阅读说明：本技术 引导件及圆管型吻合器 (Guide piece and circular tube type anastomat ) 是由 丁水澄 黄柊喻 龚银 范黎黎 于 2020-05-15 设计创作，主要内容包括：本发明提供了一种引导件及圆管型吻合器,引导件用于引导圆管型吻合器的钉仓组件进入手术部位,引导件包括：引导件本体,可拆卸地连接于钉筒的远端侧；拉出部,至少部分位于钉筒的内部,远端侧连接于引导件本体的内侧面；拉出部受到朝向近端侧的拉力时,拉出部的远端侧可带动引导件本体的内侧面朝向所述钉筒的近端侧运动,直至引导件本体可从钉筒的远端侧脱离而至少部分进入钉筒的内部腔体。该引导件可以很好地引导钉仓组件进入手术部位,并且在钉仓组件到达手术位置后,向近端侧拉动拉出部,引导件本体的内侧面可以向钉筒的近端侧运动而与钉筒远端侧脱离,使得引导件本体至少部分进入到钉筒内部,而不会对手术造成阻碍,提高了使用体验。(The invention provides a guide piece and a circular tube type anastomat, wherein the guide piece is used for guiding a nail bin assembly of the circular tube type anastomat to enter an operation site and comprises the following components: a guide body detachably connected to a distal end side of the cartridge; a pull-out part at least partially located inside the cartridge, the distal end side being connected to the inner side surface of the guide body; when the pull-out part is pulled towards the proximal side, the distal side of the pull-out part can drive the inner side surface of the guide body to move towards the proximal side of the nail barrel until the guide body can be separated from the distal side of the nail barrel and at least partially enter the inner cavity of the nail barrel. This guide can guide nail storehouse subassembly well and get into the operation position to behind nail storehouse subassembly arrival operation position, to near end side pulling pull-out portion, the medial surface of guide body can move and break away from with a nail section of thick bamboo distal end side to the near end side of a nail section of thick bamboo, makes inside the guide body at least part enters into a nail section of thick bamboo, and can not lead to the fact the hindrance to the operation, has improved and has used experience.)

1. A guide, characterized by a cartridge assembly for a circular tube-type stapler, the cartridge assembly including a cartridge, the guide comprising:

a guide body detachably connected to a distal side of the cartridge;

a pull-out portion located at least partially inside the cartridge, a distal end side of the pull-out portion being connected to an inner side surface of the guide body;

when the pull-out part is pulled towards the proximal side, the distal side of the pull-out part can drive the inner side surface of the guide body to move towards the proximal side of the nail barrel until the guide body can be separated from the distal side of the nail barrel and at least partially enter the inner cavity of the nail barrel.

2. The guide of claim 1, wherein a distal side diameter of the guide body is smaller than a proximal side diameter of the guide body, the proximal side diameter of the guide body is no greater than an outer diameter of the distal side of the cartridge, and an outer side surface of the guide body is a smooth surface.

3. The guide of claim 1, wherein a proximal side of the guide body is provided with a first mating portion by which the guide body is detachably connected to a distal side of the cartridge.

4. The guide of claim 3, wherein the first engagement feature is a protrusion, the distal side of the cartridge is provided with a groove that engages the protrusion, or,

the first matching part is a groove, and a bulge matched with the groove is arranged on the far end side of the nail barrel.

5. The guide of claim 1, wherein a proximal side of the pull-out portion is provided with at least one pull tab extending proximally in an axial direction of the stapler.

6. The guide of claim 5, wherein the cartridge includes at least one window through which the pull tab can move proximally when pulled proximally.

7. The guide of claim 6, wherein there are at least two of the windows, the inner side between adjacent windows is provided with ribs disposed in a radial direction, the guide body is provided with a plurality of tear lines extending axially in a direction from the proximal side to the distal side of the guide body, the pull tab, when pulled proximally, pulls the guide body proximally and the tear lines separate at the ribs.

8. The guide of claim 7, wherein each two adjacent tear lines form a set of tear lines corresponding one-to-one to the pull tabs, and a projection of an area of the guide body between the two tear lines of each set in a plane of the corresponding pull tab at least partially coincides with the corresponding pull tab.

9. The guide of claim 7, wherein the distal side of the tear line is provided with a notch.

10. The guide of claim 6, wherein the proximal side of the pull tab is provided with a second mating portion that is removably attached to the side of the window.

11. The guide of claim 10, wherein the second engaging portion is a bent portion formed by bending the pull tab outward, the bent portion being initially caught on an upper side of the window, and the bent portion does not protrude from an outer sidewall of the nail cartridge.

12. The guide of claim 5, wherein the pull-out portion further comprises a pull cord, and the proximal side of the pull tab is provided with a pull cord engaging portion that engages the pull cord.

13. The guide of claim 5, wherein the pull tab is provided with a window at a proximal end thereof.

14. The guide of claim 5, wherein the pull tab is in at least two pieces, and the proximal ends of the pull tabs are respectively provided with connecting structures that can be fitted to each other.

15. The guide of claim 1, wherein the guide body has an opening in a middle of a distal side thereof;

in an initial state, a distal end side of the guide body is formed as a curved surface turned toward an inner side of the guide body at a circumferential edge of the opening.

