CN113662610B - Guiding device and circular tube type anastomat - Google Patents

Abstract

The invention provides a guiding device and a circular tube type anastomat, wherein the guiding device is used for guiding a nail bin assembly of the circular tube type anastomat to enter an operation part, and comprises the following components: a guide located on a distal side of the cartridge; the positioning piece is at least partially positioned in the nail cylinder; a connector connected between the proximal side of the guide and the distal side of the positioning member, the connector being at least partially on the distal side of the cartridge, the connector having a first state and a second state; the maximum outer diameter of the guiding device is larger than the inner diameter of the distal end side of the nail cartridge when the connecting piece is in the first state, and the maximum outer diameter of the guiding device is smaller than or equal to the inner diameter of the distal end side of the nail cartridge when the connecting piece is in the second state. By means of the guiding means, the cartridge assembly can be guided well into the tissue and can be removed easily from the distal side of the cartridge assembly.

Description

Guide device and circular tube type stapler

Technical Field

The present invention relates to the technical field of medical devices, and in particular to a guiding device and a circular tubular stapler.

Background Art

In the prior art, a circular tube-type stapler includes a stapler body, an operating handle movably connected to the stapler body, and a staple anvil assembly matched with the body. The stapler body includes a firing assembly and a staple cartridge assembly disposed at the distal end. During surgery, two sections of tissue to be stapled are placed between the anvil of the staple anvil assembly and the staple cartridge of the staple cartridge assembly, and the distance between the anvil and the staple cartridge is adjusted to gradually clamp the tissues. Then, the firing assembly is driven by the operating handle to form staples on the anvil, thereby completing the staple connection of the two sections of tissue.

During the actual surgical operation, the main body of the circular tubular stapler, that is, the stapler barrel part, needs to enter the tissue cavity from one end of the tissue. For example, in low rectal surgery, it is necessary to enter through the anus. Since the anus is a muscular opening and is in a radially contracted state, it is difficult to insert a large diameter instrument into the anus. For another example, in gastric bypass surgery or gastric sleeve surgery, the main body of the stapler needs to enter the small intestine through the tissue stump and travel a distance in the small intestine. Since the small intestine is in a disconnected state after the diseased tissue is removed during the operation, and the intestinal wall is in a state of being fitted together, it is not easy for the stapler barrel part of the circular tubular stapler to enter the tubular tissue. At the same time, the inner wall of the digestive tract is tissue mucosa, and the circular tubular stapler usually passes through the small intestine and easily causes damage to the mucosa.

Although some guiding devices have appeared in the prior art for guiding the staple cartridge assembly into the tissue, after the staple cartridge assembly reaches the surgical position, it is troublesome to remove the guiding device, and the tissue may be easily damaged during the removal process.

In the present invention, the distal side and the proximal side are relative to the operator, the end closer to the operator is the proximal side, and the end farther from the operator, that is, the end closer to the surgical site is the distal side. In the stapler, the inner side and the outer side are relative to the axis of the stapler, the side closer to the axis is the inner side, and the side farther from the axis is the outer side.

Summary of the invention

In view of the problems in the prior art, the object of the present invention is to provide a guiding device and a circular tubular stapler, which can well guide the staple cartridge assembly into the tissue and can be easily removed from the distal side of the staple cartridge assembly.

An embodiment of the present invention provides a guiding device for a stapler assembly of a circular tubular stapler, wherein the stapler assembly includes a staple barrel, and the guiding device includes:

A guide member, located at the distal end side of the nail barrel;

A positioning member, wherein the positioning member is at least partially located inside the nail barrel;

A connecting member, the connecting member is connected between the proximal side of the guide member and the distal side of the positioning member, and the connecting member is at least partially located on the distal side of the nail barrel, and the connecting member has a first state and a second state;

When the connecting member is in the first state, the maximum outer diameter of the guiding device is greater than the inner diameter of the distal end of the nail tube. When the connecting member is in the second state, the maximum outer diameter of the guiding device is less than or equal to the inner diameter of the distal end of the nail tube.

Optionally, the connecting member includes a first connecting portion, a matching portion and a second connecting portion, the first end of the matching portion is rotatably connected to the proximal side of the guide member through the first connecting portion, and the second end of the matching portion is rotatably connected to the distal side of the positioning member through the second connecting portion.

Optionally, when the connector is in the first state, the second end of the matching portion is located inside the first end;

When the connecting member enters the second state from the first state, the first end of the matching portion is located at the distal end side of the second end, and the length of the connecting member along the axial direction of the nail barrel increases.

Optionally, a nail magazine surface is provided on the distal side of the nail barrel, and the connecting piece is adaptively provided with a nail magazine connecting portion with the nail magazine surface, and when the connecting piece is in the first state, the connecting piece is connected to the nail magazine surface, and when the connecting piece is in the second state, the connecting piece is detached from the nail magazine surface.

