Surgical stapler with tissue thickness sensor

Abstract

The application relates to a surgical instrument end effector cartridge and a surgical stapler applying the same, comprising a staple body for sealing and cutting tissue, characterized in that each staple body comprises a base, a head extending upward from the base and at least one leg connected to the base, each leg can be in an expanded state to fix a suture to tissue at a cutting line, thereby realizing that the staple body can drive the suture to stitch the tissue at the cutting line while sealing the tissue at the cutting line, compared with the prior art, the surgical instrument end effector cartridge can seal and stitch the cut tissue layers together near the end of the tissue layers, thereby increasing the reliability of the stitched tissue, in addition, the application further provides a surgical stapler applying the same, the surgical stapler can realize clamping and cutting tissue while stitching the tissue, so as to fix the suture to the tissue at the cutting line.

Description

TECHNICAL FIELD

[0001] The present invention relates to surgical devices, and more particularly, to a surgical stapler that better sears tissue. BACKGROUND

[0002] Endoscopic and laparoscopic surgical instruments are often preferred over traditional open surgical devices since a natural orifice or relatively small cutiing incision can reduce post-operative recovery time and complications. Consequently, there has been a drive to develop instruments for use in endoscopic and laparoscopic surgeries that are as versatile and effective as their traditional open surgery counterparts. These remote surgical instruments have end effector assemblies that interface with tissue in a variety of ways to achieve a diagnostic or therapeutic effect (e.g., grasping, cutting, stapling, clip applying, cauterizing, suturing, drug / gene therapy delivery, and energy application using ultrasonic, RF, laser, etc.). For example, surgical staplers can be used in a variety of surgical procedures to join tissue. Typically, staples are delivered to a tissue site to be stapled using a rigid end effector that fits through a cannula. In prior surgical staplers, a pair of jaws of the end effector clamps the tissue to be stapled and staples contained in a staple cartridge are driven into the clamped tissue to substantially seal together the severed tissue layers adjacent the severed ends of the tissue layers, and additionally, depending on the arrangement of the staples in the rigid staple cartridge jaw, the staples form a predetermined pattern (e.g., one or more rows of staple lines). While in some surgical procedures, it is advantageous to form a non-linear pattern of staples tailored to a particular arrangement. For example, certain gastric bypass procedures require the surgeon to create a pouch in a curved shape. Using current endoscopic surgical staplers and cutters, creating the pouch typically requires 3 or 4 separate cutting and stapling steps. In most cases, the endoscopic stapler / cutter is removed and reloaded after each cut to insert a new staple cartridge for stapling. This repeated removal and insertion is time consuming and increases the likelihood of surgical complications. To this end, it would be advantageous to combine cutting and stapling in a prior surgical stapler to reduce surgical complications while increasing the reliability of stapling tissue. To this end, further improvements to prior stapling and / or cutting instruments are needed. SUMMARY

[0003] A first technical problem addressed by the present invention is to provide a surgical instrument end effector cartridge that can drive staples through tissue layers to substantially seal together the severed tissue layers adjacent the severed ends of the tissue layers while also stapling.

[0004] The second technical problem to be solved by the present application is to provide a surgical stapler capable of clamping and pressing a layer of tissue, cutting the clamped layer of tissue, and driving the surgical instrument end effector cartridge to stitch the cut layer of tissue together near the end where the layer of tissue is cut.

[0005] The third technical problem to be solved by the present application is to provide a surgical stapler capable of inserting a new staple cartridge for stitching to be used repeatedly.

[0006] The technical solution adopted by the present application to solve the first technical problem is that the surgical instrument end effector cartridge comprises a staple body for sealing and cutting tissue, characterized in that each staple body comprises a base, a head extending upward from the base, and at least one leg connected to the base, each leg being capable of being retracted or expanded relative to the base, and each leg further having a threading hole through which a suture for stitching tissue at the cutting line can pass, after the head of each staple body drives each leg to pass through tissue at the cutting line, each leg can be in an expanded state to fix the suture to the tissue at the cutting line, thereby realizing that the staple body can seal the tissue at the cutting line while also driving the suture to stitch the tissue at the cutting line.

[0007] In order to realize that after the head of each staple body drives each leg to pass through tissue at the cutting line, the suture can be fixed to the tissue at the cutting line, preferably, the end effector cartridge further comprises a staple cartridge for accommodating each staple body, the base of the staple body is divided into two parts from bottom to top according to the change in cross-sectional area: a contraction part with a downward flared mouth and a flat part, the head is connected to the flat part, and each leg has a clamping hole for clamping the contraction part of the base to be in a retracted state in the staple cartridge, in addition, each leg is connected as a whole by a connecting ring, the base penetrates the connecting ring and the head is exposed outside the connecting ring, under the action of an external force on the head, the base and each leg can be driven out of the staple cartridge to be in an expanded state. Of course, in the final stitching state, the head of each staple body will still be further separated from the base and the leg by an external force, only the leg in the expanded state remains in the tissue at the cutting line to fix the suture.

[0008] In order to avoid the head of the staple body damaging the tissue to be cut when the implement cartridge is inserted directly through a thoracotomy or other type of incision, the implement cartridge preferably further comprises a wire channel under the staple cartridge, the wire channel being used for routing the suture wire, and the wire channel having a convergence area in the center for the suture wires of the staple bodies to converge, so as to realize the tightening operation of the staple bodies after the suture wire cuts the tissue at the cutting line. The implement cartridge is further connected with a shielding strip through a first elastic member, the shielding strip being provided with an opening for at least partially exposing the head of the staple body, and the shielding strip being capable of avoiding the head of the staple body from damaging the tissue to be cut when the implement cartridge is not clamping the tissue to be cut.

