CN106344096B - Hoop barrel for anastomosis - Google Patents

Abstract

The invention discloses a ferrule for anastomosis, comprising: a first half-tube, the first half-tube includes stoppers and a first rotating shaft part arranged on two peripheral edges thereof, and the inner wall of the first half-tube is provided with thorns. , the anti-retraction part includes a occlusal channel, and a occlusal tooth is arranged in the occlusal channel, and the first shaft part is provided with a first central hole; the second half cylinder, the second half cylinder includes guide parts and a second half cylinder arranged on its circumferential two edges. Two rotating shaft parts, the inner wall of the second half cylinder is provided with helical teeth and thorns, the thickness and width of the guide part along the circumference of the second half cylinder gradually decrease, the second rotating shaft part is provided with a second central hole; the rotating shaft , the rotating shaft passes through the first central hole and the second central hole, and forms a hinge structure with the first rotating shaft part and the second rotating shaft part. The application of the hoop can not only significantly reduce operation steps, save operation time, and allow more doctors and hospitals to carry out minimally invasive esophageal surgery techniques, but also reduce operation costs and reduce the economic burden of operation patients.

Description

A hoop for anastomosis

technical field

The invention relates to the field of medical operation consumables, in particular to a surgical operation auxiliary device applied to digestive tract anastomosis, especially for the gastroesophageal intrathoracic anastomosis process of transorally implanted nail-anvil system in minimally invasive esophageal cancer radical resection A hoop for anastomosis.

Background technique

During the operation of digestive tract reconstruction, it is usually necessary to shrink the stump of the digestive tract so that the main body of the stapler and the anvil will not come out, and the two segments are in full contact during the anastomosis so that no side holes are left after the anastomosis. Especially in the process of intrathoracic gastroesophageal anastomosis with peroral implantation of nail-anvil system in minimally invasive radical resection of esophageal cancer, the treatment of esophageal stump is more difficult due to the limitation of endoscope.

At present, the linear cutting stapler produced by Medtronic or Johnson & Johnson is mainly used to process the esophageal stump, and then a small opening is made from the top of the closed incision, the anvil is passed through, and the stomach and esophagus are anastomosed on the wound at last.

The disadvantages of the current technology with respect to the application of this device are: 1. Performing anastomosis on the wound is not conducive to the blood supply of the anastomotic stoma, thus affecting the healing of the anastomotic stoma; Lead to wound infection and increase the risk of anastomotic leakage after operation; 3. This anastomosis is not strictly end-to-side anastomosis but side-to-side anastomosis, which is more likely to cause anastomotic leakage than end-to-side anastomosis; 4. Above the incision The operation of the opening is more difficult and time-consuming, and too large opening may lead to the risk of the anvil coming out; 5. The cutting and stapler is expensive, and the burden on the patient is heavy.

Secondly, there are also some experts who use manual purse-string suture of esophageal stump under thoracoscopic surgery, but the disadvantages of this technique compared with this device are: 1. The manual purse-string suture technique is quite difficult and requires thoracic surgeons with rich endoscopic skills. 2. Manual purse-string suture under thoracoscopy is very time-consuming, which indirectly increases the risk of surgery; 3. The risk of anastomotic leakage is higher with manual purse-string suture.

Contents of the invention

The purpose of the present invention is to provide a ferrule for anastomosis to solve the above problems.

In order to achieve the above purpose, the present invention provides a ferrule for anastomosis, comprising:

The first half cylinder, the first half cylinder includes a first half cylinder body and a backstop portion and a first rotating shaft portion respectively arranged on both peripheral edges of the first half cylinder body, the inner wall of the first half cylinder There are thorns on the top, the stopper part includes an occlusal channel, an occlusal tooth is arranged in the occlusal channel, and a first central hole is provided on the first rotating shaft part;

The second half cylinder, the second half cylinder includes a second half cylinder body and guide parts and second rotating shaft parts respectively arranged on the two peripheral edges of the second half cylinder body, the inner wall of the second half cylinder Helical teeth and the thorns are provided, the thickness and width of the guide portion gradually decrease along the circumferential direction of the second half cylinder, and a second central hole is provided on the second rotating shaft portion;

a rotating shaft, the rotating shaft passes through the first central hole and the second central hole, and forms a hinge structure with the first rotating shaft part and the second rotating shaft part;

The first half cylinder and the second half cylinder rotate around the rotation axis, and when the second half cylinder passes through the engaging channel and exits, the engaging teeth engage the helical teeth to lock themselves. Through this structure, the pre-fixation and final fixation of the esophagus and the anvil can be better achieved, and the problem of movement of the esophagus, the anvil and other devices during the operation is overcome.

