CN113693661B - Guide assembly and circular tube type anastomat - Google Patents
Guide assembly and circular tube type anastomat Download PDFInfo
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- CN113693661B CN113693661B CN202010431815.0A CN202010431815A CN113693661B CN 113693661 B CN113693661 B CN 113693661B CN 202010431815 A CN202010431815 A CN 202010431815A CN 113693661 B CN113693661 B CN 113693661B
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- 230000001050 lubricating effect Effects 0.000 claims description 6
- 239000000463 material Substances 0.000 claims description 5
- 230000007704 transition Effects 0.000 claims description 4
- 210000001519 tissue Anatomy 0.000 abstract description 48
- 210000004877 mucosa Anatomy 0.000 abstract description 8
- 210000004400 mucous membrane Anatomy 0.000 description 8
- 238000000034 method Methods 0.000 description 5
- 230000008569 process Effects 0.000 description 5
- 230000000694 effects Effects 0.000 description 4
- 238000010304 firing Methods 0.000 description 4
- 239000000314 lubricant Substances 0.000 description 4
- 210000000813 small intestine Anatomy 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 239000004744 fabric Substances 0.000 description 3
- 238000004519 manufacturing process Methods 0.000 description 3
- 230000000149 penetrating effect Effects 0.000 description 3
- 210000000436 anus Anatomy 0.000 description 2
- 230000003247 decreasing effect Effects 0.000 description 2
- 230000002496 gastric effect Effects 0.000 description 2
- 230000013011 mating Effects 0.000 description 2
- 239000004033 plastic Substances 0.000 description 2
- 239000005060 rubber Substances 0.000 description 2
- 229920000297 Rayon Polymers 0.000 description 1
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 230000003872 anastomosis Effects 0.000 description 1
- 239000011324 bead Substances 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 239000011248 coating agent Substances 0.000 description 1
- 238000000576 coating method Methods 0.000 description 1
- 238000007598 dipping method Methods 0.000 description 1
- 238000001125 extrusion Methods 0.000 description 1
- 210000001035 gastrointestinal tract Anatomy 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 230000000968 intestinal effect Effects 0.000 description 1
- 238000005461 lubrication Methods 0.000 description 1
- 230000003387 muscular Effects 0.000 description 1
- 230000001575 pathological effect Effects 0.000 description 1
- 229920000642 polymer Polymers 0.000 description 1
- 229920001296 polysiloxane Polymers 0.000 description 1
- 239000002964 rayon Substances 0.000 description 1
- 230000003252 repetitive effect Effects 0.000 description 1
- 239000000741 silica gel Substances 0.000 description 1
- 229910002027 silica gel Inorganic materials 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
The invention provides a guide assembly and a circular tube type anastomat, wherein the guide assembly is used for guiding a nail bin assembly of the circular tube type anastomat to enter an operation part, the nail bin assembly comprises a nail cylinder, at least one window is arranged on the side surface of the nail cylinder, the guide assembly comprises a first guide piece and a second guide piece, the first end of the first guide piece is detachably sleeved on the far end side of the nail cylinder, and when the first guide piece is subjected to external force towards the far end side, the first guide piece can move towards the far end side to be separated from the nail cylinder; the second guide piece is sleeved on the outer side of the nail barrel, and covers the far-end side face of the window. The invention provides a guide component for a circular tube type anastomat, which can well guide a nail bin component to enter an operation part and prevent damage to tissue mucosa when the nail bin component is taken out of the tissue after the operation is finished.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a guide assembly and a circular tube type anastomat.
Background
In the prior art, the circular tube type anastomat comprises an anastomat body, an operating handle movably connected with the anastomat body and a nail anvil component matched with the body. The anastomat body comprises a firing assembly and a nail bin assembly arranged at the far end side. In the operation process, two sections of tissues needing to be anastomosed are placed between a nail anvil of a nail anvil assembly and a nail bin of a nail bin assembly, the distance between the nail anvil and the nail bin is adjusted to gradually clamp the tissues, and then a firing assembly is driven by operating a handle to enable anastomoses to be molded on the nail anvil, so that anastomotic connection of the two sections of tissues is completed.
During actual surgical procedures, the body portion of the tubular stapler, i.e., the cartridge portion, is required to enter the tissue tract from one end of the tissue. For example, in low-level rectal surgery, which requires transanal access, it is difficult to insert a large diameter instrument into the anus because the anus is a muscular opening and is in a contracted state. As another example, in gastric bypass surgery or gastric sleeve surgery, the body of the stapler needs to enter the small intestine through the tissue stump and travel a distance in the small intestine. The small intestine is in a separated state after the pathological tissues are resected in the operation, and the intestinal walls are in a state of being attached together, so that the nail barrel part of the circular tube type anastomat is not easy to enter tubular tissues, meanwhile, the inner wall of the digestive tract is a tissue mucosa, and the circular tube type anastomat is easy to damage the mucosa when passing in the small intestine. After the operation is completed, the doctor needs to take out the nail barrel part from the tissue, and the nail barrel part passes through the tissue in the process of taking out, so that the mucous membrane is easily damaged.