Optionally, the nail magazine connecting portion is a protrusion provided on the outer side surface of the connecting piece, and the nail magazine surface is provided with a concave hole, and the protrusion and the concave hole form a clamping structure.

Optionally, the nail magazine surface is provided with a nail hole, and the concave hole is the nail hole.

Optionally, the nail magazine connecting parts are at least a group arranged generally in the radial direction.

Optionally, it further comprises a drawstring, wherein the distal end of the drawstring is fixedly connected to the first connecting portion or the matching portion;

When the connecting piece is in the first state and the pull rope is subjected to an external force in the proximal direction, the pull rope can pull the matching part to rotate toward the axial direction of the nail barrel, so that the connecting piece is separated from the distal side of the nail barrel and enters the second state. When the pull rope continues to be subjected to an external force in the proximal direction, the pull rope can pull the guide device into the interior of the nail barrel.

Optionally, when the connecting member is in the first state, the matching portion matches with the nail magazine surface of the nail magazine assembly, and the projection of the matching portion on the nail magazine surface of the nail magazine assembly at least partially covers the nail holes on the nail magazine surface.

Optionally, the nail magazine assembly further comprises an anvil pull rod located inside the nail barrel, a puncture portion being provided on the distal side of the anvil pull rod, and when the anvil pull rod moves toward the distal side of the nail barrel, the puncture portion of the anvil pull rod can push the distal side of the guide member to move toward the distal side, so that the axial length of the connecting member increases and enters the second state.

Optionally, the distal end side of the guide is further provided with an opening, and when the anvil pull rod moves toward the distal end side direction of the nail barrel, the puncture portion of the anvil pull rod penetrates the opening.

Optionally, when the connecting member is in the second state and the positioning member is subjected to an external force in a proximal direction, the positioning member can pull the guiding device into the interior of the nail barrel.

Optionally, the positioning member includes a plurality of positioning pieces, and when the connecting member is in the second state and the positioning member is subjected to an external force in a proximal direction, the guiding member can be separated into at least two parts.

Optionally, the guide member comprises a plurality of bars, the distal ends of the plurality of bars are mutually weakly connected by thin walls, and the proximal ends of the plurality of bars are distributed on the circumference of the proximal end of the guide member;

When the connecting member is in the second state and the positioning member is subjected to an external force in the proximal direction, the guiding member can be torn at the thin-walled weak connection on the distal side of the grid bar and separated into a plurality of parts.

The grid bars are divided into a plurality of grid bar groups, and a thin-walled weak connecting rib is arranged between the distal ends of two adjacent grid bar groups;

When the connecting member is in the second state and the positioning member is subjected to an external force in the proximal direction, the thin-walled weak connecting rib may be broken to separate the guiding member into a plurality of parts.

Optionally, the nail tube is provided with at least two viewing windows, and the inner side surface between the adjacent viewing windows is provided with reinforcing ribs arranged in the radial direction, and the thin-walled weak connecting ribs are separated at the reinforcing ribs.

Optionally, an opening is provided on the distal side of the guide member, and a plurality of notches are provided circumferentially of the opening, and the thin-walled weak connecting rib extends axially to the notch. When the connector is in the second state and the positioning member is subjected to an external force in the proximal direction, the guide member can be torn axially along the thin-walled weak connecting rib to the notch and separated into a plurality of parts.

Optionally, the positioning member includes a plurality of positioning plates, the bars and the positioning plates are in a one-to-one or many-to-one relationship, and the connecting member includes a plurality of connecting structures, each of the connecting structures is connected between a bar and a corresponding positioning member.

Optionally, an outer diameter of the distal end side of the guide is smaller than an outer diameter of the proximal end side of the guide.

Optionally, when the connecting member is in the first state, the maximum outer diameter of the guiding device is less than or equal to the outer diameter of the distal end side of the nail barrel.

Optionally, the outer surface of the guide is at least partially coated with a lubricant.

An embodiment of the present invention further provides a circular tubular stapler, comprising the guiding device.

The guiding device and the circular tubular stapler provided by the present invention have the following advantages:

The present invention provides a guiding device for a circular tubular stapler. In an initial state, the connecting piece is in a first state, and the guiding piece can be kept on the distal side of the nail barrel, so that the nail magazine assembly can be well guided into the tissue to protect the residual tissue and the mucosal layer of the tissue. After the nail magazine assembly reaches the surgical position, the connecting piece is switched to the second state, and the maximum diameter of the guiding device is reduced. The guiding piece can be conveniently removed from the nail magazine assembly without causing damage to the tissue during the removal process. The surgical operation is simple, the damage to the tissue is reduced, and the operator's experience is improved.

BRIEF DESCRIPTION OF THE DRAWINGS

Other features, objectives and advantages of the present invention will become more apparent from a reading of the detailed description of non-limiting embodiments made with reference to the following accompanying drawings.

