CN106470630B - Surgical fastener bringing device and method for endoscopic procedure - Google Patents
Surgical fastener bringing device and method for endoscopic procedure Download PDFInfo
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- CN106470630B CN106470630B CN201480080258.5A CN201480080258A CN106470630B CN 106470630 B CN106470630 B CN 106470630B CN 201480080258 A CN201480080258 A CN 201480080258A CN 106470630 B CN106470630 B CN 106470630B
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- gear
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- surgical instrument
- handleset
- invasive surgical
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- 238000000034 method Methods 0.000 title description 12
- 238000004873 anchoring Methods 0.000 claims abstract description 57
- 238000001356 surgical procedure Methods 0.000 claims abstract description 28
- 230000005540 biological transmission Effects 0.000 claims description 29
- 230000007246 mechanism Effects 0.000 claims description 8
- 230000009471 action Effects 0.000 claims description 5
- 210000001519 tissue Anatomy 0.000 description 17
- 206010019909 Hernia Diseases 0.000 description 6
- 239000000463 material Substances 0.000 description 4
- 238000007373 indentation Methods 0.000 description 3
- 238000003780 insertion Methods 0.000 description 3
- 230000037431 insertion Effects 0.000 description 3
- 238000009527 percussion Methods 0.000 description 3
- 210000002784 stomach Anatomy 0.000 description 3
- 230000008901 benefit Effects 0.000 description 2
- 230000015572 biosynthetic process Effects 0.000 description 2
- 238000010276 construction Methods 0.000 description 2
- 235000013399 edible fruits Nutrition 0.000 description 2
- 238000010304 firing Methods 0.000 description 2
- 238000007789 sealing Methods 0.000 description 2
- AEMRFAOFKBGASW-UHFFFAOYSA-N Glycolic acid Polymers OCC(O)=O AEMRFAOFKBGASW-UHFFFAOYSA-N 0.000 description 1
- 208000029836 Inguinal Hernia Diseases 0.000 description 1
- 229920000954 Polyglycolide Polymers 0.000 description 1
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 1
- 210000001015 abdomen Anatomy 0.000 description 1
- 230000003213 activating effect Effects 0.000 description 1
- 239000000853 adhesive Substances 0.000 description 1
- 230000001070 adhesive effect Effects 0.000 description 1
- 230000003321 amplification Effects 0.000 description 1
- 230000000712 assembly Effects 0.000 description 1
- 238000000429 assembly Methods 0.000 description 1
- 229920000234 biocompatible block copolymer Polymers 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 230000008713 feedback mechanism Effects 0.000 description 1
- 210000000936 intestine Anatomy 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000003199 nucleic acid amplification method Methods 0.000 description 1
- 238000012856 packing Methods 0.000 description 1
- 244000144985 peep Species 0.000 description 1
- 239000004626 polylactic acid Substances 0.000 description 1
- 230000002787 reinforcement Effects 0.000 description 1
- 210000004872 soft tissue Anatomy 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 238000003860 storage Methods 0.000 description 1
- 229910052719 titanium Inorganic materials 0.000 description 1
- 239000010936 titanium Substances 0.000 description 1
- 230000007704 transition Effects 0.000 description 1
- 238000003466 welding Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00407—Ratchet means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0647—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
- A61B2017/0648—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks threaded, e.g. tacks with a screw thread
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2923—Toothed members, e.g. rack and pinion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2925—Pistol grips
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
Minimal invasive surgical instrument (200) includes Handleset (210) and endoscope assembly (300), and endoscope assembly can be used to selectively connect to Handleset (210) and including being loaded in its intraluminal surgery anchoring piece (100).Handleset (210) includes the trigger (214) for being operatively connectable to handle housing (212).Clutch gear (226) is arranged in handle housing (212) and can be rotated by the actuating of trigger (214) around pivot (221).Clutch gear (226) includes having gear teeth (226a1) gear (226a) and gear plate (226b), gear plate includes the spring-loaded driving plate pin (227) to extend radially outwardly from gear plate (226b).Bevel gear (228) can rotate around pivot (221) and including tapered arc-shaped cam block (228a), and cam bit has the wall for being selectively engaged the driving plate pin (227) of clutch gear (226).Pinion gear (230) is fixed non-rotatably to the drive shaft (232) distally extending from handle housing (212), and the gear teeth (230a) being operably engaged including the gear teeth (228c) with bevel gear (228).
Description
Technical field
This disclosure relates to a kind of surgical device for executing surgical procedure, surgical device and/or surgery system and its make
Use method.More specifically, this disclosure relates to a kind of surgical fastener bringing device, surgery for executing minimally invasive surgery program is tight
Firmware application devices and/or surgical fastener application system can be mounted with comprising absorbable or permanent surgical fastener
Disposable loading unit and its application method.
Background technique
Various surgical procedures are required to fastener being applied to tissue to form tissue connection or object is fixed to group
The instrument knitted.For example, usually it is expected net being fastened to bodily tissue during hernia repairing.Certain hernias (such as direct inguinal hernia or
Oblique hernia) in, a part of intestines is prominent to form hernical sac by the defect in stomach wall.Open surgery program patch can be used to lack
Damage, wherein larger notch can be manufactured and be closed hernia by being sewn to the external of stomach wall.Net is attached in stomach wall with suture
To provide reinforcement in opening.
