阅读说明：本技术 引导组件及圆管型吻合器 (Guide assembly and circular tube type anastomat ) 是由 陈伟娜 孙佳 曹元阳 于 2020-05-20 设计创作，主要内容包括：本发明提供了一种引导组件及圆管型吻合器,所述引导组件用于引导圆管型吻合器的钉仓组件进入手术部位,所述钉仓组件包括钉筒,所述钉筒的侧面设置有至少一个视窗,所述引导组件包括第一引导件和第二引导件,所述第一引导件的第一端可拆卸地套设于所述钉筒的远端侧,所述第一引导件受到朝向远端侧方向的外力时,所述第一引导件可朝向远端侧运动而与所述钉筒脱离；所述第二引导件套设于所述钉筒的外侧,且所述第二引导件覆盖所述视窗的远端侧面。本发明提供了一种用于圆管型吻合器的引导组件,引导组件可以很好地引导钉仓组件进入手术部位,并且在手术完成后将钉仓组件从组织中取出时,防止对组织粘膜造成损伤。(The invention provides a guide assembly and a circular tube type anastomat, wherein the guide assembly is used for guiding a nail bin assembly of the circular tube type anastomat to enter an operation position and comprises a nail barrel, at least one window is arranged on the side surface of the nail barrel, the guide assembly comprises a first guide piece and a second guide piece, the first end of the first guide piece is detachably sleeved on the far end side of the nail barrel, and when the first guide piece is subjected to external force towards the direction of the far end side, the first guide piece can move towards the far end side and is separated from the nail barrel; the second guide piece is sleeved on the outer side of the nail barrel, and the second guide piece covers the side face of the far end of the window. The invention provides a guide assembly for a circular tube type anastomat, which can well guide a nail bin assembly to enter a surgical site and prevent tissue mucosa from being damaged when the nail bin assembly is taken out of tissue after surgery.)

1. The guide assembly is characterized by being used for a nail bin assembly of a circular tube type anastomat, the nail bin assembly comprises a nail barrel, and the side surface of the nail barrel is provided with at least one window;

the guide assembly includes:

the first end of the first guide piece is detachably sleeved on the distal end side of the nail barrel, and when the first guide piece is subjected to external force towards the distal end side direction, the first guide piece can move towards the distal end side to be separated from the nail barrel;

the second guide piece is sleeved on the outer side of the nail barrel and covers the side face of the far end of the window.

2. The guide assembly of claim 1, wherein the first guide and the second guide are each flexible material members.

3. The guide assembly of claim 1, wherein the first end of the first guide includes a resilient portion that is in an expanded state when the resilient portion is disposed around the cartridge.

4. The guide assembly of claim 1, wherein the second guide member is an elastic member, and the elastic member is in an expanded state when the second guide member is sleeved outside the cartridge.

5. The guide assembly according to claim 4, wherein the second guide is detachably sleeved outside the cartridge;

when the second guide piece is not sleeved on the outer side of the nail barrel, the second guide piece is of a cylindrical structure.

6. The guide assembly of claim 1, wherein a connecting rib is disposed between the first end of the first guide and the distal side of the second guide, wherein the first guide is movable distally to break the connecting rib when the first guide is subjected to an external force in a distal direction.

7. The guide assembly of claim 1, wherein there is an overlap region between the first end of the first guide and the distal side of the second guide, and the first end of the first guide covers an outer side of the distal side of the second guide at the overlap region.

8. Guide assembly according to claim 1, wherein the thickness of the first guide is less than 0.1 mm and/or the thickness of the second guide is less than 0.1 mm.

9. The guide assembly of claim 1, further comprising an anvil pull rod at least partially disposed within the cartridge, wherein a distal side of the anvil pull rod defines a puncturing portion, wherein the second end of the first guide member is closed, and wherein the second end of the first guide member is disposed distal of the puncturing portion when the anvil pull rod moves toward the distal of the stapler to protrude beyond the distal of the cartridge.

10. The guide assembly of claim 1, further comprising an anvil pull rod at least partially disposed within the cartridge, wherein a distal end of the anvil pull rod is provided with a puncturing portion, the second end of the first guide member is provided with an opening, the puncturing portion of the anvil pull rod is inserted into the opening when the anvil pull rod moves toward the distal end of the stapler to protrude from the distal end of the cartridge, and the second end of the first guide member terminates at the puncturing portion.