1 is a schematic structural diagram of the cooperation between a guide device and a staple cartridge assembly according to a first embodiment of the present invention, wherein the guide device is in a first state;

2 is a top view of the cooperation between the guide device and the staple cartridge assembly according to the first embodiment of the present invention, wherein the guide device is in a first state;

Fig. 3 is a cross-sectional view taken along the A-A direction in Fig. 2;

4 is a perspective view of the guiding device of the first embodiment of the present invention in a first state;

5 is a front view of the guiding device of the first embodiment of the present invention in a first state;

6 is a schematic structural diagram of the cooperation between the guide device and the staple cartridge assembly according to the first embodiment of the present invention, wherein the guide device is in a second state;

7 is a top view of the cooperation between the guide device and the staple cartridge assembly according to the first embodiment of the present invention, wherein the guide device is in a second state;

Fig. 8 is a cross-sectional view taken along the B-B direction in Fig. 7;

9 is a front view of the guide device of the first embodiment of the present invention, wherein the guide device is in a second state;

10 is a front view of the cooperation between the guide device and the staple cartridge assembly according to the second embodiment of the present invention, wherein the guide device is in a first state;

11 is a top view of the cooperation between the guide device and the staple cartridge assembly according to the second embodiment of the present invention, wherein the guide device is in a first state;

Fig. 12 is a cross-sectional view taken along the C-C direction in Fig. 11;

13 is a perspective view of a guide device in a first state according to a second embodiment of the present invention;

14 is a top view of the cooperation between the guide device and the staple cartridge assembly according to the second embodiment of the present invention, wherein the guide device is in a second state.

Reference numerals:

1 Guide 31 Distal side of positioning member

11 Distal side of guide 32 Proximal side of positioning member

111 Opening 33 Spacer

12 Proximal side of guide 4 Pull cord

121 Circumference of the proximal side 41 Distal side of the pull cord

13 Bar 42 Near side of the pull rope

14 Connecting ribs 7 Nail tube

15 Notch 71 Distal side of the nail barrel

2 Connector 72 Proximal side of the nail barrel

21 First connection portion 73 Window

22 Mating part 8 Anvil pull rod

23 Second connecting portion 81 Distal end of the anvil pull rod

24 Nail magazine connection part 9 Nail magazine surface

3 Positioning piece 91 Nail hole

DETAILED DESCRIPTION

Example embodiments will now be described more fully with reference to the accompanying drawings. However, example embodiments can be implemented in many forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that the present invention will be comprehensive and complete and fully convey the concepts of the example embodiments to those skilled in the art. The same reference numerals in the figures represent the same or similar structures, and thus their repeated description will be omitted.

The present invention provides a guiding device for a circular tubular stapler and a circular tubular stapler including the guiding device. The circular tubular stapler includes a stapler body, an operating handle movably connected to the stapler body, and a nail anvil assembly cooperating with the body. The stapler body includes a firing assembly and a nail magazine assembly arranged on the distal side. During surgery, the nail magazine assembly is required to enter the interior of the tissue, move forward to reach the surgical position, and dock with the nail anvil assembly. The guiding device is used to better guide the nail magazine assembly into the surgical site. Specifically, the guiding device includes: a guiding member, which is located on the distal side of the nail barrel; a positioning member, which is at least partially located inside the nail barrel; a connecting member, which is connected between the proximal side of the guiding member and the distal side of the positioning member, and the connecting member is at least partially located on the distal side of the nail barrel.

The connector has a first state and a second state. When the connector is in the first state, the maximum outer diameter of the guide device is greater than the inner diameter of the distal end of the nail barrel, so that the guide device is well maintained at the distal end of the nail barrel, and the guide device can well guide the staple cartridge assembly to enter the tissue and move in the tissue. After the staple cartridge assembly reaches the surgical position, the connector can be switched to the second state, and the maximum outer diameter of the guide device is less than or equal to the inner diameter of the distal end of the nail barrel, and the guide device can be pulled toward the proximal side to cause the guide device and the connector to detach from the distal end of the nail barrel without affecting the normal firing of the subsequent stapler.

The structure of the guiding device of each specific embodiment of the present invention is described in detail below with reference to the accompanying drawings. It can be understood that each specific embodiment is not intended to limit the protection scope of the present invention.

