Surgical cutting stapler with stapling and cutting coordination

Abstract

The application discloses a surgical cutting anastomat with stitching before cutting, which has stable transmission and sudden force during firing, and good firing experience. The driving mechanism of the surgical cutting anastomat comprises a center rod which can slide in the front-back direction, the center rod has a first rack part, the driving mechanism further comprises a gear set and a push rod which can slide in the front-back direction, the push rod has a second rack part, the tooth profile lines of the first rack part and the second rack part are straight lines extending in the front-back direction, the driving mechanism has a nail hitting state and a cutting state, when the driving mechanism is in the nail hitting state, the first rack part and the second rack part are respectively engaged with the gear or the gear set so that the push rod can slide with the center rod to drive the nail pushing piece to push the sutures out of the nail warehouse shell, and the cutting knife is located in the nail warehouse shell; when the driving mechanism is in the cutting state, the second rack part is disengaged from the gear or the gear set to allow the center rod to continue to slide to push the cutting knife out of the nail warehouse shell.

Description

[0001] This application is a divisional application of the invention patent application with application number 2017101071332, filed on February 27, 2017. TECHNICAL FIELD

[0002] The present application belongs to the field of medical devices, and particularly relates to a surgical cutting anastomat with stitching before cutting. BACKGROUND

[0003] The surgical cutting stapler is a surgical instrument that has been widely used in general surgery, thoracic surgery, gynecology, and pediatric surgery. The product uses the principle of a stapler, and through linearly staggered needles, it closes and sutures organs or incisions during surgery. The surgical cutting stapler has the characteristics of neat suture, reliable suture strength, good hemostatic effect, and good blood flow preservation. However, the traditional surgical cutting stapler sutures and cuts simultaneously, and in actual operation, the cutting knife cuts the tissue before the suturing needle sutures the tissue. In this case, under the force in the vertical direction of the cut tissue and the cut tissue, the cut tissue is easily pulled away from the instrument, and the suturing needle is not punched into the tissue, which may cause a medical accident. According to statistical data, the complaint rate of the complaint that the suturing needle is not formed or not completely formed in the tissue after the tissue is cut is about 0.2%.

[0004] Therefore, a surgical cutting anastomat with stitching before cutting has been further improved and developed. For example, Chinese patent CN104921770A discloses a surgical cutting stapler capable of stitching before cutting. However, the key component that enables the surgical cutting stapler to stitch before cutting is an L-shaped sliding groove formed by the communication of a second sliding groove and a third sliding groove. This structure is simple and stable, but in the process of pushing the needle, as the crank slider four-bar mechanism of the push rod changes its position in the L-shaped sliding groove, the ratio of the pushing force of the center rod to the force of the push rod also changes in a non-curved manner. There is a force mutation point in the process of driving the suturing needle to form by the center rod pushing the four-bar mechanism. When the push rod pushes the needle to form the suturing needle, the position near the maximum deformation stress of the suturing needle is also the most laborious position of the L-shaped sliding groove. At the most laborious point, the firing force changes greatly, and there is a force mutation point in the transmission process. In addition, since the L-shaped groove is a sliding friction, the initial friction force is relatively large, and there is a mutation force at the beginning of the firing. Therefore, the experience of the firing is poor. SUMMARY

[0005] In view of the above problems, the purpose of the present application is to provide a surgical cutting anastomat with stitching before cutting, which has stable transmission, no mutation force in firing, and good firing experience.

