Pouch suturing assembly for esophageal cancer cutting under endoscope

Abstract

The utility model discloses a purse-string suturing component for esophageal cancer cutting under an endoscope, which comprises an extension tube fixedly connected with a nail bin and hinged with a nail anvil through a spring and a joint shaft; the nail bin is used for containing the anastomosis nail bin and the purse-string suture forceps tongue a, and the nail anvil is used for containing the purse-string suture forceps tongue b and the anastomosis nail anvil and is matched with the nail bin for cutting and completing purse-string suture. A push rod and a purse-string suture line are contained in the extension tube, two purse-string suture line tubes extending in the far-near direction are arranged on one side of the push rod, the opposite side walls of the two purse-string suture line tubes are not closed, and openings of the two purse-string suture line tubes are opposite; the pouch suture needles are arranged at the far ends of the pouch suture pipes, the two ends of the pouch suture are connected with the near ends of the two pouch suture needles respectively, and the remaining portions of the pouch suture are folded and symmetrically contained in the two pouch suture pipes respectively. According to the utility model, the suture line directly penetrates through the tissue for suturing, so that the operation cost is obviously reduced.

Description

Technical Field

[0001] The utility model relates to the technical field of medical instruments, in particular to a purse-string suturing component for esophageal cancer cutting under laparoscope. Background Art

[0002] With the popularity of minimally invasive surgery, laparoscopic cutting staplers have become a conventional surgical instrument due to their advantages of small trauma and good effect. At present, there are some laparoscopic cutting staplers on the foreign market. Such products are mainly used to cut solid organs, such as lungs, liver, etc. In the process of radical surgery for esophageal cancer, especially for malignant tumors of the cardia, the surgery requires the esophagus to be severed, and the esophageal end is purse-stitched, and the stomach end is cut and anastomosed to prevent the gastric contents from flowing out and contaminating the chest cavity, thereby completing the anastomosis of the broken ends in the chest cavity. The Chinese utility model patent with publication number CN 202313536 U discloses a laparoscopic surgical cutting and closing purse-string stapler, which closes the digestive tract lumen and cuts it from the middle of the closing line through the metal nails of the cutting closure device, and at the same time, the suture line is nailed to the tissue surface through the staples, and then the broken ends of the digestive tract lumen are tightened into bundles. In actual use, more staples are needed, and medical staples and staple cartridges are made of titanium metal, with a high unit price, which increases the cost of surgery. Utility Model Content

[0003] The utility model aims to provide a purse-string suture assembly for laparoscopic esophageal cancer cutting, which directly passes the suture thread through the tissue for suturing, reduces the use of titanium staples and staple magazines, and significantly reduces the cost of the operation.

[0004] In order to solve the above technical problems, the technical solution of the utility model is as follows: a purse-string suture assembly for laparoscopic esophageal cancer cutting, comprising an extension tube, the extension tube is fixedly connected to a staple cartridge and hinged to a staple anvil, the staple cartridge is used to accommodate anastomosis staple cartridge and a purse-string suture clamp tongue a, the staple anvil is used to accommodate a purse-string suture clamp tongue b and anastomosis staple anvil, and cooperates with the staple cartridge to cut and complete purse-string suture; the extension tube is used to accommodate a push rod and a purse-string suture, one side of the push rod is provided with two purse-string suture tubes extending in the distal and proximal directions, the opposite side walls of the two purse-string suture tubes are not closed and the openings are opposite; a purse-string suture needle is arranged at the distal end of the purse-string suture tube, the two ends of the purse-string suture are respectively connected to the proximal ends of the two purse-string suture needles, the remaining part of the purse-string suture is folded in half and symmetrically accommodated in the two purse-string suture tubes; when the cutting purse-string suture assembly is closed, the two purse-string suture needles respectively pass through the purse-string suture clamp tongue a provided on the staple cartridge and the purse-string suture clamp tongue b provided on the staple anvil.

[0005] Optionally, the staple cartridge is divided into left and right sides by a staple cartridge slide groove arranged in the middle, which are respectively the purse-string suture clamp tongue a and the anastomosis staple cartridge; the staple cartridge slide groove extends a distance to the left and right respectively near the bottom of the purse-string suture clamp tongue a and the anastomosis staple cartridge, and the distance extended toward the anastomosis staple cartridge side is greater than the distance extended toward the purse-string suture clamp tongue a side.

