CN203564287U

CN203564287U - End effector, surgical operating instrument and purse-string forceps

Info

Publication number: CN203564287U
Application number: CN201320597508.5U
Authority: CN
Inventors: 孙斌; 刘刚; 方云才; 汪炬
Original assignee: REACH SURGICAL INSTRUMENT (CHINA) CO Ltd
Current assignee: Reach Surgical Inc
Priority date: 2013-09-23
Filing date: 2013-09-23
Publication date: 2014-04-30
Anticipated expiration: 2023-09-23

Abstract

The utility model relates to the technical field of medical apparatuses and instruments, discloses an end effector, a surgical operating instrument and purse-string forceps. The end effector and the surgical operating instrument aim to simplify the operating process of conducting surgery on luminal tissue, shorten operating time, and relieve wounds of surgery patients. The end effector comprises a first forceps arm, a second forceps arm, a suture mechanism, a purse-string suture mechanism and a cutting mechanism, wherein the suture mechanism is arranged on one side of the longitudinal direction of the first forceps arm and the second forceps arm, the purse-string suture mechanism is arranged on the other side of the longitudinal direction of the first forceps arm and the second forceps arm, and the cutting mechanism is arranged between the suture mechanism and the purse-string suture mechanism. The purse-string suture mechanism comprises a first suture nail box and a first suture nail anvil, wherein the first suture nail box is arranged on the first forceps arm, the first suture nail anvil is arranged at the position, corresponding to the first suture nail box, of the second forceps arm when jaws are closed, the first suture nail box comprises two suture regions in the longitudinal direction and an open region, the two suture regions are internally provided with first suture nails, and the open region which is not internally provided with first suture nails is located between the two suture regions.

Description

End effector, surgical instrument and purse-string forceps

Technical Field

The utility model relates to the technical field of medical equipment, especially relate to an end effector, a surgical operation apparatus and a purse-string forceps.

Background

Gastrointestinal tract surgery usually requires cutting off a closed tissue lumen and performing purse string suturing at the disconnected lumen, wherein the purse string suturing is used for being matched with a nail anvil of a circular suturing device so as to perform subsequent suturing and other operations by using the circular suturing device.

Purse-string sutures are a common suturing technique in surgical operations, and two main ways of purse-string suturing are known. One way is to manually perform a purse string suture, as shown in fig. 1a and 1b, the physician first passes the purse string 58 through the tissue surface around the incision in the luminal tissue 59 with a purse string needle, and then tightens the purse string 58 to complete the purse string suture. The manual suture mode is complex to operate, the operation precision is difficult to grasp, and the suture is easy to fail due to thread off, so that the manual suture mode is rarely adopted in the surgical operation at present.

Another way is to use purse-string forceps to assist in making a purse-string suture. As shown in FIG. 2a, a purse-string forceps is also used to perform purse-string suture by threading a needle (i.e., a purse-string needle) with a string (i.e., a purse-string 58).

As shown in FIG. 2b, there is also a purse-string forceps that performs a purse-string suture by attaching a purse-string 58 to the surface of the lumen tissue 59 by means of a purse-string 57, typically by firing the purse-string 57 to pierce and secure it to the lumen tissue 59, and the purse-string 58 is either interconnected with the purse-string 57 or pressed between the lumen tissue 59 and the purse-string 57 by the purse-string 57 to attach the purse-string 58 to the lumen tissue 59 to perform the purse-string suture.

Generally, when a surgical operation is performed on a lumen tissue, besides a purse-string suture is required to be performed on an incision of a remaining end of the lumen tissue, a lesion end of the lumen tissue also needs to be cut and sutured. The existing purse-string forceps have single function, can only complete purse-string suture on the remaining end, and cannot cut and suture the pathological change end. Therefore, at least other surgical instruments such as cutting and suturing devices need to be used in a matched manner, and the operation of replacing the surgical instruments is complicated, so that the operation time is long, the operation risk is increased, and the pain of an operation patient is caused.

Moreover, endoscopic surgery has emerged in the eighties of the twentieth century, a technique that allows surgeons to perform surgery without causing significant trauma to the patient, primarily through endoscopy and various imaging techniques. Compared with open surgery, endoscopic surgery has the remarkable advantages of small tissue damage, quick postoperative recovery and the like, thereby becoming a development trend. In this case, purse-string forceps for endoscopic surgery appeared, and the existing purse-string forceps for endoscopic surgery also had the problem of single function as described above.

