view showing an enlarged appearance of the slide bar in the actuator of Figure 1 when pushing the cutter, the pusher block, the pusher slide and the staple;
  • Figure 14 is a perspective view showing an enlarged appearance of the anvil of Figure 1;
  • Figure 15 is an enlarged perspective view showing the actuator of Figure 1;
  • Figure 16 is an exploded view showing the cutting blade and the insert assembly with the curved chute when the cutting edge of the cutting blade in the staple cartridge of Figure 1 is located in the pusher groove of the staple cartridge housing;
  • Figure 17 is an exploded view showing the cutting blade and the insert assembly with the curved chute when the cutting edge of the cutting blade in the staple cartridge of Figure 1 protrudes from the pusher groove of the staple cartridge housing;
  • Figure 18 is a block diagram showing the cutting blade and another curved chute with an elastic baffle when the cutting edge of the cutting blade in the staple cartridge is located in the pusher groove of the staple cartridge housing prior to use. A magnified view of the component;
  • Figure 19 is a view showing the cutting blade of the cutting blade of Figure 1 in use, and the cutting blade of the cutting blade in the staple cartridge protrudes from the pusher groove of the cartridge housing, and the other has a curved chute with an elastic baffle.
  • Figure 20 is a view showing the cutting blade and another curved chute with an elastic baffle when the cutting edge of the cutting blade in the staple cartridge is located in the pusher groove of the staple cartridge case after the cutting and stapling operation of the staple cartridge of Figure 1 is completed.
  • the endoscopic sigma cutting stapler is composed of the executive head 2, the joint 3, the extension tube 4, the stapler body 5, and the operating mechanism 6.
  • the operating mechanism 6 is located at the stapler body 5, and performs the operation of the head 2 through the lumen of the extension tube 4 (the partial operating mechanism 6 in the staple body 5 and the extension tube 4 is not shown, and can refer to the US patent cited in the present specification) .
  • the execution head 2, the joint 3, the extension tube 4, and the stapler body 5 are sequentially connected in sequence.
  • the execution head 2 is composed of an actuator 7, a slide bar 8, a magazine 9 and an anvil 10.
  • a slide bar 8, a magazine 9 and an anvil 10 are mounted on the actuator 7.
  • the staple cartridge 9 is composed of a staple cartridge housing 11, a pusher block 12, a pusher slide 13 and a staple 14.
  • the staple cartridge housing 11 has a staple groove 15, a push pin hole 16, a slide groove 17, and a pusher groove 18.
  • the staples 14 are mounted within the staple slots 15.
  • the pusher block 12 is mounted within the push pin hole 16.
  • the pusher slide 13 is mounted in the slide groove 17.
  • the staple groove 15 and the push pin hole 16 of the staple cartridge case 11 are arranged in three rows on both sides of the pusher groove 18.
  • the end surface of the anvil 10 has a staple forming groove 19 corresponding to the position of the staple 14 in the staple cartridge 9, and a cutting groove 20 corresponding to the position of the pusher groove 18 in the staple cartridge housing 11.
  • the staple forming grooves 19 of the anvil 10 are arranged in three rows on each side of the cutting groove 20 of the anvil 10.
  • the anvil 10 is pivotally coupled to the actuator 7.
  • a cutter blade 21 is mounted in the pusher groove 18 of the magazine casing 11.
  • the slider 8 When the slider 8 is moved from the proximal end of the cartridge housing 11 to the distal end, the slider 8 pushes the cutter blade 21 and the pusher slider 13 to move within the pusher groove 18 of the cartridge housing 11.
  • the pusher slide 13 pushes the pusher block 12 through the bevel to push the staple 14 out of the staple groove 15 as it moves within the pusher hole 16.
  • the insert 22 is embedded at the proximal end of the cartridge housing 11.
  • the insert 22 has an arcuate chute 23 therein.
  • the arc chute 23 has a stop 24 therein.
  • the cutting blade 21 has an arcuate projection 25 having a recess 26 at the distal end thereof.
  • a bump 27 is present at the proximal end of the pusher slide 13.
  • a stopper 28 is formed in the sliding groove 17 of the cartridge housing 11.
  • the arcuate projection 25 of the cutter blade 21 is inserted into the arcuate chute 23 of the insert 22 of the cartridge housing 11, the groove 26 of the cutter blade 21 is embedded in the projection of the pusher slide 13
  • the stop 24 in the arcuate chute 23 causes the arcuate projection 25 of the cutting blade 21 to be constrained within the arcuate chute 23 of the insert 22 of the cartridge housing 11, the staple cartridge shell
  • the stopper 28 in the slide groove 17 of the 11 causes the pusher slide 13 to be approximately 1 ⁇ 2 in the slide groove 17 of the staple cartridge housing 11, so that the cutter 21 and the pusher slide 13 are restrained in the cartridge housing 11, at this time
  • the cutting angle of the cutting blade 21 is greater than 45.
  • the cutting edge 29 of the cutting blade 21 is placed in the pusher groove 18 of the cartridge housing 11.
  • the stopper 24 in the lower curved chute 23 is elastically deformed and disengaged so that the arcuate projection 25 of the cutting blade 21 is pushed out from the arcuate chute 23 of the cartridge casing 11, and at the same time, the cutter 21 is
  • the groove 26 is pivoted about the projection 27 of the pusher slide 13 such that the cutting edge 29 of the cutting blade 21 projects from the pusher groove 18 of the cartridge housing 11, and then the slider 8 pushes the cutter 21 to push the pusher
  • the slide plate 13 causes the pusher slide 13 to elastically deform and disengage from the restraint of the stopper 28 in the slide groove 17, so that the slide bar 8 pushes the cutter 21 and the pusher slide 13 from the proximal end to the distal end of the staple cartridge case 11 mobile. As shown in FIGS.
  • a slider 30 is provided at the distal end of the slider 8.
  • the projection 30 at the distal end of the slider 8 first brings the cutting blade 21 back to the proximal end of the cartridge housing 11, and then at the cutting blade
  • the stopper 24 in the arcuate chute 23 is elastically deformed by the pressing of the arcuate projection 25 of 21 so that the arcuate projection 25 of the cutting blade 21 enters the arc chute of the insert 22 of the cartridge casing 11.
  • the cutting edge 29 of the cutting blade 21 is placed in the pusher groove 18 of the cartridge housing 11.
  • the distal end of the magazine casing 11 has elastic hooks 31 and side projections 32.
  • the elastic hook 31 at the distal end of the cartridge housing 11 and the bottom portion 34 at the distal end of the actuator 7 constitute a detachable snap structure.
  • the elastic hook 31 at the distal end of the cartridge casing 11 is elastically deformed and then snapped to the bottom portion 34 at the distal end of the execution frame 7, and the movement of the staple cartridge 9 in the up and down direction of the actuator 7 is restrained.
  • the side projections 32 at the distal end of the cartridge housing 11 are withdrawn from the side recesses 33 at the distal end of the actuator 7 while the distal end of the cartridge housing 11 is
  • the elastic hook 31 is elastically deformed and disengages from the bottom portion 34 at the distal end of the actuator frame 7, so that the staple cartridge 9 is disengaged from the actuator 7.
  • a bottom cover 35 is attached to the bottom of the magazine casing 11. Both sides of the bottom cover 35 are respectively engaged on both sides of the magazine casing 11.
  • another insert 22 embedded in the proximal end of the cartridge housing 11 of the endoscopic surgical cutting stapler of the present invention has a curved chute 23 in the insert 22, the insert
  • the arcuate chute 23 of the 22 has an elastic baffle 36 therein.
  • the resilient baffle 36 divides the arcuate chute 23 of the insert 22 into a proximal arcuate chute 23-1 and a distal arcuate chute 23-2.
  • the curved projections 25 of the cutting blade 21 are inserted into the proximal curved chute 23-1 of the insert 22 such that the cutting edge 29 of the cutting blade 21 is located in the pusher slot 18 of the cartridge housing 11.
  • the elastic baffle 36 in the arcuate chute 23 of the insert 22 causes the arcuate projection 25 of the cutting blade 21 to be approximately; the proximal arcuate chute 23-1 of the insert 22, at this time, cut
  • the angle of inclination of the knife 21 is greater than 45. .
  • the slide bar 8 moves from the proximal end of the staple cartridge 9 to the distal end, first pushing the cutter blade 21, and the arcuate chute 23 under the action of the arcuate projection 25 of the cutter blade 21
  • the inner resilient baffle 36 is elastically deformed so that the arcuate projection 25 of the cutting blade 21 is pushed out from the proximal arcuate chute 23-1 of the insert 22, causing the cutting edge 29 of the cutting blade 21 to be removed from the cartridge housing 11.
  • the pusher slot 18 extends and then pushes the cutter 21 to move within the pusher slot 18 of the cartridge housing 11, while the resilient flap 36 rebounds to seal the proximal curved slot 23-1 of the insert 22. .
  • the slide bar 8 moves from the distal end of the staple cartridge 9 toward the proximal end, and the bump 30 at the distal end of the slide bar 8 first brings the cutting blade 21 back to the proximal end of the staple cartridge 9, and then
  • the elastic baffle 36 in the arcuate chute 23 is elastically deformed by the pressing of the arcuate projection 25 of the cutting blade 21 so that the arcuate projection 25 of the cutting blade 21 enters the distal curved chute of the insert 22.
  • the cutting edge 29 of the cutting blade 21 is placed in the pusher groove 18 of the cartridge housing 11, while the elastic baffle 36 in the arcuate chute 23 rebounds to constrain the arcuate projection 25 of the cutting blade 21 to The distal end of the insert 22 is in the arcuate chute 23-2.
  • the angle of inclination of the cutting blade 21 is less than 45.
  • the used staple cartridge 9 has no staples. 14.