Further, the rotating shaft includes an elastic opening at one end and a shank at the other end, so that the ferrule can be removed quickly in case of emergency surgery or other situations.

Further, a groove is provided on the outer wall of the first half cylinder, and the second half cylinder can be pressed into the groove and fixed, so as to prevent the medical scissors from being unable to bear force and the second half cylinder protruding out of the backstop Partial upturning affects the problem of surgery.

Further, the groove is a T-shaped groove, and there is a smooth transition between the inner and outer walls of the second half cylinder and the adjacent end faces. This setting makes it easy to press the second half cylinder into the groove with medical surgical forceps, The T-slot prevents it from slipping out.

Further, the inner and outer walls of the guide part are provided with protrusions, which are convenient for pre-fixing and tensioning during fixing.

Further, a transition groove is provided between the guide part and the second half-tube body, and after fixing the hoop, it can be easily torn off by surgical forceps, preventing its upturn from affecting the operation.

Further, the outer wall of the second half cylinder corresponding to the transition groove is provided with a red line or a fluorescent line, which facilitates identification of the position of the guide during surgery.

Further, the inner wall of the first half cylinder is provided with teeth, which further strengthens the fixing ability of the hoop.

Further, the second rotating shaft part is a one-way rotating shaft part, which can be clamped on the outer wall of the first rotating shaft to prevent the hoop from loosening during pre-fixing.

Further, the width of the first half-tube and the second half-tube is 5-8 mm, which can better match the stapler and the anvil.

Compared with the prior art, the present invention has the advantages of:

1. Compared with the laparoscopic manual purse-string suture technique, which requires surgeons with rich laparoscopic experience to complete in 20-40 minutes, this solution can significantly reduce the operation steps and only need 5-10 minutes of operation time, so that more Doctors and hospitals in China can carry out minimally invasive esophageal surgery techniques.

2. Compared with the most commonly used method of treating the esophageal stump with a linear cutting suturer, this plan changes the treatment of the esophageal stump from invasive to non-invasive, which reduces the wound of the esophagus and thus facilitates the blood supply of the anastomotic stoma; The application operation of the device simplifies the operation process, saves the step of opening from the top of the incision wound, and reduces the risk of falling off of the nail anvil due to too large opening.

3. Using this device to deal with the esophageal stump, the anvil head inserted through the mouth comes out of the natural cavity, and the anastomosis between the esophagus and the stomach achieves end-to-side anastomosis in the true sense, which reduces the processing compared with the original cutting and stapler. The probability of food remaining in the anastomotic stoma reduces the probability of anastomotic infection.

4. The cost of the anastomotic hoop is far lower than that of the cutter and stapler, and each patient who undergoes minimally invasive radical resection of esophagus cancer can reduce the operation cost by 7,300-11,800 yuan. So that more patients, especially those from poor families, can choose minimally invasive radical resection of esophageal cancer, and reduce postoperative complications.

The present invention will be described in further detail below with reference to the accompanying drawings.

Description of drawings

The accompanying drawings constituting a part of this application are used to provide further understanding of the present invention, and the schematic embodiments and descriptions of the present invention are used to explain the present invention, and do not constitute an improper limitation of the present invention. In the attached picture:

Fig. 1 is a schematic structural view of an anastomosis ferrule disclosed in a preferred embodiment of the present invention;

Fig. 2 is a schematic diagram of the first half cylinder sectional view disclosed by the preferred embodiment of the present invention;

Fig. 3 is a schematic diagram of a cross-sectional view of a second half cylinder disclosed in a preferred embodiment of the present invention;

Fig. 4 is a schematic cross-sectional view of the hinge structure disclosed by the preferred embodiment of the present invention;