SUMMERY OF THE UTILITY MODEL

A first object of the present invention is to provide an end effector to simplify the operation process of performing surgical operations on luminal tissues, reduce the operation time, the operation risk and the pain of the patient, and further be used for endoscopic surgery. The end effector includes: the first clamp arm and the second clamp arm can move relatively under the action of the opening and closing mechanism so as to open or close a clamp mouth formed by the first clamp arm and the second clamp arm; the stitching mechanism is arranged on one side of the first clamp arm and the second clamp arm in the longitudinal direction; the pouch stitching mechanism is arranged on the other side of the first clamp arm and the second clamp arm in the longitudinal direction; the cutting mechanism is arranged between the stitching mechanism and the pouch stitching mechanism; the purse-string suture mechanism comprises: the first staple nail box is arranged on the first clamp arm, the first staple nail anvil is arranged at a position, corresponding to the first staple nail box, of the second clamp arm when the clamp jaw is closed, the first staple nail box comprises two stitching areas, wherein the first staples are arranged inside the two stitching areas, and an opening area, located between the two stitching areas, is not provided with the first staples inside the opening area, and the first staples can be fired by the first staple nail pushing mechanism.

In this technical scheme, the sewing mechanism of end effector one side can realize the sewing up of tissue, and the purse-string of tissue can be sewed up to the purse-string sewing mechanism of opposite side, and the cutting mechanism between sewing up mechanism and purse-string sewing mechanism then can realize the cutting of tissue, and is visible, uses the utility model provides an end effector can realize that the purse-string of lumen reservation end tissue is sewed up to and the cutting and the sewing up of pathological change end tissue, compare with prior art, simplified the operation process of carrying out surgery to lumen tissue greatly, reduced the operating time, alleviateed the wound that brings for operation patient.

It is a second object of the present invention to provide a surgical instrument, comprising: a handle and an end effector as in the previous solution driven by the handle. Because the end effector has the effects, the surgical operation instrument can greatly simplify the operation process of performing the surgical operation on the lumen tissue, reduce the operation time and lighten the wound brought to the operation patient.

The third purpose of the utility model is to provide a purse-string forceps, this purse-string forceps includes: the first clamp arm and the second clamp arm can move relatively under the action of the opening and closing mechanism so as to open or close a clamp mouth formed by the first clamp arm and the second clamp arm; purse-string suture mechanism includes: the first staple nail box is arranged on the first clamp arm, the first staple nail anvil is arranged at a position, corresponding to the first staple nail box, of the second clamp arm when the clamp jaw is closed, the first staple nail box comprises two stitching areas, wherein the first staples are arranged inside the two stitching areas, and an opening area, located between the two stitching areas, is not provided with the first staples inside the opening area, and the first staples can be fired by the first staple nail pushing mechanism.

When the first staples in the first staple cartridge are completely fired, the parts of the incisions of the lumen tissue retaining ends corresponding to the suturing areas are sutured, the parts of the incisions of the lumen tissue retaining ends corresponding to the opening areas are not sutured, the purse string suturing of the lumen tissue retaining ends is realized, the connection between the staples and the lumen tissue is firmer, and the purse string suturing risk caused by the falling of the purse string staples is effectively reduced, so that the purse string forceps greatly improve the safety of the operation.

Drawings

FIG. 1a is a schematic cross-sectional view of a purse string suture of luminal tissue;

FIG. 1b is a front view of luminal tissue after tightening of the purse wire;

FIG. 2a is a schematic view illustrating a conventional purse-string suture principle of a purse-string forceps;

FIG. 2b is a schematic view of another conventional purse-string forceps purse-string suture principle;

fig. 3a is a schematic perspective view of an end effector according to an embodiment of the present invention;

fig. 3b is a schematic semi-sectional view of an end effector jaw closed according to an embodiment of the present invention;

FIG. 3c is a schematic view of an end effector with open jaws during a surgical procedure, in accordance with an embodiment of the present invention;

FIG. 3d is a cross-sectional view of an end effector of an embodiment of the present invention with jaws closed during a surgical procedure;

fig. 3e is a three-dimensional schematic view of the internal structure of the end effector (tissue suture side, staple partially fired) according to the embodiment of the present invention;

FIG. 4 is a schematic view of luminal tissue after cutting, tissue stapling, and purse string stapling;

FIG. 5a is a three-dimensional schematic view of a purse-string stapled luminal tissue mated to a circular stapler anvil;

FIG. 5b is a three-dimensional schematic view of a lumen tissue suture made by a circular stapler;

fig. 6 is a schematic structural view of a surgical instrument according to an embodiment of the present invention.