16. The guide according to claim 15, wherein in an initial state, the interior of the guide body is further provided with a tubular portion, a distal end side of the tubular portion communicates with the opening of the guide body, and a proximal end side of the tubular portion is connected with the pull-out portion;

the tubular portion has a proximal opening shape corresponding to a distal end shape of the pull-out portion.

17. The guide of claim 1, wherein the pull out portion comprises a pull cord having a distal side connected to an inner side surface of the guide body.

18. The guide of claim 1, wherein the guide body includes a plurality of circumferentially spaced guides, the guides having cross-sections of varying thickness in a circumferential direction, the guides decreasing in thickness in a direction from the proximal side to the distal side, the plurality of guides being connected by a tear line, the plurality of guides having a minimum thickness at the tear line, the guide body being separable into the plurality of guides by the tear line being pulled apart by the pull portion when the pull portion is pulled toward the proximal side.

19. The guide of claim 1, further comprising a support bar secured to the inside surface of the guide body on a distal side thereof and extending in an axial direction of the cartridge at least partially into the internal cavity of the cartridge.

20. The guide of claim 1, further comprising a first reinforcing beam fixed to the interior of the guide body and extending in a radial direction of the cartridge, and/or a second reinforcing beam;

the guide further includes a second stiffening beam affixed to the inner side of the guide body and extending in a direction pointing from the proximal side to the distal side of the guide body.

21. The guide of claim 1, wherein an outer side surface of the guide body is at least partially coated with a lubricating layer.

22. The guide of claim 1, wherein the pull out portion is integrally formed with the guide body.

23. Circular tube-type stapler, characterized in that it comprises a guide according to any of claims 1 to 22.

Technical Field

The invention relates to the technical field of medical instruments, in particular to a guide piece and a circular tube type anastomat.

Background

In the prior art, a circular tube-type anastomat comprises an anastomat body, an operating handle movably connected with the anastomat body and a nail anvil assembly matched with the anastomat body. The anastomat body comprises a firing assembly and a nail bin assembly arranged on the far end side. In the operation process, two sections of tissues to be anastomosed are placed between the nail anvil of the nail anvil assembly and the nail bin of the nail bin assembly, the distance between the nail anvil and the nail bin is adjusted to gradually clamp the tissues, and then the trigger assembly is driven by the operation handle to enable the anastomotic nails to be formed on the nail anvil, so that anastomotic connection of the two sections of tissues is completed.

During the actual operation, the body portion of the circular tube-type stapler, i.e., the cartridge portion, needs to enter the tissue tract from one end of the tissue. For example, in lower rectal surgery, access is required through the anus, which is a muscular opening and is in a contracted state, making it difficult to insert a large diameter instrument into the anus. As another example, in a gastric bypass or gastric cufflated procedure, the body of the stapler is required to enter the small intestine through a tissue stump and traverse a distance in the small intestine. The small intestine is in a separation state after the pathological tissue is cut off in the operation, and the intestinal walls are in a state of being attached together, so that the nail barrel part of the circular tube type anastomat is not easy to enter the tubular tissue, meanwhile, the inner wall of the digestive tract is a tissue mucosa, and the circular tube type anastomat is easy to damage the mucosa when passing in the small intestine.

In the present invention, the distal side and the proximal side are relative to the operator, and the end closer to the operator is the proximal side, and the end farther from the operator, i.e., the end closer to the surgical site is the distal side. In the stapler, the inner side and the outer side are relative to the axis of the stapler, wherein the side close to the axis is the inner side, and the side far away from the axis is the outer side.

Disclosure of Invention

In view of the problems in the prior art, an object of the present invention is to provide a guide and a circular tube type stapler, wherein the guide can well guide a staple cartridge assembly into a surgical site, and when a pull-out portion is pulled to a proximal end side, an inner side surface of a guide body can move to the proximal end side of a staple cartridge and at least partially enter an inner cavity of the staple cartridge without obstructing a surgical procedure.

The embodiment of the invention provides a guide piece for a nail box assembly of a circular tube type anastomat, wherein the nail box assembly comprises a nail barrel, and the guide piece comprises:

a guide body detachably connected to a distal side of the cartridge;

a pull-out portion located at least partially inside the cartridge, a distal end side of the pull-out portion being connected to an inner side surface of the guide body;

when the pull-out part is pulled towards the proximal side, the distal side of the pull-out part can drive the inner side surface of the guide body to move towards the proximal side of the nail barrel until the guide body can be separated from the distal side of the nail barrel and at least partially enter the inner cavity of the nail barrel.

Optionally, the distal side diameter of the guide body is smaller than the proximal side diameter of the guide body, the proximal side diameter of the guide body is not larger than the outer diameter of the distal side of the cartridge, and the outer side surface of the guide body is a smooth surface.

Optionally, a proximal side of the guide body is provided with a first mating portion by which the guide body is detachably connected to a distal side of the cartridge.

Optionally, the first matching part is a projection, the distal end side of the nail barrel is provided with a groove matched with the projection, or,

the first matching part is a groove, and a bulge matched with the groove is arranged on the far end side of the nail barrel.

Optionally, the proximal side of the pull-out portion is provided with at least one pull tab extending proximally in the axial direction of the stapler.

Optionally, the cartridge includes at least one window through which the pull tab is movable proximally when pulled proximally.

