Surgical instrument

Abstract

The surgical instrument comprises a handle assembly, a tubular assembly and an executing mechanism which are sequentially arranged from the near end to the far end, the surgical instrument is provided with a channel extending in the axial direction of the tubular assembly, and the near end of the channel communicates with a near end opening of the handle assembly; the executing mechanism comprises a first forceps holder and a second forceps holder which are oppositely arranged, a suturing nail is arranged in the first forceps holder, and the suturing nail can be driven to move towards the second forceps holder; the executing mechanism comprises an opening state and a closing state, and when the executing mechanism is in the opening state, the executing mechanism is provided with an opening communicated with the channel. By the adoption of the tissue sampling device, an incision can be rapidly sutured when tissue is sampled, and incision bleeding is avoided.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of medical instruments, in particular to a surgical instrument. BACKGROUND

[0002] For various reasons, doctors need to obtain tissue samples from patients. In some cases, doctors sample various organs or soft tissues of patients for disease diagnosis. There are various biopsy instruments and corresponding sampling methods. For example, pleural biopsy under thoracoscopy is often used for diagnosis of pleural diseases and staging of tumors. Its implementation methods usually include frozen biopsy, HeiBo knife pleural biopsy, IT knife pleural biopsy, SB knife pleural biopsy, and so on. This document also mentions flexible forceps biopsy (FFB) and hard forceps biopsy. According to some research data, the average area of the specimen obtained by various methods is about 7.1-22.6mm 2 .

[0003] In some cases, doctors want to obtain larger lung tissue samples to improve the case diagnosis rate. This requires obtaining larger lung tissue samples during sampling. Large-area sampling, especially large-area sampling of a single sample, will form a relatively large incision in the lung tissue. If no appropriate intervention is performed after sampling, it will cause a large amount of bleeding and gas leakage at the incision of the patient's lung, which may even endanger the patient's life. Similarly, there is also a problem of incision bleeding when sampling other organs or soft tissues of the patient. If the incision is not timely and appropriately intervened, it will have a serious impact on the patient's health or even life. SUMMARY

[0004] To solve the problems in the prior art, the purpose of the present application is to provide a surgical instrument that can quickly suture the incision when sampling tissue to avoid bleeding from the incision.

[0005] The surgical instrument provided by the embodiments of the present application comprises a handle assembly, a tubular assembly and an execution mechanism arranged in sequence from the proximal end to the distal end. The surgical instrument is provided with a channel extending along the axial direction of the tubular assembly, and the proximal end of the channel is communicated with the proximal opening of the handle assembly. The execution mechanism comprises a first jaw and a second jaw arranged oppositely, and the inside of the first jaw is provided with a suture nail which can be driven to move towards the second jaw. The execution mechanism comprises an open state and a closed state. When the execution mechanism is in the open state, the execution mechanism has an opening communicating with the channel.

[0006] In some embodiments, the channel is arranged in the tubular assembly.

[0007] In some embodiments, the actuator also includes a closing slider, the closing slider includes a first locking portion and a second locking portion, and the first jaw includes a first locking surface and a second locking surface; when the closing slider is in the first position, the first locking portion and the first locking surface are abutted to keep the actuator in an open state; when the closing slider is driven to move proximally to the second position, the first locking portion is separated from the first locking surface, and the second locking portion drives the first jaw to rotate relative to the second jaw to close the actuator, and the second locking portion and the second locking surface are abutted to keep the actuator in a closed state.

[0008] In some embodiments, the handle assembly includes a fixed handle, a closing trigger, a closing drive, a retaining member, a safety opening button and an elastic member, and the closing trigger is rotatably connected to the fixed handle; when the closing trigger is driven to move toward the fixed handle, the closing trigger drives the closing slider to move proximally through the closing drive to close the actuator, and the closing drive moves proximally to cooperate with the retaining member to keep the actuator in a closed state; after the safety opening button is operated to separate the retaining member from the closing drive, the closing trigger is driven by the elastic member to move away from the fixed handle, so as to drive the closing slider to move distally through the closing drive to open the actuator.

[0009] In some embodiments, the actuator further includes a firing slide and a cutter; the firing slide includes a first drive unit and a second drive unit. When the firing slide is driven to move distally, the first drive unit pushes the suture staple toward the second clamp, and the second drive unit pushes the cutter toward the second clamp.

[0010] In some embodiments, a tissue contact surface is provided on the side opposite to the second jaw, and the tissue contact surface is provided with a knife groove and multiple nail holes, and the cutter and suture nail are movably installed in the knife groove and nail holes respectively; when the firing slide is driven and moves distally, the nail tip of the suture nail is pushed out of the tissue contact surface before the blade of the cutter.

[0011] In some embodiments, the handle assembly includes a fixed handle, a closing drive and a firing trigger. The closing drive is configured to drive the actuator to open or close when it moves axially. The firing trigger is rotatably connected to the fixed handle, and the firing trigger includes a firing locking portion. When the closing drive is in the third position, the actuator is in an open state, and the closing drive cooperates with the firing locking portion to block the firing trigger from moving toward the fixed handle. When the closing drive is in the fourth position, the actuator is in a closed state, the closing drive is separated from the firing locking portion, and when the firing trigger is driven to move toward the fixed handle, the firing trigger drives the firing slide to move distally.

[0012] In some embodiments, the handle assembly includes a fixed handle, a closing trigger and a firing trigger, the firing trigger is connected to the firing slide through a firing push rod, the closing trigger and the firing trigger are both rotatably connected to the fixed handle, and the firing trigger includes a firing part; when the closing trigger is driven to rotate toward the fixed handle to close the actuator, the firing trigger rotates a first angle with the closing trigger, and the firing part slides with the firing push rod without driving the firing push rod; the actuator is in a closed state, and the firing trigger is driven to rotate a second angle toward the fixed handle, and the firing part drives the firing push rod to move toward the distal end.

[0013] In some embodiments, the first clamp is provided with a U-shaped tissue contact surface with a proximal opening and a receiving cavity on the side opposite to the second clamp. The tissue contact surface is arranged around the receiving cavity, and a plurality of nail holes are distributed on the tissue contact surface, and the suture nails are movably installed in the nail holes; the first clamp also includes a cutter, and the tissue contact surface is provided with a U-shaped knife groove for accommodating the cutter. The knife groove is located on the inner side of the nail hole, and the shape of the cutter is adapted to the shape of the knife groove, and is movably installed in the knife groove.

[0014] In some embodiments, the surgical instrument further includes a clamp comprising a distal clamping portion and a proximal operating portion, the clamp being configured to be inserted into the channel through the proximal opening of the handle assembly, and the clamping portion extending distally from the opening of the actuator.

[0015] The surgical instrument provided by this application has the following advantages:

[0016] The present application provides a surgical instrument, in which a channel is provided to allow tools such as clamps to pass through to clamp tissue for sampling. By providing a suture staple in the distal actuator, the incision can be quickly sutured when sampling tissue to avoid bleeding from the incision; even when sampling a large area of ​​organs or soft tissue, the incision can be quickly sutured to avoid wound bleeding, effectively improving the safety of the operation. BRIEF DESCRIPTION OF THE DRAWINGS

[0017] Other features, objects and advantages of the present application will become more apparent from the detailed description of non-limiting embodiments made with reference to the following drawings.

[0018] Figure 1 is a three-dimensional diagram of a surgical instrument according to an embodiment of the present application;

[0019] Figure 2 is an exploded view of the actuator and part of the tubular component of an embodiment of the present application;

[0020] Figure 3 is a three-dimensional diagram of an actuator according to an embodiment of the present application;

[0021] Figure 4 A front view of the actuator of an embodiment of the present application, wherein the anvil assembly is shown in cross-section;

[0022] Figure 5a -c is a schematic diagram of the closing process of the actuator in the embodiment of the present application;

[0023] Figure 6 is an exploded view of a staple cartridge assembly according to an embodiment of the present application;

[0024] Figure 7 is a bottom view of a staple cartridge assembly according to an embodiment of the present application;

[0025] Figure 8 yes Figure 7 A1-A1 cross-sectional view;

[0026] Figure 9a -b is a schematic diagram of the staple forming process of an embodiment of the present application;

[0027] Figure 10 is a top view of the actuator of an embodiment of the present application;

[0028] Figure 11a -d is a schematic diagram of the cutter working process in an embodiment of the present application;

[0029] Figure 12 This is a schematic diagram of the cooperation of the firing slide, nail pushing block, and cutting knife in an embodiment of the present application;

[0030] Figure 13 is an exploded view of a handle assembly and a portion of a tubular assembly according to an embodiment of the present application;

[0031] Figure 14a -d is a schematic diagram of the working process of the handle assembly of an embodiment of the present application;

[0032] Figure 15 is a schematic diagram of a clamp passing through a channel according to an embodiment of the present application;

[0033] Figure 16 is a flow chart of a sampling process according to an embodiment of the present application;

[0034] Figure 17 is a bottom view of a staple cartridge assembly according to another embodiment of the present application;

[0035] Figure 18 is a comparative schematic diagram of suture staples of different sizes according to another embodiment of the present application;

[0036] Figure 19a -c is a schematic diagram of the cutter recovery process of an embodiment of the present application;

[0037] Figure 20 is a perspective view of an actuator and a portion of a tubular component according to an embodiment of the present application;

[0038] Figure 21a -c is a schematic diagram of the lens assembly opening process according to an embodiment of the present application;

[0039] Figure 22 is a transverse cross-sectional view of a tubular component according to an embodiment of the present application;

[0040] Figure 23 It is a flow chart of another sampling process of this application.

