CN203564293U

CN203564293U - End effector, surgical operating instrument and purse-string forceps

Info

Publication number: CN203564293U
Application number: CN201320590571.6U
Authority: CN
Inventors: 孙斌; 刘刚; 方云才; 汪炬
Original assignee: REACH SURGICAL INSTRUMENT (CHINA) CO Ltd
Current assignee: REACH SURGICAL INSTRUMENT (CHINA) CO Ltd
Priority date: 2013-09-23
Filing date: 2013-09-23
Publication date: 2014-04-30
Anticipated expiration: 2023-09-23

Abstract

The utility model relates to the technical field of medical apparatuses and instruments, and discloses an end effector, a surgical operating instrument and purse-string forceps. Through the end effector and the surgical operating instrument, the operating process of surgery can be simplified, wounds of surgery patients can be relieved, and purse-string nails can be firmly connected with luminal tissue. The end effector comprises a first forceps arm, a second forceps arm, a suture mechanism, a purse-string suture mechanism and a cutting mechanism, wherein the suture mechanism is arranged on one side of the longitudinal direction of the first forceps arm and the second forceps arm, the purse-string suture mechanism is arranged on the other side of the longitudinal direction of the first forceps arm and the second forceps arm, and the cutting mechanism is arranged between the suture mechanism and the purse-string suture mechanism. The purse-string suture mechanism comprises a first purse-string nail box and a second purse-string nail box, wherein the first purse-string nail box is arranged on the first forceps arm, the second purse-string nail box is arranged on the second forceps arm, and a purse-string nail firing mouth of the first purse-string nail box and a purse-string nail firing mouth of the second purse-string nail box are respectively provided with a closing structure which can make legs of the passing purse-string nails closed.

Description

End effector, surgical instrument and purse-string forceps

Technical Field

The utility model relates to the technical field of medical equipment, especially relate to an end effector, a surgical operation apparatus and a purse-string forceps.

Background

Gastrointestinal tract surgery usually requires cutting off a closed tissue lumen and performing purse string suture at the disconnected lumen, wherein the purse string suture is used for being matched with a nail anvil of a circular anastomat to perform subsequent anastomosis and other operations by using the circular anastomat.

Purse-string sutures are a common suturing technique in surgical operations, and two main ways of purse-string suturing are known. One way is to manually perform a purse string suture, as shown in fig. 1a and 1b, the physician first passes the purse string 58 through the tissue surface around the incision in the luminal tissue 59 with a purse string needle, and then tightens the purse string 58 to complete the purse string suture. The manual suture mode is complex to operate, the operation precision is difficult to grasp, and the suture is easy to fail due to thread off, so that the manual suture mode is rarely adopted in the surgical operation at present.

Another way is to use purse-string forceps to assist in making a purse-string suture. As shown in FIG. 2a, a purse-string forceps is also used to perform purse-string suture by threading a needle (i.e., a purse-string needle) with a string (i.e., a purse-string 58). As shown in FIG. 2b, there is also a purse-string forceps that performs a purse-string suture by attaching a purse-string 58 to the surface of the lumen tissue 59 by means of a purse-string 57, typically by firing the purse-string 57 to pierce and secure it to the lumen tissue 59, and the purse-string 58 is either interconnected with the purse-string 57 or pressed between the lumen tissue 59 and the purse-string 57 by the purse-string 57 to attach the purse-string 58 to the lumen tissue 59 to perform the purse-string suture.

Generally, when a surgical operation is performed on a lumen tissue, besides a purse-string suture is required to be performed on an incision of a remaining end of the lumen tissue, a lesion end of the lumen tissue also needs to be cut and sutured. The existing purse-string forceps have single function, can only complete purse-string suture on the remaining end, and cannot cut and suture the pathological change end. Therefore, at least other surgical instruments such as cutting and suturing devices need to be used in a matched manner, and the operation of replacing the surgical instruments is complicated, so that the operation time is long, the operation risk is increased, and the pain of an operation patient is caused.

In the prior art shown in fig. 2b, the purse string 57 needs to be fixed on the surface of the lumen tissue 59 by a non-staple anvil forming technology, and the use of the purse-string forceps often causes the phenomenon that the purse string is torn off, thereby causing the purse-string suture to fail, which also increases the operation risk and the pain of the operation patient.

Moreover, endoscopic surgery has emerged in the eighties of the twentieth century, a technique that allows surgeons to perform surgery without causing significant trauma to the patient, primarily through endoscopy and various imaging techniques. Compared with open surgery, endoscopic surgery has the remarkable advantages of small tissue damage, quick postoperative recovery and the like, thereby becoming a development trend. In this case, purse-string forceps for endoscopic surgery appeared, and the existing purse-string forceps for endoscopic surgery also had the problem of single function as described above.

SUMMERY OF THE UTILITY MODEL

The first purpose of the utility model is to provide an end effector to simplify the operation process of carrying out the surgery to the lumen tissue, reduce the operation time, further the difficult avulsion of purse-string nail, the security of operation is higher.