Minimally invasive (for example, endoscope or laparoscope) surgical procedure is presently available for repairing hernia.In laparoscopic procedure, pass through
Small notch executes operation in abdomen, and in endoscopic procedure, pass through the narrow endoscope via the small notch insertion in body
Pipe or casing execute operation.It is intracorporal remote can to reach body usually using long and narrow instrument for laparoscope and endoscopic procedure
Journey region and be configured with insertion instrument by notch or pipe come formed sealing.In addition, being typically capable of remotely
(namely from the outside of body) actuating instrument.
Currently, the Minimally Invasive Surgical Technology for hernia repairing uses surgical fastener (for example, surgical staples, staple and fixture)
Net is fixed to tissue to provide the structure reinforced and be used to promote tissue ingrowth.Surgical fastener is often through elongated device
Tool is applied to be transported to net, and is manipulated from the outside of body cavity.
In some programs, it may be necessary to permanent securing member, and in other programs, it may be necessary to biological absorbable is tight
Firmware, or not only needed permanent securing member but also needed biological absorbable fastener.Mis instruments are typically mounted with permanently
Fastener or biological absorbable fastener.In addition, after surgical procedure, these instruments sterilized again to reuse or
It is disposed.
Summary of the invention
This disclosure relates to which surgical device and its application method for executing minimally invasive surgery program, the surgical device can fill
It is loaded with disposable loading unit, the disposable loading unit is mounted with absorbable or permanent surgical fastener.
According to the one side of the disclosure, a kind of minimal invasive surgical instrument includes Handleset and endoscope assembly, it is described in peep
Mirror assembly can be used to selectively connect to the Handleset and including being loaded in its intraluminal surgery anchoring piece.The hand
Handle component includes the trigger for being operatively connectable to handle housing.Clutch gear, transmission gear and pinion gear are arranged in the hand
In handle shell.The clutch gear can be surrounded by the actuating of the trigger and be pivoted.The clutch gear includes tool
There is the gears and gears plate of gear teeth, the gear plate includes the spring-loaded driver plate to extend radially outwardly from the gear plate
Pin.Bevel gear can be around pivoting and the diameter of the gear teeth including being arranged on the first face for being formed in the bevel gear
Tapered arc-shaped cam block inwardly.The cam bit has the driving plate pin for being selectively engaged the clutch gear
Wall.Pinion gear is fixed non-rotatably to the drive shaft distally extending from the handle housing, and including with the cone tooth
The gear teeth that the gear teeth of wheel is operably engaged.
The driving plate pin can be biased to extend radially outwardly from the gear plate, and when in the convex of the bevel gear
Can be when rotating under the action of wheel block can be moved to unbiased position.In embodiment, the driving plate pin of the clutch gear
Including with cam face band point of shoulder portion, when clutch gear when rotating in the first direction, the cam face can select
Engaged with the wall of the bevel gear to property.The band point of shoulder portion of the clutch gear can have tapered surface, the tapered surface
It is configured to slide under the action of the cam bit of the bevel gear, and the quilt when the clutch gear rotates in a second direction
It is compressed in the slot being formed in the gear plate.
The Handleset can also include ratchet mechanism, and the ratchet mechanism includes the spring clip with jerk-finger, institute
State the ratchet indented joint that jerk-finger is disposed for and is formed on the second face of the bevel gear.
The handle housing may include the driving gear for being keyed to the hub switch side of the trigger.The Handleset may be used also
To include biasing member, the biasing member has the first end for being fixedly connected to the handle housing and is connected to from institute
State the second end of the stop part of the proximal face extension of driving gear.
In embodiment, the driving gear includes gear teeth, and the gear teeth, which is arranged in, is defined in the driving gear
Extend in interior opening and along the arc length of the driving gear.The gear of the clutch gear is at least partly arranged
In the opening, so that the gear teeth of the clutch gear and the gear teeth of the driving gear are engaged.Certain
In embodiment, the gear teeth of the driving gear along in the opening, top edge arrange that and the gear is arranged in limit
Due in the distal part of the opening in the driving gear.
In embodiment, the Handleset further includes driving gear component, the driving gear component include with it is described
The first transmission gear engaged to drive gear operations and engaged with the operated gear of the clutch gear second
Transmission gear.In certain embodiments, first transmission gear includes engagingly engaging with the gear teeth of the driving gear
Gear teeth, and second transmission gear includes the gear engagingly engaged with the gear teeth of the gear of the clutch gear
Tooth.
The endoscope assembly may include outer tube, the inner tube being pivotally supported in the outer tube and connector,
Said inner tube is limited in the lumen for being wherein mounted with multiple surgery anchoring pieces.The connector, which has, is non-rotatably connected to institute
It states the proximal end of outer tube and the outconnector component and non-rotatably of the Handleset can be non-rotatably connected to
It is connected to the proximal end of said inner tube and the female connector component of gear train can be rotatably connected to, wherein the outer connection
Device component and the female connector component can rotate relative to each other.
The drive shaft can be by bonded for being used to selectively connect to be supported on the institute of the proximal end of said inner tube
State female connector component.
Below with reference to the accompanying drawings the more details and more aspects that exemplary embodiments of the present disclosure are described in more detail.
