CN1830396A - 医用缝合器 - Google Patents
医用缝合器 Download PDFInfo
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- CN1830396A CN1830396A CNA2006100580981A CN200610058098A CN1830396A CN 1830396 A CN1830396 A CN 1830396A CN A2006100580981 A CNA2006100580981 A CN A2006100580981A CN 200610058098 A CN200610058098 A CN 200610058098A CN 1830396 A CN1830396 A CN 1830396A
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- pressure head
- anvil block
- seam nail
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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
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
- A61B17/0684—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying above the tissue during stapling
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/76—Manipulators having means for providing feel, e.g. force or tactile feedback
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
- A61B2090/0811—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
Abstract
本发明的目的在于提供能够明确地感知缝合完成的缝合器。特征是包括:主体(11),其收容有多个缝钉(1);压头(3),其具有凹部(3b)和在其两侧具有推压片(3a、3a);砧座(4),其用于在与缝钉(1)的冠部(1a)两侧部抵接的状态下将冠部(1a)的中央部压入所述凹部(3b);以及扳机(12),其使压头(3)接近砧座(4)。通过使所述砧座(4)进入所述压头(3)的凹部(3b)内,将缝钉(1)折弯,在缝钉(1)的折弯完成后,移动的部件与其他的部件冲撞产生冲撞音或冲撞振动。
Description
技术领域
本发明涉及对活体组织进行缝合的医用缝合器(stapler),特别涉及能够明确地感受到缝合作业即缝钉(staple)的折弯作业的完成的装置。
背景技术
在外科手术中有使金属制的缝钉折弯来对切开部位进行缝合的方法。作为用于此目的的装置,公知有专利文献1(日本特开平5-3879)或专利文献2(日本特开2000-217829号)中记载的医用缝合器等。
图3是表示通过专利文献1和专利文献2中记载的缝合器使缝钉弯曲的步骤的图。
缝钉1刺穿活体组织并在活体的缝合部愈合之前紧贴在活体组织上。因此在具有适当强度的同时不会对活体组织产生不良影响是重要的。根据该观点,在缝钉1中使用不会生锈的奥氏体系不锈钢。缝钉1是对直径约0.5mm的圆棒进行切断并弯曲成コ字状的结构。将缝钉1的直线部分称为冠部(crown)1a,将从冠部1a的两端折弯的部分称为脚1b。为了容易刺穿活体组织,脚1b的顶端较尖。
图3(a)表示在开始状态,压头(ram)3相对砧座(anvil)4进行移动,通过形成于压头3的凹部3b的两侧的推压片3a的顶端和砧座4对缝钉1进行保持。
图3(b)表示在中间状态,压头3进一步向图的下方下降,砧座4到达凹部3b的入口,通过推压片3a使缝钉1弯曲到中途的状态。
图3(c)表示在完成状态,压头3继续向图的下方移动,砧座4进入凹部3b内,通过凹部底面3b′对缝钉1的冠部1a进行推压,通过砧座4的宽度方向的两端部使缝钉1折弯成直角状闭合的状态。该状态是缝合器的折弯完成的状态。另外,该状态时的冠部1a是指形成为矩形的缝钉的顶边。
