CN115804625B - A push-pin type nasal septum anastomosis device - Google Patents
A push-pin type nasal septum anastomosis deviceInfo
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- CN115804625B CN115804625B CN202211576422.4A CN202211576422A CN115804625B CN 115804625 B CN115804625 B CN 115804625B CN 202211576422 A CN202211576422 A CN 202211576422A CN 115804625 B CN115804625 B CN 115804625B
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- ratchet gear
- nail
- nasal septum
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- pawl
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Abstract
The invention discloses a nail pushing type nasal septum anastomat which comprises a clamping nail pushing mechanism capable of placing a nail to puncture and stitch a stitching tissue, and a control mechanism for controlling the clamping nail pushing mechanism to push nails, wherein the control mechanism is connected to the proximal end of the clamping nail pushing mechanism. The ejector pin formula nasal septum anastomat is sewed up nasal septum suture tissue by the ejector pin mechanism ejector pin of the single hand operation control mechanism control centre gripping of operator, and above structure can make the operation of nasal septum suture technique more convenient and accurate, has solved the narrow and small problem that leads to the operation inconvenient of nasal cavity, and then has solved the longer problem of nasal septum suture technique operation time, has made things convenient for operator's use. At the same time, the control mechanism has a variable ratchet mechanism which can be changed into 3 different modes, namely an operation mode, a braking mode or a return mode. The above mode is switched, so that the push-pin type nasal septum anastomat can be suitable for use modes in different places and has stronger adaptation.
Description
Technical Field
The invention belongs to the technical field of medical appliances, and particularly relates to a push-pin type nasal septum anastomat.
Background
The deflection of the nasal septum is one of the more common diseases of the otorhinolaryngology, and is a common and frequently occurring disease of the rhinology. The incidence in the population was reported to be 51% with 12% of symptomatic need for treatment, i.e. approximately 6 individuals in each hundred of the population need treatment for the disease. The deflection of nasal septum is related to congenital development, trauma and other factors, and the serious deflection degree can cause nasal ventilation and sinus drainage disorder, and symptoms such as nasal obstruction, nasal bleeding, reflex headache and the like appear, and the long-term bad symptoms can seriously influence the life quality of patients, even influence the mind.
The nasal septum correction method for treating the deflection of the nasal septum is widely applied in clinical medical treatment, and the method for fixing the nasal septum and effectively stopping bleeding after the operation is currently a nasal cavity filling method at home and abroad. During the filling period, the patients can suffer from headache, nasal obstruction, dry mouth, dysphagia and the like, and can easily suffer from complications such as nasal cavity and nasal sinus infection, tympanic effusion and the like, and serious complications such as arrhythmia, myocardial infarction and the like even can be caused by serious nose and heart reflex; the operation of taking out the nasal cavity tamponade is more painful for most patients, fear and conflict with mind are generated for treatment, secondary bleeding can be caused, and syncope shock can be caused by serious patients.
According to the results of preliminary researches in the prior period, the nasal septum suture can not only effectively fix nasal septum cartilage and repair torn mucous membrane, but also effectively avoid the pain brought to patients when the tamponade is extracted. In the aspect of postoperative recovery, the nasal septum suture is relatively clean in the nasal cavity after operation, the nasal endocrine is less required to be treated after operation, the postoperative recovery is relatively quick, the nasal septum suture can suture the incision and knot at the nasal vestibule skin, the healing of the incision is facilitated, the alignment is good, and the appearance is attractive. The nasal septum suture can obviously improve the discomfort symptom of the patient after the operation, protect the nasal mucosa function to a greater extent, reduce the occurrence of postoperative complications, ensure that the patient recovers quickly and the nasal septum deflection correction is satisfactory. In summary, nasal septum suturing is a new technique that requires a skilled intra-nasal manipulation technique from the operator. Compared with the nasal cavity filling method, the nasal septum suture method can obviously relieve the pain and the economic burden of the patient, help the patient to recover as soon as possible, has low postoperative complication occurrence rate and shortens the hospitalization time, and therefore, the nasal septum suture method is worthy of clinical popularization and application. However, since the nasal cavity is narrow, there is no special instrument suitable for suturing the nasal cavity, and the method has the disadvantages of inconvenient operation and prolonged operation time compared with the conventional filling method. For beginners, the learning difficulty is increased, and many young doctors are reluctant to learn and try, so that popularization and application of the nasal septum suturing are hindered. For this reason, it is necessary to explore a nasal septum anastomat suitable for nasal septum suturing to solve the disadvantages of inconvenient operation and prolonged operation time of the nasal septum suturing.
