CN206651850U - Medical instrument - Google Patents

Abstract

The present disclosure herein provides a medical instrument, i.e., a laparoscopic grasping and cutting instrument. The medical device includes: a clamping portion for clamping tissue; and a sharp segment that acts as a scissors to cut the suture. In some embodiments, the apparatus further comprises: a short tooth in the first jaw that sits on a corresponding hole or recess in the second jaw; flat portions on both jaws with shallow pads or grooves on both jaws to be able to grip the suture without slipping when traction is applied to tighten the knot that has been formed; and a hollow portion or small recess to hold the needle and also to act as a knot pusher to secure the knot formed by the extracorporeal knotting technique. The medical device may simplify the laparoscopic suturing procedure and make it easier for the surgeon to learn and perform the procedure.

Description

medical instruments

Cross References to Related Applications

This application claims the benefit of US Provisional Application 62/241,034, entitled "SUTURE PARTNER," filed October 13, 2015, the entire contents of which are incorporated herein by reference.

technical field

The present disclosure generally relates to surgical tools used to simplify surgical procedures, in particular the task of laparoscopic suturing.

Background technique

In laparoscopic surgery, the number and types of steps performed through the laparoscopic access increase exponentially. However, the factor limiting an individual's ability to expand the range of steps they can perform has always been a lack of suturing skills. Therefore, there is a need for a laparoscopic instrument that allows a surgeon to easily learn and perform laparoscopic procedures, such as laparoscopic suturing.

Utility model content

The present disclosure herein provides an improved laparoscopic gripping and cutting instrument. According to some embodiments, the medical device includes: a gripping portion for gripping tissue; and a sharpened section for use as scissors to cut sutures. In some embodiments, the medical device further comprises: a first jaw and a second jaw; a flat portion on both jaws, with shallow pads or grooves on both jaws to allow traction to Able to grip the suture without slipping when fastening an already formed knot; and a hollow portion or small groove to hold the needle and also serve as a knot pusher to secure knots formed by extracorporeal knot-tying techniques. In some embodiments, the medical device is configured in working length and diameter for laparoscopic surgery, micro-laparoscopic surgery, robot-assisted laparoscopic surgery, and bariatric surgery. In some embodiments, bipolar power is provided to both clamps, or unipolar power is provided to one clamp. In some embodiments, one jaw is configured to move back and forth in a horizontal plane in a motion similar to a hand saw. In some embodiments, the first jaw includes short teeth located on corresponding holes or recesses in the second jaw.

For purposes of brevity, some aspects, advantages and novel features of the invention are described herein. It is to be understood that not necessarily all such advantages may be achieved in accordance with any particular embodiment of the invention. Thus, for example, those skilled in the art will recognize that the invention may be practiced or carried out in a manner to achieve one advantage or group of advantages as taught herein without necessarily achieving other advantages as may be taught or suggested herein.

Description of drawings

The foregoing and other features, aspects, and advantages of the present disclosure are described in detail below with reference to the accompanying drawings of various embodiments that are intended to illustrate rather than limit the present disclosure. The accompanying drawings include the following figures, in which:

Figure 1 illustrates an embodiment of the end of a laparoscopic tool or instrument described herein, such as the embodiments described below;

Figures 2 and 3 show other embodiments of laparoscopic instruments where the full scale of the instrument is visible;

Figures 4, 5, 6, 7 and 8 further illustrate an embodiment of a laparoscopic instrument, providing a more detailed view of the jaws of the instrument;

Figures 9A and 9B further illustrate an embodiment of a laparoscopic instrument, providing a more detailed view of an embodiment of an instrument jaw.

detailed description

Although several embodiments, examples, and illustrations are disclosed below, those of ordinary skill in the art will appreciate that the scope of the invention described herein goes beyond the specifically disclosed embodiments, examples, and illustrations, and includes other uses of the invention and obvious modifications and their equivalents. Embodiments of the present invention are described with reference to the drawings, wherein like reference numerals refer to like elements throughout. The terminology used in the description given here is not intended to be interpreted in any limited or restrictive manner, only as it is used in conjunction with the detailed description of some specific embodiments of the present invention. Furthermore, embodiments of the invention may include several novel features, no single one of which is solely responsible for its desirable attributes or is essential to practicing the invention described herein.

In laparoscopic surgery, the number and types of steps performed through the laparoscopic access increase exponentially. However, the factor limiting an individual's ability to expand the range of steps they can perform has always been a lack of suturing skills.

Every surgeon tries to improve their suturing skills by attending a laparoscopic workshop integrated with a suturing workshop. Trainers often say to participants: "If you can't suture, you shouldn't have surgery". The first or two days in each workshop are usually devoted to laparoscopic suturing. "Hints" and "tricks" on how to tie vessels, flesh stems, and repair organs are passed from trainer to participant regarding these unfortunate complications that occur during laparoscopic surgery.