Detailed description of the invention
Example is described implementation of the disclosure herein with reference to attached drawing, in which:
Fig. 1 is the perspective view for the surgery anchoring piece in surgical device according to the disclosure；
Fig. 2 is the side view of the surgery anchoring piece of Fig. 1, elevation；
Fig. 3 is the distal side of the surgery anchoring piece of Fig. 1, end-view；
Fig. 4 is the side view of the surgery anchoring piece of Fig. 1, facade, partial sectional view；
Fig. 5 is the perspective view of surgical device according to the one side of the disclosure；
Fig. 6 is the left section of the surgical device of Fig. 5, perspective view, shows the half section from its Handleset removed；
Fig. 7 is the right section of the surgical device of Fig. 5, perspective view, shows the half section from its Handleset removed；
Fig. 8 is the amplification of the gear train of Fig. 5, partial side elevation view；
Fig. 9 is the forward sight of the clutch gear of the surgical device of Fig. 5, perspective view；
Figure 10 is the backsight of the clutch gear of Fig. 9, perspective view；
Figure 11 is the left section of surgical device according to an embodiment of the present disclosure, perspective view；
Figure 12 is the perspective view for separating each component according to the endoscope assembly of the surgical device of the disclosure；
Figure 13 is the backsight of the endoscope assembly of Figure 12, perspective view；And
Figure 14 is the cross-sectional view of the distal portions of the endoscope assembly of Figure 12, is shown according to the surgical device of the disclosure
Endoscope assembly during firing stroke.
Specific embodiment
The embodiment of the minimal invasive surgical instrument of the disclosure is described in detail by referring to the drawings, if wherein similar appended drawing reference exists
Identical or corresponding element is indicated in each of dry view.As used herein, term " distal side " refers to that surgery is set
It is standby from the farther away part of user, and term " nearside " refer to surgical device from the closer part of user.
Referring initially to Fig. 1-4, the surgery anchoring piece being used together for the minimal invasive surgical instrument with the disclosure is shown simultaneously
And it is generally designated as anchoring piece 100.As shown in Figs 1-4, anchoring piece 100 includes head part 110, net holding section 120 and spiral shell
Line tissue captures section 130.Head part 110 includes one with corresponding radially outer spiral shape head threads 114a, 114b
To opposite thread section 112a, 112b, and a pair of opposite opening or fluting section 116a, 116b.Head part 110
Distal surface is formed in net and keeps keeping the proximal end of section 120 integral on the proximal end of section 120 or with net.
The net of anchoring piece 100 keeps section 120 to capture section 130 from the distal end of head part 110 or surface and tissue
Proximal end extends and extends therebetween.When anchoring piece 100 is screwed into the tissue capture spiral shell for reaching more than tissue in net and capturing section 130
When the depth of the recent side section 138 of line 132, net keeps section 120 to be used for by the locking of Surgical indication (not shown), anchoring or with another
External square type remains on anchoring piece 100.This point can be realized be due to be not at net keep section 120 in screw thread, from
And allow that anchoring piece 100 is unscrewed or exited from net.
Net keeps section 120 to have cylindrical or conical lateral cross-sectional profile.Net keep section 120 include relative to
The transverse radial size of the central longitudinal axis of anchoring piece 100 is less than the transverse radial size of head part 110, and small
The transverse radial size of the recent side section 138 of section 130 is captured in tissue.
It includes the spiral shell being formed in tapered truncated cone shape ontology section 134 that the rib stitch of anchoring piece 100, which captures section 130,
Revolve shape screw thread 132.Distalis or end 136 limit the terminal that farthest side tissue captures screw thread 132.
As shown in figure 4, tissue capture section 130 ontology section 134 be it is tapered, i.e., towards rib stitch capture section
130 distal end becomes smaller, and terminates or end in distal side cut off before the vertex or end for reaching anchoring piece 100.Ontology
Section 134 includes spill converging transition, so that minimum diameter ontology section 134 is limited when its cut-off for designated length,
It is in embodiment about less than 0.01 inch.
Anchoring piece 100 includes capturing the lateral dimension " D " of the farthest side screw thread in section 130 in rib stitch, and is set
Meter constraint is permitted equally big, and is about greater than 0.040 inch in some embodiments.According to the disclosure, small cut-off is originally
The big value of body diameter and " D " minimize tissue indentation.Tissue captures screw thread 132 and terminates at distal end 136, at this
The distal side of the cut off of body section 134.
By providing the distal end 136 distally extending in the cut off of tissue capture section 130, it is easy to by anchoring piece
100 penetrate net；And compared to have the anchoring piece for not ending ontology with tapered thread, by anchoring piece 100 by network pressure enter compared with
Indentation in soft tissue is minimized.
For being applied to the specified force of Surgical indication by surgeon, distal force can be applied on nail applicator, anchoring piece
100 size " D " is bigger, then the distal force of application required for the indentation in order to promote following tissue and Surgical indication is smaller.
Anchoring piece 100 be non-hollow (non-cannulated) and by suitable bioabsorbable material (for example, poly-
Lactic acid and/or polyglycolide) construction.In embodiment, anchoring piece 100 is by proprietary biocompatible block copolymer (Lactomer
704 S Boehringer Ingelheim LG-857 of USS L1, Boehringer Ingelheim LR) it is formed.Anchor
Firmware can also be constructed such as suitable not-bio-absorbable material or permanent material (for example stainless steel, titanium).
Referring now to Figure 5, the minimal invasive surgical instrument in the form of endoscopic surgical follows closely applicator or staplers is integrally shown
It is 200.Following closely applicator 200 includes Handleset 210 and removable endoscope assembly 300 (for example, disposable loading is single
First SULU), the endoscope assembly extends and is configured to from Handleset 210 storage and therefrom selectively discharges or fire
Multiple anchoring pieces 100 (Fig. 1).