[0009] To solve the second technical problem, the surgical stapler preferably further comprises:

[0010] a first jaw member;

[0011] a second jaw member selectively movable relative to the first jaw member between open and closed positions to clamp tissue between the first and second jaw members when closed motion is applied thereto; and

[0012] a drive member in driving connection with the first and second jaw members to drive the relative opening and closing of the second and first jaw members;

[0013] characterized in that:

[0014] the implement cartridge is arranged on the first jaw member, and the second jaw member is provided with a clamping mechanism capable of clamping each of the staple bodies. After the clamping mechanism clamps the head of each staple body, and under the driving of the drive member, the second jaw member is in the open position relative to the first jaw member, each leg portion is capable of penetrating the tissue at the cutting line, each leg portion is in the expanded state after being separated from the staple cartridge, so as to fix the suture wire to the tissue at the cutting line.

[0015] In order to better drive the second jaw member and the first jaw member to open and close, preferably, the driving member is limited in a "pistol-like" handle portion, the first jaw member is connected with the handle portion through a sleeve, the first jaw member is configured to receive the actuator cartridge in the form of a sliding slot, the driving member comprises a linkage mechanism, the linkage mechanism comprises a first linkage mechanism having one end hinged to the catheter and the other end hinged to the first jaw member, and a second linkage mechanism having one end hinged to the catheter and the other end hinged to the second jaw member, a second transverse guide groove is opened in the handle portion, and a second wrench capable of sliding along the second transverse guide groove is directly connected with the first jaw member through a first pull wire and directly connected with the second jaw member through a second pull wire, so that in the state of pulling the second wrench, the second jaw member and the first jaw member are in a relatively open state, and in addition, the second jaw member and the first jaw member also have a second elastic member which always maintains a closed state. In the state of releasing the second wrench, the first jaw member and the second jaw member can always maintain a closed state under the action of the second elastic member, so as to clamp and cut the tissue.

[0016] To solve the third technical problem, preferably, the central part of the first jaw member is further provided with a cutting member for cutting the tissue clamped between the first jaw member and the second jaw member, wherein the cutting member can be pushed from a non-deployed position to a deployed position along the length of the first jaw member, and the cutting member further comprises an engaging portion configured to releasably engage with an actuating member of the surgical stapler, and the actuating member of the surgical stapler is also limited in the handle portion. Wherein the first jaw member is configured to receive the actuator cartridge in the form of a sliding slot, so that the actuator cartridge can be replaced to improve the use rate of the surgical stapler.

[0017] To achieve the cutting edge substantially simultaneously transecting tissue as the staple bodies are driven through the tissue, preferably, the staple bodies in the said cartridge are formed with first and second staple body rows arranged opposite to each other and aligned along the length of the first jaw member with the cutting member's engaging portion comprising first and second pull rods passing through the wire routing slots under the first and second staple body rows, respectively, and first and second flexible strips arranged side by side and deformable from an undeployed position to a deployed position distally of the cutting member, wherein the first flexible strip has a distal end connected to a first head end of the first pull rod and the second flexible strip has a distal end connected to a second head end of the second pull rod, and correspondingly, the actuation member of the surgical stapler comprises a first transverse guide slot formed in the handle portion and a first spanner slidable along the first transverse guide slot, and the first and second tail ends of the first and second pull rods pass through the sleeve to connect with the first spanner, and the cutting member is further provided with the cutting edge at the undeployed position of the first and second flexible strips, such that in the state of pulling the first spanner, the first and second flexible strips can be pushed distally from the undeployed position to the deployed position by the first and second pull rods, and the cutting edge can be pushed distally from the undeployed position to the deployed position. It should be understood that during each actuation stroke, the cutting edge can substantially simultaneously transect the tissue as the staples are driven through the tissue. Of course, it is also possible that the cutting edge only slightly lags behind the driving of the staples, so that the staples are driven through the same region of the tissue just before the cutting edge passes through the tissue, and the forming and positioning of the staples adjacent to the cutting line generated by the cutting edge can substantially seal the tissue at the cutting line, and simultaneously drive the suture to stitch the tissue at the cutting line after the staples are formed, thereby effectively reducing or preventing bleeding and / or other body fluid leakage at the cutting line.

[0018] In order to enable the second jaw member to clamp each of the nail bodies, preferably, the clamping mechanism of the second jaw member includes a second upper jaw plate and a second lower jaw plate, and the second lower jaw plate is respectively provided with a first lower nail body opening and a second lower nail body opening corresponding to each nail body in the first nail body column and the second nail body column, and the second upper jaw plate has a first upper nail opening column for exposing the nail body head, which is respectively connected with the first lower nail body opening and a second upper nail opening column opposite to the second lower nail body opening, and the second upper jaw plate and the second lower jaw plate clamped therebetween are a first adjusting member and a second adjusting member that can clamp the nail body head, wherein the first adjusting member can move along the moving direction of the cutting blade, and the second adjusting member can move against the moving direction of the cutting blade, thereby finally clamping the head of the nail body. By the relative arrangement of the first adjusting member and the second adjusting member, a limiting opening for limiting each nail body is formed, and the head of the nail body is clamped by reducing the size of the limiting opening of each nail body. In this way, when the second jaw member is in a closed position relative to the first jaw member (that is, the state of clamping the tissue to be cut), the second jaw member is opened relative to the first jaw member, thereby driving the base of the nail body and each leg to separate from the nail magazine and put it into an expanded state. Of course, in the final suturing state, the head of each nail body will still be further separated from the base and legs through the second jaw member, leaving only the tissue of the legs in the expanded state at the cutting line to fix the suture line.