A suture needle includes a tip, a body and an end. A suture is attached to the end of the needle. The suture is usually attached by being inserted into a hole at the end of the needle and then crimping the needle to hold the suture securely. The action of securing the needle is to drive the needle all the way through the fleshy stem, then cut the needle away from the suture, and finally tie the two loose suture ends together to form a knot. In the case of laparoscopic surgery, after the suture knot is tied, the needle (which is now loose) must be removed.

In one example procedure of laparoscopic suturing, a laparoscopic needle holder holding a needle is passed through a laparoscopic port, and the needle is then driven through tissue; in this case, for purposes of description, the vaginal fornix. Needles with the specific suture required are passed through both sides of the vaginal vault. A gripper passed through the other laparoscopic port, usually from the opposite side, then pulls the needle out of the tissue. The needle is then driven again through another portion of the fornix until the entire fornix opening is sutured. One holder is removed and scissors are brought in to cut the needle away from the suture. Remove the scissors and reintroduce the holder. The surgeon then forms the knot by holding one end of the suture with one holder and wrapping it around the other holder. Next, a second gripper grabs the free suture end and pulls to tie the knot. Finally, the holder is removed and the scissors reintroduced to cut the suture ends shorter. Then remove the scissors.

The exemplary laparoscopic suturing procedure described above can be complex and difficult to learn and perform. Various embodiments of the laparoscopic instruments disclosed herein can simplify the laparoscopic suturing process and make the process easier to learn and perform. The term "suture partner" is used herein to describe various embodiments of laparoscopic instruments, and the term is not always used to refer to the same embodiments of laparoscopic instruments. In some embodiments, the term suture is paired with the terms laparoscopic tool, laparoscopic instrument, surgical tool, surgical instrument, laparoscopic holder, laparoscopic scissors, surgical holder, surgical scissors, combined laparoscopic clip Holders and scissors, combined surgical holders and scissors, and/or the like may be used interchangeably.

In some embodiments, laparoscopic instrument 100 (alternatively referred to as a medical instrument, surgical tool, suture counterpart, etc.) may include at least one clamp 102 , preferably a pair of clamps 102 . Clamp 102 may include a gripping portion or end 104 , a sharpened section 106 and a tip 108 . The clamp can extend from the tip 108 to the base 112 . The clamp 102 can pivot about a pivot point 110 located at a base 112 . The tip 108 may include a tooth 252 and/or a plurality of teeth 252 . Tip 108 may include a recess or recess 254 for receiving one or more teeth 252 . In some embodiments, tip 108 is blunt or rounded. Clamp 102 may include a flat portion 116 . The clamping portion 104 or flat portion 116 may include pads or grooves 114, 114A, 120, 120A. Clamp 102 may be coupled to shaft 150 and/or insert 154 . Insert 154 may be configured to be positioned within outer sheath 152 to form shaft 150 . Shaft 150 may be connected to handle 200 . The handle 200 may include and/or be connected to a rotation or locking mechanism 202 .

One advantage of the various embodiments of the suture partner 100 disclosed herein is that they can perform all (or in some embodiments, some) of the tasks of the opposing hand (ie, the hand not driving the needle) during suturing. In some embodiments, the suture counterpart is designed to provide one, more or all of the following functions during suturing:

●Clamping organization;

● receiving needle;

Hold the suture to pull it through the knot; and/or

• After the knot is tied, cut the end of the suture.

To perform these functions, some embodiments of the suture counterpart include at least two jaws 102 including:

The clamping part 104 is used to clamp the tissue;

- Sharpened section 106, which acts as scissors to cut the suture.

In some embodiments, these features are provided sequentially along the length of suture partner jaw 102 (ie, in a linear configuration). They begin at the tip 108 in the sequence listed above and end at the pivot point 110 at the base 112 of the jaw. In other embodiments, features may be positioned or configured differently. Referring to Figure 1, in some embodiments, the length of the scissor portion is no more than 10 mm. In other embodiments, the scissor and gripper portions may be longer or shorter in length. In some embodiments, the length of the scissor portion is about the same as the length of the gripper portion. In other embodiments, the length of the scissor portion is longer or shorter than the length of the gripper portion.

In some embodiments, the suture counterpart also includes a handle 200 (any type; eg, a pistol grip, or a squeeze/release grip). In some embodiments, the suture counterpart also includes at least one shaft 150 that culminates in a clamp comprising the features described above. Optionally, some embodiments may include an outer sheath 152 and an inner insert 154 that culminates in the clamp.