在从图3(b)到(c)的过程中,缝钉1的顶端进入活体组织内,完成一个缝合。如果切开部较大,则要连续重复必要次数的缝合。另外,这里,缝钉闭合的状态是指在通过压头和砧座使缝钉折弯时最大限度折弯的折弯完成的状态,不仅是缝钉1的脚1b、1b的顶端彼此紧贴在一起的状态,也包括略微离开的状态。
专利文献1中记载的缝合器,使呈コ字型的多个缝钉以整齐排列的状态跨在主体内的砧座板上进行配置,通过扭簧向前方推压缝钉。砧座板的顶端成为砧座,压头被设置成与该砧座大致垂直。砧座固定,压头通过转动的扳机(trigger)朝向砧座进退,使送入砧座顶端的缝钉从コ字状折弯成矩形。
专利文献2中记载的缝合器,具有:以整齐排列的状态收容多个缝钉的储存部(magazine);随扳机联动的压头;以及砧座。通过操作扳机,压头和砧座将一个缝钉夹持取出,保持该状态,压头和砧座双方动作,使缝钉形成折弯。
图4是表示专利文献1记载的缝合器10的外观的图。在主体11内具有与图3同样的压头、砧座,并收容有多个缝钉1。通过使扳机12接近主体11,主体11内的压头接近砧座的顶端,使保持在砧座顶端的缝钉形成折弯。
图5是表示专利文献2中记载的缝合器20的结构的图。该缝合器20构成为在主体26内收容有以整齐排列的状态收容多个缝钉1的储存部22、压头23、砧座24以及扳机25。
扳机25以设置在主体26上的转动轴27为中心转动,与该转动轴27嵌合的孔是长孔28。并且,作为转动时的导向部,设有销29和呈“く”字形的槽30。通过这样的结构,扳机25相对主体26能够移动位置并且能够转动,在对扳机25施加力时,扳机25能够沿接近压头23的方向移动并绕转动中心转动。因此,从扳机25的转动中心到握持部的距离变大,具有能够以较小的力产生较大的转矩的效果。
但是,专利文献1或专利文献2中记载的缝合器在图3(c)的折弯完成时,使用缝钉的人对分辨缝合完成的现象没有特别感知。强调地说,折弯完成之前的扳机25的动作一直较轻,之后变重,因此基本上将此认为是缝合的完成。但是,在变轻之后,到哪里变重了的判断并不简单,存在缝合未完成却容易误认为完成的问题。
发明内容
本发明为解决该问题而提出,目的在于提供能够明确地感知缝合完成的缝合器。
为实现上述目的本发明的医用缝合器的特征是包括:主体,其能够以整齐排列的状态收容多个缝钉;压头,其设置在该主体内,在中央具有凹部,并在该凹部的两侧具有推压片;砧座,其用于在该压头的所述推压片与缝钉的冠部的两侧部抵接的状态下将冠部的中央部压入所述凹部;以及扳机,其可转动地枢轴支撑在所述主体上,以使这些压头和砧座之间引起相对移动,通过所述砧座进入所述压头的凹部内,将夹持在压头和砧座之间的缝钉折弯,在缝钉的折弯完成后,移动的部件与其他的部件冲撞产生冲撞音或冲撞振动。
另外,在缝钉的折弯完成后尽管压头和砧座的位置关系不变,从压头施加到缝钉上的载荷继续增加,当达到大于等于一定的载荷时,就不能保持压头和砧座的位置关系,变化为新的位置关系,通过该变化,移动的部件与其他的部件冲撞。
移动的部件包括例如扳机、压头、砧座等。另外,其他的部件是位于这些扳机、压头、砧座等移动的轨迹上,能够冲撞的部件,相对于扳机是缝合器主体,相对于压头是砧座。
另外,也可采用如下结构,即,所述缝钉是将截面为圆形的圆棒折弯而成的,所述压头的所述凹部的底面在其顶端具有倾斜面,该倾斜面的顶端的棱线设置为与从位于所述砧座上的缝钉的中央轴线向后方偏移的位置抵接,达到缝钉闭合的状态,所述压头的倾斜面的顶端的棱线进一步推压缝钉冠部时,通过所述倾斜面将缝钉推出。
通过上述结构起到如下作用。
在缝钉折弯的情况下,最初进行与载荷大致成比例的变形(折弯),但是,当变形进行到一定程度时,载荷达到最大,其后即使载荷减少变形仍进行。此时,该扳机非常轻地动作。并且,一旦越过该点,扳机再次加重,因此,通过与之相对抗地施加力,从而缝合器达到闭合状态。此时,例如构成为扳机与主体接触,则在折弯完成时扳机冲撞主体产生振动或冲撞音。
作为使压头与砧座冲撞的结构,采用压头的凹部的底面在其顶端具有倾斜面的结构。在缝钉的折弯即将完成之前,使该倾斜面的压头顶端侧的棱线与位于所述砧座上的圆棒的缝钉的从顶点偏离的略低的位置抵接。施加到扳机上的力原样施加到缝钉上,将缝钉向砧座推压,但是,当施加在扳机上的力增大时,压头在缝钉的表面上急速滑动,所述倾斜面与缝钉接触,将缝钉沿斜面向外推出,压头有力地与砧座冲撞。此时,产生冲撞音或者振动。并且,缝钉通过倾斜面可靠地排出到缝合器的外部,能够避免挂在缝合器上。