Handleset 210 includes the handle case that the first half section 212a by being coupled each other and the second half section 212b are formed
Body 212.The first half section 212a of handle housing 212 and the second half section 212b can be used well known by persons skilled in the art
Method is coupled each other, including but not limited to ultrasonic welding, fastener (that is, screw), elastic packing rubber, adhesive etc..Handle
The first half section 212a of shell 212 and the second half section 212b are coupled each other so that providing therebetween fluid-tight close
Envelope.
Handleset 210 includes being pivotably connected to handle housing in the pivot point being arranged in handle housing 212
212 trigger 214.Trigger 214 includes free end 214a, when trigger 214 is in extension or unactuated state, the free end
It is spaced apart with the fixed handle part 216 of handle housing 212.Trigger 214 includes extending from it and passing through handle case
The side of body 212 extends to the hub switch side 214b in handle housing 212.Fluid-tight sealing element can be located at trigger 214
Between hub switch side 214b and handle housing 212.X-shaped ring or similar department according to the disclosure, including O-ring or like
Part (not shown) can be used between the hub switch side 214b and handle housing 212 of trigger 214.
Handleset 210 includes the lasso or lantern ring 218 rotatably and being removedly supported on handle housing 212.
Handle housing 212 and lasso 218 may include the mutual of the position/orientation for locking or fixing lasso 218 relative to handle housing 212
Benefit is interconnected feature and/or structure.For example, lasso 218 can be rotatable between following position: latched position (endoscope
Component 300 is locked to Handleset 212, and staplers 200 prepare percussion)；Replacing position, (endoscope assembly 300 can connect
It is connected to Handleset 212/ to be detached from from Handleset, and staplers 200 cannot be fired)；And lasso releasing position (lasso
218 can remove from handle housing 212, and handle housing 212 can be cleaned or be sterilized).Handle housing 212 also can wrap
Include safe lock set.It, can be with about the detailed description for exemplary ferrule and the safety lock configuration being used together with handle housing 212
Be referred to submit on April 2nd, 2014 application No. is PCT/CN2014/074583 and PCT/CN2014/081618 the world specially
The full content of benefit application, each application is merged in this article by reference.
As shown in Figure 6 and Figure 7, the gear train 220 in 210 support handle shell 212 of Handleset.Gear train 220 includes
The trigger or driving gear 222 of hub switch side 214b that is bonded or being non-rotatably connected to trigger 214.Driving gear 222 is packet
Include the double-layer gear of the driving of the first driving gear 222a and second gear 222b.First driving gear 222a can be with fan-shaped gear
Etc. forms, have along its radially outward edge formed and along first driving gear 222a arc length extend it is multiple
Gear teeth 222a1.First driving gear 222a is included in gear teeth 222a1Nearside position at the strut that extends radially
Or stop part 223a.Second driving gear 222b limits the multiple gear teeth 222b formed along its radially outward edge1。
Stop part 223a is connected to the biasing member 225 of Handleset 210.Biasing member 225 is disposed for trigger
214 are maintained at extension or unactuated position.Biasing member 225 be also configured to trigger 214 partially or completely actuating it
Metapedes is so that trigger 214 returns to the spring constant of unactuated position.Biasing member 225 includes being fixedly attached to handle housing
First end 225a in 212 and it is connected to the second end from the first driving gear 222a stop part 223a extended
225b。
Gear train 220 further includes the driving gear component 224 being pivotally supported in handle housing 212.Transmission gear
Component 224 is three layers of gear for including the first transmission gear 224a, the second transmission gear 224b and third transmission gear 224c, often
One transmission gear is pivotally supported on common pivot axis.First transmission gear 224a can be in shapes such as pinion gears
Formula has the gear teeth 222a formed along its radially outward edge and with the first driving gear 222a1What is be engaged is more
A gear teeth 224a1.Second transmission gear 224b can have and be formed along its radially outward edge in the form of fan-shaped gear etc.
And the multiple gear teeth 224b extended along the arc length of the second transmission gear 224b1.Third transmission gear 224c can be with
In forms such as pinion gears, have along the formation of its radially outward edge and the gear teeth 224b with the second transmission gear 224b1
The multiple gear teeth 224c being engaged1。
Gear train 220 further includes the clutch on the pivot 221 being pivotally and slidably supported in handle housing 212
Gear 226.As seen in figs. 8-10, in conjunction with Fig. 6, clutch gear 226 includes gear 226a, and the gear is integrally formed or fixes
Ground is attached to the first side 226b of gear plate 226b1So that clutch gear 226 has overall construction.Gear 226a and gear plate
226b is arranged concentrically with respect to one another around pivot 221.Gear 226a can have in forms such as pinion gears along its diameter
Gear teeth 224b to outer edge formation and with the second transmission gear 224b1The multiple gear teeth 226a being engaged1.Gear
Second side 226b of plate 226b2The slot 226c being disposed therein including spring-loaded driving plate pin 227.Driving plate pin 227 includes tool
There is flat cam face 227a1With tapered surface 227a2Band point of shoulder portion 227a.Band point of shoulder portion 227a is biased to by spring 226d
It extends radially outwardly from gear plate 226b.