[0041] Reference numerals:

[0042] 10-surgical instruments; 40-channels; 70-display tools;

[0043] 50-clamp; 511-clamping part; 512-operating part;

[0044] 60-lens assembly; 61-clip; 62-lens lever; 63-lens assembly torsion spring; 64-lens; 65-support arm;

[0045] 11-handle assembly; 111-opening;

[0046] 13-fixed handle; 131-first housing; 132-second housing;

[0047] 14-closing trigger; 141-connecting rod; 142-closing driving member; 1421-locking surface; 1422-boss; 143-elastic member;

[0048] 15-firing trigger; 151-firing portion; 152-firing locking portion; 153-elastic member;

[0049] 16-open button; 160-holding member; 161-elastic member; 17-lens open button;

[0050] 20- tubular component; 21- main body; 22- outer sleeve; 23- firing push rod;

[0051] 30-actuator; 301-opening;

[0052] 302 - first clamp; 31 - staple cartridge assembly; 310 - staple cartridge; 311 - first tissue contact surface;

[0053] 311a-bending area; 311b-straight area;

[0054] 312-nail hole; 312a-first nail hole; 312b-second nail hole;

[0055] 313-nail pushing block; 3131-third cam surface; 3132-nail pushing piece;

[0056] 314-firing slide; 3141-first drive unit; 3142-second drive unit;

[0057] 315 - cutter; 3151 - fourth cam surface; 316 - elastic member; 317 - staple cartridge cover;

[0058] 318-suture staple; 318a-first suture staple; 318b-second suture staple;

[0059] 3181-nail crown; 3182-nail leg; 320-knife groove;

[0060] 33-nail magazine seat; 331-second locking surface; 332-first locking surface; 333-cantilever;

[0061] 303 - second jaw; 32 - anvil assembly; 321 - second tissue contact surface;

[0062] 323-nail groove; 34-rotating shaft;

[0063] 35-closing drive mechanism; 351-closing slider; 3511-first locking portion; 3512-second locking portion; 352-closing pull rod;

[0064] 36-elastic member; 37-receiving cavity. DETAILED DESCRIPTION

[0065] Example embodiments will now be described more fully with reference to the accompanying drawings. However, the example embodiments can be implemented in a variety of forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this application will be comprehensive and complete and will fully convey the concepts of the example embodiments to those skilled in the art. The same reference numerals in the figures represent the same or similar structures, and thus their repeated descriptions will be omitted. "Or" and "or" in the specification may both mean "and" or "or". Although the terms "above", "below", "between", etc. may be used in this specification to describe different exemplary features and elements of the present application, these terms are used herein only for convenience, such as according to the directions of the examples described in the accompanying drawings. Nothing in this specification should be construed as requiring a specific three-dimensional orientation of the structure to fall within the scope of this application. Although "first" or "second" etc. are used in this specification to represent certain features, they are only used to represent the function and are not intended to limit the number and importance of specific features.

[0066] In order to solve the technical problems in the prior art, an embodiment of the present application provides a surgical instrument, which is provided with a channel for tools such as clamps to pass through, and a suture nail is provided in the actuator, which can suture the incision when sampling tissue to avoid bleeding from the incision, and can also effectively avoid air leakage when used for sampling lung tissue. The surgical instrument can be used for tissue sampling in laparoscopic surgery, such as lung tissue sampling, and the clamp is, for example, a laparoscopic clamp, which is used to clamp the sampling site, but the present application is not limited to this. In other embodiments, the surgical instrument can also be used for sampling other organs or soft tissues, and the clamp can also be replaced with other tools that can clamp, grasp or fix tissue.

[0067] The structure of the surgical instrument in a specific embodiment is described in detail below with reference to the accompanying drawings. The terms "distal end" and "proximal end" are relative to the operator of the surgical instrument. The "distal end" is the end away from the operator, i.e., the end close to the surgical site, and the "proximal end" is the end close to the operator. The "axial" refers to the axial direction of the tubular component, such as Figure 1 The direction from D2 to D1 is the distal direction, and the direction from D1 to D2 is the proximal direction.

[0068] like Figure 1 As shown, the first embodiment of the present application provides a surgical instrument 10, comprising a handle assembly 11, a tubular assembly 20, and an actuator 30, which are arranged in sequence from the proximal end to the distal end. The surgical instrument is provided with a channel 40 extending along the axial direction of the tubular assembly 20, and the proximal end of the channel 40 is connected to the proximal opening 111 of the handle assembly 11. The actuator 30 includes a first jaw 302 and a second jaw 303 arranged opposite to each other, and a jaw is formed between the first jaw 302 and the second jaw 303. The first jaw 302 and the second jaw 303 are rotatably connected to open and close the jaw. When the jaw is open, the actuator 30 is in an open state, and when the jaw is closed, the actuator is in a closed state.

[0069] like Figures 2 to 5a 、 Figure 6As shown, when the actuator 30 is in the open state, the actuator 30 has an opening 301 that communicates with the channel 40. Taking the example of using a clamp to clamp a sampled tissue, when sampling tissue, the clamp is inserted into the channel 40 from the proximal opening 111 of the handle assembly 11 and passed through the opening 301 of the actuator 30, extending the clamp distally to contact the sampling site. In this embodiment, the first jaw 302 includes a staple cartridge assembly 31 and a staple cartridge seat 33, and the second jaw 303 includes an anvil assembly 32. The staple cartridge assembly 31 includes staples 318, which can be driven to move toward the anvil assembly 32. When sampling tissue, the staples 318 can be driven toward the anvil assembly 32. After the staples 318 penetrate the tissue, they close and form at the anvil assembly 32, thereby suturing the tissue. Therefore, the surgical instrument 10 can quickly suture the incision when sampling tissue by setting a suture staple 318 in the distal actuator 30 to avoid bleeding from the incision; even when sampling a large area of ​​organs or soft tissues, the incision can be quickly sutured to avoid wound bleeding, and when used for sampling lung tissue, air leakage can be effectively avoided, thereby effectively improving the safety of the operation.

[0070] In this embodiment, the channel 40 is provided through the tubular component 20, that is, the channel 40 is provided inside the tubular component 20. This arrangement allows the clamp to be smoothly extended into the jaws of the actuator 30, while making full use of the space inside the tubular component 20 and not increasing the diameter of the tubular component 20 itself. In one embodiment, the channel 40 is provided coaxially with the tubular component 20 (see FIG. 2 ). Figure 22 ), that is, in the transverse section of the tubular component 20, the channel 40 is located at the center of the tubular component 20. In another embodiment, the channel 40 can also be arranged non-coaxially with the tubular component 20 and eccentrically relative to the tubular component 20. The firing push rod 23 and the closing pull rod 352 are arranged in the tubular component 20 (see Figure 22 ), whose structure and function will be described in detail below.

[0071] like Figure 1 As shown, the handle assembly 11 includes a fixed handle 13, a closing trigger 14, and a firing trigger 15. Both the closing trigger 14 and the firing trigger 15 are rotatably connected to the fixed handle 13, with the distal end of the firing trigger 15 being further away from the fixed handle 13 than the closing trigger 14. When operating the surgical instrument 10, the surgeon grasps the fixed handle 13 to hold the instrument and closes the actuator 30 by pulling the closing trigger 14. After closing the actuator 30, the surgeon can then fire the actuator 30 by pulling the firing trigger 15, pushing the staples 318 from the staple cartridge assembly 31 toward the anvil assembly 32 to suture the incision. The specific structure and operation of the closing trigger 14 and the firing trigger 15 will be described in detail below.

[0072] A method for sampling using the surgical instrument 10 includes: first, closing the actuator 30 by pulling the closing trigger 14 to allow the actuator 30 to enter the body cavity; opening the jaws of the actuator 30 to allow the clamp to enter the body cavity through the channel 40, positioning the distal end of the clamp and exposing it in the jaws, and operating the clamp to clamp the sampling site; pulling the closing trigger 14 to close the actuator 30 to clamp the sampling site, pulling the firing trigger 15 to suture the suture 318 around the sampling site; then removing the actuator 30 and the clamp from the body cavity, and using a tool such as scissors to cut the sutured sample tissue. Because a suture line has been formed around the sample tissue before it is cut, bleeding from the incision can be effectively avoided, and air leakage can also be effectively avoided when used for lung tissue sampling.