  • the laparoscopic surgery that performs the cutting anastomosis again will cause the operation to fail. It must be replaced with a new staple cartridge with a cutting knife before it can be used again. Since the cutting edge of the cutting blade 21 is less than 45° when the curved projection 25 of the cutting blade 21 is about 1 ⁇ 2 in the distal curved chute 23-2 of the insert 22 of the cartridge housing 11, when used While the staple cartridge 9 is still on the rack 7, if the endoscopic surgical cutting stapler 1 performs the endoscopic laparoscopic surgery again, moving the slide bar 8 from the proximal end of the staple cartridge 9 to the distal end, the slide bar 8 pushing the cutting blade 21 such that the curved projection 25 of the cutting blade 21 is on the distal curved chute 23-2 of the insert 22 of the cartridge housing 11, preventing the slider 8 from further moving from the proximal end of the staple cartridge 9 The distal end moves to prevent the surgical failure caused by the used staple cartridge 9 being reused, and the user of the laparoscopic surgical
  • the endoscopic surgical cutting stapler of the present invention with a replaceable staple cartridge can be replaced only with a new one on the execution head of the same endoscopic surgical cutting stapler
  • the staple cartridge of the staple and the cutting knife can be used to perform multiple endoscopic laparoscopic surgery using the same endoscopic sigma cutting stapler, which makes the use more convenient and safe, and is more convenient when loading and unloading the nail cartridge. Lower.
  • proximal in this context refers to the end of the endoscopic cutting stapler near the operator, and the term “distal” refers to the endoscopic cutting stapler away from the operator. One end.

Abstract

An endoscopic surgical cutting stapler with a replaceable staple cartridge (9) includes a stapler body (5), an end effector (2), an extension tube(4) connecting the stapler body (5) and the end effector (2), and an operating mechanism (6) controlling the action of the end effector (2). The end effector (2) consists of an effector frame (7), a slide bar (8), a staple cartridge (9), and an anvil (10). The staple cartridge (9) consists of a staple cartridge housing (11), staple pushers (12), a staple pushing sled (13) and staples (14). Staple slots (15), staple pushing apertures (16), a sled slot (17), and a knife pushing slot (18) are provided in the staple cartridge housing (11). A cutting knife (21) is installed in the knife pushing slot (18) of the staple cartridge housing (11). An arcuate slide slot (23) is provided on a proximal end of the staple cartridge housing (11), and an arcuate bump (25) is provided on the cutting knife (21). Before use of the staple cartridge (9), the arcuate bump (25) of the cutting knife (21) is inserted in the arcuate slide slot (23) of the staple cartridge housing (11) to position the knife blade (29) of the cutting knife (21) in the knife pushing slot (18) of the staple cartridge housing (11). In use of the staple cartridge (9), the slide bar (8) is moved from the proximal end to the distal end of the staple cartridge (9). Firstly the slide bar (8) pushes the cutting knife (21) and pushes the arcuate bump (25) of the cutting knife (21) out of the arcuate slide slot (23) of the staple cartridge housing (11) so that the knife blade (29) of the cutting knife (21) protrudes out of the knife pushing slot (18) of the staple cartridge housing (11), and then the slide bar (8) pushes the cutting knife (21) to move in the knife pushing slot (18) of the staple cartridge housing (ll).When the staple pushing sled (13) pushes the staple pushers (12) with its sloped surface to move in the staple pushing apertures (16), the staples (14) are pushed out of the staple slots (15).

Description

带有可更换钉仓的腔镜外科切割吻合器  Endoscopic surgical cutting stapler with replaceable staple cartridge
技术领域 Technical field
本发明涉及到在胸腔镜外科手术中使用的腔镜外科切割吻合器, 具体地 说, 涉及一种带有可更换钉仓的腔镜外科切割吻合器, 属于医疗器械领域。 背景技术  The present invention relates to a laparoscopic surgical stapler for use in thoracoscopic surgery, and more particularly to a laparoscopic surgical stapler with a replaceable staple cartridge, which is in the field of medical devices. Background technique
在腔镜外科手术中, 腔镜夕卜科切割吻合器通常被用于消化道中食管、 胃、 十二指肠、 小肠、 结肠、 直肠、 阑尾、 胆、 胰和脾等切割吻合手术, 也被用于 呼吸道中肺和气管等切割吻合手术, 还被用于泌尿生殖系统中膀胱和子宫等切 割吻合手术, 可以减少手术时间, 提高手术质量。  In laparoscopic surgery, the endoscopic sclerotomy stapler is usually used for the anastomosis of the esophagus, stomach, duodenum, small intestine, colon, rectum, appendix, gallbladder, pancreas and spleen in the digestive tract. It is used for cutting and anastomosis of the lungs and trachea in the respiratory tract. It is also used for cutting and anastomosis of the bladder and uterus in the genitourinary system, which can reduce the operation time and improve the quality of surgery.
现有的腔镜外科切割吻合器有美国专利 20080308602、 20090206124 和 20090206123 中介绍的各种腔镜夕卜科切割吻合器。 在使用腔镜夕卜科切割吻合器 时, 先将执行头通过内径为 12mm至 13mm的穿刺针进 T 体内腔, 再控制执 行头轴向旋转和 /或关节转动以便对准待切割吻合组织, 即可操作夹持机构,推 动滑杆, 将待切割吻合组织夹持在执行头的钉砧与钉仓之间。 然后操作击发机 构, 再推动滑杆: 滑杆的两端分别插入执行头的钉砧和钉仓的两端, 使钉砧与 钉仓之间达到所需的夹紧厚度; 滑杆通过推钉滑板推动推钉块, 将吻合钉从钉 仓内推出穿透被夹紧的待切割吻合组织直抵钉砧上的吻合钉成形槽,使 U形吻 合钉弯曲成 B形, 达到将组织吻合的手术目的; 滑杆上的切割刀切割被夹紧的 待切割吻合组织, 达到将组织切割的手术目的。 完成切割吻合操作后, 操作夹 持机构, 松开已切割吻合组织, 以便退出腔镜夕卜科切割吻合器。 腔镜外科切割 吻合器的夹持机构和击发机构也可釆用其它操作机构。 操作机构还可以有指示 机构。 腔镜外科切割吻合器的夹持机构和击发机构等各种操作机构可以是如美 国专利 20080308602和 20090206123的手动的腔镜外科切割吻合器, 也可以是 如美国专利 20090090763和 20090095790的电动的腔镜外科切割吻合器, 还可 以是如美国专利 20070125826和 20080029577的流体驱动的腔镜夕卜科切割吻合 器。  The existing endoscopic surgical cutting staplers have various endoscopic singular cutting staplers as described in U.S. Patent Nos. 20080308602, 20090206124 and 20090206123. When using the laparoscopic cutting stapler, the execution head is first inserted into the T body cavity through a puncture needle having an inner diameter of 12 mm to 13 mm, and then the head axial rotation and/or joint rotation is controlled to align the tissue to be cut. The clamping mechanism can be operated to push the slide bar to clamp the anastomotic tissue to be cut between the anvil of the execution head and the staple cartridge. Then operate the firing mechanism, and then push the slider: the two ends of the slider are respectively inserted into the anvil of the execution head and the two ends of the staple cartridge, so as to achieve the required clamping thickness between the anvil and the staple cartridge; The skateboard pushes the pusher block, and pushes the staple from the staple cartridge through the stapled forming groove that is clamped to the anastomotic tissue to be cut directly to the anvil, so that the U-shaped staple is bent into a B shape, and the operation of the tissue anastomosis is achieved. Purpose; The cutting knife on the slide bar cuts the clamped tissue to be cut to achieve the purpose of cutting the tissue. After the cutting and anastomosis operation is completed, the clamping mechanism is operated to loosen the cut anastomosis tissue, so as to exit the endoscope and the cutting stapler. Endoscopic surgical cutting The clamping mechanism and firing mechanism of the stapler can also utilize other operating mechanisms. The operating mechanism can also have an indicating mechanism. Various operating mechanisms, such as the clamping mechanism and the firing mechanism of the laparoscopic surgical stapler, may be manual laparoscopic surgical stapler as in U.S. Patent Nos. 20080308602 and 20090206123, or may be electric mirrors such as U.S. Patents 20090090763 and 20090095790. The surgical cutting stapler can also be a fluid-driven endoscopic cutting stapler as disclosed in U.S. Patents 2,070,125,826 and 20080029577.
现有的腔镜外科切割吻合器, 其组成部分包括: 吻合器身、 执行头、 连接 所述吻合器身和执行头的延伸管、 控制执行头动作的操作机构。 执行头由执行 架、 滑架、 钉仓和钉砧组成。 在执行架上安装滑杆、 钉仓和钉砧。 钉仓由钉仓 壳、 推钉块、 推钉滑板和吻合钉组成。 钉仓壳内有钉槽、 推钉孔和推刀槽。 吻 合钉安装在钉槽内。 推钉块安装在推钉孔内。 推钉块可在推钉孔内移动以便将 吻合钉从钉槽内推出。 推钉滑板依靠斜面推动推钉块在推钉孔内移动时将吻合 钉从钉槽内推出。 吻合钉呈 U形, 由两个钉腿、 一个钉梁和两个钉尖组成。 钉 腿的一端分别与钉梁连接、另一端分别为钉尖。 吻合钉可釆用不锈钢丝、钽丝、 钛丝或其它具有类似性能的金属丝制造。 吻合钉的两个钉腿插在钉槽内。 吻合 钉的钉梁坐在推钉块的上边上。 钉砧的端面上有与钉仓内的吻合钉位置对应的 吻合钉成形槽和与钉仓内的推刀槽位置对应的切割槽。 钉仓壳的钉槽和推钉孔 排列在推刀槽的两侧。 钉砧的吻合钉成形槽相应排列在钉砧的切割槽的两侧。 要, 共排列成两排、 三排、 四排、 五排、 六排、 七排或八排。 滑杆上有切割刀, 可在钉仓的推刀槽和钉砧的切割槽内移动。 The existing endoscopic surgical cutting stapler comprises the following components: an anastomosis body, an execution head, an extension tube connecting the stapler body and the execution head, and an operating mechanism for controlling the action of the execution head. The actuator head consists of an actuator, a carriage, a staple cartridge and an anvil. Install the slide bar, staple cartridge and anvil on the actuator. The staple cartridge consists of a staple cartridge shell, a pusher block, a pusher slide, and a staple. There are nail slots, push nail holes and pusher slots in the cartridge housing. The staples are mounted in the staple slots. The pusher block is mounted in the push pin hole. The pusher block can be moved within the pusher hole to push the staple out of the staple slot. The pusher skateboard pushes the staples out of the staple slots by pushing the pusher blocks in the pusher holes. The staple is U-shaped and consists of two staple legs, a nail beam and two nail tips. One end of the nail leg is respectively connected with the nail beam, and the other end is a nail tip. Staples can be made of stainless steel wire, silk, Titanium wire or other wire with similar properties. The two staple legs of the staple are inserted into the staple groove. The staple beam of the staple sits on the upper side of the push block. The end face of the anvil has a staple forming groove corresponding to the position of the staple in the staple cartridge and a cutting groove corresponding to the position of the pusher groove in the staple cartridge. The nail groove and the push nail hole of the staple cartridge shell are arranged on both sides of the pusher groove. The staple forming grooves of the anvil are arranged on both sides of the cutting groove of the anvil. To be arranged in two rows, three rows, four rows, five rows, six rows, seven rows or eight rows. There is a cutting knife on the slide bar that can be moved in the cutting groove of the staple cartridge and the cutting groove of the anvil.