Gear train 220 further includes the bevel gear 228 on the pivot 221 being pivotally supported in handle housing 212.Bore tooth
Wheel 228 can be in forms such as ring gears.Bevel gear 228 is operably engaged/is associated with clutch gear 226.Bevel gear 228 includes
The tapered arc-shaped cam block 228a formed on the first face 228b of the radially inner side that it is arranged in gear teeth 228c.Cam bit
228a includes the cam face 227a for being selectively engaged clutch gear 2261Wall or shoulder 228d.
Gear train 220 further includes the pinion gear 230 being pivotally supported in the distal end of handle housing 212.Bevel pinion
230 include being operably engaged with the gear teeth 228c of bevel gear 228 or meshed gears tooth 230a.Bevel pinion 230 can not
It is rotationally fixed to the drive shaft 232 distally extending from handle housing 212.Drive shaft 232 is configured to size configurations at connecing
Close the female connector component 344 (Figure 12) of endoscope assembly 300.
In operation, when activating the trigger 214 of staplers 200, trigger 214 promotes to drive gear 222 in a first direction
Upper rotation.When driving gear 222 when rotating in the first direction, driving gear 222 promotes the first transmission gear 224a and second
Transmission gear 224b surrounds the rotation of its pivot axis in a first direction.When the second transmission gear 224b rotates in a first direction
When, the second transmission gear 224b promotes clutch gear 226 to rotate in a first direction around its pivot axis.
When clutch gear 226 when rotating in the first direction, the driving plate pin 227 of clutch gear 226 revolves in a first direction
Turn, until its cam face 227a1The wall 228d of engagement or contact bevel gear 228.In the cam face 227a of clutch gear 2261
After the wall 228d of engagement or contact bevel gear 228, the rotation that continues of clutch gear 226 in a first direction leads to bevel gear
228 accompanying rotation in a first direction.At this moment, as long as trigger 214 is actuated to closure or fully actuated state, bevel gear
228 continue to rotate in a first direction.The rotation of bevel gear 228 promotes pinion gear 230 to rotate in a first direction.When small tooth
When rotating in the first direction, rotation is transmitted to the inner tube 320 of endoscope assembly 300 to wheel 230 by pinion gear 230.
When being actuated at for trigger 214 is fully actuated before or when stopping after fully actuated, bevel gear 228 is first
Rotation on direction also stops.When the partially or completely actuating of trigger 214 is completed and its discharges, trigger 214 promotes to drive
Gear 222 rotates in the second direction opposite to the first direction.When driving gear 222 to rotate in a second direction, driving
Gear 222 promotes the first transmission gear 224a and the second transmission gear 224b to surround the rotation of its pivot axis in a second direction.
When the second transmission gear 224b rotates in a second direction, the second transmission gear 224b promotes clutch gear 226 in second party
It is rotated upward around pivot 221.When clutch gear 226 rotates in a second direction, driving plate pin 227 is also relative to bevel gear
228 rotate in a second direction, and if rotation in a second direction is enough, driving plate pin 227 is just in bevel gear 228
It is slided under the action of cam bit 228a, so that the band point of shoulder portion 227a of driving plate pin 227 is pressed into slot 227c.
If trigger 214 is fully actuated, the complete release of trigger 214 will lead to clutch gear 226 in second direction
It is upper completely to be rotated, until the band point of shoulder portion 227a of the driving plate pin 227 of clutch gear 226 leaves cone tooth via spring 226d
It takes turns 228 cam bit 228a and returns to its biased position, as shown in Figure 6.
As shown in fig. 7, nail applicator 200 Handleset 210 be equipped with ratchet mechanism 260, anchoring piece 100 (Fig. 1)
After being at least partly driven in tissue, the ratchet mechanism is configured to inhibit or prevents inner tube 320 from exiting or reversing.Ratchet
Mechanism 260 includes a series of hook tooth 228e being formed on the second face 228f of bevel gear 228.Ratchet mechanism 260 further includes
The spring clip 262 being fixed in Handleset 210.Spring clip 262 includes the hook tooth 228e being disposed for bevel gear 228
The jerk-finger 262a of engagement.
In operation, the jerk-finger 262a of the spring clip 262 and hook tooth 228e of bevel gear 228 is bonded into so that when cone tooth
When rotating in the first direction, the jerk-finger 262a of spring clip 262 is acted in hook tooth 228e overhead cam and is allowed to bore wheel 228
Gear 228 rotates.Moreover, if bevel gear 228 starts to rotate in the second direction opposite to the first direction, spring clip
262 jerk-finger 262a stops along hook tooth 228e, thus prevents or inhibits bevel gear 228 and rotates in a second direction.By
This, inhibit or prevent the endoscope assembly 300 during driving or firing stroke anchoring piece 100 or inner tube 320 it is any reversed
Rotation or " exiting " (tending to lead to bevel gear 228 to rotate in a second direction).
Additionally or alternatively, Handleset 210 can also include be supported in handle housing 212 and with driving gear
The 222 operatively associated sense of hearing/haptic feedback mechanisms 219 just for example also merge Shen in this article in previously passed reference
Please number for PCT/CN2014/074583 international patent application described in as.
Figure 11 shows the gear train of surgical device according to another embodiment of the present disclosure.Gear train 220' is substantially similar
In gear train 220, therefore only the difference between them will be described.With gear train 220 on the contrary, gear train 220' includes single
A driving gear 222', clutch gear 226, bevel gear 228 and pinion gear 230.Drive gear 222' bonded or non-rotatably
It is connected to the hub switch side 214b of trigger 214.There can be multiple gear teeth by the driving gear 222' in the form of fan-shaped gear etc.