Disclosure of Invention
The invention aims at solving the technical problems of no operation and long operation time existing in the nasal septum suture operation in the prior art, and aims to provide a push-pin nasal septum anastomat, which comprises the following components:
a clamping and nail pushing mechanism capable of placing a nail to puncture and stitch the stitch tissue;
a control mechanism for controlling the clamping and pushing mechanism to push nails, the control mechanism being connected to the proximal end of the clamping and pushing mechanism, the control mechanism having:
The base is internally provided with a rack groove at the upper part, a ratchet gear cavity is arranged at the inner middle part, and a ratchet shaft are vertically fixed in the ratchet gear cavity;
The rack assembly is slidably arranged in the rack groove of the base, and the distal end of the rack assembly is in pushing connection with the clamping and nail pushing mechanism;
the variable ratchet mechanism is positioned in the ratchet gear cavity of the base and is provided with a ratchet gear and a ratchet gear driving piece, the ratchet gear is arranged on the ratchet shaft in a penetrating mode, the ratchet gear is connected with the rack assembly in a meshed mode and used for converting circular motion of the ratchet gear into linear motion of the rack assembly, and the ratchet gear driving piece is connected with the ratchet gear in a driving mode.
Preferably, the variable ratchet-gear mechanism comprises:
the ratchet gear is provided with a ratchet wheel and a gear which are integrally and coaxially arranged, and coaxially penetrates through the ratchet gear shaft, and the gear is in meshed connection with the rack assembly;
The distal end of the movable handle is provided with a distal end shaft hole, the middle part of the movable handle is provided with a middle shaft hole, and the distal end shaft hole of the movable handle is arranged on the ratchet shaft in a penetrating way;
The ratchet gear driving piece is provided with a driving pawl and a check pawl, the thick end of the driving pawl is coaxially connected with the middle shaft hole of the movable handle, the thick end of the check pawl is connected to the pawl shaft, and the tip ends of the driving pawl and the check pawl are connected with tooth grooves of the ratchet in an inserting mode in an operating mode;
The mode conversion piece is provided with a conversion check ring and a sliding rod, a central hole of the conversion check ring is sleeved on the ratchet shaft and is positioned between the ratchet gear and the movable handle, three corners of the conversion check ring are provided with a gear shifting end, a first end and a second end, the sliding rod is arranged on the gear shifting end and is used for rotating the gear shifting end to an operation mode, a braking mode or a return mode, the second end and the gear shifting end of the conversion check ring can be respectively and privately connected with the driving pawl and the non-return pawl in the braking mode, the first end can disengage the tip of the driving pawl from a tooth socket of the ratchet wheel so as to be in abutting connection with the driving pawl, the tip of the non-return pawl can be disengaged from the tooth socket of the ratchet wheel so as to be in abutting connection with the non-return pawl, the non-return pawl is disabled, the ratchet wheel is disengaged from control, free rotation is realized, and the rack can retract.
Preferably, the ratchet-gear drive further has
One end of the driving claw spring is connected to the inner wall of the ratchet gear cavity, and the other end of the driving claw spring is connected to the driving pawl;
and one end of the claw-stopping spring is connected to the inner wall of the ratchet gear cavity, and the other end of the claw-stopping spring is connected to the non-return pawl.
The proximal end of the base of the control mechanism has a fixed handle.
Preferably, the control mechanism further has an upper cover having:
the cover plate is arranged on the base in a covering way to seal the ratchet gear cavity, and is provided with an arc-shaped groove and a running clamping position, a braking clamping position and a returning clamping position which are distributed on the arc-shaped groove and used for accommodating the sliding rod;
the handle cover extends integrally from one end of the cover plate, and is arranged on the fixed handle of the base.
Preferably, the rack assembly has:
The rack is in meshed connection with the ratchet wheel, guide rails are arranged on two side walls of the rack, guide grooves are formed in the inner wall of a rack groove of the base, and the guide rails of the rack are arranged in the guide grooves of the rack groove in a sliding mode;
the push rod is connected to the far end of the rack;
And the wedge-shaped presser foot is connected with the distal end of the push rod.