Optionally, the window is two at least, and is adjacent medial surface between the window is equipped with the strengthening rib that sets up along radial direction, the guide body is provided with many tear lines, the tear line is followed the directional distal end side's of near-end side direction axial extension of guide body, when the pulling-on piece receives the pulling force towards near-end side, the pulling the guide body is to near-end side motion, just the tear line is in strengthening rib department separation.

Optionally, each two adjacent tear lines form a group of tear lines corresponding to the pull tabs one by one, and a projection of an area of the guide body between the two tear lines of each group on the corresponding pull tab plane at least partially coincides with the corresponding pull tab.

Optionally, the distal side of the tear line is provided with a notch.

Optionally, a proximal side of the pull tab is provided with a second mating portion, and the second mating portion is detachably connected to a side surface of the window.

Optionally, the second matching portion is a bent portion formed by bending the pull piece towards the outer side, in an initial state, the bent portion is clamped on the upper side face of the window, and the bent portion does not protrude out of the outer side wall of the nail barrel.

Optionally, the pulling-out part further comprises a pulling rope, and a pulling rope matching part matched with the pulling rope is arranged on the proximal end side of the pulling piece.

Optionally, the proximal end of the pull tab is provided with a window.

Optionally, the pull tab is at least two pieces, and the proximal ends of the pull tabs are respectively provided with connecting structures which can be mutually matched.

Optionally, an opening is opened in the middle of the distal end side of the guide body;

in an initial state, a distal end side of the guide body is formed as a curved surface turned toward an inner side of the guide body at a circumferential edge of the opening.

Optionally, in an initial state, a tubular part is further arranged inside the guide body, a distal end side of the tubular part is communicated with the opening of the guide body, and a proximal end side of the tubular part is connected with the pulling part;

the tubular portion has a proximal opening shape corresponding to a distal end shape of the pull-out portion.

Optionally, the pull-out portion comprises a pull cord, a distal side of the pull cord being connected to the inner side surface of the guide body.

Optionally, the guide body includes a plurality of circumferentially spaced guides, cross-sections of the guides have different thicknesses in a circumferential direction, the thickness of the guides gradually decreases from a proximal end to a distal end, a tear line is formed at a connection of the guides, the guides have the smallest thickness at the tear line, and when the pull-out portion is pulled toward the proximal end, the guide body is pulled by the pull-out portion to be separated into the guides when the tear line is broken.

Optionally, the guide further comprises a support bar, a distal side of the support bar being secured to the inner side surface of the guide body, and the support bar extending in an axial direction of the cartridge at least partially into the internal cavity of the cartridge.

Optionally, the guide further comprises a first reinforcing beam and/or a second reinforcing beam, the first reinforcing beam is fixed to the inside of the guide body, and the first reinforcing beam extends in the radial direction of the cartridge;

the guide further includes a second stiffening beam affixed to the inner side of the guide body and extending in a direction pointing from the proximal side to the distal side of the guide body.

Optionally, the outer side of the guide body is at least partially coated with a lubricating layer.

Optionally, the pull-out portion is integrally formed with the guide body.

The embodiment of the invention also provides the circular tube type anastomat which comprises the guide piece.

The guide piece and the circular tube type anastomat provided by the invention have the following advantages:

the invention provides a guide piece for a circular tube type anastomat, which can well guide a nail bin assembly to enter an operation position to protect residual tissues and a mucous membrane layer of the tissues, and after the nail bin assembly reaches the operation position, a pulling part is pulled to a near end side, the inner side surface of a guide piece body can move to the near end side to be separated from the far end side of a nail barrel, so that at least part of the guide piece body enters the nail barrel, the operation cannot be hindered, the tissue cannot be damaged in the separation process, the operation is simple, and the use experience is improved.

Drawings

Other features, objects and advantages of the present invention will become more apparent upon reading of the following detailed description of non-limiting embodiments thereof, with reference to the accompanying drawings.

FIG. 1 is a schematic structural view of a staple cartridge assembly;

FIG. 2 is a schematic view of the first embodiment of the present invention showing the engagement of the guide with the cartridge assembly;

FIG. 3 is a schematic view of the first embodiment of the present invention showing the engagement of the guide with the cartridge assembly;

FIG. 4 is a front view of the guide of the first embodiment of the present invention in cooperation with a cartridge assembly;

FIG. 5 is a sectional view taken along line A-A of FIG. 4;

FIG. 6 is a schematic structural view of a guide of the first embodiment of the present invention;

FIG. 7 is a schematic structural view of a guide of the first embodiment of the present invention;

FIG. 8 is a schematic view of the guide of the second embodiment of the present invention in cooperation with a cartridge assembly;

FIG. 9 is a cross-sectional view of a guide of a second embodiment of the present invention in cooperation with a cartridge assembly;

FIG. 10 is a schematic view of the structure of a guide according to a second embodiment of the present invention;

FIG. 11 is a schematic structural view of a guide of a second embodiment of the present invention;

FIG. 12 is a schematic view of the structure of a guide according to a third embodiment of the present invention;

FIG. 13 is a top view of a guide of a third embodiment of the present invention;

FIG. 14 is a front view of a guide of a third embodiment of the present invention;

FIG. 15 is a schematic structural view of a guide according to a fourth embodiment of the present invention;

FIG. 16 is a front view of a guide of a fourth embodiment of the present invention;

FIG. 17 is a front view of a fourth embodiment of the guide of the present invention adding a tear line;

FIG. 18 is a schematic view of an alternative cord engaging portion for use with a guide according to a fourth embodiment of the present invention;

fig. 19 is a front view of the guide of fig. 18.

