CN115844478A - Magnetic anastomat for treating rectal stenosis under single transanal passage - Google Patents

Abstract

The invention discloses a magnetic stapling device for treating rectal stenosis through an anal single channel, which comprises a first magnetic anastomotic ring, an auxiliary operation device and a second magnetic anastomotic ring; the first magnetic anastomotic ring includes The first semicircular magnetic ring and the second semicircular magnetic ring, the first joint end of the first semicircular magnetic ring and the second joint end of the second semicircular magnetic ring are configured to be rotatable along the circumferential direction Connection; the auxiliary operation device includes a first pull wire and a second pull wire, the two ends of the two pull wires are configured to be respectively connected to the two control ends, and the two tail ends are configured to make the two semicircular magnetic rings The control ends are connected, that is, the first magnetic anastomosis ring is controlled to change from S-shape to O-shape; Face-to-face suction to squeeze the narrow rectum. The invention solves the problems of difficult insertion and excessive trauma when surgical instruments are used to treat anastomotic stenosis.

Description

A magnetic stapler for the treatment of rectal stenosis through anal single access

technical field

The invention belongs to the technical field of clinical medical instruments, relates to a surgical stapler, in particular to a magnetic stapler for treating rectal stenosis through an anal single channel.

Background technique

With the continuous maturity of low and ultra-low rectal cancer resection techniques, the survival period of patients with low rectal cancer has been prolonged, and the anus preservation rate has continued to increase. However, with the increase in the anus preservation rate, the occurrence of anastomosis stenosis (AS) rate also increased.

At present, the clinical treatment of AS after rectal cancer surgery can use mechanical expansion therapy, endoscopic balloon dilatation, endoscopic intestinal stenting, and endoscopic anastomotic radial incision after the exclusion of tumor recurrence factors. For severe anastomotic strictures, mechanical dilation and endoscopic treatment have limited effects, and some patients require proximal colostomy or ileostomy. The above-mentioned treatment methods have their own advantages and disadvantages. Most patients with mild AS can obtain good therapeutic effect, while patients with severe AS often face huge surgical trauma and limited clinical benefits. Therefore, it is necessary to explore minimally invasive, Effective treatment methods are of great significance in clinical practice.

Contents of the invention

In order to overcome the above-mentioned shortcomings of the prior art, the object of the present invention is to provide a magnetic stapler for the treatment of rectal stenosis through the anal single channel, in order to solve the problem of difficult insertion and excessive trauma when surgical instruments are used to treat anastomotic stenosis The problem.

In order to achieve the above object, the technical scheme adopted in the present invention is:

A magnetic stapler for treating rectal stenosis through an anal single access, comprising a first magnetic anastomotic ring, an auxiliary operating device and a second magnetic anastomotic ring;

The first magnetic anastomosis ring includes a first semicircular magnetic ring and a second semicircular magnetic ring that are identical in shape and size, one end of the first semicircular magnetic ring is the first control end, and the other end is the first control end. The first joint end; one end of the second semicircular magnetic ring is the second control end, and the other end is the second joint end; the first joint end and the second joint end are arranged in a circumferential direction rotatable connection;

The auxiliary operation device includes a first pulling line and a second pulling line, the two ends of the first pulling line are respectively the first head end and the first tail end, and the two ends of the second pulling line are respectively the second a head end and a second tail end;

The first head end is configured to be connectable to the first control end, the second head end is configured to be connectable to the second control end, the first tail end and the second tail end The ends are configured to connect the first control end to the second control end by pulling, that is, to control the change of the first magnetic anastomotic ring from S-shape to O-shape;

The second magnetic anastomotic ring is configured to attract at the end face of the first magnetic anastomotic ring that changes into an O-shape at the distal end of the rectum to squeeze the rectal narrow section.

In one embodiment, the first joint end is connected to the second joint end through a short rotation shaft, one end of the short rotation shaft is connected to the first joint end or the second joint end, and the other end is embedded in In the circumferential short groove of the second joint end or the first joint end; the first tail end pulls the first control end, or the second tail end pulls the second control end, so that the The first semicircular magnetic ring or the second semicircular magnetic ring rotates along the short axis of rotation. During the rotation, the plane where the first semicircular magnetic ring is located and the second semicircular magnetic ring The range of the included angle of the plane is 0°-180°.

In one embodiment, the N-S polarity of the first control terminal is opposite to that of the second control terminal, and the N-S polarity of the first joint terminal is opposite to that of the second joint terminal; The second joint end is attracted to realize the rotatable connection; the first tail end and the second tail end are configured to make the first control end and the second control end attract each other by pulling .