The end effector includes: the first clamp arm and the second clamp arm can move relatively under the action of the opening and closing mechanism so as to open or close a clamp mouth formed by the first clamp arm and the second clamp arm; the stitching mechanism is arranged on one side of the first clamp arm and the second clamp arm in the longitudinal direction; the pouch stitching mechanism is arranged on the other side of the first clamp arm and the second clamp arm in the longitudinal direction; the cutting mechanism is arranged between the stitching mechanism and the pouch stitching mechanism; the purse-string suture mechanism comprises: the first purse-string nail box is arranged on the first forceps arm, the second purse-string nail box is arranged on the second forceps arm, purse-string nails are respectively arranged in the first purse-string nail box and the second purse-string nail box and are triggered by a purse-string nail pushing mechanism, purse-string nail triggering ports of the first purse-string nail box and the second purse-string nail box are provided with closing structures which enable nail legs of the passing purse-string nails to be folded, and purse-string lines between the two nail legs of the purse-string nails are arranged on the surfaces of the first purse-string nail box and the second purse-string nail box facing the forceps jaws.

In this technical scheme, the sewing mechanism of end effector one side can realize the sewing up of tissue, and the purse-string of tissue can be sewed up to the purse-string sewing mechanism of opposite side, and the cutting mechanism between sewing up mechanism and purse-string sewing mechanism then can realize the cutting of tissue, and is visible, uses the utility model provides an end effector can realize that the purse-string of lumen reservation end tissue is sewed up to and the cutting and the sewing up of pathological change end tissue, compare with prior art, simplified the operation process of carrying out surgery to lumen tissue greatly, reduced the operating time, alleviateed the wound that brings for operation patient.

Preferably, the pouch nail firing openings of the first pouch nail box and the second pouch nail box are provided with closing structures which enable the nail legs of the passing pouch nails to be crossed and gathered. The end effector can firmly connect the purse-string nail with the lumen tissue, greatly improves the phenomenon that the purse-string nail is easy to tear off, and improves the safety of the operation.

It is a second object of the present invention to provide a surgical instrument, comprising: a handle and an end effector as in the previous solution driven by the handle. Because the end effector has the effects, the surgical operation instrument can greatly simplify the operation process of performing surgical operation on the lumen tissue, reduce the operation time, relieve the wound brought to the operation patient, further more firmly connect the purse-string nail with the lumen tissue and improve the operation safety.

The third purpose of the utility model is to provide a purse-string forceps, can make the purse-string nail more firm with lumen tissue connection, the purse-string nail is difficult for tearing off, has improved the security of operation greatly. The purse-string forceps comprises: the first clamp arm and the second clamp arm can move relatively under the action of the opening and closing mechanism so as to open or close a clamp mouth formed by the first clamp arm and the second clamp arm; purse-string suture mechanism includes: the first purse-string nail box is arranged on the first forceps arm, the second purse-string nail box is arranged on the second forceps arm, purse-string nails are respectively arranged in the first purse-string nail box and the second purse-string nail box and are triggered by a purse-string nail pushing mechanism, purse-string nail triggering ports of the first purse-string nail box and the second purse-string nail box are provided with closing structures which enable the nail legs of the passing purse-string nails to be crossed and folded, and purse-string lines between the two nail legs of the purse-string nails are arranged on the surfaces of the first purse-string nail box and the second purse-string nail box facing the forceps jaws.

When the purse-string nail is fired to pierce into the lumen tissue, the nail legs of the purse-string nail are folded in a crossed manner, are firmly connected with the lumen tissue and are not easy to fall off from the lumen tissue, so that the purse-string forceps greatly improve the safety of purse-string suturing.

Drawings

FIG. 1a is a schematic cross-sectional view of a purse string suture of luminal tissue;

FIG. 1b is a front view of luminal tissue after tightening of the purse wire;

FIG. 2a is a schematic view illustrating a conventional purse-string suture principle of a purse-string forceps;

FIG. 2b is a schematic view of another conventional purse-string forceps purse-string suture principle;

fig. 3a is a schematic perspective view of an end effector according to an embodiment of the present invention;

fig. 3b is a schematic view of an end effector jaw closure according to an embodiment of the present invention;

FIG. 3c is a schematic view of an end effector with jaws open after a surgical procedure, in accordance with an embodiment of the present invention;

fig. 4 is a schematic structural diagram of a first clamp arm according to an embodiment of the present invention;

fig. 5a is a three-dimensional schematic view of the internal structure of an end effector (tissue suture side, unfired staples) according to an embodiment of the present invention;

fig. 5b is a three-dimensional schematic view of the internal structure of the end effector (tissue stapling side, staple partially fired) according to an embodiment of the present invention;

fig. 6a is a three-dimensional schematic view of the internal structure of the end effector according to the embodiment of the present invention (the purse-string suture side, the purse-string nail is not fired);

fig. 6b is a schematic cross-sectional view of an end effector according to an embodiment of the present invention (the purse string nail is unfired);

fig. 6c is a three-dimensional schematic view of the internal structure of the end effector according to the embodiment of the present invention (the purse-string suture side, the purse-string nail portion is fired);

fig. 6d is a schematic cross-sectional view of an end effector according to an embodiment of the present invention (the purse string nail is fired);

fig. 7 is a schematic view illustrating a firing process of the purse-string nail according to an embodiment of the present invention;

FIG. 8 is a schematic view of luminal tissue after cutting, tissue stapling, and purse string stapling;

fig. 9 is a schematic structural view of a surgical instrument according to an embodiment of the present invention.