In the present invention, the distal end side and the proximal end side are the proximal end side with respect to the operator, and the end closer to the operator, that is, the end closer to the surgical site is the distal end side. In the anastomat, the inner side and the outer side are relative to the axis of the anastomat, the side close to the axis is the inner side, and the side far away from the axis is the outer side.
Disclosure of Invention
Aiming at the problems in the prior art, the invention aims to provide a guide assembly and a circular tube type anastomat, wherein the guide assembly can well guide a nail bin assembly to enter an operation part, and prevent damage to a tissue mucosa when the nail bin assembly is taken out of the tissue after the operation is finished.
The embodiment of the invention provides a guide assembly, which is used for a nail bin assembly of a circular tube type anastomat, wherein the nail bin assembly comprises a nail cylinder, and at least one window is formed in the side surface of the nail cylinder;
the guide assembly includes:
The first end of the first guide piece is detachably sleeved on the distal end side of the nail barrel, and when the first guide piece is subjected to external force in the distal end side direction, the first guide piece can move towards the distal end side to be separated from the nail barrel;
the second guide piece is sleeved on the outer side of the nail barrel, and covers the far-end side face of the window.
Optionally, the first guide and the second guide are each a flexible material member.
Optionally, the first end of the first guide member includes an elastic portion, and when the elastic portion is sleeved on the nail barrel, the elastic portion is in an expanded state.
Optionally, the second guiding piece is an elastic piece, and when the second guiding piece is sleeved on the outer side of the nail barrel, the elastic piece is in an expanded state.
Optionally, the second guide piece is detachably sleeved on the outer side of the nail barrel;
When the second guide piece is not sleeved on the outer side of the nail barrel, the second guide piece is of a cylindrical structure.
Optionally, a connecting rib is disposed between the first end of the first guide member and the distal end side of the second guide member, and when the first guide member is subjected to an external force in the distal end side direction, the first guide member can move toward the distal end side to break the connecting rib.
Optionally, there is an overlap region of the first end of the first guide with the distal side of the second guide, and the first end of the first guide covers the outer side of the distal side of the second guide at the overlap region.
Optionally, the thickness of the first guide is less than 0.1 mm and/or the thickness of the second guide is less than 0.1 mm.
Optionally, the cartridge assembly further comprises an anvil pull rod at least partially located inside the cartridge, a puncture part is provided at a distal end side of the anvil pull rod, a second end of the first guide member is a closed end, and when the anvil pull rod moves to the distal end side of the stapler to protrude out of the distal end side of the cartridge, the second end of the first guide member is located at the distal end side of the puncture part.
Optionally, the cartridge assembly further comprises an anvil pull rod at least partially located inside the cartridge, a piercing portion is disposed at a distal end side of the anvil pull rod, an opening is disposed at a second end of the first guide member, when the anvil pull rod moves to the distal end side of the stapler to protrude out of the distal end side of the cartridge, the piercing portion of the anvil pull rod penetrates through the opening, and the second end of the first guide member is stopped at the piercing portion.
Optionally, the nail barrel comprises a first tubular part, a connecting part and a second tubular part from the far end side to the near end side, the window is arranged on the connecting part, the outer diameter of the first tubular part is larger than that of the second tubular part, and the outer surface of the connecting part is a smooth transition curved surface;
when the second guide piece is sleeved on the outer side of the nail barrel, the inner diameter of the distal end side of the second guide piece is larger than the inner diameter of the proximal end side of the second guide piece.
Optionally, an opening is provided at a position of the second guide corresponding to the window, and a distance from a distal side surface of the opening to a distal side of the cartridge is greater than a distance from a distal side surface of the window to a distal side of the cartridge.
Optionally, the second guiding piece can be unfolded to a one-piece structure, and two opposite sides of the one-piece structure are provided with positioning parts, and when the second guiding piece is sleeved outside the nail barrel, the two opposite sides of the one-piece structure are connected through the positioning parts.
Optionally, the positioning portion includes concave-convex edges disposed on two opposite sides of the one-piece structure, and when the second guide member is sleeved on the outer side of the nail barrel, the concave-convex edges on the two opposite sides of the one-piece structure are meshed with each other.
Optionally, the inner side surface of the second guide is provided with a protrusion.
Optionally, the outer surface of the first guide is at least partially coated with a lubricating layer and/or the surface of the second guide is at least partially coated with a lubricating layer.
The embodiment of the invention also provides a circular tube type anastomat, which comprises the guide assembly.