[0006] Furthermore, a plurality of teeth extending in the proximal and distal directions are arranged on the mating surface of the purse-string suture forceps tongue a, grooves are formed between the spaced teeth, and a linear groove a extending in the proximal and distal directions is arranged on the end surface of each tooth facing the anvil, and each linear groove a is concentrically arranged to form a needle eye channel extending in the proximal and distal directions on the mating surface of the purse-string suture forceps tongue a.

[0007] Furthermore, two rows of titanium staples extending in the distal and proximal directions are arranged in the mating plane of the staple magazine, and two rows of slideways penetrating the distal end and the proximal end in the distal and proximal directions are arranged in the staple magazine, each row of the slideways is respectively opposite to a row of titanium staples, and a side of the slideway facing away from the titanium staples is connected to an extended end of the staple magazine slideway at the bottom of the staple magazine side; a nail pushing block that can move in the distal and proximal direction of the slideway is arranged in the slideway, and a side of the nail pushing block facing away from the bottom of the staple magazine side can contact the titanium staples when the nail pushing block slides along the slideway, and is arranged to be an inclined surface or an arc surface, so that when the cutter moves forward, the nail pushing block can be pushed forward and the titanium staples can be lifted toward the anvil side to be exposed to the mating surface of the staple magazine.

[0008] Optionally, it also includes a cutter for cutting off the tissue to be sutured. In an initial state, the push rod is combined with the cutter and placed in the extension tube, and does not enter the nail magazine and the nail anvil slide groove for the time being.

[0009] Furthermore, the cutter has a driving end and a blade end; and the bottom of the cutter extends a length toward the purse-string suture forceps tongue a, which is called the base purse-string suture end, and the bottom of the cutter extends a length toward the anastomotic staple magazine, which is called the base anastomotic end; the upper end of the base anastomotic end is provided with base anastomotic end forceps teeth parallel to the cutter, and the cutter and its bottom can be embedded in the staple magazine slide groove and the extension section of the staple magazine slide groove between the purse-string suture forceps tongue a and the bottom of the staple magazine, and at the same time, the base anastomotic end forceps teeth can be embedded in the slideway in the staple magazine; when the cutter moves toward the distal end along the staple magazine slide groove in the staple magazine, the base anastomotic end forceps teeth are pushed to contact the nail pushing block and the nail pushing block is made to contact the anastomotic titanium nails, so as to facilitate the anastomotic titanium nails to be fully exposed to the anastomotic surface of the anastomotic staple magazine.

[0010] Optionally, the anvil is divided into left and right sides through an anvil slide groove provided in the middle, which are respectively a purse-string suture clamp tongue b and an anastomosis staple anvil; the purse-string suture clamp tongue b is similar in structure to the purse-string suture clamp tongue a provided on the staple magazine, and the two clamp tongues correspond to each other; the surface of the anastomosis staple anvil is uneven, and the cutter and its top can be embedded in the anvil slide groove and its top, and when the top and bottom of the cutter are respectively embedded in the anvil slide groove and the staple magazine slide groove, the closed staple magazine and anvil can be locked, and when the cutting purse-string suture assembly is closed, the anastomosis titanium staple can penetrate the tissue and hit the anastomosis staple anvil to be closed.

[0011] Optionally, when the cutting purse-string suture assembly is closed, two purse-string suture needles respectively pass through the linear groove a of the purse-string suture clamp tongue a provided on the nail magazine and the linear groove b of the purse-string suture clamp tongue b provided on the nail anvil.

[0012] The beneficial effect of adopting the above technical solution is that in thoracoscopic radical resection of esophageal cancer, during the operation, the sutures are not nailed to the tissue surface by staples, but are directly sutured by passing the sutures through the tissue, thereby reducing the use of titanium staples and staple magazines, and significantly reducing the cost of the operation. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Figure 1 It is a schematic diagram of the overall structure of the utility model;

[0014] Figure 2 It is a side view of the utility model;

[0015] Figure 3 This is a schematic diagram of the cutter structure of the utility model;

[0016] Figure 4 This is a schematic diagram of the push rod structure of the utility model;

[0017] Figure 5 This is a schematic diagram of the push rod structure of the utility model;

[0018] Figure 6 It is a schematic cross-sectional view of the components of the utility model;

[0019] Figure 7 It is a schematic diagram of a nail pushing block in a nail magazine of the utility model.