[0006] To achieve the above purpose, the technical scheme adopted by the present application is as follows:

[0007] A surgical cutting stapler with the function of cutting after stapling comprises a front end execution head, a rear end handle assembly, a driving mechanism for connecting the execution head and the handle assembly, the execution head comprises a staple cartridge assembly, the staple cartridge assembly comprises a staple cartridge shell, a staple and a cutter which are slidably arranged in the staple cartridge shell, a pusher which is slidably arranged in the staple cartridge shell for pushing the staple,

[0008] The driving mechanism further comprises a gear or a gear set and a push rod which is slidably arranged in the front-rear direction, the central rod has a first rack portion which is engaged with the gear or the gear set, the push rod has a second rack portion which is engaged with the gear or the gear set, the first rack portion and the second rack portion are respectively provided with a plurality of teeth which are arranged in the front-rear direction, the tooth profile lines of the first rack portion and the second rack portion are straight lines which extend in the front-rear direction, the surgical cutting stapler has an initial state, a staple firing state and a cutting state, when the surgical cutting stapler is in the initial state, the front end portion of the central rod is located at a distance behind the front end portion of the push rod, when the surgical cutting stapler is in the staple firing state, the first rack portion and the second rack portion are engaged with the gear or the gear set so that the push rod can slide with the central rod to drive the pusher to push the staple out of the staple cartridge shell, and the cutter is located in the staple cartridge shell, when the surgical cutting stapler is in the cutting state, the second rack portion is disengaged from the gear or the gear set to allow the central rod to continue to slide to push the cutter out of the staple cartridge shell.

[0009] Preferably, the driving mechanism comprises a rear shell, a resilient member which is arranged between the central rod and the rear shell for resetting the central rod after being fired, and the central rod and the push rod are slidably arranged on the rear shell in the front-rear direction.

[0010] More preferably, a sliding groove which extends in the front-rear direction is formed on the front portion of the central rod, a guide pin which is slidably arranged in the sliding groove is arranged on the push rod, and the guide pin has a position which abuts against the front side groove wall of the sliding groove to reset the push rod with the central rod.

[0011] Further, the length of the sliding groove is not less than the difference between the forward sliding distance of the central rod and the forward sliding distance of the push rod.

[0012] Preferably, the driving mechanism further comprises a rear shell, a firing handle which is rotatably arranged on the rear shell, and a firing member which is connected with the firing handle to rotate with the firing handle, and the firing member has a position which abuts against the rear end portion of the central rod to push the central rod to slide forward.

[0013] More preferably, the drive mechanism further includes a handle spring disposed on the rear housing for resetting the firing handle.

[0014] Preferably, the length of the first rack portion is greater than the length of the second rack portion.

[0015] Preferably, when the surgical stapler is in the nailing state, the central rod and the push rod move at the same speed.

[0016] Preferably, the push rods are in two sets and are symmetrically arranged on the left and right sides of the central rod.

[0017] Preferably, the first rack portion and the second rack portion are located on the same side of the gear or gear set.

[0018] The present invention adopts the above technical solution and has the following advantages compared with the prior art:

[0019] The instantaneous transmission ratio of the gear meshing is constant, the transmission is smooth, the firing force changes smoothly, there is no sudden force during firing, and the firing experience is good; during startup, because the gear, center rod, and push rod are rolling friction, the initial friction force is also relatively small, and the startup is also smooth. Attached Figure Description

[0020] To more clearly illustrate the technical solution of the present invention, the accompanying drawings used in the description of the embodiments will be briefly introduced below. Obviously, the accompanying drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort.

[0021] Appendix Figure 1 This is a schematic diagram of the structure of a surgical cutting stapler of the present invention in its initial position;

[0022] Appendix Figure 2 For the appendix Figure 1 A magnified view of a section at point A in the middle;

[0023] Appendix Figure 3 For the appendix Figure 1 Top view of the surgical stapler shown;

[0024] Appendix Figure 4 For the appendix Figure 1 The diagram shows the push rod and center rod of the surgical stapler in the initial position;

[0025] Appendix Figure 5 For the appendix Figure 1 A schematic diagram of the central rod of the surgical stapler in its initial position;

[0026] Appendix Figure 6 For the appendixFigure 1 schematic diagram of the center rod and the push rod of the surgical cutting stapler in the staple firing state;

[0027] attached Figure 7 for attached Figure 1 schematic diagram of the center rod of the surgical cutting stapler in the staple firing state;

[0028] attached Figure 8 for attached Figure 1 schematic diagram of the center rod of the surgical cutting stapler in the cutting state.

