CN114343824B - Removable medical devices - Google Patents
Removable medical devices Download PDFInfo
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- CN114343824B CN114343824B CN202011092123.4A CN202011092123A CN114343824B CN 114343824 B CN114343824 B CN 114343824B CN 202011092123 A CN202011092123 A CN 202011092123A CN 114343824 B CN114343824 B CN 114343824B
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- 230000007246 mechanism Effects 0.000 claims abstract description 110
- 230000033001 locomotion Effects 0.000 claims abstract description 69
- 230000005540 biological transmission Effects 0.000 claims abstract description 15
- 238000009434 installation Methods 0.000 claims abstract description 13
- 230000000149 penetrating effect Effects 0.000 abstract description 4
- 238000000034 method Methods 0.000 description 20
- 230000008569 process Effects 0.000 description 20
- 238000000926 separation method Methods 0.000 description 6
- 210000004204 blood vessel Anatomy 0.000 description 5
- 238000010586 diagram Methods 0.000 description 3
- 238000006073 displacement reaction Methods 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 230000009471 action Effects 0.000 description 2
- 238000013459 approach Methods 0.000 description 2
- 238000013461 design Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 230000009466 transformation Effects 0.000 description 2
- 102000008186 Collagen Human genes 0.000 description 1
- 108010035532 Collagen Proteins 0.000 description 1
- 102000009123 Fibrin Human genes 0.000 description 1
- 108010073385 Fibrin Proteins 0.000 description 1
- BWGVNKXGVNDBDI-UHFFFAOYSA-N Fibrin monomer Chemical compound CNC(=O)CNC(=O)CN BWGVNKXGVNDBDI-UHFFFAOYSA-N 0.000 description 1
- 238000005299 abrasion Methods 0.000 description 1
- 230000000712 assembly Effects 0.000 description 1
- 238000000429 assembly Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 238000004140 cleaning Methods 0.000 description 1
- 229920001436 collagen Polymers 0.000 description 1
- 238000005260 corrosion Methods 0.000 description 1
- 230000007797 corrosion Effects 0.000 description 1
- 230000000249 desinfective effect Effects 0.000 description 1
- 239000012636 effector Substances 0.000 description 1
- 238000009297 electrocoagulation Methods 0.000 description 1
- 229950003499 fibrin Drugs 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 230000023597 hemostasis Effects 0.000 description 1
- 230000002452 interceptive effect Effects 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 230000013011 mating Effects 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 238000004064 recycling Methods 0.000 description 1
- 230000001954 sterilising effect Effects 0.000 description 1
- 238000013519 translation Methods 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
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- Health & Medical Sciences (AREA)
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- Biomedical Technology (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Plasma & Fusion (AREA)
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- Heart & Thoracic Surgery (AREA)
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Abstract
The invention provides a detachable medical instrument which comprises a handle, a transmission device and an execution device, wherein one end of the transmission device is detachably connected with the handle, the other end of the transmission device is detachably connected with the execution device, the transmission device comprises a guide mechanism and a push rod, a clamp head is arranged at the proximal end of the execution device, one end of the guide mechanism can be detachably connected with the handle, the clamp head is arranged near the other end of the guide mechanism in an openable manner, the push rod is movably arranged in the guide mechanism and is detachably connected with the execution device penetrating through an opening of the clamp head, in a first state, the push rod axially moves in the guide mechanism and simultaneously circumferentially rotates, and the execution device axially moves in the guide mechanism and realizes the installation and the detachment of the push rod and the execution device through the relative movement between the execution device and the push rod in the first state. The parts of the device can be fully disassembled and then cleaned, and especially the parts except the blade can be disassembled so that the device can be repeatedly used after being cleaned and sterilized.
Description
Technical Field
The invention belongs to the technical field of medical instruments, relates to a medical instrument, and in particular relates to a detachable medical instrument.
Background
High frequency electrosurgical instruments are used in surgical instruments for electrocoagulation hemostasis and/or cutting tissue during a surgical procedure. High frequency electrosurgical instruments generally include both gun and clamp configurations. The high-frequency electrosurgical instrument has the action principle that the blood vessel is clamped and physically pressurized by the two clamps at the front end, and high-frequency electric energy is provided by the high-frequency energy generator and is transmitted to the metal clamps at the front end of the instrument, so that collagen in the blood vessel and fibrin are dissolved, denatured and fused together, and the blood vessel is closed. After the blood vessel is closed, the knife can be directly pulled out to cut off the closing belt, so that the operation time is greatly shortened, the bleeding is reduced, and the operation risk is reduced to the minimum. Are widely used in surgical procedures due to their high efficiency and reliability relative to conventional suture ligatures.
The existing high-frequency electrosurgical instrument is mostly a disposable instrument, and is discarded after one operation, so that the use cost is high. If the device is made reusable in order to reduce the use cost, on one hand, the problem of service life of the parts needs to be considered, and usually, the parts with short service life, easy abrasion, easy corrosion and lower use cost are made disposable, and the parts with long service life, high reliability and higher cost are made reusable, on the other hand, the problem of cleaning, sterilizing and disinfecting the device after the operation is completed needs to be considered. Therefore, the design of the instrument needs to ensure that blood or tissue fluid flowing into the lumen of the instrument after the previous operation can be conveniently cleaned, otherwise, even if the structure and the performance of the electrosurgical instrument are still good, the electrosurgical instrument cannot be reused.
In view of this, there is an urgent need to design a detachable medical device so as to overcome the above-mentioned drawbacks of the existing detachable medical devices.
Disclosure of Invention
The invention provides a detachable medical instrument, which has simple and convenient cutter changing process and is easy to operate.
In order to solve the technical problems, according to one aspect of the present invention, the following technical scheme is adopted:
The detachable medical instrument comprises a handle, a transmission device and an execution device, wherein one end of the transmission device is detachably connected with the handle, and the other end of the transmission device is detachably connected with the execution device;
The pliers head is arranged near the other end of the guide mechanism in an openable manner;
the push rod is movably arranged in the guide mechanism and is detachably connected with the execution device passing through the opening of the clamp head;
In the first state, the push rod axially moves in the guide mechanism and simultaneously circumferentially rotates;
the actuating device moves axially in the guide mechanism, and the push rod and the actuating device are mounted and dismounted through the relative movement between the push rod and the actuating device in the first state.