[0073] In another embodiment of the surgical instrument 10 for sampling, a cutter can be provided in the first jaw 302. When the trigger 15 is pulled to suture the area around the sampling site, the cutter simultaneously cuts the sampling site, separating it from the body. After the actuator 30 and the jaws are removed from the body cavity, the sampled tissue can be directly obtained. Since the sampled tissue is quickly sutured while being cut, bleeding from the incision can be effectively avoided. This also effectively prevents air leakage when used for lung tissue sampling.

[0074] The following combination Figure 1 、 Figure 3 5 specifically introduces the implementation method of closing and opening the actuator 30. In this embodiment, a first tissue contact surface 311 is provided on the side of the staple cartridge assembly 31 facing the anvil assembly 32, and a second tissue contact surface 321 is provided on the side of the anvil assembly 32 facing the staple cartridge assembly 31. The proximal end of the staple cartridge seat 33 and the proximal end of the anvil assembly 32 are rotatably connected to the distal end of the tubular assembly 20 via a rotating shaft 34. When the actuator 30 is in the open state, the first tissue contact surface 311 and the second tissue contact surface 321 form an angle, and the distal ends of the two tissue contact surfaces are away from each other. When the actuator 30 is in the closed state, the first tissue contact surface 311 and the second tissue contact surface 321 are roughly parallel, and the distal ends of the two tissue contact surfaces are close to each other.

[0075] like Figure 1 and Figure 2As shown, a closing rod 352 is provided in the tubular assembly 20, and the actuator 30 further includes a closing slider 351. The closing rod 352 and the closing slider 351 constitute a closing drive mechanism 35. The closing slider 351 is provided between the nail magazine seat 33 and the nail anvil assembly 32, and is restricted by the distal end of the tubular assembly 20 and the nail anvil assembly 32, and can only move axially toward the distal end or the proximal end. The distal end of the closing rod 352 is fixedly connected to the closing slider 351, and the closing rod 352 can drive the closing slider 351 to move axially to close and open the actuator 30. The proximal end of the closing rod 352 is mechanically connected to the closing trigger 14. When the closing trigger 14 is pulled, the closing trigger 14 can drive the closing rod 352 to move proximally, thereby closing the actuator 30.

[0076] Figure 5a -c shows the closing process of the actuator 30 in the embodiment, in which only some parts are shown for the convenience of showing the relationship between the various parts. The closing slider 351 includes a first locking portion 3511 and a second locking portion 3512. In this embodiment, the first locking portion 3511 is a first boss, and the second locking portion 3512 is a second boss. The nail magazine seat 33 includes a first locking surface 332 and a second locking surface 331. The nail magazine seat 33 has a cantilever 333, and the actuator 30 also includes an elastic member 36, which is, for example, a torsion spring sleeved on the outside of the rotating shaft 34. As shown Figure 5a As shown, the cantilever 333, under the elastic force of the elastic member 36, keeps the nail magazine seat 33 at its distal end away from the nail anvil assembly 32, that is, keeps the actuator 30 in an open state. The closing slider 351 can be driven by the closing pull rod 352 to move between a first position, an intermediate position, and a second position, which are arranged in order from the distal end to the proximal end.

[0077] like Figure 5a As shown, when the closing slider 351 is in the first position, that is, when the closing slider 351 is in its farthest position, the first locking portion 3511 abuts against the first locking surface 332 to limit the rotation of the nail magazine seat 33, thereby keeping the actuator 30 in the open state. At this time, the nail magazine seat 33 cannot rotate and the jaws cannot be closed.

[0078] When the closing trigger 14 is pulled, the closing rod 352 is pulled toward the proximal end for a distance, and the closing slider 351 moves toward the proximal end to Figure 5b The middle position is shown, at this time, the first locking portion 3511 of the closing slider 351 is separated from the first locking surface 332 of the nail magazine seat 33, and the first locking portion 3511 no longer restricts the rotation of the nail magazine seat 33. If the nail magazine seat 33 is driven at this time, the nail magazine seat 33 can be rotated to close the jaws.

[0079] When the closing trigger 14 is continuously pulled and the closing rod 352 is continuously pulled toward the proximal end for a distance, the closing slider 351 is driven toward the proximal end to move to the Figure 5c In the second position shown, during the movement of the closing slider 351 from the middle position to the second position, the second locking portion 3512 interacts with the second locking surface 331 (the cam surface in this embodiment) of the nail magazine seat 33, and the closing slider 351 drives the nail magazine seat 33 to rotate along the R1 direction relative to the anvil assembly 32 to close the jaws, and the actuator 30 enters the closed state, and the elastic member 36 undergoes elastic deformation. At this time, the second locking portion 3512 abuts against the second locking surface 331 to keep the actuator 30 in the closed state to prevent the nail magazine seat 33 from bouncing upward under the elastic force of the elastic member 36.

[0080] The opening process of the actuator 30 is the reverse process of the closing process. The operation of opening the actuator 30 includes: driving the closing rod 352 to move distally, so that the closing rod 352 drives the closing slider 351 to move distally from the second position to the intermediate position, the second locking portion 3512 separates from the second locking surface 331, the nail magazine seat 33 opens under the elastic force of the elastic member 36, and the jaws of the actuator 30 open. The closing rod 352 is further driven distally, so that the closing rod 352 drives the closing slider 351 to move distally from the intermediate position to the first position, the first locking portion 3511 and the first locking surface 332 abut against each other, thereby limiting the rotation of the nail magazine seat 33 toward the anvil assembly 32, and the jaws cannot be closed and remain in the open state. The open jaws facilitate user replacement of the nail magazine assembly 31.

[0081] like Figure 6 As shown in FIG. 3 , in this embodiment, the staple cartridge assembly 31 includes a staple cartridge 310, a staple pusher block 313, a firing slide 314, a cutter 315, an elastic member 316, and a staple cartridge cover 317. Figure 7 and Figure 8 As shown, the first tissue contact surface 311 of the staple cartridge assembly 31 is provided with a plurality of staggered staple holes 312, each of which is provided with at least one suture staple 318. The first tissue contact surface 311 is also provided with a knife groove 320, in which a cutter 315 is movably disposed.

[0082] In this embodiment, the first tissue contact surface 311 is a U-shaped tissue contact surface, and the first tissue contact surface 311 surrounds the receiving cavity 37, the first tissue contact surface 311 has one arc-shaped region and two linear regions, and the two linear regions are parallel to the axial direction. The surface of the receiving cavity 37 is recessed relative to the surface of the first tissue contact surface 311 in a direction away from the anvil assembly 20 to accommodate the sampling site during sampling. The knife slot 320 is also U-shaped, and the knife slot 320 is located on the inner side of the staple hole 312, and the knife slot 320 is located between the staple hole 312 and the receiving cavity 37. The shape of the cutting knife 315 is adapted to the shape of the knife slot 320, that is, the cutting knife 315 is a U-shaped cutting knife 315 having two mutually parallel side walls. When the tissue is sutured and cut, the U-shaped cutting knife 315 can form a U-shaped incision in the tissue, so that the sampling site is separated from the human body, and at the same time, the surgical staple 318 sutures the tissue and forms a U-shaped suture line to seal the incision of the tissue.

[0083] In other embodiments, the first tissue contact surface 311 can also be a U-like tissue contact surface, wherein the two linear regions are not parallel to each other but are at an angle, for example, the distal end of at least one of the two linear regions is inclined outward relative to the proximal end, and / or the distal end of at least one of the two linear regions is inclined inward relative to the proximal end. The cutting knife 315 can also be a U-like cutting knife, and the two side walls of the cutting knife 315 are not parallel.

[0084] Figure 8 A lateral cross section of the staple cartridge assembly 31 is shown. The firing slide 314 includes a first drive portion 3141, and when the firing slide 314 is driven to move distally, the first drive portion 3141 pushes the surgical staple 318 out of the anvil assembly 32. The process of pushing the surgical staple 318 out will be described in detail below. The pusher block 313 is provided with a third cam surface 3131, and the first drive portion 3141 of the firing slide 314 is a first cam surface, both the first cam surface and the third cam surface 3131 are inclined inclined surfaces to convert the axial movement of the firing slide 314 into the movement of the pusher block 313 toward the anvil assembly 32. The pusher block 313 has a pusher piece 3132 corresponding to each staple hole 312, and the pusher piece 3132 cooperates with the crown 3181 of the surgical staple 318 to push the surgical staple 318 out of the staple hole 312.