腔镜外科切割吻合器每完成一次切割吻合操作后, 吻合钉已从钉仓内被推 出, 需更换新的装有吻合钉的钉仓, 以便执行下一次切割吻合操作。 如美国专 利 20090206123中所介绍的腔镜外科切割吻合器, 完成切割吻合操作后, 更换 一次性加载装置以便再次使用。 一次性加载装置包括新的装有吻合钉的钉仓的 执行头和端连接器。 这种式样的腔镜外科切割吻合器的令人不满意处是, 在同 一病人的同一次手术中需要更换几个一次性加载装置, 由于一次性加载装置包 括执行头和端连接器, 因此其总费用相当高。 这种式样的腔镜外科切割吻合器 的另一令人不满意处是, 如美国专利 20090206123中所述, 一次性加载装置的 端连接器可能无意中从腔镜夕卜科切割吻合器的细长主体脱离, 致使腔镜外科切 割吻合器发生故障或不能操作, 因此美国专利 20090206123又提出一次性加载 装置可以沿着细长主体轴既不共线、 也不平行的方向安装到细长主体上, 还提 出在一次性加载装置的端连接器中增加螺紋、 或棘爪机构、 或扣合装置, 以保 证一次性加载装置能可靠地连接到腔镜外科切割吻合器的细长主体上。 由于在 腔镜外科手术中, 腔镜夕卜科切割吻合器的细长主体的直径为 12mm至 13mm, 因此, 如此复杂的一次性加载装置的端连接器的加工和装配的难度高、 质量难 以保证, 手术中反复装拆^艮麻烦, 其总费用^目当高。 因此腔镜外科切割吻 合器的一次性加载装置还需改进。  After each scalpel surgical cutting stapler completes the cutting and anastomosis operation, the staple has been pushed out of the staple cartridge, and a new staple cartridge with staples is required to perform the next cutting and anastomosis operation. The laparoscopic surgical stapler as described in U.S. Patent No. 20090206123, after completion of the cutting and anastomosis operation, replaces the disposable loading device for reuse. The disposable loading device includes a new actuator head and end connector for a staple cartridge. The unsatisfactory aspect of this type of laparoscopic surgical stapler is that several disposable loading devices need to be replaced during the same procedure in the same patient, since the disposable loading device includes an actuator head and end connector, The total cost is quite high. Another unsatisfactory aspect of this type of laparoscopic surgical stapler is that, as described in U.S. Patent No. 20090206123, the end connector of the disposable loading device may inadvertently cut the stapler from the endoscope. The long body disengages, causing the laparoscopic surgical cutting stapler to malfunction or be inoperable, and therefore, US Patent No. 20090206123 proposes that the disposable loading device can be mounted to the elongated body along the elongated body axis in a direction that is neither collinear nor parallel. It is also proposed to add a thread, or a detent mechanism, or a snap-fit device to the end connector of the disposable loading device to ensure that the disposable loading device can be securely attached to the elongated body of the endoscopic surgical cutting stapler. Since the diameter of the elongated body of the endoscopic cutting stapler is 12 mm to 13 mm in laparoscopic surgery, the end connector of such a complicated disposable loading device is difficult and difficult to process and assemble. It is guaranteed that it is troublesome to repeatedly install and disassemble during the operation, and the total cost is high. Therefore, the disposable loading device of the endoscopic surgical cutting kisser needs to be improved.
由上述显然可以看出, 现在已经设计了不同式样的腔镜外科切割吻合器, 并且新的腔镜外科切割吻合器的研制工作仍在继续, 以便对每年世界上大量使 用的腔镜外科切割吻合器作进一步的改进,使得使用时更方便、装拆时更便利, 手术费用更低。  It can be clearly seen from the above that different types of endoscopic surgical cutting staplers have been designed, and the development of new endoscopic surgical cutting staplers continues, so that the endoscopic surgical cutting anastomosis is widely used in the world every year. The device is further improved to make it more convenient to use, more convenient to assemble and disassemble, and lower in surgical cost.
发明内容 Summary of the invention
本发明的目的是克服现有技术的不足, 提供一种使用方便、 装拆钉仓便利 的带有可更换钉仓的腔镜外科切割吻合器。  SUMMARY OF THE INVENTION The object of the present invention is to overcome the deficiencies of the prior art and to provide a laparoscopic surgical stapler with a replaceable staple cartridge that is convenient to use and convenient for loading and unloading a staple cartridge.
实现上述目的的技术方案是: 一种带有可更换钉仓的腔镜外科切割吻合 器, 包括吻合器身、 执行头、 连接吻合器身和执行头的延伸管、 控制执行头动 作的操作机构, 执行头由执行架、 滑杆、 钉仓和钉砧组成, 钉仓由钉仓壳、 推 钉块、 推钉滑板和吻合钉组成, 钉仓壳内有钉槽、 推钉孔、 滑板槽和推刀槽, 吻合钉安装在钉槽内, 推钉块安装在推钉孔内, 推钉滑板安装在滑板槽内, 钉 仓壳的钉槽和推钉孔排列在推刀槽的两侧, 钉砧的端面上有与钉仓内的吻合钉 位置对应的吻合钉成形槽和与钉仓壳内的推刀槽位置对应的切割槽, 钉仓壳的 推刀槽内安装有切割刀, 钉仓壳的近端处有弧形滑槽, 且切割刀上具有弧形凸 块, 钉仓在使用前, 切割刀的弧形凸块插在所述钉仓壳的弧形滑槽内, 使切割 刀的刀刃位于钉仓壳的推刀槽内; 钉仓在使用时, 滑杆从钉仓的近端处向远端 处移动, 首先滑杆推动切割刀, 并将切割刀的弧形凸块从钉仓壳的弧形滑槽内 推出, 使切割刀的刀刃从钉仓壳的推刀槽内伸出, 然后滑杆推动切割刀在钉仓 壳的推刀槽内移动, 推钉滑板依靠其斜面推动推钉块在推钉孔内移动时将吻合 丁槽内推出。 The technical solution for achieving the above object is: a laparoscopic surgical cutting stapler with a replaceable staple cartridge, comprising an anastomosis body, an execution head, an extension tube connecting the anastomosis body and the execution head, and an operating mechanism for controlling the execution of the head movement The execution head is composed of an actuator, a slider, a staple cartridge and an anvil, and the staple cartridge is pushed by the staple cartridge shell. The nail block, the push nail slide plate and the staple nail are composed. The nail cartridge shell has a nail groove, a push nail hole, a slide plate groove and a push knife groove. The staple is installed in the nail groove, and the push nail block is installed in the push nail hole, and the push nail is pushed. The sliding plate is installed in the sliding slot, and the nail groove and the pushing nail hole of the nail housing are arranged on two sides of the pushing knife groove, and the end surface of the anvil has an anastomotic forming groove and a nail storage corresponding to the position of the staple in the staple cartridge a cutting slot corresponding to the position of the pushing slot in the shell, a cutting knife installed in the pushing slot of the nail housing, a curved chute at the proximal end of the nail housing, and an arc-shaped lug on the cutting knife, the nail cartridge Before use, the arcuate projection of the cutting blade is inserted into the arc chute of the cartridge housing such that the cutting edge of the cutting blade is located in the pusher slot of the cartridge housing; when the cartridge is in use, the slider is from the nail The proximal end of the cartridge moves toward the distal end. First, the slider pushes the cutter, and the arcuate projection of the cutter is pushed out from the arc chute of the cartridge casing, so that the blade of the cutter is pushed from the cartridge casing. The sipe is extended, and then the slider pushes the cutter to move in the pusher slot of the staple cartridge shell, and the pusher skateboard pushes against the inclined plane The staple pushing block bore when the pusher moves anastomotic staple Release butoxy tank.
所述钉仓壳近端处的弧形滑槽位于钉仓壳近端处的两侧, 所述切割刀的弧 形凸块位于切割刀的两侧。  An arcuate chute at the proximal end of the cartridge housing is located on either side of the proximal end of the cartridge housing, and the arcuate projections of the cutter are located on either side of the cutter.
所述钉仓壳的弧形滑槽内有弹性挡块; 弹性挡块使切割刀的弧形凸块被约 束在钉仓壳的弧形滑槽内。  The arcuate chute of the cartridge housing has an elastic stop therein; the resilient stopper causes the arcuate projection of the cutter to be constrained within the arcuate chute of the cartridge housing.
所述切割刀的远端处有凹槽, 所述推钉滑板的近端处有凸块, 所述切割刀 的凹槽嵌入所述推钉滑板的凸块形成局部枢轴连接。  The cutting blade has a groove at a distal end thereof, and a protruding block is formed at a proximal end of the pusher blade, and a groove of the cutting blade is embedded in the protrusion of the pusher slide to form a partial pivotal connection.
所述钉仓壳的近端处嵌有镶块, 弧形滑槽位于镶块内。  An insert is embedded in the proximal end of the staple cartridge housing, and the curved chute is located in the insert.
所述滑杆的远端处有凸块, 当滑杆从所述钉仓的远端处向近端处移动时, 凸块将所述切割刀带回钉仓的近端处。  A bump is located at the distal end of the slide bar, and the bump brings the cutter back to the proximal end of the staple cartridge as the slide bar moves from the distal end of the staple cartridge toward the proximal end.