Reference numerals:

57-purse-string nail 58-purse-string 59-lumen tissue

10 a-first jawarm 10 b-second jawarm 11-suturing mechanism

12-pouch stapling mechanism 13-cutting mechanism 14-first staple magazine

15-circular stapler anvil 16-first staple pushing slider 17-first staple

18-first staple anvil 19-second staple cartridge 20-second staple

21-second staple ejector slide 22-first staple ejector 23-cutting knife

24-knife slot 25-second staple anvil 26-handle

27-end effector 28-elongated body 29-transmission mechanism

30-second staple pusher 31-closure Flange

Detailed Description

In order to use same apparatus just can accomplish the purse-string suture, cut and sew up, simplify and carry out the operation process that the surgery was carried out to the tissue that needs to carry out the purse-string suture (especially lumen tissue), reduce operation time, risk and patient's misery, further can be used for laparoscopic surgery, the embodiment of the utility model provides an end effector and a surgical operation apparatus. The utility model discloses among the technical scheme, the sewing mechanism of end effector one side can realize sewing up of tissue, and the purse-string sewing mechanism of opposite side can realize that the purse-string of tissue is sewed up, and the cutting mechanism between sewing mechanism and purse-string sewing mechanism then can realize the cutting of tissue, uses the embodiment of the utility model provides an end effector or surgical operation apparatus can realize that the purse-string of lumen reservation end tissue is sewed up to and the cutting of pathological change end tissue is sewed up, have simplified the operation process of carrying out the surgery to the lumen tissue greatly, have reduced the operating time, further still can be used to the operation chamber mirror. In order to make the objects, technical solutions and advantages of the present invention clearer, the present invention will be further described in detail by referring to the following embodiments.

As shown in fig. 3a to 3d, the end effector of the embodiment of the present invention includes:

the first forceps arm 10a and the second forceps arm 10b can move relatively under the action of an opening and closing mechanism, so that a jaw formed by the first forceps arm 10a and the second forceps arm 10b is opened or closed;

a suturing mechanism 11, the suturing mechanism 11 being provided on one side in the longitudinal direction of the first and

second forceps arms

10a and 10 b;

a purse-string suture mechanism 12, the purse-string suture mechanism 12 being provided on the other side of the first and

second forceps arms

10a and 10b in the longitudinal direction;

the cutting mechanism 13, the cutting mechanism 13 is set up between stitching mechanism 11 and the purse string stitching mechanism 12;

the purse string device 12 includes:

a first staple cartridge 14 arranged on the first jaw arm 10a, a first staple anvil 18 arranged at a position of the second jaw arm 10b corresponding to the first staple cartridge 14 when the jaws are closed, the first staple cartridge 14 comprising two stapling areas in which the first staples 17 are arranged, and an opening area between the two stapling areas and in which the first staples 17 are not arranged, in the longitudinal direction, the first staples 17 being capable of being fired by the first staple pusher mechanism.

In various embodiments of the present invention, "distal" refers to the side of the device that is distal to the user when the device is operated, and "proximal" refers to the side of the device that is proximal to the user when the device is operated. "forward" refers to movement away from the user and "backward" refers to movement closer to the user. The embodiment of the utility model provides an end effector can cooperate actuating mechanism to use, provides drive power by actuating mechanism. The specific structural style of the driving mechanism is not limited, for example, the end effector at the front end of the existing cutting stitching instrument can be directly detached, the end effector provided by the embodiment of the utility model is assembled, and the driving mechanism of the existing cutting stitching instrument provides driving force for opening the closing mechanism, the stitching mechanism, the purse-string stitching mechanism and the cutting mechanism. In addition, the driving mechanism can be additionally designed for the end effector provided by the embodiment of the invention.

The embodiment of the utility model provides an end effector can divide into according to the function and open closing mechanism, sew up mechanism, purse-string suture mechanism and cutting mechanism four bibliographic categories branch. The opening and closing mechanism is used for opening and closing the jaws formed by the two forceps arms of the end effector, when the end effector is used, the jaws can be driven to open so as to place the lumen tissue to be operated in, then the jaws are driven to close so as to clamp the lumen tissue to perform surgical actions such as purse string suture, cutting, suturing and the like, and after the surgical actions are finished, the jaws can be driven to open again so as to release the tissue. The cutting mechanism is used for realizing the cutting function of the tissue and can cut and separate the lesion end and the remaining end of the lumen tissue. The suturing mechanism is used for realizing the function of suturing the tissues and can suture at the incision of the lesion end of the lumen tissues. The purse string suturing mechanism is used for realizing the purse string suturing function of tissues, can carry out purse string suturing at the incision of the lumen tissue retaining end, and is matched with the nail anvil of a circular suturing device to be installed in the subsequent operation, and the circular suturing device is used for carrying out suturing and other operations.