Fig. 5 is a schematic diagram of the second half cylinder being pressed into the T-shaped groove of the first half cylinder disclosed by the preferred embodiment of the present invention.

illustration:

10, the first half cylinder; 110, the anti-retraction part; 111, the occlusal teeth; 112, the occlusal channel; 113, the groove; 114, the thorn; 120, the first shaft part; 121, the first center hole; Cylinder body; 20, second half cylinder; 210, guide part; 211, protrusion; 212, transition groove; 213, red line part; 220, second rotating shaft part; 221, second center hole; 230, second half cylinder body; 240, helical teeth; 30, hinge structure; 40, rotating shaft; 401, shaft shank; 402, elastic opening.

detailed description

The embodiments of the present invention will be described in detail below with reference to the accompanying drawings, but the present invention can be implemented in many different ways defined and covered by the claims.

As shown in Figures 1 to 5, the embodiment of the present invention firstly discloses a ferrule for anastomosis. The whole device is made of a conventional plastic material with a certain hardness and elasticity, preferably medical nylon material. The ferrule for anastomosis is mainly used in In the surgical operation of digestive tract anastomosis, the following components are included:

The first half cylinder 10, as shown in FIG. The inner wall is provided with thorns 114, and the number can be more than one. The anti-retraction part 110 includes a occlusal channel 112, and a occlusal tooth 111 is arranged in the occlusal channel 112. A first center hole 121 is provided at the center of the first rotating shaft part 120. The hole It is a through hole. In this embodiment, the inner wall of the first half cylinder 10 is provided with teeth, so as to better prevent the hoop from falling off or loosening during fixing.

The second half cylinder 20, as shown in FIG. 3 , includes a second half cylinder body 230 and a guide portion 210 and a second shaft portion 220 arranged on both edges of the second half cylinder body 230 in the circumferential direction, and the inner wall of the second half cylinder 10 Helical teeth 240 and thorns 114 are arranged on the top, and the thickness and width of the guide part 210 along the circumferential direction of the second half cylinder 20 gradually decrease. This setting is for the second half cylinder 20 to pass through the first half cylinder more easily. In the engaging channel 112 of 10, a second center hole 221 is provided at the center of the second shaft part 220, which is also a through hole. Furthermore, the second rotating shaft part 220 is a one-way rotating shaft part, and its cross section is G-shaped or cam-like in shape with a uniformly changing radius. The first hoop 10 can be expanded and finally can be stuck on the outer wall of the first half-tube 10. The main function is that when the second half-tube 20 passes through the occlusal channel 112 of the backstop 110 during pre-fixation, it can be stuck. The self-locking effect on the outer wall of the first half cylinder 10 prevents its reverse rotation, that is, the hoop will not fall off during the initial fixation stage of the operation.

The rotating shaft 40, the rotating shaft 40 passes through the first central hole 121 and the second central hole 221, and forms a hinge structure 30 with the first rotating shaft part 120 and the second rotating shaft part 220, in this embodiment, the rotating shaft 40 includes The elastic opening 402 at one end and the shaft shank 401 at the other end, the elastic opening 402 is pre-compressed with a certain elastic force, which restricts the rotation shaft 40 from freely detaching from the first central hole 121 and the second central hole 221, but a certain external force is applied , the opening of the elastic opening part 402 shrinks, so that the rotating shaft 40 is pulled out. The rotating shaft 40 can be made of metal or plastic, as shown in FIG. 5 . The first half cylinder 10 and the second half cylinder 20 rotate around the rotation axis 40. When the second half cylinder 20 passes through the engaging channel 112 and exits, the engaging teeth 111 engage the helical teeth 240 and self-lock, that is, there is a single joint similar to an ordinary cable tie. direction movement, reverse self-locking function, and the extractable structural design of the rotating shaft 40 is to quickly unlock the hoop by pulling out the rotating shaft 40 when it is necessary to open the hoop that has been self-locked , which is particularly important in emergency situations in medical operations. In practice, the shaft handle 401 is not limited to the cylindrical shape in this embodiment, and can be inverted cone, inverted pyramid, dumbbell, etc., which are conducive to the rapid extraction of surgical forceps. other structures.