In summary, by adopting the guide assembly of the invention, the cartridge assembly can be well guided into the operation site to protect the residual tissues and the mucous membrane layers of the tissues, and after the cartridge assembly reaches the operation position, the first guide member is applied with an external force towards the distal end side, so that the guide member can be conveniently removed from the distal end side at least partially, the operation is simple, the additional burden on the operation process is not increased, the operation effect is not influenced by the existence of the guide member, and when the cartridge assembly is taken out from the tissues after the operation is finished, the second guide member can protect the mucous membrane layers of the tissues, thereby preventing damage to the mucous membrane of the tissues and improving the use experience.
Drawings
Other features, objects and advantages of the present invention will become more apparent upon reading of the detailed description of non-limiting embodiments, made with reference to the following drawings.
FIG. 1 is a schematic view of the structure of a cartridge assembly;
FIG. 2 is a schematic view of the configuration of a guide assembly of a first embodiment of the present invention applied to a staple cartridge assembly;
FIG. 3 is a cross-sectional view of a first embodiment of the present invention as applied to a cartridge assembly with an anvil pull rod in an initial state;
FIG. 4 is a cross-sectional view of a first embodiment of the present invention as applied to a cartridge assembly with an anvil pull rod in an operative configuration;
FIG. 5 is a cross-sectional view of the guide assembly of the first embodiment of the present invention as applied to a staple cartridge assembly with the anvil pull rod in an operative condition and the first guide removed;
FIG. 6 is a schematic view of the first guide cooperating with the second guide of the first embodiment of the present invention;
FIG. 7 is a schematic view of the first embodiment of the present invention with the addition of a post-attachment tab guide assembly mated with a cartridge assembly;
FIG. 8 is a schematic view of a guide assembly of the first embodiment of the present invention with the addition of connecting ribs;
FIG. 9 is a cross-sectional view of a second embodiment of the present invention as applied to a staple cartridge assembly with an anvil pull rod in an initial state;
FIG. 10 is a cross-sectional view of a second embodiment of the present invention as applied to a staple cartridge assembly with an anvil pull rod in an operative configuration;
FIG. 11 is a schematic view of the first guide member of the second embodiment of the present invention sleeved outside the cartridge;
FIG. 12 is a schematic view of the structure of the second embodiment of the present invention with the first guide removed from the distal end;
fig. 13 is a schematic structural view of a second guide member of a second embodiment of the present invention;
fig. 14 is a schematic view showing the structure of a second guide member with a positioning portion added thereto according to a second embodiment of the present invention;
FIG. 15 is a schematic view of the second guide of FIG. 14 after deployment;
FIG. 16 is a schematic view of the configuration of a guide assembly of a third embodiment of the present invention applied to a staple cartridge assembly;
FIG. 17 is a schematic view of a guide assembly of a fourth embodiment of the present invention applied to a staple cartridge assembly;
FIG. 18 is a schematic view of a guide assembly of a fifth embodiment of the present invention applied to a staple cartridge assembly.
Reference numerals:
1. second end of first guide of cartridge 22
11. First tubular portion 23 first opening
111. Distal side 3 of the first tubular part second guide
12. Distal end side of the second guide of the connecting portion 31
121. Distal side 32 of the connection portion proximal side of the second guide
122. Proximal side 33 of the connection portion is second opening
13. Second tubular portion 34 positioning portion
131. Proximal 41 bead of second tubular portion
14. Window 42 boss
141. Distal end side 5 anvil pull rod of window
142. Proximal side 51 of the window distal side of the anvil pull rod
2. The first guide 6 connects the rib
21. First end of first guide
Detailed Description
Example embodiments will now be described more fully with reference to the accompanying drawings. However, the exemplary embodiments can be embodied in many forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the concept of the example embodiments to those skilled in the art. The same reference numerals in the drawings denote the same or similar structures, and thus a repetitive description thereof will be omitted.
The invention provides a guide assembly for a circular tube type anastomat and the circular tube type anastomat comprising the guide assembly. The circular tube anastomat comprises an anastomat body, an operating handle movably connected with the anastomat body and an anvil component matched with the body. The anastomat body comprises a firing assembly and a nail bin assembly arranged at the far end side, the nail bin assembly comprises a nail cylinder, and at least one window is arranged on the side face of the nail cylinder. During operation, the cartridge assembly is required to enter the tissue, move forward to reach the operative site, and then interface with the anvil assembly. The guide assembly is used to better guide the cartridge assembly into the surgical site. Specifically, the guide assembly comprises a first guide piece and a second guide piece, wherein the first end of the first guide piece is detachably sleeved on the distal end side of the nail barrel, and when the first guide piece is subjected to external force in the distal end direction, the first guide piece can move towards the distal end side to be separated from the nail barrel; the second guide piece is sleeved on the outer side of the nail barrel, and covers the far-end side face of the window.