[0085] As shown in Figure 9a and 9b , the second tissue contact surface 321 of the anvil assembly 32 has a staple slot 323 corresponding to each staple hole 312. The proximal end of the firing slide 314 is in contact with the firing push rod 23, and the proximal end of the firing push rod 23 is in contact with the firing trigger 15 Figure 1) mechanical cooperation. After the jaws are closed, the firing trigger 15 is pulled, the firing trigger 15 drives the firing push rod 23 to move distally, and the firing push rod 23 drives the firing slide 314 to move distally. During the movement of the firing slide 314 toward the distal end, the first driving portion 3141 cooperates with the third cam surface 3131 of the nail pushing block 313, so that the nail pushing block 313 moves along the direction of the nail hole 312 ( Figure 9b The nail pushing block 313 pushes the suture nail 318 in the nail hole 312 toward the direction of the nail anvil assembly 32, and the suture nail 318 forms a "B" shape under the guidance of the nail groove 323 and closes ( Figure 9b If biological tissue is clamped in the jaws when the jaws are closed, the legs 3182 of the staples 318 will pass through the tissue to sew the tissue together.

[0086] Figure 10 The top view of the actuator 30 in the embodiment is shown. The actuator 30 is cut open along the A2-A2 direction (longitudinal direction). Figures 11a-11d . Figures 11a-11d The cutter 315 is shown cutting tissue. The firing slide 314 further includes a second drive portion 3142, which is configured to push the cutter 315 toward the anvil assembly 32 during distal movement. In this embodiment, the cutter 315 is positioned on the inner side of the staple cartridge 310. The cutter 315 is provided with a fourth cam surface 3151. The second drive portion 3142 is a second cam surface provided on the firing slide 314. The second cam surface and the fourth cam surface 3151 are both inclined surfaces, which convert axial movement of the firing slide 314 into movement of the cutter 315 toward the anvil assembly 32.

[0087] The following combination Figure 11a -d specifically introduces the firing process of the actuator 30. Figure 11a As shown, when the firing slide 314 is not driven, the firing slide 314 is located at the first slide position, the second driving portion 3142 of the firing slide 314 is located at the proximal side of the cutter 315, and the second driving portion 3142 of the firing slide 314 is spaced apart from the fourth cam surface 3151 of the cutter 315. The elastic member 316 exerts a force on the cutter 315 to keep it away from the anvil assembly 32. The cutter 315 is in the elastic member 316 ( Figure 6 ) and remains in its initial position. At this time, the blade of the cutter 315 does not protrude from the first tissue contact surface 311 to avoid scratching the tissue.

[0088] The firing trigger 15 is pulled to drive the firing slide 314 to move distally through the firing push rod 23 to push the suture staple 318 out of the staple cartridge 310. The process includes: the firing slide 314 first moves distally to a first distance to reach the first distance. Figure 11bIn the second slider position shown, the second driving portion 3142 contacts the fourth cam surface 3151. At the same time, the firing slider 314 pushes the nail pushing block 313 to push a portion of the nail leg 3182 of the suture nail 318 out of the first tissue contact surface 311. If there is biological tissue in the jaws at this time, the nail leg 3182 will gradually contact the tissue and gradually pierce the tissue. The firing slider 314 continues to move distally to a second distance to reach Figure 11c The third slider position is shown. During this process, the second driving portion 3142 interacts with the fourth cam surface 3151 to move the cutter 315 toward the anvil assembly 32. If biological tissue is contained in the jaws at this time, the cutter 315 will cut the biological tissue. At this time, the elastic member 316 undergoes elastic deformation, and the suture staple 318 is closed and formed under the action of the anvil assembly 32 and sutured on the tissue. The firing slider 314 continues to move distally for a third distance to reach Figure 11d In the fourth slider position shown, the second driving portion 3142 moves to the distal end of the fourth cam surface 3151 and separates from the fourth cam surface 3152. Figure 6 ), the cutter 315 returns to its initial position, i.e., the blade of the cutter 315 retracts into the interior of the staple cartridge 310 and does not protrude beyond the first tissue contact surface 311. The elastic member 316 may be an elastic structure such as a spring or a compression spring disposed between the cutter 315 and the staple cartridge 310, but the present application is not limited thereto.

[0089] Therefore, in this embodiment, when the firing slide 314 is driven to move distally, the nail tip of the suture staple 318 is pushed out of the first tissue contact surface 311 before the blade of the cutter 315, and the nail tip contacts the tissue before the blade of the cutter 315, so that the suturing action is faster than the cutting action, which is beneficial to minimize incision bleeding.

[0090] Figure 12 The figure shows the mating relationship between the firing slide 314, the nail pushing block 313, and the cutter 315. The firing slide 314 is flipped to better illustrate the first and second driving parts 3141 and 3142. In this embodiment, the firing slide 314 is equipped with four first driving parts 3141 and three second driving parts 3142, with the first driving parts 3141 located outside the second driving parts 3142. The nail pushing block 313 is equipped with four third cam surfaces 3131, and the cutter 315 is equipped with three fourth cam surfaces 3151, with the third cam surfaces 3131 located outside the fourth cam surfaces 3151. The number of first and second driving parts 3141 and 3142 shown here is merely illustrative; in actual applications, their number and location can be adjusted as needed. The third and fourth cam surfaces 3131 and 3151 are provided to correspond to them, respectively.

[0091] like Figure 1 and Figure 13As shown, in this embodiment, the housing of the fixed handle 13 includes a first housing 131 and a second housing 132, and the closing trigger 14 is partially located inside the housing of the fixed handle 13 and can rotate along a fixed axis located on the fixed handle 13. Figure 13 and Figure 14a As shown, in this embodiment, the handle assembly 11 further includes a closing drive member 142, a retaining member 160 and an elastic member 143 disposed inside the housing, and a safety opening button 16 partially exposed from the housing. The closing drive member 142 is connected to the closing slider 351 ( Figure 5b ). Pull the closing trigger 14 so that the closing trigger 14 moves along Figure 14b When the trigger 14 rotates in the direction of R30 and moves toward the fixed handle 13, the closing trigger 14 drives the closing slider 351 to move proximally through the closing driving member 142 to close the actuator 30, and the closing driving member 142 moves proximally to cooperate with the retaining member 160 (such as Figure 14b The closing drive member 142 is shown to be engaged with the closing slider 351 to keep the actuator 30 in the closed state. After the safety opening button 16 is operated to separate the retaining member 160 from the closing drive member 142 ( Figure 14d The closing trigger 14 is driven by the elastic member 143 to move away from the fixed handle 13, so that the closing slider 351 is driven to move distally by the closing driving member 142 to open the actuator 30.

[0092] As described above, the firing trigger 15 is connected to the firing slide 314 via a firing push rod 23. The firing trigger 15 is at least partially disposed within the housing of the fixed handle 13 and is rotatably connected to the fixed handle 13 via a fixed shaft disposed on the fixed handle 13. The firing trigger 15 includes a firing portion 151 that can drive the firing push rod 23 to move distally to cause the distal firing slide 314 ( Figure 11a ) moves distally, thereby pushing the staples 318 and the cutter 315 outward. In this embodiment, the closing trigger 14 and the firing trigger 15 are coaxially arranged, and rotation of the closing trigger 14 drives rotation of the firing trigger 15. When the closing trigger 14 is driven to rotate toward the fixed handle 13 to close the actuator 30, the firing trigger 15 rotates along with the closing trigger 14 by a first angle. The firing portion 151 slides with the firing push rod 23 without driving the firing push rod 23. At this time, the distance between the firing trigger 15 and the fixed handle 13 is reduced, facilitating operation by the physician. After the actuator 30 is in the closed state, when the physician pulls the firing trigger 15, the firing trigger 15 is driven to rotate toward the fixed handle 13 by a second angle. The firing portion 151 drives the firing push rod 23 to move distally, pushing the staples 318 and the cutter 315 outward, thereby achieving tissue suturing and cutting. Therefore, during the process from closing of the actuator 30 to firing, the total rotation angle of the firing trigger 15 is (first angle+second angle).

[0093] The following combination Figures 14a-14d The following describes in detail the closing and firing process of the actuator 30 in this embodiment. In this embodiment, the closing actuator 142 is a slider. The retaining member 160 is a hook, connected to the close / open button 16. The elastic member 143 is a closing trigger torsion spring. Furthermore, an elastic member 161 is provided at the close / open button 16. In this embodiment, the elastic member 161 is a compression spring. The closing trigger 14 is connected to the closing actuator 142 via a connecting rod 141, so that rotation of the closing trigger 14 drives the closing actuator 142 axially.

[0094] like Figure 14a As shown, in the initial state, the doctor has not pulled the closing trigger 14 and the firing trigger 15, and the retaining member 160 is above the closing driving member 142 and is not engaged with the closing driving member 142. When the closing trigger 14 is pulled, the closing trigger 14 drives the closing driving member 142 to move proximally through the connecting rod 141, and the jaws are closed by the proximal movement of the closing pull rod 352 and the closing slide 351. Under the action of the elastic member 161, the closing and opening button 16 is rotated clockwise (along the Figure 14b The retaining member 160 is engaged with the locking surface 1421 of the closing driving member 142 to prevent the closing driving member 142 from moving distally, thereby keeping the jaws in the closed state and the closing trigger 142 in the closed state. Figure 14b Shown in closed state.