弧形滑槽内有弹性挡板, 所述弹性挡板将的弧形滑槽分隔成近端弧形滑槽 和远端弧形滑槽; 所述钉仓在使用前, 所述切割刀的弧形凸块分别插在镶块的 近端弧形滑槽内, 使切割刀的刀刃位于所述钉仓壳的推刀槽内, 镶块的弧形滑 槽内的弹性挡板使切割刀的弧形凸块被约束在镶块的近端弧形滑槽内; 钉仓在 使用时, 所述滑杆从钉仓的近端处向远端处移动, 首先推动切割刀, 在切割刀 的弧形凸块的挤压作用下弧形滑槽内的弹性挡板发生弹性变形, 以便切割刀的 弧形凸块从镶块的近端弧形滑槽内被推出, 使切割刀的刀刃从钉仓壳的推刀槽 内伸出, 然后滑杆推动切割刀在钉仓壳的推刀槽内移动, 同时弹性挡板回弹将 镶块的近端弧形滑槽封住; 当滑杆从钉仓的远端处向近端处移动时, 滑杆先将 切割刀带回钉仓的近端处, 然后在切割刀的弧形凸块的挤压作用下弧形滑槽内 的弹性挡板发生弹性变形,以便切割刀的弧形凸块进入镶块的远端弧形滑槽内, 使切割刀的刀刃位于钉仓壳的推刀槽内, 同时弧形滑槽内的弹性挡板回弹将切 割刀的弧形凸块约束在镶块的远端弧形滑槽内。  The curved chute has an elastic baffle therein, and the elastic baffle divides the arc chute into a proximal arc chute and a distal arc chute; before the use, the cutting knives of the cutting knives The curved protrusions are respectively inserted into the proximal curved chutes of the inserts, so that the cutting edge of the cutting knife is located in the pushing groove of the nail housing, and the elastic baffle in the curved sliding groove of the insert makes the cutting knife The curved bump is constrained in the proximal curved chute of the insert; when the staple cartridge is in use, the slide rod moves from the proximal end of the staple cartridge to the distal end, first pushing the cutter, in the cutter The elastic baffle in the arc chute is elastically deformed by the pressing of the arcuate lug, so that the arcuate lug of the cutting blade is pushed out from the proximal arc chute of the insert, so that the cutting edge of the cutting blade Extending from the pusher slot of the staple cartridge shell, and then the slide bar pushes the cutter to move in the pusher slot of the staple cartridge shell, and the elastic baffle rebounds to seal the proximal curved chute of the insert; When the rod moves from the distal end of the staple cartridge to the proximal end, the slide rod first brings the cutter back to the proximal end of the staple cartridge, and then the arc of the cutter The elastic baffle in the arc chute is elastically deformed by the pressing of the bump, so that the arcuate lug of the cutting blade enters the arcuate chute of the distal end of the insert, so that the cutting edge of the cutting knife is located in the nail cartridge shell In the pusher slot, at the same time, the elastic baffle rebound in the arc chute restrains the arcuate lug of the cutter in the arcuate chute of the distal end of the insert.
当所述切割刀的弧形凸块被约束在所述钉仓壳的远端弧形滑槽内时, 切割 刀的倾角小于 45。 。 Cutting when the arcuate projection of the cutting blade is constrained within the arcuate chute of the distal end of the cartridge housing The angle of inclination of the knife is less than 45. .
所述钉仓壳的远端处有弹性卡钩和侧面凸块, 所述执行架的远端处有侧面 凹槽, 所述钉仓壳远端处的弹性卡钩与所述执行架远端处的底部组成可装拆的 卡扣结构; 当将钉仓安装到执行架上时, 钉仓壳远端处的侧面凸块插入执行架 远端处的侧面凹槽内, 约束钉仓沿执行架前后方向的移动, 钉仓壳远端处的弹 性卡钩弹性变形后卡接在执行架远端处的底部, 约束钉仓沿执行架上下方向的 移动; 当将钉仓从执行架上拆卸时, 钉仓壳远端处的侧面凸块从执行架远端处 的侧面凹槽内被抽出, 钉仓壳远端处的弹性卡钩弹性变形后脱离执行架远端处 的底部, 使钉仓脱离执行架。  The distal end of the cartridge housing has an elastic hook and a side protrusion, the distal end of the actuator has a side groove, and the elastic hook at the distal end of the cartridge shell and the distal end of the actuator The bottom part of the assembly constitutes a detachable snap structure; when the staple cartridge is mounted on the execution frame, the side projections at the distal end of the staple cartridge housing are inserted into the side grooves at the distal end of the execution frame, and the binding staple cartridges are executed along the edge The movement of the frame in the front-rear direction, the elastic hook at the distal end of the nail cartridge shell is elastically deformed and then snapped to the bottom of the distal end of the execution frame to restrain the movement of the staple cartridge along the vertical direction of the execution frame; when the staple cartridge is removed from the execution frame When the side protrusion at the distal end of the nail cartridge shell is withdrawn from the side groove at the distal end of the actuator frame, the elastic hook at the distal end of the nail cartridge shell is elastically deformed and is separated from the bottom portion of the distal end of the execution frame, so that the nail The warehouse is separated from the execution rack.
所述钉仓壳的底部安装有底罩, 所述底罩的两侧分别卡接在钉仓壳的两侧 上。  The bottom of the cartridge housing is mounted with a bottom cover, and the two sides of the bottom cover are respectively engaged on both sides of the cartridge housing.
釆用上述技术方案后, 钉仓壳的推刀槽内安装带有凸块的切割刀, 钉仓壳 的近端处有弧形滑槽, 钉仓壳远端处的弹性卡钩与执行架远端处的底部组成可 装拆的卡扣结构。 当将钉仓壳安装到执行架上时, 钉仓壳远端处的弹性卡钩弹 性变形后卡接在执行架远端处的底部, 约束钉仓壳沿执行架上下方向的移动。 当将钉仓壳从执行架上拆卸时, 钉仓壳远端处的弹性卡钩弹性变形后脱离执行 架远端处的底部, 使钉仓壳脱离执行架。 钉仓在使用前, 切割刀的凸块被约束 在钉仓壳的弧形滑槽内, 并且切割刀的刀刃位于钉仓壳的推刀槽内。 钉仓在使 用时, 滑杆推动切割刀, 使切割刀的刀刃从钉仓壳的推刀槽内伸出。 钉仓在使 用后, 滑杆将切割刀带回使切割刀的凸块重新被约束在钉仓壳的弧形滑槽内, 并使切割刀的刀刃重新位于钉仓壳的推刀槽内, 此时, 切割刀的倾角小于 45 。 , 无法在滑杆的推动下从钉仓的近端处向远端处移动, 可防止使用过的钉仓 被再次使用。 从而可在同一腔镜外科切割吻合器的执行头上仅更换带有切割刀 的钉仓, 即可使用同一把腔镜夕卜科切割吻合器执行多次切割吻合的腔镜外科手 术, 使得使用时更方便安全、 装拆钉仓时更便利, 手术费用更低。  After using the above technical solution, a cutting knife with a bump is installed in the pusher slot of the nail cartridge shell, and a curved chute is arranged at the proximal end of the nail cartridge shell, and the elastic hook and the execution frame at the distal end of the nail cartridge shell The bottom portion at the distal end constitutes a detachable snap structure. When the cartridge housing is mounted to the mounting frame, the resilient hook at the distal end of the cartridge housing is elastically deformed and snapped to the bottom of the distal end of the actuator to restrain the movement of the cartridge housing in the up and down direction of the actuator. When the cartridge housing is removed from the actuator, the resilient hook at the distal end of the cartridge housing is resiliently deformed and disengaged from the bottom of the distal end of the actuator to disengage the cartridge housing from the actuator. Before the staple cartridge is used, the projection of the cutter is restrained in the arc chute of the cartridge housing, and the cutting edge of the cutter is located in the pusher groove of the cartridge housing. When the staple cartridge is in use, the slide bar pushes the cutter to extend the blade edge of the cutter from the pusher slot of the staple cartridge housing. After the staple cartridge is in use, the slide bar brings the cutter back to cause the projection of the cutter to be re-constrained in the arc chute of the cartridge casing, and the blade edge of the cutter is relocated in the pusher slot of the cartridge casing. At this time, the cutting angle of the cutter is less than 45. It cannot be moved from the proximal end of the staple cartridge to the distal end under the push of the slide bar, preventing the used staple cartridge from being used again. Therefore, only the staple cartridge with the cutting knife can be replaced on the execution head of the same endoscopic surgical cutting stapler, and the same endoscopic surgical cutting stapler can be used to perform multiple endoscopic laparoscopic surgery, so that the use It is more convenient and safer, more convenient when loading and unloading staples, and lower operating costs.
