CN104546046A - 包括支撑材料的圆形手术吻合装置 - Google Patents
包括支撑材料的圆形手术吻合装置 Download PDFInfo
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
Abstract
本发明公开了一种包括支撑材料的圆形手术吻合装置。提供了一种用于与圆形手术吻合装置一起使用的支撑材料和安装结构件组件。所述组件包括:环状的安装结构件,其被定大小为具有摩擦性地接合吻合钉钉仓组件的径向内表面的外径,其中所述安装结构件被布置在所述吻合钉钉仓组件的径向内表面内;环形的支撑材料,其覆于所述吻合钉钉仓组件的组织面向表面之上,所述环形的支撑材料限定了外径向末端边缘以及径向内末端边缘,所述外径向末端边缘径向延伸超过一对环形阵列的吻合钉接纳狭槽,所述径向内末端边缘延伸横过所述安装结构件;以及至少一个缝合部,其将所述支撑材料固定至所述安装结构件。
Description
技术领域
本公开涉及手术吻合装置以及用于与所述手术吻合装置一起使用的支撑材料,并且更具体地,涉及用于将支撑材料附接至用于在吻合术操作中使用的手术吻合装置的结构和方法。
背景技术
当连结或用吻合术接合多种身体结构(例如肠或支气管)时,已经惯例地使用吻合钉来替代缝合。被用来施加这些吻合钉的手术吻合装置通常被设计为同时地切断并密封患者体内的组织的延伸段,从而极大地减小了这种操作的时间和风险。
为了将身体组织段连结在一起和/或为了吻合的产生,外科医生利用线性的或环形的手术吻合装置来按照顺序地或同时地施加一个或多个线性排的手术紧固件(例如,吻合钉或两件式的紧固件)至身体组织。线性的手术吻合装置通常包括一对钳夹或类似手指的结构,待被连结的身体组织被放置在上述一对钳夹或类似手指的结构之间。当手术吻合装置被致动和/或“被发射”时,发射杆纵向地移动并且接触钳夹之一中的吻合钉驱动构件,并且手术吻合钉被推动穿过身体组织并且进入/抵靠在相对钳夹中的砧座,从而使吻合钉卷曲闭合。可以设置刀具刀片以在吻合钉排/线之间切断。在序号为4,354,628、5,014,899和序号为5,040,715的美国专利中描述了这种手术吻合装置的实例,上述专利中的每一个全部均通过引用合并在此。
环形手术吻合装置通常包括:环形的吻合钉钉仓组件,其包括多个环形排的吻合钉,通常为两排;砧座组件,其与环形的钉仓组件操作性地结合;以及环形刀片,其被布置在吻合钉排的内部。在序号为5,799,857和序号为5,915,616的属于Robertson等人的美国专利中描述了这种环形手术吻合装置的实例,上述专利中的每一个全部均通过引用合并在此。
通常,端对端的吻合术的吻合器典型地将一阵列的吻合钉放入患者的肠或其他管状器官的邻近的段。因而发生的吻合术包含反转的肠段,该肠段包含大量“B”形状的吻合钉以在肠的邻近段之间保持固定的连接。
对于大多数操作,使用光秃(bare)的吻合钉通常是能够接受的,其中,吻合钉与患者的组织直接接触。一般来说,组织的完整将用于防止吻合钉在愈合发生之前撕下组织且危及密封。然而,在一些手术操作中,外科医生将手术支撑件(例如,网状件或支撑材料)与线性的吻合装置结合使用从而桥接、修复和/或加强患者体内的组织缺损,尤其是那些发生在身体的腹壁、胸壁、横膈膜、以及其他肌-腱膜区域的组织缺损。在序号为3,054,406、3,124,136、4,347,847、4,655,221、4,838,884、5,002,551和7,942,890的美国专利中公开了这种适合的手术支撑件的实例,上述专利中的每一个的全部均通过引用合并在此。
当在使用手术支撑件(即,加强材料)的手术操作中施加吻合钉时,吻合钉的支腿典型地从钉仓钳夹穿过一层手术支撑件,并在遇到砧座钳夹之前穿过患者的组织。
