TW567051B - Multifunctional operation clamp and ligation ring for the operation clamp - Google Patents
Multifunctional operation clamp and ligation ring for the operation clamp Download PDFInfo
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- TW567051B TW567051B TW92109565A TW92109565A TW567051B TW 567051 B TW567051 B TW 567051B TW 92109565 A TW92109565 A TW 92109565A TW 92109565 A TW92109565 A TW 92109565A TW 567051 B TW567051 B TW 567051B
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567051 五、發明說明(1) 【發明所屬之技術領域】 本發明係與手術用之哭b 術钳裝置,該裝置係具有詳而言之係指一種手 織並將之結紮止血等一連貫^術部位之組織、切開組 自操作者。 、乍業之功能,並便於手術者獨 【先前技術】 按,利用手術刀片切開組織、 線結紮出血點或大血管或含 & w械止血、用縫 ,是外科醫師-般手術::;二==1…_ 手術空間狹小或較深之手術部位;程,但在 廣為流行的内視鏡手術為例二展。以目前 或血管里端都必需依靠昂貴的替 ” & 較λΙ的血其C血&吉^ SCalpel)為例,它們僅能對 最乂二:在—以下)有止血效果;另以目前 最廣泛使^的雙極電燒儀(bipQlar eleetWgery 'd:::孰么能對較大的血管凝固止▲,但對週邊組 ^有本大的”,、侩。,即使以最新的組織凝集儀 )以尚電流低電壓降低週邊組織熱傷害為優點,其能凝固 用ϊΐ血官直徑雖據稱可達7nim,但較諸以一條普通手術 =秦即可以輕易結紮直徑達〗〇mm的血管而言,適用範圍 ’常用的欽合金單個夹子(ciip)或是直 排的釘(Staplers)可以夾住血管或封住一片含血管的組織 -有永不及收的異物存留組織反應。單純為結紮用發展 567051 五、發明說明(2) 出的各式圈套(例如:r〇e(ier loop......等),其使用時遠 不如想像的方便,而且大體積組織的結紮時其所具有之結 糸力塁是否可靠值得存疑。上述各種替代結紮或止血方式 所使用的裔械设備或能源,不僅是非常昂貴(動辄數拾萬 或數百萬台幣)且須配合耗時的學習使用過程,部份設備 使用不慎更有嚴重的重大危險。 【發明内容】 本發明旨於解決上揭缺失,其主要目的在於提供一種 多功能手術钳,其操作非常容易、便利、安全,尤其適合 深而狹小的手術空間。 [實施方式】 為使貴審查委員能進一步瞭解本發明之目的、特徵 以及所達成=功效,以下茲舉本發明一較佳實施例,並配 合圖式詳細說明於后,其中,圖式之安排為: 第/圖係一標準外科結之結構圖。 第二圖顯不將標準外科結轉換成本發明之結紮圈套之 中間過稃。 第彡圖顯示本發明之結紮圈套之結構。 第四圖係顯不結紮圈套可調整套口大小之狀態 第五圖顯f將結紮圈套形成一安全結之狀態Γ 第六圖儀第五圖之局部放大圖。 第七圖係本發明—較佳實施例之手術鉗之立體圖。 第八圖係第七圖之大部分解立體圖。 第九圖係第七圖之前半段之立體圖。567051 V. Description of the invention (1) [Technical field to which the invention belongs] The present invention relates to a surgical bladder forceps device, which has a coherent technique such as a kind of hand weaving and ligation to stop bleeding. The organization and incision of the site are performed by the operator. The function of Zhaye and it is convenient for the surgeon. [Previous technology] Press and use a surgical blade to cut open tissues, ligate bleeding points or large blood vessels or contain & w to stop bleeding and use sutures. It is a surgeon-like operation ::; Two == 1 ..._ Surgery site with narrow or deep surgical space; Cheng, but in the popular endoscopic surgery as an example. For example, the current or the inner end of the blood vessel must rely on expensive replacement "& C blood & ^ SCalpel) than λ1 blood, they can only have the best effect on the second most (below-below); The most widely used bipolar electric burner (bipQlar eleetWgery 'd ::: 孰 can stop coagulation of larger blood vessels ▲, but has a large size for peripheral groups ^, 侩, even with the latest organization Agglutination instrument) has the advantage of low current and low voltage to reduce thermal damage to surrounding tissues. Although its diameter can be up to 7nim, it can be easily ligated with a diameter of up to 0 mm compared with a common surgery = Qin. In terms of blood vessels, the scope of application 'common ciip alloy single clips (staples) or straight nails (staples) can clamp blood vessels or seal a piece of tissue containing blood vessels-there is never a foreign body retention tissue response. Development of 567051 for ligation only V. Various types of snares (for example: roe (ier loop ...)) from the description of invention (2), which are far less convenient than imagined, and have large volume of tissue It is doubtful whether the ligament strength it has at the time of ligation is reliable. The above-mentioned alternative equipment or energy used by various methods of ligation or hemostasis are not only very expensive (tens of thousands or millions of Taiwan dollars) and must be used. In conjunction with the time-consuming learning and use process, some equipment is used with care and has more serious and serious dangers. [Summary of the Invention] The present invention aims to solve the missing problem, and its main purpose is to provide a multifunctional surgical forceps, whose operation is very easy, Convenient and safe, especially suitable for deep and small surgical space. [Embodiment] In order to make your reviewers understand the purpose, features, and effectiveness of the present invention, a preferred embodiment of the present invention is given below and cooperated with The drawings are explained in detail later, among which, the arrangement of the drawings is as follows: Figure / Figure is a structural diagram of a standard surgical knot. The second figure shows a standard ligature loop that does not convert the standard surgical knot into an invention. The middle part of the sleeve is crossed. The second figure shows the structure of the ligature snare according to the present invention. The fourth figure shows the state where the size of the ligature can be adjusted and the size of the mouth is adjusted. The fifth figure shows the state where the ligation snare forms a safety knot. Partial enlarged view of the fifth figure of the plotter. The seventh figure is a perspective view of the surgical forceps of the preferred embodiment of the present invention. The eighth figure is a mostly exploded perspective view of the seventh figure. The ninth figure is the first half of the seventh figure Perspective view.