Preferably, one end of the push rod is inserted into the guide mechanism from an end far away from the binding clip, and is detachably connected with the actuating device penetrating through the binding clip opening.
As one embodiment of the present invention, the guiding mechanism includes an inner sleeve, a first guiding part is provided in the inner sleeve, and a third guiding part corresponding to the first guiding part is provided on the push rod;
and under the cooperation of the first guide part and the third guide part, the push rod axially moves in the inner sleeve and simultaneously circumferentially rotates.
In one embodiment of the present invention, the first guiding portion is a first protrusion provided on an inner wall of the inner sleeve, the third guiding portion is a first groove provided on an outer wall of the push rod and extending along an axial curve, or the first guiding portion is a first groove provided on an inner wall of the inner sleeve and extending along an axial curve, the third guiding portion is a first protrusion provided on an outer wall of the push rod, and the push rod moves axially in the inner sleeve and simultaneously moves circumferentially in a rotation manner by a movement of the first protrusion in the first groove. The first groove is preferably a curved groove extending along an axial curve, such as a spiral groove.
In a second state, the push rod moves axially within the guide mechanism.
As one embodiment of the present invention, a second guiding portion is disposed in the inner sleeve, a fourth guiding portion corresponding to the second guiding portion is disposed on the push rod, and the push rod moves axially in the inner sleeve under the cooperation of the second guiding portion and the fourth guiding portion.
As one implementation mode of the invention, the second guide part is a second bulge which is arranged on the inner sleeve and is arranged along the axial direction, the fourth guide part is a second groove which is arranged on the push rod and corresponds to the second bulge, or the second guide part is a second groove which is arranged on the inner sleeve and is arranged along the axial direction, the fourth guide part is a second bulge which is arranged on the push rod and corresponds to the second groove, and the push rod moves along the axial direction in the inner sleeve through the movement of the second bulge in the second groove. Wherein the second groove may be a straight groove.
As one implementation mode of the invention, the guide mechanism further comprises a guide support piece, wherein the guide support piece is provided with a limit support part which is arranged in parallel with the axial direction of the inner sleeve, the limit support part is a linear groove, one end of the execution device is opened, the side walls of the opening end of the execution device are abutted against the inner walls of the two sides of the linear groove, do reciprocating axial movement along the inner walls of the two sides of the linear groove, and are detachably connected with the far end of the push rod after the near end of the execution device passes through the linear groove.
As one embodiment of the present invention, the strip-shaped protrusion passes through the opening end of the actuating device, and two sides of the strip-shaped protrusion respectively abut against two side wall parts of the actuating device, and the actuating device performs reciprocating axial movement under the guiding cooperation of the strip-shaped protrusion. Preferably, when the executing device is a blade, especially the blade is thin, the strip-shaped bulge is used for guiding, and the strip-shaped bulge also can prevent the deformation of the open end of the blade, especially the opening and the shrinking of the two side parts of the open end of the blade.
As one implementation mode of the invention, the executing device is a blade, one end of the executing device is opened, a first connecting mechanism is arranged at the opening end of the executing device, a second connecting mechanism corresponding to the first connecting mechanism is arranged on the push rod, and the first connecting mechanism and the second connecting mechanism are installed and removed through the motion coordination of the first state and the second state of the push rod. The blade is of an open long flat structure, the first connecting mechanism is a concave blade clamping part, the second connecting mechanism is a push rod clamping part corresponding to the blade clamping part, and the blade clamping part and the push rod clamping part move relatively under the second state to realize the installation and the disassembly of the blade and the executing device.
When the blade is installed, the push rod rotates a certain angle towards a first direction after passing through a first state and a second state so as to avoid the axial movement of a first connecting mechanism of the blade, the blade is inserted into the inner sleeve from an opening of the clamp head through the guide support piece and moves to a second connecting mechanism along the axial direction and then continuously pushes towards the direction away from the opening of the clamp head until the first connecting mechanism of the blade is abutted with the second connecting mechanism on the push rod, the push rod rotates a certain angle towards a second direction after passing through the second state, and the first connecting mechanism and the second connecting mechanism are completely clamped, so that the installation of the blade and the push rod is realized;
When the blade is in a working state, the push rod enters a first state, and the blade moves axially along with the push rod;
When the blade is detached, the push rod is pushed along the axial direction towards the opening direction close to the clamp head, after the push rod sequentially passes through a first state and a second state, the push rod rotates for a certain angle towards the first direction relative to the blade clamping part, the second connecting mechanism of the push rod is completely separated from the first connecting mechanism of the blade, the blade is detached from the push rod and then taken out from the jaw, and the detachment of the blade is completed.
The detachable medical instrument provided by the invention has the aim of realizing the installation and the detachment of the cutting blade from the jaw part of the forceps head and the push rod, and replacing the cutting blade. However, in the use process, the whole apparatus has 2 states, namely, one is in an installation and disassembly replacement state, and the other is in a normal working state.
More specifically, in a normal working state, the blade clamping part and the push rod clamping part are mutually clamped and are in a clamping state, the push rod is in linear motion through the mutual matching of the second guide part and the fourth guide part, and meanwhile, the blade is limited in a groove of the guide support piece, and at the moment, the blade can only perform linear reciprocating motion under the drive of the push rod.
The detachable medical instrument has the beneficial effects that the detachable medical instrument is simple and convenient in tool changing process and easy to operate. The device can be cleaned after being disassembled, and particularly, all parts except the blade can be reused after being cleaned and sterilized.
Drawings
Fig. 1 is a schematic view of a detachable medical device according to an embodiment of the present invention.
Fig. 2 is a schematic view of a detachable medical device according to an embodiment of the present invention (with the handle and the blade detached).