[0020] Description of reference numerals:

[0021] 1. Linear cutting stapler;

[0022] 2. Extension tube: 21. Cutter; 22. Push rod; 23. Purse string suture; 24. Purse string suture needle; 25. Purse string suture tube;

[0023] 211, blade end; 212, driving end; 213, purse string suture end of base; 214, anastomotic end of base; 215, forceps teeth of anastomotic end of base;

[0024] 3. Nail magazine: 31. Nail magazine slide; 32. Purse string suture clamp tongue a; 33. Anastomotic nail magazine; 34. Linear groove a; 35. Anastomotic titanium nail; 36. Slide rail; 37. Clamp teeth; 38. Groove; 39. Nail pusher block;

[0025] 4. Anvil: 41. Anvil slide groove; 42. Purse-string suture clamp tongue b; 43. Anastomosis anvil; 44. Linear groove b. DETAILED DESCRIPTION

[0026] The exemplary embodiments of the present invention will be described in more detail below with reference to the accompanying drawings. Although the exemplary embodiments of the present invention are shown in the accompanying drawings, it should be understood that the present invention can be implemented in various forms and should not be limited by the embodiments described herein. On the contrary, these embodiments are provided to enable a more thorough understanding of the present invention and to fully convey the scope of the present invention to those skilled in the art. Throughout the specification, the term "far" refers to the part that is farther away from the user, and "near" refers to the part that is closer to the user.

[0027] The utility model provides a purse-string suture assembly for laparoscopic esophageal cancer cutting, such as Figure 1 , Figure 2 As shown, it includes a stapler magazine 3 for accommodating anastomosis stapler 33 and a purse-string suture clamp tongue a 32, a stapler anvil 4 for cooperating with the stapler magazine 3 to cut and complete purse-string suture, a cutter 21 for cutting off the tissue to be sutured, a push rod 22 for driving the cutter 21 to move, and an extension tube 2 for accommodating the push rod 22 and the purse-string suture 23, wherein the extension tube 2 is fixedly connected to the stapler magazine 3, and is hinged to the stapler anvil 4 through a spring and a joint axis, and the laparoscopic cutting stapler 1 controls the opening and closing of the stapler anvil 4. CN101683284A and CN101683284A disclose the connection method of the stapler anvil 4 and the extension tube 2, and how to realize the opening and closing method with the stapler magazine 3, which will not be repeated in the present utility model.

[0028] like Figure 2 , Figure 6As shown, the staple cartridge 3 is divided into left and right sides through a staple cartridge slide 31 disposed in the middle, which are respectively a purse-string suture clamp tongue a 32 and an anastomosis staple cartridge 33; and the staple cartridge slide 31 extends about 3 mm and 15 mm to the left and right sides respectively near the bottom of the purse-string suture clamp tongue a 32 and the anastomosis staple cartridge 33. The anastomosis surface of the purse-string suture clamp tongue a 32 is provided with a plurality of clamp teeth 37 extending in the distal and proximal directions, and grooves 38 are formed between the spaced clamp teeth 37. The end surface of each clamp tooth 37 facing the nail anvil 4 is provided with a linear groove a 34 extending in the distal and proximal directions, and each linear groove a 34 is concentrically disposed to form a needle eye channel extending in the distal and proximal directions on the anastomosis surface of the purse-string suture clamp tongue a 32. Two rows of titanium staples 35 extending in the distal and proximal directions are arranged in the mating plane of the staple magazine 33, and two rows of slideways 36 penetrating the distal end and the proximal end in the distal and proximal directions are arranged in the staple magazine 33, each row of slideways 36 is respectively opposite to a row of titanium staples 35, and the side of the slideway 36 facing away from the titanium staples 35 is connected to the extended end of the staple magazine slideway 31 at the bottom of the side of the staple magazine 33; a nail pushing block 39 that can move along the distal and proximal directions of the slideway 36 is arranged in the slideway 36, and when the nail pushing block 39 slides along the slideway 36, the side of the nail pushing block 39 facing away from the bottom of the side of the staple magazine 33 can contact the titanium staples 35, and is set to an inclined surface or an arc surface, so that when the cutter 21 moves forward, it can push the nail pushing block 39 to move forward and simultaneously lift the titanium staples 35 toward the side of the anvil 4 to expose them to the mating surface of the staple magazine 33.