As shown in Figures 1 to 9, it is a schematic diagram of the structure of the cooperation between the guide device and the nail magazine assembly of the first embodiment of the present invention. Among them, Figures 1 to 5 show the structure of the cooperation between the guide device and the nail magazine assembly when the connecting member is in the first state, and Figures 6 to 9 show the structure of the cooperation between the guide device and the nail magazine assembly when the connecting member is in the second state. In this embodiment, the guide device includes a guide member 1, a positioning member 3 and a connecting member 2. The guide member 1 is located at the distal side 71 of the nail barrel 7, the positioning member 3 is at least partially located inside the nail barrel 7, the connecting member 2 is connected between the proximal side 12 of the guide member 1 and the distal side 31 of the positioning member 3, and the connecting member 2 is at least partially located at the distal side 71 of the nail barrel 7, and the connecting member 2 has a first state and a second state. In this embodiment, the first state of the connecting member 2 is a radial expansion state, and the second state is a radial contraction state, that is, in the first state, the maximum outer diameter of the guide device is greater than the maximum outer diameter of the guide device in the second state. The guide 1 is used to guide the staple cartridge assembly to enter the tissue and move in the tissue. In order to further reduce the friction between the guide 1 and the tissue surface, the outer surface of the guide 1 is at least partially lubricating or partially coated with a lubricant to form a lubricating coating. The lubricant can be an aqueous lubricant or an oily lubricant already available in the prior art, such as a hydrophilic coating. For example, the outer side of the guide 2 can be coated with a hydrophilic coating. Before use, the surface of the guide 2 is dipped in water and becomes very lubricated. This technology has been widely used in the field of surgery.

The guide device has two different states: an initial state and a disengaged state. In the initial state, the connector 2 is in the first state, at which the maximum outer diameter of the guide device is greater than the inner diameter of the distal side 71 of the nail barrel 7. In this embodiment, the maximum outer diameter of the guide device is at the connection position of the connector 2 and the guide 1, so that the guide 1 can be well kept at the distal side 71 of the nail barrel 7, and the guide 1 can play a good guiding role in the movement of the nail magazine assembly into the tissue and in the tissue. After the nail magazine assembly reaches the surgical position, the connector 2 switches to the second state, that is, the outer diameter of the guide device is reduced, and the maximum outer diameter of the guide device is less than or equal to the inner diameter of the distal side 71 of the nail barrel 7. At this time, when the guide device is pulled toward the proximal side, the guide 1 and the connector 2 can be pulled to move toward the proximal side, and after being disengaged from the distal side 71 of the nail barrel 7, at least part of the guide 1 enters the interior of the nail barrel 7, which is the disengaged state. In the disengaged state, when the guide device is further pulled toward the proximal side, the guide device can move to the outside of the nail barrel 7 through the window 71 of the nail barrel 7, that is, removed from the nail barrel 7, and is now in the removed state.

In the present invention, the distal side and the proximal side are relative to the operator, the end closer to the operator is the proximal side, the end farther from the operator, that is, the end closer to the surgical site is the distal side, and the direction along the axis of the stapler is the axial direction, that is, the direction from the distal side to the proximal side of the stapler, or from the proximal side to the distal side of the stapler. For example, in the perspective of Figure 3, for the nail barrel 7, its distal side 71 is the upper side, and the proximal side 72 is the lower side. For the anvil pull rod 8, its distal side 81 is the upper side. In the present invention, for a nail barrel 7, the inner side and the outer side are relative to the axis of the nail barrel 7, the side close to the axis is the inner side, and the side away from the axis is the outer side. For the guide member 1, it at least partially covers the distal side surface of the nail barrel 7. The outer side and the inner side of the guide member 1 are relative to the axis of the nail barrel 7. The side facing the axis of the nail barrel 7 is the inner side, and the side away from the axis of the nail barrel 7 is the outer side, that is, after the nail magazine assembly enters the tissue, the side of the guide member 1 that is in direct contact with the tissue is the outer side.

In this embodiment, the proximal side 32 of the positioning member 3 can extend out of the viewing window 71 of the nail barrel 7, or a pull-out portion is connected to the proximal side 32 of the positioning member 3, and the pull-out portion extends out of the viewing window 71 of the nail barrel 7. In the initial state, and after the connecting member 2 is switched from the first state to the second state, the doctor can pull the positioning member 3 in the proximal direction, and the positioning member 3 can pull the connecting member 2 and the guide member 1 toward the proximal side 72 of the nail barrel 7, so that the connecting member 2 and the guide member 1 are separated from the distal side 71 of the nail barrel 7 and at least partially enter the interior of the nail barrel 7, that is, enter the separation state. In the separation state, the doctor continues to pull the positioning member 3, and can pull the positioning member 3, the connecting member 2 and the guide member 1 out of the outside of the nail barrel 7 together, and enter the removal state. However, the removal state is not necessary. If the guiding device does not block the movement of the anvil pull rod 8 and the nail pusher after entering the nail barrel 7, the guiding device can also be left inside the nail barrel 7. After the stapler is fired, the guiding device and the nail magazine assembly are removed from the tissue together.