222a', the gear teeth along in being defined in driving gear 222' in the opening 222b' that limits, top edge formed, and
And extend along the arc length of driving gear 222'.The gear 226a of clutch gear 226 is at least partially disposed at sliding tooth
In the opening 222' for taking turns 222'.Therefore, in such embodiments, transmission gear 224 is omitted.In use, when trigger 214
When being activated, trigger promotes that gear 222' is driven to rotate in a first direction, then promotes clutch gear 226 in a first direction
Rotation, so that the driving plate pin 227 of clutch gear 226 rotates in a first direction, until cam face 227a1Engagement or contact
The wall 228d of bevel gear 228, as described in detail above.
As shown in figs. 12-14, endoscope assembly 300 includes outer tube 310, the inner tube being rotatably disposed in outer tube 310
320, guidance coil or spring 330 between outer tube 310 and inner tube 320, the multiple anchoring pieces being loaded in inner tube 310 are arranged in
100 and be supported on outer tube 310 and inner tube 320 proximal end connector 340.
The outer tube 310 of endoscope assembly 300 includes proximal end 310a and distal end 310b, and limits and pass through lumen therein
310c.It is such as briefly described above, endoscope assembly 300 further includes the guidance being fixedly placed in at least distal part of outer tube 310
Coil or spring 330.
Inner tube 320 includes proximal part 320a and spline distal portions 320b, and limits and pass through lumen 320c therein.
The distal portions 320b of inner tube 320 slots, and limits a pair of opposite plug 320b1With a pair of opposite channel 320b2.Inner tube 320
Distal portions 320b multiple anchoring pieces 100 can be received in inner tube 320.Particularly, anchoring piece 100 is loaded into endoscope group
So that a pair of opposite thread section 112a, 112b (Fig. 1) of anchoring piece 100 extend through the distal end of inner tube 320 in part 300
The corresponding channel 320b of part 320b2And it is slidably disposed in the groove of coil 330, and the distal end of inner tube 320
A pair of of plug 320b of part 320b1It is arranged in cross-notching section 116a, 116b (Fig. 3) of anchoring piece 100.
In use, when inner tube 320 is rotated around its longitudinal axis relative to coil 330, a pair of of plug of inner tube 320
320b1Rotation is transmitted to anchoring piece 100 and is made since head threads 114a, 114b of anchoring piece 100 are engaged with coil 330
Anchoring piece 100 distally advances.
Connector 340 has the outconnector component 342 and not for the proximal end 310a for being non-rotatably connected to outer tube 310
It is rotatably connected to the female connector component 344 of the proximal end 320a of inner tube 320.Female connector component 344 is substantial cylindrical
And it limits radially projecting to the longitudinal extension internal-rib 344a of at least one of its lumen.Female connector component 344 is nested in outer
In connector members 342.Outconnector component 342 be it is substantial cylindrical and limit extend through its proximal end at least one is vertical
Extend inner groovy 342b to extension outer radial groove 342a and at least one longitudinal direction.The size and shape of outconnector component 342
It is configured for insertion into the distal openings of lasso 218 of Handleset 210, as shown in Figure 6.When outconnector component 342 is inserted completely
When entering in lasso 218, the distal end of drive shaft 232 enters female connector component 344, so that female connector component 344 is at least
One longitudinal multiple axially extending ribs 232a for extending internal-rib 344a and being mechanically engaged or engage the far-end for being located at drive shaft 232
(Figure 11).About for connecting, locking and/or replacing showing for endoscope assembly 300 relative to handle housing 210 and lasso 218
The detailed description of example property configuration, the world that can be PCT/CN2014/074583 and PCT/CN2014/081618 with application reference number
Patent application, each application have previously passed through reference and have merged in this article.
Endoscope assembly 300 includes being configured to and being adapted selectively to be connected to the transport wedge of connector 340, transport plug
Or transit cap 350.Cap 350 includes end wall 352, extends from end wall 352 and is configured to size configurations at for selectively
It receives in corresponding longitudinal at least one leg 354, Yi Jicong extended in outer radial groove 342a of outer connector members 342
End wall 352 extend and be configured to size configurations at for selectively receive in female connector component 344 so as to it is interior
(one or more) of connector members 344 longitudinally extends the strut (not shown) that internal-rib 344a is engaged.When cap 350 is fixed to
When connector 340, at least one leg 354 of cap 350 and strut engage outconnector component 342 and female connector component 344
To prevent them from rotating relative to each other.
Cap 350 is for fixing inner tube 320 relative to the radial position of outer tube 310 and therefore ensuring that in endoscope assembly
300 are connected to Handleset 210, and stacking for surgery anchoring piece 100 will not prematurely be advanced through endoscope assembly 300 before.Such as
Fruit stacking for surgery anchoring piece 100 before endoscope assembly 300 is connected to Handleset 210 is advanced through endoscope assembly
300, the opportunity of the percussion of nail applicator 200 may be will affect, thus each full stroke of trigger 214 possibly can not be peeped from interior
The percussion surgery anchoring piece 100 completely of mirror assembly 300 may fire the second surgery anchoring piece since endoscope assembly 300
100。
In the operation of surgical stapler 200, Handleset is operatively connected and is locked in endoscope assembly 300
In the case where 210, as described above, when drive shaft 232 is rotated due to the actuating of trigger 214, also as described above, the rotation
Via the multiple axially extending ribs 232a for the far-end for being located at drive shaft 232 and at least one longitudinal direction of female connector component 344
Extend the engagement of internal-rib 344a and is transmitted to the inner tube 320 of endoscope assembly 300.