In one embodiment, the first semicircular magnetic ring and the second semicircular magnetic ring are made of NdFeB permanent magnet material, ferrite material, samarium cobalt material or neodymium cobalt nickel, and the edges are chamfered , Axial magnetization; the first semicircular magnetic ring and the second semicircular magnetic ring adopt titanium nitride coating, nickel coating, epoxy resin coating or parylene coating for surface protection.

In one embodiment, the first control end is provided with a first threading hole, the second control end is provided with a second threading hole, and both the first threading hole and the second threading hole are along the side of the outer ring The opening on the side of the inner ring; the first head end passes through the first threading hole to realize connection; the second head end passes through the second threading hole to realize connection.

In one embodiment, both the first threading hole and the second threading hole are radial holes.

In one embodiment, the first head end is provided with an enlarged end head whose size is larger than the first threading hole, and the second head end is provided with an enlarged end head whose size is larger than the second threading hole, and the The enlarged end is stuck on the side of the inner ring, and the first tail end and the second tail end are led out from the side of the outer ring respectively.

In one embodiment, the first pulling wire and the second pulling wire are wires or nylon wires or threads made of other polymer materials.

In one embodiment, the auxiliary operation device further includes a control tube, and the control tube is provided with a first control hole and a second control hole in the axial direction, and the first control hole is used for the first traction The wire passes through, and the second control hole is used for the second pulling wire to pass through.

In one embodiment, the outer diameter of the first semicircular magnetic ring is 10-40mm, and the inner diameter is 5-35mm; the length of the control tube is 5cm-50cm.

Compared with the prior art, the present invention connects two semicircular magnetic rings by rotating at one end and unfolding the other end in an "S" shape with a smaller cross-sectional area, so that it can pass through the rectum in a serpentine motion The narrow section enters the proximal end of the rectum; then it is controlled by a traction wire to close it into an "O" shape. Finally, another magnetic anastomosis ring is placed at the distal end of the rectum, and the two attract each other to squeeze the stenotic segment of the rectum to achieve anastomosis.

The invention effectively solves the problem that the conventional magnetic ring cannot pass through the narrow section by making the first magnetic anastomotic ring change from "S" shape to "O" shape and serpentine movement, so when designing the outer diameter of the magnetic anastomotic ring, it can be Ignore the problem of insertion operation, and make the outer diameter of the magnetic anastomosis ring as close as possible to the inner diameter of the rectum to create conditions for "eradicating" the anastomotic scar as much as possible and achieve long-term patency of the anastomosis.

Description of drawings

Fig. 1 is a structural schematic diagram of the first semicircular magnetic ring of the present invention.

Fig. 2 is a schematic structural diagram of the second semicircular magnetic ring of the present invention.

Fig. 3 is a schematic structural view of the first pulling wire of the present invention.

Fig. 4 is a schematic structural view of the second pulling wire of the present invention.

Fig. 5 is a schematic structural diagram of the control tube of the present invention.

Fig. 6 is a schematic view of the "S" shape of the first magnetic anastomosis ring of the present invention before being placed in the rectum.

Fig. 7 is a schematic diagram of the state of the first magnetic anastomotic ring of the present invention before being deformed into an "O" shape.

Fig. 8 is a schematic diagram of the deformation of the first magnetic anastomotic ring into an "O" shape according to the present invention.

Fig. 9 is a schematic diagram of the first magnetic anastomosis ring of the present invention being placed in the distal end of the rectum in an "S" shape.

Fig. 10 is a schematic diagram of the first magnetic anastomotic ring of the present invention passing through the rectal stenosis in an "S" shape.

Fig. 11 is a schematic diagram of the first magnetic anastomotic ring entering the proximal rectum in an "S" shape according to the present invention.

Fig. 12 is a schematic diagram of the process of the first magnetic anastomotic ring changing from "S" to "O" shape at the proximal end of the rectum according to the present invention.

Fig. 13 is a schematic diagram of the first magnetic anastomotic ring changing to an "O" shape at the proximal end of the rectum according to the present invention.

Fig. 14 is a schematic diagram of the first magnetic anastomotic ring of the present invention after the proximal end of the rectum becomes "O" and the auxiliary operation device is removed.

Fig. 15 is a schematic diagram of the second magnetic anastomosis ring of the present invention placed in the distal rectum.

Fig. 16 is a schematic diagram of the attraction between the first magnetic anastomotic ring at the proximal end of the rectum and the second magnetic anastomotic ring at the distal end of the rectum according to the present invention.

Fig. 17 is a schematic diagram of discharging the magnetic anastomosis ring after the press anastomosis is completed in the present invention.