[0095] The firing trigger 15 is coaxial with the closing trigger 14. The firing portion 151 is an arc-shaped groove, and the proximal end of the firing push rod 23 is bent to form a hook, which cooperates with the arc-shaped groove. Figure 14a In the initial state shown, the hook is located at the farthest end of the arc groove. An elastic member 153 is provided between the firing trigger 15 and the closing trigger 14. In this embodiment, the elastic member 153 is a firing trigger torsion spring for resetting the firing trigger 15. When the closing trigger 14 is pulled and the trigger 15 is closed, the elastic member 153 is provided. Figure 14b At the same time as the middle R30 moves in the direction, the firing trigger 15 also moves with the closing trigger 14 to reach Figure 14b In the position shown, the arc groove moves relative to the retractor but does not drive the retractor during this process, and the retractor reaches the near end of the arc groove. At this time, the distance between the firing trigger 15 and the fixed handle 13 is small, which is convenient for the user to operate the firing trigger 15.

[0096] exist Figure 14b In the state shown, the doctor pulls the firing trigger 15, and the firing trigger 15 continues to Figure 14c Rotate in the R3 direction to reach Figure 14cThe firing completion position is shown. During this process, the firing portion 151 drives the firing push rod 23 to push the suture staples 318 and the cutter 315 out of the staple cartridge 310, thereby firing the actuator 30 and completing the suturing and cutting of the tissue.

[0097] like Figure 14d As shown, when the jaws of the actuator 30 need to be opened, the doctor presses the close-open button 16, the retaining member 160 and the locking surface 1421 of the closing drive member 142 are released, and the closing trigger 14 is released along the elastic member 143. Figure 14d The jaws are rotated in the direction R4 to return to their initial open position. Simultaneously, the closing trigger 14 drives the closing driver 142 to move distally via the connecting rod 141, which in turn drives the closing slider 351 to move distally via the closing pull rod 352, releasing the restriction on the jaws. The jaws are restored to their open state under the action of the elastic member 36. Under the action of the elastic member 153, the firing trigger 15 also returns to its initial position.

[0098] In this embodiment, the handle assembly 11 is also provided with a firing safety mechanism. Figure 14a As shown, the firing trigger 15 includes a firing locking portion 152. In this embodiment, the firing locking portion 152 is a groove. The closing drive member 142 is provided with a boss 1422. The closing drive member 142 is in a Figure 14a In the third position shown, the actuator 30 is in the open state, and the boss 1422 cooperates with the firing lock portion 152 (in this embodiment, it is embedded) to prevent the firing trigger 15 from moving toward the fixed handle 13. Therefore, when the jaws are open, the firing trigger 15 is locked and cannot move toward the fixed handle 13. The doctor cannot directly pull the firing trigger 15, thereby preventing the doctor from making an erroneous operation during use. Figure 14b In the fourth position shown, the actuator 30 is in a closed state, the boss 1422 of the closing drive member 142 is separated from the firing locking portion 152, and the firing trigger 15 is unlocked. The doctor can then pull the firing trigger 15. When the firing trigger 15 is driven to move toward the fixed handle 13, the firing trigger 15 drives the firing slide 314 to move distally to fire the actuator 30.

[0099] like Figure 15 As shown, in this embodiment, the surgical instrument further includes a clamp 50, which may be, for example, a laparoscopic clamp, but the present application is not limited thereto. The clamp 50 includes a distal clamping portion 511 and a proximal operating portion 512. The clamp 50 is configured to be inserted into the channel 40 through the proximal opening 111 of the handle assembly 11. When the jaws of the actuator 30 are opened, the clamping portion 511 extends distally from the opening 301 of the actuator 30.

[0100] Figure 16A sample method flow chart is shown using the surgical instrument. Using the surgical instrument, the complete tissue sampling procedure includes the following steps: cocking the closure trigger 14 to close the firing mechanism 30 to a small size for entry into the body cavity through a trocar or incision protector. Pressing the closure opening button 16 to open the firing mechanism 30, the jaws 50 enter the body cavity through the passage 40, locate and clamp the sample site, manipulating the jaws 50 to draw the sample site into the receiving chamber 37 of the firing mechanism 30, cocking the closure trigger 14 to close the firing mechanism 30 and clamp the sample site. Cocking the firing trigger 15 to cut the sample site while applying a staple 18 to the incision. Removing the surgical instrument from the body to obtain the biological tissue sample clamped inside the jaws. If further sampling is desired, repeating the above steps with a replacement staple cartridge assembly 31 to obtain further biological tissue samples.

[0101] As mentioned above, in another embodiment, the cutting knife is not provided in the staple cartridge assembly 31. Then the complete tissue sampling procedure includes the following steps: cocking the closure trigger 14 to close the firing mechanism 30 to a small size for entry into the body cavity through a trocar or incision protector. Pressing the closure opening button 16 to open the firing mechanism 30, the jaws 50 enter the body cavity through the passage 40, locate and clamp the sample site, manipulating the jaws 50 to draw the sample site into the receiving chamber 37 of the firing mechanism 30, cocking the closure trigger 14 to close the firing mechanism 30 and clamp the sample site. Cocking the firing trigger 15 to apply a staple 18 to the sample site to form a line of staples around the sample site. Removing the surgical instrument from the body and using scissors to cut the tissue inside the line of staples to obtain the biological tissue sample. If further sampling is desired, repeating the above steps with a replacement staple cartridge assembly 31 to obtain further biological tissue samples.

[0102] As Figure 1 and Figure 15 shown, the second embodiment of the present application provides a surgical instrument 10 comprising a handle assembly 11, a tubular assembly 20, a firing mechanism 30 and a jaw 50, the tubular assembly 20 being connected between the handle assembly 11 and the firing mechanism 30, the surgical instrument 10 being provided with a passage 40 extending along the axial direction of the tubular assembly 20, a proximal end of the passage 40 being communicated to a proximal opening 111 of the handle assembly 11. The firing mechanism 30 comprises an open state and a closed state, when the firing mechanism 30 is in the open state, the firing mechanism 30 has an opening 301 communicated to the passage 40 (see Figure 5a ). The jaw 50 comprises a clamping portion 511 at a distal end and a manipulating portion 512 at a proximal end, the jaw 50 is configured to be arranged in the passage 40 through the proximal opening 111 of the handle assembly 11, and when the jaw of the firing mechanism 30 is open, the clamping portion 511 extends distally from the opening 301 of the firing mechanism 30.

[0103] By providing the surgical instrument 10, when using the surgical instrument 10, after the actuator 30 of the surgical instrument 10 enters the body cavity, the jaws of the actuator 30 are opened, and the clamp 50 can be inserted into the channel 40 through the proximal opening 111 of the handle assembly 11. The clamping portion 511 of the clamp 50 extends from the jaws. The clamp 50 is operated to clamp the sampling site and pull it into the jaws. The jaws of the actuator 30 are closed to clamp the tissue. At this time, the tissue can be processed using the surgical instrument 10. For example, if a suture staple is provided in the actuator 30, the tissue can be sutured; and / or if a cutter is provided in the actuator 30, the tissue can be cut.

[0104] The implementation structure of each component in this embodiment can adopt the implementation structure of the corresponding component in the first embodiment, or adopt other alternative structures that can realize the function of the surgical instrument.

[0105] like Figure 1 、 Figures 6-12 As shown, the third embodiment of the present application provides a surgical instrument 10, including a handle assembly 11, a tubular assembly 20 and an actuator 30 arranged in sequence from the proximal end to the distal end, the actuator 30 includes a first jaw 302 and a second jaw 303 arranged opposite to each other, as shown in FIG. Figure 6 and Figure 7 As shown, a U-shaped tissue contact surface 311 with a proximal opening is provided on the side of the first jaw 302 facing the second jaw 303. The U-shaped tissue contact surface 311 allows for a U-shaped closed suture of the sampling site when the surgical instrument 10 is used for sampling, thereby preventing bleeding from the incision at the sampling site and effectively preventing air leakage when used for sampling lung tissue.

[0106] In this embodiment, the first jaw 302 includes a staple cartridge assembly 31 and a staple cartridge seat 33. The staple cartridge assembly 31 includes a staple cartridge 310 and a plurality of staples 318 disposed in the staple cartridge 310. The second jaw 303 includes an anvil assembly 32. The side of the staple cartridge assembly 31 facing the anvil assembly 32 is a tissue contact surface 311.