Therefore, during operation, the first guide piece and the second guide piece can effectively prevent the damage to mucous membrane in the tissue when the nail bin assembly enters the tissue through the guiding and protecting functions of the first guide piece and the second guide piece. After the nail bin assembly reaches the operation position, the first guide piece is at least partially exposed out of the tissue, a doctor can directly clamp the first guide piece by using tools such as surgical forceps and the like, and pull force is applied to the distal side direction of the anastomat, so that the whole first guide piece is separated from the nail bin assembly, and the first guide piece can be pulled out of the tissue, and the first guide piece is prevented from obstructing operation. After the operation is finished, when the nail bin assembly is taken out of the tissue, the second guide piece protects the tissue mucosa, so that the tissue mucosa can be prevented from being damaged.
The following describes the structure of the guide assembly of various embodiments of the present invention in detail with reference to the accompanying drawings, and it is to be understood that the various embodiments are not limiting of the scope of the present invention.
As shown in fig. 1-5, a schematic view of the configuration of the engagement of the guide assembly and cartridge assembly according to a first embodiment of the present invention is shown. In this embodiment, the cartridge module comprises a cartridge 1, and at least one window 14 is formed on a side surface of the cartridge 1. The guide assembly comprises a first guide piece 2 and a second guide piece 3, wherein the first end 21 of the first guide piece 2 is detachably sleeved on the distal end side of the nail barrel 1, and when the first guide piece 2 is subjected to external force in the distal end side direction, the first guide piece 2 can move towards the distal end side to be separated from the nail barrel 1; the second guide member 3 is sleeved outside the nail barrel 1, and the second guide member 3 covers the distal side 141 of the window 14, so that the nail barrel 1 is not separated even if the second guide member is subjected to external force to the distal end.
Therefore, when the nail bin assembly enters the tissue, the first guide piece 2 and the second guide piece 3 can provide good guiding effect for the nail barrel 1, after the nail bin assembly reaches the operation position, the first guide piece 2 is at least partially exposed out of the tissue, a doctor can directly clamp the first guide piece 2 by using tools such as surgical forceps and the like, and apply pulling force to the distal side direction of the anastomat, and the whole first guide piece 2 is separated from the nail barrel 1, so that the first guide piece 2 can be very conveniently pulled out of the tissue, no extra burden is added to the operation process, the operation effect is not influenced by the existence of the guide pieces, and the use experience is improved. And when the cartridge assembly is removed from the tissue after the operation is completed, the second guide 3 can provide protection to the tissue mucosa from damaging the tissue during the cartridge motion.
In this embodiment, as shown in fig. 1, the nail cartridge 1 includes a first tubular portion 11, a connecting portion 12 and a second tubular portion 13 disposed from a distal end side thereof toward a proximal end side, the window 14 is disposed on the connecting portion 12, a distal end side 121 of the connecting portion 12 is connected to the first tubular portion 11, and a proximal end side 122 of the connecting portion 12 is connected to the second tubular portion 13. The distal side 111 of the first tubular portion 11 corresponds to the distal side of the cartridge 1 and the proximal side 131 of the second tubular portion 13 corresponds to the proximal side of the cartridge 1.
In the present invention, the distal end side and the proximal end side are the proximal end side with respect to the operator, the end closer to the operator, the end farther from the operator, i.e., the end closer to the operation position, are the distal end sides, and the direction along the axis of the stapler is the axial direction, i.e., the direction from the distal end side to the proximal end side of the stapler, or the direction from the proximal end side to the distal end side of the stapler. For example, in the view of fig. 3, the distal end side of the nail cartridge 1 is the upper side, the proximal end side is the lower side, and the distal end side 31 of the second guide portion 3 is the upper side, and the proximal end side 32 is the lower side. In the present invention, the inner side and the outer side of one member are the inner side with respect to the axis of the stapler, and the outer side away from the axis.
In this embodiment, the first guide 2 and the second guide 3 are each flexible material members, so as to avoid damage to the tissue when in contact with the mucosa of the tissue. Further, the first end 21 of the first guide member 2 includes an elastic portion, which is in an expanded state when the cartridge 1 is sleeved with the elastic portion, so that the cartridge 1 is fastened by the elastic portion to form a tighter fit with the cartridge 1, thereby ensuring that the cartridge module is not detached when the cartridge module does not reach the operative position. In this embodiment, the first guide member 2 may be a film made of rubber, plastic, silica gel, or the like, so as to reduce the influence on the outer diameter of the nail cartridge 1, so as not to expand the outer diameter of the tissue to be anastomosed and not to damage the same. At the same time, the first guide 2 can be easily pulled out of the tissue when subjected to an external force. In this embodiment, the thickness of the first guide 2 is less than 0.1 mm, for example selected between 0.1 mm and 0.01 mm. In other embodiments, the thickness may also be increased or decreased as appropriate, such as 0.2 millimeters, 0.25 millimeters, etc., as permitted.