567051 五、發明說明(3) 第十圖係本發明之手術鉗之後半段之立體圖。 第十一圖顯示各該下顎前端之結構。 第十二圖係各該下顎末端之結構。 第十三圖係第十二圖中將小刀片裝設於下顎末端之狀 態。 第十四圖顯示結紮圈套與定位元件之配合狀態。 第十五圖係本發明之局部構造圖,顯示拉引件之相關 位置。567051 V. Description of the invention (3) The tenth figure is a perspective view of the second half of the surgical forceps of the present invention. The eleventh figure shows the structure of each front end of the lower jaw. The twelfth figure is the structure of each end of the lower jaw. The thirteenth figure is a state in which the small blade is installed at the end of the lower jaw in the twelfth figure. The fourteenth figure shows the mating state of the ligation collar and the positioning element. The fifteenth figure is a partial structural drawing of the present invention, showing the relevant position of the pull-in member.
第十六圖顯示結紮圈套裝設於鉗口之狀態。 第十七圖顯示本發明操作時夾住組織之狀態。 第十八圖顯示切割組織之狀態。 第十九圖及第二十圖係顯示使結紮圈套結紮切割後之 莖端之過程。 第二十一圖係顯示扣壓扳機以拉動第二拉動件之狀 態。 第二十二圖顯示連動第三拉動件之狀態。The sixteenth figure shows the state where the ligature ring set is set in the jaw. Figure 17 shows the state where the tissue is clamped during operation of the present invention. The eighteenth figure shows the state of the cut tissue. Figures 19 and 20 show the process of ligating the cut end of the ligature loop after cutting. The twenty-first figure shows a state in which the trigger is pulled to pull the second puller. The twenty-second figure shows the state of interlocking the third puller.
第二十三圖係顯示切割結紮圈套之多餘缝線之狀態。 第二十四圖係顯示本發明實際操作之連續示意圖,即 夾住-> 切割—套住—套牢—固結—切餘線。 本發明一較佳實施例係提供如第七圖所示之一手術鉗 裝置’包含:一手術甜以及二裝設於該手術甜上之結紮圈 套。以下首先說明有關該結紮圈套之部份。 本發明之結紮圈套(2 0 )之構形係如第三圖所示,各該 結紮圈套可由一標準的外科結衍變而成。請參閱第一圖,The twenty-third figure shows the state of the extra suture of the cutting and ligation snare. The twenty-fourth figure is a continuous schematic diagram showing the actual operation of the present invention, that is, clamping-> cutting-locking-fixing-consolidation-cutting line. A preferred embodiment of the present invention provides a surgical forceps device 'as shown in FIG. 7 including: a surgical sweet and two ligatures mounted on the surgical sweet. The following first explains the part about the ligation snare. The configuration of the ligating snare (20) of the present invention is shown in the third figure, and each of the ligating snares can be derived from a standard surgical knot. See the first picture,
第6頁 567051 五、發明說明(4) 顯示一般用以結紮組織(如血管)之標準外科結(1〇),係以 外科Μ用的多股編織及表面處理過(braided & coated) ,縫線(本實施例係以coated usp"〇” p〇lyglactin91〇 為 簽考縫線)編結而成。所編結成之標準外科結(丨〇 )具有一 兩次纏繞部位(1 2 )、一位於外側之第一單次交纏部位(丨4 ) 以及一位於最外側之第二單次交纏部位(16)。將該外科結 (10)之線#又A於該一單次交纏部位(14)(16)之處拉直時, 可呈第二圖之狀態,接著再將線段A於該二次纏繞部位 (12)之處拉直時,即可形成第三圖所示之本發明之呈變形 =科結的結紮圈套(2〇)。該結紮圈套具有一套口(21)以及 二/了結部位(22),該打結部位(22)具有由線段b繞設於線 ^ A t之多數個圈部··線段6首先自套口( 2 1 ) 一側纏繞於線 ^上,形成一第一圈部(23),接著於該圈部(23)近套口 之侧繞成一第二圈部(2 4 ),自該第二圈部(2 4 )形成一 一圈部(23)之第一跨部(25)後,於第一圈部(23)另 二==成了第三圈部(26),復於該第三圈部(26)之自由側 ^ 第四圈部(27),該第三、第四圈部(26)(27)間並 具有一苐二跨部(28)。 般之Ξ ΐ ί之該變形的結紮圈套於使用狀態上即有別於一 之端Α科結,盍,標準外科結係將縫線兩端(即圖一 纏緊於每一交纏部位(12)(14)(16)均施以拉力進而 —死了;而本發明之結紮圈套係具有二項特色: 姓,於每f結紮圈套(2〇)並非為死結,而係呈可滑動之活 ° :該打結部位(22)被定位之狀態下,例如以手捏住該Page 6 567051 V. Description of the invention (4) The standard surgical knot (10), which is generally used to ligate tissue (such as blood vessels), is braided &coated; The suture (coated usp " 〇 "p〇lyglactin 91〇 is used as the signature suture in this embodiment) is knitted. The knitted standard surgical knot (丨 〇) has one or two entangled parts (1 2), one The first single entanglement site (丨 4) located on the outer side and the second single entanglement site (16) located on the outermost side. The line #A of the surgical knot (10) is in the single entanglement When the part (14) (16) is straightened, it can be in the state of the second figure, and then when the line segment A is straightened at the secondary winding part (12), it can be formed as shown in the third figure According to the present invention, the ligature loop (20) is deformed = knotted. The ligature loop has a set of mouths (21) and two / knotted portions (22), and the knotted portions (22) have a line b wound around the line ^ Most loops of A t ... The line segment 6 is first wound on the thread ^ from one side of the ferrule (2 1) to form a first loop (23), and then the loop The side of the sleeve (23) near the mouth of the sleeve is wound into a second loop portion (2 4). After the second loop portion (2 4) forms a first span portion (25) of a loop portion (23), One lap section (23) and the other two == become the third lap section (26), which is the free side of the third lap section (26) ^ The fourth lap section (27), the third and fourth lap sections (26) (27) and has a two-span section (28). 之 Ξ ΐ The deformed ligature loop is different from the one at the end of the department A knot, 盍, standard surgical tie The two ends of the suture (that is, the figure 1 is entangled to each entangled part (12) (14) (16) are all pulled and died—and the ligating loop of the present invention has two characteristics: surname, Yu Each ligature loop (20) is not a dead knot, but is slidable. °: The knotted part (22) is positioned, for example, the pinch
567051567051
J結部位;或將結紫圈套穿入於具有開口之 弟四圖所示之環體(18)為例),使打結部位受到擋j而j 位,此%,拉動活動端A時,可改變套口( 21)之^小。 用J二ΐ套口(21)調整至適當尺寸後,如第五圖所示 用力拉動固疋端Β,使該打結部位(22)之第四圈部 拉直,而線段Α則被迫形成—結部(29) ’如第五圖, 於線段B上,如此,該結紮圈套(2〇)係形成一牢靠的 結(壬死結狀悲)。藉此,該套口( 2丨)即無法被外張,產生 束套作用。經發明人實際試驗,該安全結具有和標準外 結一樣的結紮強度。 須5兒明的疋,本發明於圖式上係將打結部位(2 2 )書的 較寬鬆以便於瞭解,實際上係呈緊密狀態。 旦 而本發明所提供之手術鉗(30),請參閱第七、八圖, 包含有: 一鉗體(32),具有一固定柄(33)及一活動柄(36),該 固定柄(3 3 )上側設一朝前延伸之管身(3 4 ): 一指孔(3 5), 位於該管身(34)上方;該活動柄(36)頂端係樞接於該固定 柄(3 3)頂端,並位於固定柄後方,而得與固定柄相開合。 活動柄(36)設有一通孔(361),恰對應於該管身(34)後端 ,一對開槽(3 7)’係沿該管身轴向設於管身中段之周面。 一對透空部(3 8 ),設於管身前端二側。 一第一連桿(40)與一第二連桿(45),係穿設於該管身 (3 4 )中,而得沿管身滑移,且該二連桿前端均凸伸至管身 前端。其中,第一連桿(40)後端係樞接於該活動柄(36)之J-knot position; or put the knot of purple knot into the ring body (18) shown in Figure 4 with the opening brother as an example), so that the knotted part is blocked by j and j position, this%, when pulling the movable end A, The size of the mouthpiece (21) can be changed. After adjusting to the proper size with the J2 sleeve (21), pull the fixed end B strongly as shown in the fifth figure, so that the fourth circle of the knotted part (22) is straightened, and the line segment A is forced Formation-knot (29) 'As shown in the fifth figure, on the line segment B, so, the ligature loop (20) is formed into a firm knot (undead knot-like sadness). As a result, the sleeve opening (2 丨) cannot be stretched out, which causes a binding effect. After practical experiments by the inventors, the safety knot has the same ligating strength as a standard external knot. To be clear, the present invention is to loosen the knotted part (2 2) of the book on the drawing for easy understanding, but it is actually in a tight state. Once the surgical forceps (30) provided by the present invention, please refer to the seventh and eighth figures, including: a forceps body (32) having a fixed handle (33) and a movable handle (36), the fixed handle ( 3 3) A pipe body (3 4) extending forward is provided on the upper side: a finger hole (3 5) is located above the pipe body (34); the top of the movable handle (36) is pivotally connected to the fixed handle (3 3) The top end is located behind the fixed handle so as to open and close with the fixed handle. The movable handle (36) is provided with a through hole (361), which corresponds to the rear end of the pipe body (34). A pair of slots (37) are arranged along the axial direction of the pipe body on the circumferential surface of the middle section of the pipe body. A pair of hollow portions (38) are provided on two sides of the front end of the tube body. A first connecting rod (40) and a second connecting rod (45) are threaded through the tube body (3 4) to slide along the tube body, and the front ends of the two connecting rods both protrude to the tube. Body front. The rear end of the first link (40) is pivotally connected to the movable handle (36).