另外,此时也可以不使压头与砧座冲撞,确保少许间隔,使扳机与主体等其他部件冲撞。
根据本发明,在缝钉的折弯完成时,由于一个部件与其他部件冲突产生振动或声音,使用者能够明确地自己感觉到缝合作业的完成,具有能够避免在中途未完成时结束缝合的优良效果。
附图说明
图1是配合本发明的目的对图4的现有例中所示的缝合器进行改良的图,(a)表示缝钉折弯前的状态,(b)表示缝钉折弯完成时的状态。图2是表示本发明的第二实施例的图。图3是表示使用缝合器对缝钉进行折弯的步骤的图,(a)表示开始时,(b)表示中间状态,(c)表示完成状态。图4是表示现有的缝合器的外观的图。图5是表示现有的别的缝合器的结构的图。
具体实施方式
以下参照附图对本发明的实施方式进行说明。
图1是配合本发明的目的对图4的现有例所示的缝合器进行改良的图,(a)表示缝钉折弯前的状态,(b)表示缝钉折弯完成时的状态。
图1所示的缝合器10在主体11内通过轴12a转动自由地支撑扳机12的一端。在扳机12上形成板凸轮12b,扳机12以轴12a为中心顺时针方向转动时,板凸轮12b推压压头3的突起3c,压头3向图的下方动作。解除对扳机12施加的力时,压头3通过未图示的弹簧的弹力返回到图的上方,由此使扳机12沿逆时针方向转动恢复到初始状态。缝钉1跨过砧座4地被收容有多个,在图1(a)中仅示出最前头的一个。该缝钉1通过未图示的弹簧被向垂直纸面的方向推压,通过主体11或覆盖主体11的罩(未图示)避免向外部飞出。
推压扳机12的顶端使其沿顺时针方向转动时,板凸轮12b推压压头3下降,如图3的(a)到(c)所示缝钉1成为闭合状态。并且,在将要达到图3(c)的闭合状态之前,施加在扳机12上的载荷急剧减少,扳机12的旋转达到急速,完成缝钉1的折弯。在本发明的实施例中,构成为当该折弯完成时扳机12与主体11冲撞,产生冲撞音。通过该结构,使用者能够明确地知道缝合的完成,能够避免不完全缝合。
图2是表示本发明的第二实施例的图。在该实施例中在压头3的凹部底面3b′上形成倾斜面3d。凹部底面3b′和倾斜面3d的边界成为棱线3e。作为扳机可以是任何形式,可以是图4的扳机12或者是图5的扳机25,下面以图4的扳机12为例进行说明。
对扳机12施加力时,扳机12开始沿顺时针方向旋转,扳机12的板凸轮12b推压压头3的突起3c,开始推动压头3。很快,如图3(a)所示压头3的推压片3a的顶端与缝钉1的冠部抵接。其后,如果施加在扳机12上的力增加,则缝钉1如图3(b)所示开始弯曲。此时施加在扳机12上的力与缝钉1的弯曲度大致成比例地增加。施加在缝钉1上的力增加到某种程度时,达到缝钉1的屈服点,其后,施加在扳机12上的力减少,进行缝钉1的折弯。在缝钉1的折弯大致完成的图3(c)的阶段,压头的凹部底面3b′与缝钉1的冠部抵接,从棱线3e接触缝钉1。此后,进一步对扳机12施加力,逐渐增加施加在压头3上的力F。另一方面,在缝合器内收容多个缝钉1,这些缝钉1通过未图示的弹簧以力f被朝图2(a)的左方向推动。并且,砧座4的上表面并非水平而是以微小的角度θ带有顶端向上的坡度。
在力F较小的期间,缝钉1被向砧座4推压,压头3和砧座4的位置关系不发生变化,但是当力F超过某种限度时,由力F产生的转动力矩与力f的力矩之和,超过砧座4和缝钉1的摩擦力。该瞬间,棱线3e从B点在缝钉1的外周面上滑落,倾斜面3d向图的左方推动缝钉1,缝钉1从砧座4释放。同时,压头3的棱线3e或凹部底面3b′与砧座4激烈冲撞,产生例如喀嚓(カチン)那样的冲撞音。由此,缝合器的使用者能够确认缝合完成。也可以用引起振动来代替冲撞音。
在以上实施例中,使压头3和砧座4冲撞产生声音或振动,但是也可以不使压头3和砧座4发生冲撞,而使扳机12与主体11冲撞,来引起声音或振动。
Claims (5)
1、一种医用缝合器,其特征在于,包括:主体,其能够以整齐排列的状态收容多个缝钉;压头,其设置在该主体内,在中央具有凹部,在该凹部的两侧具有推压片;砧座,其用于在该压头的所述推压片与缝钉的冠部两侧部抵接的状态下将冠部的中央部压入所述凹部;以及扳机,其可转动地枢轴支撑在所述主体上,以使这些压头和砧座之间引起相对移动,