In this embodiment, the second guide 3 may be a film made of rubber, plastic, silicone, or the like, and the thickness of the second guide 3 is also preferably less than 0.1 mm, for example, selected between 0.1 mm and 0.01 mm. In other embodiments, the thickness may also be increased or decreased as appropriate, such as 0.2 millimeters, 0.25 millimeters, etc., as permitted. Thus, the second guide 3 does not substantially increase the outer diameter of the cartridge 1, i.e., does not increase the difficulty in inserting and removing the cartridge 1 into and from tissue. The second guide member 3 may be an elastic member, and when the second guide member 3 is sleeved on the outer side of the nail barrel 1, the elastic member is in an expanded state.
In other alternative embodiments, the first guide 2 and the second guide 3 may also be made of flexible fabric, such as a braid, a knitted fabric, etc., the material of which may be a rayon material or spun yarn obtained by extrusion of a polymer, etc., and the first guide 2 and the second guide 3 are preferably elastic fabrics.
In this embodiment, the outer side walls of the first and second guides 2, 3 are at least partially lubricious, or the outer side walls of the first and second guides 2, 3 are at least partially coated with a lubricious layer. The lubricant layer may be pre-coated on the outer side walls of the first guide member 2 and the second guide member 3, and then the first guide member 2 and the second guide member 3 are mounted on the cartridge assembly, or the lubricant layer may be coated on the surfaces of the first guide member 2 and the second guide member 3 after the first guide member 2 and the second guide member 3 are mounted on the cartridge assembly. The lubrication layer may further enhance the guiding action of the first guide 2 and the second guide 3, reducing friction between the guides and the inner wall of the tissue. The lubricating layer may be made of a water-soluble lubricant, an oil-based lubricant, or the like which are already known in the art, for example, hydrophilic coating is performed on the outer side surfaces of the first guide member 2 and the second guide member 3, and before use, the surfaces of the first guide member 2 and the second guide member 3 become very lubricated by dipping water, which has been widely used in the surgical field.
As shown in fig. 3 and 4, the cartridge assembly further comprises an anvil pull rod 5 at least partially inside the cartridge 1, the distal side 51 of the anvil pull rod 5 being provided with a piercing portion. In the present invention, the state of the anvil pull rod 5 can be divided into two types: an initial state and an operating state. As shown in fig. 3, in the initial state, the piercing portion of the anvil pull rod 5 is located inside the nail barrel 1, the first end 21 of the guide member 2 is sleeved outside the nail barrel 1, the second end 22 of the guide member 2 is sleeved on the piercing portion of the anvil pull rod 5, and the second end 22 of the guide member 2 is in the expanded state, so as to tighten the piercing portion of the anvil pull rod 5 in the initial state. As shown in fig. 4, when the cartridge assembly reaches the operative position, the knob of the stapler is rotated to move the anvil pull rod 5 in the distal direction, and the stapler is put into an operative state in which the penetrating portion of the distal end side 51 of the anvil pull rod 5 is protruded from the distal end side of the cartridge 1 to a state where the first guide member 2 is butted, and at this time, the first guide member 2 is not yet removed from the cartridge assembly 1, and at this time, the second end 22 of the first guide member 2 is located on the distal end side of the penetrating portion of the anvil pull rod 5.
When the anvil pull rod 5 is in the working state, the puncture part of the anvil pull rod 5 drives the second end 22 of the first guide member 2 to puncture the tissue together and expose the tissue, and at this time, a pulling force in the distal direction is applied to the second end 22 of the first guide member 2, so that the first guide member 2 can be separated from the staple cartridge 1 and the anvil pull rod 5, and the state shown in fig. 5 is entered. At this point, the anvil pull rod 5 can be docked with the anvil assembly without the blocking of the first guide 2, and then firing of the stapler is performed.
In this embodiment, the second guide member 3 may be detachably sleeved on the outside of the nail cartridge 1. When the second guide 3 is not installed at the outside of the cartridge 1, the second guide 3 may be a simple hollow cylinder structure, and the manufacturing process is simpler. Before the operation, the second guide 3 and the first guide 2 are mounted together on the outside of the nail cartridge 1, and the first end 21 of the first guide 2 and the second guide 3 are both in an expanded state to improve the fitting strength with the nail cartridge 1. After the operation is completed, the second guide 3 may be removed from the cartridge 1 after the second guide 3 is removed from the tissue together with the cartridge 1.
In this embodiment, in order to avoid that the second guide 3 affects the visibility of the window 14, a second opening 33 may be provided at a position of the second guide 3 corresponding to the window 14, and a distance from a distal side surface of the second opening 33 to a distal side of the cartridge 1 is larger than a distance from a distal side surface 141 of the window 14 to a distal side of the cartridge 1, thereby ensuring that the second guide 3 may cover the distal side surface of the window 14.