[0029] like Figure 3 As shown, the cutter 21 has a driving end 212 and a blade end 211; and the bottom of the cutter 21 extends 2-3 mm toward the side of the purse-string suture clamp tongue a 32, which is called the base purse-string suture end 213, and the bottom of the cutter extends 8-9 mm toward the side of the staple cartridge 33, which is called the base staple end 214. The base staple end 214 is provided with a base staple end forceps tooth 215 parallel to the cutter 21, and the cutter 21 and its bottom can be embedded in the staple cartridge slide groove 31 and the staple cartridge slide groove 31 is in the purse-string suture clamp tongue a 32 is an extension section of the bottom of the anastomotic staple cartridge 33, and at the same time, the base anastomotic end forceps teeth 215 can be embedded in the slideway 36 in the anastomotic staple cartridge 33. When the cutter 21 moves toward the distal end along the staple cartridge slideway 31 in the staple cartridge 3, the base anastomotic end forceps teeth 215 are pushed to contact the staple pusher block 39 and the staple pusher block 39 contacts the anastomotic titanium staple 35, so that the anastomotic titanium staple 35 rises 2-3 mm, which is convenient for the anastomotic titanium staple 35 to be fully exposed to the anastomotic surface of the anastomotic staple cartridge 33.

[0030] like Figure 6As shown, the anvil 4 is divided into left and right sides through the anvil chute 41 provided in the middle, which are respectively the purse-string suture forceps tongue b 42 and the staple anvil 43; the purse-string suture forceps tongue b 42 is similar in structure to the purse-string suture forceps tongue a 32, and the two forceps tongues correspond to each other; the surface of the staple anvil 43 is uneven, the top of the anvil chute 41 extends about 3mm toward the purse-string suture forceps tongue b 42 and the staple anvil 43, and the top of the cutter 21 extends 2-3mm toward the purse-string suture forceps tongue b 42 and the staple anvil 43, the cutter 21 and its top can be embedded in the anvil chute 41 and its top, when the top and bottom of the cutter 21 are respectively embedded in the anvil chute 41 and the staple magazine chute 31, the closed staple magazine 3 and the anvil 4 can be locked, and when the purse-string suture assembly is cut and closed, the staple anvil 35 can penetrate the tissue and hit the staple anvil 43 to be closed.

[0031] like Figure 2 As shown, a push rod 22 is provided in the extension tube 2, and two purse-string suture tubes 25 extending in the proximal and distal directions are provided on one side of the push rod 22, and the opposite side walls of the two purse-string suture tubes 25 are not closed and the openings are opposite to each other; a purse-string suture needle 24 is provided at the distal end of the purse-string suture tube 25, the distal end of the push rod 22 is connected to the driving end 212 of the cutter 21, and the purse-string suture needle 24 is located on the side of the purse-string suture clamp tongue a 32 of the cutter 21, and the two ends of the purse-string suture 23 are respectively connected to the proximal ends of the two purse-string suture needles 24, and the remaining part of the purse-string suture 23 is folded in half and symmetrically accommodated in the two purse-string suture tubes 25, respectively. When the cutting purse-string suture assembly is closed, the two purse-string suture needles 24 can respectively pass through the linear groove a 34 of the purse-string suture clamp tongue a 32 and the linear groove b 44 of the purse-string suture clamp tongue b 42.