当上述的手术支撑件与线性的手术吻合装置协力使用时,则存在一种需求,即需求一种用于与环形或圆形手术吻合装置协力使用的环形的支撑结构,例如,端对端吻合术的吻合钉,诸如可从COVIDIEN LP,New Haven,CT获得的并且在序号为5,392,979的属于Green等的美国专利中公布的“EEATM”器械。
任何端对端的肠吻合术的一个可能的副作用是其随着时间而遭受器官狭窄的倾向,这可以使管腔的直径随着时间而减小。因此,存在一种需求,即需求一种环形的手术结构,其与任何端对端的、环形的、或圆形吻合术或吻合装置协力操作并协助于使用吻合术接合的肠或其他管状的器官的管腔随着时间而保持打开。
还存在一种需求,即需求一种环形的支撑结构,其与任何端对端的、环形的或圆形吻合装置协力操作以减小患者所承受的损伤、减小渗漏情况、减小流血情况并在邻近身体组织之间产生相对强的联结。
发明内容
本公开涉及用于将支撑材料附接至用于在吻合术操作中使用的手术吻合装置的结构和方法。
根据本公开的一个方案,提供了用于连结组织部分的手术吻合装置,其包括:手柄组件;管状主体部,其被支撑在手柄组件的远侧端上,所述管状主体部具有包含多个手术吻合钉的吻合钉钉仓组件,多个手术吻合钉在一对环形阵列的吻合钉接纳狭槽内,所述吻合钉接纳狭槽形成在吻合钉钉仓组件的组织面向表面内,吻合钉钉仓组件限定了径向内表面和径向外表面;以及砧座组件,其在手术吻合装置的远侧端,砧座组件具有轴,轴用于将砧座组件可拆卸地连接至管状主体部,砧座组件和管状主体部沿着轴相对于彼此并置并且被布置为使得相对于彼此接近。
手术吻合装置进一步包括:环状的安装结构件,其被定大小为具有摩擦性地接合吻合钉钉仓组件的径向内表面的外径,其中所述安装结构件被布置在吻合钉钉仓组件的径向内表面内;环形的支撑材料,其覆于吻合钉钉仓组件的组织面向表面之上,环形的支撑材料限定了外径向末端边缘以及径向内末端边缘,外径向末端边缘径向延伸超过一对环形阵列的吻合钉接纳狭槽,径向内末端边缘延伸横过安装结构件;以及至少一个缝合部,其将支撑材料固定至安装结构件。
根据本公开的另一个方案,提供了用于与圆形手术吻合装置一起使用的支撑材料和安装结构件组件,圆形手术吻合装置包括包含多个手术吻合钉的吻合钉钉仓组件,多个手术吻合钉在一对环形阵列的吻合钉接纳狭槽内,吻合钉接纳狭槽形成在吻合钉钉仓组件的组织面向表面内,吻合钉钉仓组件限定了径向内表面和径向外表面。支撑材料和安装结构件组件包括环状的安装结构件,环状的安装结构件被定大小为具有摩擦性地接合吻合钉钉仓组件的径向内表面的外径,其中所述安装结构件被布置在吻合钉钉仓组件的径向内表面内;环形的支撑材料,其覆于吻合钉钉仓组件的组织面向表面之上,环形的支撑材料限定了外径向末端边缘以及径向内末端边缘,外径向末端边缘径向延伸超过一对环形阵列的吻合钉接纳狭槽,径向内末端边缘延伸横过安装结构件;以及至少一个缝合部,其将支撑材料固定至安装结构件。
安装结构件可以由弹性材料制成。
每一个缝合部可以延伸穿过支撑材料并穿过安装结构件。
每一个缝合部可包括第一端、第二端、以及将所述第一端和所述第二端相互连接的桥接部,其中每一个缝合部的所述第一端和所述第二端延伸穿过支撑材料并穿过安装结构件。
支撑材料可以限定:环形的内附接部;环形的中间吻合钉接合部,其被布置在内部的径向外部;和环形的外部,其被布置在中间部的径向外部。
每一个缝合部可以延伸穿过支撑材料的环形的内附接部。每一个缝合部的所述第一端和所述第二端可延伸穿过支撑材料并穿过安装结构件。
每一个缝合部的桥接部可以沿横向于支撑材料的中央轴线的方向延伸。
安装结构件的近侧的且外部的角可为倒角的。