As shown in fig. 1, the outer diameter of the first tubular portion 11 is larger than the outer diameter of the second tubular portion 13, and the outer surface of the connecting portion 12 is a smooth transition curved surface. In order to better adapt to the structure of the outer side of the nail barrel 1, when the second guide member 3 is sleeved on the outer side of the nail barrel 1, since the distal end side 31 of the second guide member 3 is located on the outer side of the first tubular portion 11, the proximal end side 32 of the second guide member 3 is located on the outer side of the connecting portion 12, and the inner diameter of the distal end side 31 of the second guide member 3 is larger than the inner diameter of the proximal end side 32 of the second guide member 3, the second guide member 3 and the outer side of the nail barrel 1 can be guaranteed to be better attached, and the nail barrel 1 can be taken out from tissues more smoothly.
As shown in fig. 6, in this embodiment, the length of the first guide member 2 may be further increased, where the first end 21 of the first guide member 2 and the distal end side 31 of the second guide member 3 have an overlapping region, and where the first end 21 of the first guide member 2 covers the outer side of the distal end side 31 of the second guide member 3. By this, the mating strength of the first guide member 2 and the second guide member 3 with the cartridge 1 can be enhanced by the mating of the first end 21 of the first guide member 2 and the distal end side 31 of the second guide member 3, avoiding the cartridge assembly from accidentally falling off before reaching the operative position. The outer surface of the portion of the second guide 3 covered by the first guide 2 is not coated with a lubricating layer.
As shown in fig. 7 and 8, in this embodiment, a connecting rib 6 may be further disposed between the first end 21 of the first guide member 2 and the distal end side 31 of the second guide member 3, so as to enhance the fitting strength between the first guide member 2 and the second guide member 3 and the nail cartridge 1, and avoid the accidental falling off before the nail cartridge assembly does not reach the operation position. When the first guide member 2 is subjected to an external force in the distal direction, the first guide member 2 can move toward the distal side to break the connecting rib 6, so that the second guide member 3 can remain on the outer side surface of the cartridge 1 when the first guide member 2 is removed.
Fig. 9-13 are schematic illustrations of the configuration of the engagement of the guide assembly and cartridge assembly in accordance with a second embodiment of the present invention. This embodiment differs from the first embodiment in that the second end 22 of the first guide 2 is provided with a first opening 23. As shown in fig. 9, in the initial state, the first guide 2 is not fixedly connected to the anvil pull rod 5, and the diameter of the first opening 23 is smaller than the diameter of the penetrating portion of the distal end side 51 of the anvil pull rod 5. As shown in fig. 10, when the cartridge assembly moves to the operation position, the anvil pull rod 5 is moved to protrude from the distal end side of the cartridge 1 in the distal end side direction of the stapler, the anvil pull rod 5 is inserted into the first opening 23 to protrude from the first guide member 2 to pierce the tissue, and the anvil pull rod 5 opens the first opening 23, so that the first opening 23 grips the anvil pull rod 5, and the second end 22 of the first guide member 2 is driven by the anvil pull rod 5 to be exposed out of the tissue, thereby facilitating the operation of removing the first guide member 2 by the doctor. In this embodiment, the distal portion of the first guide member 2 includes a tapered portion that increases in diameter from its side proximate the second end 22 of the first guide member 2 to its side proximate the first end 21 of the first guide member 2 to form a tapered structure that better guides the cartridge assembly into tissue. In other alternative embodiments, the first guide member 2 may be configured such that the diameters of the first end 21 and the second end 22 are substantially the same, and remain within the scope of the present invention. In the state of fig. 10, the first guide 2 is pulled in the distal direction and removed, and the structure shown in fig. 5 is obtained. As shown in fig. 11 and 12, the first guide 2 is elastically expanded when it is fitted over the distal end of the cartridge 1 and is detached from the cartridge 1, and the first end 21 of the first guide 2 is contracted to an unexpanded state after the first guide 2 is fitted over the outside of the cartridge 1, so that the first guide can be removed from the tissue more conveniently. As shown in fig. 13, the second guide member 2 may have a simple hollow cylindrical structure when not being sleeved outside the nail cartridge 1, the production process is simpler, the second guide member 2 is preferably an elastic structure, and when being mounted outside the nail cartridge 1, the second guide member 2 is outwards spread to be sleeved outside the nail cartridge 1.
As shown in fig. 14 and 15, the second guide 3 may be unfolded to have a one-piece structure, and two opposite sides of the one-piece structure are provided with positioning portions 34, and when the second guide 3 is sleeved on the outer side of the nail barrel 1, the two opposite sides of the one-piece structure are connected by the positioning portions 34. In this embodiment, the second guide 3 may not have elasticity, and the fixing of the second guide 3 to the outside of the nail cartridge 1 may be achieved by the positioning portion 34. In this embodiment, the positioning portion 34 includes concave-convex edges disposed on two opposite sides of the one-piece structure, and when the second guide member 3 is sleeved on the outer side of the nail barrel 1, the concave-convex edges on the two opposite sides of the one-piece structure are engaged with each other. In other alternative embodiments, the positioning portion 34 may also be a connection structure such as a buckle.