567051 五、發明說明(6) 通孔(361)中;而該第二連桿(45)後端則自該通孔(361)穿 出’並凸伸出活動柄後方。一第一彈性元件(4 6 ),套設於 該第二連桿(45)上,一端抵於第二連桿末端,而另一端則 抵於該活動柄,使第二連桿於未受外力作用時保持往後滑 移之狀態。一狹槽(42),自該第一連桿(40)前端沿軸向往 内開設;一刀片(48),固設於該第二連桿(45)前端。該第 一連桿(45)係置於第一連桿(40)頂面,如第十圖,該刀片 (48)恰置入於該狹槽(42)中,如第九圖。 一按壓裝置(5 0 ),於本實施例係包括一扳機(5丨)與一 槓桿(60)。 ^ 該扳機(51)於本實施例中具有一圓盤狀之身部(52)及 一連接於身部周面之扳桿(55),該身部周面另設有一凸輪 部(5 3 )。扳機(51 )係以其身部(5 2 )樞設於該钳體上而可轉 動;該扳桿(55)係朝前凸伸出鉗體前緣,以供人手扳動。 一保險栓(56),係樞設於該鉗體上而可角位移,其一 知具一鉤部(5 7 )。當該保險栓位於--^扣位置時,該鉤部 恰可鉤接於扳機之凹部(54),使扳機無法轉動。 該槓桿(6 0 )底端係樞設於固定柄(3 3 )而可擺動,並位 於扳機(51)後方,·一第二彈性元件(65),係連接於該扳機 與=f桿,其彈性能一方面使槓桿未受外力作用時,保持 往前靠之狀態,而另一方面則使扳機保持於未扳動之位置 。該槓桿(6 0 )所設凸部係觸接於扳機之身部(5 2 ),扳動扳 機時,其凸輪部(53)得撥動槓桿(60)之凸部(62),使槓桿 之自由端向後擺動。須說明的是,該扳機不以圖式所示者 567051 五、發明說明(7) 為限,將一扳機以可前後滑移之方式裝設於該鉗體,將扳 機往後按壓時,同樣可使扳機後端推動槓桿往後位移。 一拉環(70),具有一環身(72)以及二分別固接於該環 身頂底端之環部(74);該拉環係以該環身(72)穿套設於总 身(3 4 )外周而可滑移。 g 拉動件(75) 拉動件(76)以及一第三拉 第 第 動件(78),如第九、十圖,係以鋼絲為佳,其均設於&管 身(34)内,而可前後滑動。該二第一、第二拉動件(75) (76 )刀別位於官身二側;而該第三拉動件(78 )係位於管身 底側。須說明的是,管身内周壁於設置該等拉動件(75) (76)(78)及該第二連桿(45)之處可製成較大壁厚,並於壁 厚處設置細小的孔道,以供該等物件穿設其中。 ^苐拉動件(7 5 )後端係分別固設於拉環之環身 件(di如第十圖’俾可受拉環所拉動。該二第二拉動 = ? = :別連接於該槓桿(6°)之自由端,俾受槓 兮其身:欠 第一拉動件(75)(76)之前端係暴露於 :二身(34)之各該透空部(38)之處,如第七九圖。該第 端屮係自該管身(34)近钳體(32)處之底緣所 二Vi Γ:Λ,並連接於一設在鉗體上之連接鈕 本〜: ί連ί(79?可於固定柄(33)上上下位移。 ,二】\ fi不疋柄丽緣係一斷面呈ΐ形之導軌(331) 該導=接紐(79)係—呈㈣之桿件,欲接於 成等軌而可上下移動。惟,車 此為限。一第三彈性元件(/如 移動之方式不以 TViai),如弟八、十圖所示,其 567051 五、發明說明(8) 一端係連接於該連接鈕(79),而另一端係連接^_連接部 (58),該連接部係為該保險栓("56—部份 同步位移;該彈性元件(7 9 1 )之彈性能係使該保險栓保持 於卡扣位置,並使該連接紐(7 9 )保持於其位移行程中之上 止點’該連接鈕位於上止點時,恰位於該扳機之扳桿(5 5 ) 正下方。 一鉗口(80),具有二併列之下顎(82)及二併列之上顯 (84)。本實施例中,該二下顎(82)係一體成型於一桿體^ (81 )之前端,該二下顎間並具有一間隙(821 )。藉由將該 桿體(81)自管身(34)前端固設於管身中,即可使該二下^ (82)位於管身前端,同時,該桿體(81)係位於第一連桿^ (40)下方。該二上顎(84)後端各具有二樞接點(c)(d),位 於下方之樞接點(c )係分別樞接於桿體(8丨),形成一轉動 支點j位於上方之樞接點(d)則樞接於該第一連桿(4〇)前 端。藉此,該二上顎係樞接於該二下顎上方,當第一連桿 位移而連動上顎(84)時,該二上顎即可與該二下顎產生 開、合之作動。另,於該二上顎前端可共同以一釘體(87) 口疋叮更確保上顎之開合動作一致。該二上顎間係且一 間隙⑽),上、下顎之間隙(821 )(841 )與第一連桿之/狹 槽(4 2 )係位於同一軸向。 此外,各該上顎(84)周面係環設一凹槽(842);各該 Z顎(82)叫配合參閱第十一圖,於前端頂緣係設一漏斗 ^之凹入(821),略大於結紮圈套(2〇)之打結部位(22)之 積且各下顎之外側面前緣於臨近該凹入(821 )處係設 第11頁 567051 五、發明說明(9) " ~ 一小溝( 822),略大於縫線之直徑。二鋼片(85),分別固 設於該二下顆(82)前端,並各具有一透孔(85〇對應於各 該凹入(821) °復凊參閱苐十二圖,各該下顆(μ)之末端 外側面於近樞接關節處係往内開設一小縫(8 2 3 ),且其底 面於該小缝(823)後方係設一導槽(824)。 ’… 二小刀片(95),如第十二、十三圖,其刀刃係朝上, 該二小刀片係分別塞設於該二小縫(823)中,並可取出更 換。各該小刀片外端並設一保護片(9 5 1 )。 一定位元件(1 0 0 ),呈細桿狀,請參閱第十四圖,乃 係於一塑膠外皮内包覆一銅絲,銅絲二端並凸伸出塑膠外 皮,形成二可受力變形之鉤部(102)。 一拉引件(105),如第十五圖所示,本實施所示者係 為一圈套,該拉引件(105)中段係鉤接於該第三拉動件 (7 8 )鈾端之鉤部(7 8 1 )’而其二端係分別跨在各下顎底面 之導槽(824)並可反折向上,用以拉引縫線。 上述之各結紮圈套(20)係裝設各對上、下顆(82)(84) 中,請參閱第十四圖,首先將其套口(21)調整於配合各對 顎夾之大小,復將該定位元件(1 〇 〇 )二端之鉤部(丨〇 2 )鉤接 於該套口二侧。接著如第十六圖所示,將套口( 21)之上緣 嵌設於各上顎(84)之凹槽(842)中,並將各定位元件(1〇〇) 嵌設於各下顎頂面末端所設之嵌槽(825),之後將結紮圈 套(20)之^一線端A、B穿入各鋼片(85)之透孔,並使活動端 之線段A自該小溝(8 2 2)往後穿出,而固定端B之線段則自 該凹入(821)穿出,結紮圈套(20)之打結部位(22)係被定567051 V. Description of the invention (6) in the through hole (361); and the rear end of the second link (45) penetrates through the through hole (361) and protrudes behind the movable handle. A first elastic element (4 6) is sleeved on the second link (45), one end of which is against the end of the second link, and the other end of which is against the movable handle, so that the second link is When external force is applied, it keeps sliding backward. A slot (42) is opened axially inward from the front end of the first link (40); a blade (48) is fixed on the front end of the second link (45). The first link (45) is placed on the top surface of the first link (40), as shown in the tenth figure, and the blade (48) is just inserted into the slot (42), as shown in the ninth figure. A pressing device (50) includes a trigger (5) and a lever (60) in this embodiment. ^ In this embodiment, the trigger (51) has a disc-shaped body (52) and a lever (55) connected to the peripheral surface of the body, and a cam portion (5 3) is provided on the peripheral surface of the body. ). The trigger (51) is pivoted on the pliers body with its body (5 2) pivoted; the trigger lever (55) protrudes forward from the front edge of the pliers body for human hand to move. A safety bolt (56) is pivotally arranged on the pliers body and is angularly displaceable. One of the grips (57) is known. When the safety bolt is in the-^ buckle position, the hook portion can be hooked to the recess (54) of the trigger, so that the trigger cannot rotate. The bottom end of the lever (60) is pivotally mounted on the fixed handle (33) and is swingable, and is located behind the trigger (51). A second elastic element (65) is connected to the trigger and the = f lever. On the one hand, its elastic energy keeps the lever leaning forward when it is not subjected to external force, and on the other hand, it keeps the trigger in the un-trigger position. The convex part of the lever (60) is in contact with the trigger