[0029] in the above-mentioned drawings,

[0030] 1, the head; 2, handle assembly; 3, drive mechanism;

[0031] 11, the body; 12, anvil assembly; 13, staple cartridge assembly;

[0032] 121, the knife pad; 122, the staple seat;

[0033] 131, the staple cartridge shell; 132, the cutter; 133, the pusher;

[0034] 30, the rear shell; 31, the center rod; 310, the first rack part; 311, the tension spring; 312, the sliding groove; 32, the push rod; 320, the second rack part; 321, the guide pin; 33, the gear set; 34, the firing handle; 340, the handle spring; 35, the firing member. DETAILED DESCRIPTION

[0035] The preferred embodiments of the present application will be described in detail with reference to the drawings, so that the advantages and features of the present application can be more easily understood by those skilled in the art. It should be noted that the description of these embodiments is used to help understand the present application, but does not constitute a limitation of the present application. In addition, the technical features involved in the various embodiments of the present application described below can be combined with each other as long as they do not conflict with each other.

[0036] The front, back, left, right and other orientation words mentioned in the present application are defined according to the usual observation angle of those skilled in the art and for the convenience of description, without limiting the specific direction. For example, front and back correspond to the left side and right side of the paper in the drawings, respectively, and left and right correspond to the lower side and upper side of the paper in the drawings, respectively. Figure 1 Figure 2

[0037] As shown in the drawings, a surgical cutting stapler includes a head 1 at the front end, a handle assembly 2 at the rear end, and a drive mechanism 3 for connecting the head 1 and the handle assembly 2. Figures 1-8

[0038] ​​​The execution head 1 comprises a body 11, an anvil assembly 12 fixedly arranged on the front end of the body 11, and a staple cartridge assembly 13 slidably arranged on the body 11 in the front-rear direction.

[0039] The staple cartridge assembly 13 comprises a staple cartridge shell 131 having a cavity inside, a plurality of staples for suturing tissue inside the staple cartridge shell 131, and a cutter 132 for cutting tissue inside the staple cartridge shell 131. The staple cartridge shell 131 is formed with a cutter slot for the cutter 132 to extend out and a plurality of staple slot holes for the staples to shoot out. The staple cartridge assembly 13 further comprises a pusher 133 slidably arranged inside the staple cartridge shell 131 in the front-rear direction for pushing the staples out of the staple slot holes. The cutter slot is located in the middle of the front end surface of the staple cartridge shell 131, and a plurality of rows of needle slot holes for accommodating the staples are arranged on the left and right sides of the cutter slot respectively. The anvil assembly 12 comprises a cutter pad 121 capable of cooperating with the cutter 132 and a staple abutting seat 122 capable of cooperating with the staples. When the staples are pushed out of the staple cartridge shell 131 and pass through the tissue, the staples come into contact with the staple abutting seat 122 and are bent and formed under the action of the staple abutting seat 122.

[0040] The driving mechanism 3 comprises a rear shell 30, a central rod 31 slidably arranged on the rear shell 30 in the front-rear direction, a push rod 32 slidably arranged on the rear shell 30 in the front-rear direction, and a gear 33 or a gear set rotatably arranged on the rear shell 30 about its own axis. The central rod 31 has a first rack portion 310 capable of engaging with the gear 33 or the gear set. The first rack portion 310 is integrally formed with or fixedly connected to the other part of the central rod 31. A row of teeth arranged in the front-rear direction is arranged on the lower edge of the first rack portion 310. The tooth profile line of the teeth is a straight line extending in the front-rear direction. The push rod 32 also has a second rack portion 320 capable of engaging with the gear 33 or the gear set. The second rack portion 320 is integrally formed with or fixedly connected to the other part of the push rod 32. A row of teeth arranged in the front-rear direction is also arranged on the lower edge of the second rack portion 320. The tooth profile line of the teeth is also a straight line extending in the front-rear direction. The first rack portion 310 and the second rack portion 320 are both located on the upper side of the gear set. The surgical cutting anastomat has a staple shooting state and a cutting state. When the surgical cutting anastomat is in the staple shooting state, the first rack portion 310 and the second rack portion 320 engage with the gear 33 or the gear set respectively, so that the push rod 32 can slide forward together with the central rod 31, and the pusher 133 moves to push the staples out of the staple cartridge shell 131 for suturing, and the cutter 132 remains in the state of being located inside the staple cartridge shell 131. When the surgical cutting anastomat is in the cutting state, the second rack portion 320 is disengaged from the gear 33 or the gear set, and the central rod 31 continues to slide to push the cutter 132 out of the staple cartridge shell 131 for cutting.