Similarly, when inner tube 320 is rotated around its longitudinal axis relative to coil 330, due to the head of anchoring piece 100
Screw thread 114a, 114b are engaged with coil 330, a pair of of plug 320a of inner tube 3201Rotation is transmitted to the entire of anchoring piece 100
It stacks and distally advances entirely stacking for anchoring piece 100.
According to the disclosure, the component of surgical stapler 200 and the list for being dimensioned such that trigger 214 of anchoring piece 100
It is secondary completely and complete actuating leads to fire single anchoring piece 100 from endoscope assembly 300 (that is, being loaded in endoscope assembly 300
In the stacking of anchoring piece 100 in farthest anchors).
Surgical stapler 200 can repeatedly be fired to fire anchoring piece from endoscope assembly 300, until surgical procedure
It completes or until endoscope assembly 300 is finished anchoring piece 100.If endoscope assembly 300 is finished anchoring piece 100, and such as
Fruit needs additional anchor part 100 to complete surgical procedure, then used endoscope assembly 300 can be changed to new (that is, loading
Have anchoring piece 100) endoscope assembly 300.Alternatively, if it is desired to change the just anchoring piece 100 used in surgical procedure
Type, unspent endoscope assembly 300 (anchoring piece 100 for being mounted with the first kind) can be changed to another endoscope group
Part 300 (anchoring piece 100 for being mounted with different Second Types).
According to the disclosure, it is foreseen that be capable of providing a variety of different endoscope assemblies 300, wherein be mounted with by not
The endoscope assembly of the surgery anchoring piece of same material (for example, biological absorbable, permanent etc.) manufacture can be available, or
Endoscope assembly with different length (for example, short, medium and long etc.) can be available, wherein the endoscope group of specific length
Part is mounted with the surgery anchoring piece of respective numbers.Therefore, according to specific surgical procedure (for example, hernia program), surgeon can
To select any combination of any endoscope assembly or endoscope assembly being desired or needed for, and surgeon can be with
As needed or expectation replacement or replacement endoscope assembly during surgical procedure.
It should be understood that various modifications can be carried out to embodiment disclosed herein.So above description should not
It is interpreted restrictive, and the only illustration of various embodiments.Those skilled in the art have the ability to anticipate appended
Other variant schemes in scope and spirit of the claims.
Claims (13)
1. a kind of minimal invasive surgical instrument, comprising:
Handleset, the Handleset include:
Trigger, the trigger are operatively connectable to handle housing；
Clutch gear, the clutch gear are arranged in the handle housing and can be surrounded by the actuating of the trigger
It pivots, the clutch gear includes gear plate and the gear with gear teeth, and the gear plate includes from the gear plate
The spring-loaded driving plate pin to extend radially outwardly；
Bevel gear, the bevel gear can pivot around described and be formed in the first of the bevel gear including being arranged in
The tapered arc-shaped cam block of the radially inner side of gear teeth on face, the cam bit have for being selectively engaged the clutch
The wall of the driving plate pin of gear；And
Pinion gear, the pinion gear is fixed non-rotatably to the drive shaft distally extending from the handle housing, described small
Gear includes the gear teeth that the gear teeth on the first face with the bevel gear is operably engaged；And
Endoscope assembly, the endoscope assembly can be used to selectively connect to the Handleset and described including being loaded in
Intraluminal multiple surgery anchoring pieces of endoscope assembly.
2. minimal invasive surgical instrument according to claim 1, wherein the driving plate pin of the clutch gear includes having CAM table
Face band point of shoulder portion, when the clutch gear when rotating in the first direction, the cam face can selectively with it is described
The wall of bevel gear engages.
3. minimal invasive surgical instrument according to claim 2, wherein the band point of shoulder portion of the clutch gear has tapered table
Face, the tapered surface are configured to slide under the action of the cam bit of the bevel gear, and when the clutch gear is the
It is compressed in the slot being formed in the gear plate when being rotated on two directions.
4. minimal invasive surgical instrument according to claim 1, wherein the driving plate pin is biased to radial from the gear plate
Extend outwardly, and unbiased position can be moved to when rotating under the action of the cam bit of the bevel gear.
5. minimal invasive surgical instrument according to claim 1, wherein the Handleset further includes ratchet mechanism, the spine
Taking turns mechanism includes the spring clip with jerk-finger, and the jerk-finger is disposed for and is formed on the second face of the bevel gear
Ratchet indented joint.
6. minimal invasive surgical instrument according to claim 1, wherein the Handleset further includes being keyed to the trigger
The driving gear of hub switch side.
7. minimal invasive surgical instrument according to claim 6, wherein the driving gear includes gear teeth, the sliding tooth
The gear teeth of wheel is arranged in the opening being defined in the driving gear and prolongs along the arc length of the driving gear
Stretch, the gear of the clutch gear is at least partially disposed in the opening so that the gear teeth of the clutch gear with
The gear teeth of the driving gear is engaged.