body (5 2). When the trigger is triggered, the cam part (53) of the lever (60) must move the convex part (62) of the lever (60) to make the lever Its free end swings backwards. It should be noted that the trigger is not limited to the one shown in the figure 567051 V. Invention description (7) is limited. When a trigger is installed on the pliers body in a way that can be slid forward and backward, when the trigger is pressed backward, the same The rear end of the trigger can move the lever backward. A pull ring (70) has a ring body (72) and two ring portions (74) respectively fixed to the top and bottom ends of the ring body; the pull ring is sleeved on the body with the ring body (72) ( 3 4) Sliding around the periphery. g pulling member (75) pulling member (76) and a third pulling member (78), as shown in the ninth and tenth drawings, it is better to use steel wires, which are all set in the & body (34), And can slide back and forth. The two first and second pulling members (75) (76) are located on the two sides of the official body; and the third pulling member (78) is located on the bottom side of the pipe body. It should be noted that the inner peripheral wall of the pipe body can be made with a larger wall thickness at the place where the pulling members (75) (76) (78) and the second link (45) are provided, and a small thickness can be provided at the wall thickness. Perforations for the passage of such objects. ^ 苐 The rear ends of the pull parts (7 5) are respectively fixed to the ring body parts of the pull ring (di as shown in the tenth figure '俾 can be pulled by the pull ring. The second and second pull =? =: Do not connect to the lever The free end of (6 °), the bearing body: its front end is owed to the first puller (75) (76) is exposed to: each of the hollow portions (38) of the second body (34), such as Figure 79. The second end is connected to the bottom edge of the tube body (34) near the clamp body (32), Vi Γ: Λ, and is connected to a connection button set on the clamp body ~: ί Lian (79?) Can be moved up and down on the fixed handle (33)., [2] \ fi does not have a handle. The edge of the rim is a cross-shaped guide rail (331). The guide = the joint (79) system-showing ㈣ The rod can be moved up and down if it is connected to an equal track. However, the car is limited to this. A third elastic element (/ if the way of movement is not TViai), as shown in figure 8 and 10, its 567051 5 2. Description of the invention (8) One end is connected to the connection button (79), and the other end is connected to the connection part (58), and the connection part is the safety bolt (" 56-partial synchronous displacement; the elasticity The elastic energy of the element (7 9 1) keeps the safety bolt in the snap position And keep the connecting button (7 9) at the top dead center in its displacement stroke. When the connecting button is located at the top dead center, it is just below the trigger lever (5 5) of the trigger. A jaw (80), There are two juxtaposed lower jaws (82) and two juxtaposed upper jaws (84). In this embodiment, the two lower jaws (82) are integrally formed at the front end of a rod body (81), and there is a space between the two lower jaws. The gap (821). By fixing the rod body (81) from the front end of the tube body (34) in the tube body, the two bottoms (82) can be located at the front end of the tube body, and at the same time, the rod body (81 ) Is located below the first link ^ (40). The rear ends of the two upper jaws (84) each have two pivot joints (c) (d), and the pivot joints (c) located below are pivotally connected to the rod respectively. (8 丨), forming a pivot joint point (d) where the pivot point j is located above is pivotally connected to the front end of the first link (40). Thus, the two upper jaws are pivotally connected above the two lower jaws. When the first link is displaced and the upper jaw (84) is linked, the two upper jaws can be opened and closed with the two lower jaws. In addition, a nail body (87) can be used at the front end of the two upper jaws to ensure more Opening and closing of palate The actions are the same. The gap between the two upper jaws and a gap ⑽), the gap between the upper and lower jaws (821) (841) and the first slot / slot (4 2) are in the same axial direction. In addition, each of the upper jaws ( 84) A groove (842) is provided on the peripheral ring; each Z jaw (82) is called as shown in FIG. 2〇) The product of the knotted part (22) and the front edge of the outer side of each jaw is adjacent to the recess (821). Page 11 567051 V. Description of the invention (9) " ~ a small groove (822), Slightly larger than the diameter of the suture. Two steel plates (85) are fixed on the