[0019] In order to realize the relative movement of the first adjusting member and the second adjusting member, preferably, the first adjusting member is a "U"-shaped frame, and the two relatively horizontal parts of the frame are respectively provided with adjustment protrusions at intervals, and the vertical part connecting the two relatively horizontal parts is connected with a "T"-shaped push rod, and the push rod includes a horizontal rod part parallel to the two relatively horizontal parts and a vertical rod part parallel to the vertical part, and the first gear and the second gear that drive the adjustment frame to move are provided on both sides of the horizontal rod part, and correspondingly, the horizontal rod part has a first meshing part and a second meshing part for meshing the first gear and the second gear, and the second adjusting member is a "U"-shaped frame. The parts are a first plate and a second plate in the shape of an "I", the first plate having a third meshing portion meshing with the first gear, and the first plate having a first adjusting block with a corresponding adjusting protrusion on the side opposite to the third meshing portion to form a limiting opening for the head of the limiting nail body, and the second plate having a second adjusting block with a corresponding adjusting protrusion on the side opposite to the fourth meshing portion to form a limiting opening for the head of the limiting nail body, and the rotation of the first gear and the second gear then drives the first adjusting member and the first plate and the second plate to move toward each other, which is achieved by limiting the trigger mechanism on the handle part.

[0020] Further, the trigger mechanism comprises a trigger head and a transmission mechanism connecting the trigger head and the vertical rod part, the transmission mechanism comprising a first hydraulic cylinder, a second hydraulic cylinder and a conduit connecting the two, wherein a first piston rod of the first hydraulic cylinder is in abutment with the trigger head, a second piston rod of the second hydraulic cylinder is in abutment with the vertical rod part, and in the state that the trigger head is pressed, the "T"-shaped push rod can be moved under the transmission of the transmission mechanism, thereby driving the first gear and the second gear to rotate and in turn driving the first adjusting member and the second adjusting member to move, and the second upper jaw plate is provided with an exposed opening corresponding to the part of the second hydraulic cylinder.

[0021] Compared with the prior art, the surgical instrument end effector cartridge has the advantages that the staple body seals the tissue at the cutting line, the leg of each staple body further has a threading hole through which a suture thread for suturing the tissue at the cutting line passes, after the head of each staple body drives the leg to pass through the tissue at the cutting line, the leg can be in an expanded state to fix the suture thread to the tissue at the cutting line, thereby realizing that the staple body can drive the suture thread to suture the tissue at the cutting line while sealing the tissue at the cutting line, which can make the driving staple pass through the layers of tissue to seal the cut tissue layers together near the cut end while suturing, thereby increasing the reliability of the sutured tissue, and the application further provides a surgical suture device provided with the end effector cartridge, which can realize clamping and cutting of the tissue while suturing the tissue to fix the suture thread to the tissue at the cutting line. BRIEF DESCRIPTION OF DRAWINGS

[0022] Figure 1 FIG. 1 is a structural schematic view of a surgical instrument end effector cartridge in an embodiment of the application;

[0023] Figure 2 FIG. 2 is a sectional view of FIG. 1; Figure 1

[0024] Figure 3 FIG. 3 is a structural schematic view of a staple body in an embodiment of the application;

[0025] Figure 4 FIG. 4 is a structural schematic view of each staple body in an embodiment of the application in a state that the head drives the leg to pass through the tissue at the cutting line, and the leg can be in an expanded state to fix the suture thread to the tissue at the cutting line;

[0026] Figure 5 FIG. 5 is a structural schematic view of the first jaw member and the second jaw member in an embodiment of the application in a relatively open state;

[0027] Figure 6 ​Structure schematic diagram of the surgical stapler in the embodiment of the present application in the state that the head of each staple body is about to be separated from the base and the suture thread passes through the tissue;

[0028] Figure 7 Structure schematic diagram of the surgical stapler in the embodiment of the present application in the state that the end effector cartridge is separated from the first jaw member;

[0029] Figure 8 Structure schematic diagram of the second jaw member in the embodiment of the present application;

[0030] Figure 9 Structure schematic diagram of the second plate body in the embodiment of the present application;

[0031] Figure 10 Structure schematic diagram of the first plate body in the embodiment of the present application;

[0032] Figure 11 Structure schematic diagram of the first adjusting member in the embodiment of the present application;

[0033] Figure 12 Structure schematic diagram of the first adjusting member and the second adjusting member in the embodiment of the present application in the state that they clamp the head of the staple body;

[0034] Figure 13 Structure schematic diagram of the first flexible strip and the second flexible strip in the first jaw member in the embodiment of the present application in the state that they are located in the wire slot;

[0035] Figure 14 Structure schematic diagram of the surgical stapler in the embodiment of the present application in the state that the first jaw member and the second jaw member are relatively opened (i.e. about to clamp the tissue to be cut);

[0036] Figure 15 Structure schematic diagram of the first jaw member and the second jaw member in the embodiment of the present application in the state that they are connected with the second wrench through the first pull wire and the second pull wire; Figure 14 A is an enlarged structure schematic diagram;

[0037] Figure 16 Structure schematic diagram of the cutting blade in the embodiment of the present application in the state that it is in the undeployed position;

[0038] Figure 17 Structure schematic diagram of the cutting blade in the embodiment of the present application in the state that it is in the deployed position;

[0039] Figure 18 Structure schematic diagram of the first jaw member and the second jaw member in the embodiment of the present application in the state that they are connected with the second wrench through the first pull wire and the second pull wire;