8. minimal invasive surgical instrument according to claim 7, wherein the gear teeth of the driving gear is along the opening
Interior, top edge arrangement, and the gear of the clutch gear is arranged in the distal portion for the opening being defined in the driving gear
In point.
9. minimal invasive surgical instrument according to claim 6, wherein the Handleset further includes driving gear component, institute
State driving gear component include the first transmission gear engaged with the drive gear operations and with the clutch gear
The second transmission gear for engaging of operated gear ground.
10. minimal invasive surgical instrument according to claim 9, wherein first transmission gear includes and the sliding tooth
The gear teeth that the gear teeth of wheel engagingly engages, and second transmission gear includes the gear with the gear of the clutch gear
The gear teeth engaged to tooth engagement.
11. minimal invasive surgical instrument according to claim 6, wherein the Handleset further includes biasing member, described inclined
Pressure component has the first end for being fixedly connected to the handle housing and is connected to the nearside table from the driving gear
The second end for the stop part that face extends.
12. minimal invasive surgical instrument according to claim 6, wherein the endoscope assembly includes:
Outer tube；
The inner tube being pivotally supported in the outer tube, said inner tube are limited in the pipe for being wherein mounted with multiple surgery anchoring pieces
Chamber；And
Connector, the connector include
It is non-rotatably connected to the proximal end of the outer tube and the outer of the Handleset can be non-rotatably connected to connect
Connect device component；And
It is non-rotatably connected to the proximal end of said inner tube and the female connector component of gear train can be rotatably connected to,
Wherein, the outconnector component and the female connector component can rotate relative to each other.
13. minimal invasive surgical instrument according to claim 12, wherein the drive shaft is by bonded for selectively connecting
It is connected to the female connector component for the proximal end for being supported on said inner tube.
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| PCT/CN2014/081646 WO2016000255A1 (en) | 2014-07-04 | 2014-07-04 | Surgical fastener applying apparatus and methods for endoscopic procedures |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN106470630A CN106470630A (en) | 2017-03-01 |
| CN106470630B true CN106470630B (en) | 2019-10-11 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201480080258.5A Active CN106470630B (en) | 2014-07-04 | 2014-07-04 | Surgical fastener bringing device and method for endoscopic procedure |
Country Status (2)
| Country | Link |
|---|---|
| CN (1) | CN106470630B (en) |
| WO (1) | WO2016000255A1 (en) |
Families Citing this family (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106455936B (en) * | 2014-04-02 | 2019-03-08 | 柯惠有限合伙公司 | Surgical fastener bringing device, external member and method for endoscopic surgery |
| US10159471B2 (en) | 2015-05-13 | 2018-12-25 | C.R. Bard, Inc. | Actuation lockout for a surgical instrument |
| US10405858B2 (en) | 2015-06-30 | 2019-09-10 | C.R. Bard, Inc. | Actuation lockout for a surgical instrument |
| CN110269655B (en) * | 2019-06-26 | 2024-07-12 | 北京博辉瑞进生物科技有限公司 | Repair fixer with nail taking function |
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| EP0934024B1 (en) * | 1996-09-20 | 2006-08-30 | United States Surgical Corporation | Coil fastener applier |
| EP1990014A2 (en) * | 2007-05-10 | 2008-11-12 | Tyco Healthcare Group LP | Powered tacker instrument |
| CN101327135A (en) * | 2007-06-18 | 2008-12-24 | 伊西康内外科公司 | Cable driven surgical stapling and cutting instrument with apparatus for preventing inadvertant cable disengagement |
| CN101390765A (en) * | 2008-10-30 | 2009-03-25 | 上海创亿医疗器械技术有限公司 | Laparoscopy hernia repair stitching device |
| CN102281822A (en) * | 2008-12-16 | 2011-12-14 | 德威科医疗产品公司 | Hand actuated tetherless biopsy device with pistol grip |
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|---|---|---|---|---|
| US10478179B2 (en) * | 2004-04-27 | 2019-11-19 | Covidien Lp | Absorbable fastener for hernia mesh fixation |
| US9861359B2 (en) * | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
| US7753245B2 (en) * | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
| KR101064825B1 (en) * | 2010-11-18 | 2011-09-14 | 정창욱 | Minimally invasive surgical instruments |
| AU2013206807A1 (en) * | 2012-07-18 | 2014-02-06 | Covidien Lp | Apparatus for endoscopic procedures |
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2014
- 2014-07-04 WO PCT/CN2014/081646 patent/WO2016000255A1/en active Application Filing
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Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP0934024B1 (en) * | 1996-09-20 | 2006-08-30 | United States Surgical Corporation | Coil fastener applier |
| EP1990014A2 (en) * | 2007-05-10 | 2008-11-12 | Tyco Healthcare Group LP | Powered tacker instrument |
| CN101327135A (en) * | 2007-06-18 | 2008-12-24 | 伊西康内外科公司 | Cable driven surgical stapling and cutting instrument with apparatus for preventing inadvertant cable disengagement |
| CN101390765A (en) * | 2008-10-30 | 2009-03-25 | 上海创亿医疗器械技术有限公司 | Laparoscopy hernia repair stitching device |
| CN102281822A (en) * | 2008-12-16 | 2011-12-14 | 德威科医疗产品公司 | Hand actuated tetherless biopsy device with pistol grip |
Also Published As
| Publication number | Publication date |
|---|---|
| CN106470630A (en) | 2017-03-01 |
| WO2016000255A1 (en) | 2016-01-07 |
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