Fig. 18 is a schematic diagram of the state change process of the magnetic stapler in the experimental verification of the present invention.

Detailed ways

In order to make the purpose, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments It is a part of embodiments of the present invention, but not all embodiments. The components of the embodiments of the invention generally described and illustrated in the figures herein may be arranged and designed in a variety of different configurations.

Accordingly, the following detailed description of the embodiments of the invention provided in the accompanying drawings is not intended to limit the scope of the claimed invention, but merely represents selected embodiments of the invention. Based on the embodiments of the present invention, all other embodiments obtained by persons of ordinary skill in the art without creative efforts fall within the protection scope of the present invention.

It should be noted that like numerals and letters denote similar items in the following figures, therefore, once an item is defined in one figure, it does not require further definition and explanation in subsequent figures.

In the description of the present invention, it should be noted that if the orientation or positional relationship indicated by the terms "upper", "lower", "inner" and "outer" appear, it is based on the orientation or positional relationship shown in the drawings, or It is the orientation or positional relationship that the invention product is usually placed in use, and it is only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the referred device or element must have a specific orientation, be constructed and operated in a specific orientation , and therefore cannot be construed as a limitation of the present invention.

In addition, terms such as "first" and "second" are used only for distinguishing descriptions, and should not be understood as indicating or implying relative importance.

It should be noted that, in the case of no conflict, the features in the embodiments of the present invention may be combined with each other.

As mentioned above, due to the size limitation of the rectal stenosis, the outer diameter of the existing magnetic anastomosis ring is limited in its structural design, and it is obviously difficult for a small-sized magnetic anastomosis ring to achieve effective compression anastomosis. Based on this, the present invention provides a magnetic stapler for treating rectal stenosis through anal single access.

As shown in FIGS. 1 to 17 , the present invention mainly includes a first magnetic anastomotic ring, an auxiliary operation device and a second magnetic anastomotic ring 8 .

Wherein, with reference to Fig. 1 and Fig. 2, the first magnetic anastomosis ring comprises the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2, or only consists of the first semicircular magnetic ring 1 and the second semicircular magnetic ring The magnetic ring is composed of 2. The shapes and dimensions of the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 are exactly the same.

Referring to FIG. 1 , one end of the first semicircular magnetic ring 1 is a first control end 12 , and the other end is a first joint end 13 . Referring to FIG. 2 , one end of the second semicircular magnetic ring 2 is the second control end 22 , and the other end is the second joint end 23 . Both ends of the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 are preferably smooth surfaces, so as to facilitate connection and rotation at the ends. In the present invention, the first joint end 13 and the second joint end 23 are configured to be rotatably connected along the circumferential direction, that is, the connection method between the first joint end 13 and the second joint end 23 can realize the first semicircular magnetic The relative rotation between the ring 1 and the second semicircular magnetic ring 2, when the angle between the two planes is 0°, the whole of the first magnetic anastomosis ring is S-shaped, and when the angle between the two planes is When the angle is 180°, that is, when the first control end 12 and the second control end 22 meet or touch, the whole first magnetic anastomotic ring is in an O-shape.

Referring to FIGS. 3 and 4 , the auxiliary operation device includes a first pulling wire 14 and a second pulling wire 24 . Two ends of the first pulling wire 14 are respectively a first head end 141 and a first tail end 142 , as shown in FIG. 3 . Two ends of the second pulling wire 24 are respectively a second head end 241 and a second tail end 242 , as shown in FIG. 4 .

Referring to FIG. 6 , the first head end 141 of the present invention is configured to be able to connect to the first control end 12 , and the second head end 241 is configured to be able to be connected to the second control end 22 . The relative rotation between the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 can be driven by pulling the first tail end 142 or the second tail end 242, so that the angle between the two planes is Change, when the included angle is 180°, the first control end 12 and the second control end 22 can meet or touch. Thus, the change of the first magnetic anastomotic ring from S-shape to O-shape can be controlled. The process of change is shown in Figure 7, and the result is shown in Figure 8.

When in use, the function of changing to an S shape is to facilitate sending the first magnetic anastomotic ring into the proximal rectum 4 through the rectal stenosis section 5 , and the whole of the first magnetic anastomotic ring is located at the proximal rectum 4 after changing to an O shape. The second magnetic anastomotic ring 8 is configured to attract the first magnetic anastomotic ring in an O-shape at the distal end of the rectum 6 and the proximal end of the rectum 4 to squeeze the rectal narrow section 5 .