Preferably, the clamping and pushing mechanism comprises:
A push pin beam, one end of which is integrally connected with the upper part of the far end of the base, wherein a box groove and a push rod groove communicated with the box groove are arranged in the push pin beam;
the clamping beam is parallel to the nail pushing beam, and one end of the clamping beam is movably arranged at the lower part of the far end of the base;
The double-row nail storage box is arranged in the box groove of the base, and the wedge-shaped presser foot can push the nail shooting in the double-row nail storage box to penetrate through the suture tissue to the other end of the clamping beam.
Preferably, the dual row magazine has:
The middle part of the box body is provided with an axial groove which can accommodate the middle part of the wedge-shaped presser foot, and two sides of the box body are respectively provided with a row of double-row nail storage grooves which are mutually communicated;
The two rows of double-head sliding blocks are respectively positioned at the upper parts of the double-row nail storage grooves, and the wedge-shaped presser feet can be pressed on the double-head sliding blocks.
Preferably, the outer wall of the box body is provided with a plurality of buckles, the side wall of the nail pushing beam is provided with a plurality of bayonets, and the buckles of the box body are connected with the bayonets of the nail pushing beam in a clamping manner.
Preferably, the lower part of the far end of the base is provided with a chute, and a fastening nut is arranged in the chute;
one end of the clamping beam is connected with a fastening screw capable of fixing the clamping beam in the chute, and the fastening screw is connected with the fastening nut;
the other end of the clamping beam is provided with a slotted hole corresponding to one side of the box slot, through which the nail can pass.
Preferably, the two rows of double-head sliding blocks are internally provided with nail shooting clamping positions for fixing the nail shooting in the nail storage box.
The invention has the positive progress effects that:
1) According to the push-pin type nasal septum anastomat, an operator holds a movable control handle of a base to drive a ratchet gear to drive a rack to linearly move along a rack groove, the rack drives a push rod to push a wedge-shaped presser foot to slide distally, the wedge-shaped presser foot pushes a double-end sliding block to move in a double-row nail storage box, and the double-end sliding block pushes a nail to push out suturing tissues close to a nasal septum to be sutured in cooperation with clamping Liang Duifeng of the suturing tissues. And the clamping beam is also provided with a slotted hole for the shooting nail to stay, so that the puncturing position of the shooting nail can be more accurate while the puncturing action is finished. The structure can enable the operation of the nasal septum suture technology to be more convenient and accurate, reduces the difficulty of the nasal septum suture technology, solves the problem of inconvenient operation caused by narrow nasal cavity, further solves the problem of longer operation time of the nasal septum suture technology, and is convenient for an operator to use.
2) The base of the push-pin type nasal septum anastomat is integrally designed, so that the integral structural strength and the mounting precision of the push-pin type nasal septum anastomat are improved, the number of parts and the assembly cost are reduced, and the assembly difficulty is reduced.
3) The variable ratchet gear mechanism of the push-pin type nasal septum anastomat can be changed into 3 different modes, namely an operation mode, a braking mode or a return mode, and the modes enable the push-pin type nasal septum anastomat to be applicable to the use modes at different stages in the suture process.
Drawings
FIG. 1A is a schematic view of the overall structure of the push pin type nasal septum stapler of the present invention;
FIG. 1B is an exploded view of the structure of the push pin type nasal septum stapler of the present invention;
Fig. 2A shows the structure of the upper cover 22 of the control mechanism 20
Fig. 2B is a perspective view of the internal structure of the control mechanism 20;
FIG. 2C is a schematic view of the internal structure of the variable ratchet mechanism 23 of the control mechanism 20;
fig. 2D is a schematic structural view of the ratchet gear 232;
Fig. 2E is a schematic view of the internal structure of the ratchet-gear chamber 213;
FIG. 2F is a schematic view of the internal structure of the variable ratchet mechanism 23 in the operating mode;
fig. 2G is a schematic view of the internal structure of the variable ratchet mechanism 23 in the braking mode;
FIG. 2H is a schematic view of the internal structure of the variable ratchet mechanism 23 in the return mode;
FIG. 2I is a schematic diagram of the rack assembly 24;
FIG. 3A is a schematic view of the clamping and stapling mechanism 10 of the stapling instrument;
Fig. 3B is a side view of the ejector beam 11;
fig. 3C is a schematic structural view of the magazine body 121 of the dual row magazine 12;
FIG. 3D is a side view of the dual-headed slider 122;
Fig. 3E is a schematic diagram illustrating the cooperation of the fastening screw 133 and the fastening nut 2141 on the clamping beam 13.