附图说明 DRAWINGS
图 1是表示本发明实施例的带有可更换钉仓的腔镜外科切割吻合器的关节 未转动时钉仓与钉砧之间张开时的外观立体图;  1 is a perspective view showing the appearance of a joint between a staple cartridge and an anvil when the joint of the endoscopic surgical cutting stapler with a replaceable staple cartridge is opened;
图 2是表示图 1的腔镜外科切割吻合器的关节转动时钉仓与钉砧之间张开 时的外观立体图;  Figure 2 is a perspective view showing the appearance when the joint between the staple cartridge and the anvil is rotated when the joint of the endoscopic surgical cutting stapler of Figure 1 is rotated;
图 3是表示图 1的腔镜外科切割吻合器的吻合器身、 延伸管、 关节和操作 机构被移去后执行头的钉仓与钉砧之间张开处的放大夕卜观立体图;  Figure 3 is an enlarged perspective view showing the opening of the staple cartridge, the extension tube, the joint and the operating mechanism of the endoscopic surgical cutting stapler of Figure 1 after the removal of the staple cartridge and the anvil;
图 4是表示图 1的腔镜外科切割吻合器的吻合器身、 延伸管、 关节和操作 机构被移去后执行头的钉仓与钉砧之间张开时的放大夕卜观立体图; 图 5是表示图 4的执行头的颈圈被移去后钉仓与钉砧之间张开时的放大外 观立体图; Figure 4 is an enlarged perspective view showing the staple body, the extension tube, the joint and the operating mechanism of the endoscopic surgical cutting stapler of Figure 1 when the staple cartridge and the anvil of the head are opened; Figure 5 is a perspective view showing an enlarged appearance when the collar of the actuator of Figure 4 is removed and the staple cartridge and the anvil are opened;
图 6是表示图 1的腔镜外科切割吻合器的吻合器身、 延伸管、 关节和操作 机构被移去后执行头的钉仓与钉砧之间闭合时的放大夕卜观立体图;  Figure 6 is an enlarged perspective view showing the staple body, the extension tube, the joint and the operating mechanism of the endoscopic surgical cutting stapler of Figure 1 when the staple cartridge and the anvil of the head are closed;
图 7是表示图 6的执行头的颈圈被移去后钉仓与钉砧之间闭合时的放大外 观立体图;  Figure 7 is an enlarged perspective view showing the closed state between the staple cartridge and the anvil after the collar of the actuator of Figure 6 is removed;
图 8是表示图 1 的腔镜夕卜科切割吻合器的执行头的背面的放大外观立体 图;  Figure 8 is an enlarged perspective view showing the back side of the execution head of the endoscopic cutting stapler of Figure 1;
图 9是表示图 1 的腔镜夕卜科切割吻合器的钉仓被取出后的放大外观立体 图;  Figure 9 is an enlarged perspective view showing the staple cartridge of the laparoscopic cutting stapler of Figure 1 taken out;
图 10是表示图 1的腔镜夕卜科切割吻合器的钉仓的底罩被移去后的放大外 观立体图;  Figure 10 is an enlarged perspective view showing the bottom cover of the staple cartridge of the laparoscopic cutting stapler of Figure 1 removed;
图 11是表示图 10的钉仓壳的放大外观立体图;  Figure 11 is a perspective view showing an enlarged appearance of the cartridge case of Figure 10;
图 12是表示图 1的执行头内的滑杆在推动切割刀、 推钉块、 推钉滑板和 吻合钉之前的放大夕卜观立体图;  Figure 12 is an enlarged perspective view showing the slider in the actuator of Figure 1 before pushing the cutter, the pusher block, the pusher slide and the staple;
图 13是表示图 1的执行头内的滑杆在推动切割刀、 推钉块、 推钉滑板和 吻合钉时的放大外观立体图;  Figure 13 is a perspective view showing an enlarged appearance of the slide bar in the actuator of Figure 1 when pushing the cutter, the pusher block, the pusher slide and the staple;
图 14是表示图 1的钉砧的放大外观立体图;  Figure 14 is a perspective view showing an enlarged appearance of the anvil of Figure 1;
图 15是表示图 1的执行架的放大夕卜观立体图;  Figure 15 is an enlarged perspective view showing the actuator of Figure 1;
图 16是表示图 1的钉仓内的切割刀的刀刃位于钉仓壳的推刀槽内时切割 刀与带有弧形滑槽的镶块组件的爆炸图;  Figure 16 is an exploded view showing the cutting blade and the insert assembly with the curved chute when the cutting edge of the cutting blade in the staple cartridge of Figure 1 is located in the pusher groove of the staple cartridge housing;
图 17是表示图 1的钉仓内的切割刀的刀刃从钉仓壳的推刀槽内伸出时切 割刀与带有弧形滑槽的镶块组件的爆炸图;  Figure 17 is an exploded view showing the cutting blade and the insert assembly with the curved chute when the cutting edge of the cutting blade in the staple cartridge of Figure 1 protrudes from the pusher groove of the staple cartridge housing;
图 18是表示图 1的钉仓在使用前, 钉仓内的切割刀的刀刃位于钉仓壳的 推刀槽内时切割刀与带有弹性挡板的另一种弧形滑槽的镶块组件的放大外观立 体图;  Figure 18 is a block diagram showing the cutting blade and another curved chute with an elastic baffle when the cutting edge of the cutting blade in the staple cartridge is located in the pusher groove of the staple cartridge housing prior to use. A magnified view of the component;
图 19是表示图 1的钉仓在使用时, 钉仓内的切割刀的刀刃从钉仓壳的推 刀槽内伸出时切割刀与带有弹性挡板的另一种弧形滑槽的镶块组件的放大外观 立体图;  Figure 19 is a view showing the cutting blade of the cutting blade of Figure 1 in use, and the cutting blade of the cutting blade in the staple cartridge protrudes from the pusher groove of the cartridge housing, and the other has a curved chute with an elastic baffle. An enlarged perspective view of the insert assembly;
图 20是表示图 1的钉仓在完成切割吻合操作后, 钉仓内的切割刀的刀刃 位于钉仓壳的推刀槽内时切割刀与带有弹性挡板的另一种弧形滑槽的镶块组件 的放大夕卜观立体图。  Figure 20 is a view showing the cutting blade and another curved chute with an elastic baffle when the cutting edge of the cutting blade in the staple cartridge is located in the pusher groove of the staple cartridge case after the cutting and stapling operation of the staple cartridge of Figure 1 is completed. A magnified perspective view of the inlay assembly.
具体实施方式 detailed description
下面结合附图和实施例对本发明作进一步详细的说明。 如图 1和图 2所示, 腔镜夕卜科切割吻合器由执行头 2、 关节 3、 延伸管 4、 吻合器身 5和操作机构 6组成。 操作机构 6位于吻合器身 5处, 经过延伸管 4 内腔控制执行头 2动作 (在吻合器身 5和延伸管 4内的部分操作机构 6未显示, 可参考本说明书中引用的美国专利)。执行头 2、 关节 3、延伸管 4、 吻合器身 5 依次顺序相连。 如图 4至图 13所示, 执行头 2由执行架 7、 滑杆 8、 钉仓 9和 钉砧 10组成。 在执行架 7上安装滑杆 8、 钉仓 9和钉砧 10。 钉仓 9由钉仓壳 11、 推钉块 12、 推钉滑板 13和吻合钉 14组成。 钉仓壳 11内有钉槽 15、 推钉 孔 16、滑板槽 17和推刀槽 18。 吻合钉 14安装在钉槽 15内。推钉块 12安装在 推钉孔 16内。推钉滑板 13安装在滑板槽 17内。钉仓壳 11的钉槽 15和推钉孔 16排列在推刀槽 18的两侧各排列三排。钉砧 10的端面上有与钉仓 9内的吻合 钉 14位置对应的吻合钉成形槽 19和与钉仓壳 11内的推刀槽 18位置对应的切 割槽 20。钉砧 10的吻合钉成形槽 19相应在钉砧 10的切割槽 20的两侧各排列 三排。 钉砧 10与执行架 7用枢轴连接。 The present invention will be further described in detail below with reference to the accompanying drawings and embodiments. As shown in FIGS. 1 and 2, the endoscopic sigma cutting stapler is composed of the executive head 2, the joint 3, the extension tube 4, the stapler body 5, and the operating mechanism 6. The operating mechanism 6 is located at the stapler body 5, and performs the operation of the head 2 through the lumen of the extension tube 4 (the partial operating mechanism 6 in the staple body 5 and the extension tube 4 is not shown, and can refer to the US patent cited in the present specification) . The execution head 2, the joint 3, the extension tube 4, and the stapler body 5 are sequentially connected in sequence. As shown in FIGS. 4 to 13, the execution head 2 is composed of an actuator 7, a slide bar 8, a magazine 9 and an anvil 10. A slide bar 8, a magazine 9 and an anvil 10 are mounted on the actuator 7. The staple cartridge 9 is composed of a staple cartridge housing 11, a pusher block 12, a pusher slide 13 and a staple 14. The staple cartridge housing 11 has a staple groove 15, a push pin hole 16, a slide groove 17, and a pusher groove 18. The staples 14 are mounted within the staple slots 15. The pusher block 12 is mounted within the push pin hole 16. The pusher slide 13 is mounted in the slide groove 17. The staple groove 15 and the push pin hole 16 of the staple cartridge case 11 are arranged in three rows on both sides of the pusher groove 18. The end surface of the anvil 10 has a staple forming groove 19 corresponding to the position of the staple 14 in the staple cartridge 9, and a cutting groove 20 corresponding to the position of the pusher groove 18 in the staple cartridge housing 11. The staple forming grooves 19 of the anvil 10 are arranged in three rows on each side of the cutting groove 20 of the anvil 10. The anvil 10 is pivotally coupled to the actuator 7.
如图 4至图 13所示, 钉仓壳 11的推刀槽 18内安装有切割刀 21。 当滑杆 8从钉仓壳 11的近端处向远端处移动时, 滑杆 8推动切割刀 21和推钉滑板 13 在钉仓壳 11的推刀槽 18内移动。 推钉滑板 13依靠斜面推动推钉块 12在推钉 孔 16内移动时将吻合钉 14从钉槽 15内推出。  As shown in Figs. 4 to 13, a cutter blade 21 is mounted in the pusher groove 18 of the magazine casing 11. When the slider 8 is moved from the proximal end of the cartridge housing 11 to the distal end, the slider 8 pushes the cutter blade 21 and the pusher slider 13 to move within the pusher groove 18 of the cartridge housing 11. The pusher slide 13 pushes the pusher block 12 through the bevel to push the staple 14 out of the staple groove 15 as it moves within the pusher hole 16.