In the embodiment of the present invention, according to the above structure, the present invention provides the first specific rotation realization structure, that is, the first joint end 13 and the second joint end 23 are connected by a short axis of rotation, and the short axis of rotation can be Tangentially or circumferentially, it should obviously be shorter in order to facilitate rotation. One end of the short axis of rotation is connected to the first joint end 13 or the second joint end 23 , and the other end is embedded in a tangential or circumferential short groove of the second joint end 23 or the first joint end 13 . During use, the first control end 12 is pulled by the first tail end 142, or the second control end 22 is pulled by the second tail end 242, so that the first semicircular magnetic ring 1 or the second semicircular magnetic ring 2 Rotate along the short axis of rotation, the angle between the plane where the first semicircular magnetic ring 1 is located and the plane where the second semicircular magnetic ring 2 is located can be changed within the range of 0° to 180°, that is, the S-shaped orientation to O shape change.

In this embodiment, the method of mechanical rotation is adopted. Obviously, its advantage is that it is easy to handle, and the two semicircular magnetic rings, that is, the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 are always integrated. , will not separate. At the same time, the requirements for the magnetic force between the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 are not high, but its disadvantage is that the processing is relatively complicated, and this embodiment is only a rotational realization of the present invention. .

For this reason, in another embodiment of the present invention, the present invention provides a second specific structure for realizing rotation. The first articulation end 13 and the second articulation end 23 are no longer mechanically connected, but are directly connected by magnetic force. Attract each other. Specifically, the N-S polarity of the first control end 12 is opposite to that of the second control end 22, which can automatically align and attract, and the N-S polarity of the first joint end 13 and the second joint end 23 are opposite, and can automatically align and attract. The first joint end 13 is attracted to the second joint end 23 to realize the rotatable connection described in the present invention. During use, the first control end 12 is pulled by the first tail end 142, or the second control end 22 is pulled by the second tail end 242, so that the first semicircular magnetic ring 1 or the second semicircular magnetic ring 2, and finally realize the suction between the first control end 12 and the second control end 22. Therefore, this structure can also realize that the angle between the plane where the first semicircular magnetic ring 1 is located and the plane where the second semicircular magnetic ring 2 is located can be changed within the range of 0° to 180°, that is, the transformation from S-shape to O-shape can be completed. Variety.

In this embodiment, a pure magnetic force action mode is adopted, and no complicated machining is required. By properly adjusting the magnetic force, two semicircular magnetic rings, that is, the first semicircular magnetic ring 1 and the second semicircular magnetic ring 1, can also be ensured. The intensity that shape magnetic ring 2 combines, the present invention is preferably structure with this structure.

In an embodiment of the present invention, both the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 can be made of permanent magnetic materials such as NdFeB permanent magnet materials, ferrite materials, samarium cobalt materials or neodymium cobalt nickel. Machined, axially magnetized, and edge chamfered. At the same time, the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 can adopt titanium nitride coating, nickel coating, epoxy resin coating or parylene coating for surface protection.

In this embodiment, the permanent magnetic material is used to process the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2, which can ensure that the two always have magnetism, and the axial magnetization can finally match the second magnetic ring 8 attract each other at the end faces of the axial direction. The way of chamfering the edges can keep the surface of the structure smooth, making it easy to insert into the body during use. On the one hand, the surface protection can protect the surface of the magnetic material, and on the other hand, it can also prevent potential damage to the human body. Obviously, in practical applications, those skilled in the art can also use more types of permanent magnet materials or other surface protection schemes.

In an embodiment of the present invention, the shapes of the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 may also be similar to a semicircle, that is, they are not a standard semicircle. At the same time, the consistency of the shape and size of the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 is not critical, as long as the two are attracted or touched at both ends, it is a rough Just ring. For example, the outer radius of the first semicircular magnetic ring 1 may be slightly larger, or the inner radius of the second semicircular magnetic ring 2 may be slightly larger, and so on. However, the axial distance between the two should be the same. Because only in this way can it be ensured that when the two ends attract or touch each other, a complete smooth end surface is formed, so that the axial end surface of the second magnetic anastomosis ring 8 can be completely fitted and attracted to each other for pressing .

Equally, it is easy to understand that in the embodiment of the present invention, the cross-sectional shapes of the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 can be various shapes such as rectangle, trapezoid, and similar racetrack shapes. , the end face should be flat, and the inner and outer ring sides can be sloped, straight or arc-shaped, selected according to factors such as the ease of processing, these choices are conventional choices that can be made by those skilled in the art according to the actual situation.