Detailed Description
Other advantages and effects of the present invention will become apparent to those skilled in the art from the following disclosure, which describes the embodiments of the present invention with reference to specific examples. The invention may be practiced or carried out in other embodiments that depart from the specific details, and the details of the present description may be modified or varied from the spirit and scope of the present invention.
In the present invention, "distal", "proximal", and "orientation" are used as terms commonly used in the field of medical devices, where "distal" refers to an end of a surgical procedure that is away from an operator and "proximal" refers to an end of a surgical procedure that is near an operator.
As shown in FIG. 1A, the ejector pin type nasal septum anastomat of the present invention comprises a clamping ejector pin mechanism 10 for placing ejector pins 90 to perform puncture suturing on a tissue to be sutured and a control mechanism 20 for controlling the clamping ejector pin mechanism 10 to perform ejector pin pushing, and is connected to the proximal end of the clamping ejector pin mechanism 10.
As shown in fig. 1B, the control mechanism 20 has a base 21, a fixed handle 211 integrally connected to the proximal end of the base 21, an elongated rack slot 212 provided in the upper portion of the base 21, and a ratchet-gear cavity 213 provided in the middle portion of the base. The ratchet gear cavity 213 may be a hollow square-like shape or any other suitable structure, and the ratchet gear shaft 2131 and the pawl shaft 2132 are vertically fixed in the hollow position in the ratchet gear cavity 213, the ratchet gear shaft 2131 is located in the middle position of the ratchet gear cavity 213, and the pawl shaft 2132 is located around the ratchet gear cavity 213. The ratchet shaft 2131 is formed by integrally connecting two small cylindrical shafts with different radiuses in the axial direction.
In this example, the control mechanism 20 further includes an upper cover 22, the upper cover 22 having a cover plate 221 and a handle cover 222 integrally connected from a proximal end of the cover plate 221, as shown in fig. 2A, the upper cover 22 having a shape similar to that of the base 21. Four small cover plate shafts 2133 are respectively arranged at four corners of the ratchet-gear cavity 213 of the base 21, six cover plate shaft holes are formed in the upper cover 221, the four first cover plate shaft holes 223 are positioned at four corners corresponding to the ratchet-gear cavity 213 and are correspondingly and fixedly connected with the small cover plate shafts 2133 at four corners of the ratchet-gear cavity 213 of the base 21. The upper cover 221 is also provided with a second cover plate shaft hole 224 which is positioned at the middle position corresponding to the ratchet gear cavity 213 and is correspondingly connected and fixed with the ratchet gear shaft 2131 of the hollow position of the ratchet gear cavity 213 of the base 21. The cover 22 further has a third cover shaft hole 225 located at the proximal end of the handle cover 222, and the handle cover 222 is fixedly connected to the proximal end of the fixed handle 211. The upper cover 22 is fixedly connected with the base 21 through six cover plate shaft holes to fix the upper cover 22 on the base 21, and is correspondingly connected with the four cover plate small shafts 2133 through four first cover plate shaft holes 223 and correspondingly connected with the ratchet gear shaft 2131 through second cover plate shaft holes 224 to fix the internal structure of the ratchet gear cavity 213.
In this example, the cover 221 further has an arc slot 226 located at a middle position of a distal end of the cover 221, and three operation detents 2261, a brake detent 2262, and a return detent 2263 for accommodating the slide bar 2342 are uniformly distributed on the arc slot 226, wherein the operation detent 2261 is located at a middle position of the arc slot 226, and the brake detent 2262 and the return detent 2263 are located at two ends of the arc slot 226.
In this example, the control mechanism further comprises a variable ratchet-gear mechanism 23 located within the ratchet-gear cavity 213 of the base 21. As shown in fig. 2B, the variable ratchet-gear mechanism 23 includes a movable handle 231, a finger control end 2311 is provided at a proximal end of the movable handle 231, and an L-shaped hook 2312 is connected to a middle portion thereof to form an inverted U-shaped groove 2313 for preventing the fingers from slipping out when the operator holds the movable handle. The distal end of the movable handle 231 has a distal shaft hole 2314 and a central shaft hole 2315, and the distal shaft hole 2314 of the movable handle 231 is penetrated through the ratchet 2321 end of the ratchet gear shaft 2131 near the ratchet gear 232.