[0107] like Figure 7 As shown, in this embodiment, the first tissue contact surface 311 includes a first region I, a second region II, and a third region III, which collectively surround the receiving cavity 37. The second region II is located distally of the first region I and the third region III. The first region I and the third region III are located on either side of the second region II and extend proximally relative to the first region I. The first region I, the second region II, and the third region III are each provided with at least one staggered staple hole 312. Each staple hole 312 is provided with at least one suture staple 318.

[0108] In one embodiment, the first region I and the third region III are parallel straight lines, and the second region II is an arc-shaped region connecting the distal end of the first region I and the distal end of the third region III. The nail holes 312 in the first region I and the third region III are arranged parallel to each other and parallel to the axial direction. At least some of the nail holes 312 in the second region II are arranged at an angle to the axial direction. Specifically, the nail holes 312 can be divided into a first type of nail holes 312 arranged parallel to the axial direction and a second type of nail holes 312 arranged at an angle to the axial direction. For example, the nail holes 312 in the first region I and the nail holes 312 in the third region III are substantially parallel, while the nail holes 312 in the second region II are arranged at an angle relative to the nail holes 312 in the first region I. Specifically, the nail holes 312 at the corners of the second region II are arranged at an acute angle relative to the nail holes 312 in the first region I, while the nail holes 312 at the center of the second region II are arranged at a right angle relative to the nail holes 312 in the first region I.

[0109] like Figure 7 As shown, the nail holes 312 in the first region I and the third region III are arranged along an axial straight line, while the nail holes 312 in the second region II are arranged along a broken line or arc. The nail holes 312 in each region can be arranged in one or more rows. In this embodiment, each region is provided with two staggered rows of nail holes, but the present application is not limited thereto.

[0110] In this embodiment, the second region II is provided with at least two rows of nail holes 312, each row of nail holes 312 is arranged along a fold line or an arc, and the inscribed circles of the fold lines of nail holes 312 in different rows are arranged concentrically, or the arc lines of nail holes 312 in different rows are arranged concentrically. Figure 7 As shown, the nail holes 312 in the second region II are arranged as a partial fold line of a pentagon. Specifically, the three nail holes 312 on the inner side of the second region II are arranged on three sides of a regular pentagon, while the three nail holes 312 on the outer side are arranged on two sides of another regular pentagon. The inscribed circles of the two regular pentagons are arranged concentrically but have different radii, and the inner nail holes 312 and the outer nail holes 312 are arranged alternately. In other embodiments, the nail holes 312 in the second region II can also be arranged as a partial fold line of other shapes, such as a triangle, quadrilateral, polygon, etc. When a large number of nail holes 312 are provided in the second region II, each row of nail holes 312 is arranged in an arc.

[0111] In another embodiment, the first region I and the third region III can be disposed non-parallel to the axial direction, but can be disposed at an angle with respect to the axial direction. For example, the first region I and the third region III are respectively outwardly inclined structures at the proximal end with respect to the distal end, then an obtuse angle is formed between the first region I and the third region III, or the first region I and the third region III are respectively inwardly inclined structures at the proximal end with respect to the distal end, then an acute angle is formed between the first region I and the third region III, or the first region I and the third region III can be disposed at an angle with respect to the axial direction, and the other is parallel to the axial direction.

[0112] In another embodiment, at least one of the first region I and the third region III can also be an arc-shaped region, and is not limited to a straight line region.

[0113] As shown in FIGS. 1, 2 and 3, the first region I and the third region III are respectively outwardly inclined structures at the proximal end with respect to the distal end, then an obtuse angle is formed between the first region I and the third region III. Figure 6 and Figure 7 As shown in FIGS. 1, 2 and 3, the first region I and the third region III are respectively outwardly inclined structures at the proximal end with respect to the distal end, then an obtuse angle is formed between the first region I and the third region III.

[0114] As shown in Figures 9 to 12, the actuator 30 also includes a firing slide 314 and a nail pushing block 313. The nail pushing block 313 includes a plurality of nail pushing pieces 3132. The nail pushing pieces 3132 carry and drive the suture nails 318. The firing slide 314 includes a first driving portion 3141 and a second driving portion 3142. The first driving portion 3141 is located outside the second driving portion 3142. When the firing slide 314 is driven to move toward the distal end, the first driving portion 3141 pushes the suture nail 318 out of the tissue contact surface 311 through the nail pushing piece 3132, and the second driving portion 3142 pushes the cutter 315 out of the tissue contact surface 311, thereby simultaneously achieving tissue cutting and suturing. In this embodiment, when the firing slide 314 moves distally, the firing slide 314 simultaneously drives all the staple pushers 3132, pushing all the staples 318 toward the anvil assembly 32 at the same time. All the staples 318 move simultaneously and are guided into shape by the anvil assembly 32. Only one firing is required to suture all the staples 318 to the tissue. At the same time, when the firing slide 314 moves distally, the firing slide 314 acts on the cutter 315, causing the cutter 315 to move as a whole toward the anvil assembly 32. The U-shaped blade of the cutter 315 can cut the tissue simultaneously at one time, and only one firing is required to complete the complete cutting of the sampling site.

[0115] In this embodiment, different suture pins 318 at different positions may also be provided with different crown lengths. For example, the first jaw 302 further includes at least one first suture pin 318 and at least one second suture pin 318, the first suture pin 318 and the second suture pin 318 being movably mounted in the pin hole 312, and the crown length of the first suture pin 318 is different from the crown length of the second suture pin 318. Figure 7 The staple holes 312 shown in the figure are configured to have two lengths: the staple holes 312 arranged linearly in the first region I and the third region III have a second staple hole length, while the staple holes 312 located in the center-outer portion of the second region II have a first staple hole length, and the staple holes 312 located in the center-inner portion of the second region II have a second staple hole length, with the first staple hole length being greater than the second staple hole length. Accordingly, a first staple 318 is positioned within the staple holes 312 of the first staple hole length, while a second staple 318 is positioned within the staple holes 312 of the second staple hole length. The crown length of the first staple 318 is greater than the crown length of the second staple 318. This prevents excessive spacing between staples 318 within the staple holes 312 located in the outer portion of the second region II, enabling a good tissue suture.

[0116] The implementation structure of each component in this embodiment can adopt the implementation structure of the corresponding component in the first embodiment, or adopt other alternative structures that can realize the function of the surgical instrument.

[0117] like Figure 1 、 Figure 6 、 Figure 17 and Figure 18 As shown, the fourth embodiment of the present application provides a surgical instrument 10, comprising a handle assembly 11, a tubular assembly 20, and an actuator 30, which are arranged in sequence from the proximal end to the distal end. The actuator 30 includes a first jaw 302 and a second jaw 303 arranged opposite each other. The first jaw 302 is provided with a suture staple 318 inside, and the suture staple 318 can be driven to move toward the second jaw 303. The suture staple 318 includes at least one first suture staple 318a and at least one second suture staple 318b. The first suture staple 318a has a first nail crown length, and the second suture staple 318b has a second nail crown length, and the first nail crown length is different from the second nail crown length. Therefore, in this embodiment, by providing two types of suture staples 318 with different nail crown lengths in the surgical instrument, the two types of suture staples 318 can be arranged as needed. For example, when the first clamp 302 is used and has a bending area and at least two rows of nail holes 312 are provided in the bending area, since the center distance between two adjacent nail holes 312 on the outside of the bending area is greater than the center distance between two adjacent nail holes 312 on the inside, in order to avoid the outer suture staples 318 from having too large a spacing after suturing, a first suture staple 318a with a longer nail crown length can be provided on the outside of the bending area, and a second suture staple 318b with a shorter nail crown length can be provided on the inside of the bending area to ensure that the tissue can be well sutured on both the inside and the outside.

[0118] by Figure 17 For example, the first jaw 302 includes a staple cartridge 310, and a tissue contact surface 311 is provided on the side of the staple cartridge 310 facing the second jaw 303. The tissue contact surface 311 has a bending area 311a, and at least two rows of staple holes 312 are provided at the position of the bending area 311a. A first suture staple 318a is provided in the first staple hole 312a located on the outside, and a second suture staple 318b is provided in the second staple hole 312b located on the inside. The length of the first staple hole 312a is greater than the length of the second staple hole 312b, and the first nail crown length of the first suture staple 318a is greater than the second nail crown length of the second suture staple 318b. Figure 17 As shown, the tissue contact surface 311 also includes at least one straight area 311b, which is provided with a plurality of second nail holes 312b. Second suture nails 318b are provided in the second nail holes 312b of the straight area 311b. The bending area here refers to an area with at least one corner. The bending area can be an arc-shaped area or a broken line area. The straight area 311b can be an area parallel to the axial direction or an inclined area at a certain angle to the axial direction. For example, when the tissue contact surface 311 of the first clamp 302 is U-shaped, the first nail holes 312a are provided on the outside of the U-shaped arc-shaped area, and the second nail holes 312b are provided on the inside of the U-shaped arc-shaped area.