11. The guide assembly according to claim 1, wherein the cartridge includes a first tubular portion, a connecting portion and a second tubular portion from a distal side to a proximal side thereof, the window being disposed at the connecting portion, the first tubular portion having an outer diameter larger than an outer diameter of the second tubular portion, the connecting portion having an outer surface with a smooth transition surface;

when the second guide piece is sleeved on the outer side of the nail barrel, the inner diameter of the far end side of the second guide piece is larger than that of the near end side of the second guide piece.

12. The guide assembly according to claim 1, wherein an opening is provided at a position of the second guide corresponding to the window, and a distance from a distal side of the opening to a distal side of the cartridge is greater than a distance from the distal side of the window to the distal side of the cartridge.

13. The guide assembly according to claim 1, wherein the second guide member is expandable into a one-piece structure, and two opposite side edges of the one-piece structure are provided with positioning portions, and when the second guide member is sleeved outside the nail barrel, the two opposite side edges of the one-piece structure are connected through the positioning portions.

14. The guide assembly of claim 13, wherein the positioning portion includes a male and female edge disposed on opposite sides of the one-piece structure, and the male and female edges of the two opposite sides of the one-piece structure engage with each other when the second guide member is sleeved on the outside of the cartridge.

15. Guide assembly according to claim 1, wherein the inner side of the second guide is provided with a raised portion.

16. Guide assembly according to claim 1, wherein the outer surface of the first guide is at least partially coated with a lubricating layer and/or the surface of the second guide is at least partially coated with a lubricating layer.

17. A circular tube-type stapler, characterized in that it comprises a guide assembly according to any one of claims 1 to 16.

Technical Field

The invention relates to the technical field of medical instruments, in particular to a guide assembly 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. After the operation is completed, the surgeon needs to take out the nail barrel part from the tissue, and the nail barrel part is easy to damage the mucosa when passing through the tissue in the process of taking out.

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 assembly and a circular tube type stapler, wherein the guide assembly can guide a cartridge assembly into a surgical site well and prevent a tissue mucosa from being damaged when the cartridge assembly is taken out from a tissue after a surgery is completed.

The embodiment of the invention provides a guide assembly which is used for a nail bin assembly of a circular tube type anastomat, wherein the nail bin assembly comprises a nail barrel, and the side surface of the nail barrel is provided with at least one window;

the guide assembly includes:

the first end of the first guide piece is detachably sleeved on the distal end side of the nail barrel, and when the first guide piece is subjected to external force towards the distal end side direction, the first guide piece can move towards the distal end side to be separated from the nail barrel;

the second guide piece is sleeved on the outer side of the nail barrel and covers the side face of the far end of the window.

Optionally, the first guide and the second guide are each a flexible material member.

Optionally, the first end of the first guide comprises an elastic part, and when the elastic part is sleeved on the nail barrel, the elastic part is in an expanded state.

Optionally, the second guide is an elastic member, and when the second guide is sleeved outside the nail barrel, the elastic member is in an expanded state.

Optionally, the second guide piece is detachably sleeved outside the nail barrel;

when the second guide piece is not sleeved on the outer side of the nail barrel, the second guide piece is of a cylindrical structure.

Optionally, a connecting rib is disposed between the first end of the first guide and the distal end side of the second guide, and when the first guide is subjected to an external force in the distal direction, the first guide can move toward the distal end side to break the connecting rib.

Optionally, there is an overlap region between the first end of the first guide and the distal side of the second guide, and the first end of the first guide covers an outer side surface of the distal side of the second guide at the overlap region.

Optionally, the thickness of the first guide is less than 0.1 mm and/or the thickness of the second guide is less than 0.1 mm.

Optionally, the staple cartridge assembly further includes an anvil pull rod at least partially located inside the staple cartridge, a puncturing portion is disposed on a distal end side of the anvil pull rod, the second end of the first guide is a closed end, and when the anvil pull rod moves to protrude from the distal end side of the staple cartridge toward the distal end side of the stapler, the second end of the first guide is located on the distal end side of the puncturing portion.

Optionally, the staple cartridge assembly further comprises a staple anvil pull rod at least partially located inside the staple cartridge, a puncturing part is arranged on the distal end side of the staple anvil pull rod, an opening is formed in the second end of the first guide, when the staple anvil pull rod moves to protrude out of the distal end side of the staple cartridge towards the distal end side of the anastomat, the puncturing part of the staple anvil pull rod penetrates through the opening, and the second end of the first guide is stopped at the puncturing part.