Reference numerals:

57-purse-string nail 58-purse-string 59-lumen tissue

10 a-first jawarm 10 b-second jawarm 11-suturing mechanism

12-pouch stapling mechanism 13-cutting mechanism 14 a-first pouch magazine

14 b-second pouch staple magazine 56-closing structure 17 a-tightening slot

15-line clamp 16-pouch nail pushing slide block 17-pouch nail pusher

18-staple anvil 19-staple magazine 20-staple

21-staple pushing slider 22-staple pusher 23-cutting knife

24-knife slot 25-closing flange 26-handle

27-end effector 28-elongated body 29-transmission mechanism

571-staple legs 572-crowns

Detailed Description

In order to use same apparatus just can accomplish the purse-string suture, cut and sew up, simplify and carry out the operation process that the surgery was carried out to the tissue that needs to carry out the purse-string suture (especially lumen tissue), reduce operation time, risk and patient's misery, further can be used for laparoscopic surgery, the embodiment of the utility model provides an end effector and a surgical operation apparatus. The utility model discloses among the technical scheme, the sewing mechanism of end effector one side can realize sewing up of tissue, and the purse-string sewing mechanism of opposite side can realize that the purse-string of tissue is sewed up, and the cutting mechanism between sewing mechanism and purse-string sewing mechanism then can realize the cutting of tissue, uses the embodiment of the utility model provides an end effector or surgical operation apparatus can realize that the purse-string of lumen reservation end tissue is sewed up to and the cutting of pathological change end tissue is sewed up, have simplified the operation process of carrying out the surgery to the lumen tissue greatly, have reduced the operating time, further still can be used to the operation chamber mirror. In order to make the objects, technical solutions and advantages of the present invention clearer, the present invention will be further described in detail by referring to the following embodiments.

As shown in fig. 3a to 3c and fig. 6b, the end effector according to the embodiment of the present invention includes:

the first forceps arm 10a and the second forceps arm 10b can move relatively under the action of an opening and closing mechanism, so that a jaw formed by the first forceps arm 10a and the second forceps arm 10b is opened or closed;

a suturing mechanism 11, the suturing mechanism 11 being provided on one side in the longitudinal direction of the first and

second forceps arms

10a and 10 b;

a purse-string suture mechanism 12, the purse-string suture mechanism 12 being provided on the other side of the first and

second forceps arms

10a and 10b in the longitudinal direction;

the cutting mechanism 13, the cutting mechanism 13 is set up between stitching mechanism 11 and the purse string stitching mechanism 12;

the purse string device 12 includes:

the first purse-string nail box 14a is arranged on the first forceps arm 10a, the second purse-string nail box 14b is arranged on the second forceps arm 10b, the first purse-string nail box 14a and the second purse-string nail box 14b are respectively provided with a purse-string nail 57, the purse-string nail 57 is triggered by a purse-string nail pushing mechanism, the purse-string nail triggering ports of the first purse-string nail box 14a and the second purse-string nail box 14b are provided with a closing structure 56 which enables the nail legs 571 of the passing purse-string nail 57 to be closed, and the jaw-facing surfaces of the first purse-string nail box 14a and the second purse-string nail box 14b are provided with a purse string 58 between the two nail legs 571 of the purse-string nail 57.

In various embodiments of the present invention, "distal" refers to the side of the device that is distal to the user when the device is operated, and "proximal" refers to the side of the device that is proximal to the user when the device is operated. "forward" refers to movement away from the user and "backward" refers to movement closer to the user. The embodiment of the utility model provides an end effector can cooperate actuating mechanism to use, provides drive power by actuating mechanism. The specific structural style of the driving mechanism is not limited, for example, the end effector at the front end of the existing cutting stitching instrument can be directly detached, the end effector provided by the embodiment of the utility model is assembled, and the driving mechanism of the existing cutting stitching instrument provides driving force for opening the closing mechanism, the stitching mechanism, the purse-string stitching mechanism and the cutting mechanism. In addition, the driving mechanism can be additionally designed for the end effector provided by the embodiment of the invention.

The embodiment of the utility model provides an end effector can divide into according to the function and open closing mechanism, sew up mechanism, purse-string suture mechanism and cutting mechanism four bibliographic categories branch. The opening and closing mechanism is used for opening and closing the jaws formed by the two forceps arms of the end effector, when the end effector is used, the jaws can be driven to open so as to place the lumen tissue to be operated in, then the jaws are driven to close so as to clamp the lumen tissue to perform surgical actions such as purse string suture, cutting, suturing and the like, and after the surgical actions are finished, the jaws can be driven to open again so as to release the tissue. The cutting mechanism is used for realizing the cutting function of the tissue and can cut and separate the lesion end and the remaining end of the lumen tissue. The suturing mechanism is used for realizing the function of suturing the tissues and can suture at the incision of the lesion end of the lumen tissues. The purse string suture mechanism is used for realizing the purse string suture function of the tissue, can carry out purse string suture at the incision of the lumen tissue retention end, and is matched with a nail anvil of a circular anastomat to be installed in the subsequent operation, and the circular anastomat is used for carrying out the operations of anastomosis and the like. The structures of these four sections will be described in further detail below.