front ends of the two lower pieces (82), respectively, and each has a through hole (85 ° corresponding to each of the recesses (821)). A small slit (8 2 3) is opened inward at the outer side of the end of the particle (μ) near the pivot joint, and a bottom surface is provided with a guide groove (824) behind the slit (823). The small blades (95), as shown in the twelfth and thirteenth drawings, have the blades facing upwards, and the two small blades are respectively inserted in the two small slits (823) and can be removed and replaced. The outer ends of the small blades A protective sheet (9 5 1) is also provided. A positioning element (100 0) is thin rod-shaped, please refer to the fourteenth figure, which is covered with a copper wire inside a plastic sheath, and the two ends of the copper wire are connected together. The plastic sheath protrudes to form two hooks (102) that can be deformed by force. A pull-out piece (105), as shown in FIG. 15, is shown in this embodiment as a snare, the pull-out piece ( 105) The middle section is hooked to the hook portion (7 8 1) 'of the uranium end of the third pulling member (7 8), and the two ends thereof respectively cross over the guide grooves (824) on the bottom surface of each jaw and can be folded back upward, Used to pull the sutures. The ligature ring (20) is installed in each pair of upper and lower particles (82) (84), please refer to the fourteenth figure, first adjust its sleeve (21) to match the size of each pair of jaws, The hooks (丨 〇2) at the two ends of the positioning element (100) are hooked to the two sides of the sleeve. Then, as shown in FIG. 16, the upper edge of the sleeve (21) is embedded in each upper jaw ( 84) in the groove (842), and each positioning element (100) is embedded in the recess (825) provided at the top end of each lower jaw, and then the first end A, B penetrates the through hole of each steel sheet (85), and makes the line segment A of the movable end pass out of the small groove (8 2 2), and the line segment of the fixed end B passes out of the recess (821), The knotted part (22) of the ligature snare (20) is fixed
第12頁 567051 五、發明說明(10) 位於各鋼片之透孔(851)以及該凹入(821)中。而套口(21) 下緣則環繞於各下顎(82)周面。下顎前端(或鋼片)周面可 設凹痕( 852),以利套口之下緣定位。藉此,該二結紫圈 套(2 0 )即分別定位於該二對顎夾(8 2 )上。 ” 接著’將各該結紮圈套(20)二端A、B穿過拉引件 (105) —端,如第十五圖,並使各該第一拉動件(75)之鉤 部(7 5 1)鉤接於結紮圈套(2 〇 )之活動端a所設之死結,如十 六圖,各該第二拉動件(76)之鉤部(761)前鉤接於固定端B 之死結。如此,即完成本發明之裝設狀態。 本發明於手術過程中之操作狀態說明如下: 首先以一手(如右手)握住該手術鉗(3〇)之固定柄(33) 及活動柄(36),將活動柄(36)外張,該第一連桿(4〇)即被 往後拉動而帶動該二上顆(84)往上張開。 將張開之钳口(80)對正待結紮之組織,復將活動柄 (36)往前靠合’如第十七圖,即可經由第一連桿(4〇)連動 上顆(84)閉合’將組織夾住於鉗口(8〇)中。活動柄(36)底 面之凸出部(361)所設之棘齒,可咬合於固定柄(33)後端 所設之棘齒(3 3 2 ),使手術鉗之把手保持閉合。 接著以另一手(如左手)往前推動該第二連桿(45),如 第十八圖,使該刀片(48)移入該二對顎夾間之間隙(821) (841),並移位至鉗口(80)前端進而切開組織。此外,如 第七圖所示,第二連桿(45)上得設一定位元件(49),可抵 於活動柄(36)背面,以作為第二連桿位移時之前止點。釋 放按壓之施力後,該第一彈性元件(46)之彈性能可將該第 567051 五、發明說明(11) 二連桿(45)推回,使刀片(48)歸位於桿體(81)間之狹槽 (42)中。 手術者復如第十九、二十圖所示,以左手之拇指穿入 钳體(32)之指孔(35)、食指與中指分別穿入拉環(7〇)之該 二環部(74),將拉環(70)往後拉動,經由該二第一拉動件 (75)同步將該二結紮圈套(2〇)之活動端a往後拉引,使結 紮圈套之套口( 21 )縮小,此時,各定位元件(丨〇 〇 )之鉤部 (102)係受力變形,使得各套口脫離被各定位元件鉤住之 狀恶,套口被拉引細小時,即脫離钳口,並往該二下顎之 前端外側收縮,且隨著手術者收攏套口之狀態,該二套口 即分別套住被切割分開後之莖端。之後,如第二十圖所示 ,操作者右手可逐漸將該活動柄(36)扳開,而左手則持續 的拉動拉環(70),以完成套口將莖端結紮至足夠緊度之動 完成上述動作後,扳動該保險栓(56)於解扣位置,如 第二十一圖,使其脫離扳機(51)之凹部(54),以右手食指 ^壓扳,,使身部(52)轉動,並由該凸輪部(53)將該 (6〇)在後推移,該二第二拉動件(76)即同步被槓桿往後拉 動’而拉引該二結紮圈套之固定端B ’使 五圖之安全結,令結紮圈套保持於結紮之大小翁办成弟 繼=往下㈣扳機⑸)時’即可觸動該連接鈕(?9), H :圖:進而拉動該第三拉動件(78)及該拉引件 (105),拉引件(1{)5)被拉動時其:端即分別 套(20)之a、B線斷下拉,如第-十-圓 :以…糸圈 乐一十二圖,並受各該小刀片Page 12 567051 V. Description of the invention (10) is located in the through hole (851) of each steel sheet and in the recess (821). The lower edge of the sleeve (21) surrounds the periphery of each jaw (82). The front surface of the lower jaw (or steel sheet) can be provided with dents (852) to facilitate positioning of the lower edge of the sleeve. As a result, the two-knot purple loops (20) are respectively positioned on the two pairs of jaw clamps (82). "Next, pass the two ends A and B of each of the ligating loops (20) through the end of the pull member (105), as shown in the fifteenth figure, and make the hook portion (7 5) of each of the first pull members (75). 