如图 4至图 17所示, 钉仓壳 11的近端处嵌有镶块 22。 镶块 22内有弧形 滑槽 23。 弧形滑槽 23内有挡块 24。 切割刀 21有弧形凸块 25, 切割刀 21的远 端处有凹槽 26。 推钉滑板 13的近端处有凸块 27。 钉仓壳 11的滑板槽 17内有 挡块 28。 钉仓 9在使用前, 当切割刀 21的弧形凸块 25插在钉仓壳 11的镶块 22的弧形滑槽 23内、 切割刀 21的凹槽 26嵌入推钉滑板 13的凸块 27形成局 部枢轴连接时, 弧形滑槽 23内的挡块 24使切割刀 21的弧形凸块 25被约束在 钉仓壳 11的镶块 22的弧形滑槽 23内, 钉仓壳 11的滑板槽 17内的挡块 28使 推钉滑板 13被约; ½钉仓壳 11的滑板槽 17内, 从而使切割刀 21和推钉滑板 13被约束在钉仓壳 11 内, 此时, 切割刀 21的倾角大于 45。 , 并且使切割刀 21的刀刃 29位于钉仓壳 11的推刀槽 18内。 钉仓 9在使用时, 当滑杆 8从钉 仓壳 11的近端处向远端处移动时, 滑杆 8首先推动切割刀 21 , 在切割刀 21的 弧形凸块 25的挤压作用下弧形滑槽 23内的挡块 24发生弹性变形后脱离约束, 以便切割刀 21的弧形凸块 25从钉仓壳 11的弧形滑槽 23内被推出, 同时, 使 切割刀 21的凹槽 26绕推钉滑板 13的凸块 27枢轴转动, 使切割刀 21的刀刃 29从钉仓壳 11的推刀槽 18内伸出, 然后, 滑杆 8推动切割刀 21以推动推钉 滑板 13, 使推钉滑板 13发生弹性变形后脱离滑板槽 17内的挡块 28的约束, 以便滑杆 8推动切割刀 21和推钉滑板 13从钉仓壳 11的近端处向远端处移动。 如图 10至图 17所示, 滑杆 8的远端处有凸块 30。 当滑杆 8从钉仓壳 11 的远端处向近端处移动时, 滑杆 8远端处的凸块 30先将切割刀 21带回钉仓壳 11的近端处, 然后在切割刀 21的弧形凸块 25的挤压作用下弧形滑槽 23内的 挡块 24发生弹性变形,以便切割刀 21的弧形凸块 25进入钉仓壳 11的镶块 22 的弧形滑槽 23的深处, 使切割刀 21的刀刃 29位于钉仓壳 11的推刀槽 18内。 As shown in Figures 4 to 17, the insert 22 is embedded at the proximal end of the cartridge housing 11. The insert 22 has an arcuate chute 23 therein. The arc chute 23 has a stop 24 therein. The cutting blade 21 has an arcuate projection 25 having a recess 26 at the distal end thereof. A bump 27 is present at the proximal end of the pusher slide 13. A stopper 28 is formed in the sliding groove 17 of the cartridge housing 11. Before the staple cartridge 9 is used, when the arcuate projection 25 of the cutter blade 21 is inserted into the arcuate chute 23 of the insert 22 of the cartridge housing 11, the groove 26 of the cutter blade 21 is embedded in the projection of the pusher slide 13 When the partial pivotal connection is formed 27, the stop 24 in the arcuate chute 23 causes the arcuate projection 25 of the cutting blade 21 to be constrained within the arcuate chute 23 of the insert 22 of the cartridge housing 11, the staple cartridge shell The stopper 28 in the slide groove 17 of the 11 causes the pusher slide 13 to be approximately 1⁄2 in the slide groove 17 of the staple cartridge housing 11, so that the cutter 21 and the pusher slide 13 are restrained in the cartridge housing 11, at this time The cutting angle of the cutting blade 21 is greater than 45. And the cutting edge 29 of the cutting blade 21 is placed in the pusher groove 18 of the cartridge housing 11. When the staple cartridge 9 is in use, when the slider 8 is moved from the proximal end of the cartridge housing 11 to the distal end, the slider 8 first pushes the cutter blade 21, and the pressing action of the curved projection 25 of the cutter blade 21 is performed. The stopper 24 in the lower curved chute 23 is elastically deformed and disengaged so that the arcuate projection 25 of the cutting blade 21 is pushed out from the arcuate chute 23 of the cartridge casing 11, and at the same time, the cutter 21 is The groove 26 is pivoted about the projection 27 of the pusher slide 13 such that the cutting edge 29 of the cutting blade 21 projects from the pusher groove 18 of the cartridge housing 11, and then the slider 8 pushes the cutter 21 to push the pusher The slide plate 13 causes the pusher slide 13 to elastically deform and disengage from the restraint of the stopper 28 in the slide groove 17, so that the slide bar 8 pushes the cutter 21 and the pusher slide 13 from the proximal end to the distal end of the staple cartridge case 11 mobile. As shown in FIGS. 10 to 17, a slider 30 is provided at the distal end of the slider 8. When the slider 8 is moved from the distal end of the cartridge housing 11 toward the proximal end, the projection 30 at the distal end of the slider 8 first brings the cutting blade 21 back to the proximal end of the cartridge housing 11, and then at the cutting blade The stopper 24 in the arcuate chute 23 is elastically deformed by the pressing of the arcuate projection 25 of 21 so that the arcuate projection 25 of the cutting blade 21 enters the arc chute of the insert 22 of the cartridge casing 11. In the depth of 23, the cutting edge 29 of the cutting blade 21 is placed in the pusher groove 18 of the cartridge housing 11.
如图 3至图 8、 图 11和图 15所示, 钉仓壳 11的远端处有弹性卡钩 31和 侧面凸块 32。 执行架 7的远端处有侧面凹槽 33。 钉仓壳 11远端处的弹性卡钩 31与执行架 7远端处的底部 34组成可装拆的卡扣结构。 当将钉仓 9安装到执 行架 7上时, 钉仓壳 11远端处的侧面凸块 32插入执行架 7远端处的侧面凹槽 33内, 约束钉仓 9沿执行架 7前后方向的移动, 同时, 钉仓壳 11远端处的弹 性卡钩 31弹性变形后卡接在执行架 7远端处的底部 34,约束钉仓 9沿执行架 7 上下方向的移动。 当将钉仓 9从执行架 7上拆卸时,钉仓壳 11远端处的侧面凸 块 32从执行架 7远端处的侧面凹槽 33内被抽出, 同时,钉仓壳 11远端处的弹 性卡钩 31弹性变形后脱离执行架 7远端处的底部 34, 使钉仓 9脱离执行架 7。 如图 9所示, 钉仓壳 11的底部安装有底罩 35。底罩 35的两侧分别卡接在钉仓 壳 11的两侧上。  As shown in Figs. 3 to 8, Fig. 11, and Fig. 15, the distal end of the magazine casing 11 has elastic hooks 31 and side projections 32. There is a side groove 33 at the distal end of the actuator 7. The elastic hook 31 at the distal end of the cartridge housing 11 and the bottom portion 34 at the distal end of the actuator 7 constitute a detachable snap structure. When the staple cartridge 9 is mounted to the actuator 7, the side projections 32 at the distal end of the cartridge housing 11 are inserted into the side grooves 33 at the distal end of the actuator 7, and the staple cartridges 9 are restrained in the front-rear direction of the actuator 7. At the same time, the elastic hook 31 at the distal end of the cartridge casing 11 is elastically deformed and then snapped to the bottom portion 34 at the distal end of the execution frame 7, and the movement of the staple cartridge 9 in the up and down direction of the actuator 7 is restrained. When the staple cartridge 9 is detached from the actuator 7, the side projections 32 at the distal end of the cartridge housing 11 are withdrawn from the side recesses 33 at the distal end of the actuator 7 while the distal end of the cartridge housing 11 is The elastic hook 31 is elastically deformed and disengages from the bottom portion 34 at the distal end of the actuator frame 7, so that the staple cartridge 9 is disengaged from the actuator 7. As shown in Fig. 9, a bottom cover 35 is attached to the bottom of the magazine casing 11. Both sides of the bottom cover 35 are respectively engaged on both sides of the magazine casing 11.
如图 18至图 20所示, 本发明的腔镜外科切割吻合器的钉仓壳 11的近端 处嵌有的另一种镶块 22, 镶块 22内有弧形滑槽 23 , 镶块 22的弧形滑槽 23内 有弹性挡板 36,弹性挡板 36将镶块 22的弧形滑槽 23分隔成近端弧形滑槽 23-1 和远端弧形滑槽 23-2。钉仓 9在使用前,切割刀 21的弧形凸块 25插在镶块 22 的近端弧形滑槽 23-1内,使切割刀 21的刀刃 29位于钉仓壳 11的推刀槽 18内, 镶块 22的弧形滑槽 23内的弹性挡板 36使切割刀 21的弧形凸块 25被约; ½镶 块 22的近端弧形滑槽 23-1内, 此时, 切割刀 21的倾角大于 45。 。 钉仓 9在 使用时, 滑杆 8从钉仓 9的近端处向远端处移动, 首先推动切割刀 21 , 在切割 刀 21的弧形凸块 25的挤压作用下弧形滑槽 23内的弹性挡板 36发生弹性变形, 以便切割刀 21的弧形凸块 25从镶块 22的近端弧形滑槽 23-1内被推出, 使切 割刀 21的刀刃 29从钉仓壳 11的推刀槽 18内伸出,然后推动切割刀 21在钉仓 壳 11的推刀槽 18内移动,同时弹性挡板 36回弹将镶块 22的近端弧形滑槽 23-1 封住。 完成切割吻合操作后, 滑杆 8从钉仓 9的远端处向近端处移动, 滑杆 8 远端处的凸块 30先将切割刀 21带回钉仓 9的近端处,然后在切割刀 21的弧形 凸块 25的挤压作用下弧形滑槽 23内的弹性挡板 36发生弹性变形,以便切割刀 21的弧形凸块 25进入镶块 22的远端弧形滑槽 23-2内,使切割刀 21的刀刃 29 位于钉仓壳 11的推刀槽 18内, 同时弧形滑槽 23内的弹性挡板 36回弹将切割 刀 21的弧形凸块 25约束在镶块 22的远端弧形滑槽 23-2内。当切割刀 21的弧 形凸块 25被约束在镶块 22的远端弧形滑槽 23-2内时, 切割刀 21的倾角小于 45。 18 to 20, another insert 22 embedded in the proximal end of the cartridge housing 11 of the endoscopic surgical cutting stapler of the present invention has a curved chute 23 in the insert 22, the insert The arcuate chute 23 of the 22 has an elastic baffle 36 therein. The resilient baffle 36 divides the arcuate chute 23 of the insert 22 into a proximal arcuate chute 23-1 and a distal arcuate chute 23-2. Prior to use, the curved projections 25 of the cutting blade 21 are inserted into the proximal curved chute 23-1 of the insert 22 such that the cutting edge 29 of the cutting blade 21 is located in the pusher slot 18 of the cartridge housing 11. Inside, the elastic baffle 36 in the arcuate chute 23 of the insert 22 causes the arcuate projection 25 of the cutting blade 21 to be approximately; the proximal arcuate chute 23-1 of the insert 22, at this time, cut The angle of inclination of the knife 21 is greater than 45. . When the staple cartridge 9 is in use, the slide bar 8 moves from the proximal end of the staple cartridge 9 to the distal end, first pushing the cutter blade 21, and the arcuate chute 23 under the action of the arcuate projection 25 of the cutter blade 21 The inner resilient baffle 36 is elastically deformed so that the arcuate projection 25 of the cutting blade 21 is pushed out from the proximal arcuate chute 23-1 of the insert 22, causing the cutting edge 29 of the cutting blade 21 to be removed from the cartridge housing 11. The pusher slot 18 extends and then pushes the cutter 21 to move within the pusher slot 18 of the cartridge housing 11, while the resilient flap 36 rebounds to seal the proximal curved slot 23-1 of the insert 22. . After the cutting and stapling operation is completed, the slide bar 8 moves from the distal end of the staple cartridge 9 toward the proximal end, and the bump 30 at the distal end of the slide bar 8 first brings the cutting blade 21 back to the proximal end of the staple cartridge 9, and then The elastic baffle 36 in the arcuate chute 23 is elastically deformed by the pressing of the arcuate projection 25 of the cutting blade 21 so that the arcuate projection 25 of the cutting blade 21 enters the distal curved chute of the insert 22. In 23-2, the cutting edge 29 of the cutting blade 21 is placed in the pusher groove 18 of the cartridge housing 11, while the elastic baffle 36 in the arcuate chute 23 rebounds to constrain the arcuate projection 25 of the cutting blade 21 to The distal end of the insert 22 is in the arcuate chute 23-2. When the arc of the cutter 21 When the shaped lug 25 is constrained within the distal arcuate chute 23-2 of the insert 22, the angle of inclination of the cutting blade 21 is less than 45.