Some embodiments of the suture counterpart desirably include one or more of the following features that help achieve the stated benefits:

• In some embodiments (eg, FIGS. 9A and 9B ), the front tip 108 of one jaw includes short teeth 252 perpendicular to the flat surface of the jaw. The teeth are located in corresponding holes or recesses 254 in the opposing jaws to allow for good tissue gripping when the jaws are closed. This ensures that tissue does not slip out of the gripper's handle when under tension.

- In some embodiments, the front tip 108 of the one or more jaws is blunt or rounded. The blunt tip can desirably grip delicate tissue such as the bladder or bowel.

- behind the front tip 108, the flat portion 116 on the jaws, with shallow pads or grooves 114, 114A, 120, 120A on both jaws, so that when traction is applied to tighten the formed knot , able to grip the suture without slipping.

• Additionally, the hollow portion or small groove 118 is used to hold the needle and also acts as a knot pusher to secure knots formed by extracorporeal knot tying techniques;

• Finally, the short scissor portion 106 on both jaws is used to cut sutures or knots.

In some embodiments, it is desirable for the shaft 150 or inner insert 154 of the suture counterpart to have a rotation mechanism 202 so that the gripper and scissor portions can be positioned at different angles to provide greater maneuverability. For example, a knob or dial (as shown in FIG. 2 ) can be used to rotate the shaft through 360° (or, in some embodiments, less than 360°) in order to change the axis of opening and closing of the gripper so that the suture The counterpart holds tissue presented at different angles. In this and other embodiments, a mechanism may be provided to lock the gripper jaws in place when they are fully closed, thereby securely holding tissue. It may be safer that the surgeon does not need to exert constant pressure on the handle 200 to keep the jaws closed, but instead must manually unlock the jaws (eg, by pressing a button) before opening them.

Some embodiments provide a range of features for laparoscopic suturing that in other cases can only be provided through the sequential use of several different instruments. During laparoscopic surgery, changing between two instruments is a time-consuming process that involves the surgeon removing the first instrument through the laparoscopic port, passing it to a nurse or technician for replacement on an instrument cart, the option and identifying the new instrument needed (in most cases, verbally), receiving the new instrument from the nurse or technician (assuming the nurse or technician correctly identified the requested instrument), and finally introducing it through the laparoscopic port in vivo. Embodiments of the present disclosure thus simplify and shorten laparoscopic suturing procedures by providing all of the most necessary functions in one instrument; namely, gripping tissue under traction without slipping, gripping and holding suture material without slipping, thereby Helps form knots, then cut knots.

In some embodiments, the outer diameter of the suture counterpart can vary, for example, from a larger instrument to a typical laparoscope size of between 5mm and 10mm, to a miniature laparoscope size of 2mm-3mm, or any other desired variation. In some embodiments, the length of the instrument will be a standard laparoscopic length of approximately 35 cm, determined by the shaft length of the instrument or the length of the outer sheath and inner insert of the instrument. However, the suture counterpart can be provided in any length desired. In some embodiments, such as robotic-assisted laparoscopic surgery, longer lengths may be required.

The advent of robot-assisted laparoscopic surgery necessitated a change in the location of the laparoscopic port to a higher position on the anterior abdominal wall. Whereas laparoscopic ports are usually placed below the umbilical cord, robotic ports are placed in line with or above the umbilical cord.

In robot-assisted laparoscopic surgery, the robotic console is pushed in and placed on the left side of the patient. The boom holding the laparoscope holder is then extended over the patient. There is usually one camera port and as many as 3 or 4 other ports, since the robot has 3 or 4 arms (depending on the model). Long robotic instruments are attached to a panel that moves the instruments in response to input from a surgeon who operates the robot from a control station remote from the operating table. The surgical assistant stands on the right side of the patient, taking care not to obstruct the moving robotic handle and boom. Assistant operating ports through which suction can be introduced, applied and removed, additional grippers, scissors and needles to assist the robotic surgeon. In particular, the assistant has to introduce the needle which the attending physician will manipulate using the robotic arm. The assistant's ports are placed much higher than the robot's ports to avoid collisions of the instruments during manipulation and to avoid the boom and handle hitting the assistant.

Some embodiments of suture counterpart 100 may be suitable for use in assisting robotic-assisted laparoscopic surgery. These embodiments of the suture partner 100 may, for example, provide a longer working length than conventional laparoscopic versions. Typically, the laparoscopic length will be in the region of 35 cm, while in many cases the robotic length is desirably in the region of 45 cm to account for higher port placements. This longer length is also suitable for bariatric surgery where the larger girth of the patient requires a longer working length of the laparoscopic instrument.