In this embodiment, after the purse string suture is performed at the incision of the lumen tissue retention end (as shown in fig. 4), the lesion tissue at the lesion end of the lumen tissue is cut off by using the elasticity of the lumen tissue itself, as shown in fig. 5a and 5b, the circular stapler anvil 15 enters the inside of the retention end of the lumen tissue 59 through the opening of the retention end of the lumen tissue 59, and the circular stapler is used to perform the end-to-end suture of the lumen tissue. The structures of these four sections will be described in further detail below.

In the end effector of the embodiment of the utility model, at least two of the opening and closing mechanism, the stitching mechanism, the purse string stitching mechanism and the cutting mechanism can be synchronously driven; alternatively, the opening and closing mechanism, the suturing mechanism, the purse string suturing mechanism, and the cutting mechanism may be driven separately. The specific structure of the end effector can be designed according to different driving modes.

An opening and closing mechanism:

in various embodiments of the present invention, the first forceps arm 10a and the second forceps arm 10b are movable relative to each other, and may be both movable rotatable forceps arms; or the first clamp arm 10a is a fixed clamp arm which cannot rotate, and the second clamp arm 10b is a movable clamp arm which can rotate; alternatively, the second caliper arm 10b is a fixed caliper arm that is not rotatable, and the first caliper arm 10a is a movable caliper arm that is rotatable. Whether only one movable jawarm or both are movable jawarms, it is sufficient that both jawarms can be driven to open and close the jaws formed by the two jawarms.

The opening and closing mechanism of the end effector of the utility model can be realized by adopting various technical schemes of the opening and closing mechanism of the end effector of the existing cutting stitching instrument, for example, a sleeve type opening and closing scheme, an I-shaped beam type opening and closing scheme and the like.

For example, the opening and closing mechanism may include a closure bar having a closure flange disposed at a distal end thereof, a compression spring disposed between the first and second jawarms, the closure flange engaging a closure surface on the first and/or second jawarms when the closure bar is actuated to move longitudinally distally so that the jawarms close against the force of the compression spring, and the jaws may open upon return of the closure bar under the force of the compression spring. The closure flange may only engage the closure surface on the first or second jawarm when the closure bar is actuated to move longitudinally distally, but to achieve a more balanced force, it is preferred that the closure flange simultaneously engage the closure surfaces on the first and second jawarms.

The closing rod can be connected with a first staple pushing rod for firing a first staple, a second staple pushing rod for firing a second staple or a cutter rod for driving a cutting knife into an integral structure or different components; the closing lever, the first staple pusher bar, the second staple pusher bar or the knife bar may also be different parts, respectively; the closing rod can be further connected with any two of the first staple pushing rod, the cutter rod and the second staple pushing rod as an integral structure or different components; furthermore, it is also possible that the closing rod is of one piece construction (which may be called a drive rod) with the first staple pusher bar, the knife bar and the second staple pusher bar or that different parts are interconnected.

Referring to fig. 3a and 3e, in an embodiment of the present invention, the cutting blade 23 and the blade bar are an integral structure and serve as a closing rod of the opening and closing mechanism, a pressure spring (not shown in the figure) is disposed between the first forceps arm 10a and the second forceps arm 10b, and a closing flange 31 parallel to the cutting direction is fixed at the distal end of the closing rod at a side of the movable forceps arm departing from the jaws; when the closing rod moves forward, the closing flange 31 pushes the movable clamp arm to rotate until the jaws are closed, and when the closing rod moves backward, the pressure spring pushes the movable clamp arm to rotate until the jaws are opened. It should be noted here that the stroke taken by the closing flange 31 when closing the jaws need not be very large.

The cutting mechanism comprises:

the utility model discloses an end effector's cutting mechanism can adopt the current cutting to sew up the various technical scheme realization of end effector's cutting mechanism of ware.

For example, as shown in fig. 3a, the cutting mechanism may include a cutting blade 23, the cutting blade 23 is capable of moving between the suturing mechanism and the purse string suturing mechanism under the action of a push-type cutter mechanism, such as a push-type cutter rod or other component, to separate the sutured and purse string sutured tissues, respectively, and the cutting blade 23 and the push-type cutter mechanism may be integrated or separated (in this case, the cutting blade 23 is disposed at the far side of the push-type cutter mechanism). The first and second jawarms are provided with a slot 24 to accommodate movement of the cutting blade 23 (as shown in figure 3a, the slot of the second jawarms 10b is not shown for viewing angle reasons) to provide guidance for movement of the cutting blade 23 to make the cutting movement more smooth and accurate.