In the embodiment of the present invention, the connection structure between the first head end 141 and the first control end 12 and the connection structure between the second head end 241 and the second control end 22 are given. Referring to FIG. 6 , the first control end 12 is provided with a first threading hole 11 , and the second control end 22 has a second threading hole 21 . Both the first threading hole 11 and the second threading hole 21 are openings along the side of the outer ring to the side of the inner ring. Preferably, both are radial holes, that is, pointing to the first semicircular magnetic ring 1 or the second half A through hole at the center of the circular magnetic ring 2. The first head end 141 passes through the first threading hole 11 and is fixedly connected; the second head end 241 passes through the second threading hole 21 and is fixedly connected.

In this embodiment, the connection between the traction wire and the semicircular magnetic ring is realized by means of perforation. After the wire is threaded, it can be bound at the control end, and the connection is fast and reliable. Pull out the first tail end 142 and the second tail end 242, then pull the first tail end 142 or the second tail end 242, and then pull the first control end 12 or the second control end 22 to drive the first half The overall rotation of the circular magnetic ring 1 or the second semicircular magnetic ring 2 transforms the first magnetic matching ring from an S-shape to an O-shape.

In the embodiment of the present invention, further, the first head end 141 is provided with an enlarged end, and the second head end 241 is provided with an enlarged end, and the size of the first head end 141 is larger than that of the first end. In the threading hole 11 , the enlarged end of the second head end 241 is larger than the second threading hole 21 . That is, the first threading hole 11 allows the first tail end 142 of the first pulling wire 14 to pass through, but does not allow the first head end 141 of the first pulling wire 14 to pass through. The second threading hole 21 allows the second tail end 242 of the second pulling wire 24 to pass through, but does not allow the second head end 241 of the second pulling wire 24 to pass through. For the first pulling wire 14 , its enlarged end is stuck on the side of the inner ring of the first semicircular magnetic ring 1 , and the first tail end 142 is drawn out from the side of the outer ring of the first semicircular magnetic ring 1 . The enlarged end of the second pulling wire 24 is stuck on the inner ring side of the second semicircular magnetic ring 2 , and the second tail end 242 is drawn out from the outer ring side of the second semicircular magnetic ring 2 .

In this embodiment, a more preferable connection structure between the first head end 141 and the first control end 12 , and a more preferable connection structure between the second head end 241 and the second control end 22 are given. This structure realizes a more convenient connection, and it is more convenient to withdraw the pulling wire, and at the same time, it prevents the pulling wire from passing through the axial end face, which is the preferred structure of the present invention.

In various embodiments of the present invention, the first pulling wire 14 and the second pulling wire 24 are silk wires or nylon wires, which are of moderate length and should have better strength, flexibility and smoothness. At the same time, its diameter obviously cannot be too large, and it can be selected arbitrarily under the premise of being easy to operate and satisfying the strength.

In the embodiment of the present invention, the auxiliary operation device also includes a control tube 3, referring to Fig. 5, the control tube 3 is provided with an axial first control hole 31 and a second control hole 32, that is, the control tube 3 is a belt The hollow tubular object with the first control hole 31 and the second control hole 32 can be made of stainless steel, copper, polymer materials and the like. The first control hole 31 is used for smoothly passing the first tail end 142 of the first pulling wire 14 , and the second control hole 32 is used for smoothly passing the second tail end 242 of the second pulling wire 24 . That is, the first tail end 142 of the first pulling wire 14 can pass through the first threading hole 11 and the first control hole 31 . The second tail end 242 of the second pulling wire 24 can pass through the second threading hole 21 and the second control hole 32 .

In this embodiment, one end of the control tube 3 is used to withstand the first semicircular magnetic ring 1, so as to ensure that when the control line is pulled to drive one semicircular magnetic ring, the other semicircular magnetic ring remains motionless. , and then complete the change from S-shape to O-shape.

Specifically, when the control tube 3 is set, the principles of the present invention are as follows:

As shown in Figure 6, the first joint end 13 of the first semicircular magnetic ring 1 and the second joint end 23 of the second semicircular magnetic ring 2 are aligned and attracted, and the first joint end 13 of the first semicircular magnetic ring 1 The control end 12 and the second control end 22 of the second semicircular magnetic ring 2 are respectively located on both sides of the suction position and on the same plane. The first tail end 142 of the first pulling wire 14 passes through the first control hole 11 on the first control end 12 and the first control hole 31 of the control tube 3 in sequence, and passes through the control tube 3. The first pulling wire 14 The first head end 141 is fixed to the first threading hole 11 . The second tail end 242 of the second pull wire 24 passes through the second control hole 21 on the second control end 22 and the second control hole 32 of the control tube 3 in sequence, and passes through the control tube 3 , the second pull wire 24 The second head end 241 is fixed to the second threading hole 21 . Compared with the first semicircular magnetic ring 1 , the second semicircular magnetic ring 2 is closer to the control tube 3 . Pull the second tail end 242 of the second pulling wire 24 to make it in a tightened state, while the first pulling wire 14 remains in a loose state, and at this time, the two semicircular magnetic rings are in an "S" shape.