In the end effector of the embodiment of the utility model, at least two of the opening and closing mechanism, the stitching mechanism, the purse string stitching mechanism and the cutting mechanism can be synchronously driven; alternatively, the opening and closing mechanism, the suturing mechanism, the purse string suturing mechanism, and the cutting mechanism may be driven separately. The specific structure of the end effector can be designed according to different driving modes.

An opening and closing mechanism:

in various embodiments of the present invention, the first forceps arm 10a and the second forceps arm 10b are movable relative to each other, and may be both movable rotatable forceps arms; or the first clamp arm 10a is a fixed clamp arm which cannot rotate, and the second clamp arm 10b is a movable clamp arm which can rotate; alternatively, the second caliper arm 10b is a fixed caliper arm that is not rotatable, and the first caliper arm 10a is a movable caliper arm that is rotatable. Whether only one movable jawarm or both are movable jawarms, it is sufficient that both jawarms can be driven to open and close the jaws formed by the two jawarms.

The opening and closing mechanism of the end effector of the utility model can be realized by adopting various technical schemes of the opening and closing mechanism of the end effector of the existing cutting stitching instrument, for example, a sleeve type opening and closing scheme, an I-shaped beam type opening and closing scheme and the like.

For example, the opening and closing mechanism may include a closure bar having a closure flange disposed at a distal end thereof, a compression spring disposed between the first and second jawarms, the closure flange engaging a closure surface on the first and/or second jawarms when the closure bar is actuated to move longitudinally distally so that the jawarms close against the force of the compression spring, and the jaws may open upon return of the closure bar under the force of the compression spring. The closure flange may only engage the closure surface on the first or second jawarm when the closure bar is actuated to move longitudinally distally, but to achieve a more balanced force, it is preferred that the closure flange simultaneously engage the closure surfaces on the first and second jawarms.

The closing rod can be connected with a staple pushing rod for firing staples, a pouch nail pushing rod for firing pouch nails or a cutter rod for driving a cutting knife into an integral structure or different components; the closing rod, the staple pushing rod, the cutter rod or the purse-string staple pushing rod can also be different parts respectively; the closing rod can be integrated with any two of the staple pushing rod, the cutter rod and the pouch staple pushing rod or connected with different components; in addition, the closing rod may be an integral structure (may be referred to as a driving rod) with the staple pusher bar, the knife bar and the purse string pusher bar or may be connected to each other by different components.

Referring to fig. 3c, 5a and 5b, in an embodiment of the present invention, the cutting blade 23 and the blade bar are an integral structure and serve as a closing rod of the opening and closing mechanism, a compression spring (not shown) is disposed between the first forceps arm 10a and the second forceps arm 10b, and a closing flange 25 parallel to the cutting direction is fixed at the distal end of the closing rod on the side of the movable forceps arm away from the jaws; when the closing rod moves forward, the closing flange 25 pushes the movable clamp arm to rotate until the jaws are closed, and when the closing rod moves backward, the pressure spring pushes the movable clamp arm to rotate until the jaws are opened. It should be noted here that the stroke taken by the closing flange 25 when closing the jaws need not be very large.

The cutting mechanism comprises:

the utility model discloses an end effector's cutting mechanism can adopt the current cutting to sew up the various technical scheme realization of end effector's cutting mechanism of ware.

For example, as shown in fig. 4, 5a and 5b, the cutting mechanism may include a cutting blade 23, the cutting blade 23 is capable of moving between the suturing mechanism and the purse string suturing mechanism under the action of a push-type cutter mechanism, such as a push-type cutter rod or other component, to separate the sutured and purse string sutured tissues, respectively, and the cutting blade 23 and the push-type cutter mechanism may be integrated or separated (in this case, the cutting blade 23 is disposed at the far side of the push-type cutter mechanism). The first and second jawarms are provided with a knife slot 24 (shown in fig. 4) for accommodating the movement of the cutting knife 23, so as to provide guidance for the movement of the cutting knife 23, and make the cutting movement more stable and accurate.

A sewing mechanism:

the utility model discloses an end effector's sewing mechanism can adopt the current various technical scheme of the end effector's of cutting stitching instrument sewing mechanism to realize.

For example, as shown in fig. 5a and 5b, the stapling mechanism may be arranged on one side in the longitudinal direction of two jawarms, one arranged with a staple anvil 18 and the other arranged with a staple magazine 19, in which magazine 19 staples 20 are arranged, which staples 20 may be arranged in one or more rows in the longitudinal direction, which staples 20 can be fired by a staple pusher mechanism. The staple pusher mechanism for firing the staples 20 may comprise a staple pusher bar (in this embodiment, the knife bar of the cutting knife 23 acts as a staple pusher bar), a staple pusher shoe 21 and a staple pusher 22. The firing process may be that the staple pusher bar moves longitudinally distally to drive the staple pusher shoe 21, the inclined surface of the staple pusher shoe 21 acts on the staple pusher 22 to move it laterally, and then the staples 20 are pushed out of the staple magazine 19 by the staple pusher 22, pass through the lumen tissue 59, and press against the staple anvil 18, and the staples 20 are formed into a B-shape by the staple anvil 18, thereby completing the stapling.