Reference numerals:

1 proximal side of body 31 of first embodiment guide 312

11 guide 1 body 32 guide 3 first mating portion

111 distal end side 33 of body 11 guide 3 pull-out part

112 proximal side 331 tab of body 11

12 guide 1 first mating portion 34 first reinforcement beam

13 guide 1 pull-out part 35 guide 3 opening

131 guide 1 second fitting part 36 tubular part

14 first cut out (proximal side) 361 tubular part proximal side

15 second notch (distal end side) 4 fourth embodiment guide

16 guide 1 tear line 41 guide 4 body

17 guide 1 distal side of opening 411 body 41

18 distal arc 412 proximal side of body 41

2 second embodiment guide 42 guide 4 first mating portion

21 body 43 of guide 2 guide 4 pull-out part

211 distal end side 431 of body 21 pull cord mating section

212 window 432 of proximal side 21

22 guide 2 first mating portion 44 guide 4 tear line

23 guide 2 pull-out 45 second reinforcement beam

231 guide 2 second mating portion 8 cartridge 8

24 first notch (proximal side) 81 distal side of the cartridge 8

25 support bar 82 proximal side of the cartridge 8

26 guide 2 tear line 83 window

3 third embodiment guide 84 Cartridge 8 internal Cavity

31 guide 3 body 9 anvil pull rod

311 distal side 91 of body 31 the distal side of the anvil pull rod

Detailed Description

Example embodiments will now be described more fully with reference to the accompanying drawings. Example embodiments may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the concept of example embodiments to those skilled in the art. The same reference numerals in the drawings denote the same or similar structures, and thus their repetitive description will be omitted.

The invention provides a guide for a circular tube type anastomat and the circular tube type anastomat comprising the guide. The circular tube anastomat comprises an anastomat body, an operating handle movably connected with the anastomat body and a nail anvil assembly matched with the anastomat body. The anastomat body comprises a firing assembly and a nail bin assembly arranged on the far end side. During operation, the nail box assembly is required to enter the tissue, move forwards to reach a surgical position and then butt with the nail anvil assembly. The guide is used to better guide the cartridge assembly into a surgical site. Specifically, the guide includes: the guide body is detachably connected to the distal end side of the nail barrel and used for guiding the nail cartridge assembly; the pull-out part is at least partially positioned in the nail barrel, and the distal end side of the pull-out part is connected to the inner side surface of the guide body and used for pulling the guide body when the nail cartridge assembly reaches the operation position, so that the guide body is separated from the distal end side of the nail barrel, and the cutting and the suturing of the anastomat are not influenced.

Specifically, when the pulling part is pulled towards the proximal side, the distal side of the pulling part can drive the inner side surface of the guide body to move towards the proximal side of the cartridge until the guide body can be disengaged from the distal side of the cartridge and at least partially enter the internal cavity of the cartridge. Because the guide piece body is separated from the far end side of the nail barrel and cannot block the nail bin surface on the far end side of the nail barrel, the nail anvil assembly and the nail bin assembly can be assembled at the moment, and the firing assembly is pushed by holding the operating handle, so that the tissue is cut and sutured by the anastomat.

The structure of the guide according to various embodiments of the present invention will be described in detail with reference to the accompanying drawings, and it should be understood that the embodiments are not intended to limit the scope of the present invention.

Fig. 1 is a schematic structural view of a staple cartridge assembly, which includes a staple cartridge 8. Fig. 2 to 7 are schematic views showing the structure of the guide member and the cartridge assembly according to the first embodiment of the present invention. In this embodiment, the guide 1 comprises: a guide body 11 and a pull-out part 13, the guide body 11 being detachably connected to a distal end side 81 of the cartridge 8 in an initial state, the pull-out part 13 being at least partially located inside the cartridge 8, the distal end side of the pull-out part 13 being connected to an inner side surface of the guide body 11.

In this embodiment, the initial state refers to the state before the cartridge assembly reaches the surgical site, requiring the guide body 11 to be detachably connected to the distal side 81 of the cartridge 8, while guiding the cartridge assembly to better enter the tissue. The outer side surface of the guide body 11 may be at least partially coated with a lubricant or the outer side surface of the guide body 11 itself is lubricious, and the lubricant may be an aqueous lubricant or an oil lubricant, etc. commonly used in the art to better perform the guiding function. For example, hydrophilic coating of the outer side surface of the guide body 11, and dipping of the surface of the guide body 11 with water before use, becomes very lubricious, and this technique has been widely used in the surgical field.