As shown in fig. 2C, the variable ratchet mechanism 23 further has a ratchet gear 232 and a ratchet gear drive 233, the ratchet gear 232 being threaded onto the ratchet gear shaft 2131, the ratchet gear 232 being in meshed connection with the rack assembly 24. As shown in fig. 2D, the ratchet gear 232 has a ratchet 2321 and a gear 2322 that are integrally formed and coaxially arranged, and coaxially penetrates through the ratchet gear shaft 2131, wherein the gear 2322 is on one side close to the base 21, and the ratio of the radius of the gear 2322 to the radius of the ratchet 2321 is 20-15:10, preferably 17:10.
As shown in fig. 2E, the ratchet-gear driver 233 has a driving pawl 2331 and a check pawl 2332, the thick ends of the driving pawl 2331 and the check pawl 2332 are semicircular, and the tip ends are arc-shaped claws integrally connected with the thick end semicircle. The thick end of the driving pawl 2331 is coaxially connected with the middle shaft hole 2315 of the movable handle 231 and is mounted on the side of the movable handle 231 close to the ratchet-gear cavity 213 by a shoulder screw. The check pawl 2332 is attached to the pawl shaft 2132 within the ratchet-gear cavity 213 and the tips of the drive pawl 2331 and the check pawl 2332 are insertable into the tooth slots of the ratchet 2321 in the operating mode. The driving pawl 2331 of the ratchet-gear driving piece 233 is also provided with a pawl driving spring 23311, one end of the pawl driving spring 23311 is connected to the inner wall of the ratchet-gear cavity 213, the other end of the pawl driving spring 2333 is connected to the middle part of the driving pawl 2331, the non-return pawl 2332 of the ratchet-gear driving piece 233 is also connected with a pawl stopping spring 23321, one end of the pawl stopping spring 23321 is connected to the inner wall of the ratchet-gear cavity 213, and the other end of the pawl stopping spring 23321 is connected to the non-return pawl 2332.
In this example, the variable ratchet-gear mechanism 23 further comprises a mode shifter 234, the mode shifter 234 having a shifter collar 2341 and a slide bar 2342, the center hole of the shifter collar 2341 being sleeved over the ratchet-gear shaft 2131 and located between the ratchet-gear 232 and the movable handle 231. The three corners of the shifting collar 2341 are provided with a shifting end 23411, a first end 23412 and a second end 23413, and 120 degrees of the shifting end 23411, the first end 23412 and the second end 23413 are uniformly distributed around the shifting collar 2341. Slide bar 2342 may be cylindrical or otherwise available as a rod, with slide bar 2342 being provided on shift end 23411 for rotating shift end 23411 to a run mode, a brake mode or a return mode. The second end 23413 and the shift end 23411 of the shift collar 2341 are configured to be abuttingly coupled to the drive pawl 2331 and the check pawl 2332, respectively, as shown in fig. 2G, in the braking mode, the shift end 23411, the first end 23412 and the second end 23413 of the shift collar 2341 are not in contact with the drive pawl 2331 and the check pawl 2332, respectively, as shown in fig. 2F, in the operating mode, the first end 23412 is configured to disengage the tip of the drive pawl 2331 from the tooth slot of the ratchet 2321 to abuttingly couple the drive pawl 2331, such that the drive pawl is disabled, the second end 23413 is configured to disengage the tip of the check pawl 2332 from the tooth slot of the ratchet 2321 to abuttingly couple the check pawl 2332, such that the check pawl is disabled, the ratchet is disengaged from control, such that free rotation is achieved, and the rack is retractable, as shown in fig. 2H.
As shown in fig. 2I, the control mechanism further includes a rack assembly 24 slidably disposed within a rack slot 212 of the base 21, the distal end of the rack assembly 24 being in pushable connection with the clamp push mechanism 10. The ratchet gear 232 is meshingly connectable with the rack assembly 24 for converting circular motion of the ratchet gear 232 into linear motion of the rack assembly 24, and the gear 2322 of the ratchet gear 232 is meshingly connectable with the rack assembly 24. The rack assembly 24 includes a rack 241, wherein the rack 241 is elongated, two side walls are respectively provided with two elongated guide rails 2411, the elongated guide rails 2411 are slidably disposed in the guide grooves of the rack slot 212, and the rack 241 is slidably disposed on the rack slot 212 through the guide rails 2411 and is engaged with the gear 2322 of the ratchet gear 232. The rack assembly 24 further includes a push rod 242 connected to the distal end of the rack 241, the push rod 242 being generally T-shaped and slidably disposed within the push rod channel 112 of the push rod beam 11. The rack assembly 24 further includes a wedge-shaped presser foot 243 in contact with and connected to the distal end of the push rod 242, the wedge-shaped presser foot 243 being integrally constructed in a "mountain" shape and being integrally fixedly connected to the distal end of the push rod 242. The wedge-shaped presser foot 243 is slidably disposed in an axial slot 1211 in the middle of the housing 121 of the dual row magazine 12 for urging the dual-headed slide 122 to move within the magazine.