Fig. 3 is a schematic view of the detachable medical device (handle, blade, and blade detached) according to an embodiment of the present invention.
Fig. 4 is a schematic view of a part of a detachable medical device according to an embodiment of the present invention.
Fig. 5 is a schematic view of a removable medical device removal blade in accordance with an embodiment of the present invention.
Fig. 6 is a partially exploded view of a detachable medical device according to an embodiment of the present invention.
Fig. 7 is a schematic view of a detachable medical device blade and guide support according to an embodiment of the present invention.
Fig. 8 is a schematic structural view of a guide support according to an embodiment of the present invention.
Fig. 9 is a schematic view of a blade according to an embodiment of the present invention.
Fig. 10 is a schematic view of a portion of a blade according to an embodiment of the present invention.
FIG. 11 is a schematic view of a portion of a blade according to an embodiment of the present invention.
Fig. 12 is a schematic view showing a part of the structure of a detachable medical device according to an embodiment of the present invention.
Fig. 13 is a schematic view of a detachable medical device clamp head according to an embodiment of the present invention.
Fig. 14 is a schematic view of a part of the structure of a detachable medical apparatus (a knife out process) according to an embodiment of the present invention.
Fig. 15 is a partial enlarged view of fig. 14.
FIG. 16 is a schematic view of the cooperation of the pusher bar and the blade (the pusher face of the pusher bar pushes the blade against the pushed face) according to an embodiment of the present invention.
Fig. 17 is a schematic view of the cooperation of the push rod and the blade (the cooperation of the first connecting mechanism/push rod clamping portion and the second connecting mechanism/blade clamping portion) according to an embodiment of the present invention.
Fig. 18 is a cross-sectional view taken along A-A of fig. 17.
FIG. 19 is a schematic view of the second channel of the removable medical device mated with the second protrusion in an embodiment of the invention.
Fig. 20 is a schematic view of a part of the structure of a detachable medical apparatus (a knife back process) according to an embodiment of the present invention.
FIG. 21 is a schematic view of a structure for pushing the pusher bar away from the binding clip for linear movement according to an embodiment of the present invention.
Fig. 22 is a schematic diagram showing a state that the first connecting mechanism/push rod clamping portion and the second connecting mechanism/blade clamping portion are clamped in an embodiment of the present invention.
FIG. 23 is a schematic view showing a state where the second groove is engaged with the second protrusion according to an embodiment of the present invention.
Fig. 24 is a cross-sectional view taken along A-A of fig. 23.
FIG. 25 is a schematic view showing the relative positions of the pushing rod, the blade and the inner sleeve according to an embodiment of the present invention.
FIG. 26 is a schematic view showing a part of the structure of a detachable medical instrument pusher bar according to an embodiment of the present invention.
FIG. 27 is a schematic view of a first protrusion entering a first slot and rotating a push rod according to an embodiment of the present invention.
Fig. 28 is a schematic view showing the first connecting mechanism/push rod clamping portion and the second connecting mechanism/blade clamping portion separated from each other in an embodiment of the present invention.
Fig. 29 is an a-direction view of fig. 28.
FIG. 30 is a schematic view showing the relative positions of the push rod and the inner sleeve after the push rod rotates according to an embodiment of the present invention.
Fig. 31 is a schematic view showing an initial pushing state of the push rod according to an embodiment of the present invention.
FIG. 32 is a schematic diagram of a locking of a pusher bar to a blade in an embodiment of the present invention.
Fig. 33 is an a-direction view of fig. 32.
Fig. 34 is a schematic structural view of the cooperation of the pushing tool bar and the blade according to an embodiment of the present invention.
Fig. 35 is a cross-sectional view taken along A-A of fig. 34.
Fig. 36 is a B-B cross-sectional view of fig. 34.
Fig. 37 is a schematic view showing that the first connecting mechanism/push rod clamping portion and the second connecting mechanism/blade clamping portion are completely clamped in an embodiment of the invention.
FIG. 38 is a schematic view of a pusher bar clamping/engaging with a blade according to an embodiment of the present invention.
Fig. 39 is a cross-sectional view taken along A-A of fig. 38.
FIG. 40 is a partial schematic view of the completion of blade installation in accordance with one embodiment of the present invention.
FIG. 41 is a partial schematic view of the completion of blade installation in accordance with one embodiment of the present invention.
FIG. 42 is a schematic diagram illustrating a structure of a cutter bar according to an embodiment of the present invention.
Fig. 43 is a schematic structural view of a first connecting mechanism/push rod clamping portion according to an embodiment of the invention.
Fig. 44 is a schematic structural view of a push rod latch mechanism according to an embodiment of the present invention.
Fig. 45 is a schematic view of an inner sleeve according to an embodiment of the present invention.
Fig. 46 is a cross-sectional view of an inner sleeve in an embodiment of the present invention.
Fig. 47 is an axial view of an inner sleeve in an embodiment of the present invention.
Detailed Description
Preferred embodiments of the present invention will be described in detail below with reference to the accompanying drawings.
For a further understanding of the present invention, preferred embodiments of the invention are described below in conjunction with the examples, but it should be understood that these descriptions are merely intended to illustrate further features and advantages of the invention, and are not limiting of the claims of the invention.
The description of this section is intended to be illustrative of only a few exemplary embodiments and the invention is not to be limited in scope by the description of the embodiments. It is also within the scope of the description and claims of the invention to interchange some of the technical features of the embodiments with other technical features of the same or similar prior art.
In the specification, a spiral motion (helicoidal motion) is a spatial transformation, which refers to the product of a rotation and a translation transformation in space with a direction of movement parallel to the axis of rotation. The distal end in the specification is the end far away from the handle 1, and the proximal end is the end close to the handle 1. The first state and the second state in the specification may be the state of the push rod 22 or the state of the catch mechanism 220 (wherein the catch mechanism 220 is a part of the push rod).
The invention discloses a detachable medical instrument, which comprises a handle 1, a transmission device (comprising a blade body 2) and an executing device (comprising a blade 3) (refer to fig. 3), wherein the detachable medical instrument is in a schematic structure from whole to detached as shown in fig. 1 to 3, one end of the transmission device is detachably connected with the handle 1, and the other end of the transmission device is detachably connected with the executing device.