通过使所述砧座进入所述压头的凹部内,将夹持在压头和砧座之间的缝钉折弯,在缝钉的折弯完成后,使移动的部件与其他的部件冲撞产生冲撞音或冲撞振动。
2、根据权利要求1所述的医用缝合器,其特征在于,在缝钉的折弯完成后在压头和砧座的位置关系不变的状态下,从压头施加到缝钉上的载荷继续增加,当达到大于等于一定的载荷时,则不能保持压头和砧座的位置关系,变化为新的位置关系,通过该变化,使移动的部件与其他的部件冲撞。
3、根据权利要求1所述的医用缝合器,其特征在于,所述移动的部件是扳机,所述其他的部件是缝合器主体。
4、根据权利要求2所述的医用缝合器,其特征在于,所述移动的部件是压头或砧座中的任何一方,所述其他的部件是压头和砧座中的任何另一方。
5、根据权利要求1所述的医用缝合器,其特征在于,所述缝钉的截面为圆形,所述压头的所述凹部的底面在其顶端具有倾斜面,该倾斜面的顶端的棱线设置为与位于所述砧座上的缝钉的从中央轴线向后方偏移的位置抵接,当缝钉达到闭合的状态、所述压头的倾斜面的顶端的棱线进一步推压缝钉冠部时,所述压头滑过缝钉的表面,与所述砧座冲撞而产生冲撞音或冲撞振动。
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JP2005052330A JP4712409B2 (ja) | 2005-02-28 | 2005-02-28 | 医療用ステープラー |
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CN112914653A (zh) * | 2021-03-29 | 2021-06-08 | 常州安康医疗器械有限公司 | 一种腔镜吻合器的钉仓组件 |
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2005
- 2005-02-28 JP JP2005052330A patent/JP4712409B2/ja active Active
-
2006
- 2006-02-21 US US11/357,814 patent/US7458494B2/en active Active
- 2006-02-24 EP EP06110395.8A patent/EP1695668B1/en active Active
- 2006-02-24 ES ES06110395.8T patent/ES2564805T3/es active Active
- 2006-02-28 CN CNB2006100580981A patent/CN100496417C/zh active Active
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN109906057A (zh) * | 2016-08-16 | 2019-06-18 | 美登国际有限公司 | 用固定构件固定植入装置的医疗固定装置 |
CN109906057B (zh) * | 2016-08-16 | 2022-02-22 | 美登国际有限公司 | 用固定构件固定植入装置的医疗固定装置 |
CN112914653A (zh) * | 2021-03-29 | 2021-06-08 | 常州安康医疗器械有限公司 | 一种腔镜吻合器的钉仓组件 |
Also Published As
Publication number | Publication date |
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US20060191974A1 (en) | 2006-08-31 |
ES2564805T3 (es) | 2016-03-29 |
CN100496417C (zh) | 2009-06-10 |
US7458494B2 (en) | 2008-12-02 |
EP1695668A1 (en) | 2006-08-30 |
JP4712409B2 (ja) | 2011-06-29 |
JP2006230836A (ja) | 2006-09-07 |
EP1695668B1 (en) | 2015-12-23 |
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