In one embodiment, the variable ratchet-gear mechanism 23 has three modes, namely an operating mode, a braking mode and a return mode. As shown in fig. 2F, in the braking mode, the slide bar 2342 slides onto the braking detent 2262 on the arc-shaped groove 226 to fix the ratchet wheel 232, the driving pawl 2331 and the non-return pawl 2332 are inserted into the tooth groove of the ratchet wheel 2321 connected to the ratchet wheel 232, the driving pawl 2331 is abutted against the first end 23412 of the ratchet wheel 2341, the non-return pawl 2332 is abutted against the second end 23413 of the ratchet wheel 2341, the ratchet wheel 232 is clamped by the structure, and at the moment, the movable handle 231 cannot drive the ratchet wheel 232 to rotate through the driving pawl 2331, so that the whole variable ratchet mechanism 23 enters the braking mode. As shown in fig. 2G, in the operation mode, the slide bar 2342 slides onto the operation detent 2261 on the arc-shaped groove 226 to fix the conversion retainer 2341, at this time, the conversion retainer 2341 does not have any contact with the driving pawl 2331 and the non-return pawl 2332, and the operator can drive the movable handle 231 to move and further drive the ratchet gear 232 to rotate by holding the movable handle 231 and the fixed handle 211 and applying force by fingers, at this time, the driving pawl 2331 and the non-return pawl 2332 are inserted into the tooth grooves of the ratchet 2321 of the ratchet gear 232 and move along with the rotation of the ratchet gear 232 in the working range. As shown in fig. 2H, in the return mode, the slide bar 2342 slides onto the return catch 2263 on the arcuate slot 226 to secure the transition collar 2341, at which time the transition collar 2341 lifts the check pawl 2332 and the drive pawl 2331 out of contact with the ratchet wheel 232 to disable the drive pawl and the check pawl, the ratchet wheel is free to rotate, the rack is disabled in retraction, the ratchet wheel 232 is rotatable with movement of the rack 241, and retraction of the rack assembly 24 is enabled by pushing the edges of the rack 241 to retract and withdraw the nasal cavity.
In this example, the clamping and nailing mechanism 10 has a nailing beam 11, and as shown in fig. 3B, the nailing beam 11 may be a long strip or other shape for nailing, and one end of the nailing beam 11 is integrally connected with the upper distal end of the base 21. The nail pushing beam 11 has a box groove 111 and a push rod groove 112 communicating with the box groove 111, and the box groove 111 may be formed in a rectangular parallelepiped shape or any other suitable shape. As shown in fig. 1B, the two side walls of the nail pushing beam 11 are respectively provided with a plurality of bayonets 113.
As shown in fig. 3A, the clamping and nail pushing mechanism 10 further has a double-row nail storage box 12, as shown in fig. 3C, the whole double-row nail storage box 12 may be rectangular or have other suitable shapes, the double-row nail storage box 12 is installed in the box groove 111 of the base 21, and the wedge-shaped presser foot 243 can push the nail shooting 90 in the double-row nail storage box 12 to penetrate through the suture tissue to the other end of the clamping beam 13. The double-row nail storage box 12 is provided with a box body 121, an axial groove 1211 is formed in the middle of the box body 121, the axial groove 1211 is positioned in the middle of the box body 121, and the axial groove 1211 can accommodate the middle of the wedge-shaped presser foot 243. The outer wall of the box body 121 is provided with a plurality of buckles 1213, the positions of the buckles of the box body 121 correspond to the positions of the bayonets 113 of the nail pushing beams 11, and the buckles of the box body 121 are connected with the bayonets 113 of the nail pushing beams 11 in a clamping manner and used for fixing the double-row nail storage box 12 in the box grooves 111 of the nail pushing beams 11. The two sides 21 of the box body 121 are respectively provided with a plurality of rows of mutually communicated nail storage slots 1212, and the double rows of nail storage slots 1212 can accommodate the nail shooting 90 used for penetrating and suturing tissue at the nasal septum.