1) The dead knot provided on the movable end a of the ligature loop (20) is hooked to the dead knot on the fixed end B in front of the hook portion (761) of each of the second pulling members (76), as shown in FIG. In this way, the installation state of the present invention is completed. The operation state of the present invention during surgery is described as follows: First, hold the fixed handle (33) and movable handle (36) of the surgical forceps (30) with one hand (such as the right hand). ), The movable handle (36) is stretched out, and the first link (40) is pulled backward to drive the two upper pieces (84) to open upward. Align the opened jaws (80) to be ligated For the organization, move the movable handle (36) forward, as shown in the seventeenth figure, and then close the upper (84) through the first link (40) to clamp the tissue in the jaw (80). ). The ratchet teeth provided on the protruding portion (361) on the bottom surface of the movable handle (36) can be engaged with the ratchet teeth (3 3 2) provided on the rear end of the fixed handle (33) to keep the handle of the surgical forceps closed. . Then with the other hand (Such as the left hand) push the second link (45) forward, as shown in the eighteenth figure, move the blade (48) into the gap (821) (841) between the two pairs of jaw clamps, and shift to the jaw ( 80) The front end further cuts the tissue. In addition, as shown in the seventh figure, a positioning element (49) must be provided on the second link (45), which can abut the back of the movable handle (36) as a second link displacement Before the dead center. After the pressing force is released, the elastic energy of the first elastic element (46) can push the 567051 V. Description of the invention (11) the two connecting rods (45) back to return the blade (48) It is located in the slot (42) between the rods (81). As shown in Figures 19 and 20, the operator uses the thumb of his left hand to penetrate the finger holes (35), index and middle fingers of the forceps (32). The two ring portions (74) of the pull ring (70) are respectively penetrated, the pull ring (70) is pulled backward, and the two ligature loops (20) are synchronized by the two first pull members (75). The end a is pulled back to shrink the sleeve opening (21) of the ligature loop. At this time, the hook portion (102) of each positioning element (丨 〇〇) is deformed by force, so that each sleeve opening is disengaged from the hook of each positioning element. State of living Evil, the sleeve is pulled for a small time, that is, it is released from the jaw and contracted to the outside of the front end of the two lower jaws, and as the operator gathers the sleeve, the two sleeves respectively cover the cut stems. Afterwards, as shown in the twentieth picture, the operator can gradually pull the movable handle (36) away with the right hand, while the pull ring (70) is continuously pulled by the left hand to complete the sleeve mouth and ligate the stem end sufficiently tightly. After completing the above action, move the safety bolt (56) to the unlocking position, as shown in Figure 21, to release it from the recess (54) of the trigger (51). The body part (52) rotates, and the cam part (53) pushes the (60) back, and the two second pulling members (76) are simultaneously pulled backward by the lever, thereby pulling the two ligature loops. Fixed end B 'When the safety knot of the five pictures is made, and the ligature loop is kept at the size of the ligature, then the brother can turn the trigger button (⑸), then the connection button (? 9), H: Figure: The third pulling member (78) and the pulling member (105) are further pulled. When the pulling member (1 {) 5) is pulled, its: ends are respectively a, (a) of the sleeve (20), The B line is pulled down, such as the -Tenth-circle: take the picture of the circle 12 and ...
第14頁Page 14
JO/UMJO / UM
五、發明說明(12) 即順利完成 置。 只須重新將 結紮後切除縫線之作業。 二個結紮圈套裝設於該钳 (95)所切斷。藉此, 即可移開該手術錯裝 欲再次使用時, 口即可。 本發明所提供之手撤扭壯 於手術者獨自操作,對於丄其設計相當合理,且易 縫線等手術過程係一貫以;、!:結紫莖端及切除多餘 . 貝并菜迅速完成。在狹空間内所能*士 糸1組織體積與厚度較現有昂貴之内視鏡手術器械為佳、: 同柃,本發明係摸擬手指功能而設計,及利用任何外科較 師早已具備的手術技巧’故無需長時間學習。4复因本 為機械性之設計,不需任可危險能源,故安全性極高,同 567051 圖式簡單說明 第一圖係一標準外科結之結構圖。 第二圖顯示將標準外科結轉換成本發明之結紮圈套之 中間過程。 第三圖顯示本發明之結紮圈套之結構。 第四圖係顯示結紮圈套可調整套口大小之狀態。 第五圖顯示將結紮圈套形成一安全結之狀態。 第六圖係第五圖之局部放大圖。 第七圖係本發明一較佳實施例之手術鉗之立體圖。 第八圖係第七圖之大部分解立體圖。 第九圖係第七圖之前半段之立體圖。 第十圖係本發明之手術鉗之後半段之立體圖。 第十一圖顯示各該下顎前端之結構。 第十二圖係各該下顎末端之結構。 第十三圖係第十二圖中將小刀片裝設於下顎末端之狀 態。 第十四圖顯示結紮圈套與定位元件之配合狀態。 弟十五圖係本發明之局部構造圖’顯不拉引件之相關 位置。 第十六圖顯示結紮圈套裝設於钳口之狀態。 第十七圖顯示本發明操作時夾住組織之狀態。 第十八圖顯示切割組織之狀態。 第十九圖及第二十圖係顯示使結紮圈套結紮切割後之 莖端之過程。 第二十一圖係顯示扣壓扳機以拉動第二拉動件之狀V. Description of the invention (12) The installation was completed successfully. It is only necessary to cut the suture again after ligation. Two sets of ligature rings are set in the forceps (95) for cutting. In this way, you can remove the surgical disguise when you want to use it again. The hand withdrawing provided by the present invention is stronger than the operation performed by the surgeon alone, which is quite reasonable in design and easy to suture. Surgical procedures such as easy suture are consistent;,!: Knotting purple stem ends and removing excess. Pipid vegetables are quickly completed. What can be done in a narrow space: The tissue volume and thickness of Shiyi 1 is better than the existing expensive endoscopic surgical instruments. Same as above, the present invention is designed to mimic the function of fingers, and to use any surgery that the surgeon already has. Skills' so it doesn't take long to learn. 