Referring also to fig. 4 to 6, which are schematic views showing the structure of the detachable medical apparatus according to the present invention in which the actuator is detached from the actuator, wherein the actuator may be a power transmission structure including the blade body 2, and the actuator may be a distal end effector for cutting tissue according to the power transmitted from the actuator, it is understood that the actuator includes the blade 3, and one end of the blade body 2 is detachably connected to the handle 1, and the other end is detachably connected to the blade 3 (refer to fig. 4), wherein the blade 3 is used to cut the tissue of the human body, especially in the case of using the electrosurgical apparatus to cut the closing band by re-using the blade after closing the blood vessel during the operation. In other preferred embodiments, the implement may also be a scissor, forceps, tweezers or the like.
Further, the transmission means (blade 2) comprises a guiding mechanism and a push rod (push rod 22), and the proximal end of the actuator comprises a forceps head 25. Wherein, one end of the guiding mechanism can be detachably connected with the handle, the clamp head 25 is arranged near the other end of the guiding mechanism in an openable and closable manner, and the push rod (push rod 22) is arranged in the guiding mechanism and can move in the guiding mechanism, so that the push rod (push rod 22) can be detachably connected with the executing device (blade 3) penetrating through the opening of the clamp head.
In the first state, the push rod (push rod 22) performs a circumferential rotational movement while performing an axial movement in the guide mechanism. When the actuator moves axially within the guide mechanism, the attachment or detachment of the actuator from the push rod is accomplished by relative movement between the actuator and the push rod (push rod 22) in the first state.
In one embodiment, as shown in fig. 4, the guiding mechanism further comprises an inner sleeve 21.
One end of the guide mechanism comprising the inner sleeve 21 (see fig. 4, proximal end of the inner sleeve 21) is detachably connected to the handle 1, and the clamp head 25 is provided in the vicinity of the other end of the guide mechanism comprising the inner sleeve 21 (see fig. 4, distal end of the inner sleeve 21) in a detachable manner. The push rod (push rod 22) is arranged in the inner sleeve 21 of the guide mechanism, and when the push rod is installed, the push rod (push rod 22) is inserted into the inner sleeve 21 from the end far away from the clamp head 25 (as shown in fig. 4) so as to be detachably connected with the blade 3 penetrating through the opening of the clamp head 25. Wherein the distal end of the blade 3 is used for cutting, the proximal end is detachably connected with the push rod 22 and is assembled in the inner sleeve 21 of the guiding mechanism of the blade body 2, wherein the distal end of the blade 3 is one end far away from the handle 1, and the proximal end of the blade 3 is one end close to the handle 1 (as shown in fig. 5). In this embodiment, the guiding mechanism may also be other structures including the inner sleeve 21, and the push rod may be other structures including the push rod 22, and the specific structure is not limited herein.
In the first state, the push rod 22 performs a circumferential rotational movement while axially moving within the inner sleeve 21 (guide mechanism) to effect attachment and detachment of the proximal end of the push rod to and from the distal end of the actuator. In the second state, the push rod 22 moves axially within the inner sleeve 21. The first state may be a state in which the proximal end of the blade 3 is in contact with the distal end of the pusher bar 22 from just before the completion of the mounting by the axial movement and the circumferential rotation of the pusher bar 22, or a state in which the proximal end of the blade 3 is separated from the distal end of the pusher bar 22 from just before the completion of the separation by the axial movement and the circumferential rotation of the pusher bar 22, or the second state may include a process in which the pusher bar 22 is initially moved in the axial direction (in the distal axial direction) toward the direction toward the clamp head 25 and pushed into the inner sleeve 21 of the guide mechanism, and at this time, the pusher bar 22 is not in contact with the blade 3, or a state in which the pusher bar 22 is moved in the axial direction to operate together with the blade 3 mounted thereto after the completion of the mounting of the pusher bar 22 and the blade 3. In the first state and the second state, the movement state of the blade 3 is not included, and the movement state of the blade 3 is mainly realized by the movement state of the push rod 22 when the blade 3 is mounted on the push rod 22 or detached from the push rod 22, and the movement state of the blade 3 is mainly the movement state when the blade is mounted proximally along the axial direction and/or the movement state when the blade is completely detached/detached distally.
In more detail, the mounting and dismounting of the blade 3 and the push rod 22 can be accomplished in a state that the handle 1 and the blade body 2 are separated, and at this time, the cooperation (reciprocating axial and rotational movement) of the blade 3 and the push rod 22 in the first state and the second state in the inner sleeve 21 controls the relative movement (axial movement and circumferential rotational movement including but not limited to spiral movement) between the distal end of the push rod 22 and the connection part of the proximal end of the blade 3, thereby realizing the mounting and dismounting of the push rod 22 and the blade 3.
Fig. 7 is a schematic structural view of a detachable medical device blade and a guide support according to an embodiment of the present invention, and as shown in fig. 6 and 7, the inner sleeve 21 may further include a guide support 24 (also referred to as a blade support) for guiding the blade 3 to reciprocate in an axial direction, wherein fig. 8 is a schematic structural view of the guide support according to an embodiment of the present invention in an axial section, and a limit support portion (a linear groove 241) disposed parallel to the axial direction of the inner sleeve 21 is provided on the guide support 24.
In one embodiment of the present invention, the limit supporting portion is a linear slot 241, and correspondingly, one end of the blade 3 is opened, and the side walls of the opening end (the proximal end of the blade 3) of the blade 3 are respectively abutted against the inner walls of two sides of the linear slot 241, so that the blade 3 can make reciprocating axial movement under the guidance of the linear slot 241, and the proximal end of the blade 3 passes through the linear slot 241 and then is detachably connected with the distal end of the push rod 22 passing through the inner sleeve 21.