A sewing mechanism:

the utility model discloses an end effector's sewing mechanism can adopt the current various technical scheme of the end effector's of cutting stitching instrument sewing mechanism to realize.

For example, as shown in FIG. 3a, in combination with FIGS. 3d and 3e, the stapling mechanism may be arranged on one side in the longitudinal direction of two jawarms, one of which is provided with a second staple anvil 25, the other of which is provided with a second staple magazine 19, in which second staple magazine 19 a second staple 20 is arranged, which second staple 20 may be arranged in one or more rows in the longitudinal direction, which second staple 20 can be fired by a second staple pusher mechanism. The second staple pusher mechanism for firing the second staple 20 may comprise a second staple pusher bar (in this embodiment, the knife bar of the cutting knife 23 acts as a second staple pusher bar), a second staple pusher shoe 21 and a second staple pusher 30. The firing process may be that the second staple pusher bar moves longitudinally distally to drive the second staple pusher slider 21, the inclined surface of the second staple pusher slider 21 acts on the second staple pusher 30 to move it laterally, and then the second staple pusher 30 pushes the second staple 20 out of the second staple magazine 19, passes through the lumen tissue 59 and presses against the second staple anvil 25, and the second staple 20 is formed into a B-shape by the second staple anvil 25, thereby completing the stapling.

The number of rows of the second staple 20 is not limited, but at least one row, preferably at least two rows, is provided, so that at least two sutures can be placed at the diseased end of the luminal tissue, and the risk of suture failure is greatly reduced. When the second staples 20 are arranged in a plurality of rows in the longitudinal direction, only one second staple pusher shoe 21 may be arranged to push the front plurality of second staple pushers 30.

When the cutter arbor of cutting knife 23 pushed away the nail pole as the second staple, the position of cutting knife 23 can set up to pushing away nail slider 21 for the second staple and leaning on more (being closer to the near side promptly) for sew up earlier the back cutting, can reduce pathological change end internal tissue outflow like this, improve the success rate of operation. In one embodiment, the second staple pusher shoe 21 is pushed by the knife bar of the cutting knife 23, and before the cutting edge of the cutting knife 23 cuts the tissue, the inclined surface of the second staple pusher shoe 21 already pushes the second staple pusher 30 in front to fire the second staple 20, i.e. to suture the lumen tissue in front first, so that the cutting knife 23 always cuts after the tissue is sutured.

The purse-string suture mechanism comprises:

the purse string suture mechanism may be provided on the other side of the longitudinal direction of the two forceps arms, that is, on the side opposite to the suture mechanism.

Preferably, the first staples 17 are arranged in at least two rows along the longitudinal direction, and the specific number of the rows is not limited, so that at least two suturing operations can be performed on the incision of the lumen tissue retaining end and the corresponding parts of the two suturing regions, thereby greatly reducing the risk of purse-string suturing failure. When the first staples 17 are arranged in a plurality of rows in the longitudinal direction, only one second staple pusher shoe 21 may be arranged to push the front plurality of first staple pushers 22. In one embodiment, as shown in fig. 4, the first staples 17 are arranged in three rows in the longitudinal direction.

As shown in FIG. 3d, in conjunction with FIGS. 3a and 3e, a first staple pusher mechanism comprises: a first staple pusher bar, a first staple pusher sled 16 and a first staple pusher 22. when the first staple pusher bar longitudinally drives the first staple pusher sled 16 distally, the inclined surface of the first staple pusher sled 16 drives the first staple pusher 22 laterally, causing the first staple pusher 22 to push the first staples 17 out of the first staple magazine 14 and to be formed by the first staple anvil 18.

The first staple pushing mechanism and the second staple pushing mechanism can be driven synchronously, the first staple pushing rod and the second staple pushing rod are integrated with the cutter bar of the cutter (the first staple pushing rod, the second staple pushing rod and the cutter bar can also be connected with each other by different components), the first staple pushing slider 16 and the second staple pushing slider 21 are integrated (or connected with each other by different components), for example, when the staple pushing slider is driven longitudinally, the staple pushing slider can drive the first staple pusher 22 and the second staple pusher 30, so that staples arranged in the first staple magazine 14 and the second staple magazine 19 are fired respectively. In addition, the first staple pushing mechanism and the second staple pushing mechanism can be two mechanisms which are independent from each other and are driven respectively, the first staple pushing rod and the second staple pushing rod are different components respectively, and the first staple pushing slider and the second staple pushing slider are different components respectively.