During laparoscopic suturing, the main task of the robotic assistant is to cut and remove the suture ends and used needles. Typically, an assistant will use a separate gripper and scissors for these tasks. Each insertion requires careful inspection to ensure that no vital organs are in the path of the instrument, for this purpose the telescope must be retracted to provide visualization. This results in a further loss of continuity in the operational flow, in addition to the existing delays due to instrument changeover as previously described. The delay is particularly undesirable in robotic situations where the patient is in a steep "head down" position. Prolonged anesthesia is also undesirable in obese patients with a high body mass index. Thus, providing at least dual functionality in one embodiment of the suture counterpart reduces the chance of instruments colliding with each other during surgery and reduces the frequency of required instrument changes.

In addition to the suture partner configurations described above, other embodiments may include various additional designs and features.

In one embodiment, bipolar tissue sealing or monopolar functionality may be provided such that both suture counterpart jaws 102 are active and conductive. In this and other embodiments, the suture counterpart may incorporate a bipolar holder having a sealing member and a cutting member. The sealing member will be provided through the use of bipolar coagulation energy and/or the like, while the grooves 120, 114 in the gripper jaws and/or the like will provide protection against the stalk held by the suture counterpart. compression of blood vessels. The cutting function can be provided by bipolar energy, or alternatively continue to be performed with manual "cold" scissors.

Alternatively, in some embodiments, suture partner 100 may be used as a monopolar dissector or cutter. For example, one clamp 102 would be active while the other clamp would be a straight piece of non-conductive insulating material upon which the first clamp would rest when the other clamp is closed. A typical application is in laparoscopic total hysterectomy, where the lower segment of the cervix is transected to leave the cervix in situ. After inserting the instrument through the laparoscopic port, the active unipolar clamp will be opened so that the insulated clamp is placed under the cervix. This placement of the insulated clamps will hold the bowel away from the energy and cutting action when the cervix is transected by closing the active clamps. Both clamps can be of variable length, with their outer diameters adapted to the ports through which they are required to pass. In various embodiments, some of the possible shapes for the active clamp can vary from sharpened needles to blades with or without serrations.

In another embodiment, the suture counterpart can provide a manual or motorized dissector by moving the active jaws back and forth in a horizontal plane in a motion similar to a hand saw. This embodiment may be manually operated by hand, or operated by batteries or an external battery source. When used in this embodiment, the instrument can achieve a cutting effect without the need for monopolar electrical activity of the active jaws.

Although the suture counterpart 100 has been primarily disclosed in the context of a laparoscopic surgical instrument, it could readily be used in other settings. These settings include, for example, other forms of abdominal surgery, as well as other industries. Accordingly, the invention of the suture counterpart should be considered to include such modifications in size and strength as are necessary for these modes of use.

Unless specifically stated otherwise or otherwise understood in the context of use, conditional terms such as "could," "would," "could," or "may" are generally intended to mean that certain embodiments include, while others Embodiments do not include certain features, elements and/or steps. Thus, such conditional language is generally not intended to imply that features, elements and/or steps are in any way essential to one or more embodiments, or that one or more embodiments must include The logic of the decision is made where prompted regardless of which features, elements and/or steps are included or will be implemented in any particular embodiment. Headings used herein are for the convenience of the reader only and are not meant to limit the scope of the invention or the claims.

Although these inventions have been disclosed in the context of certain embodiments and examples, those skilled in the art will appreciate that the invention extends beyond the specifically disclosed embodiments to other alternative embodiments and/or uses of the invention, and obvious modifications and equivalents thereof. Additionally, those skilled in the art will recognize that any of the above methods may be performed using any suitable equipment. Furthermore, any particular feature, aspect, method, property, characteristic, quality, attribute, element, etc. disclosed herein in connection with an embodiment can be used in all other embodiments set forth herein. For all of the embodiments described herein, the steps of the methods need not be performed sequentially. Therefore, the scope of the invention disclosed herein should not be limited by the specific disclosed embodiments described above.

Claims (5)

1. a kind of medicine equipment, it includes：

First clamp and the second clamp, it has to clamp the retained part of tissue respectively；

Sharp section, the sharp section are used as scissors to cut suture；

Flat on two clamps, there is shallow underbed or groove on two clamps, to apply traction with tight Gu during the knot formed, suture can be clamped without sliding；With

Hollow space or little groove, to keep syringe needle and also serve as knot propeller to fasten by external knot tying techniques shape Into knot.

2. medicine equipment according to claim 1, the medicine equipment is configured to be suitable to abdomen in active length and diametrically Endoscope-assistant surgery, Micro laparoscopic operation, Robot-assisted transperitoneal laparoscopic operation and bariatric procedure.

3. medicine equipment according to claim 1, wherein bipolarity electric flux are provided to described two clamps, Huo Zhedan Polarity electric flux is provided to a clamp.

4. medicine equipment according to claim 1, one of pincer structure is in the horizontal plane with similar to handsaw Motion is movable.

5. medicine equipment according to claim 1, wherein first clamp includes the phase being located in second clamp Short tooth on the hole answered or depression.