As shown in FIGS. 3 to 5 , the positioning member 3 includes a plurality of positioning pieces 33. When the connecting member 2 is in the second state and the positioning member 3 is subjected to an external force toward the proximal side, the guide member 1 can be separated into a plurality of parts and more conveniently enter the interior of the nail barrel 7. The positioning piece 33 is preferably arranged close to the inner wall of the nail barrel 7, and will not block the axial movement of the various components inside the nail barrel 7. Moreover, after the guide member 1 is separated into a plurality of parts and enters the interior of the nail barrel 7, it can also be more conveniently removed from the viewing window 73 together with the positioning member 3. In addition, after the guide member 1 is separated into a plurality of parts and enters the interior of the nail barrel 7, if the axial movement of the nail anvil pull rod 8 and the nail push piece is not blocked, the guide member 1 can also be left unremoved first. After the stapler is fired, the guide member 1, the connecting member 2 and the positioning member 3 are removed from the tissue together with the nail magazine assembly.

As shown in FIG2 , the guide member 1 includes a plurality of bars 13, the distal ends of the plurality of bars 13 are mutually thin-walled and weakly connected, and the proximal ends of the plurality of bars 13 are distributed on the circumference 121 of the proximal end of the guide member 1. In this embodiment, the outer diameter of the distal end 11 of the guide member 1 is smaller than the outer diameter of the proximal end 12 of the guide member 1, and the overall structure of the guide member 1 is formed into an umbrella-like structure by adopting a plurality of bars 13, and when the connector 2 radially contracts and expands, the proximal end 12 of the guide member 1 can more conveniently contract and expand with the connector 2. The guide member 1 is preferably made of a flexible and deformable material, such as a silicone material, a rubber material, a plastic material, and the like. For example, the guide member 1 can be made of TPE (Thermoplastic Elastomer, also known as artificial rubber or synthetic rubber). The connector 2 and the positioning member 3 can also be made of silicone material, rubber material, plastic material, and the like, for example, TPE material.

In the initial state, when the nail magazine assembly reaches the surgical position, after the connecting member 2 switches from the first state to the second state, the doctor can pull the positioning member 3 in the proximal direction, and the guide member 1 can be torn at the thin-walled weak connection on the distal side of the grid bar 13 and separated into multiple parts. Specifically, as shown in Figures 2 to 5, the grid bar 13 is divided into multiple grid bar groups, and a thin-walled weak connection rib 14 that is easy to be pulled apart is provided between the distal sides of two adjacent grid bar groups. When the doctor pulls the positioning member 3 in the proximal direction, the thin-walled weak connection rib 14 can be broken, so that the guide member 1 is separated into multiple parts.

In an optional embodiment, the nail tube 7 is provided with at least two viewing windows 73, and the inner side surface between the adjacent viewing windows is provided with reinforcing ribs arranged in the radial direction. When the doctor pulls the positioning member 3 toward the proximal side, the thin-walled weak connecting ribs 14 can be separated at the reinforcing ribs, thereby separating the guide member 1 into multiple parts.

In this embodiment, the bar group forms a one-to-one relationship with the positioning piece 33, and the connecting member 2 may include a plurality of telescopic structures, each of which has a first state and a second state, and each of the telescopic structures is connected between a bar 13 and a corresponding positioning member 3. Thus, when it is necessary to switch the guiding device from an initial state to a disengaged state, the doctor pulls the positioning member 3 toward the proximal side, and the connecting member 2 and the guiding member 1 can be more conveniently separated into a plurality of parts, respectively, so that the connecting member 2 and the guiding member 1 can be more easily disengaged from the distal side 71 of the nail tube 7, and at least partially enter the interior of the nail tube 7.

In other alternative embodiments, the guide member 1 may also be configured as an integral structure, with multiple tear lines provided on the surface of the guide member 1. When the positioning member 3 pulls the guide member 1 toward the proximal side, the tear lines of the guide member 1 break, causing the guide member 1 to be separated into multiple parts. Alternatively, the guide member 1 may be configured as a structure with uneven thickness, where thin thickness locations are easily torn. When the positioning member 3 pulls the guide member 1 toward the proximal side, the guide member 1 is broken at thin thickness locations and separated into multiple parts. In other alternative embodiments, the positioning member 3 may also be an integral structure, and the connector 2 may also be an integral contraction structure. The guide member 1, connector 2 and positioning member 3 may be made of the same material, or may be made of different materials.

As shown in FIG1 , when the connecting member 2 is in the first state, the maximum outer diameter of the guide device is less than or equal to the outer diameter of the distal end 71 of the nail barrel 7. Therefore, the guide device does not increase the outer diameter of the nail magazine assembly, and the burden of the nail magazine assembly entering and moving in the tissue is not increased due to the addition of the guide device.