In this example, the nail 90 is a tee nail, and the tip of the tail of the nail 90 can effectively increase the local pressure on the suture tissue when the nail 90 performs the puncturing operation, so that the nail 90 can puncture easily. The top row bar of the nail 90 can bear the pushing force well after the puncturing operation is completed, and the contact surface is enlarged after the top row bar reaches the suturing tissue, so that the pressure on the suturing tissue is reduced, and a stop surface is provided for the nail pushing process. After the nail 90 is pierced, the hook-shaped tail part of the nail 90 can effectively prevent the nail 90 from sliding off, so that the nail 90 can still remain on the suture tissue after the clamping and nail pushing mechanism 10 is loosened and withdrawn, and a certain shrinkage force is maintained, thereby realizing the suture of the suture tissue.
As shown in fig. 3D, the double-row nail storage box 12 further has two rows of double-head sliders 122 respectively located at the upper parts of the double-row nail storage slots 1212, the wedge-shaped presser foot 243 can be pressed on the double-head sliders 122, the inclined surface of the wedge-shaped presser foot 243 can be matched with the inclined surface of the double-head sliders 122, and when the wedge-shaped presser foot 243 slides distally, the double-head sliders 122 are pushed to slide in the double-row nail storage slots 1212 of the double-row nail storage box 12 so as to push the nail shooting 90 to approach the suturing tissue for suturing. The double-end slide block 122 is also provided with a nail shooting clamping position 1221 which can be matched with the top bar of the nail shooting 90 to fix the nail shooting 90 in the double-row nail storage groove 1212 in a sewing action.
In this example, the clamping and stapling mechanism 10 also has a clamping beam 13, which is parallel to the stapling beam 11. The distal lower portion of the base 21 has a chute 214, and the chute 214 has a fastening nut 2141 therein. The whole clamping beam 13 is L-shaped, a cross bar at one end of the L-shaped clamping beam 13 is movably arranged at the lower part of the far end of the base 21, and a horizontal plane parallel to the L-shaped clamping beam 13 and the ejector pin beam 11 is a clamping surface. The holding beam 13 is slidably disposed at one end of the distal lower portion of the base 21 with a slide rail 131, and the holding beam 13 is slidably disposed in the slide groove 214 of the distal lower portion of the base 21 via the slide rail 131. As shown in fig. 3E, one end of the clamping beam 13 is connected with a fastening screw 133 that can fix the clamping beam 13 in the chute 214, the fastening screw 133 is connected with a fastening nut 2141, and when the clamping beam 13 reaches the clamping position, the fastening screw 133 and the fastening nut 2141 are screwed together to fix the clamping beam 13. The other end of the clamping beam 13 is provided with N slotted holes 132 corresponding to one side of the box slot 111 for the penetrating of the nail 90, so that pressure difference can be formed on two sides of the suture tissue in the process of penetrating the nail 90, the completion of the penetrating action is facilitated, and the penetrating position is more accurate.
In one embodiment, prior to performing a septal suturing procedure, the variable ratchet gear mechanism 23 is first secured in a braking mode, i.e., the slide bar 2342 is slid onto the braking detent 2262 on the arcuate slot 226, the stationary handle 211 and the movable handle 231 are held in one hand, and the fingers are held in the inverted U-shaped slot 2313 of the movable handle 231, ensuring that the device is not pulled out of the hand. The clamping and nail pushing mechanism 10 is adjusted and loosened, and when the clamping beam 13 reaches the clamping position, the fastening screw 133 and the fastening nut 2141 are matched and screwed up, so that the clamping and nail pushing mechanism 10 is fixed. After the clamping beam 13 is fixed, the clamping and nail pushing mechanism 10 is sent into the nasal cavity.
Next, the variable ratchet mechanism 23 is adjusted to the operational mode, i.e., sliding the slide bar 2342 onto the operational catch 2261 on the arcuate slot 226, so that the variable ratchet mechanism 23 can operate normally. Then, the movable handle 231 is operated to reciprocate within a certain angle range by finger force, power is transmitted to the ratchet gear 232 through the movable handle 231, and the power is transmitted to the rack 241 through the rotation of the ratchet gear 232 to drive the rack 241 to slide distally in the rack slot 212. While the rack 241 slides distally, the push rod 242 connected to the rack 241 simultaneously moves distally within the rack slot 212, driving the wedge presser 243 to slide distally within the push rod slot 112 of the push beam.