Optionally, the nail barrel comprises a first tubular part, a connecting part and a second tubular part from the distal end side to the proximal end side of the nail barrel, the window is arranged on the connecting part, the outer diameter of the first tubular part is larger than that of the second tubular part, and the outer surface of the connecting part is a smooth transition curved surface;

when the second guide piece is sleeved on the outer side of the nail barrel, the inner diameter of the far end side of the second guide piece is larger than that of the near end side of the second guide piece.

Optionally, an opening is provided at a position of the second guide corresponding to the viewing window, and a distance from a distal side of the opening to the distal side of the staple cartridge is greater than a distance from the distal side of the viewing window to the distal side of the staple cartridge.

Optionally, the second guide piece can be unfolded into a one-piece structure, two opposite side edges of the one-piece structure are provided with positioning portions, and when the second guide piece is sleeved on the outer side of the nail barrel, the two opposite side edges of the one-piece structure are connected through the positioning portions.

Optionally, the positioning portion includes concave and convex edges disposed on two opposite side edges of the one-piece structure, and when the second guide piece is sleeved on the outer side of the nail barrel, the concave and convex edges of the two opposite side edges of the one-piece structure are engaged with each other.

Optionally, the inner side surface of the second guide is provided with a convex portion.

Optionally, the outer surface of the first guide is at least partially coated with a lubricating layer and/or the surface of the second guide is at least partially coated with a lubricating layer.

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

In summary, by adopting the guide assembly of the present invention, the cartridge assembly can be well guided to enter the surgical site to protect the stump tissue and the mucosal layer of the tissue, and after the cartridge assembly reaches the surgical site, an external force towards the distal side direction is applied to the first guide, at least part of the guide can be conveniently removed from the distal side, the surgical operation is simple, no additional burden is added to the surgical process, the surgical effect is not affected by the existence of the guide, and when the cartridge assembly is taken out from the tissue after the surgical operation is completed, the mucosal layer of the tissue can be protected by the second guide, so as to prevent the tissue mucosa from being damaged, 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 structural view of the guide assembly of the first embodiment of the present invention applied to a cartridge assembly;

FIG. 3 is a cross-sectional view of the guide assembly of the first embodiment of the present invention applied to a cartridge assembly with the anvil pull rod in an initial state;

FIG. 4 is a cross-sectional view of the guide assembly of the first embodiment of the present invention applied to a cartridge assembly with an anvil pull rod in the operative configuration;

FIG. 5 is a cross-sectional view of the guide assembly of the first embodiment of the present invention applied to a cartridge assembly with the anvil pull rod in the operative condition and the first guide removed;

FIG. 6 is a schematic view of the first guide member and the second guide member of the first embodiment of the present invention in cooperation;

FIG. 7 is a schematic view of the guide assembly in cooperation with the cartridge assembly after the addition of a connecting rib according to the first embodiment of the present invention;

FIG. 8 is a schematic view of the guide assembly with the addition of tie bars according to the first embodiment of the present invention;

FIG. 9 is a cross-sectional view of the guide assembly of the second embodiment of the present invention as applied to a cartridge assembly with the anvil pull rod in an initial state;

FIG. 10 is a cross-sectional view of the guide assembly of the second embodiment of the present invention applied to a cartridge assembly with an anvil pull rod in the operative configuration;

FIG. 11 is a schematic structural view of the first guide member sleeved outside the staple cartridge according to the second embodiment of the present invention;

FIG. 12 is a schematic view of the second embodiment of the present invention with the first guide removed from the distal end;

FIG. 13 is a schematic view of a second guide of the second embodiment of the present invention;

fig. 14 is a schematic structural view of a positioning portion added to the second guide according to the second embodiment of the present invention;

FIG. 15 is a schematic view of the second guide of FIG. 14 after deployment;

FIG. 16 is a schematic structural view of a third embodiment of the guide assembly of the present invention applied to a cartridge assembly;

FIG. 17 is a schematic structural view of a fourth embodiment of the guide assembly of the present invention applied to a cartridge assembly;

FIG. 18 is a schematic structural view of a fifth embodiment of the guide assembly of the present invention applied to a cartridge assembly.