As shown in FIG. 7 , when the first tail end 141 of the first pulling wire 14 is tightened and pulled, the first semicircular magnetic ring 1 can undergo rotational deformation around the second joint end 23 . When the first tail end 141 is continuously pulled to a certain extent, the first control end 12 of the first semicircular magnetic ring 1 and the second control end 22 of the second semicircular magnetic ring 2 are aligned and attracted. The semicircular magnetic ring 1 and the second semicircular magnetic ring 2 form an "O" shape, as shown in FIG. 8 .

In the embodiment of the present invention, the outer diameter of the second magnetic anastomotic ring 8 is equal to the outer diameter of the first magnetic anastomotic ring that changes into an O shape. This size limitation makes the fit between the second magnetic anastomotic ring 8 and the first magnetic anastomotic ring more regular.

In the embodiment of the present invention, the outer diameter of the first semicircular magnetic ring 1 is 10-40 mm, and the inner diameter is 5-35 mm; the length of the control tube 3 is 5 cm-50 cm. This size allows easy insertion of the part into the body, does not interfere with compression and facilitates ejection.

When the present invention is used in the operation, operate according to the following steps:

a: Make the first magnetic anastomotic ring assume an initial "S" shape, that is, the first joint end 13 and the second joint end 23 attract each other, and the first control end 12 and the second control end 22 do not attract each other. The first magnetic anastomosis ring in the shape of an "S" is placed into the distal rectum 6 of the rectal narrow segment 5, as shown in FIG. 9 . In this step, the first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 are located on the same plane, and the angle between the two planes is 0°, and they may not be completely on the same plane. angle.

b: The first magnetic anastomosis ring in an "S" shape gradually passes through the rectal narrow section 5 in a serpentine motion and enters the proximal end of the rectum 4, as shown in FIG. 10 .

c: The first magnetic anastomosis ring in an "S" shape completely passes through the rectal narrow section 5 and enters the proximal end of the rectum 4 as a whole, as shown in FIG. 11 .

d: The proximal end of the control tube 3 is in contact with the outer ring side of the second control end 22 of the second semicircular magnetic ring 2. After the operator fixes the control tube 3 by hand or other medical clamping instruments, he pulls the first tail end 142 , the first semicircular magnetic ring 1 rotates and deforms around the second joint end 23 , as shown in FIG. 12 .

e: When the first tail end 142 is continuously pulled to a certain extent, the first control end 12 of the first semicircular magnetic ring 1 and the second control end 22 of the second semicircular magnetic ring 2 align and attract each other. The first semicircular magnetic ring 1 and the second semicircular magnetic ring 2 form an "O" shape, and the angle between the two planes is 180°, and the first magnetic anastomosis ring in the "O" shape is located at the proximal end of the rectum as a whole 4, as shown in Figure 13.

f: After withdrawing the control tube 3, the first puller wire 14 and the second puller wire 24, only the first magnetic anastomosis ring in the shape of "O" is located in the proximal rectum 4 as a whole, as shown in Fig. 14 . It is worth noting that the proximal end of the control tube 3 is in contact with the outer ring side of the second semicircular magnetic ring 2, and the distal end is located outside the body, so it can be pulled out directly. The first pulling wire 14 and the second pulling wire 24 can be cut with wire scissors close to the magnetic ring. If the position is relatively deep, a colonoscope can be used to cut them with endoscopic scissors under the colonoscope. It is also not necessary to deal with the first puller wire 14 and the second puller wire 14, the presence or absence of the two has no substantial influence on the anastomosis.

g: A second magnetic anastomotic ring 8 is inserted into the distal rectum 6, as shown in FIG. 15 .

h: The first magnetic anastomotic ring in the proximal rectum 4 and the second magnetic anastomotic ring 8 in the distal rectum 6 attract each other on the axial end faces and press the rectal stricture 5 , as shown in FIG. 16 .

i: After pressing for a period of time (usually 5-14 days), the stenotic segment 5 of the rectum is opened, and the overall structure of the first magnetic anastomosis ring and the second magnetic anastomosis ring 8 falls off into the distal end of the rectum 6 and can be voluntarily After being excreted from the body, a rectal anastomosis 7 is established, as shown in FIG. 17 .

For verifying the application of the present invention, the present invention has carried out animal experiments as follows:

As the experimental animals, 6 New Zealand rabbits were selected, half male and half male, weighing 3-3.5 kg. The experimental animals were provided by the Experimental Animal Center of Xi'an Jiaotong University. The whole experimental process strictly complied with the relevant regulations of Xi'an Jiaotong University on the management of experimental animals, ensuring animal welfare and reducing animal suffering during the experiment.