[0041] If the first rack portion 310 and the second rack portion 320 are engaged with only one gear 33 in the tacking state, the gear 33 should have a larger thickness, preferably greater than or equal to the sum of the thicknesses of the teeth of the first rack portion 310 and the second rack portion 320. If the first rack portion 310 and the second rack portion 320 are engaged with the gear set in the tacking state, the gears 33 of the gear set have the same transmission ratio, and the first rack portion 310 and the second rack portion 320 are respectively engaged with one of the gears 33 to keep the center rod 31 and the push rod 32 sliding forward at the same speed in the tacking state. The push rod 32 is provided in two groups and symmetrically arranged on the left and right sides of the center rod 31.

[0042] The length of the first rack portion 310 is greater than the length of the second rack portion 320, so that after the tacking is completed, the second rack portion 320 is completely moved to the front side of the gear 33 and disengaged from the gear 33, that is, the second rack portion 320 is not engaged with the gear 33, even if the center rod 31 continues to move forward, the push rod 32 will not move forward with it. The surgical cutting stapler also has an initial state, when the surgical cutting stapler is in the initial state, the front end of the center rod 31 is located a distance behind the front end of the push rod 32.

[0043] The drive mechanism 3 further comprises a resilient member provided between the center rod 31 and the rear shell 30 for resetting the center rod 31 after being fired. The resilient member is specifically a tension spring 311 connected between the center rod 31 and the rear shell 30. When the center rod 31 is fired and slides forward, the tension spring 311 is in a compressed state and has a resilient reset force, and once the firing thrust applied to the center rod 31 disappears, the resilient reset force drives the center rod 31 to move backward and reset.

[0044] The front portion of the center rod 31 is provided with a sliding groove 312 extending in the front-rear direction, and the push rod 32 is provided with a guide pin 321 matched with the sliding groove 312, the guide pin 321 being slidably inserted into the sliding groove 312 in the front-rear direction. The guide pin 321 has a position abutting against the front side groove wall of the sliding groove 312 to make the push rod 32 reset with the center rod 31, that is, the center rod 31 is first driven by the tension spring 311 to return to a certain position, in the process, the sliding groove 312 also moves to the position where the front side groove wall abuts against the guide pin 321, and then the push rod 32 is driven by the front side groove wall of the sliding groove 312 to move backward together with the center rod 31, and returns to the initial position to make the second rack portion 320 engage with the gear 33 again. The length of the sliding groove 312 is not less than the difference between the forward sliding distance of the center rod 31 and the forward sliding distance of the push rod 32, and the length of the sliding groove 312 is actually equivalent to the maximum distance that the center rod 31 can slide relative to the push rod 32 in the cutting state.

[0045] The driving mechanism 3 further comprises a firing handle 34 rotatably arranged on the rear shell 30, a firing member 35 connected with the firing handle 34 and rotatable with the firing handle 34, and a handle spring 340 arranged on the rear shell 30 for resetting the firing handle 34. The firing member 35 has a position for abutting against the rear end of the central rod 31 to push the central rod 31 to slide forward.