[0119] The implementation structure of each component in this embodiment can adopt the implementation structure of the corresponding component in the first embodiment described above, or adopt other alternative structures capable of realizing the function of the surgical instrument.

[0120] As shown in Figure 1 , Figure 11a -d、 Figure 19a -c, the fifth embodiment of the present application provides a surgical instrument 10, which comprises an execution mechanism 30, the execution mechanism 30 comprises a first jaw 302 and a second jaw 303 arranged oppositely, the first jaw 302 comprises a cartridge assembly 31, the cartridge assembly 31 comprises a cartridge 310, the second jaw 303 comprises an anvil assembly 32, the cartridge assembly 31 is provided with a tissue contact surface 311 on the side facing the anvil assembly 32, and the inside of the cartridge assembly 31 is provided with a knife 315, an elastic member 316 and a firing slide 314. The firing slide 314 comprises a first driving part 3142, the knife 315 comprises a second driving part 3151, and the knife 315 has a cutting state (as shown in Figure 11c ) in which the blade of the knife 315 protrudes from the tissue contact surface 311 and a storage state (as shown in Figure 11a , Figure 11b and Figure 11d ) in which the blade of the knife 315 does not protrude from the tissue contact surface 311.

[0121] As shown in Figure 11a and Figure 19a , when the firing slide 314 is in the first position, the first driving part 3142 is located on the proximal side of the second driving part 3151, the blade of the knife 315 does not protrude from the tissue contact surface 311, and the knife 315 is kept in the storage state under the action of the elastic member 316, which provides the knife 315 with an elastic force to move away from the anvil assembly 32. As shown in Figure 11b and Figure 11c , when the firing slide 314 moves to the second position in the distal direction, the first driving part 3142 acts on the second driving part 3151, causing the knife 315 to move towards the second jaw 303 and enter the cutting state, and the elastic member 316 is compressed and elastically deformed, as shown in Fig. 19. Figure 11d and Figure 19c , when the firing slide 314 continues to move to the third position in the distal direction, the first driving part 3142 moves to the distal side of the second driving part 3151, and the knife 315 is driven by the elastic member 316 to move away from the anvil assembly 32, thereby entering the storage state, and at this time the blade of the knife 315 does not protrude from the tissue contact surface 311 to avoid scratching the tissue.

[0122] In this embodiment, the movement direction of the firing slide 314 is not perpendicular to the tissue contact surface 311.

[0123] In this embodiment, the movement direction of the firing slide 314 is parallel to the tissue contact surface 311.

[0124] like Figure 11a As shown in FIG-d, the mating surfaces of the first driving portion 3142 and the second driving portion 3151 are inclined surfaces. When the firing slide 314 moves distally, the two inclined surfaces convert the axial motion of the firing slide 314 into the motion of the cutter 315 toward the anvil assembly 32.

[0125] like Figure 19a As shown, the cutter 315 and the elastic member 316 are movably mounted within the staple cartridge 310. The elastic member 316 is a spring, with its ends respectively abutting against the cutter 315 and the staple cartridge 310. The cutter 315 is U-shaped, with a spring disposed on each of the outer sides of the two walls of the cutter 315 parallel to the axial direction. The two springs are symmetrically arranged to provide a balanced elastic force to the cutter 315. This is only one embodiment of the elastic member 316. In other embodiments, the elastic member 316 may be fixed in other ways, or the elastic member 316 may also adopt other elastic structures, such as a compression spring.

[0126] The implementation structure of each component in this embodiment can adopt the implementation structure of the corresponding component in the first embodiment, or adopt other alternative structures that can realize the function of the surgical instrument.

[0127] like Figure 1 、 Figure 20-22 As shown, the sixth embodiment of the present application provides a surgical instrument 10, comprising a tubular component 20, an actuator 30 and a lens assembly 60, wherein the distal end of the tubular component 20 is connected to the actuator 30, and the lens assembly 60 is provided at the distal end of the tubular component 20, and the lens assembly 60 is configured to be in an open state ( Figure 20 and Figure 21c ) and storage status ( Figure 21a and Figure 22 ) between the movement. Figure 20 As shown, when the lens assembly 60 is in the open state, the actuator 30 is at least partially located within the field of view of the lens assembly 60. By arranging the lens assembly 60 at the distal end of the surgical instrument 10, the surgical instrument 10 also has an imaging function, and the sampling process can be completed within the field of view provided by the surgical instrument 10. The surgical instrument 10 is highly integrated, which can reduce the number of instruments operated by the doctor, reduce the complexity of sampling and reduce the cost of the instrument. Figure 21a As shown, when the lens assembly 60 is in the stowed state, the outer surface of the lens assembly 60 does not exceed the outer contour of the tubular assembly 20, thereby not increasing the diameter of the tubular assembly 20. Furthermore, the lens assembly 60 can be inserted into a body cavity along with the instrument. The lens assembly 60 may also be provided with a light source, for example, located on one side of the lens 64. The lens 64 has a camera function and can transmit the captured image to the display device 70 via a wired or wireless method.

[0128] like Figure 20 As shown, the lens assembly 60 includes a lens 64, a support arm 65, a buckle 61, and a lens lever 62. The lens 64 is mounted to the first end of the support arm 65, the second end of the support arm 65 is rotatably mounted to the side wall of the tubular assembly 20, the lens lever 62 is mounted to the side wall of the tubular assembly 20, and the buckle 61 is fixedly connected to the support arm 65. When the lens lever 62 is in the first position and the buckle 61 engages with the lens lever 62, the first end of the support arm 65 remains close to the tubular assembly 20, and the lens assembly 60 is in a stowed state. When the lens lever 62 moves axially along the tubular assembly 20 to the second position, the buckle 61 separates from the lens lever 62, and the support arm 65 moves to a position where its first end is away from the tubular assembly 20, and the lens assembly 60 enters an open state.

[0129] The lens assembly 60 further includes a lens assembly torsion spring 63, which can keep the lens assembly 60 in an open state. The buckle 61 and the lens pull rod 62 can keep the lens assembly 60 in a closed state when they cooperate.

[0130] In this embodiment, the surgical instrument 10 further includes a handle assembly 11 disposed proximally of the tubular assembly 20. The handle assembly 11 is provided with a lens opening button 17, which is fixedly connected to the proximal end of the lens pull rod 62. The lens opening button 17 can be operated to drive the lens pull rod 62 proximally from a first position to a second position, thereby opening the lens assembly 60. When the lens assembly 60 is in the open position, the second end of the support arm 65 abuts against the sidewall of the tubular assembly 20, limiting the maximum opening angle of the support arm 65.

[0131] Figures 21a-21c FIG. 4 shows the process of opening the lens assembly 60. Figure 21a As shown, the lens lever 62 is in the first position, and when the buckle 61 is engaged with the lens lever 62, the first end of the support arm 65 is kept close to the tubular assembly 20, the lens assembly 60 is in the storage state, and the lens assembly torsion spring 63 is compressed. Figure 21b and Figure 21c As shown, by operating the lens opening button 17, the lens pull rod 62 moves along the axial direction of the tubular assembly 20 toward the proximal end to the second position, the buckle 61 moves outward and separates from the lens pull rod 62, and under the elastic force of the lens assembly torsion spring 63, the support arm 65 moves to a position where its first end is away from the tubular assembly 20, and the lens assembly 60 enters the open state.

[0132] The lens pull rod 62 is made of a thin metal wire, and its distal end is a cantilever with elasticity. Figure 22As shown, buckle 61 is chamfered. When stowing lens assembly 60 outside the body, manually pressing down on lens assembly 60 causes the chamfered corner of buckle 61 to deform the distal end of lens lever 62. When lens assembly 60 is fully depressed, buckle 61 and the distal end of lens lever 62 engage, retaining lens assembly 60 in its stowed position. When the device is withdrawn from the body cavity, lens assembly 60 can be pressed down by a trocar or incision protection sleeve, returning it to its stowed position.

[0133] like Figure 22 As shown, the tubular assembly 20 includes a main body 21 and an outer sleeve 22. The main body 21 is partially arranged inside the outer sleeve 22. The closing rod 352, the firing push rod 23 and the lens pull rod 62 are placed inside the outer sleeve 22, parallel to the main body 21, and extend from the proximal end to the distal end.

[0134] In this embodiment, the first jaw 302 includes a staple cartridge assembly 31 and a staple cartridge seat 33, and the second jaw 303 includes an anvil assembly 32. The staple cartridge assembly 31 includes staples 318, which can be driven toward the anvil assembly 32. When tissue sampling is performed, the staples 318 can be driven toward the anvil assembly 32. After penetrating the tissue, the staples 318 close and form at the anvil assembly 32, thereby suturing the tissue. The staple cartridge assembly 31 also includes a cutter 315 and a firing slide 314. By driving the firing slide 314, the staples 318 can be driven to suture the tissue, and the cutter 315 can be driven to cut the tissue.