[0040] Figure 19 Structure schematic diagram of the first adjusting member and the second adjusting member in the embodiment of the present application in the state that they are connected with the trigger mechanism;

[0041] Figure 20Fig. 1 is a schematic view of a surgical instrument end effector cartridge according to an embodiment of the present application, showing the first jaw member and the second jaw member in a relative closed configuration;

[0042] Figure 21 Fig. 2 is a schematic view of the surgical instrument end effector cartridge of Fig. 1, showing the first adjustment member and the second adjustment member in another configuration clamping the heads of the staple bodies;

[0043] Figure 22 Fig. 3 is a schematic view of the surgical instrument end effector cartridge of Fig. 1, showing the first adjustment member and the second adjustment member in a configuration not clamping the heads of the staple bodies. DETAILED DESCRIPTION

[0044] The present application is further described in detail by the following embodiments with reference to the accompanying drawings.

[0045] As Figures 1 to 22 shown in the best embodiment of the present application. The surgical instrument end effector cartridge 10 in this embodiment includes staple bodies 1 that seal tissue at a cut line, each staple body 1 including a base 11, a head 12 extending upwardly from the base 11, and at least one leg 13 connected to the base 11, each leg 13 being collapsible or expandable relative to the base 11 and each leg 13 further having a threading hole 131 through which a suture for suturing tissue at the cut line can pass, each leg 13 being in an expanded state to secure the suture to the tissue at the cut line after the head 12 of each staple body 1 drives each leg 13 through the tissue at the cut line, thereby enabling the staple body 1 to seal the tissue at the cut line while also driving the suture to suture the tissue at the cut line. The surgical instrument end effector cartridge 10 has staple bodies 1 that seal tissue at a cut line, each leg 13 of each staple body 1 further having a threading hole 131 through which a suture for suturing tissue at the cut line can pass, each leg 13 being in an expanded state to secure the suture to the tissue at the cut line after the head 12 of each staple body 1 drives each leg 13 through the tissue at the cut line, thereby enabling the staple body 1 to seal the tissue at the cut line while also driving the suture to suture the tissue at the cut line, which enables the staple to drive through layers of tissue to suture the cut layers of tissue together substantially at the end of the cut layers of tissue to increase the reliability of suturing the tissue, the staple of this embodiment can be made of a metallic material such as titanium, titanium alloy (e.g., 6Al-4V titanium, 3al-2.5V titanium), stainless steel, etc.

[0046] Specifically, in order to enable the head 12 of each staple body 1 to drive the leg 13 to pass through the tissue at the cutting line, so that the suture can be fixed on the tissue at the suture cutting line, the implement cartridge 10 further comprises a staple cartridge 2 for accommodating each staple body 1, the base 11 of the staple body 1 is divided into two parts from bottom to top according to the change of the cross section: the contraction part 111 with the downward flared mouth and the flat part 112, the head 12 of the staple body 1 is directly connected with the flat part 112, and each leg 13 has a clamping opening for clamping the contraction part 111 of the base 11 to be in a retracted state in the staple cartridge 2, in addition, each leg 13 is connected into a whole through the connecting ring 14, the base 11 penetrates through the connecting ring 14 and makes the head 12 exposed outside the connecting ring 14, under the action of external force, the head 12 can drive the base 11 and each leg 13 to be separated from the staple cartridge 2 and be in an expanded state, since the maximum diameter of the contraction part 111 and the flat part 112 of the base 11 is still smaller than that of the connecting ring 14, therefore, in the final suture state, the head 12 of each staple body 1 will be further separated from the base 11 and the leg 13 by external force, only the leg 13 in the expanded state is left on the tissue at the cutting line to fix the suture. In order to avoid the exposed head 12 of the staple body 1 from damaging the tissue to be cut when the implement cartridge 10 is used with the surgical stapler and directly inserted through the thoracotomy or other types of incisions, preferably, the implement cartridge 10 further comprises a wire slot 3 under the staple cartridge 2, the wire slot 3 is used for the wire of the suture, and the center of the wire slot 3 has a convergence area for the suture wire of each staple body 1 to converge (and the suture wire converges in the convergence area in a slipknot state, the specific slipknot tying method can adopt the existing slipknot form, which will not be described here), and then the staple body 1 is implemented to tighten the tissue at the cutting line after driving the wire to suture the tissue, the implement cartridge 10 is further connected with a shielding strip 5 through the first elastic member 4, the shielding strip 5 is provided with an opening 51 for at least partially exposing the head 12 of the staple body 1, and the head 12 is not damaged by the tissue to be cut under the action of external force, so that the shielding strip 5 can at least shield the head 12 of the staple body 1 when the implement cartridge 10 does not clamp the tissue to be cut.