根据本公开的又一个方案,提供了使用与圆形手术吻合装置一起使用的支撑材料和安装结构件组件的方法,圆形手术吻合装置包括包含多个手术吻合钉的吻合钉钉仓组件,多个手术吻合钉在一对环形阵列的吻合钉接纳狭槽内,吻合钉接纳狭槽形成在吻合钉钉仓组件的组织面向表面内,吻合钉钉仓组件限定了径向内表面和径向外表面。
所述方法包括如下步骤:提供支撑材料和安装结构件组件,支撑材料和安装结构件组件包括环状的安装结构件,环状的安装结构件被定大小为具有摩擦性地接合吻合钉钉仓组件的径向内表面的外径;使环形的支撑材料覆于吻合钉钉仓组件的组织面向表面之上,其中,环形的支撑材料限定了外径向末端边缘以及径向内末端边缘;以及至少一个缝合部将支撑材料固定至安装结构件。
所述方法进一步包括如下步骤:将支撑材料和安装结构件组件至少部分地定位在手术吻合装置的钉仓组件内从而使得安装结构件被布置在吻合钉钉仓组件的径向内表面内;以及,环形的支撑材料的外径向末端边缘径向地延伸超过一对环形阵列的吻合钉接纳狭槽,环形的支撑材料的径向内末端边缘延伸横过安装结构件。
所述方法进一步包括如下步骤:接纳砧座组件和钉仓组件之间的身体组织;抓紧砧座组件和钉仓组件之间的身体组织;以及发射手术吻合装置以从吻合钉钉仓组件驱动出多个吻合钉穿过支撑材料和身体组织;以及切断至少一个缝合部的径向外部的支撑材料。
安装结构件可以由弹性材料制成,并且,将支撑材料和安装结构件组件至少部分地定位在手术吻合装置的钉仓组件内的步骤可以包括:弹性的安装结构件以压配合的方式径向地接合吻合钉钉仓组件的内表面。
所描述的本公开的上述方案中的任何一个都可以与本公开的任何其他方案结合而不会脱离本公开的范围。
附图说明
被并入且构成本说明书一部分的附图图示出本公开的实施例,并且所述附图与上文中本公开的概括描述以及下文中实施例的详细描述一起用于解释本公开的原理,其中:
图1是根据本公开的范例性的环形手术吻合装置的立体图;
图2是图1的手术吻合装置的头部的部件分离的立体图;
图3是图1的手术吻合装置的头部的另一个立体图,图示出了从头部分离的支撑材料和安装结构件;
图4是图1的手术吻合装置的头部的另一个立体图,图示出了被连接至头部的支撑材料;
图5是沿图4中的线5-5截取的图1的手术吻合装置的头部和砧座组件的剖视图,并且显示为处于一对身体管腔之间的位置;
图6是图5细部所指示区域的放大视图;
图7是根据本公开的另一个实施例的紧固件的立体剖视图,所述紧固件用于将支撑材料固定至安装结构件;
图8是图7细部所指示区域的放大视图;
图9是根据本公开的另一个实施例的紧固件的放大的、立体的剖视图,所述紧固件用于将支撑材料固定至安装结构件;以及
图10是患者的肠内区域的立体图,图示出了定位图1的环形手术吻合装置以将砧座组件连接至管状主体部的方法。
具体实施方式
现在将参照附图详细描述本公开的环形手术吻合装置的实施例,其中,相同附图标记指代相似或相同的元件。如本文所使用的以及惯用的,术语“远侧”指的是最远离用户的部分,而术语“近侧”指的是最接近用户的部分。
首先参照图1和图2,本文公开了一种用于与支撑材料一起使用的环形手术吻合装置,并且,所述环形手术吻合装置总体指定为10。手术吻合装置10包括手柄组件12,该手柄组件12具有至少一个能枢转的致动手柄构件20,以及推进构件22。提供了管状主体或轴部14,其从手柄构件12延伸出,并且其可以被构造为沿着其长度具有弯曲形状。主体或轴部14终止在吻合钉钉仓头组件16内。吻合钉钉仓头组件16被配置为在其内接纳吻合钉导引件60。吻合钉导引件60包括至少一个环形阵列的吻合钉接纳狭槽62和多个吻合钉70,其中,环形阵列的吻合钉接纳狭槽62被限定在吻合钉导引件60的远侧端内,多个吻合钉70中的每一个被各自布置在每一个吻合钉接纳狭槽62内。例如,吻合钉导引件60可以包括一个、两个、或多于两个环形阵列的吻合钉接纳狭槽62。吻合钉接纳狭槽62被限定在吻合钉导引件60远侧端的组织面向或接触表面内。