After the cartridge assembly reaches the surgical position, a proximally-directed pulling force may be applied to the pull-out portion 13, and the distal side of the pull-out portion 13 may draw the guide body 11 toward the interior of the cartridge 8, such that the guide body 11 may be disengaged from the distal side 81 of the cartridge 8 and at least partially into the internal cavity 84 of the cartridge 8, into a disengaged state. As shown in fig. 2, the inner side surface of the guide body 11 moves in the direction S2 toward the proximal end side 82 of the cartridge 8. In the disengaged state, since the guide body 11 is disengaged from the distal end side 81 of the cartridge 8, the cartridge surface of the cartridge 8 is not shielded, and the normal operation is not affected. Further, in the disengaged state, the pullout portion 13 is pulled further to the proximal end side, and the pullout portion 13 together with the guide body 11 can be completely pulled out from the cartridge 8 into the removed state. In another alternative embodiment, the guide body 11 may remain in the internal cavity 84 of the cartridge 8 and the cartridge assembly and guide 1 may be removed from the tissue interior after the tissue cutting and stapling is completed. The guide 1 may be made of a deformable flexible material such as silicone, rubber, etc. so that its inner side can be moved more easily towards the proximal side 82 of the cartridge 8 into the cartridge 8.

In the present invention, the distal end side and the proximal end side are, with respect to the operator, the end closer to the operator is the proximal end side, the end farther from the operator, that is, the end closer to the surgical site is the distal end side, and the direction along the axial center of the stapler is the axial direction, that is, the direction from the distal end side to the proximal end side of the stapler, or the direction from the proximal end side to the distal end side of the stapler. For example, in the perspective of FIG. 5, the distal side 81 is up and the proximal side 82 is down for the cartridge 8. The distal side 91 of the anvil pull rod 9 is the upper side. The distal end side 111 of the guide body 11 is the upper side, and the proximal end side 112 is the lower side. In the present invention, the inside and the outside of one cartridge 8 are relative to the axial center S1 of the cartridge 8, and the side closer to the axial center S1 is the inside and the side farther from the axial center S1 is the outside. The guide body 11 at least partially covers the distal surface of the cartridge 8, and the outside and inside of the guide body 11 are relative to the axial center S1 of the cartridge 8, the side facing the axial center S1 of the cartridge 8 is the inside surface, and the side facing away from the axial center S1 of the cartridge 8 is the outside surface, that is, the side of the guide body 11 directly contacting the tissue after the cartridge assembly enters the tissue is the outside surface.

In this embodiment, the distal end side 111 of the lead body 11 has a smaller diameter than the proximal end side 112 of the lead body 11, and the outer side surface of the lead body 11 is a smooth surface. Thus, the outer side of the guide body 11 forms a substantially conical surface, which allows the guide body 11 to provide a better guidance after the cartridge assembly has entered the tissue. Moreover, the diameter of the proximal end side 112 of the guide body 11 is smaller than or equal to the outer diameter of the distal end side 81 of the cartridge 8, so the guide 1 does not increase the outer diameter of the cartridge assembly, the additional burden of the cartridge assembly entering and moving in the tissue due to the addition of the guide 1 is not increased, the outer diameter of the tissue to be anastomosed is not expanded, and the tissue to be anastomosed is not damaged.

In this embodiment, as shown in fig. 6, the proximal end side 112 of the guide body 11 is provided with a first mating portion 12, and the guide body 11 is detachably connected to the distal end side 81 of the cartridge 8 through the first mating portion 12. In this embodiment, the first mating portion 12 is a protrusion and the distal side 81 of the cartridge 8 is provided with a recess that mates with the protrusion. In another alternative embodiment, the first mating portion may be a groove, and the distal side 81 of the cartridge 8 may be provided with a protrusion for mating with the groove. In other alternative embodiments, the first mating portion 12 may also have other detachable connecting structures, such as a snap, etc.

In this embodiment, as shown in fig. 6, the proximal side of the pull-out part 13 is provided with at least one pull tab extending in the axial direction of the stapler towards the proximal side of the stapler. The pull tab may also serve as an integral axial support for the lead body 11, keeping the shape of the lead body 11 in the initial state less prone to collapse inwardly. The tabs may be evenly distributed around a circumference around the axial center S1 of the cartridge 8, whereby the inner side of the guide body 11, starting from the position of connection with the tabs, gradually moves towards the axial center S1 of the cartridge 8 towards the proximal side 82 of the cartridge 8 and disengages from the distal side 81 of the cartridge 8 at the proximal side 112 of the guide body 11, when the tabs are simultaneously pulled proximally.

In this embodiment, the cartridge 8 includes at least one window 83, as shown in fig. 3 and 6. The proximal side of the pull-out portion 13 may be at least partially exposed outside of the viewing window 83 to facilitate manipulation by the physician. The proximal side of the pull tab is provided with a second mating portion 131, and the second mating portion 131 is detachably connected to the side of the window 83. In this embodiment, the second engaging portion 131 is a bent portion formed by bending the pull tab outward, and in an initial state, the bent portion is clamped on the upper side surface of the window 83 and does not protrude from the outer side wall of the nail barrel 8. The second engagement portion 131 ensures that the pull-out portion 13 is not displaced in the initial state, maintaining the structural stability of the guide body 11 on the distal end side 81 of the cartridge 8. In other alternative embodiments, the second mating portion 131 may also adopt other structures, such as a snap, etc. Further, since the second fitting portion 131 initially defines the position of the pull-out portion 13, the pull-tab can better axially support the guide body 11 in the initial state. In this embodiment, a plurality of pull tabs can be provided, and the proximal ends of the pull tabs are respectively provided with a connecting structure which can be mutually adapted, so that the proximal end sides of the pull tabs can be connected together, and when a doctor operates, all the pull tabs can be pulled to the proximal end side by pulling one position.

