CN102525585A - 手术缝合装置 - Google Patents
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Abstract
本发明提供了一种手术缝合装置,其包括:手柄;细长管状构件,其从所述手柄向远侧延伸;照明缝合钉容纳钉仓,其安装在所述细长管状构件的远端上;以及光源,其与所述细长管状构件的远端相连接,以使从该光源发出的光被传输到所述照明缝合钉容纳钉仓。
Description
本申请是申请号为200810173582.8、申请日为2008年11月6日、发明名称为“用于手术缝合器械的涂覆手术缝合钉和照明缝合钉钉仓”的专利申请的分案申请。
相关申请的交叉引用
本申请要求享有于2007年11月6日提交的申请号为60/985,661的美国临时专利申请的权益和优先权,其全部内容通过引用合并于此。
技术领域
本公开涉及在手术缝合器械中使用的手术缝合钉。本公开尤其涉及被涂覆以提高其在组织中的放置的可见度的手术缝合钉。本公开进一步涉及一种缝合钉钉仓,其具有内部照明以提高钉仓在组织中的位置的可见度以及缝合钉钉仓的内部组件的定位的可见度。
背景技术
在某些手术操作过程中,使用各种手术缝合装置来将一行或多行缝合钉应用于组织,并且在某些情况下,切割多行缝合钉之间的组织。在患者身体内使用的缝合装置的远端的可见度对于确保缝合装置相对于组织的合适的放置是很重要的。可视地监控手术缝合装置的远端的能力对于确定实际已缝合多少组织和/或手术缝合装置实际已切割多少组织也是有用的。
当手术缝合装置被用于内窥镜检查或腹腔镜检查时,观察手术缝合装置的远端更难。在这些情形下,通过身体中的开口将手术缝合装置插入身体中。在通过具有有限视野的内窥镜或腹腔镜的观察下执行手术操作。这使得难于检验手术缝合装置是否合适地操作以及难于估计由手术缝合装置形成的缝合线的完整性。
使用由不锈钢和/或钛制成的常规缝合钉可能会阻碍估计缝合线的完整性的能力,因为这些材料会朝着内窥镜或腹腔镜中的透镜使光反射回来从而使缝合线的清晰视野变模糊。
因此,需要一种具有在使用过程中在患者的身体内更可见的远端的手术缝合装置。还需要一种能够在身体内被清晰观察到而不会朝观察装置反射回大量光的手术紧固件。
发明内容
手术紧固件形成为常规的U形手术缝合钉,其具有后跨部和从后跨部向远侧延伸的一对支腿。每个支腿以组织刺穿尖端收尾。手术缝合钉涂覆有配置用来提高手术缝合钉在组织内的可见度并且同时降低手术缝合钉的反射性的材料。在具体的实施例中,手术缝合钉的组织刺穿尖端不被涂覆以避免锐利的尖端被钝化。
在一个可选实施例中,手术紧固件被形成为螺旋状线圈紧固件,该螺旋状线圈紧固件具有便于插入组织的在扁平的近侧线圈中的锐利的远侧组织刺穿尖端。已公开的螺旋状线圈紧固件被涂覆以在降低反射性的同时提高可见度。
还公开了一种在具有光源的手术缝合装置中使用的缝合钉钉仓。缝合钉钉仓通常包括U形外凹槽构件和位于U形外凹槽构件内的透明的插入件。该透明的插入件包括主体部,该主体部具有用于发光的锥形导向缘和用于发光的朝上的表面。在一个特别的实施例中,U形外凹槽形成有一系列纵向延伸的窗口,窗口允许从透明的插入件的侧面发出的光穿过。使用时,缝合钉发射器和与手术缝合装置相连接的刀片的相对地定位,削弱了穿过透明的插入件的光的量和穿出U形外凹槽中的窗口的光的量。在滑块或推杆通过之前,滑块或推杆将挡住远侧光窗口的任何光,以此来指示缝合线位置状况。
还公开了一种手术缝合装置,其具有缝合钉钉仓以便于手术缝合装置的远端在组织内的可见的定位。缝合钉钉仓定位在手术缝合装置的远端,以使与手术缝合装置连接的光源处于适当的位置,以将光传输到与缝合钉钉仓连接的透明的插入件。
附图说明
此处,结合附图公开了本公开的手术缝合钉和合并有照明缝合钉钉仓的手术器械的各种实施例。
图1为涂覆手术缝合钉的侧视图;
图1A为图1的涂覆手术缝合钉的端视图,局部显示出截面;
图2是涂覆手术缝合钉的可选实施例的侧视图;
图2A是图2的涂覆手术缝合钉的侧视图,局部显示出截面;
图3是定位在管状组织部周围的手术缝合装置的远端的立体图;
图4是在缝合及切割管状组织部之后,图3的管状组织部和手术缝合装置的远端的立体图;