典型地,吻合钉钉仓头组件16包括吻合钉推动器53,该吻合钉推动器53包括近侧部和远侧部,其中,近侧部具有大体截头圆椎体的形状,远侧部限定了两个同心环的沿圆周分隔的指状部52,指状部52中的每一个被各自接纳在吻合钉导引件60的对应的吻合钉接纳狭槽62的一个中。
此外,吻合钉钉仓头组件16包括刀具74,该刀具74是大致开口杯的形式,并且该刀具的边限定了刀具边缘,刀具被布置在吻合钉钉仓头组件16内并被安装至吻合钉推动器53。刀具边缘布置在一对环形阵列的吻合钉70和一对环形排的吻合钉接纳狭槽62的径向外部。因此,在使用时,当吻合钉推动器53被推进,刀具74也沿线性方向被轴向地推进。
如图1和图5所示,提供了被定位在吻合钉钉仓头组件16的远侧的砧座组件30,该砧座组件30包括砧座构件32和轴34,该轴34与其操作性地结合以用于将砧座组件30可拆卸地连接至吻合装置10的远侧端部。砧座组件30的轴34能够连接至吻合装置10的中央轴22,该中央轴22延伸穿过吻合钉钉仓头组件16并将砧座组件30连接至手术器械10的吻合钉钉仓头组件16。
关于环形吻合装置10的构造和操作的详细讨论,可以参照序号为8,322,590的美国专利,该专利属于Patel等人,并且该专利的全部内容通过引用合并在此。
设想的到的是,在本公开的任一实施例中的头组件都是能够拆卸的并且能够替换的头组件,其包括钉仓组件、砧座构件和附属机构。
现在参照图2至图6,示出且将描述支撑材料100和安装结构件120一起形成的组件,该组件用于将支撑材料100连接至吻合钉钉仓头组件16。支撑材料100的形状大致是环形的并且包括:环形的内附接部102;环形的中间吻合钉接合部104,其被布置在内部102的径向外部;和环形的外部106,其被布置在中间部104的径向外部。大致位于中央的孔隙108,其由内部102的内周限定,并且其穿过支撑材料100或在支撑材料100内形成。支撑材料100可以是在手术吻合装置10被发射之后足够为组织的吻合提供支撑的任何形状,包括,例如,长方形、椭圆形、三角形或任何其他多边形或其他形状。
如图3至图6所示,支撑材料100被定大小为使得当支撑材料100被定位在吻合钉导引件60的组织接触或面向表面之上时,支撑材料100的外部106基本上轴向地对准吻合钉钉仓头组件16的外表面,并且支撑材料100的环形中间吻合钉接合部104覆于吻合钉导引件60的吻合钉保持狭槽62的上面。支撑材料100的孔隙108被定大小以至少接纳贯通其中的砧座组件30的轴34和手术吻合装置10的中央轴22。还预想的到的是,支撑材料100可以沿径向延伸超出吻合钉导引件60的内表面和外表面。
支撑材料100可以由手术用等级的、生物适合的、不可吸收的材料(即,永久的)或可吸收的材料(即,不是永久的)制成,例如期望地随意地包含、被注入、或涂有胶粘剂、密封剂和/或其他药剂的网状件或其他多孔或无孔的材料。还设想的到的是,支撑件的每一个部分或多个部分可以是包括不可吸收和可吸收材料两者的合成物。用于制成支撑材料100的合适的材料以及注入或涂覆到支撑材料100的合适的胶粘剂、密封剂和/或药剂可以在如上面所引用的序号为7,942,890的美国专利中找到。
如图2至图6所示,通过使用一个或多个紧固件或被缝到安装结构件120上的缝合部140,支撑材料100可紧固至吻合钉头组件16。通常,每一个缝合部140包括第一端或支腿部140a、第二端或支腿部140b、以及在第一端140a和第二端140b之间延伸并且使第一端140a和第二端140b相互连接的主体或桥接部140c,这将在后文的实施例中描述。还设想的到的是,连续的一股缝合线可以穿过支撑件和仪器。