Experimental animals were fasted for 1 day before operation, and were not allowed to drink. 3% sodium pentobarbital solution was injected into the ear vein (1 mL/kg), and the experimental rabbit was fixed in the supine position after successful anesthesia. The lower abdomen and around the anus were shaved to prepare the skin, and sterile drape was spread for routine disinfection. Remove the midline abdominal incision with a length of about 8 cm, enter the abdomen layer by layer, and search for the rectum, insert a 14F gastric tube through the anus to the rectum, partially ligate the rectum with 1-0 silk thread at the lower rectum to prepare the rectal stricture model, and push the 14F gastric tube through the anus After the injection of contrast medium, the gastric tube was removed, and an abdominal X-ray examination was performed immediately to clarify the location and degree of stenosis. After the model was successfully prepared, the abdomen was closed layer by layer. At the same time, under X-ray monitoring, the first "S"-shaped magnetic anastomosis ring was placed through the anus, and pushed in a serpentine motion. After the "S"-shaped first magnetic anastomosis ring completely crossed the rectal stenosis segment 5, the puller wire was tightened. , the first magnetic anastomosis ring becomes circular and exits the control tube 3 . The second magnetic anastomosis ring 8 is directly inserted through the anus after forming a loop, and the operation is completed after the first magnetic anastomosis ring and the second magnetic anastomosis ring 8 at both ends of the rectal stenosis section 5 are aligned and closed. During the magnetic ring insertion process, the X-ray shows the state change process of the magnetic stapler, as shown in Figure 18. In the figure: a. Colonography shows the rectal stenosis segment 5; b. Push the first magnetic anastomotic ring in an "S" shape through the Rectal stenosis section 5; b. The "S"-shaped first magnetic anastomosis ring completely crosses the rectal stenosis section 5 to the proximal end of the rectum 4; c, d. The state change process of the first magnetic anastomosis ring; e. The first magnetic anastomosis ring From "S" shape magnetic ring to "O" shape; f. push the second magnetic anastomosis ring 8 at the distal end; g. automatic phase alignment between the first magnetic anastomosis ring and the second magnetic anastomosis ring 8 at both ends of the rectal narrow section 5 Suction (the arrow in the figure indicates the rectal stenosis segment 5).

In the present invention, the rectal stricture model is successfully established through partial ligation of the silk thread, and the diameter of the rectal stricture section 5 is about 4mm. The first magnetic anastomotic ring of the present invention is successfully inserted into the proximal end of the rectum 4 after adopting "S" deformation and serpentine movement, and through the operation of the pulling wire and the control tube 3, the first magnetic anastomotic ring is successfully realized from the "S" shape To the "O" shape deformation ring forming process. Excluding the preparation time of rectal stenosis model, the operation time of rectal stenosis magnetic anastomosis was 9.5-12 minutes, with an average time of 10.67±0.93 minutes. The magnet discharge time ranged from 3 to 5 days, with an average of 3.67±0.81 days. After the magnetic stapler was discharged, the colonography showed that the stenotic segment disappeared. One week later, the rectal stricture anastomosis specimen was obtained. The anastomosis was well formed and the rectal mucosa of the anastomosis was smooth and flat.

In summary, the present invention effectively solves the problem that the conventional magnetic ring cannot pass through the narrow section by making the first magnetic anastomotic ring change from "S" shape to "O" shape and serpentine motion. Therefore, when designing the diameter of the magnetic anastomotic ring, The problem of insertion operation can be ignored, and the diameter of the magnetic anastomosis ring can be close to the inner diameter of the rectum to the greatest extent, so as to create conditions for "eradicating" the anastomotic scar as much as possible and achieve long-term patency of the anastomosis. The invention makes a beneficial exploration for applying the magnetic anastomosis technique to treat anastomotic stenosis after rectal cancer operation under a single transanal channel. Further optimization of the design and operation path of the magnetic ring is expected to be applied in clinical practice.