The first staple and the second staple can be components with the same structure, in addition, the first staple anvil and the second staple anvil can also be components with the same structure, the first staple pusher and the second staple pusher can also be components with the same structure, and the first staple pusher slider and the second staple pusher slider can also be components with the same structure.

The utility model discloses among the technical scheme of the embodiment, closing lever, first staple push away the nail pole, cutter arbor and second staple push away the nail pole and can be for an organic whole structure or for different part interconnect in order to realize synchronous drive, for example, in an embodiment, closing lever, first staple push away the nail pole, cutter arbor and second staple push away the nail pole structure as an organic whole, can be called the actuating lever. When the surgical stapler is used, the driving rod moves to the far side to drive, the closing mechanism is driven to open to close the forceps arms, the suturing mechanism and the purse-string suturing mechanism are driven along with the further movement of the driving rod, after the first staples in the first staple cartridge are sequentially fired, the incision of the lumen tissue retaining end is sutured with the parts corresponding to the two suturing areas, the incision of the lumen tissue retaining end is not sutured with the part corresponding to the opening area, namely, the purse-string suturing of the lumen tissue retaining end is realized, the second staples in the second staple cartridge are sequentially fired to realize the suturing at the incision of the lesion end of the lumen tissue, and meanwhile, the cutting knife cuts the tissue between the suturing mechanism and the purse-string suturing mechanism under the driving of the driving rod, so that the cutting, the suturing and the purse-string suturing are simultaneously finished (the lumen tissue after the cutting, the tissue suturing and the purse-string suturing is shown in figure 4, wherein the direction indicated by the arrow is the length direction of the lumen tissue), which further simplifies the operation process of performing the surgical operation on the lumen tissue and reduces the operation time, thereby further reducing the trauma brought to the operation patient. In addition, as the stitching nail and the lumen tissue can be firmly connected, the reliability of the purse-string stitching is greatly improved, and the safety of the operation is improved.

To sum up, in the technical scheme of the utility model, the sewing up of tissue can be realized to the sewing up mechanism of end effector one side, and the purse-string sewing up mechanism of opposite side can realize that the purse-string of tissue is sewed up, and the cutting mechanism between sewing up mechanism and purse-string sewing up mechanism then can realize the cutting of tissue, and is visible, uses the embodiment of the utility model provides an end effector can realize that the purse-string of lumen reservation end tissue is sewed up to and the cutting and the sewing up of pathological change end tissue, compare with prior art, the frequency of changing surgical instruments that has significantly reduced has simplified the operation process of carrying out the surgery to lumen tissue, has reduced the operation time, has alleviateed the wound that brings for operation patient.

It should be noted that, in the embodiments of the present invention, the specification and the size of the end effector are not limited, and the end effector can be designed according to the specific surgical needs. For example, when the end effector is an end effector with an endoscope specification, the end effector can be used together with an endoscope, so that the operation has the advantages of high safety, small wound surface, less pain, quick recovery and the like.

As shown in fig. 6, embodiments of the present invention also provide a surgical instrument, including: a handle 26 and an end effector 27 as in any of the previous embodiments driven by the handle 26.

Also included in this embodiment is an elongated body 28 having a drive mechanism 29 disposed therein, the distal side of handle 26 being connected to end effector 27 by elongated body 28, handle 26 driving drive mechanism 29, drive mechanism 29 in turn transmitting drive to end effector 27 to provide drive for its opening and closing, stapling, cutting and purse string suturing. The surgical operation instrument with the structure can be matched with an endoscope for use, so that the operation has the advantages of high safety, small wound surface, less pain, quick recovery and the like.

Use the embodiment of the utility model provides a surgical instruments can realize that the purse-string of lumen reservation end tissue is sewed up to and the cutting and the sewing up of pathological change end tissue, compare with prior art, simplified the operation process of carrying out surgery to the lumen tissue greatly, reduced the operation time, alleviateed the wound that brings for operation patient, further can also be used to laparoscopic surgery.

The embodiment of the utility model provides a purse-string forceps is still provided, include:

the first clamp arm and the second clamp arm can move relatively under the action of the opening and closing mechanism so as to open or close a clamp opening formed by the first clamp arm and the second clamp arm;

purse-string suture mechanism includes: the first staple nail box is arranged on the first clamp arm, the first staple nail anvil is arranged at a position, corresponding to the first staple nail box, of the second clamp arm when the clamp jaw is closed, the first staple nail box comprises two stitching areas, wherein the first staples are arranged inside the two stitching areas, and an opening area, located between the two stitching areas, is not provided with the first staples inside the opening area, and the first staples can be fired by the first staple nail pushing mechanism.