[0047] In addition, the present embodiment also provides a surgical stapler using the surgical stapler end effector cartridge 10 as described above, which uses a pair of jaws to clamp the tissue to be stapled, the staples contained in the staple cartridge 2 are driven into the clamped tissue to substantially seal the cut tissue layers together near the cut ends of the tissue layers, specifically including a first jaw member 6 and a second jaw member 7, the second jaw member 7 is selectively movable relative to the first jaw member 6 between an open position and a closed position to clamp the tissue between the first jaw member 6 and the second jaw member 7 when a closing motion is applied thereto, and a drive member in driving connection with the first jaw member 6 and the second jaw member 7, which can drive the relative opening and closing of the second jaw member 7 and the first jaw member 6, and the end effector cartridge 10 is arranged on the first jaw member 6, and the clamping mechanism 71 capable of clamping each staple body 1 is arranged on the second jaw member 7, after the clamping mechanism 71 clamps the head 12 of each staple body 1, and in the state that the second jaw member 7 is in the open position relative to the first jaw member 6 under the driving of the drive member, each leg 13 can pass through the tissue at the cutting line, each leg 13 is in an expanded state after being detached from the staple cartridge 2, so as to fix the suture to the tissue at the cutting line. Wherein, the drive member of the present embodiment is limited in the "pistol-type" handle portion 8, the drive member includes a linkage mechanism, the linkage mechanism includes a first linkage mechanism 20 having one end hinged to the conduit 804 and the other end hinged to the first jaw member 6, and a second linkage mechanism 30 having one end hinged to the conduit 804 and the other end hinged to the second jaw member 7, and the second transverse guide groove 81 opened in the handle portion 8, and the second wrench 82 capable of sliding along the second transverse guide groove 81 are directly connected to the first jaw member 6 through the first pull wire 830 and directly connected to the second jaw member 7 through the second pull wire 831, so that in the state that the second wrench 82 is pulled, the second jaw member 7 and the first jaw member 6 are in the relative open state, in addition, the second jaw member 7 and the first jaw member 6 also have the second elastic member 84 which always maintains the tendency of the closed state between the two, in the state that the second wrench 82 is released, the first jaw member 6 and the second jaw member 7 can always maintain the tendency of the closed state under the action of the second elastic member 84, so as to clamp the clamped tissue.Wherein the first jaw member 6 is connected with the handle portion 8 through the sleeve 9 together with the effector cartridge 10 or the second jaw member 7, the first jaw member 6 together with the effector cartridge 10 and the second jaw member 7 are referred to the handle portion 8 which is gripped by the clinician, the first jaw member 6 together with the effector cartridge 10 or the second jaw member 7 are located "distally" relative to the more proximal handle portion 8, in addition to the first jaw member 6, it is further configured to accept the effector cartridge 10 in the form of a slide groove 60, so that different effector cartridges 10 can be replaced according to the tissue to be cut, and correspondingly, the first jaw member 6 is configured to accept the effector cartridge 10 in the form of a slide groove 60, so that the effector cartridge 10 can be replaced to improve the utilization rate of the surgical stapler.

[0048] As Figure 17As shown, the central part of the first jaw member 6 is further provided with a cutting member 40 for cutting the tissue clamped between the first jaw member 6 and the second jaw member 7, wherein the cutting member 40 is capable of being advanced distally from an undeployed position 401 to a deployed position 402 along the length of the first jaw member 6, wherein the undeployed position 401 mainly refers to the part of the tissue where no cutting is needed, and the deployed position 402 mainly refers to the part of the tissue where cutting is needed; in order to achieve that the cutting edge 400 can substantially simultaneously cut through the tissue as the staples are driven through the tissue, the staple bodies 1 in the implement cartridge 10 are formed with a first staple body row 101 and a second staple body row 102 which are oppositely arranged and arranged along the length of the first jaw member 6 with the cutting line as the center, wherein the cutting member 40 further comprises an engaging portion 403 which is configured to be releasably engaged with an actuating member of the surgical stapler, the engaging portion 403 of the cutting member 40 comprises a first pull rod 4031 which passes through the wire slot 3 under the first staple body row 101 corresponding thereto, and a second pull rod 4032 which passes through the wire slot 3 under the second staple body row 102 corresponding thereto, and further comprises a first flexible strip 4033 and a second flexible strip 4034 which are arranged side by side and capable of being deformed from the undeployed position 401 to the deployed position 402 of the cutting member 40 distally, wherein the end of the first flexible strip 4033 is connected with a first head end 4031a of the first pull rod 4031, and the end of the second flexible strip 4034 is connected with a second head end 4032a of the second pull rod 4032, correspondingly, the actuating member of the surgical stapler comprises a first transverse guide slot 85 which is opened in the handle portion 8 and a first wrench 86 which is capable of sliding along the first transverse guide slot 85, the first tail end 4031b of the first pull rod 4031 and the second tail end 4032b of the second pull rod 4032 pass through the sleeve 9 and are connected with the first wrench 86, and the cutting member 40 is further provided with the cutting edge 400 at the undeployed position 401 of the first flexible strip 4033 and the second flexible strip 4034, so as to achieve that in the state of pulling the first wrench 86, the first flexible strip 4033 and the second flexible strip 4034 can be pulled by the first pull rod 4031 and the second pull rod 4032, and the cutting edge 400 can be advanced distally from the undeployed position 401 to the deployed position 402. It should be understood that during each actuating stroke, the cutting edge 400 can substantially simultaneously cut through the tissue as the staples are driven through the tissue. Of course, it is also possible that the cutting edge 400 is slightly behind the driving of the staples, so that the staples are driven through the same region of the tissue just before the cutting edge 400 passes through the tissue, adjacent to the cutting line generated by the cutting edge 400, the forming and positioning of the staples can substantially seal the tissue at the cutting line, and the tissue at the cutting line is also simultaneously stitched by the suture after the staples are formed, so as to effectively reduce or prevent bleeding and / or other leakage of body fluids at the cutting line.