The number of rows of staples 20 is not limited, but should be at least one row, and preferably at least two rows, so that at least two sutures can be placed at the diseased end of the luminal tissue, greatly reducing the risk of suture failure. When the staples 20 are arranged in a plurality of longitudinal rows, only one staple pusher shoe 21 may be provided to push the forward plurality of staple pushers 22.

When the cutter arbor of cutting knife 23 pushed out the nail pole as the staple, the position of cutting knife 23 can set up to pushing out the nail slider 21 for the staple and leaning on more (being close to near side more promptly) for sew up earlier the back cutting, can reduce pathological change end internal tissue outflow like this, improve the success rate of operation. In one embodiment, the staple pusher shoe 21 is pushed by the knife bar of the cutting knife 23, and before the cutting blade of the cutting knife 23 cuts the tissue, the inclined surface of the staple pusher shoe 21 already pushes the front staple pusher 22 to fire the staples 20, i.e., to suture the front lumen tissue, so that the cutting knife 23 always cuts after the tissue is sutured.

The purse-string suture mechanism comprises:

the purse string suture mechanism may be provided on the other side of the longitudinal direction of the two forceps arms, that is, on the side opposite to the suture mechanism. As shown in FIG. 6b, the first purse-string staple magazine 14a provided on the first jawarm 10a and the second purse-string staple magazine 14b provided on the second jawarm 10b are positioned opposite to each other when the jaws are closed, so that a better purse-string suture can be obtained.

As shown in fig. 6a to 6d, the pouch nail pushing mechanism includes: a pouch nail pushing rod, a pouch nail pushing slider 16 and a pouch nail pusher 17 which are arranged aiming at each pouch nail box; for each pouch nail magazine, when the pouch nail pushing rod longitudinally drives the pouch nail pushing slider 16 towards the far side, the inclined surface of the pouch nail pushing slider 16 transversely drives the pouch nail pusher 17, so that the pouch nail pusher 17 pushes the pouch nails 57 out of the pouch nail firing opening.

The pouch nail pushing mechanism and the staple pushing mechanism can be two mechanisms which are independent from each other and driven respectively, at this time, the pouch nail pushing rod and the staple pushing rod are different parts respectively, the pouch nail pushing slider and the staple pushing slider are different parts respectively, in addition, the pouch nail pushing mechanism and the staple pushing mechanism can be driven synchronously, as shown in fig. 5b, the pouch nail pushing rod and the staple pushing rod are integrated with a cutter bar of the cutting knife (the pouch nail pushing rod, the staple pushing rod and the cutter bar can also be different parts connected with each other), the pouch nail pushing slider 16 and the staple pushing slider 21 are integrated (or different parts are connected with each other), for example, when the staple pushing slider is driven longitudinally, the inclined surface of the staple pushing slider can drive the pouch nail pusher 17 and the staple pusher 22 transversely, so that the pouch nails and the staples are fired respectively.

As shown in fig. 4, the positioning manner of the purse wire 58 on the surface of the nail box is not limited, and preferably, the surfaces of the first purse nail box 10a and the second purse nail box facing the jaws are respectively provided with a line card 15, and the purse wire 58 is clamped on the line card 15. The purse wire is arranged between the two nail legs of the purse-string nail, when the purse-string nail is fired to pierce into the lumen tissue, the purse wire is pressed between the crown of the purse-string nail and the lumen tissue, and when the purse-string nail is fired and the jaw of the end effector is opened, the purse wire is separated from the first purse-string nail box and the second purse-string nail box.

In order to make the purse wire 58 more flat and reliably positioned on the surface of the nail box, at least two wire clamps 15 are preferably arranged between two adjacent purse nails 57 of the first purse nail box 14 a; at least two line cards 15 are arranged between two adjacent poufs 57 of the second pouched staple magazine 14 b. The specific number of the line cards 15 may be determined according to the arrangement pitch of the purse nails 57, and is not particularly limited herein.

Preferably, the purse string firing ports of the first and second

purse string staples

14a, 14b have a binding structure 56 that causes the legs 571 of the passing purse string staples 57 to cross close. As shown in FIGS. 6b, 6d and 7, the binding structures 56 of the first and

second magazines

14a, 14b are binding ramps located on the outside of the two legs 571 of the purse nail 57. When the pouch nail pusher 17 pushes the pouch nail 57 towards the direction of the firing opening of the pouch nail, the two nail legs 571 of the pouch nail 57 gradually get close after penetrating into the lumen tissue 59 under the pressing of the closing slope, and then the lumen tissue 59 is held in a crossed manner. In fig. 7, a is the width of the pouch nail, which is also equal to the width of the nail groove of the pouch nail box, B is the width of the firing opening of the pouch nail, and B < a, C are the height of the closing-up slope. B, C can be sized according to relevant experience or experimentation so that the two legs 571 of the fired purse-string staples 57 will cross-grip the luminal tissue 59 without piercing another layer of luminal tissue 59.

When the purse-string nails are fired to pierce the lumen tissue, the purse-string nail legs are folded in a crossed manner to hold the lumen tissue and are firmly connected with the lumen tissue, and the purse-string nails are not easy to fall out of the lumen tissue, so that the end effector of the embodiment greatly improves the safety of the operation.