As shown in fig. 5 to 7, in this embodiment, an opening 17 is opened in the middle of the distal end side 111 of the guide body 11. In the initial state, the distal end side 111 of the lead body 11 is formed at the circumferential edge of the opening 17 as a smooth arc 18 turned toward the inside of the lead body 11 to avoid the opening 17 edge from directly contacting the tissue to damage the tissue.

In this embodiment, as shown in fig. 5, the inside of the cartridge 8 is provided with an anvil pull rod 9, and the distal side 91 of the anvil pull rod 9 is provided with a piercing part. In the initial state, the distal side 91 of the anvil pull rod 9 is located in the internal cavity 84 of the cartridge 8. Because the distal side 111 of the guide body 11 is formed with the opening 17, movement of the anvil pull rod 9 to the distal side is not affected even if the guide body 11 is not removed from the distal side 81 of the cartridge 8. After the cartridge assembly reaches the surgical position, the guide body 11 can be drawn into the internal cavity 84 of the cartridge 8 or even removed from the cartridge 8 without the anvil pull rod 9 being moved distally, and the pull-out 13 can be pulled again after the anvil pull rod 9 has been moved distally so that its distal side 91 protrudes beyond the distal side 81 of the cartridge 8, so that the guide body 11 disengages from the distal side 81 of the cartridge 8.

As shown in fig. 6 and 7, the lead body 11 may be further provided with a plurality of tear lines 16, the tear lines 16 extending in a direction from the proximal side 112 to the distal side 111 of the lead body 11, and when the pull-out portion 13 is pulled toward the proximal side, the lead body 11 may be broken at the tear lines 16 to be separated into a plurality of portions by the pull of the pull-out portion 13. The tear line 16 may be a broken line formed by a point break or a thin tear line, and when a plurality of tabs are pulled in the proximal direction, the tear line 16 is pulled and broken, so that the guide body 11 is separated into a plurality of parts, and is more easily moved into the internal cavity 84 of the cartridge 8 and is more easily moved out of the cartridge 8 through the window 83. In other alternative embodiments, it is also possible that no tear line 16 is provided.

In this embodiment, as shown in fig. 6, in order that the tear line 16 can be easily torn when the pull-out portion 13 is pulled, the position of the tear line 16 corresponds to the position of the tab. Specifically, every two adjacent tear lines 16 form a group of tear lines 16 corresponding to the pull tabs one by one, and a projection of an area of the guide body 11 between the two tear lines 16 of each group on the plane of the corresponding pull tab at least partially coincides with the corresponding pull tab.

To further facilitate separation of the lead body 11 into multiple parts when pulled proximally by a pull tab, the proximal side 112 of the lead body 11 and/or the distal side 111 of the lead body 11 may also be provided with a notch, as shown in fig. 7. In this embodiment, the proximal side 112 of the lead body 11 is provided with a first notch 14, the distal side 111 of the lead body 11 is provided with a second notch 15, and the positions of the first notch 14 and the second notch 15 are arranged correspondingly. In other alternative embodiments, it is also possible to provide only one recess. When the pullout portion 13 pulls the guide body 11 toward the proximal end side, the guide body 11 can be torn apart at the notch to be separated into a plurality of parts, more easily enters the internal cavity 84 of the cartridge 8, and can be more easily moved out of the cartridge 8 through the window 83. Further, a tear line 16 may also be provided between the first and second opposing notches 14, 15.

Further, the guide body 11 may also be made separable into a plurality of parts when pulled by the pull-out portion 13 by providing a non-uniform thickness. For example, the lead body 11 includes a first thickness portion having a thickness larger than that of a second thickness portion, and when the pull-out portion 13 receives a pulling force toward the proximal end side due to the smaller thickness of the second thickness portion, the lead body 11 may be separated into a plurality of portions by being pulled apart by the pull-out portion 13 when the second thickness portion is pulled apart by the pull-out portion 13. The second thickness portion may be provided at a position corresponding to the notch or at a position corresponding to the pull tab, but the present invention is not limited thereto.

Further, the guide body 11 may also include a plurality of circumferentially spaced guides, the cross-section (interface in a plane perpendicular to the axial direction of the cartridge 8) of which has a thickness that is not uniform in the circumferential direction and that gradually decreases in the direction from the proximal end side to the distal end side, the connection of the plurality of guides being a tear line at which the plurality of guides have a minimum thickness to facilitate separation of the plurality of guides at the tear line, and the guide body 11 may be separated into the plurality of guides by breaking the tear line when the pull-out portion is pulled by a pulling force toward the proximal end side.

In this embodiment, the pulling part 13 and the guide body 11 may be integrally formed, or may be two separate components fixedly connected to each other, and may be made of the same material or different materials.

Referring to FIGS. 8-11, the structure of the guide 2 and its cooperation with the cartridge assembly of the second embodiment of the present invention is shown. In this embodiment, the guide 2 again comprises two parts, a guide body 21 and a pull-out 23, the proximal side 212 of the guide body 21 being provided with a first engagement portion 22 for engagement with the distal side 81 of the cartridge 8, and the pull-out 23 comprising at least one pull tab, the proximal side of which is bent outwardly to form a second engagement portion 231 for engagement with the window 83. This embodiment differs from the first embodiment in that: no opening is provided on the distal end side 211 of the lead body 21 and no second notch is provided on the distal end side 211 of the lead body 21.