Claims (10)

1. A magnetic anastomat for treating rectal stenosis under transanal single access, which is characterized by comprising a first magnetic anastomosis ring, an auxiliary operation device and a second magnetic anastomosis ring (8);

the first magnetic anastomosis ring comprises a first semicircular magnetic ring (1) and a second semicircular magnetic ring (2) which are completely the same in shape and size, one end of the first semicircular magnetic ring (1) is a first control end (12), and the other end of the first semicircular magnetic ring is a first joint end (13); one end of the second semicircular magnetic ring (2) is a second control end (22), and the other end of the second semicircular magnetic ring is a second joint end (23); the first joint end (13) and the second joint end (23) are configured to be rotatably connected in the circumferential direction;

the auxiliary operating device comprises a first traction wire (14) and a second traction wire (24), wherein the two ends of the first traction wire (14) are respectively a first head end (141) and a first tail end (142), and the two ends of the second traction wire (24) are respectively a second head end (241) and a second tail end (242);

the first head end (141) is configured to be connectable with the first control end (12), the second head end (241) is configured to be connectable with the second control end (22), and the first tail end (142) and the second tail end (242) are configured to make the first control end (12) and the second control end (22) connected by pulling, i.e. to control the change of the first magnetic anastomosis ring from the S-shape to the O-shape;

said second magnetic anastomosis ring (8) is configured to attract, at the end surface, said first magnetic anastomosis ring, transformed into an O-shape, at the distal rectal end (6) and at the proximal rectal end (4), so as to squeeze the rectal stenosis (5).

2. The magnetic stapler for transanal single access sub-rectal stenosis therapy according to claim 1, characterized in that said first joint end (13) and said second joint end (23) are connected by a rotation stub shaft, one end of which is connected to said first joint end (13) or said second joint end (23) and the other end is embedded in a short circumferential groove of said second joint end (23) or first joint end (13); the first tail end (142) pulls the first control end (12) or the second tail end (242) pulls the second control end (22), so that the first semicircular magnetic ring (1) or the second semicircular magnetic ring (2) rotates along the short rotation axis, and the change range of the included angle between the plane where the first semicircular magnetic ring (1) is located and the plane where the second semicircular magnetic ring (2) is located in the rotating process is 0-180 degrees.

3. The magnetic stapler for transanal single access sub-rectal stenosis therapy according to claim 1, characterized in that the first control end (12) and the second control end (22) have opposite N-S polarity, the first articulation end (13) and the second articulation end (23) have opposite N-S polarity; the first joint end (13) and the second joint end (23) attract each other to realize the rotatable connection; the first tail end (142) and the second tail end (242) are configured to cause the first control end (12) to attract with the second control end (22) by pulling.

4. The magnetic anastomat for the single-channel transanal rectal stenosis treatment is characterized in that the first semicircular magnetic ring (1) and the second semicircular magnetic ring (2) are made of neodymium-iron-boron permanent magnet materials, ferrite materials, samarium-cobalt materials or neodymium-cobalt-nickel materials, the edges of the magnetic anastomats are chamfered, and the magnetic anastomat is magnetized axially; the first semicircular magnetic ring (1) and the second semicircular magnetic ring (2) adopt a titanium nitride coating, a nickel coating, an epoxy resin coating or a parylene coating for surface protection.

5. The magnetic stapler for transanal single access sub-rectal stenosis treatment according to claim 1, wherein the first control end (12) is provided with a first threading hole (11), the second control end (22) is provided with a second threading hole (21), and the first threading hole (11) and the second threading hole (21) are both open holes facing the inner ring side along the outer ring side; the first head end (141) penetrates into the first threading hole (11) to realize connection; the second head end (241) penetrates into the second threading hole (21) to realize connection.

6. The magnetic stapler for the transanal single access sub-rectal stenosis treatment according to claim 5, characterized in that the first threading hole (11) and the second threading hole (21) are both radial holes.

7. The magnetic anastomat for the transanal single-path lower rectal stenosis treatment is characterized in that the first head end (141) is provided with an expansion end which is larger than the first threading hole (11), the second head end (241) is provided with an expansion end which is larger than the second threading hole (21), the expansion end is clamped on the side surface of the inner ring, and the first tail end (142) and the second tail end (242) are respectively led out from the side surface of the outer ring.

8. The magnetic stapler for the transanal single access sub-rectal stenosis treatment according to claim 5, characterized in that said first traction wire (14) and second traction wire (24) are threads made of silk thread or nylon thread or other high molecular material.

9. The magnetic stapler for transanal single access sub-rectal stenosis treatment according to any one of claims 1 to 8, wherein the auxiliary operating device further comprises a control tube (3), a first control hole (31) and a second control hole (32) are axially arranged in the control tube (3), the first control hole (31) is used for the first traction wire (14) to pass through, and the second control hole (32) is used for the second traction wire (24) to pass through.

10. The magnetic stapler for the transanal single access sub-rectal stenosis treatment according to claim 9, characterized in that the first semi-circular magnetic ring (1) has an outer diameter of 10-40mm and an inner diameter ranging from 5-35mm; the length range of the control tube (3) is 5cm-50cm.

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