Preferably, the middle part of the crown 572 of the purse-string nail 57 is bent towards the firing opening of the purse-string nail, and the shape of the crown 572 can guide the deformation of the purse-string nail 57, which is beneficial to improving the forming consistency of the purse-string nail.

To ensure the stroke of the motion of the staples in the magazine during firing of the staples, the staple pusher 17 should be able to enter the closing structure 56 of the magazine. Optionally, the pouch nail pusher 17 is made of an elastic material, or a tightening groove 17a is formed in one side of the pouch nail pusher 17 facing the crown 572 of the pouch nail 57, and when the pouch nail pusher 17 pushes the pouch nail 57 out of the pouch nail firing opening, the pouch nail pusher 17 is located in the closing structure 56 and is in a compressed state.

The utility model discloses among the technical scheme of the embodiment, closing lever, staple push away nail pole, cutter arbor and the nail of being in a purse of a lotus push away nail pole can be for a body structure or for different part interconnect in order to realize synchronous drive, for example, in an embodiment, closing lever, staple push away nail pole, cutter arbor and the nail of being in a purse of a lotus push away nail pole structure as an organic whole, can be called the actuating lever. When the surgical forceps are used, the driving rod moves to the far side to drive, the opening and closing mechanism is driven to close the forceps arms, the suturing mechanism and the pouch suturing mechanism are driven along with further movement of the driving rod, the suturing nails are sequentially fired to realize suturing, the pouch nails are sequentially fired to penetrate into tissues to realize pouch suturing, and meanwhile the cutting knife cuts the tissues between the suturing mechanism and the pouch suturing mechanism under the pushing of the driving rod, so that the cutting, the suturing and the pouch suturing are simultaneously completed (the lumen tissues after the cutting, the tissue suturing and the pouch suturing are shown in figure 8, wherein the direction shown by an arrow is the length direction of the lumen tissues), the operation process of performing the surgical operation on the lumen tissues is further simplified, the operation time is shortened, and the wound brought to an operation patient is further relieved.

To sum up, in the technical scheme of the utility model, the sewing up of tissue can be realized to the sewing up mechanism of end effector one side, and the purse-string sewing up mechanism of opposite side can realize that the purse-string of tissue is sewed up, and the cutting mechanism between sewing up mechanism and purse-string sewing up mechanism then can realize the cutting of tissue, and is visible, uses the embodiment of the utility model provides an end effector can realize that the purse-string of lumen reservation end tissue is sewed up to and the cutting and the sewing up of pathological change end tissue, compare with prior art, the frequency of changing surgical instruments that has significantly reduced has simplified the operation process of carrying out the surgery to lumen tissue, has reduced the operation time, has alleviateed the wound that brings for operation patient. And when the purse-string nails are fired to pierce the lumen tissue, the legs of the purse-string nails are folded in a cross way, are firmly connected with the lumen tissue and are not easy to fall off from the lumen tissue, so that the safety of purse-string suturing is greatly improved.

It should be noted that, in the embodiments of the present invention, the specification and the size of the end effector are not limited, and the end effector can be designed according to the specific surgical needs. For example, when the end effector is an end effector with an endoscope specification, the end effector can be used together with an endoscope, so that the operation has the advantages of high safety, small wound surface, less pain, quick recovery and the like.

As shown in fig. 9, embodiments of the present invention also provide a surgical instrument, including: a handle 26 and an end effector 27 as in any of the previous embodiments driven by the handle 26.

Also included in this embodiment is an elongated body 28 having a drive mechanism 29 disposed therein, the distal side of handle 26 being connected to end effector 27 by elongated body 28, handle 26 driving drive mechanism 29, drive mechanism 29 in turn transmitting drive to end effector 27 to provide drive for its opening and closing, stapling, cutting and purse string suturing. The surgical operation instrument with the structure can be matched with an endoscope for use, so that the operation has the advantages of high safety, small wound surface, less pain, quick recovery and the like.

Use the embodiment of the utility model provides a surgical instruments can realize that the purse of lumen reservation end tissue is sewed up to and the cutting and the sewing up of pathological change end tissue, compare with prior art, simplified the operation process of carrying out surgery to lumen tissue greatly, reduced the operation time, and can make the purse of a lotus nail more firmly be connected with lumen tissue, improved the security of operation, alleviateed the wound that brings for operation patient, further can also be used to laparoscopic surgery.

The embodiment of the utility model provides a purse-string forceps is still provided, include:

the first clamp arm and the second clamp arm can move relatively under the action of the opening and closing mechanism so as to open or close a clamp opening formed by the first clamp arm and the second clamp arm;

purse-string suture mechanism includes: the nail driving device comprises a first purse-string nail box arranged on a first clamp arm, a second purse-string nail box arranged on a second clamp arm, wherein purse-string nails are respectively arranged in the first purse-string nail box and the second purse-string nail box, the purse-string nails are triggered by a purse-string nail pushing mechanism, purse-string nail triggering ports of the first purse-string nail box and the second purse-string nail box are provided with closing-up structures enabling passing purse-string nail legs to be alternately folded, and the surfaces of the first purse-string nail box and the second purse-string nail box facing a jaw are provided with purse strings positioned between the two nail legs of the purse-string nail.