Simultaneously, because during operation, the special-purpose scissors of minimally invasive surgery laparoscopic surgery is not stressed, especially when cutting plastics. At the same time, in order to prevent the shortened second half cylinder 20 from stretching out from the end of the backstop 110, so that the body of the anastomotic chamber cannot contain the hoop, a groove structure is provided on the outer wall of the first half cylinder 10 of the device. To block the part of the second half cylinder 20 protruding from the anti-retraction part 110, in the specific design, a groove 113 is provided on the outer wall of the first half cylinder 10, and the second half cylinder 20 can be easily pressed in by surgical forceps or scissors In the groove 113 and fixed therein, in the present embodiment, the groove 113 is a T-shaped groove structure, as shown in Figure 5, the width B2 of the second half cylinder 20 is smaller than the T-shaped groove opening width B1 of the first half cylinder 10, Simultaneously, the thickness H2 of the second half cylinder 20 is smaller than the thickness H1 of the first half cylinder 10, and at the edge of the second half cylinder 20, a circular arc transition is adopted or the cross-section is set as a rounded rectangle, so that it can be easily used in surgery. During the process of pressing the second half-tube 20 into the T-shaped groove of the first half-tube 10 by surgical forceps, the smooth transition edge of the second half-tube 20 can squeeze and expand the opening of the T-shaped groove and be restricted inside the groove. .

Further, protrusions 211 are provided on the inner and outer walls of the guide part 210, which can be strip-shaped protrusions or point-shaped protrusions. The main purpose is to prevent slipping, facilitate the traction and force application of surgical forceps, and facilitate the tightening of the entire device. Wall, between the guide part 210 and the second half cylinder body 230 is provided with a transition groove 212, the depth of the groove is almost the same as the thickness of the second half cylinder 20, so that during the operation, the guide part 210 can be easily moved through surgical forceps. tear it off or cut it off with scissors to prevent its upturn from affecting the operation process. A red line part 213 is provided on the outer wall of the second half cylinder 20 corresponding to the transition groove 212, which is optionally a fluorescent line part. It is convenient to identify the exact position of the guide part 210 and the transition groove 212 during the operation, to facilitate the fixed positioning during the operation, and to tear off the guide part 210 .

In this embodiment, combined with the actual size of the stapler and the anvil during the specific operation, the width of the first half cylinder 10 and the second half cylinder 20 is 5-8 mm, preferably, the width of the first half cylinder 10 is 7 mm.

The procedure for using the device is as follows:

First, pre-fix the device with the esophagus, enclose the device at the stump of the esophagus, and pass the guide part 210 through the backstop part 110. At this time, when the second rotating shaft part 220 of the hinge structure 30 rotates around the rotating shaft 40, Due to the smooth transition of the raised part on the upper part, there will be a sense of breakthrough after expanding the first half cylinder 10. At this time, the raised part just reaches the position of the outer wall of the first half cylinder 10. This design plays a positioning role of locking degree And to prevent the opening of the hoop, at this time, the red line part 213 has just come out of the backstop 110, which plays a double positioning role; at the same time, the thorns 114 of the first half cylinder 10 and the thorns 114 of the second half cylinder 20 have penetrated into the food The tube wall is used to prevent the anastomotic hoop from protruding from the esophagus; then, the distal end of the esophageal stump is cut off along the outer edge of the device. At this time, the tightness is just suitable for the transoral anvil catheter to pass through the esophageal stump while ensuring that the device does not fall off. After the transoral anvil is fully in place, the locking device is further tightened to the maximum, and the anvil is fully fixed at this time. Then tear off the guide part 210 with surgical forceps, press the second half cylinder 20 extending out of the locking ring into the T-shaped concave groove 113 of the first half cylinder 10 with surgical forceps, this design can prevent the second half cylinder 20 from The bounce affects the annular blade of the stapler to cut the tissue; finally, the stapler gun body and the anvil are conventionally docked to activate the stapler to complete the anastomosis. After the anastomosis, the device is taken out together with the stapler and the esophageal stump and discarded. In addition, this device is also designed with an emergency device, that is, the rotating shaft 40, and the shaft handle 401 protruding from the hinge structure 30 is conducive to grasping instruments such as surgical forceps. Shaft 40, the device then spreads out, thereby releasing the necking.