As shown in fig. 8 and 9, since the distal side of the guide 2 is not open, after the cartridge assembly has been brought into the operative position, the pull-out portion 23 of the guide 2 needs to be pulled first so that the inner side of the guide body 21 moves towards the proximal side 82 of the cartridge 8, and so that the first mating portion 22 of the proximal side 212 of the guide body 21 disengages from the distal side 81 of the cartridge 8, and the guide body 21 enters at least partially into the internal cavity 84 of the cartridge 8. The anvil pull rod 9 is then extended outwardly until the distal side 91 protrudes beyond the distal side 81 of the cartridge 8.

In this embodiment, the inner side surface of the guide body 21 may also be separated into a plurality of portions when moving toward the proximal side 82 of the cartridge 8, for example, with the aid of the first notch 24 at the proximal side 212 of the guide body 21, or, as in the structure shown in fig. 10 and 11, a plurality of tear lines 26 may be provided on the surface of the guide body 21, the tear lines 26 may correspond to the pull tab position of the pull-out portion 23, and when the pull-out portion 23 pulls the guide body 21 toward the proximal side, the tear lines 26 are torn off, the guide body 21 is split into a plurality of portions, and is more easily accessible to the inside of the cartridge 8, into a disengaged state, and does not block movement of the anvil pull-out lever 9 toward the distal side. After the guide body 21 has entered the inside of the cartridge 8, the pull-out portion 23 may be pulled further, removing the guide 2 as a whole from the cartridge 8 through the viewing window 83, into a removed state.

In an alternative embodiment, the inner side surface between adjacent windows 83 may be provided with ribs arranged in the radial direction, the guide body 21 is provided with a plurality of tear lines extending axially in a direction from the proximal side to the distal side of the guide body 21, and when the pull-out portion 23 is pulled toward the proximal side, the guide body 21 is pulled to move toward the proximal side, and the tear lines are separated at the ribs. This structure can also be applied to the first embodiment described above, in which a tear line is provided in the guide body 11, the tear line extending axially in a direction from the proximal side to the distal side of the guide body 11, and when the pull-out portion 13 is subjected to a pulling force toward the proximal side, the guide body 11 is pulled to move toward the proximal side, and the tear line is separated at the reinforcing bead. Further, this structure can also be applied to the respective embodiments described below.

In this embodiment, as shown in fig. 10 and 11, the guide 2 further comprises a support bar 25, the distal side of the support bar 25 is fixed to the inner side surface of the guide body 21, and the support bar 25 extends in the axial direction of the cartridge 8 at least partially into the internal cavity of the cartridge 8. The support strip 25 can better provide axial support to the guide body 21, reducing inward collapse of the surface of the guide body 21 in the initial state.

Further, in the first and second embodiments, the pulling-out portions 13,23 may further include a pulling rope, one end of the pulling rope is connected to the proximal end side of the pulling-on piece, and a plurality of pulling-on pieces may be simultaneously connected by using one pulling rope, so that when a doctor pulls one pulling rope to the proximal end side, the plurality of pulling-on pieces may be simultaneously pulled to the proximal end side direction, so that the position where the guide body is connected to the pulling-on pieces is evenly stressed, and the guide body is evenly turned toward the axial center direction of the cartridge.

Fig. 12 to 14 are schematic structural views of a guide 3 according to a third embodiment of the present invention. In this embodiment, the guide 3 also includes two parts, a guide body 31 and a pull-out portion 33, the proximal end side 312 of the guide body 31 is provided with a first engaging portion 32 that engages with the distal end side 81 of the cartridge 8, and the distal end side 311 of the guide body 31 is provided with an opening 35. This embodiment differs from the first embodiment in that: the pull-out portion 33 includes a pull cord, a distal end side of which is connected to the inner side surface of the guide body 31.

In this embodiment, in the initial state, the inside of the lead body 31 is further provided with a tubular portion 36, a distal end side of the tubular portion 36 communicates with the opening 35 of the lead body 31, and a proximal end side of the tubular portion 36 is connected to the pull-out portion 33. Further, the opening shape of the proximal end side 361 of the tubular part 36 may be adapted to the shape of the distal end side of the pull cord to better enable the connection of the tubular part 36 with the pull cord. The proximal side of stay cord can also set up pull ring 331, and the doctor can pull the stay cord through pull ring 331 and move to proximal side during the operation to the inboard of driving guide body 11 moves towards proximal side 82 of the nail section of thick bamboo 8, promotes the doctor and uses experience.

As shown in fig. 12, in this embodiment, the guide 3 further includes a first reinforcing beam 34, the first reinforcing beam 34 is fixed to the inside of the guide body 31, and the first reinforcing beam 34 extends in the radial direction of the cartridge 8. Both ends of the first reinforcing beam 34 may be fixed to the inner surface of the guide body 31 and the tubular portion 36, respectively, to radially reinforce the guide body 31. The first stiffening beam 34 is preferably made of a flexible material, which deforms when the inner side of the guide body 31 moves towards the proximal side 82 of the cartridge 8 without hindering the guide body 31 from entering the cartridge 8. Further, a central rod is arranged inside the nail barrel 8, a reinforcing rib for limiting and reinforcing the central rod is arranged between the central rod and the inner side surface of the nail barrel, and the position of the first reinforcing beam 34 can correspond to the position of the reinforcing rib, so that the first reinforcing beam 34 is cut off by the reinforcing rib in the process that the guide body 31 moves towards the near end side to enter the inner cavity 84 of the nail barrel 8.