When the purse-string nails are fired to pierce the lumen tissue, the purse-string nail legs are folded in a cross way, are firmly connected with the lumen tissue and are not easy to fall off from the lumen tissue, so that the safety of purse-string suturing is greatly improved.

The pouch nail pushing mechanism comprises: the nail pushing rod of the pouch nail, and a pouch nail pushing slider and a pouch nail pusher which are arranged aiming at each pouch nail box; for each pouch nail box, when the pouch nail pushing rod longitudinally drives the pouch nail pushing slider towards the far side, the inclined surface of the pouch nail pushing slider transversely drives the pouch nail pusher, so that the pouch nail pusher pushes the pouch nails out of the pouch nail firing opening.

Preferably, the closing-up structure is a closing-up inclined plane. The middle part of the crown of the purse-string nail is bent towards the firing opening of the purse-string nail. The surfaces of the first pouch nail box and the second pouch nail box facing the jaw are respectively provided with a line clamp, and the pouch lines are clamped on the line clamps. At least two line cards are arranged between two adjacent purse nails of the first purse-string nail box, and at least two line cards are arranged between two adjacent purse-string nails of the second purse-string nail box. The advantages of the embodiments are as before, and the description is not repeated here.

The embodiment of the utility model provides a purse-string forceps, the concrete form that the tong arm opened closing mechanism is not limited, for example, can adopt the similar structural style with aforementioned end effector, also can adopt the structural style of ordinary operation pincers, and first tong arm and second tong arm are articulated, will keep silent through two grab handles of operator manual operation and close. When the end effector is similar in structure to the end effector described above, the opening and closing mechanism and the purse-string suturing mechanism may be driven synchronously, the closing lever and the purse-string nail pushing lever may be of an integral structure or different members may be connected to each other to achieve synchronous driving, and further, the opening and closing mechanism and the purse-string suturing mechanism may be driven separately.

It will be apparent to those skilled in the art that various changes and modifications may be made without departing from the spirit and scope of the invention. Thus, if such modifications and variations of the present invention fall within the scope of the claims and their equivalents, the present invention is also intended to include such modifications and variations.

Claims

1. An end effector, comprising:

a first clamp arm (10a) and a second clamp arm (10b), wherein the first clamp arm (10a) and the second clamp arm (10b) can move relatively under the action of an opening and closing mechanism so as to open or close a jaw formed by the first clamp arm (10a) and the second clamp arm (10 b);

a suturing mechanism (11), the suturing mechanism (11) being provided on one side of the longitudinal direction of the first and second forceps arms (10a, 10 b);

a purse-string suture mechanism (12), wherein the purse-string suture mechanism (12) is arranged on the other side of the first forceps arm (10a) and the second forceps arm (10b) in the longitudinal direction;

a cutting mechanism (13), the cutting mechanism (13) being disposed between the suturing mechanism (11) and the purse string suturing mechanism (12);

the purse string device (12) comprises:

the nail driving device comprises a first pouch nail box (14a) arranged on the first clamp arm (10a), a second pouch nail box (14b) arranged on the second clamp arm (10b), pouch nails (57) are respectively arranged in the first pouch nail box (14a) and the second pouch nail box (14b), the pouch nails (57) are triggered by a pouch nail pushing mechanism, pouch nail triggering ports of the first pouch nail box (14a) and the second pouch nail box (14b) are provided with closing structures (56) enabling nail legs (571) of passing pouch nails (57) to be closed, and pouch lines (58) located between the two nail legs (571) of the pouch nails (57) are arranged on the surfaces, facing the first pouch nail box (14a) and the second pouch nail box (14 b).

2. The end effector as claimed in claim 1, characterized in that the purse nail firing ports of the first and second purse nail magazines (14a, 14b) have a closing-in structure (56) that brings the legs (571) of passing purse nails (57) together crosswise.

3. The end effector as claimed in claim 2, wherein said cuff structure (56) is a cuff ramp.

4. The end effector as claimed in claim 2, wherein a middle of a crown (572) of said purse-string staples (57) is curved towards said purse-string staple firing ports.

5. The end effector as claimed in claim 1, characterized in that the jaw-facing surfaces of the first and second purse-string nail magazine (14a, 14b) are each provided with a line clip (15), the purse wire (58) being clipped to the line clip (15).

6. The end effector as claimed in claim 5, characterized in that at least two said line cards (15) are provided between two adjacent said purse nails (57) of said first purse nail magazine (14 a); at least two line cards (15) are arranged between two adjacent poufs (57) of the second pouf magazine (14 b).

7. The end effector as claimed in claim 1, wherein said purse-string staple pushing mechanism comprises: a pouch nail pushing rod, a pouch nail pushing slider (16) and a pouch nail pusher (17) which are arranged aiming at each pouch nail box;

for each pouch nail box, when the pouch nail pushing rod longitudinally drives the pouch nail pushing slider (16) towards the far side, the inclined surface of the pouch nail pushing slider (16) transversely drives the pouch nail pusher (17), so that the pouch nail pusher (17) pushes the pouch nails (57) out of the pouch nail firing opening.