After the first staple in the first staple cartridge is completely fired, the incision of the lumen tissue retaining end is sutured with the parts corresponding to the two suturing areas, and the incision of the lumen tissue retaining end is not sutured with the part corresponding to the opening area, so that purse-string suturing of the lumen tissue retaining end is realized.

The first staple pushing mechanism comprises: when the first staple pushing rod longitudinally drives the first staple pushing slider to the far side, the inclined plane of the first staple pushing slider transversely drives the first staple pusher, so that the first staple pusher pushes the first staple out of the first staple box and forms under the action of the corresponding first staple anvil.

Preferably, the first staples are arranged in at least two rows in the longitudinal direction. The advantages of the embodiments are as before, and the description is not repeated here.

The embodiment of the utility model provides a purse-string forceps, the concrete form that the tong arm opened closing mechanism is not limited, for example, can adopt the similar structural style with aforementioned end effector, also can adopt the structural style of ordinary operation pincers, and first tong arm and second tong arm are articulated, will keep silent through two grab handles of operator manual operation and close. When a similar configuration to the end effector described above is employed, the opening and closing mechanism and the purse-string suturing mechanism may be driven simultaneously, in which case the closing lever and the first staple pusher lever may be of one-piece construction, or different parts may be connected to each other to achieve synchronous driving, and in addition, the opening and closing mechanism and the purse-string suturing mechanism may be driven separately.

It will be apparent to those skilled in the art that various changes and modifications may be made without departing from the spirit and scope of the invention. Thus, if such modifications and variations of the present invention fall within the scope of the claims and their equivalents, the present invention is also intended to include such modifications and variations.

Claims

1. An end effector, comprising:

a first clamp arm (10a) and a second clamp arm (10b), wherein the first clamp arm (10a) and the second clamp arm (10b) can move relatively under the action of an opening and closing mechanism so as to open or close a jaw formed by the first clamp arm (10a) and the second clamp arm (10 b);

a suturing mechanism (11), the suturing mechanism (11) being provided on one side of the longitudinal direction of the first and second forceps arms (10a, 10 b);

a purse-string suture mechanism (12), wherein the purse-string suture mechanism (12) is arranged on the other side of the first forceps arm (10a) and the second forceps arm (10b) in the longitudinal direction;

a cutting mechanism (13), the cutting mechanism (13) being disposed between the suturing mechanism (11) and the purse string suturing mechanism (12);

the purse string device (12) comprises:

the first staple nail box (14) is arranged on the first clamp arm (10a), the first staple nail anvil (18) is arranged at a position, corresponding to the first staple nail box (14), of the second clamp arm (10b) when the clamp mouth is closed, the first staple nail box (14) comprises two stitching areas, wherein a first staple (17) is arranged inside the two stitching areas, and an opening area, located between the two stitching areas and not provided with the first staple inside the opening area, the first staple (17) can be fired by a first staple pushing mechanism.

2. The end effector as claimed in claim 1, characterized in that said first staples (17) are arranged in at least two rows in the longitudinal direction.

3. The end effector as claimed in claim 1, wherein said first staple pusher mechanism includes: the nail pushing device comprises a first nail pushing rod, a first nail pushing slider (16) and a first nail pusher (22), when the first nail pushing rod longitudinally drives the first nail pushing slider (16) towards the far side, the inclined surface of the first nail pushing slider (16) transversely drives the first nail pusher (22), so that the first nail pusher (22) pushes the first nail (17) out of the first nail box (14) and forms under the action of the first nail anvil (18).

4. The end effector as claimed in claim 3, characterized in that said stitching mechanism (11) comprises:

a second staple magazine (19) arranged on the first jaw arm (10a), a second staple anvil (25) arranged at a position of the second jaw arm (10b) corresponding to the second staple magazine (19) when the jaws are closed, a second staple (20) arranged in the second staple magazine (19), the second staple (20) being cocked by a second staple pusher mechanism, wherein:

the second staple pusher mechanism comprises: the nail pushing device comprises a second nail pushing rod, a second nail pushing slider (21) and a second nail pusher (30), when the second nail pushing rod longitudinally drives the second nail pushing slider (21) towards the far side, the inclined surface of the second nail pushing slider (21) transversely drives the second nail pusher (30), so that the second nail pusher (30) pushes the second nail (20) out of the second nail box (19) and is formed under the action of the second nail anvil (25).