[0135] The lens assembly 60 can be used in conjunction with the structure of the surgical instrument 10 of the first embodiment. Figure 23 A flow chart illustrating a sampling method using the surgical instrument of this embodiment is provided. Using this surgical instrument, the complete tissue sampling process includes the following steps: Pulling the closing trigger 14 closes the actuator 30, allowing the instrument to enter the body cavity with a smaller size through a trocar or incision sheath. Operating the lens opening button 17 opens the lens assembly 60, obtaining a visual field within the body cavity. The internal environment of the body cavity can be observed using the display tool 70. Pressing the closing / opening button 16 opens the actuator 30, allowing the clamp 50 to enter the body cavity through the channel 40, locate and clamp the sampling site. The clamp 50 is operated to draw the sampling site into the receiving cavity 37 of the actuator 30. Pulling the closing trigger 14 closes the actuator 30 and clamps the sampling site. Pulling the firing trigger 15 excises the sampling site and simultaneously applies staples 18 to the incision. The surgical instrument is removed from the body to obtain a biological tissue sample. If further sampling is required, the staple cartridge assembly 31 is replaced and the above steps are repeated to obtain more biological tissue samples.

[0136] In another embodiment, the staple cartridge assembly 31 can also be configured without a knife. The complete tissue sampling procedure then includes the following steps: cocking the closure trigger 14 to close the firing mechanism 30 to a small size for entry into the body cavity through the puncture or incision protector. The scope lens is opened by pressing the scope lens open button 17 to open the scope lens assembly 60 to obtain a field of view within the body cavity. The firing mechanism 30 is opened by pressing the closure open button 16 to open the firing mechanism 30 and the jaws 50 are advanced through the channel 40 into the body cavity to locate and clamp the sample site. The jaws 50 are operated to draw the sample site into the receiving chamber 37 of the firing mechanism 30. The closure trigger 14 is cocked to close the firing mechanism 30 and clamp the sample site. The firing trigger 15 is cocked to apply the staple 18 to the sample site. The surgical instrument is removed from the body and the tissue sample is obtained by cutting the tissue along the staple line using scissors. If additional samples are desired, the above steps are repeated with a new staple cartridge assembly 31 to obtain additional tissue samples.

[0137] The implementation structure of each component in this embodiment can adopt the implementation structure of the corresponding component in the first embodiment described above, or adopt other alternative structures that can achieve the function of the surgical instrument.

[0138] The above is a further detailed description of the present application in combination with specific preferred embodiments, and it cannot be considered that the specific implementation of the present application is limited to these descriptions. For ordinary skilled persons in the technical field to which the present application belongs, several simple deductions or substitutions can be made without departing from the concept of the present application, and all of them should be considered to fall within the protection scope of the present application.

Claims

1. A surgical instrument (10), characterized in that: The surgical instrument comprises a handle assembly (11), a tubular assembly (20), and an actuator (30) which are sequentially arranged from the proximal end to the distal end. The surgical instrument is provided with a channel (40) extending along the axial direction of the tubular assembly (20), and the proximal end of the channel (40) is connected to the proximal opening (111) of the handle assembly (11); The actuator (30) comprises a first jaw (302) and a second jaw (303) arranged opposite to each other, wherein a suture staple (318) is provided inside the first jaw (302), and the suture staple (318) can be driven to move toward the second jaw (303); The actuator (30) includes an open state and a closed state. When the actuator (30) is in the open state, the actuator (30) has an opening (301) communicating with the channel (40).

2. The surgical instrument (10) according to claim 1, characterized in that The channel (40) is provided through the tubular component (20).

3. The surgical instrument (10) according to claim 1, characterized in that The actuator (30) further comprises a closing slider (351), the closing slider (351) comprising a first locking portion (3511) and a second locking portion (3512), and the first clamp (302) comprises a first locking surface (332) and a second locking surface (331); When the closing slider (351) is located at the first position, the first locking portion (3511) abuts against the first locking surface (332) to keep the actuator (30) in an open state; When the closing slider (351) is driven to move proximally to the second position, the first locking portion (3511) separates from the first locking surface (332), and the second locking portion (3512) drives the first clamp (302) to rotate relative to the second clamp (303) to close the actuator (30), and the second locking portion (3512) abuts against the second locking surface (331) to keep the actuator (30) in a closed state.

4. The surgical instrument (10) according to claim 3, characterized in that The handle assembly (11) comprises a fixed handle (13), a closing trigger (14), a closing drive member (142), a retaining member (160), a safety opening button (16) and an elastic member (143), wherein the closing trigger (14) is rotatably connected to the fixed handle (13); When the closing trigger (14) is driven to move toward the fixed handle (13), the closing trigger (14) drives the closing slider (351) to move proximally through the closing drive member (142) to close the actuator (30), and the closing drive member (142) moves proximally until it cooperates with the retaining member (160) to keep the actuator (30) in a closed state; After the safety opening button (16) is operated to separate the retaining member (160) from the closing drive member (142), the closing trigger (14) is driven by the elastic member (143) to move away from the fixed handle (13), so as to drive the closing slider (351) to move distally through the closing drive member (142) to open the actuator (30).

5. The surgical instrument (10) according to claim 1, characterized in that The actuator (30) further includes a firing slide (314) and a cutter (315); The firing slide (314) includes a first driving portion (3141) and a second driving portion (3142). When the firing slide (314) is driven to move toward the distal end, the first driving portion (3141) pushes the suture nail (318) toward the second clamp (303), and the second driving portion (3142) pushes the cutter (315) toward the second clamp (303).

6. The surgical instrument (10) according to claim 5, characterized in that A tissue contact surface (311) is provided on a side of the first clamp (302) opposite to the second clamp (303), and the tissue contact surface (311) is provided with a knife groove (320) and a plurality of nail holes (312). The cutter (315) and the suture nail (318) are movably installed in the knife groove (320) and the nail hole (312), respectively; when the firing slide (314) is driven to move toward the distal end, the nail tip of the suture nail (318) is pushed out of the tissue contact surface (311) in priority to the blade of the cutter (315).

7. The surgical instrument (10) according to claim 5, characterized in that The handle assembly (11) includes a fixed handle (13), a closing drive member (142) and a firing trigger (15), wherein the closing drive member (142) is configured to drive the actuator (30) to open or close when moving along the axial direction, and the firing trigger (15) is rotatably connected to the fixed handle (13), and the firing trigger (15) includes a firing locking portion (152); When the closing drive member (142) is in the third position, the actuator (30) is in the open state, and the closing drive member (142) cooperates with the firing locking portion (152) to prevent the firing trigger (15) from moving toward the fixed handle (13); When the closing drive member (142) is in the fourth position, the actuator (30) is in a closed state, the closing drive member (142) is separated from the firing locking portion (152), and when the firing trigger (15) is driven to move toward the fixed handle (13), the firing trigger (15) drives the firing slide (314) to move toward the distal end.

8. The surgical instrument (10) according to claim 5, characterized in that The handle assembly (11) includes a fixed handle (13), a closing trigger (14) and a firing trigger (15), wherein the firing trigger (15) is connected to the firing slide (314) via a firing push rod (23), and the closing trigger (14) and the firing trigger (15) are both rotatably connected to the fixed handle (13), and the firing trigger (15) includes a firing portion (151); When the closing trigger (14) is driven to rotate toward the fixed handle (13) to close the actuator (30), the firing trigger (15) rotates to a first angle along with the closing trigger (14), and the firing portion (151) slides with the firing push rod (23) without driving the firing push rod (23); The actuator (30) is in a closed state, and the firing trigger (15) is driven to rotate toward the fixed handle (13) by a second angle, and the firing portion (151) drives the firing push rod (23) to move toward the distal end.

9. The surgical instrument (10) according to claim 1, characterized in that A U-shaped tissue contact surface (311) with a proximal opening and a receiving cavity (37) are provided on a side of the first clamp (302) opposite to the second clamp (303); the tissue contact surface (311) is arranged around the receiving cavity (37); a plurality of nail holes (312) are distributed on the tissue contact surface (311); the suture nails (318) are movably installed in the nail holes (312); The first clamp (302) further includes a cutter (315), and the tissue contact surface (311) is provided with a U-shaped cutter groove (320) for accommodating the cutter (315). The cutter groove (320) is located on the inner side of the nail hole (312). The shape of the cutter (315) is adapted to the shape of the cutter groove (320) and is movably installed in the cutter groove (320).

10. The surgical instrument (10) according to claim 1, characterized in that It also includes a clamp (50), which includes a distal clamping portion (511) and a proximal operating portion (512). The clamp (50) is configured to be inserted into the channel (40) through the proximal opening (111) of the handle assembly (11), and the clamping portion (511) extends distally from the opening (301) of the actuator (30).

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