[0049] Reference Figure 19 , 21And 22, in order to enable the second jaw member 7 to clamp each staple body 1, the clamping mechanism 71 of the second jaw member 7 of the embodiment comprises a second upper jaw plate 711 and a second lower jaw plate 712, the second lower jaw plate 712 is respectively provided with a first lower staple jaw 7121 and a second lower staple jaw 7122 corresponding to each staple body 1 in the first staple body row 101 and the second staple body row 102, and the second upper jaw plate 711 has a first upper staple row 7111 for the head 12 of the staple body 1 to protrude out and communicate with the first lower staple jaw 7121 respectively, and a second upper staple row 7112 opposite to the second lower staple jaw 7122, and the second upper jaw plate 711 and the second lower jaw plate 712 clamp the first adjusting member 501 and the second adjusting member 502 capable of clamping the head 12 of the staple body 1, wherein the first adjusting member 501 is capable of moving along the moving direction of the cutting blade 400, and the second adjusting member 502 is capable of moving against the moving direction of the cutting blade 400, so as to finally clamp the head 12 of the staple body 1. In this way, after the second jaw member 7 is relative to the first jaw member 6 in the closed position (i.e. the state of clamping the tissue to be cut), the second jaw member 7 is opened relative to the first jaw member 6, so as to drive the base 11 and each leg 13 of the staple body 1 to be separated from the cartridge 2 and be in the expanded state. Of course, in the final suture state, the head 12 of each staple body 1 will be further separated from the base 11 and the leg 13 by the second jaw member 7, only the leg 13 in the expanded state is left on the tissue at the cutting line to fix the suture line.In order to realize the relative movement of the first adjusting member 501 and the second adjusting member 502, the first adjusting member 501 is a "U"-shaped frame body, two opposite horizontal parts of the frame body are respectively provided with adjusting protrusions 5010 at intervals, and a vertical part connecting the two opposite horizontal parts is connected with a "T"-shaped push rod 503, the push rod 503 includes a horizontal rod part 5031 parallel to the two opposite horizontal parts and a vertical rod part 5032 parallel to the vertical part, the horizontal rod part 5031 is provided with a first gear 60 and a second gear 70 on both sides for driving the adjusting frame 501 to move, correspondingly, the horizontal rod part 5031 has a first meshing part 5011 and a second meshing part 5012 for the first gear 60 and the second gear 70 to mesh, and the second adjusting member 502 is a first plate body 50a and a second plate body 50b respectively in the shape of "one", the first plate body 50a has a third meshing part 5013 for meshing with the first gear 60, and the first plate body 50a has a first adjusting block 501a corresponding to the adjusting protrusion 5010 on the side opposite to the third meshing part 5013 to form a limiting hole of the head part 12 of the limiting pin body 1, and the second plate body 50b has a second adjusting block 501b corresponding to the adjusting protrusion 5010 on the side opposite to the fourth meshing part 5014 to form a limiting hole of the head part 12 of the limiting pin body 1, and the rotation of the first gear 60 and the second gear 70 in turn drives the relative movement of the first adjusting member 501, the first plate body 50a and the second plate body 50b is realized by limiting the trigger mechanism 80 of the handle part 8. The trigger mechanism 80 includes a trigger head 801 and a transmission mechanism connecting the trigger head 801 and the vertical rod part 5032, the transmission mechanism includes a first hydraulic cylinder 802, a second hydraulic cylinder 803 and a conduit 804 connecting the two, wherein the first piston rod 8021 of the first hydraulic cylinder 802 abuts against the trigger head 801, the second piston rod 8031 of the second hydraulic cylinder 803 abuts against the vertical rod part 5032, in the state that the trigger head 801 is pressed, the "T"-shaped push rod 503 can be driven to move by the transmission of the transmission mechanism, so as to drive the first gear 60 and the second gear 70 to rotate in turn and drive the first adjusting member 501 and the second adjusting member 502 to move, and the second upper jaw plate 711 is provided with an exposed hole 711a for exposing the part corresponding to the second hydraulic cylinder 803.

[0050] In summary, how the surgical stapler of the embodiment realizes the clamping of the to-be-cut tissue, the cutting of the to-be-cut tissue, the stapling of the to-be-cut tissue and the stapling, the specific operation is as follows:

[0051] Firstly, it is emphasized that the surgeon of the present embodiment needs to pull the second wrench 82 before using the surgical stapler to determine the tissue to be cut, so that the second jaw member 7 and the first jaw member 6 are in a relatively open state, and at least part of the blocking bar 5 can still block the head 12 of the staple body 1 before determining the cutting of the tissue to avoid tissue damage; and after determining the cutting of the tissue, the second wrench 82 is loosened, and the second jaw member 7 and the first jaw member 6 are in a relatively closed state under the action of the second elastic member 84, so as to realize the clamping of the tissue to be cut;

[0052] At the same time, the surgeon can pull the first wrench 86, and the first flexible bar 4033 and the second flexible bar 4034 can be pulled by the first pull rod 4031 and the second pull rod 4032, so that the cutting edge 400 can be pushed from the undeployed position 401 to the deployed position 402, and the tissue to be cut can be cut. At this time, the first flexible bar 4033 and the second flexible bar 4034 pass through the corresponding walking grooves in sequence, and then slightly push the leg 13 of each staple body 1 upward (for details, please refer to Figure 17 ), the head 12 of each staple body 1 falls into the first lower staple port 7121 and the second lower staple port 7122 of the second jaw member 7 of the second lower jaw plate 712 and the jaw opening 7110 of the second upper jaw plate 711 from bottom to top, respectively. For details, please refer to Figure 20 ;

[0053] At this time, the surgeon needs to press the trigger head 801, and under the state that the trigger head 801 is pressed, the “T” type push rod 503 can be moved under the transmission of the transmission mechanism, so as to drive the first gear 60 and the second gear 70 to rotate and then drive the opposite movement of the first plate body 50a and the second plate body 50b, and each first adjusting block 501a of the first plate body 50a and each second adjusting block 501a of the second plate body 50b can be relatively moved, so as to realize the clamping of the head 12 of each staple body 1. The next step is to solve the operation of stapling and unstapling, for details, please refer to Figure 6 , as follows:

[0054] Again pulling the second wrench 82, the second jaw member 7 and the first jaw member 6 are in the relatively open state, so as to drive the base 11 and the leg 13 of the staple 1 to be separated from the cartridge 2 and be in the expanded state, so as to pass the suture through the leg 13 of the staple 1 and through the tissue, of course, in the final suture state, the head 12 of the staple 1 is further separated from the base 11 and the leg 13 by the second jaw member 7, only the leg 13 in the expanded state is left on the tissue at the cutting line to fix the suture, finally, the surgeon needs to tighten the suture in the convergence of the staple 1, effectively suture the cut tissue layer near the cut end, so as to finally realize the clamping, cutting, nailing, suturing and un-nailing of the tissue to be cut.