与支撑材料100相似,缝合部140可以由手术用等级的、生物适合的、不可吸收的材料(即,永久的)或可吸收的材料(即,不是永久的)或被期望地注入胶粘剂、密封剂和/或其他药剂的材料制成。还设想的到的是,缝合部140可以是包括不可吸收和可吸收材料两者的合成物。参照支撑材料100在上文描述了缝合部140的合适的材料,并且所述合适的材料可以在如上面所引用的序号为7,942,890的美国专利中找到。
如上所提到的,缝合部140起到将支撑材料100紧固至安装结构件120的作用。具体地,缝合部140的第一端140a和第二端140b中的每一个可以延伸穿过支撑材料100并延伸穿过安装结构件120并且可以通过使用打结、熔融、热焊接、打桩(staking)或其他类似的方法彼此紧固在恰当的位置,其中,上述方法将限制或防止缝合部140的第一端140a和第二端140b穿过或从安装结构件120收回。设想的到的是,缝合部140的桥接部140c可以抵靠支撑材料100的组织面向或接触表面或抵靠安装结构件120来安置。
尽管缝合部140的第一端140a和第二端140b被示出和描述为延伸穿过安装结构件120,但是设想的到的是,缝合部140的第一端140a和第二端140b可以环绕安装结构件120延伸并将支撑材料100固定至安装结构件120。
如图2至图6所示,安装结构件120是环的形式,该环被定尺寸为以压配合的方式装配在吻合钉钉仓头组件16的吻合钉导引件60的内壁60a的圆周内。在实施例中,环120由弹性材料形成,并且具有使得在环120和吻合钉导引件60的内壁60a之间建立一定程度的摩擦从而防止或抑制安装结构件120自由地离开吻合钉钉仓头组件16的直径。设想的到的是,环可以由其他材料制作,并且设置有用于接合内壁60a的其他工具。预想的到的是,环120可以具有大体圆形的、横截面的轮廓,或如图2、图5和图6所示,可以具有长方形的、横截面的轮廓。如图5和图6所示,环120可以沿其外部的且近侧的边缘限定倒角120a。这样,当刀具74的刀具边缘在发射时可以先进入环120的倒角120a,并且因此减少环120妨碍或阻挡手术吻合装置10的发射的任何倾向。
因为环120摩擦性地接合吻合钉导引件60的内壁60a,且支撑材料100通过缝合部140被缝至环120,因此当环120被置于吻合钉导引件60内时,支撑材料100覆于吻合钉导引件60的吻合钉保持狭槽62之上。具体地,缝合部140用于将支撑材料100的环形的内附接部102固定至环120,并且,支撑材料100的环形的中间吻合钉接合部104覆于吻合钉导引件60的吻合钉保持狭槽62之上。
在使用时,当手术吻合装置10被发射,并且吻合钉推动器53和刀具74被推进时,吻合钉推动器53将吻合钉70从吻合钉导引件60的吻合钉保持狭槽62驱出并进入支撑材料100,并且刀具74切割在环形的内附接部102和环形的中间吻合钉接合部104之间的支撑材料100。通过切割环形的内附接部102和环形的中间吻合钉接合部104之间的支撑材料100,内附接部102可以与手术吻合装置10一起从手术部位移除,并且,环形的中间吻合钉接合部104(与外部106一起)被吻合钉70固定至下面的组织。
现在转向图7和图8,根据本公开的另一个实施例,用于将支撑材料100固定至安装结构件120的紧固件被总体指定为240。紧固件240包括环状的主体或框架部242,环状的主体或框架部242具有覆于支撑材料100的环形的内附接部102之上的径向尺寸。紧固件240进一步包括多个有倒钩的销244,有倒钩的销244从框架部242沿平行于框架部242的中央轴线“A”的方向延伸,并且是从框架部242沿着向近侧的方向延伸。