FIG. 16 is a schematic view of a guide assembly according to a third embodiment of the present invention as applied to a cartridge assembly. This embodiment differs from the first embodiment in that: the length of the second guide 3 is longer and the proximal side 32 of the second guide 3 covers the proximal side 142 of the viewing window 14. In this embodiment, in order to avoid that the second guide 3 affects the visibility of the window 14, a second opening 33 is provided at a position of the second guide 3 corresponding to the window 14, and a distance from a distal side surface of the second opening 33 to a distal side of the cartridge 1 is larger than a distance from a distal side surface 141 of the window 14 to a distal side of the cartridge 1, thereby ensuring that the second guide 3 can cover the distal side surface 141 of the window 14.
As shown in fig. 1, the outer diameter of the first tubular portion 11 is larger than the outer diameter of the second tubular portion 13, and the outer surface of the connecting portion 12 is a smooth transition curved surface. In order to better adapt to the structure of the outer side of the nail barrel 1, when the second guide member 3 is sleeved on the outer side of the nail barrel 1, since the distal end side 31 of the second guide member 3 is located at the outer side of the first tubular portion 11, the proximal end side 32 of the second guide member 3 is located at the outer side of the second tubular portion 13, and the inner diameter of the distal end side 31 of the second guide member 3 is larger than the inner diameter of the proximal end side 32 of the second guide member 3, so that the second guide member 3 can be guaranteed to be better attached to the outer side of the nail barrel 1, and the nail barrel 1 can be taken out from tissues more smoothly.
Fig. 17 is a schematic view of a guide assembly according to a fourth embodiment of the present invention applied to a cartridge assembly. In this embodiment, the inner side surface of the second guide 3 is further provided with a protrusion, which is a protrusion 41, and the protrusion 41 preferably extends along the circumferential direction of the nail barrel 1, but the present invention is not limited thereto, and in other alternative embodiments, the protrusion 41 may also extend along the axial direction of the nail barrel 1, or form an included angle with the axial direction, or the like.
Fig. 18 is a schematic view showing the structure of a guide assembly according to a fifth embodiment of the present invention applied to a cartridge assembly. In this embodiment, the inner side surface of the second guide 3 is further provided with a boss 42. Fig. 18 shows a circular boss, and in alternative embodiments, other shapes and arrangements of bosses 42 are possible and are within the scope of the present invention.
The guide assembly provided by the invention can be independently placed and not mounted on the nail barrel part of the anastomat before being used, is selectively mounted by a user according to the needs, has simple operation, and only needs to mount the first guide piece and the second guide piece on the outer side of the nail barrel, and in some embodiments, the second end of the first guide piece needs to be mounted on the far end of the nail anvil pull rod; can also be directly arranged on the nail cylinder part of the anastomat without the self-installation of a user. Meanwhile, as the first guide piece and the second guide piece are elastic, the anastomat can be matched with anastomat of a plurality of models, and the universality of production and use is good.
In summary, by adopting the guide assembly of the invention, the cartridge assembly can be well guided into the operation site to protect the residual tissues and the mucous membrane layers of the tissues, and after the cartridge assembly reaches the operation position, the first guide member is applied with an external force towards the distal end side, so that the guide member can be conveniently removed from the distal end side at least partially, the operation is simple, the additional burden on the operation process is not increased, the operation effect is not influenced by the existence of the guide member, and the second guide member can still protect the mucous membrane layers of the tissues when the cartridge assembly is taken out of the tissues after the operation is finished, thereby preventing the mucous membrane of the tissues from being damaged and improving the use experience.
The foregoing is a further detailed description of the invention in connection with the preferred embodiments, and it is not intended that the invention be limited to the specific embodiments described. It will be apparent to those skilled in the art that several simple deductions or substitutions may be made without departing from the spirit of the invention, and these should be considered to be within the scope of the invention.
Claims (16)
1. The guide assembly is characterized by being used for a nail bin assembly of the circular tube type anastomat, wherein the nail bin assembly comprises a nail cylinder, and at least one window is formed in the side surface of the nail cylinder;
the guide assembly includes:
The first end of the first guide piece is detachably sleeved on the far end side of the nail barrel, the first end of the first guide piece comprises an elastic part, and when the elastic part is sleeved on the nail barrel, the elastic part is in an expanded state;
The second guide piece is sleeved outside the nail barrel and covers the far-end side face of the window;
wherein when the first guide is subjected to an external force in a distal direction, the first guide is movable to a distal side to disengage from the cartridge and the second guide, and the second guide remains outside the cartridge.