[0055] Finally, it needs to be emphasized that when the implement cartridge needs to be replaced, the specific operation method is as shown in Figure 7 the buckle is pulled out, the "U" type head of the first flexible strip 4033 and the second flexible strip 4034 is bent downward, that is, the whole implement cartridge 10 is pulled out of the first jaw member 6 in the form of sliding insertion through the sliding groove 6000, after being pulled out, the replacement implement cartridge 10 is inserted into the first jaw member 6, and the "U" type head of the first flexible strip 4033 and the second flexible strip 4034 is reset at the same time and the buckle 600 is re-fixed in it.

Claims

1. A surgical stapler with a surgical instrument end effector cartridge, comprising: a first jaw member (6); a second jaw member (7) selectively movable relative to the first jaw member (6) between an open position and a closed position to clamp tissue between the first jaw member (6) and the second jaw member (7) when a closing motion is applied thereto; and a drive member in driving connection with the first jaw member (6) and the second jaw member (7) to drive relative opening and closing of the second jaw member (7) and the first jaw member (6); characterized in that: the end effector cartridge (10) is provided on the first jaw member (6) and comprises staple bodies (1) for sealing tissue at a cutting line, each of the staple bodies (1) comprising a base (11), a head (12) extending upwardly from the base (11), and at least one leg (13) connected to the base (11), each leg (13) being collapsible or expandable relative to the base (11) and each leg (13) further having a threading hole (131) for a suture thread to pass through for stapling tissue at the cutting line, each leg (13) being expandable to secure the suture thread to the tissue at the cutting line after the head (12) of each staple body (1) drives each leg (13) through the tissue at the cutting line, thereby enabling the staple body (1) to seal the tissue at the cutting line while driving the suture thread to staple the tissue at the cutting line; the end effector cartridge (10) further comprises a staple cartridge (2) for accommodating each staple body (1), the base (11) of each staple body (1) is divided into two parts from bottom to top according to a change in cross section, i.e. a tapered portion (111) with a downward flared mouth and a flat portion (112), the head (12) is connected to the flat portion (112), and each leg (13) has a clamping opening for the tapered portion (111) of the base (11) to clamp thereon so as to be in a collapsed state in the staple cartridge (2), in addition, each leg (13) is connected into a whole by a connecting ring (14), the base (11) penetrates through the connecting ring (14) and makes the head (12) exposed outside the connecting ring (14), under the action of an external force on the head (12), the base (11) and each leg (13) can be driven to disengage from the staple cartridge (2) so as to be in an expanded state; the second jaw member (7) is provided with a clamping mechanism (71) capable of clamping each of the staple bodies (1), after the clamping mechanism (71) clamps the head (12) of each staple body (1) and under the driving of the drive member, the second jaw member (7) is in an open position relative to the first jaw member (6) to drive each leg (13) to pass through the tissue at the cutting line, each leg (13) disengages from the staple cartridge (2) so as to be in an expanded state, thereby securing the suture thread to the tissue at the cutting line, and the drive member is limited in a "pistol-like" handle portion (8). ​ 2. The surgical stapler according to claim 1, characterized in that: The executor warehouse (10) further comprises a wire slot (3) below the staple warehouse (2), the wire slot (3) is used for the wire of the suture line, and the central part of the wire slot (3) has a convergence area for the suture line of each staple body (1) to converge, and then the tissue behind the staple body (1) at the driving line suture cutting line is realized. The executor warehouse (10) is further connected with a shielding strip (5) through a first elastic member (4), the shielding strip (5) is provided with an opening (51) for at least partially exposing the head (12) of the staple body (1), and the shielding strip (5) can avoid the damage of the tissue to be cut by the head (12) under the action of external force.

3. The surgical stapler according to claim 2, wherein: The first jaw member (6) is connected with the executor warehouse (10) or the second jaw member (7) and the handle part (8) through a sleeve (9), the first jaw member (6) is configured to accept the executor warehouse (10) in the form of a sliding groove (6000), the driving member comprises a linkage mechanism, the linkage mechanism comprises a first linkage mechanism (20) having one end hinged to a guide pipe (804) and the other end hinged to the first jaw member (6), and a second linkage mechanism (30) having one end hinged to the guide pipe (804) and the other end hinged to the second jaw member (7), a second transverse guide groove (81) opened in the handle part (8), and a second wrench (82) capable of sliding along the second transverse guide groove (81) are directly connected with the first jaw member (6) through a first pull wire (830) and directly connected with the second jaw member (7) through a second pull wire (831), so that the second jaw member (7) and the first jaw member (6) are in a relatively open state when the second wrench (82) is pulled. In addition, the second jaw member (7) and the first jaw member (6) also have a second elastic member (84) which always keeps the two in a closed state.