在使用时,有倒钩的销244穿透支撑材料100并且穿透进入或装入弹性的安装结构件120内,从而将支撑材料100相对于安装结构件120保持在适当的位置。
现在转向图9,根据本公开的再另一个实施例,用于将支撑材料100固定至安装结构件120的紧固件被总体指定为340。紧固件340包括销或杆344,销或杆344与安装结构件120一体地形成并且从安装结构件120延伸。销344沿平行于安装结构件120的中央轴线的方向从安装结构件120延伸,并且是从安装结构件120沿远侧方向延伸。每一个销344都终止在蘑菇形头部346内,该蘑菇形头部346被配置并被定尺寸为穿过孔隙、狭缝或类似物,其中,所述孔隙、狭缝或类似物形成在支撑材料100内,具体地,形成在支撑材料100的环形的内附接部102内。
在使用时,紧固件340的头部346延伸穿过支撑材料100从而将支撑材料100相对于安装结构件120保持在适当的位置。
现在转向图10,描述了环形手术吻合装置10和能够拆卸的砧座组件30在实现邻近的肠段“T1和T2”的连结的吻合术操作中的使用。通常使用包括腹腔镜检查工具和器械的微创手术技术来执行吻合术操作。在如图10所示操作中的位置时,患病的肠段已经先前移除,砧座组件30已经通过手术切口或经肛被施加到操作部位并被定位在肠段“T2”内,并且手术吻合装置10的吻合钉钉仓头组件16已经经肛插入肠段“T1”。还显示肠段“T1和T2”关于其对应的部件(例如,砧座组件30的轴34,以及通过荷包缝合等的手术吻合装置10的吻合钉钉仓头组件16的中央轴22)临时地固定。
根据一个方法,参照图10,可以使用上文所述的任何一个安装结构件120将支撑材料100定位并固定至吻合钉钉仓头组件16的吻合钉导引件60的组织接触或面向表面。预想的到的是,吻合钉钉仓头组件16和/或手术吻合装置10可以与支撑材料100一起供给,其中,支撑材料100被预先定位并固定至吻合钉钉仓头组件16的吻合钉导引件60的组织接触或面向表面。可选地,外科医生可以在使用前将支撑材料100固定至吻合钉钉仓头组件16的吻合钉导引件60的组织接触或面向表面。
当支撑材料100被固定在适当的位置时,外科医生操纵砧座组件30,直到轴34的近侧端插入手术吻合装置10的吻合钉钉仓头组件16的中央轴22为止。现在中央轴22接合到轴34,且肠段“T1和T2”被布置在砧座组件30和吻合钉钉仓头组件16之间。如图5和图10所示,例如,支撑材料100被布置在头组件16和肠段“T1”之间。
然后砧座组件30和吻合钉钉仓头组件16接近从而使肠段“T1和T2”接近。然后发射手术吻合装置10以将支撑材料100和肠段“T1和T2”吻合在一起,并且刀具74被致动以切断组织的部分和支撑材料100的任何部分(即,内部102),从而完成吻合术。一旦吻合术完成,砧座组件30和吻合钉钉仓头组件16远离以释放肠段“T1和T2”以及夹在其间的支撑材料100。
依照本公开,预想的到的是,本文公开的实施例中的任何实施例可以与动力致动组件一起使用。公布于2011年7月21日的公布号为2011/0174099的共同拥有的美国专利公开了具有动力致动器组件的手术装置,其中动力致动器组件包括动力驱动构件,上述专利的内容通过引用其全部合并在此。
尽管在此参照附图已经描述了本公开的例证性的实施例,但是上述描述、公开、以及附图不应该被理解为限制性的,而仅仅作为特定实施例的例证。因此,将被理解的是,本公开没有限制于在此所描述的精确的实施例上,并且可以由本领域的技术人员在不脱离本公开的范围或精神的情况下实现多种其他的改变和改进。
Claims (20)
1.一种手术吻合装置,其用于连结组织部分,其包括:
手柄组件;