In one embodiment, the guide support 24 is further provided with a strip-shaped protrusion 242, and the blade 3 moves axially under the guide of the strip-shaped protrusion 242. Fig. 9 is a schematic view of a blade structure according to an embodiment of the present invention, as shown in fig. 9, one end (proximal end) of the blade 3 is provided with an opening, that is, the blade 3 presents a long U-shaped flat structure (of course, other structures may also be adopted), and when the strip-shaped protrusion 242 is matched with the blade 3, the strip-shaped protrusion 242 passes through the open end of the blade 3 and two sides thereof respectively abut against two side wall portions of the executing device, so that the strip-shaped protrusion 242 is disposed in a hollow area of the blade 3, that is, the blade 3 is a U-shaped blade, and the strip-shaped protrusion 242 is clamped between two side walls of the blade 3, so as to further strengthen the guiding of the U-shaped blade and prevent the deformation of the blade 3.
In one embodiment, the inner sleeve 21, the guide support 24 and the clamp head 25 may be integrally formed or assembled as a single unit.
Fig. 10 to 11 are schematic views of a proximal end structure of a blade detachably connected to a push rod 22 according to an embodiment of the present invention, please refer to fig. 9 to 11 together, wherein a first connecting mechanism (a fastening structure 31) is disposed at an opening end (proximal end) of the blade 3, wherein the first connecting mechanism (the fastening structure 31) is a fastening mechanism with an inner wall recessed radially outwards, and the fastening structure 31 includes a blade fastening portion 32 and a blade pushed surface 33 (refer to fig. 10 and 11). The fastening structure 31 for detachably connecting with the push rod 22 includes a fastening mechanism with a concave middle (refer to fig. 10 and 11).
Referring to fig. 6, 13, 15, and 21-41, in an embodiment of the present invention, a latch mechanism 220 corresponding to the latch structure 31 is disposed at a distal end of the pushing bar 22, so as to be capable of being connected to, clamped to, or detached from, the latch structure 31 at a proximal end of the blade 3. Referring to fig. 42 to 44, in an embodiment of the present invention, a push rod clamping portion 223 and a push rod surface 224 (refer to fig. 43 and 44) are provided on the clamping mechanism 220, and the clamping mechanism 220 can clamp the clamping structure 31 of the blade 3.
In the first position interval of the inner sleeve 21 (corresponding to the second state, which may include a state where the push rod 22 is not in contact with the blade 3, and a state where the push rod 22 is mounted on the blade 3 to a state before the separation is started), the latch mechanism 220 can move axially along the inner sleeve 21. In the second position interval (corresponding to the first state described above, which may include a state in which the blade 3 is contacted by the push rod 22 from the beginning to the completion of installation, and a state in which the blade 3 is released from the push rod 22 from the beginning to the completion of separation) of the inner sleeve 21, the latch mechanism 220 can perform axial movement under the restriction of the inner sleeve 21 while performing circumferential rotational movement (which may also be referred to as helical movement) to clamp or disengage with the latch structure 31, thereby achieving installation or removal of the blade 3. In a preferred embodiment, the fastening structure 31 includes two L-shaped connection mechanisms, and the distal end of the push rod 22 is provided with an inverted L-shaped connection mechanism corresponding to the L-shaped connection mechanism, and the state of the fastening structure 31 when fastened to the push rod 22 can be shown in fig. 38.
Referring to fig. 12, in an embodiment, the cutter body 2 further includes a reset mechanism 23, where the reset mechanism 23 is disposed in the inner sleeve 21, and the reset mechanism 23 cooperates with the push rod 22 to enable the push rod 22 to actively reset after the cutting is completed, preferably, the reset mechanism 23 is a reset spring, specifically, in an operating state in which the push rod 22 is pushed to move distally after the installation of the detachable medical apparatus is completed, the reset mechanism 23 is in a stretched state to provide a reset force for moving the push rod 22 proximally, and in a state in which the push rod 22 is at the most distal after the cutting is completed, the reset force applied to the push rod 22 is the largest, and when no external force is applied to the push rod 22, that is, the push rod 22 moves proximally under the reset force generated by the reset mechanism 23 in the state in which the push rod 22 is not subjected to the external force, so as to restore to the initial position when the push rod is discharged.
Further, referring to fig. 13 to 44, in an embodiment of the present invention, a first guiding portion for guiding the pushing rod 22 to move axially and simultaneously rotate is provided in the inner sleeve 21, a third guiding portion corresponding to the first guiding portion is provided on the pushing rod 22, and the pushing rod 22 can move circumferentially and simultaneously move axially in the inner sleeve under the cooperation of the first guiding portion and the third guiding portion. In detail, the first guiding portion may be a first protrusion 212 provided on the inner wall of the inner sleeve, and preferably, the first protrusion 212 may be a cylindrical protrusion (as shown in fig. 26-27), although other structures may be adopted, and correspondingly, the third guiding portion may be a first groove 222 (as shown in fig. 22) provided on the outer wall of the cutter bar 22 and extending along an axial curve, and preferably, the first groove 222 may be a spiral groove, although other structures are also possible.
The push rod 22 is capable of circumferential rotational movement while axially moving within the inner sleeve 21 under the mating guidance of the first protrusion 212 and the first groove 222. In another embodiment of the present invention, the first guiding portion is a first groove 222 formed on the inner wall of the inner sleeve 21 and extending along an axial curve, and the third guiding portion is a first protrusion 212 formed on the outer wall of the push rod, and the working principle is the same as that described above.
Fig. 45 to 47 are schematic structural views of an inner sleeve according to an embodiment of the present invention, please refer to fig. 45 to 47, and refer to fig. 15 to 41, in which in an embodiment of the present invention, a second guiding portion is provided in the inner sleeve 21, wherein the second guiding portion may be a second protrusion 211 disposed on the inner sleeve along an axial direction, the second protrusion 211 may be a linear protrusion, or of course, other structures, a fourth guiding portion (may be a second groove 221 disposed on the push rod and corresponding to the second protrusion 211, the second groove 221 may be a linear groove, or of course, other structures) corresponding to the second guiding portion is provided on the push rod, and the push rod 22 moves axially in the inner sleeve 21 under the cooperation of the second protrusion 211 and the second groove 221. As shown in fig. 41, the second protrusion 211 is an extending portion that is disposed in parallel along the axial direction, and the outer wall of the axial side portion of the extending portion abuts against two side wall portions of the second groove 221, further, linear guide strips may be further disposed on two side wall portions of the extending portion, which are in contact with the second groove 221, so as to further limit the rotation of the push rod 22, which is not limited in particular, and in other embodiments, the second protrusion 211 may also be a strip-shaped protrusion disposed along the axial direction.