图5是合并有缝合钉钉仓以照明手术缝合装置的远端的手术缝合装置的立体图;
图6是手术缝合装置的远端的部件分解立体图;
图7是手术缝合装置的照明远端的组装立体图;
图8是在缝合行程期间被局部照明的手术缝合装置的远端的立体图,其中砧座处于打开位置;
图9是在切割行程期间被局部照明的手术缝合装置的远端的立体图,其中砧座处于打开位置;以及
图10是定位在管状组织部周围的手术缝合装置的被局部照明的远端的立体图。
具体实施方式
现在将参考附图详细描述本公开的手术紧固件和手术缝合装置的实施例,其中相同的附图标记指代多幅视图中的每一幅图中的相同或相应元件。正如本领域中通用的,术语“近侧”表示更靠近用户或操作者即外科医生或内科医师的部分或部件,而术语“远侧”表示远离用户的部分或部件。
参考图1,公开了一种手术紧固件或手术缝合钉10,其包括涂层、色料或其他材料以辅助观察患者身体内的缝合钉,以及辅助观察将缝合钉10适当形成为特有的“B”的完全成形形状。缝合钉10通常包括后跨部12,后跨部12具有分别从后跨部12向远侧延伸的第一和第二支腿14和16。第一支腿14以组织刺穿尖端18收尾,而第二支腿16以相似的组织刺穿尖端20收尾。
参考图1和图1A,缝合钉10包括型芯22,活性涂层24涂覆在型芯22上。例如,型芯22可以由诸如不锈钢、钛或其他可变形/可锻材料等金属物质形成。活性涂层24可以包括具有分子荧光、分子磷光、化学发光等的材料,其发射可见光线“R”,使得在患者身体内能够容易地观察缝合钉10。通过将型芯22涂覆一层或多层这种活性涂层24,能够在患者的身体内观察缝合钉10而不是基本依赖反射光。例如,通过紫外线可以使一些上述涂层被激活,使得它们发出荧光或“在黑暗中发光”。可选择地,其他上述涂层发射其自身的光源以便于观察缝合钉,或可以不发射可见光以便由于与底层组织的巨大反差从而能够观察缝合钉。
在缝合钉10的构造中,可以通过众多本领域公知的方法将以上描述的涂层24涂覆在型芯22上。例如,可以通过以下方法涂覆涂层24:阳极电镀、染色(dying)、电泳涂装、光致发光涂层、涂覆氮化物、甲基丙烯酸甲酯、涂漆、粉末涂层、石蜡涂层、油性着色剂或磷光层、使用羟基磷灰石、聚合物、氮氧化钛(titanium oxinitrides)、硫化锌、碳化物等。应注意的是,虽然列出的涂层24如此处所公开的非常具体,但是本领域公知的提高型芯22的可见度的其他涂层也在本公开的考虑范围内。
在利用涂层24对型芯22具体涂覆期间,可以遮掩或覆盖组织刺穿尖端18和20以避免被涂层24涂覆。这样可以理想地防止组织刺穿尖端18和20的钝化,从而使得尖端18和20更利索地刺穿组织。
现在参考图2和图2A,首先关于图2,公开了一中可选紧固件或线圈紧固件30,其也被构造为不需反射光的辅助就能够在组织内很容易地被观察到。线圈紧固件30通常包括螺旋状线圈主体32,螺旋状线圈主体32具有形成在螺旋状线圈主体32的远端36上的组织刺穿尖端34。螺旋状线圈主体32另外还包括扁平的近端线圈38以便于将线圈紧固件30推进到组织中。
具体参考图2A,同以上描述的缝合钉10,线圈紧固件30包括涂覆有活性涂层42的金属型芯40。涂层42同样发射可见光线“R”,这使得在组织内能容易地观察到线圈紧固件30。涂层42以与以上描述的关于缝合钉10的方式类似的方式形成,并且被涂覆在型芯40上。同以上描述的关于缝合钉10的组织刺穿尖端18和20,在涂覆期间可以盖住组织刺穿尖端34以避免钝化。
现在参考图3和图4,首先关于图3,现在将描述使用具有远端44的部分的手术缝合装置(未示出)将例如缝合钉10的紧固件施加到组织上。远端44部包括细长管状构件46,细长管状构件46具有安装在其上的缝合钉钉仓48。砧座构件50可移动地连接到细长管状构件46上,并且在大致与缝合钉钉仓48隔开的打开位置与大致邻近缝合钉钉仓48的关闭位置之间可以移动。
参考图4,缝合钉钉仓48形成有纵向地贯穿缝合钉钉仓48的刀槽52。刀片54与远端44相连接并且可移动地通过刀槽52以便切开缝合钉钉仓48与砧座构件50之间抓取的组织。缝合钉钉仓48进一步包括定位在缝合钉钉槽56内的多行缝合钉10以用于施加到诸如管状组织部T的组织。使用时,远端44作用在组织部T上以使组织部T被抓取在缝合钉钉仓48与可移动地安装在细长管状构件46上的砧座构件50之间。此后,手术缝合器被驱动以使从缝合钉钉仓48内的缝合钉钉槽56射出缝合钉10、穿过组织部T并且射入砧座构件50,从而以公知的方式缝合组织部T。此后,刀片54被推进通过刀槽52以便切割当前施加到管状组织部T上的多行缝合钉10之间的管状组织部T。