2. The guide assembly of claim 1, wherein the first guide and the second guide are each a flexible material member.
3. The guide assembly of claim 1, wherein the second guide member is an elastic member, the elastic member being in an expanded state when the second guide member is sleeved outside the cartridge.
4. A guide assembly according to claim 3, wherein the second guide is detachably sleeved outside the cartridge;
When the second guide piece is not sleeved on the outer side of the nail barrel, the second guide piece is of a cylindrical structure.
5. The guide assembly of claim 1, wherein a connecting rib is disposed between the first end of the first guide member and the distal side of the second guide member, the first guide member being movable distally to break the connecting rib when the first guide member is subjected to an external force in a distal direction.
6. The guide assembly of claim 1, wherein the first end of the first guide has an overlap region with the distal side of the second guide, and the first end of the first guide covers the outer side of the distal side of the second guide at the overlap region.
7. The guide assembly of claim 1, wherein the first guide has a thickness of less than 0.1 millimeters and/or the second guide has a thickness of less than 0.1 millimeters.
8. The guide assembly of claim 1, wherein the cartridge assembly further comprises an anvil pull rod at least partially disposed within the cartridge, wherein a distal side of the anvil pull rod is provided with a piercing portion, wherein the second end of the first guide is a closed end, and wherein the second end of the first guide is disposed on a distal side of the piercing portion when the anvil pull rod is moved toward the distal side of the stapler to protrude from the distal side of the cartridge.
9. The guide assembly of claim 1, wherein the cartridge assembly further comprises an anvil pull rod at least partially inside the cartridge, wherein a distal side of the anvil pull rod is provided with a piercing portion, wherein the second end of the first guide is provided with an opening, wherein the piercing portion of the anvil pull rod passes through the opening when the anvil pull rod is moved to protrude from the distal side of the cartridge toward the distal side of the stapler, and wherein the second end of the first guide terminates at the piercing portion.
10. The guide assembly of claim 1, wherein the cartridge includes a first tubular portion, a connecting portion, and a second tubular portion from a distal side to a proximal side thereof, the window being disposed in the connecting portion, an outer diameter of the first tubular portion being greater than an outer diameter of the second tubular portion, an outer surface of the connecting portion being a smooth transition curve;
when the second guide piece is sleeved on the outer side of the nail barrel, the inner diameter of the distal end side of the second guide piece is larger than the inner diameter of the proximal end side of the second guide piece.
11. The guide assembly of claim 1, wherein the second guide is provided with an opening at a location corresponding to the window, a distance from a distal side of the opening to a distal side of the cartridge being greater than a distance from a distal side of the window to a distal side of the cartridge.
12. The guide assembly of claim 1, wherein the second guide member is deployable in a one-piece structure, and two opposite sides of the one-piece structure are provided with positioning portions, and when the second guide member is sleeved outside the nail cartridge, the two opposite sides of the one-piece structure are connected by the positioning portions.
13. The guide assembly of claim 12, wherein the positioning portion includes concave-convex edges disposed on two opposite sides of the one-piece structure, the concave-convex edges of the two opposite sides of the one-piece structure engaging one another when the second guide is positioned over the outside of the cartridge.
14. The guide assembly of claim 1, wherein an inner side of the second guide is provided with a boss.
15. The guide assembly according to claim 1, wherein an outer surface of the first guide is at least partially coated with a lubricating layer and/or a surface of the second guide is at least partially coated with a lubricating layer.
16. A tubular stapler comprising the guide assembly according to any one of claims 1 to 15.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010431815.0A CN113693661B (en) | 2020-05-20 | 2020-05-20 | Guide assembly and circular tube type anastomat |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010431815.0A CN113693661B (en) | 2020-05-20 | 2020-05-20 | Guide assembly and circular tube type anastomat |
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| Publication Number | Publication Date |
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| CN113693661A CN113693661A (en) | 2021-11-26 |
| CN113693661B true CN113693661B (en) | 2024-07-09 |
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| CN202010431815.0A Active CN113693661B (en) | 2020-05-20 | 2020-05-20 | Guide assembly and circular tube type anastomat |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN212382681U (en) * | 2020-05-20 | 2021-01-22 | 天臣国际医疗科技股份有限公司 | Guide assembly and circular tube type anastomat |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| AU2003234718A1 (en) * | 2002-04-15 | 2003-11-03 | Tyco Healthcare Group, Lp | Instrument introducer |
| US8662370B2 (en) * | 2010-04-08 | 2014-03-04 | Hidehisa Thomas Takei | Introducer system and assembly for surgical staplers |
| CN209236266U (en) * | 2018-04-18 | 2019-08-13 | 北京博辉瑞进生物科技有限公司 | A kind of nail-anvil assembly and tube type anastomat |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN212382681U (en) * | 2020-05-20 | 2021-01-22 | 天臣国际医疗科技股份有限公司 | Guide assembly and circular tube type anastomat |
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