In an embodiment, the first groove 222 and the second groove 221 may be disposed at the distal end of the push rod 22 together with the catch mechanism 220, and the catch mechanism 220 is located near the most distal end of the push rod 22.
Referring to fig. 26 again, in an embodiment, in the first state (the state that the first protrusion 212 is located in the first groove 222 and the state that the second protrusion 211 is separated from the second groove 221) of the latch mechanism 220, when the push rod 22 is subjected to a set force (such as a force towards the distal side or the proximal side), due to the restriction and guidance of the first groove 222 to the first protrusion 212, the latch mechanism 220 can move spirally towards the distal side or the proximal side due to the relative sliding between the first groove 222 and the first protrusion 212 (as shown in fig. 27 and 28). In the second state (state in which the first protrusion 212 is separated from the first groove 222 while being located in the second groove 221), the push rod 22 (the click mechanism 220) moves in the axial direction (as shown in fig. 31) on the push rod 22 due to restriction and guidance of the second protrusion 211 by the second groove 221 when the push rod 22 receives a set force.
In an embodiment of the invention, the detachable medical apparatus further includes a first critical point and a second critical point. In this process, the detachable medical device switches between the first state and the second state by switching the different state critical points, that is, switches between the axial movement and the spiral movement (or any other form of "axial movement and circumferential rotation movement").
Specifically, at the first critical point, the first protrusion 212 is located at the furthest port of the first slot 222 (i.e., the distal end side of the first slot 222), while the second protrusion 211 is located at the closest port of the second slot 221 (as shown in fig. 26, 40), and the push rod 22 in this state includes a state ending with the second state and being in the first state beginning, and also includes a state ending with the first state and being in the second state beginning.
At the second critical point, the first protrusion 212 is located at the innermost end of the first groove 222 (i.e., the proximal end of the first groove 222), and the pusher bar 22 is moved by the spiral motion to pass through the first state to the state at the end of the first state (see fig. 27 and 34), and the second protrusion 211 is separated from the second groove 221. Further, when the proximal end of the blade 3 is fully mounted with the distal end of the push rod 22, the push rod 22 cannot continue further distally relative to the blade 3 due to the restriction of the first protrusion 212 by the innermost end of the second slot 222. When the blade 3 is mounted, the push rod 22 is pushed axially to the most distal end of the inner sleeve 21, and the push rod 22 is rotated by a certain angle relative to the inner sleeve 21, at which time the push rod 22 is at a first critical point, while the blade 3 is pushed axially from the distal end toward the inner sleeve 21 to gradually approach the push rod 22, and when the blade 3 comes into contact with the push rod 22 until the blade pushed surface 33 comes into contact with the push surface 224, the push rod 22 is at a second critical point (the first protrusion 212 is located at the most inner end of the first groove 222), and the push rod 22 is pushed axially toward the blade 3. In this process, the push rod 22 enters the first state from the first critical point, the push rod 22 (the most distal end of the push rod 22) performs a spiral motion relative to the blade 3 (the most proximal end of the blade 3), at this time, the fastening structure 31 of the blade 3 starts to be locked by the fastening mechanism 220 gradually, that is, in this process, the push rod 22 performs a spiral motion, the blade 3 moves axially, and at the same time, a circumferential displacement is generated between the fastening structure 31 and the fastening mechanism 220, at this time, the push rod fastening portion 223 and the blade fastening portion 32 start to be contacted with each other gradually, so as to complete the installation of the blade 3, and it can be understood that the contact surface of the fastening structure 31 and the fastening mechanism 220 gradually may be an inclined surface for smoothly achieving the relative motion, which is not limited in particular.
When the blade 3 is detached, the push rod 22 returns to the initial state of the blade by axially moving the push rod back (axially moving proximally) and is at a second critical point, and because the push rod clamping part 223 is in contact with the blade clamping part 32, when the push rod 22 is pushed by the proximally force, the push rod clamping part 223 applies the proximally pushing force to the blade clamping part 32, so that the push rod 22 starts to enter a first state from the second critical point, at this time, the medical apparatus is in a state of starting to detach the blade 3 (the push rod clamping part 223 starts to be separated from the blade clamping part 32), in the first state, the push rod 22 performs spiral movement under the guiding cooperation of the first protrusion 212 and the first groove 222, correspondingly, the push rod clamping part 223 of the push rod 22 gradually separates from the blade clamping part 32 due to the spiral movement of the push rod 22, and when the push rod 22 is at the first critical point, the separation of the blade clamping part 32 of the blade 3 from the push rod clamping part 223 of the push rod 22 is completed (at least circumferentially separated), and the blade 3 is completely removed (completely removed along the axial direction opposite to the axial direction) to the blade 3, so that the blade 3 is detached and removed.
Specifically, in the first state, the portion where the blade engagement portion 32 and the push rod engagement portion 223 are mounted and separated is outside the inner sleeve 21, and therefore the inner sleeve 21 does not affect the mounting and removal of the blade 3.
In one embodiment of the present invention, the removable medical device of the present invention is in the blade-out condition wherein the pusher bar 22 is brought back into the second condition (the pusher bar 22 moves axially) at the end of the first condition, at which time, because the blade 3 is mounted to the pusher bar 22, the pusher face 224 pushes the blade to be pushed by the pusher face 33 in an axial movement in a direction toward or away from the binding clip (as shown in fig. 14-16), i.e., the blade 3 moves axially in a distal direction with the pusher bar 22. In this state, the blade engaging portion 32 cooperates with the push rod engaging portion 223, so that the blade 3 cannot be separated from the push rod 22 (as shown in fig. 17 and 18), and the second protrusion 211 located in the second groove 221 on the inner sleeve 21 limits the rotation of the push rod 22 (as shown in fig. 19). The blade 3 is restrained from rotation by the guide support 24 (as shown in figure 20).