当从管状组织部T周围移开手术缝合器的远端44时,在管状组织部T的当前的自由端,通过从缝合钉10发射出的光线“R”能够容易地观察多行缝合钉10以及每个独立缝合钉10的合适的成形。因而,能够容易地观察组织部内的缝合钉10的合适的定位和成形而不会因反射光而变模糊。
现在参考图5,公开了具有缝合钉钉仓62的手术缝合器60,缝合钉钉仓62合并有一个或多个光源以便于观察缝合钉钉仓62在患者身体内的定位。另外,如以下更详细地描述的,当手术缝合器60施加缝合钉到组织及切割缝合组织时,缝合钉钉仓62也提供了手术缝合器60的正常功能的指示。手术缝合器60通常包括手枪式握把手柄64,手枪式握把手柄64具有从手枪式握把手柄64向远侧延伸的细长管状构件66。照明缝合钉钉仓62安装在细长管状构件66的远端68上,并且包括容纳在大体U形外凹槽72内的透明钉仓插入件70。设置钉仓插入件70以可视光的形式将光辐射传输到环绕照明缝合钉钉仓62的区域,而U形外凹槽72屏蔽一部分光辐射。一个或更多光源可以与手术缝合器60相连接以提供为缝合钉钉仓62照明的光源。
砧座构件74可移动地安装在细长管状构件66的远端68。砧座构件74可以从与照明缝合钉钉仓62隔开的打开位置移动到大致邻近照明缝合钉钉仓62的关闭位置。起动器76设置在手枪式握把手柄64上,以在打开与关闭位置之间定位砧座构件74,并且以下面更详细描述的方式从照明缝合钉钉仓62射出缝合钉。最后,设置旋转卡圈78以旋转细长管状构件66以及将照明缝合钉钉仓62和砧座构件74相对于组织定位。
现在参考图6,钉仓插入件70通常包括具有锥形导向缘82的主体部80。如以上指出的,主体部80对光辐射是透明的以使当光源作用到主体部80上时,从主体部80的端面84、侧面86和88以及从底面90发出光线。
主体部80另外还包括容纳用于插入组织的缝合钉94的多个缝合钉钉槽92。缝合钉94可以是常规的形式或可以类似于以上描述的关于缝合钉10的形式。缝合钉发射器96和98设置为延伸进入钉仓插入件70中对应的狭槽内并且从缝合钉钉槽92发射出缝合钉94并射入组织。刀槽100纵向地贯穿主体部80和端面84。刀片102与手术缝合器60相连接并且可移动地通过刀槽100以便切开照明缝合钉钉仓62与砧座构件74之间抓取的组织。
如图所示,U形外凹槽构件72包括多个窗口104。设置窗口104用于从主体部80的侧面86和88的光线的通道。窗口104另外还可以被用作主体部80中形成的对应的凸起(未示出)的安装结构,以便于将钉仓插入件70安装在U形外凹槽72内。
如以上指出的,手术缝合器60可以设置有各种光源以便于插入件70的照明和穿过插入件70。在一个实施例中,手术缝合器60设置有定位在细长管状构件66的远端68内的光源106。光源106可以包括一个或多个发光体,包括LED光、白炽灯、电致发光灯、利用氙气的光源或卤素灯等,或者可以通过光纤细丝或线等被传递到其期望的位置,虽然光源106被公开为定位在细长管状构件66的远端68内,但是可选择地可以将光源106直接合并到钉仓插入件70内。在一可选的实施例中,光源106可以是注入钉仓插入件70的具有UV反应光荧光或磷光添加剂的添加剂,以使钉仓70为可见的。此外,可以利用辅助器件经由光纤导管将光源传送到钉仓插入件70。钉仓插入件70的表面可以被磨光或由反射性材料涂覆以进一步朝向主体部80的锥形导向缘82放大和集中光源。
虽然没有具体地示出,但是手术缝合器60,尤其是手柄64可以设置有供给光和/或电到缝合钉钉仓62的各种公知的器件。和开关机构一起提供电的各种公知的器件相对于电烙装置(electrocaurterydevices)是本领域公知的,并且可以合并到手柄64中。