管状主体部,其被支撑在所述手柄组件的远侧端,所述管状主体部具有包含多个手术吻合钉的吻合钉钉仓组件,所述多个手术吻合钉在一对环形阵列的吻合钉接纳狭槽内,所述吻合钉接纳狭槽形成在所述吻合钉钉仓组件的组织面向表面内,所述吻合钉钉仓组件限定了径向内表面和径向外表面;
砧座组件,其在所述手术吻合装置的远侧端,所述砧座组件具有轴,所述轴用于将所述砧座组件可拆卸地连接至所述管状主体部,所述砧座组件和所述管状主体部沿着所述轴相对于彼此并置并且被布置为以便相对于彼此接近;
环状的安装结构件,其被定大小为具有摩擦性地接合所述吻合钉钉仓组件的径向内表面的外径,其中所述安装结构件被布置在所述吻合钉钉仓组件的径向内表面内;
环形的支撑材料,其覆于所述吻合钉钉仓组件的组织面向表面之上,所述环形的支撑材料限定了外径向末端边缘以及径向内末端边缘,其中,所述外径向末端边缘径向地延伸超过所述一对环形阵列的吻合钉接纳狭槽,所述径向内末端边缘延伸横过所述安装结构件;以及
至少一个缝合部,其将所述支撑材料固定至所述安装结构件。
2.根据权利要求1所述的手术吻合装置,其中所述安装结构件由弹性材料制成。
3.根据权利要求2所述的手术吻合装置,其中每一个缝合部延伸穿过所述支撑材料并穿过所述安装结构件。
4.根据权利要求3所述的手术吻合装置,其中每一个缝合部包括第一端、第二端、以及将所述第一端和所述第二端相互连接的桥接部,其中每一个缝合部的所述第一端和所述第二端延伸穿过所述支撑材料并穿过所述安装结构件。
5.根据权利要求3所述的手术吻合装置,其中所述支撑材料限定:
环形的内附接部;
环形的中间吻合钉接合部,其被布置在所述内部的径向外部;以及
环形的外部,其被布置在所述中间部的径向外部。
6.根据权利要求5所述的手术吻合装置,其中每一个缝合部延伸穿过所述支撑材料的环形的内附接部。
7.根据权利要求6所述的手术吻合装置,其中每一个缝合部包括第一端、第二端、以及将所述第一端和所述第二端相互连接的桥接部,其中每一个缝合部的所述第一端和所述第二端延伸穿过所述支撑材料并穿过所述安装结构件。
8.根据权利要求7所述的手术吻合装置,其中每一个缝合部的桥接部沿横向于所述支撑材料的中央轴线的方向延伸。
9.根据权利要求2所述的手术吻合装置,其中所述安装结构件的近侧的且外部的角为倒角的。
10.一种支撑材料和安装结构件组件,其用于与圆形手术吻合装置一起使用,所述圆形手术吻合装置包括包含多个手术吻合钉的吻合钉钉仓组件,所述多个手术吻合钉在一对环形阵列的吻合钉接纳狭槽内,所述吻合钉接纳狭槽形成在所述吻合钉钉仓组件的组织面向表面内,所述吻合钉钉仓组件限定了径向内表面和径向外表面,所述支撑材料和安装结构件组件包括:
环状的安装结构件,其被定大小为具有摩擦性地接合所述吻合钉钉仓组件的径向内表面的外径,其中所述安装结构件被布置在所述吻合钉钉仓组件的径向内表面内;
环形的支撑材料,其覆于所述吻合钉钉仓组件的组织面向表面之上,所述环形的支撑材料限定了外径向末端边缘以及径向内末端边缘,所述外径向末端边缘径向延伸超过一对环形阵列的吻合钉接纳狭槽,所述径向内末端边缘延伸横过所述安装结构件;以及
至少一个缝合部,其将所述支撑材料固定至所述安装结构件。
11.根据权利要求10所述的支撑材料和安装结构件组件,其中所述安装结构件由弹性材料制成。
12.根据权利要求11所述的支撑材料和安装结构件组件,其中每一个缝合部延伸穿过所述支撑材料并穿过所述安装结构件。
13.根据权利要求12所述的支撑材料和安装结构件组件,其中每一个缝合部包括第一端、第二端、以及将所述第一端和所述第二端相互连接的桥接部,其中每一个缝合部的所述第一端和所述第二端延伸穿过所述支撑材料并穿过所述安装结构件。
14.根据权利要求12所述的支撑材料和安装结构件组件,其中所述支撑材料限定了:
环形的内附接部;
环形的中间吻合钉接合部,其被布置在所述内部的径向外部;以及