8. The end effector as claimed in claim 7, wherein the pouch nail pusher (17) is a resilient pouch nail pusher, or the pouch nail pusher (17) has a tightening groove (17 a) formed on a side facing the crown (572) of the pouch nail (57), and when the pouch nail pusher (17) pushes the pouch nail (57) out of the pouch nail firing opening, the pouch nail pusher (17) is located in the closing structure (56) and is in a compressed state.

9. The end effector as claimed in claim 1, characterized in that said stapling mechanism (11) comprises:

the nail anvil (18) is arranged on the first clamp arm (10a), the nail magazine (19) is arranged at a position, corresponding to the nail anvil (18), of the second clamp arm (10b) when the clamp is closed, the nail (20) is arranged in the nail magazine (19), the nail (20) can be fired by the nail pushing mechanism, and the nail pushing mechanism comprises:

the staple pushing mechanism comprises: the nail pushing device comprises a nail pushing rod, a nail pushing slider (21) and a nail pusher (22), when the nail pushing rod longitudinally drives the nail pushing slider (21) towards the far side, the inclined surface of the nail pushing slider (21) transversely drives the nail pusher (22), so that the nail pusher (22) pushes the nail (20) out of the nail box (19) and is formed under the action of the nail anvil (18).

10. The end effector as claimed in claim 1, characterized in that said cutting mechanism (13) comprises: a cutting knife (23) which can move between the stitching mechanism (11) and the purse string stitching mechanism (12) under the action of the push knife mechanism.

11. The end effector as claimed in claim 10, wherein said first and second jawarms (10a, 10b) have a slot (24) to accommodate movement of said cutting blade (23).

12. The end effector as claimed in claim 1, wherein said first jawarm (10a) and said second jawarm (10b) are both rotatable movable jawarms; or the first clamp arm (10a) is a fixed clamp arm which cannot rotate, and the second clamp arm (10b) is a movable clamp arm which can rotate; or the second clamp arm (10b) is a fixed clamp arm which cannot rotate, and the first clamp arm (10a) is a movable clamp arm which can rotate.

13. The end effector as claimed in claim 12, wherein said opening and closing mechanism includes a closure bar having a closure flange (25) disposed at a distal end thereof, said first and second jawarms (10a, 10b) having a compression spring disposed therebetween, said closure flange (25) engaging a closure surface on said first and/or second jawarms (10a, 10b) and closing said jaws against a spring force of said compression spring when said closure bar is actuated to move longitudinally distally, said jaws being openable upon return of said compression spring when said closure bar is retracted.

14. The end effector as claimed in any one of claims 1 to 13,

at least two of the opening and closing mechanism, the suturing mechanism (11), the purse string suturing mechanism (12) and the cutting mechanism (13) are synchronously driven; or,

the opening and closing mechanism, the suturing mechanism (11), the purse string suturing mechanism (12) and the cutting mechanism (13) are driven respectively.

15. The end effector as claimed in claim 14, wherein the end effector is an end effector having endoscopic specifications.

16. A surgical instrument, comprising: a handle (26) and an end effector (27) according to any of claims 1 to 15 driven by the handle (26).

17. The surgical instrument according to claim 16, further comprising an elongated body (28) having a drive mechanism (29) disposed therein, a distal side of the handle (26) being coupled to the end effector (27) through the elongated body (28), the handle (26) providing drive for opening and closing, stapling, cutting, and purse string suturing of the end effector (27) through the drive mechanism (29).

18. Purse-string forceps, characterized in that it comprises:

the first clamp arm and the second clamp arm can move relatively under the action of an opening and closing mechanism so as to open or close a clamp opening formed by the first clamp arm and the second clamp arm;

19. The purse-string forceps of claim 18, wherein the cinching structure is a cinching ramp.

20. The purse-string forceps according to claim 18, wherein a crown of the purse-string staples is curved toward the purse-string staple firing mouth.

21. The purse-string forceps according to claim 18, wherein the first and second purse-string nail magazines have respective wire clips on their surfaces facing the jaws, the purse-string being clipped to the wire clips.

22. The purse-string forceps according to claim 21, wherein at least two of the line clips are disposed between adjacent two of the purse nails of the first purse-string nail magazine; at least two line cards are arranged between every two adjacent purse nails of the second purse nail box.

23. Purse-string forceps according to any one of claims 18 to 22,

the opening and closing mechanism and the purse string mechanism are synchronously driven; alternatively, the opening and closing mechanism and the purse string suturing mechanism are driven separately.

24. The purse-string forceps according to claim 23, wherein the purse-string nail pushing mechanism comprises: the nail pushing rod of the pouch nail, and a pouch nail pushing slider and a pouch nail pusher which are arranged aiming at each pouch nail box;

aiming at each pouch nail box, when the pouch nail pushing rod longitudinally drives the pouch nail pushing slider towards the far side, the inclined plane of the pouch nail pushing slider transversely drives the pouch nail pusher, so that the pouch nail pusher pushes the pouch nails out of the pouch nail firing opening.

25. The purse-string forceps according to claim 24, wherein the purse-string nail pusher is an elastic purse-string nail pusher, or a tightening groove is formed in one side of the purse-string nail pusher facing the crown of the purse-string nail, and when the purse-string nail pusher pushes the purse-string nail out of the purse-string nail firing opening, the purse-string nail pusher is located in the closing-up structure and is in a compressed state.