现在参考图7,如以上指出的,钉仓插入件70的照明使得从主体部80发射出光线“R”。具体来说,如图所示,从锥形的导向缘82和端面84发射出光线“R”以便使照明缝合钉钉仓62合适的定位在患者的身体内。此外,当主体部80向远侧突出到U形外凹槽72外时,从底面90发出的光线能够被用于确定砧座构件74和照明缝合钉钉仓62在患者的身体内的具体放置。另外,从侧面86和88发射出的光线“R”穿过形成在U形外凹槽72中的窗口104。穿过窗口104发出的光线“R”的强度也可以被用于给出在钉仓插入件70的主体部80内和/或砧座构件74内缝合钉发射器96和98的定位以及刀片102的位置的大体指示。
现在参考图8和图9,在钉仓插入件70的主体部80内缝合钉发射器96和98的移动以及刀片102的移动阻断了由光源106照射到钉仓插入件70上的一部分光的内部传输。具体参考图8,当缝合钉发射器96在主体部80内向远侧移动以使缝合钉94射出缝合钉钉槽92时,缝合钉发射器96挡住了照射到主体部80内部的大量光,从而极大地减少或消除了从U形外凹槽72中的窗口104射出的光的量。在使用期间,外科医生可以利用这个特征,通过留意邻近照明缝合钉钉仓62的近端的多少个窗口104不发射光,从而给出缝合钉发射器96的位置的指示,因而给出哪个缝合钉94实际已经被射入组织的指示。
如图9所示,当刀片102在形成于主体部80内的刀槽100内被推进时,由于刀片102的存在阻止了来自主体部80的一侧的定量的光传输到主体部80的相对侧。这导致了从U形外凹槽72中的窗口104射出的光线“R1”的量的降低或减少。因而,在使用期间外科医生能够确定刀片104在照明缝合钉钉仓62内的位置,以确保目标组织部已经被完全切割。
现在参考图10,在外科医生不能完全看见目标组织部的情况下,诸如,例如组织部T模糊时,照明缝合钉钉仓62可以被使用在某种意义上用于识别组织部T的位置和/或确保在照明缝合钉钉仓62与砧座构件74之间已经合适地抓住组织部T。例如,如图所示,当稍微从上面看时,组织部T使从多数窗口104发射出的光线变模糊而允许离开锥形导向缘82和远侧多数窗口104的光线是可见的。
因而,以这种方式可以看到,能够利用缝合钉钉仓62同时指示手术缝合器的远端在患者的身体内的定位以及指示缝合钉发射器和刀片在缝合钉钉仓62自身内的相对位置。
应理解的是,可以对此处所公开的实施例进行各种改进。例如,上述公开可以涉及除了公开的常规缝合钉和螺旋状的线圈紧固件之外的紧固件,诸如例如手术夹、两部分紧固件等。此外,虽然上述公开是关于照亮缝合钉钉仓和手术缝合装置,但是当与具有一对钳构件的手术器械结合时,通过照明一个或两个钳构件以便于观察手术器械在患者内的放置,本发明可以起到同等效用。另外,如以上指出的,照明缝合钉钉仓和/或砧座内的公开的插入件可以是完全透明的或可以包括透明的特定地带或区域以便于操作者观察。因此,上述描述不应视为限制,而仅仅是特殊实施例的示范。本领域的技术人员将预想到在附随的权利要求的范围和精神内的其他改进。
Claims (3)
1.一种手术缝合装置,包括:
手柄;
细长管状构件,其从所述手柄向远侧延伸;
照明缝合钉容纳钉仓,其安装在所述细长管状构件的远端上;以及
光源,其与所述细长管状构件的远端相连接,以使从该光源发出的光被传输到所述照明缝合钉容纳钉仓。
2.根据权利要求1所述的手术缝合装置,其中所述照明缝合钉容纳钉仓包括U形外凹槽和透明的缝合钉容纳插入件。
3.根据权利要求1所述的手术缝合装置,其中所述U形外凹槽包括多个窗口。
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- 2008-11-04 CA CA2918901A patent/CA2918901A1/en not_active Abandoned
- 2008-11-04 CA CA2642796A patent/CA2642796C/en not_active Expired - Fee Related
- 2008-11-05 JP JP2008284816A patent/JP2009160379A/ja active Pending
- 2008-11-05 EP EP12163643.5A patent/EP2476379B1/en not_active Not-in-force
- 2008-11-05 EP EP08253611A patent/EP2057948A3/en not_active Ceased