使用过的钉仓 9内已无吻合钉 14,再次执行切割吻合的腔镜夕卜科手术必将 造成手术失败, 必须更换成新的带有切割刀的钉仓才可再次使用。 由于当切割 刀 21的弧形凸块 25被约; ½钉仓壳 11的镶块 22的远端弧形滑槽 23-2内时, 切割刀 21的倾角小于 45° , 因此当使用过的钉仓 9仍在执行架 7上时, 如果 腔镜外科切割吻合器 1再次执行切割吻合的腔镜外科手术, 将滑杆 8从钉仓 9 的近端处向远端处移动, 则滑杆 8推动切割刀 21使切割刀 21的弧形凸块 25 在钉仓壳 11的镶块 22的远端弧形滑槽 23-2上,防止滑杆 8进一步从钉仓 9的近端处向远端处移动, 既可防止使用过的钉仓 9被再次使用而造成的手术 失败, 又可及时提醒腔镜外科切割吻合器的使用者应该更换成新的钉仓。  The used staple cartridge 9 has no staples. 14. The laparoscopic surgery that performs the cutting anastomosis again will cause the operation to fail. It must be replaced with a new staple cartridge with a cutting knife before it can be used again. Since the cutting edge of the cutting blade 21 is less than 45° when the curved projection 25 of the cutting blade 21 is about 1⁄2 in the distal curved chute 23-2 of the insert 22 of the cartridge housing 11, when used While the staple cartridge 9 is still on the rack 7, if the endoscopic surgical cutting stapler 1 performs the endoscopic laparoscopic surgery again, moving the slide bar 8 from the proximal end of the staple cartridge 9 to the distal end, the slide bar 8 pushing the cutting blade 21 such that the curved projection 25 of the cutting blade 21 is on the distal curved chute 23-2 of the insert 22 of the cartridge housing 11, preventing the slider 8 from further moving from the proximal end of the staple cartridge 9 The distal end moves to prevent the surgical failure caused by the used staple cartridge 9 being reused, and the user of the laparoscopic surgical cutting stapler should be promptly replaced with a new staple cartridge.
与现有的各种腔镜外科切割吻合器相比较, 本发明的带有可更换钉仓的腔 镜外科切割吻合器可在同一腔镜外科切割吻合器的执行头上仅更换带有新的吻 合钉和切割刀的钉仓, 即可使用同一把腔镜夕卜科切割吻合器执行多次切割吻合 的腔镜外科手术,使得使用时更方便安全、装拆钉仓时更便利, 手术费用更低。  Compared with the existing various endoscopic surgical cutting staplers, the endoscopic surgical cutting stapler of the present invention with a replaceable staple cartridge can be replaced only with a new one on the execution head of the same endoscopic surgical cutting stapler The staple cartridge of the staple and the cutting knife can be used to perform multiple endoscopic laparoscopic surgery using the same endoscopic sigma cutting stapler, which makes the use more convenient and safe, and is more convenient when loading and unloading the nail cartridge. Lower.
这里所述的仅仅是本发明申请的典型的最佳实施形式, 可以对上述结构作 某些变化也不违背本发明的精神和范围。 本发明不局限或被限止于这里所陈述 的具体细节, 而应保留对所属领域中等技术人员来说是显而易见的任何改进或 改型。  The present invention has been described in terms of a typical preferred embodiment of the present invention, and it is possible to make some changes to the above-described structure without departing from the spirit and scope of the invention. The invention is not limited or limited to the specific details set forth herein, and any modifications or variations that are obvious to those skilled in the art are
需要补充说明的是: 本文中的术语 "近端" 是指腔镜夕卜科切割吻合器靠近 操作者的一端, 而术语 "远端" 是指腔镜夕卜科切割吻合器远离操作者的一端。  It should be added that the term "proximal" in this context refers to the end of the endoscopic cutting stapler near the operator, and the term "distal" refers to the endoscopic cutting stapler away from the operator. One end.

Claims

权 利 要 求 书 Claim
1、 一种带有可更换钉仓的腔镜外科切割吻合器, 包括吻合器身 (5)、 执 行头( 2 )、 连接吻合器身 ( 5 )和执行头( 2 )的延伸管( 4 )、 控制执行头( 2 ) 动作的操作机构 (6), 执行头(2) 由执行架(7)、 滑杆(8)、 钉仓(9)和钉 砧( 10 )组成, 钉仓 ( 9 )由钉仓壳( 11 )、 推钉块 ( 12 )、 推钉滑板( 13 )和吻 合钉 ( 14 )组成, 钉仓壳( 11 ) 内有钉槽 ( 15 )、 推钉孔 ( 16 )、 滑板槽 ( 17 ) 和推刀槽 ( 18 ), 吻合钉 ( 14 )安装在所述钉槽( 15 )内, 所述推钉块( 12 )安 装在所述推钉孔 (16) 内, 所述推钉滑板( 13 )安装在所述滑板槽 (17) 内, 钉仓壳 ( 11 )的钉槽 ( 15 )和推钉孔 ( 16 )排列在推刀槽 ( 18 )的两侧, 所述 钉砧 ( 10 )的端面上有与钉仓( 9 )内的吻合钉 ( 14 )位置对应的吻合钉成形槽1. A laparoscopic surgical cutting stapler with a replaceable staple cartridge, comprising an anastomotic body (5), an executive head (2), an anastomotic body (5), and an extension tube for the execution head (2) (4) ), an operating mechanism (6) that controls the execution of the head (2), and an actuator (2) consisting of an actuator (7), a slider (8), a staple cartridge (9), and an anvil (10), a staple cartridge ( 9) consisting of a staple cartridge shell (11), a pusher block (12), a pusher slide (13) and a staple (14), the staple cartridge shell (11) having a nail groove (15) and a push nail hole (16) a slide groove (17) and a pusher groove (18), the staple (14) is installed in the nail groove (15), and the push block (12) is installed in the push hole (16) The pusher slide plate (13) is installed in the slide groove (17), and the nail groove (15) and the push pin hole (16) of the staple cartridge case (11) are arranged on both sides of the pusher groove (18) The end surface of the anvil (10) has an anastomosis forming groove corresponding to the position of the staple (14) in the staple cartridge (9)
( 19 )和与钉仓壳( 11 )内的推刀槽( 18 )位置对应的切割槽( 20 ), 其特征在 于: 钉仓壳( 11 )的推刀槽( 18 ) 内安装有切割刀 (21 ), 钉仓壳( 11 )的近端 处有弧形滑槽(23), 且切割刀(21)上具有弧形凸块(25), 所述钉仓(9)在 使用前,切割刀(21 )的弧形凸块(25 )插在所述钉仓壳 ( 11 )的弧形滑槽(23 ) 内, 使切割刀 (21 )的刀刃 (29)位于所述钉仓壳(11)的推刀槽(18) 内; 钉仓 ( 9 )在使用时, 所述滑杆( 8 )从钉仓 ( 9 )的近端处向远端处移动, 首先 滑杆(8)推动切割刀(21 ), 并将切割刀(21 )的弧形凸块(25)从钉仓壳(11 ) 的弧形滑槽(23) 内推出, 使切割刀 (21)的刀刃 (29)从钉仓壳(11 )的推 刀槽(18) 内伸出, 然后滑杆(8)推动切割刀 (21 )在钉仓壳(11)的推刀槽(19) and a cutting groove (20) corresponding to the position of the pusher groove (18) in the magazine casing (11), characterized in that: a cutter is installed in the pusher groove (18) of the magazine casing (11) (21), the proximal end of the staple cartridge shell (11) has a curved chute (23), and the cutting blade (21) has an arcuate projection (25), and the staple cartridge (9) is used before use. An arcuate projection (25) of the cutting blade (21) is inserted into the arcuate chute (23) of the cartridge housing (11) such that the cutting edge (29) of the cutting blade (21) is located in the cartridge housing (11) inside the pusher slot (18); when the staple cartridge (9) is in use, the slider (8) moves from the proximal end of the staple cartridge (9) to the distal end, first the slider (8) Pushing the cutting blade (21) and pushing the curved projection (25) of the cutting blade (21) out of the curved chute (23) of the cartridge housing (11) to make the cutting edge of the cutting blade (21) ) projecting from the pusher slot (18) of the cartridge housing (11), and then the slider (8) pushes the cutter knife (21) into the pusher slot of the cartridge housing (11)
( 18 ) 内移动, 推钉滑板 ( 13 )依靠其斜面推动推钉块 ( 12 )在推钉孔 ( 16 ) 内移动时将吻合钉 (14)从钉槽 (15) 内推出。 (18) Moving inside, the pusher slide (13) pushes the staple (14) out of the staple groove (15) by pushing the pusher block (12) in the pusher hole (16).
2、 根据权利要求 1 所述的带有可更换钉仓的腔镜外科切割吻合器, 其特 征在于: 所述钉仓壳 ( 11 )近端处的弧形滑槽(23 )位于钉仓壳 ( 11 )近端处 的两侧, 所述切割刀 (21 )的弧形凸块(25)位于切割刀 (21 )的两侧。  2. The endoscopic surgical cutting stapler with a replaceable staple cartridge according to claim 1, wherein: the curved chute (23) at the proximal end of the staple cartridge shell (11) is located in the staple cartridge shell (11) On both sides of the proximal end, the arcuate projections (25) of the cutting blade (21) are located on both sides of the cutting blade (21).