As shown in FIG3 , the connecting member 2 includes a first connecting portion 21, a matching portion 22, and a second connecting portion 23. The first end of the matching portion 22 is rotatably connected to the proximal side 12 of the guide member 1 through the first connecting portion 21, and the second end of the matching portion 22 is rotatably connected to the distal side 31 of the positioning member 3 through the second connecting portion 23. When the connecting member 2 includes a plurality of telescopic structures, each telescopic structure includes a first connecting portion 21, a matching portion 22, and a second connecting portion 23.

As shown in FIG3 , when the connector 2 is in the first state, the second end of the matching portion 22 is located inside the first end, where the inside means that the second end of the matching portion 22 is closer to the axis of the nail barrel 7 than the first end of the matching portion 22. At this time, the matching portion 22 matches with the nail magazine surface 9 of the nail magazine assembly. Further, when the connector 2 is in the first state, the projection of the matching portion 22 on the nail magazine surface 9 of the nail magazine assembly at least partially covers the nail hole 91 on the nail magazine surface 9. That is, in the initial state, the matching portion 22 of the connector 2 can also serve as a nail guard to maintain the stability of the position of the staples in the nail hole 91. The first connecting portion 21 and the second connecting portion 23 are respectively a sheet-like connecting portion that can be bent and stretched. When the connector 2 is in the first state, the first connecting portion 21 and the second connecting portion 23 are bent in opposite directions respectively. After switching to the second state, the first connecting portion 21 and the second connecting portion 23 are at least partially stretched. In other alternative embodiments, the first connection portion 21 and the second connection portion 23 may also respectively adopt the structure of a hinge connection portion or a rotating shaft connection portion, as long as a rotatable connection between the matching portion 22 and the guide member 1 and the positioning member 3 is achieved.

As shown in FIG. 13 , in an optional embodiment, the connector 2 is adapted to be provided with a nail magazine connecting portion 24 on the nail magazine surface 9. When the connector 2 is in the first state, the connector 2 is connected to the nail magazine surface, thereby improving the matching stability of the guide device and the nail barrel 7. When the connector 2 is in the second state, the connector 2 is separated from the nail magazine surface. The nail magazine connecting portion 24 is at least one group arranged substantially in the radial direction. For example, the nail magazine connecting portion 24 can be a protrusion provided on the outer side surface of the connector 2, and the nail magazine surface 9 is provided with a concave hole, and the protrusion and the concave hole form an easily separable snap-on structure. The concave hole can be a nail hole 91 on the surface of the nail magazine surface 9, or can be another concave hole other than the nail hole 91.

In this embodiment, the switching of the connecting member 2 from the first state to the second state is driven by the anvil rod 8, and the distal side 81 of the anvil rod 8 is provided with a puncture portion. In the initial state, the puncture portion of the distal side 81 of the anvil rod 8 is located inside the nail barrel 7, and does not contact the distal side 11 of the guide member 1. As shown in Figures 6 to 8, after the nail magazine assembly reaches the surgical position, the knob on the proximal side of the stapler is rotated to move the anvil rod 8 toward the distal side, so that the puncture portion of the distal side 81 of the anvil rod 8 protrudes from the distal side 71 of the nail barrel 7, and the puncture portion of the distal side 81 of the anvil rod 8 drives the distal side 11 of the guide member 1 to move toward the distal side, driving the first end of the matching portion 22 to move toward the distal side relative to the second end, and the connecting member 2 enters the second state, and the length of the connecting member 2 along the axial direction of the nail barrel 7 increases. As shown in FIG. 9 , when the connecting member 2 switches from the first state to the second state, the first connecting portion 21 also moves toward the distal side relative to the second connecting portion 23 to reduce the maximum outer diameter of the guiding device.

As shown in FIG8 , the distal end 11 of the guide member 1 may also be provided with an opening 111. When the anvil rod 8 moves toward the distal end 71 of the nail barrel 7, the puncture portion of the distal end 81 of the anvil rod 8 is inserted into the opening 111 to puncture the tissue. In other alternative embodiments, the distal end 11 of the guide member 1 may not be provided with the opening 111, and the puncture portion of the anvil rod 8 drives the distal end 11 of the guide member 1 to puncture the tissue together.