- 2008-11-05 AU AU2008243121A patent/AU2008243121B2/en not_active Ceased
- 2008-11-05 ES ES12163643.5T patent/ES2636957T3/es active Active
- 2008-11-06 CN CNA2008101735828A patent/CN101427935A/zh active Pending
- 2008-11-06 CN CN201410267800.XA patent/CN104013448B/zh not_active Expired - Fee Related
- 2008-11-06 CN CN201210004737.1A patent/CN102525585B/zh not_active Expired - Fee Related
-
2014
- 2014-03-18 JP JP2014054430A patent/JP2014195657A/ja not_active Ceased
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2015
- 2015-06-03 JP JP2015112821A patent/JP2015186584A/ja active Pending
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2017
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CN106714705A (zh) * | 2014-04-16 | 2017-05-24 | 伊西康内外科有限责任公司 | 包括具有从其延伸的突出部的砧座的端部执行器 |
CN106714705B (zh) * | 2014-04-16 | 2020-01-17 | 伊西康内外科有限责任公司 | 包括具有从其延伸的突出部的砧座的端部执行器 |
CN108338812A (zh) * | 2018-04-17 | 2018-07-31 | 四川大学华西医院 | 一种冷光源引导缝合器 |
Also Published As
Publication number | Publication date |
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EP2476379A1 (en) | 2012-07-18 |
CA2918901A1 (en) | 2009-05-06 |
CN104013448A (zh) | 2014-09-03 |
ES2636957T3 (es) | 2017-10-10 |
US7954687B2 (en) | 2011-06-07 |
JP2009160379A (ja) | 2009-07-23 |
CA2642796C (en) | 2016-04-12 |
EP2476379B1 (en) | 2017-07-12 |
CN101427935A (zh) | 2009-05-13 |
US20090114701A1 (en) | 2009-05-07 |
CN102525585B (zh) | 2015-02-18 |
AU2008243121B2 (en) | 2014-01-23 |
EP2057948A3 (en) | 2009-09-30 |
CA2642796A1 (en) | 2009-05-06 |
JP2014195657A (ja) | 2014-10-16 |
JP2017176855A (ja) | 2017-10-05 |
AU2008243121A1 (en) | 2009-05-21 |
CN104013448B (zh) | 2018-10-30 |
JP2015186584A (ja) | 2015-10-29 |
EP2057948A2 (en) | 2009-05-13 |
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