3、 根据权利要求 2 所述的带有可更换钉仓的腔镜外科切割吻合器, 其特 征在于:所述钉仓壳( 11 )的弧形滑槽 ( 23 )内有弹性挡块 ( 24 );弹性挡块 ( 24 ) 使切割刀 ( 21 )的弧形凸块( 25 )被约; ½钉仓壳( 11 )的弧形滑槽( 23 )内。  3. The endoscopic surgical cutting stapler with a replaceable staple cartridge according to claim 2, wherein the curved chute (23) of the staple cartridge shell (11) has an elastic stop (24) The elastic stop (24) causes the arcuate projection (25) of the cutter (21) to be approximately; 1⁄2 within the arcuate chute (23) of the staple cartridge shell (11).
4、 根据权利要求 1 所述的带有可更换钉仓的腔镜外科切割吻合器, 其特 征在于: 所述切割刀(21 )的远端处有凹槽(26 ), 所述推钉滑板 ( 13 )的近端 处有凸块 ( 27 ), 所述切割刀 ( 21 )的凹槽 ( 26 )嵌入所述推钉滑板( 13 )的凸 块(27)形成局部枢轴连接。  4. The endoscopic surgical cutting stapler with a replaceable staple cartridge according to claim 1, wherein: the cutting blade (21) has a groove (26) at a distal end thereof, and the pusher skateboard At the proximal end of (13) there is a bump (27), and the groove (26) of the cutting blade (21) is embedded in the projection (27) of the pusher slide (13) to form a partial pivotal connection.
5、 根据权利要求 1 所述的带有可更换钉仓的腔镜外科切割吻合器, 其特 征在于: 所述钉仓壳的( 11 )近端处嵌有镶块(22), 弧形滑槽(23 )位于镶块 (22) 内。 5. The endoscopic surgical cutting stapler with a replaceable staple cartridge according to claim 1, wherein: the insert (22) is embedded in the proximal end of the staple cartridge shell, and is curved and slippery. Slot (23) is located in the insert (22) Inside.
6、 根据权利要求 1或 3或 4所述的带有可更换钉仓的腔镜外科切割吻合 器, 其特征在于: 所述滑杆(8)的远端处有凸块(30), 当滑杆(8)从所述钉 仓(11)的远端处向近端处移动时, 凸块(30)将所述切割刀 (21 )带回钉仓 6. The endoscopic surgical cutting stapler with a replaceable staple cartridge according to claim 1 or 3 or 4, wherein: the slider (8) has a projection (30) at the distal end thereof, When the slider (8) moves from the distal end of the staple cartridge (11) to the proximal end, the bump (30) brings the cutting blade (21) back to the staple cartridge
(11 )的近端处。 At the proximal end of (11).
7、 根据权利要求 1 所述的带有可更换钉仓的腔镜外科切割吻合器, 其特 征在于: 弧形滑槽内 ( 23 )有弹性挡板 ( 36 ), 所述弹性挡板 ( 36 )将的弧形滑 槽(23)分隔成近端弧形滑槽(23-1)和远端弧形滑槽(23-2); 所述钉仓在使 用前, 所述切割刀 (21)的弧形凸块(25)分别插在镶块(22)的近端弧形滑 槽(23-1 ) 内, 使切割刀 (21 )的刀刃 (29)位于所述钉仓壳(11 )的推刀槽 7. The endoscopic surgical cutting stapler with a replaceable staple cartridge according to claim 1, wherein: the curved chute (23) has an elastic baffle (36), and the elastic baffle (36) Separating the curved chute (23) into a proximal arc chute (23-1) and a distal arc chute (23-2); the cutting knives (21) before use The arcuate projections (25) are respectively inserted into the proximal arcuate chutes (23-1) of the inserts (22) such that the cutting edges (29) of the cutting blades (21) are located in the staple cartridge shells (11). Pusher slot
(18) 内, 镶块(22)的弧形滑槽(23) 内的弹性挡板 (36)使切割刀 (21) 的弧形凸块(25)被约束在镶块 (22)的近端弧形滑槽(23-1 ) 内; 钉仓(9) 在使用时, 所述滑杆(8)从钉仓(9)的近端处向远端处移动, 首先推动切割 刀 (21 ), 在切割刀 (21)的弧形凸块(25)的挤压作用下弧形滑槽(23)内的 弹性挡板 ( 36 )发生弹性变形, 以便切割刀( 21 )的弧形凸块( 25 )从镶块( 22 ) 的近端弧形滑槽(23-1 )内被推出,使切割刀(21)的刀刃(29)从钉仓壳(11 ) 的推刀槽( 18 ) 内伸出, 然后滑杆( 8 )推动切割刀 ( 21 )在钉仓壳( 11 )的推 刀槽( 18 )内移动,同时弹性挡板 ( 36 )回弹将镶块 ( 22 )的近端弧形滑槽 ( 23-1 ) 封住; 当滑杆( 8 )从钉仓 ( 9 )的远端处向近端处移动时, 滑杆( 8 )先将切割 刀 (21)带回钉仓 (9)的近端处, 然后在切割刀(21)的弧形凸块(25)的挤 压作用下弧形滑槽( 23 )内的弹性挡板( 36 )发生弹性变形, 以便切割刀 ( 21 ) 的弧形凸块(25)进入镶块的远端弧形滑槽(23-2) 内, 使切割刀 (21 )的刀 刃 (29)位于钉仓壳(11 )的推刀槽(18) 内, 同时弧形滑槽(23) 内的弹性 挡板(36)回弹将切割刀 (21 )的弧形凸块(25)约束在镶块 (22)的远端弧 形滑槽(23-2) 内。 (18) Inside, the elastic baffle (36) in the curved chute (23) of the insert (22) causes the curved lug (25) of the cutting blade (21) to be constrained to the vicinity of the insert (22) Inside the curved chute (23-1); the staple cartridge (9), in use, moves from the proximal end of the staple cartridge (9) to the distal end, first pushing the cutter (21) The elastic baffle (36) in the arc chute (23) is elastically deformed under the action of the arcuate projections (25) of the cutting blade (21) so as to be curved convex of the cutting blade (21) The block (25) is pushed out from the proximal curved chute (23-1) of the insert (22), causing the cutting edge (29) of the cutting blade (21) to be pushed from the pusher groove of the staple cartridge casing (11) (18) ) extends inside, and then the slider (8) pushes the cutter (21) to move within the pusher slot (18) of the cartridge housing (11) while the resilient flap (36) rebounds to insert the insert (22) The proximal curved chute ( 23-1 ) is sealed; when the sliding rod ( 8 ) moves from the distal end of the staple cartridge ( 9 ) to the proximal end, the sliding rod ( 8 ) first takes the cutting blade ( 21 ) Pressing the proximal end of the staple cartridge (9) and then pressing under the arcuate projections (25) of the cutting blade (21) The elastic baffle (36) in the curved chute (23) is elastically deformed so that the arcuate projection (25) of the cutting blade (21) enters the distal curved chute (23-2) of the insert, The cutting edge (29) of the cutting blade (21) is placed in the pusher groove (18) of the cartridge housing (11), while the elastic baffle (36) in the curved chute (23) rebounds to cut the knife (21) The arcuate projections (25) are constrained within the distal arcuate chute (23-2) of the insert (22).
8、 根据权利要求 8 所述的带有可更换钉仓的腔镜外科切割吻合器, 其特 征在于: 当所述切割刀 (21)的弧形凸块(25)被约; ½所述钉仓壳(11)的 远端弧形滑槽(23-2) 内时, 切割刀的倾角小于 45。 。  8. The endoscopic surgical cutting stapler with a replaceable staple cartridge according to claim 8, wherein: when the arcuate projection (25) of the cutting blade (21) is about; When the distal end of the casing (11) is in the curved chute (23-2), the angle of inclination of the cutter is less than 45. .
9、 根据权利要求 1 所述的带有可更换钉仓的腔镜外科切割吻合器, 其特 征在于: 所述钉仓壳 ( 11 )的远端处有弹性卡钩(31 )和侧面凸块 ( 32 ), 所述 执行架(7)的远端处有侧面凹槽(33), 所述钉仓壳(11 )远端处的弹性卡钩 9. The endoscopic surgical cutting stapler with a replaceable staple cartridge according to claim 1, wherein: the distal end of the cartridge housing (11) has an elastic hook (31) and a side projection (32), the distal end of the actuator frame (7) has a side groove (33), and the elastic hook at the distal end of the nail cartridge shell (11)
(31 )与所述执行架 ( 7 )远端处的底部组成可装拆的卡扣结构; 当将钉仓 ( 9 ) 安装到执行架 ( 7 )上时,钉仓壳 ( 11 )远端处的侧面凸块 ( 33 )插入执行架 ( 7 ) 远端处的侧面凹槽(33)内, 约束钉仓沿执行架(7)前后方向的移动, 钉仓壳 ( 11 )远端处的弹性卡钩 (31 )弹性变形后卡接在执行架(7 )远端处的底部, 约束钉仓沿执行架( 7 )上下方向的移动; 当将钉仓 ( 9 )从执行架( 7 )上拆卸 内被抽出, 钉仓壳(n)远端处的弹性卡钩 (31)弹性变形后脱离执行架(7) 远端处的底部, 使钉仓 (8)脱离执行架(7)。 (31) forming a detachable snap structure with the bottom at the distal end of the actuator (7); when mounting the staple cartridge (9) to the actuator (7), the distal end of the staple cartridge (11) The side lug (33) is inserted into the side groove (33) at the distal end of the actuator (7) to restrain the movement of the staple cartridge in the front-rear direction of the actuator (7), and the cartridge housing (11) The elastic hook (31) at the distal end is elastically deformed and then snapped to the bottom of the end of the actuator (7) to restrain the movement of the staple cartridge along the upper and lower directions of the actuator (7); when the staple cartridge (9) ) is removed from the actuator (7), and the elastic hook (31) at the distal end of the cartridge housing (n) is elastically deformed and then disengaged from the bottom of the distal end of the actuator (7) to make the staple cartridge (8) Detach the actuator (7).
10、 根据权利要求 1所述的带有可更换钉仓的腔镜外科切割吻合器, 其特 征是: 所述钉仓壳(11 )的底部安装有底罩(35), 所述底罩(35)的两侧分别 卡接在钉仓壳(11)的两侧上。  10. The endoscopic surgical cutting stapler with a replaceable staple cartridge according to claim 1, wherein: the bottom of the cartridge housing (11) is provided with a bottom cover (35), the bottom cover ( The two sides of the 35) are respectively snapped on both sides of the staple cartridge case (11).
PCT/CN2010/079796 2010-09-28 2010-12-15 Endoscopic surgical cutting stapler with replaceable staple cartridge WO2012040984A1 (en)

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