As shown in Figures 10 to 14, it is a schematic diagram of the structure of the cooperation between the guide device and the nail magazine assembly of the second embodiment of the present invention. The difference between this embodiment and the first embodiment is that the guide device also includes a pull rope 4, the distal end side 41 of the pull rope 4 is connected to the first connecting part 21 or the matching part 22, and the proximal end side 42 of the pull rope 4 can extend out of the nail barrel 7 through the window 73 of the nail barrel 7. When the guide device is in the initial state and the nail magazine assembly moves to the surgical position, the doctor can pull the pull rope 4 in the proximal direction. When the pull rope 4 is subjected to an external force in the proximal direction, the pull rope 4 can pull the first end of the matching part 22 to rotate in the axial direction of the nail barrel 7, so that the connecting member 2 enters the second state, that is, the state shown in Figure 14. At this time, when the pull rope 4 continues to be subjected to an external force in the proximal direction, the pull rope 4 can pull the guide device into the interior of the nail barrel 7. When the first end of the matching part 22 moves in the axial direction of the nail barrel 7, it simultaneously moves in the distal direction relative to the second end of the matching part 22. At this time, if the positioning member 3 is pulled toward the proximal side again, the guide member 1 and the connecting member 2 can be separated from the distal side 71 of the nail barrel 7 and enter a disengaged state, and if the positioning member 3 is further pulled toward the proximal side, the guide member 1, the connecting member 2 and the positioning member 3 can be removed from the nail barrel 7 together and enter a removal state. In the embodiment where the guide member 1, the connecting member 2 and the positioning member 3 need to be removed from the nail barrel 7 together, the guide member 1, the connecting member 2 and the positioning member 3 are preferably all made of a flexible and deformable material so that they can be more conveniently pulled out of the nail barrel 7.

In this embodiment, the distal end 11 of the guide member 1 is provided with an opening 111, and a plurality of notches 15 are provided on the circumference of the opening 111. In the initial state, the connector 2 is in the second state, and when the positioning member 3 is subjected to an external force in the proximal direction, the guide member 1 can be torn from the notch 15 and separated into multiple parts, and can be more easily pulled to enter the interior of the nail tube 7. Specifically, the thin-walled weak connecting rib 14 extends axially to the notch 15, and when the connector 2 is in the second state, and when the positioning member 3 is subjected to an external force in the proximal direction, the guide member 1 can be torn axially to the notch 15 along the thin-walled weak connecting rib 14 and separated into multiple parts. The connector 2 also preferably adopts multiple independent telescopic structures, and after the guide member 1 is separated into multiple parts, the connector 2 is also separated into multiple telescopic structures. In other alternative embodiments, the connector 2 can also adopt an integral structure, and after the guide member 1 is separated into multiple parts, the connector 2 is also torn into multiple parts under the action of tension.

The guide device provided by the present invention can be placed separately without being installed on the stapler barrel portion of the stapler before use, and can be selectively installed by the user according to needs. The operation is also relatively simple, and only requires the guide member 1 to be installed on the distal end side 71 of the stapler barrel 7; it can also be directly installed on the stapler barrel portion of the stapler without the need for the user to install it by themselves.

The guiding device and the circular tubular stapler provided by the present invention have the following advantages:

The present invention provides a guiding device for a circular tubular stapler. In an initial state, the connecting piece is in a radially expanded state, and the guiding piece can be kept on the distal side of the nail barrel, so that the nail magazine assembly can be well guided into the tissue to protect the residual tissue and the mucosal layer of the tissue. After the nail magazine assembly reaches the surgical position, the connecting piece is converted into a radially contracted state, which reduces the maximum diameter of the guiding device and allows the guiding piece to be removed without causing damage to the tissue during the removal process. The surgical operation is simple, the damage to the tissue is reduced, and the operator's experience is improved.

The above contents are further detailed descriptions of the present invention in combination with specific preferred embodiments, and it cannot be determined that the specific implementation of the present invention is limited to these descriptions. For ordinary technicians in the technical field to which the present invention belongs, several simple deductions or substitutions can be made without departing from the concept of the present invention, which should be regarded as falling within the protection scope of the present invention.

Claims (21)