Reference numerals:

1 cartridge 22 first guide second end

11 first tubular portion 23 first opening

111 distal 3 second guide of the first tubular part

12 distal end side of connecting portion 31 second guide

Distal side 32 of the 121 connection part proximal side of the second guide

122 proximal side 33 second opening of the connection

13 second tubular portion 34 positioning portion

131 proximal side 41 bead of the second tubular part

14 window 42 boss

Distal end side 5 anvil pull rod of 141 window

Proximal side 51 of 142 window distal side of anvil pull rod

2 first guide 6 connecting rib

21 first end of the first guide

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 assembly for a circular tube type anastomat and the circular tube type anastomat comprising the guide assembly. 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, the nail bin assembly comprises a nail barrel, and at least one window is arranged on the side face of the nail barrel. 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 assembly is used for better guiding the cartridge assembly into a surgical site. Specifically, the guide assembly comprises a first guide and a second guide, wherein a first end of the first guide is detachably sleeved on the distal end side of the nail barrel, and when the first guide is subjected to an external force in the direction of the distal end side, the first guide can move towards the distal end side to be separated from the nail barrel; the second guide piece is sleeved on the outer side of the nail barrel, and the second guide piece covers the side face of the far end of the window.

Therefore, when the nail bin assembly enters the tissue, the injury to the mucosa in the tissue can be effectively prevented through the guiding and protecting effects of the first guide piece and the second guide piece during the operation. After the nail bin assembly reaches the surgical site, at least part of the first guide part is exposed outside the tissue, a doctor can directly clamp the first guide part by using tools such as surgical forceps and the like, and pull force is applied to the far-end side direction of the anastomat, so that the first guide part is integrally separated from the nail bin assembly, the first guide part can be pulled out of the tissue, and the first guide part is prevented from obstructing surgical operation. After the operation is finished, when the nail bin assembly is taken out of the tissue, the tissue mucosa is protected through the second guide piece, and the tissue mucosa can be prevented from being damaged.

The structure of the guide assembly 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 to 5 are schematic views showing the structure of the guide assembly and the magazine assembly according to the first embodiment of the present invention. In this embodiment, the staple cartridge assembly comprises a staple cartridge 1, and at least one window 14 is opened on a side surface of the staple cartridge 1. The guide assembly comprises a first guide 2 and a second guide 3, a first end 21 of the first guide 2 is detachably sleeved on the distal end side of the nail barrel 1, and when the first guide 2 is subjected to an external force towards the distal end side, the first guide 2 can move towards the distal end side to be separated from the nail barrel 1; the second guide 3 is sleeved outside the nail barrel 1, and the second guide 3 covers the distal side surface 141 of the window 14, so that the nail barrel 1 is not separated even if external force towards the distal end is applied.

From this, when nail storehouse subassembly gets into tissue inside, first guide 2 and second guide 3 can provide fine guide effect for nail section of thick bamboo 1, after nail storehouse subassembly arrives the operation position, first guide 2 is at least partially exposed outside organizing, the doctor can directly use tools such as operation pincers to carry first guide 2, apply pulling force to the distal end side direction of anastomat, first guide 2 is whole to be separated with nail section of thick bamboo 1, thereby can pull out first guide 2 from organizing very conveniently, can not increase extra burden for the operation process, also can not influence the operation effect because of the existence of guide, use experience has been improved. After the operation is finished and the nail bin assembly is taken out of the tissue, the second guide piece 3 can protect the mucosa of the tissue and avoid damaging the tissue in the movement process of the nail bin.

In this embodiment, as shown in fig. 1, the cartridge 1 comprises a first tubular part 11, a connecting part 12 and a second tubular part 13 arranged from the distal side to the proximal side thereof, the viewing window 14 is arranged in the connecting part 12, the distal side 121 of the connecting part 12 is in contact with the first tubular part 11, and the proximal side 122 of the connecting part 12 is in contact with the second tubular part 13. The distal end side 111 of the first tubular part 11 corresponds to the distal end side of the cartridge 1 and the proximal end side 131 of the second tubular part 13 corresponds to the proximal end side of the cartridge 1.

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. 3, the distal end side of the cartridge 1 is the upper side and the proximal end side is the lower side, and the distal end side 31 of the second guide 3 is the upper side and the proximal end side 32 is the lower side. In the present invention, the inner side and the outer side of one member are relative to the axis of the stapler, and the side close to the axis is the inner side and the side far from the axis is the outer side.