4 The multi-factor is a mechanical design and does not require any dangerous energy, so it is extremely safe. It is briefly explained with the 567051 diagram. The first diagram is a structural diagram of a standard surgical knot. The second figure shows the intermediate process of converting a standard surgical knot into the ligation snare of the invention. The third figure shows the structure of the ligature snare of the present invention. The fourth picture shows the state of the adjustable mouth size of the ligature snare. The fifth figure shows a state in which the ligation snare is formed into a safety knot. The sixth figure is a partially enlarged view of the fifth figure. The seventh figure is a perspective view of a surgical forceps according to a preferred embodiment of the present invention. The eighth figure is a mostly exploded perspective view of the seventh figure. The ninth figure is a perspective view of the first half of the seventh figure. The tenth figure is a perspective view of the second half of the surgical forceps of the present invention. The eleventh figure shows the structure of each front end of the lower jaw. The twelfth figure is the structure of each end of the lower jaw. The thirteenth figure is a state in which the small blade is installed at the end of the lower jaw in the twelfth figure. The fourteenth figure shows the mating state of the ligation collar and the positioning element. The fifteenth figure is a partial structural drawing of the present invention 'showing the relevant position of the pull-out member. The sixteenth figure shows the state where the ligature ring set is set in the jaw. Figure 17 shows the state where the tissue is clamped during operation of the present invention. The eighteenth figure shows the state of the cut tissue. Figures 19 and 20 show the process of ligating the cut end of the ligature loop after cutting. The twenty-first picture shows the state that the trigger is pulled to pull the second puller.
567051 圖式簡單說明 態。 弟一十二圖顯不連動第三拉動件之狀雜。 ,二十三圖係顯示切割結紮圈套之多餘縫線之狀態。 第二十四圖係顯示本發明實際操作之連續示意圖,即 士7?划-卷/拿一> 卷定 —^ ΙΪ1 、 1 ^ i · 夹住·切割~~>套住 圖號簡單說明: 套牢—固結—切餘線。 結紮圈套(20) 套口(21) 打結部位(22) 圈部(23)(34)(26)(27) 跨部(25)(28) 手術鉗(30) 鉗體(32) 固定柄(33) 管身(34) 指孔(35) 活動柄(3 6 ) 通孔(361 ) 開槽(37) 透空部(38) 連桿(40 )(45) 狹槽(42) 彈性元件(46) 刀片(48) 按壓裝置(50) 扳機(51) 身部(52) 凸輪部(53) 凹部(5 4 ) 扳桿(55) 保險栓(56) 鉤部(57) 連接部(58) 槓桿(60) 凸部(6 2 ) 彈性元件(65) 拉環(70) 環身(72) 環部(74) 拉動件(75)(76)(78) 連接鈕(79) 彈性元件(7 91) 钳口( 8 0 ) 下顎(82) 間隙(821) 凹槽(842) 下顎(84) 凹入(821) 小溝(822) 小縫(823) 導槽(824) 鋼片(85) 透孔(851) 拉引件(105) 小刀片(95) 定位元件(1 0 0 )567051 Schematic description of the state. Brother Twelve shows that the shape of the third puller is not mixed. , Twenty-three pictures show the state of the extra suture of the cutting and ligation snare. The twenty-fourth figure is a continuous schematic diagram showing the actual operation of the present invention, that is, 7 strokes-roll / take one > roll-up— ^ ΙΪ1, 1 ^ i · pinch · cut ~~ > Description: Fasten-consolidation-tangent line. Ligation ferrule (20) Ferrule (21) Knotted part (22) Loop (23) (34) (26) (27) Span (25) (28) Surgical forceps (30) Forceps body (32) Fixing handle (33) Tubular body (34) Finger hole (35) Movable handle (3 6) Through hole (361) Slot (37) Hollow section (38) Connecting rod (40) (45) Slot (42) Elastic element (46) Blade (48) Pressing device (50) Trigger (51) Body (52) Cam (53) Recess (5 4) Trigger lever (55) Safety bolt (56) Hook (57) Connecting portion (58 ) Lever (60) Convex part (6 2) Elastic element (65) Pull ring (70) Ring body (72) Ring part (74) Pulling member (75) (76) (78) Connecting button (79) Elastic element ( 7 91) Jaw (80) Jaw (82) Clearance (821) Groove (842) Jaw (84) Recessed (821) Small groove (822) Small slit (823) Guide groove (824) Steel sheet (85) Through-hole (851) Pull-out piece (105) Small blade (95) Positioning element (1 0 0)
第17頁Page 17
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TW92109565A TW567051B (en) | 2003-04-24 | 2003-04-24 | Multifunctional operation clamp and ligation ring for the operation clamp |
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WO2025000599A1 (en) * | 2023-06-30 | 2025-01-02 | 麦迪领先医疗科技(深圳)有限公司 | Ligation device capable of automatically cutting ligature wire |
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WO2025000599A1 (en) * | 2023-06-30 | 2025-01-02 | 麦迪领先医疗科技(深圳)有限公司 | Ligation device capable of automatically cutting ligature wire |
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