In the condition that the detachable medical apparatus is in the retracting state by the reset mechanism 23, the push rod 22 is in the second state (the push rod 22 moves axially), and at this time, the push rod clamping part 223 clamps the blade clamping part 32 to drive the blade 3 to move axially in the inner sleeve 21 in the direction away from the forceps head 25 (as shown in fig. 20 and 21) until the blade returns to the initial state when the blade is retracted. In this state, the blade engaging portion 32 cooperates with the push rod engaging portion 223, the blade 3 cannot be separated from the push rod 22 (as shown in fig. 22), the second protrusion 211 on the inner sleeve 21 is located in the linear groove 221, and the rotation of the push rod 22 is restricted (as shown in fig. 23 and 24), and the blade 3 is restricted from rotating by the guide support 24.
Under one use scenario of the invention, the process of the detachable medical instrument mounting blade of the invention is as follows:
(1) The distal end of the push rod 22 is pushed into the inner sleeve 21 from the proximal side of the inner sleeve 21, and the distal end of the push rod 22 is pushed axially to the most distal end of the inner sleeve 21 so as to protrude from the distal end port of the inner sleeve 21, so that the push rod 22 enters the first state from the second state to be at the first critical point.
(2) The jaws 25 are opened, and the blade 3 is axially inserted into the inner sleeve 21 from the jaws 25 through the strip-shaped protrusions 242 of the guide support 24 and gradually approaches the distal end of the push rod 22.
In this process, when the push rod 22 starts to push into the inner sleeve 21, the push rod 22 is in the second state (the push rod 22 moves axially), and after entering the first critical point, the push rod 22 moves spirally in the axial direction, and finally enters the second critical point. In this state, the push rod 22 is rotated by a certain angle along the axial center axis, so that the fastening mechanism 220 rotates circumferentially to realize that the push rod fastening portion 223 completely avoids the movement space of the blade 3 (as shown in fig. 29), thereby further realizing the installation of the blade fastening portion 32 with the blade 3.
(3) The pushing source of the push rod is slowly removed to continuously push the blade 3 into the inner sleeve 21, when the pushed surface 33 of the blade meets the pushing surface 224 of the push rod 22, the pushed surface 33 of the blade applies force to the pushing surface 224, so that the push rod 22 starts to move proximally by the pushing force applied by the blade 3, at the moment, the push rod 22 enters a first state to perform spiral motion, and the blade clamping part 32 of the blade 3 starts to gradually clamp and lock with the push rod clamping part 223, in the process, due to the spiral motion of the push rod 22, the axial motion of the blade 3 can generate circumferential displacement between the clamping structure 31 and the clamping structure 220 and simultaneously generate axial displacement.
More specifically, the first protrusion 212 of the inner sleeve 21 allows the push rod 22 to perform a circumferential rotational movement while axially moving under the guide of the first groove 222 (shown in fig. 38) on the push rod 22, while the blade 3 cannot rotate under the restriction of the limit support portion (linear groove 241) of the guide support 24.
(4) When the first state of the push rod 22 is completed and the second critical point is reached, the blade 3 is locked by the locking mechanism 220, that is, the push rod locking portion 223 and the blade locking portion 32 are locked to each other (as shown in fig. 28).
(5) In the working state (knife-out/knife-back state), the jaw is closed, the push knife bar 22 is in the second state under the action of the second groove 221 and the second protrusion 211, at this time, the push knife bar 22 can only move axially, and the push rod clamping part 223 and the knife blade clamping part 32 realize clamping and locking to drive the knife blade 3 to move axially together.
During this process, the first protrusion 212 of the inner sleeve 21 moves proximally along the distal outlet of the first slot 222 of the push rod 22 to eventually effect the clamping of the blade by the push surface 33 and push surface 224 (as shown in fig. 40), while the second protrusion 211 of the inner sleeve 21 disengages from the second slot 221 of the push rod 22 (as shown in fig. 26).
Under the use scene of the invention, the process of detaching the blade of the detachable medical instrument is as follows:
(1) Opening the jaw and pushing the push rod 22, wherein the push rod 22 is in the second state, and the push rod 22 can only make a single axial movement, see fig. 13 and 14.
In this process, since the push rod engaging portion 223 is in contact with the blade engaging portion 32, the push rod engaging portion 223 applies a pushing force to the blade engaging portion 32 in the proximal direction, and the blade 3 moves in the proximal direction following the push rod 22. In the second state, the second groove 221 of the pusher bar 22 is engaged with the second protrusion 211 of the inner sleeve 21, and the blade 3 is restrained in the setting groove by the guide support 24, so that the blade 3 and the pusher bar 22 can move only in the axial direction.
(2) Continuing to push the pusher bar 22, at this point, the blade 3 starts to be removed, and the pusher bar engaging portion 223 starts to be separated from the blade engaging portion 32 to enter the second critical point.
In this process, the second groove 221 of the push rod 22 is disengaged from the second protrusion 211 of the inner sleeve 21, and at the same time, the first protrusion 212 of the inner sleeve 21 meets the first groove 222 of the push rod 22 (as shown in fig. 26 and 27).
(3) After passing the second critical point, the push rod 22 enters the first state, the push rod 22 moves spirally distally until the push rod clamping portion 223 is separated from the blade clamping portion 32 (at least circumferential separation is achieved), and at this time, the push rod 22 is at the first critical point (the first protrusion 212 is separated from the first groove 222 on the push rod 22), and the blade 3 is removed by moving the blade 3 axially.