Compared with the laparoscopic manual purse-string suture technique, which requires surgeons with rich laparoscopic experience to complete in 20-40 minutes, this solution can significantly reduce the operation steps, only 5-10 minutes of operation time, so that more doctors And hospitals can carry out minimally invasive esophageal surgery techniques. Compared with the most commonly used method of treating the esophageal stump with a linear cutting suturer, this solution changes the treatment of the esophageal stump from invasive to non-invasive, reduces the wound of the esophagus, and thus facilitates the blood supply of the anastomosis; this device The application operation simplifies the surgical process, saves the step of opening from the top of the incision wound, and reduces the risk of the anvil falling off due to excessive opening. At the same time, using this device to deal with the esophageal stump, the anvil head inserted through the mouth comes out of the natural cavity, and the anastomosis between the esophagus and the stomach achieves end-to-side anastomosis in the true sense, which reduces the processing compared with the original cutter and stapler. The probability of food remaining in the anastomotic stoma reduces the probability of anastomotic infection. The cost of the anastomotic hoop is far lower than that of the cutter and stapler, and each patient who underwent minimally invasive radical resection of esophagus cancer reduced the operation cost by 7300-11800 yuan. So that more patients, especially those from poor families, can choose minimally invasive radical resection of esophageal cancer, and reduce postoperative complications.

The above descriptions are only preferred embodiments of the present invention, and are not intended to limit the present invention. For those skilled in the art, the present invention may have various modifications and changes. Any modifications, equivalent replacements, improvements, etc. made within the spirit and principles of the present invention shall be included within the protection scope of the present invention.

Claims (9)

1. A ferrule for anastomosis, characterized in that it comprises: The first half cylinder, the first half cylinder includes a first half cylinder body and a backstop portion and a first rotating shaft portion respectively arranged on both peripheral edges of the first half cylinder body, the inner wall of the first half cylinder There are thorns on the top, the stopper part includes an occlusal channel, an occlusal tooth is arranged in the occlusal channel, and a first central hole is provided on the first rotating shaft part; The second half cylinder, the second half cylinder includes a second half cylinder body and guide parts and second rotating shaft parts respectively arranged on the two peripheral edges of the second half cylinder body, the inner wall of the second half cylinder Helical teeth and the thorns are provided, the thickness and width of the guide portion gradually decrease along the circumferential direction of the second half cylinder, and a second central hole is provided on the second rotating shaft portion; a rotating shaft, the rotating shaft passes through the first central hole and the second central hole, and forms a hinge structure with the first rotating shaft part and the second rotating shaft part; The first half cylinder and the second half cylinder rotate around the rotation axis, and when the second half cylinder passes through the occlusal channel and exits, the occlusal teeth engage the helical teeth to lock themselves; The rotating shaft includes an elastic opening at one end and a shank at the other end. 2. The ferrule for anastomosis according to claim 1, wherein a groove is provided on the outer wall of the first half cylinder, and the second half cylinder can be pressed into the groove and fixed. 3. The ferrule for anastomosis according to claim 2, wherein the groove is a T-shaped groove, and the inner and outer walls of the second half cylinder and the adjacent end surfaces make a smooth transition. 4 . The ferrule for anastomosis according to claim 1 , wherein protrusions are provided on the inner and outer walls of the guide portion. 5 . The ferrule for anastomosis according to claim 1 , wherein a transition groove is provided between the guide portion and the second half-cylinder body. 6 . 6 . The ferrule for anastomosis according to claim 5 , characterized in that, the outer wall of the second half cylinder corresponding to the transition groove is provided with a red line or a fluorescent line. 7 . 7. The ferrule for anastomosis according to claim 1, characterized in that teeth are provided on the inner wall of the first half cylinder. 8. The ferrule for anastomosis according to any one of claims 1-7, characterized in that, the second rotating shaft part is a one-way rotating shaft part, which can be clamped on the outer wall of the first rotating shaft. 9 . The ferrule for anastomosis according to claim 8 , wherein the width of the first half-tube and the second half-tube is 5-8 mm.