[0032] In the initial state, the push rod 22 is combined with the cutter 21 and placed in the extension tube 2, and does not enter the nail magazine 3 and the nail anvil slide 41 for the time being. When in use, firstly free the thoracic esophagus in a conventional manner, then select the part of the esophagus that needs to be cut, and connect the utility model with the laparoscopic cutting stapler 1. When implemented, the Yisi universal laparoscopic cutting stapler and the nail magazine-stapler part can be used, specification: U12M. The nail magazine 3 and the nail anvil 4 are in an open state, and are inserted into the chest cavity so that the esophageal cavity is completely placed between the purse string suture forceps tongue a 32 and the purse string suture forceps tongue b 42. The nail magazine 3 and the nail anvil 4 are closed, and the laparoscopic cutting stapler 1 is fired, and the following actions will occur simultaneously:

[0033] a. The push rod 22 pushes the driving end 212 of the cutter 21 to move distally along the nail magazine chute 31 of the nail magazine 3 and the nail anvil chute 41 of the nail anvil 4, and the blade end 211 cuts the esophageal tissue.

[0034] b. The push rod 22 drives the purse-string suture tube 25 and the purse-string suture needle 24 to pass through the linear groove a34 and the linear groove b44 on the teeth of the purse-string suture forceps tongue a32 and the purse-string suture forceps tongue b42. At this time, the purse-string suture needle 24 drives the purse-string suture thread 23 to pass through the esophageal serosal layer to complete the purse-string suture.

[0035] c. The pushing rod 22 pushes the driving end 212 of the cutter 21 to move distally along the staple magazine slide groove 31 of the staple magazine 3 and the anvil slide groove 41 of the staple anvil 4, pushing the base anastomotic end forceps 215 to contact the staple pushing block 39 and make the staple pushing block 39 contact the anastomotic titanium staple 35, so that the anastomotic titanium staple 35 rises 2-3mm, and the anastomotic titanium staple 35 floats out of the anastomotic surface of the staple magazine 33 and staples the severed stomach end of the tissue.

[0036] After completing the above actions, the staple cartridge 3 and the staple anvil 4 are kept in a closed state, and a needle holder is placed in the chest cavity to respectively clamp the heads of the two purse-string suture needles 24 and rotate them so that the purse-string suture needles 24 completely pass through the purse-string suture forceps tongue a 32 and the purse-string suture forceps tongue b 42. The closed laparoscopic esophageal cancer cutting purse-string suture assembly is opened and taken out of the chest cavity, and the esophageal stump is purse-stitched and the gastric stump is stapled.

[0037] The above description is only a preferred implementation example of the present utility model, and its purpose is to enable people familiar with this technology to understand the content of the present utility model and implement it. It cannot be used to limit the protection scope of the present utility model. Any modifications, equivalent substitutions and improvements made within the spirit and principles of the present utility model should be included in the protection scope of the present utility model.

Claims

1. A purse-string suture assembly for laparoscopic esophageal cancer cutting, comprising an extension tube, the extension tube being fixedly connected to the staple cartridge and hinged to the staple anvil, characterized in that: The staple cartridge is used to accommodate the anastomotic staple cartridge and the purse-string suture clamp tongue a, the staple anvil is used to accommodate the purse-string suture clamp tongue b and the anastomotic staple anvil, and cooperates with the staple cartridge to cut and complete the purse-string suture; the extension tube is used to accommodate the push rod and the purse-string suture, one side of the push rod is provided with two purse-string suture tubes extending in the distal and proximal directions, the opposite side walls of the two purse-string suture tubes are not closed and the openings are opposite; a purse-string suture needle is arranged at the distal end of the purse-string suture tube, the two ends of the purse-string suture are respectively connected to the proximal ends of the two purse-string suture needles, the remaining part of the purse-string suture is folded in half and symmetrically accommodated in the two purse-string suture tubes; when the cutting purse-string suture assembly is closed, the two purse-string suture needles respectively pass through the purse-string suture clamp tongue a provided on the staple cartridge and the purse-string suture clamp tongue b provided on the staple anvil.

2. The purse-string suture assembly for laparoscopic esophageal cancer cutting according to claim 1, characterized in that: The staple cartridge is divided into left and right sides by a staple cartridge slide groove arranged in the middle, which are respectively a purse-string suture clamp tongue a and an anastomotic staple cartridge; the staple cartridge slide groove extends a distance to the left and right respectively near the purse-string suture clamp tongue a and the bottom of the anastomotic staple cartridge, and the distance extended toward the anastomotic staple cartridge side is greater than the distance extended toward the purse-string suture clamp tongue a side.