In this process, when the push rod 22 is at the second critical point, the separation of the blade 3 from the catch mechanism 220 is completed, and the smooth removal of the blade 3 can be achieved because a part of the blade 3 is outside the inner sleeve 21. Further, at this time, the pushing rod 22 is further limited to move distally in the axial direction, that is, the pushing rod 22 cannot move distally any more, so as to prevent the blade 3 from interfering with the catch mechanism 220 to affect the smooth detachment of the blade 3.
In one use scenario of the invention, the detachable medical device of the invention may be a high frequency electrosurgical device, which is used in the same manner as existing high frequency electrosurgical devices during surgery. When the scalpel is required to be used, the blade is mounted into the blade as described above. The medical staff can adjust the position of the blade through the handle in the operation process, if the medical staff can hold the handle in the operation process, the blade stretches out to perform the operation, and after the instrument is used, the handle can be loosened, and the blade contracts. After the operation is finished, the blade is only required to be taken out according to the operation of detaching the blade, and other parts of the high-frequency electrosurgical instrument can be reused after being cleaned and sterilized.
In summary, the detachable medical instrument provided by the invention can improve the recycling rate of parts of the instrument due to the fact that the parts can be fully detached, and the blade can be detachably mounted with the push rod (push rod) through relative movement relative to the push rod, so that the replacement process of the parts to be replaced is simple and convenient, and the operation is easy. Most parts of the device can be reused, and parts except for executing parts such as blades and the like can be cleaned and sterilized for reuse after the device is disassembled.
The technical features of the above-described embodiments may be arbitrarily combined, and all possible combinations of the technical features in the above-described embodiments are not described for brevity of description, however, as long as there is no contradiction between the combinations of the technical features, they should be considered as the scope of the description.
The description and applications of the present invention herein are illustrative and are not intended to limit the scope of the invention to the embodiments described above. Variations and modifications of the embodiments disclosed herein are possible, and alternatives and equivalents of the various components of the embodiments are known to those of ordinary skill in the art. It will be clear to those skilled in the art that the present invention may be embodied in other forms, structures, arrangements, proportions, and with other assemblies, materials, and components, without departing from the spirit or essential characteristics thereof. Other variations and modifications of the embodiments disclosed herein may be made without departing from the scope and spirit of the invention.
Claims (5)
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011092123.4A CN114343824B (en) | 2020-10-13 | 2020-10-13 | Removable medical devices |
| PCT/CN2021/119359 WO2022078160A1 (en) | 2020-10-13 | 2021-09-18 | Detachable medical device |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011092123.4A CN114343824B (en) | 2020-10-13 | 2020-10-13 | Removable medical devices |
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| CN114343824A CN114343824A (en) | 2022-04-15 |
| CN114343824B true CN114343824B (en) | 2024-12-10 |
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| WO (1) | WO2022078160A1 (en) |
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| CN116370020B (en) * | 2023-06-07 | 2023-08-25 | 杭州锐健马斯汀医疗器材有限公司 | Planing tool and planing system |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN214342580U (en) * | 2020-10-13 | 2021-10-08 | 上海逸思医疗科技股份有限公司 | Detachable medical instrument |
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| US5827279A (en) * | 1996-12-06 | 1998-10-27 | Ethicon Endo-Surgery, Inc. | Knife coupler mechanism for an endoscopic instrument |
| US7150749B2 (en) * | 2003-06-13 | 2006-12-19 | Sherwood Services Ag | Vessel sealer and divider having elongated knife stroke and safety cutting mechanism |
| US8133254B2 (en) * | 2009-09-18 | 2012-03-13 | Tyco Healthcare Group Lp | In vivo attachable and detachable end effector assembly and laparoscopic surgical instrument and methods therefor |
| US8756819B2 (en) * | 2010-04-12 | 2014-06-24 | Bettcher Industries, Inc. | Power operated rotary knife with disposable blade support assembly |
| US9924941B2 (en) * | 2011-10-26 | 2018-03-27 | Intuitive Surgical Operations, Inc. | Surgical instrument with integral knife blade |
| CN104783868B (en) * | 2014-01-20 | 2018-08-10 | 北京安和加利尔科技有限公司 | A kind of ultrasonic surgical blade knife bar with interchangeable cutter head |
| CN204293233U (en) * | 2014-12-09 | 2015-04-29 | 韩新文 | A kind of neurosurgery scalpel |
| US9949786B2 (en) * | 2015-01-16 | 2018-04-24 | Ethicon Llc | Surgical devices having removable blade and jaws |
| WO2016197348A1 (en) * | 2015-06-10 | 2016-12-15 | 深圳迈瑞生物医疗电子股份有限公司 | Ultrasonic surgery device and end effector |
| CN105012010A (en) * | 2015-07-02 | 2015-11-04 | 吉林大学 | Electric shears for laparoscopy |
| CN107280735B (en) * | 2017-07-21 | 2020-08-04 | 上海逸思医疗科技有限公司 | Repeatedly-usable ultrasonic surgical instrument |
| CN211066895U (en) * | 2017-12-25 | 2020-07-24 | 上海逸思医疗科技有限公司 | Ultrasonic surgical instrument with detachable sleeve assembly |
| CN108354652A (en) * | 2018-02-08 | 2018-08-03 | 南昌元合泽众科技有限公司 | A kind of reusable ultrasonic surgical blade |
| CN109009264A (en) * | 2018-08-24 | 2018-12-18 | 微创（上海）医疗机器人有限公司 | Snakelike surgical instrument |
| CN109077798B (en) * | 2018-09-07 | 2023-12-29 | 武汉半边天医疗技术发展有限公司 | Radio frequency ultrasonic knife with replaceable knife tube |
| CN109674527B (en) * | 2018-12-25 | 2024-04-12 | 上海逸思医疗科技股份有限公司 | Detachable surgical instrument |
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2020
- 2020-10-13 CN CN202011092123.4A patent/CN114343824B/en active Active
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- 2021-09-18 WO PCT/CN2021/119359 patent/WO2022078160A1/en active Application Filing
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|---|---|---|---|---|
| CN214342580U (en) * | 2020-10-13 | 2021-10-08 | 上海逸思医疗科技股份有限公司 | Detachable medical instrument |
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