1. A guiding device, characterized in that it is used for a stapler assembly of a cylindrical stapler, the stapler assembly comprising a staple barrel, and the guiding device comprising: A guide member, located at the distal end side of the nail barrel; A positioning member, wherein the positioning member is at least partially located inside the nail barrel; A connecting member, the connecting member is connected between the proximal side of the guide member and the distal side of the positioning member, and the connecting member is at least partially located at the distal side of the nail barrel, the connecting member comprises a first connecting portion, a matching portion, and a second connecting portion, the first end of the matching portion is rotatably connected to the proximal side of the guide member through the first connecting portion, the second end of the matching portion is rotatably connected to the distal side of the positioning member through the second connecting portion, and the connecting member has a first state and a second state; When the connecting member is in the first state, the maximum outer diameter of the guiding device is greater than the inner diameter of the distal end of the nail tube. When the connecting member is in the second state, the maximum outer diameter of the guiding device is less than or equal to the inner diameter of the distal end of the nail tube. 2. The guiding device according to claim 1, characterized in that when the connecting member is in the first state, the second end of the matching portion is located inside the first end; When the connecting member enters the second state from the first state, the first end of the matching portion is located at the distal end side of the second end, and the length of the connecting member along the axial direction of the nail barrel increases. 3. The guiding device according to claim 2 is characterized in that a nail magazine surface is provided on the distal side of the nail barrel, and the connecting piece is adaptively provided with a nail magazine connecting portion with the nail magazine surface, and when the connecting piece is in the first state, the connecting piece is connected to the nail magazine surface, and when the connecting piece is in the second state, the connecting piece is detached from the nail magazine surface. 4. The guiding device according to claim 3 is characterized in that the nail magazine connecting portion is a protrusion provided on the outer side surface of the connecting piece, and the nail magazine surface is provided with a concave hole, and the protrusion and the concave hole form a snap-fit structure. 5. The guiding device according to claim 4 is characterized in that the nail magazine surface is provided with a nail hole, and the concave hole is the nail hole. 6 . The guiding device according to claim 3 , wherein the nail magazine connecting parts are at least one group arranged substantially in a radial direction. 7. The guiding device according to claim 2, further comprising a pull rope, wherein the distal end of the pull rope is fixedly connected to the first connecting portion or the matching portion; When the connecting piece is in the first state and the pull rope is subjected to an external force in the proximal direction, the pull rope can pull the matching part to rotate toward the axial direction of the nail barrel, so that the connecting piece is separated from the distal side of the nail barrel and enters the second state. When the pull rope continues to be subjected to an external force in the proximal direction, the pull rope can pull the guide device into the interior of the nail barrel. 8. The guiding device according to claim 2 is characterized in that, when the connecting member is in the first state, the matching portion matches with the nail magazine surface of the nail magazine assembly, and the projection of the matching portion on the nail magazine surface of the nail magazine assembly at least partially covers the nail holes on the nail magazine surface. 9. The guiding device according to claim 1 is characterized in that the nail magazine assembly also includes an anvil pull rod located inside the nail barrel, and a puncture portion is provided on the distal side of the anvil pull rod. When the anvil pull rod moves toward the distal side of the nail barrel, the puncture portion of the anvil pull rod can push the distal side of the guiding member to move toward the distal side, so that the axial length of the connecting member increases and enters the second state. 10. The guiding device according to claim 9, characterized in that an opening is further provided on the distal side of the guiding member, and when the anvil rod moves toward the distal side of the nail barrel, the piercing portion of the anvil rod penetrates the opening. 11. The guiding device according to claim 10, characterized in that when the connecting member is in the second state and the positioning member is subjected to an external force in a proximal direction, the positioning member can pull the guiding device into the interior of the nail tube. 12. The guiding device according to claim 1 is characterized in that the positioning member comprises a plurality of positioning pieces, and when the connecting member is in the second state and the positioning member is subjected to an external force in a proximal direction, the guiding member can be separated into at least two parts. 13. The guiding device according to claim 12, characterized in that the guiding member comprises a plurality of bars, the distal ends of the plurality of bars are mutually weakly connected by thin walls, and the proximal ends of the plurality of bars are distributed on the circumference of the proximal end side of the guiding member; When the connecting member is in the second state and the positioning member is subjected to an external force in the proximal direction, the guiding member can be torn at the thin-walled weak connection on the distal side of the grid bar and separated into a plurality of parts. 14. The guiding device according to claim 13, characterized in that the grid bars are divided into a plurality of grid bar groups, and a thin-walled weak connecting rib is provided between the distal ends of two adjacent grid bar groups; When the connecting member is in the second state and the positioning member is subjected to an external force in the proximal direction, the thin-walled weak connecting rib may be broken to separate the guiding member into a plurality of parts. 15. The guiding device according to claim 14, characterized in that the nail barrel is provided with at least two viewing windows, the inner side surface between the adjacent viewing windows is provided with reinforcing ribs arranged in a radial direction, and the thin-walled weak connecting ribs are separated at the reinforcing ribs. 16. The guiding device according to claim 14 is characterized in that an opening is provided on the distal side of the guiding member, a plurality of notches are provided in the circumferential direction of the opening, the thin-walled weak connecting rib extends axially to the notch, and when the connecting member is in the second state and the positioning member is subjected to an external force in the proximal direction, the guiding member can be torn along the thin-walled weak connecting rib axially to the notch and separated into a plurality of parts. 17. The guiding device according to claim 13 is characterized in that the positioning member includes a plurality of positioning plates, the bars and the positioning plates are in a one-to-one or many-to-one relationship, and the connecting member includes a plurality of connecting structures, each of the connecting structures is connected between one of the bars and the corresponding positioning member. 18 . The guide device according to claim 1 , wherein an outer diameter of a distal end side of the guide member is smaller than an outer diameter of a proximal end side of the guide member. 19. The guiding device according to claim 1, characterized in that when the connecting member is in the first state, the maximum outer diameter of the guiding device is less than or equal to the outer diameter of the distal end side of the nail barrel. 20. The guide device of claim 1, wherein an outer surface of the guide member is at least partially coated with a lubricant. 21. A circular tubular stapler, characterized by comprising the guiding device according to any one of claims 1 to 20.