The distal end inclined plane of the wedge presser foot 243 is matched with the inclined plane of the double-end slider 122, when the wedge presser foot 243 slides distally in the push rod groove 112 of the push rod beam 11, the wedge presser foot 243 also moves distally in the double-row nail storage groove 1212, so that the double-end slider 122 is pushed to move in the double-row nail storage groove 1212 of the double-row nail storage groove 1212, the double-end slider moves in the double-row nail storage groove 1212 to provide larger pressure to push the nail 90 out of the double-row nail storage groove 12 to the suture tissue to approach the suture tissue, then the tip at the tail of the nail 90 contacts with the suture tissue and pierces the suture tissue, and as the slotted hole 132 is formed at the corresponding position of the upper surface of the clamping beam 13, the tip at the tail of the nail 90 stays in the slotted hole 132 of the clamping beam 13 after piercing the tissue is completed, and the slotted hole 132 can form pressure difference at two sides in the piercing process of the nail 90, so that the piercing action is completed, and the piercing position is more accurate. After the nail 90 is pierced, the hook-shaped tail part of the nail 90 can effectively prevent the nail 90 from sliding off, so that the nail 90 can still remain on the suture tissue after the clamping and nail pushing mechanism 10 is loosened and withdrawn, and a certain shrinkage force is maintained, thereby realizing the suture of the suture tissue.
After the suturing motion is completed, the variable ratchet-gear mechanism 23 is adjusted to a return mode, i.e., sliding bar 2342 is slid onto return catch 2263 on arcuate slot 226, at which time movable handle 231 is rotated, but no longer drives rack 241. After the clamping beam 13 and the nail pushing beam 11 are pushed out of the nasal cavity, the rack 241 is pushed back to the initial position to adjust or replace the double-row nail storage box 12 to wait for the next use, and if the double-row nail storage box is not used any more, the operation slide bar 2342 is rotated back to the braking clamping position 2262 again, so that the device is returned to the braking mode again. The above operations are all that an operator holds the fixed handle 211 and the movable handle 231 outside the nasal cavity by one hand, and applies force to the movable handle 231 to drive the variable ratchet mechanism 23 and further drive the clamping nail pressing mechanism 10 to press nails in the nasal cavity to suture tissue of the nasal septum.
The present invention has been described in detail with reference to the embodiments of the drawings, and those skilled in the art can make various modifications to the invention based on the above description. Accordingly, certain details of the embodiments are not to be interpreted as limiting the invention, which is defined by the appended claims.
Claims (9)
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| CN202211576422.4A CN115804625B (en) | 2022-12-09 | 2022-12-09 | A push-pin type nasal septum anastomosis device |
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| CN202211576422.4A CN115804625B (en) | 2022-12-09 | 2022-12-09 | A push-pin type nasal septum anastomosis device |
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| CN115804625B true CN115804625B (en) | 2025-08-26 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN219250305U (en) * | 2022-12-09 | 2023-06-27 | 复旦大学附属眼耳鼻喉科医院 | Nasal septal stapler of pushing nail type |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US5937951A (en) * | 1997-07-18 | 1999-08-17 | Ethicon Endo-Surgery, Inc. | Skin stapler with rack and pinion staple feed mechanism |
| CN202446170U (en) * | 2012-02-03 | 2012-09-26 | 北京中法派尔特医疗设备有限公司 | Stitching instrument with knife and dragging mechanism thereof |
| US10617413B2 (en) * | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
| CN105919640B (en) * | 2016-05-30 | 2018-07-27 | 杭州天任生物科技有限公司 | Endo-GIA under the hysteroscope of one-part form propulsion, backing mechanism and its composition |
| CN116138829B (en) * | 2017-02-27 | 2025-12-05 | 苏州法兰克曼医疗器械有限公司 | Surgical stapler that involves suturing before cutting |
| US11166723B2 (en) * | 2018-09-21 | 2021-11-09 | Lexington Medical, Inc. | Surgical handle assembly modes of operation |
| WO2021109547A1 (en) * | 2019-12-05 | 2021-06-10 | 山东威瑞外科医用制品有限公司 | Dual-power intracavity cutting stapler |
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| CN219250305U (en) * | 2022-12-09 | 2023-06-27 | 复旦大学附属眼耳鼻喉科医院 | Nasal septal stapler of pushing nail type |
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