[0046] When the firing handle 34 is pulled, the firing member 35 pushes the central rod 31, the central rod 31 drives the gear set to rotate, the gear set drives the push rod 32 to move linearly, thereby pushing the push nail member 133, the push nail member 133 pushes the staple into the slot of the staple seat, and the staple is formed. When the staple is completely formed, the push rod 32 stops because it cannot engage with the gear 33. At this time, the central rod 31 continues to move forward, pushes the cutter 132, and completes the cutting action. When the firing handle 34 is released, the firing handle 34 is driven by the restoring force of the handle spring 340 to return to the original position, and the central rod 31 is driven by the restoring force of the tension spring 311 to return to the original position. When the central rod 31 returns to a certain position, the central rod 31 slides in the sliding groove 312, drives the guide pin 321, and drives the push rod 32 to return to the position for engaging with the gear 33.

[0047] The above embodiment is only a preferred embodiment for illustrating the technical concept and characteristics of the present application, and its purpose is to enable those skilled in the art to understand the content of the present application and implement it, and it cannot limit the protection scope of the present application. Any equivalent changes or modifications made according to the spirit and principle of the present application should be covered within the protection scope of the present application.

Claims

1. A surgical cutting stapler of the kind that staples first and cuts later, comprising an operating head at the front end, a handle assembly at the rear end, a driving mechanism for connecting the operating head and the handle assembly, the operating head comprising a staple cartridge assembly, the staple cartridge assembly comprising a staple cartridge shell, a staple and a cutter slidable back and forth in the staple cartridge shell, a pusher for pushing the staple, the pusher being arranged in the staple cartridge shell and slidable back and forth, the driving mechanism comprising a center rod slidable back and forth, characterized in that: the driving mechanism further comprises a gear or a gear set and a push rod slidable back and forth, the center rod has a first rack portion engaging with the gear or the gear set, the push rod has a second rack portion engaging with the gear or the gear set, the first rack portion and the second rack portion are respectively provided with a plurality of teeth arranged in sequence in the back and forth direction, the tooth profile lines of the first rack portion and the second rack portion are straight lines extending in the back and forth direction, the surgical cutting stapler has an initial state, a staple firing state and a cutting state, when the surgical cutting stapler is in the initial state, the front end portion of the center rod is located at a distance behind the front end portion of the push rod, when the surgical cutting stapler is in the staple firing state, the first rack portion and the second rack portion are engaged with the gear or the gear set so that the push rod can slide with the center rod to drive the pusher to push the staple out of the staple cartridge shell, and the cutter is located in the staple cartridge shell, when the surgical cutting stapler is in the cutting state, the second rack portion is disengaged from the gear or the gear set to allow the center rod to continue to slide to push the cutter out of the staple cartridge shell; the driving mechanism further comprises a rear shell, a resilient member arranged between the center rod and the rear shell for resetting the center rod after being fired, and the center rod and the push rod are arranged on the rear shell slidable back and forth; a sliding groove extending in the back and forth direction is formed on the front portion of the center rod, a guide pin is arranged on the push rod and is slidably inserted into the sliding groove, the guide pin has a position abutting against the front side groove wall of the sliding groove to reset the push rod with the center rod; the length of the sliding groove is not less than the difference between the forward sliding distance of the center rod and the forward sliding distance of the push rod; the driving mechanism further comprises a firing handle rotatably arranged on the rear shell, and a firing member abutting against the firing handle and rotatable with the firing handle, the firing member has a position abutting against the rear end portion of the center rod to push the center rod to slide forward; the length of the first rack portion is greater than the length of the second rack portion, and the first rack portion and the second rack portion are located on the same side of the gear or the gear set. the driving mechanism further comprises a handle spring arranged on the rear shell for resetting the firing handle.

2. The surgical cutting stapler according to claim 1, wherein: when the surgical cutting stapler is in the staple firing state, the moving speed of the center rod is the same as that of the push rod.

3. The surgical cutting stapler according to claim 1, wherein: the push rod is arranged symmetrically on the left and right sides of the center rod.

4. The surgical cutting stapler according to claim 1, wherein: ​

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