4. The surgical stapler according to claim 3, wherein: The central part of the first jaw member (6) is further provided with a cutting member (40) for cutting the tissue clamped between the first jaw member (6) and the second jaw member (7), wherein the cutting member (40) can be pushed distally from a non-deployed position (401) to a deployed position (402) along the length of the first jaw member (6), wherein the cutting member (40) further comprises an engagement portion (403) configured to releasably engage with the actuation member of the surgical stapler, and the actuation member of the surgical stapler is also limited in the handle part (8).

5. The surgical stapler according to claim 4, wherein: The staple body (1) in the said executor warehouse (10) is formed with a first staple body column (101) and a second staple body column (102) which are oppositely arranged and arranged along the length direction of the first jaw member (6) with the cutting line as the center, and the engaging portion (403) of the cutting member (40) comprises a first pull rod (4031) which passes through the wire slot (3) corresponding to the first staple body column (101) below it and a second pull rod (4032) which passes through the wire slot (3) corresponding to the second staple body column (102) below it, and further comprises a first flexible strip (4033) and a second flexible strip (4034) which are arranged side by side and can be deformed from the undeployed position (401) of the cutting member (40) to the deployment position (402) distally, wherein the end of the first flexible strip (4033) is connected with the first head end (4031a) of the first pull rod (4031), and the end of the second flexible strip (4034) is connected with the second head end (4032a) of the second pull rod (4032). Correspondingly, the actuating member of the surgical stapler comprises a first transverse guide groove (85) opened in the handle portion (8) and a first wrench (86) which can slide along the first transverse guide groove (85), the first tail end (4031b) of the first pull rod (4031) and the second tail end (4032b) of the second pull rod (4032) pass through the sleeve (9) and are connected with the first wrench (86), and the cutting member (40) is further provided with a cutting blade (400) at the undeployed position (401) of the first flexible strip (4033) and the second flexible strip (4034), so that in the state of pulling the first wrench (86), the first flexible strip (4033) and the second flexible strip (4034) can be pushed from the undeployed position (401) to the deployment position (402) distally under the pulling of the first pull rod (4031) and the second pull rod (4032), and the cutting blade (400) can be pushed from the undeployed position (401) to the deployment position (402) distally.

6. The surgical stapler according to claim 5, wherein: The clamping mechanism (71) of the second jaw member (7) comprises a second upper jaw plate (711) and a second lower jaw plate (712), the second lower jaw plate (712) is provided with a first lower nail body opening (7121) and a second lower nail body opening (7122) corresponding to each nail body (1) in the first nail body column (101) and the second nail body column (102) respectively, the second upper jaw plate (711) has a first upper nail opening column (7111) for the head (12) of the nail body (1) to be exposed and pass through the first lower nail body opening (7121) respectively, and a second upper nail opening column (7112) opposite to the second lower nail body opening (7122), and the second upper jaw plate (711) and the second lower jaw plate (712) clamp the first adjusting member (501) and the second adjusting member (502) capable of clamping the head (12) of the nail body (1), wherein the first adjusting member (501) can move along the moving direction of the cutting edge (400), and the second adjusting member (502) can move against the moving direction of the cutting edge (400), so as to finally clamp the head (12) of the nail body (1).

7. The surgical stapler according to claim 6, wherein: The first adjusting member (501) is a "U" shaped frame, two opposite horizontal parts of the frame are respectively provided with adjusting protrusions (5010) at intervals, and the vertical part connecting the two opposite horizontal parts is connected with a "T" shaped push rod (503), the push rod (503) comprises a horizontal rod part (5031) parallel to the two opposite horizontal parts and a vertical rod part (5032) parallel to the vertical part, the horizontal rod part (5031) is provided with a first gear (60) and a second gear (70) driving the first adjusting member (501) to move on both sides, correspondingly, the horizontal rod part (5031) has a first meshing part (5011) and a second meshing part (5012) for the first gear (60) and the second gear (70) to engage, and the second adjusting member (502) is a first plate body (50a) and a second plate body (50b) respectively in the shape of "one", the first plate body (50a) has a third meshing part (5013) engaging with the first gear (60), and the first plate body (50a) has a first adjusting block (501a) corresponding to the adjusting protrusion (5010) on the side opposite to the third meshing part (5013) to form a limiting opening limiting the head (12) of the nail body (1), and the second plate body (50b) has a second adjusting block (501b) corresponding to the adjusting protrusion (5010) on the side opposite to the fourth meshing part (5014) to form a limiting opening limiting the head (12) of the nail body (1), and the rotation of the first gear (60) and the second gear (70) drives the opposite movement of the first adjusting member (501) and the first plate body (50a) and the second plate body (50b), which is realized by the limiting trigger mechanism (80) in the handle part (8).

8. The surgical stapler according to claim 7, wherein: The trigger mechanism (80) comprises a trigger head (801) and a transmission mechanism connecting the trigger head (801) and the vertical rod part (5032), the transmission mechanism comprising a first hydraulic cylinder (802), a second hydraulic cylinder (803) and a conduit (804) connecting the two, wherein a first piston rod (8021) of the first hydraulic cylinder (802) is in abutment with the trigger head (801), a second piston rod (8031) of the second hydraulic cylinder (803) is in abutment with the vertical rod part (5032), and under the state that the trigger head (801) is pressed, the "T"-shaped push rod (503) can be moved under the transmission of the transmission mechanism, thereby driving the first gear (60) and the second gear (70) to rotate and in turn drive the first adjusting member (501) and the second adjusting member (502) to move, and the second upper jaw plate (711) is provided with an exposed opening (711a) corresponding to the part of the second hydraulic cylinder (803) for exposing the second hydraulic cylinder (803).

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