Fig. 15 to 19 are schematic structural views of a guide 4 according to a fourth embodiment of the present invention. In this embodiment, the guide 4 also includes two parts, a guide body 41 and a pull-out portion 43, and the proximal end side 412 of the guide body 41 is provided with a first engaging portion 42 that engages with the distal end side 81 of the cartridge 8. The pull-out portion 43 comprises a plurality of pull tabs, the distal sides of which are preferably attached near the distal side 411 of the lead body 41. This embodiment differs from the first embodiment in that: a pull cord engaging portion 431 for engaging with a pull cord is formed on the proximal end side of the pull tab. The pull cord engagement portion 431 may be a protrusion or a groove that matingly engages with the pull cord, and the shape of the pull cord engagement portion 431 on each pull tab may be different to form a non-releasable connection with the pull cord. In other alternative embodiments, the pull rope matching part can adopt other structures, and the connection with the pull rope can be realized.

As shown in fig. 15, in this embodiment, the guide 4 further includes a second reinforcing beam 45, the second reinforcing beam 45 is attached to the inner side surface of the guide body 41, and the second reinforcing beam 45 extends in a direction from the proximal end side 412 to the distal end side 411 of the guide body 41 to reinforce the guide body 41 in the axial direction, so that the guide body 41 is not easily collapsed to the inner side in the initial state.

As shown in fig. 17, in this embodiment, the surface of the guide 4 may be further provided with a tear line 44, and the position of the tear line 44 corresponds to the position of the pull-tab, so that when the guide body 41 is pulled proximally by the pull-tab, the guide body 41 is torn apart at the position of the tear line 44 to be separated into a plurality of parts. Further, in this embodiment, a notch may be disposed on the surface of the guide body 41, so that the guide body 41 is separated from the notch gradually when being pulled, or the surface of the guide body 41 may be disposed in a structure with a non-uniform thickness, and the like, which all fall within the protection scope of the present invention.

As shown in fig. 18 and 19, the structure of the guide member 4 in which the window 432 is provided on the proximal side of the pull-tab of the pull-out portion 43 in the fourth embodiment is shown. The window 432 is a slot extending along the axial direction of the nail barrel 8. The surgeon may pull the pull tab directly by hand at the window 432 or may pull the pull tab with a surgical tool at the window 432.

The guide provided by the invention is separated from the distal end surface of the nail barrel and enters the nail barrel after reaching the surgical position, the doctor can select to pull the guide out of the nail barrel completely, and the guide can be separated from the distal end surface of the nail barrel without separating from the nail barrel. The tear line at the detachment of the guide occurs in a space within the outer diameter of the cartridge, i.e., protected by the guide body more distal than the tear, so that the detachment process does not cause damage to the tissue.

The guide piece provided by the invention can be independently placed without being arranged on the nail barrel part of the anastomat before being used, and can be selectively arranged by a user according to the requirement, the operation is simpler, and only the guide piece body needs to be arranged on the far end side of the nail barrel; the stapler can also be directly arranged on the nail barrel part of the stapler in advance, and the user does not need to install the stapler by himself.

The above embodiments are only examples, and the structures in the above embodiments may be combined and used, all of which fall within the scope of the present invention. For example, the outer side surfaces of the guide bodies 21,31,41 of the second, third and fourth embodiments may each be at least partially coated with a lubricant to enhance the guiding of the cartridge assembly. The guide body 21,31,41 and the pull-out portion 23,33,43 of the second, third and fourth embodiments may be respectively of an integrally formed structure or separate two parts fixedly connected to each other. The supporting bar 25 of the second embodiment can be used in other embodiments, the first reinforcing beam 34 of the third embodiment can be used in other embodiments, and the second reinforcing beam 45 of the fourth embodiment can be used in other embodiments to achieve strength reinforcement in different directions of the guide body. The guides of the above embodiments may be made, at least in part, of deformable flexible material such as silicone rubber, etc., for example, TPE (Thermoplastic Elastomer, also known as Elastomer or Elastomer).

The guide piece and the circular tube type anastomat provided by the invention have the following advantages:

the invention provides a guide piece for a circular tube type anastomat, which can well guide a nail bin assembly to enter an operation position to protect residual tissues and a mucous membrane layer of the tissues, and after the nail bin assembly reaches the operation position, a pulling part is pulled to a near end side, the inner side surface of a guide piece body can move to the near end side of a nail barrel to be separated from the far end side of the nail barrel, so that at least part of the guide piece body enters the inside of the nail barrel, the operation cannot be hindered, the tissue cannot be damaged in the separation process, the operation is simple, and the use experience is improved.

The foregoing is a more detailed description of the invention in connection with specific preferred embodiments and it is not intended that the invention be limited to these specific details. For those skilled in the art to which the invention pertains, several simple deductions or substitutions can be made without departing from the spirit of the invention, and all shall be considered as belonging to the protection scope of the invention.