3. The purse-string suture assembly for laparoscopic esophageal cancer cutting according to claim 2, characterized in that: The mating surface of the purse-string suture forceps tongue a is provided with a plurality of forceps teeth extending in the distal direction, grooves are formed between the spaced apart forceps teeth, and the end surface of each forceps tooth facing the anvil is provided with a linear groove a extending in the distal direction, and each linear groove a is concentrically arranged to form a needle eye channel extending in the distal direction on the mating surface of the purse-string suture forceps tongue a.

4. The purse-string suture assembly for laparoscopic esophageal cancer cutting according to claim 2, characterized in that: Two rows of titanium staples extending in the distal and proximal directions are arranged in the mating plane of the staple magazine, and two rows of slideways penetrating the distal end and the proximal end in the distal and proximal directions are arranged in the staple magazine, each row of the slideways is respectively opposite to a row of titanium staples, and the side of the slideway facing away from the titanium staples is connected to the extended end of the staple magazine slideway at the bottom of the staple magazine side; a nail pushing block that can move in the distal and proximal direction of the slideway is arranged in the slideway, and when the nail pushing block slides along the slideway, the side of the nail pushing block facing away from the bottom of the staple magazine side can contact the titanium staples, and is arranged to be an inclined surface or an arc surface, so that when the cutter moves forward, it can push the nail pushing block forward and simultaneously lift the titanium staples toward the anvil side to expose them to the mating surface of the staple magazine.

5. The purse-string suture assembly for laparoscopic esophageal cancer cutting according to claim 1, characterized in that: It also includes a cutter for cutting off the tissue to be sutured. In the initial state, the push rod is combined with the cutter and placed in the extension tube, and does not enter the nail magazine and the nail anvil slide groove for the time being.

6. The purse-string suture assembly for laparoscopic esophageal cancer cutting according to claim 5, characterized in that: The cutter has a driving end and a blade end; and the bottom of the cutter extends a length toward the purse-string suture forceps tongue a, which is called the base purse-string suture end, and the bottom of the cutter extends a length toward the anastomotic staple magazine, which is called the base anastomotic end; the upper end of the base anastomotic end is provided with base anastomotic end forceps teeth parallel to the cutter, and the cutter and its bottom can be embedded in the staple magazine slide groove and the extension section of the staple magazine slide groove between the purse-string suture forceps tongue a and the bottom of the staple magazine, and at the same time, the base anastomotic end forceps teeth can be embedded in the slideway in the staple magazine; when the cutter moves toward the distal end along the staple magazine slide groove in the staple magazine, the base anastomotic end forceps teeth are pushed to contact the nail pushing block and the nail pushing block is made to contact the anastomotic titanium nails, so as to facilitate the anastomotic titanium nails to be fully exposed to the anastomotic surface of the anastomotic staple magazine.

7. The purse-string suture assembly for laparoscopic esophageal cancer cutting according to claim 1, characterized in that: The anvil is divided into left and right sides through an anvil slide groove arranged in the middle, which are respectively a purse-string suture clamp tongue b and an anastomotic staple anvil; the purse-string suture clamp tongue b is similar in structure to the purse-string suture clamp tongue a arranged on the staple magazine, and the two clamp tongues correspond to each other; the surface of the anastomotic staple anvil is uneven, and the cutter and its top can be embedded in the anvil slide groove and its top, and when the top and bottom of the cutter are respectively embedded in the anvil slide groove and the staple magazine slide groove, the closed staple magazine and the anvil can be locked, and when the cutting purse-string suture assembly is closed, the anastomotic titanium staple can penetrate the tissue and hit the anastomotic staple anvil to be closed.

8. The purse-string suture assembly for laparoscopic esophageal cancer cutting according to claim 1, characterized in that: When the cutting purse-string suture assembly is closed, two purse-string suture needles respectively pass through the linear groove a of the purse-string suture clamp tongue a provided on the nail magazine and the linear groove b of the purse-string suture clamp tongue b provided on the nail anvil.

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