环形的外部,其被布置在所述中间部的径向外部。
15.根据权利要求14所述的支撑材料和安装结构件组件,其中每一个缝合部延伸穿过所述支撑材料的环形的内附接部。
16.根据权利要求15所述的支撑材料和安装结构件组件,其中每一个缝合部包括第一端、第二端、以及将所述第一端和所述第二端相互连接的桥接部,其中每一个缝合部的所述第一端和所述第二端延伸穿过所述支撑材料并穿过所述安装结构件。
17.根据权利要求16所述的支撑材料和安装结构件组件,其中每一个缝合部的所述桥接部沿横向于所述支撑材料的中央轴线的方向延伸。
18.根据权利要求11所述的支撑材料和安装结构件组件,其中所述安装结构件的近侧的且外部的角为倒角的。
19.一种使用与圆形手术吻合装置一起使用的支撑材料和安装结构件组件的方法,所述圆形手术吻合装置包括包含多个手术吻合钉的吻合钉钉仓组件,所述多个手术吻合钉在一对环形阵列的吻合钉接纳狭槽内,所述吻合钉接纳狭槽形成在所述吻合钉钉仓组件的组织面向表面内,所述吻合钉钉仓组件限定了径向内表面和径向外表面,所述方法包括如下步骤:
提供支撑材料和安装结构件组件,包括:
环状的安装结构件,其被定大小为具有摩擦性地接合所述吻合钉钉仓组件的径向内表面的外径;
环形的支撑材料,其覆于所述吻合钉钉仓组件的组织面向表面之上,其中,所述环形的支撑材料限定了外径向末端边缘以及径向内末端边缘;以及
至少一个缝合部,其将支撑材料固定至所述安装结构件;
将所述支撑材料和安装结构件组件至少部分地定位在所述手术吻合装置的钉仓组件内从而使得:
所述安装结构件被布置在所述吻合钉钉仓组件的径向内表面内;以及
所述环形的支撑材料的外径向末端边缘径向地延伸超过一对环形阵列的吻合钉接纳狭槽,并且,所述环形的支撑材料的径向内末端边缘延伸横过安装结构件;
接纳所述砧座组件和所述钉仓组件之间的身体组织;
抓紧所述砧座组件和所述钉仓组件之间的身体组织;以及
发射所述手术吻合装置以:
从所述吻合钉钉仓组件驱动多个吻合钉穿过所述支撑材料和所述身体组织;以及
切断所述至少一个缝合部的径向外部的支撑材料。
20.根据权利要求19所述的方法,其中所述安装结构件由弹性材料制成,并且,其中将所述支撑材料和安装结构件组件至少部分地定位在所述手术吻合装置的钉仓组件内的步骤包括:弹性的安装结构件以压配合的方式径向地接合所述吻合钉钉仓组件的内表面。
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US20150115015A1 (en) | 2015-04-30 |
JP2015085186A (ja) | 2015-05-07 |
ES2660767T3 (es) | 2018-03-26 |
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CA2861125A1 (en) | 2015-04-28 |
AU2014215979B2 (en) | 2018-11-22 |
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US9655620B2 (en) | 2017-05-23 |
CN204293212U (zh) | 2015-04-29 |
US20170238931A1 (en) | 2017-08-24 |
EP2865344A1 (en) | 2015-04-29 |
AU2014215979A1 (en) | 2015-05-14 |
EP2865344B1 (en) | 2018-01-31 |
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