5. The end effector as claimed in claim 4, characterized in that said first and second staple pusher bars are of one piece construction or are interconnected by different parts, and said first and second staple pusher shoes (16, 21) are of one piece construction or are interconnected by different parts.

6. The end effector as claimed in claim 1, characterized in that said cutting mechanism (13) comprises: a cutting knife (23) which can move between the stitching mechanism (11) and the purse string stitching mechanism (12) under the action of the push knife mechanism.

7. The end effector as claimed in claim 6, wherein said first and second jawarms (10a, 10b) have a slot (24) to accommodate movement of said cutting blade (23).

8. The end effector as claimed in claim 1, wherein said first jawarm (10a) and said second jawarm (10b) are both rotatable movable jawarms; or the first clamp arm (10a) is a fixed clamp arm which cannot rotate, and the second clamp arm (10b) is a movable clamp arm which can rotate; or the second clamp arm (10b) is a fixed clamp arm which cannot rotate, and the first clamp arm (10a) is a movable clamp arm which can rotate.

9. The end effector as claimed in claim 8, wherein said opening and closing mechanism includes a closure bar having a closure flange disposed at a distal end thereof, a compression spring disposed between said first and second jawarms (10a, 10b), said closure flange (31) engaging a closure surface on said first and/or second jawarms (10a, 10b) and closing said jaws against the force of said compression spring when said closure bar is driven in a longitudinal distal direction, said jaws being openable upon return of said compression spring when said closure bar is retracted.

10. The end effector as claimed in any one of claims 1 to 9,

at least two of the opening and closing mechanism, the suturing mechanism (11), the purse string suturing mechanism (12) and the cutting mechanism (13) are synchronously driven; or,

the opening and closing mechanism, the suturing mechanism (11), the purse string suturing mechanism (12) and the cutting mechanism (13) are driven respectively.

11. The end effector as claimed in claim 10, wherein the end effector is an end effector having endoscopic specifications.

12. A surgical instrument, comprising: a handle (26) and an end effector (27) according to any of claims 1 to 9 driven by the handle (26).

13. The surgical instrument according to claim 12, further comprising an elongated body (28) having a drive mechanism (29) disposed therein, a distal side of the handle (26) being coupled to the end effector (27) through the elongated body (28), the handle (26) providing drive for opening and closing, stapling, cutting, and purse string suturing of the end effector (27) through the drive mechanism (29).

14. A surgical instrument, comprising: a handle (26) and an end effector (27) according to claim 10 driven by the handle (26).

15. The surgical instrument according to claim 14, further comprising an elongated body (28) having a drive mechanism (29) disposed therein, a distal side of the handle (26) being coupled to the end effector (27) through the elongated body (28), the handle (26) providing drive for opening and closing, stapling, cutting, and purse string suturing of the end effector (27) through the drive mechanism (29).

16. A surgical instrument, comprising: a handle (26) and an end effector (27) according to claim 11 driven by the handle (26).

17. The surgical instrument according to claim 16, further comprising an elongated body (28) having a drive mechanism (29) disposed therein, a distal side of the handle (26) being coupled to the end effector (27) through the elongated body (28), the handle (26) providing drive for opening and closing, stapling, cutting, and purse string suturing of the end effector (27) through the drive mechanism (29).

18. Purse-string forceps, characterized in that it comprises:

the first clamp arm and the second clamp arm can move relatively under the action of an opening and closing mechanism so as to open or close a clamp opening formed by the first clamp arm and the second clamp arm;

purse-string suture mechanism includes: the first staple nail box arranged on the first clamp arm, the first staple nail anvil arranged at the position corresponding to the first staple nail box when the clamp jaw is closed on the second clamp arm, the first staple nail box comprises two suturing areas with first staples arranged inside and an opening area which is positioned between the two suturing areas and is not provided with the first staples inside along the longitudinal direction, and the first staples can be fired by the first staple nail pushing mechanism.

19. The end effector as claimed in claim 18, wherein said first staples are arranged in at least two rows in a longitudinal direction.

20. Purse-string forceps according to claim 18 or 19,

the opening and closing mechanism and the purse string mechanism are synchronously driven; alternatively, the opening and closing mechanism and the purse string suturing mechanism are driven separately.

21. The purse-string forceps according to claim 18, wherein the first staple pushing mechanism comprises: when the first staple pushing rod longitudinally drives the first staple pushing slider towards the far side, the inclined plane of the first staple pushing slider transversely drives the first staple pusher, so that the first staple is pushed out of the first staple box by the first staple pusher and is formed under the action of the first staple anvil.