In this embodiment, the first guide 2 and the second guide 3 are each a flexible material part, so as to avoid damage to the tissue when in contact with the tissue mucosa. Further, the first end 21 of the first guide 2 comprises an elastic part, and when the elastic part is sleeved on the nail barrel 1, the elastic part is in an expanded state, so that the nail barrel 1 is tightly clamped by the elastic part to form a tighter fit with the nail barrel 1, and the nail cartridge assembly is ensured not to be detached when the nail cartridge assembly does not reach the surgical position. In this embodiment, the first guide 2 may be a film made of rubber, plastic, silicon, etc. to reduce the influence on the outer diameter of the cartridge 1, so as not to expand and damage the outer diameter of the tissue to be anastomosed. While the first guide 2 can be easily pulled out of the tissue when subjected to an external force. In this embodiment, the thickness of the first guide 2 is less than 0.1 mm, for example chosen between 0.1 mm and 0.01 mm. In other embodiments, the thickness may be increased or decreased as appropriate, as permitted, such as 0.2 mm, 0.25 mm, etc.

In this embodiment, the second guide 3 may be a film made of rubber, plastic, silicone, etc., and the thickness of the second guide 3 is also preferably less than 0.1 mm, for example, selected between 0.1 mm and 0.01 mm. In other embodiments, the thickness may be increased or decreased as appropriate, as permitted, such as 0.2 mm, 0.25 mm, etc. Thus, the second guide 3 does not substantially increase the outer diameter of the cartridge 1, nor does it increase the difficulty of the cartridge 1 entering and removing from the tissue. The second guide 3 may be an elastic member, and when the second guide 3 is sleeved on the outer side of the nail barrel 1, the elastic member is in an expanded state.

In other alternative embodiments, the first guide member 2 and the second guide member 3 may be made of a flexible fabric, such as a woven fabric, a knitted fabric, or the like, the fabric may be made of a rayon material or a spun yarn obtained by a polymer extrusion method, or the like, and the first guide member 2 and the second guide member 3 are preferably elastic fabrics.

In this embodiment, the outer side walls of the first and second guides 2, 3 are at least partially lubricious, or the outer side walls of the first and second guides 2, 3 are at least partially coated with a lubricious layer. The lubricating layer may be pre-coated on the outer side walls of the first guide 2 and the second guide 3, and then the first guide 2 and the second guide 3 are mounted on the cartridge assembly, or the lubricating layer may be coated on the surfaces of the first guide 2 and the second guide 3 after the first guide 2 and the second guide 3 are mounted on the cartridge assembly. The lubricating layer may further improve the guiding action of the first guide 2 and the second guide 3, reducing the friction between the guides and the inner wall of the tissue. The lubricant layer may be a water-soluble lubricant, an oil-based lubricant, or the like, which is known in the art, for example, a hydrophilic coating is applied to the outer side surfaces of the first guide 2 and the second guide 3, and the surfaces of the first guide 2 and the second guide 3 are dipped in water before use, which becomes very lubricant, and this technique has been widely used in the field of surgery.

As shown in FIGS. 3 and 4, the cartridge module further comprises an anvil pull rod 5 at least partially located inside the cartridge 1, and a distal side 51 of the anvil pull rod 5 is provided with a puncturing part. In the present invention, the states of the anvil pull rod 5 can be divided into two types: an initial state and an operating state. As shown in fig. 3, in the initial state, the puncturing part of the anvil pull rod 5 is located inside the cartridge 1, the first end 21 of the guide 2 is sleeved outside the cartridge 1, the second end 22 of the guide 2 is sleeved on the puncturing part of the anvil pull rod 5, and the second end 22 of the guide 2 is in the expanded state to clamp the puncturing part of the anvil pull rod 5 in the initial state. As shown in fig. 4, when the cartridge module reaches the surgical position, the knob of the stapler is rotated to move the anvil pull rod 5 toward the distal end side, and the cartridge module enters a working state, in which the distal end side 51 of the anvil pull rod 5 protrudes out of the distal end side of the cartridge 1 to reach a state of being capable of being butted, and at this time, the first guide 2 is not removed from the cartridge module 1, and at this time, the second end 22 of the first guide 2 is located at the distal end side of the puncturing portion of the anvil pull rod 5.

When the anvil pull rod 5 is in the working state, the puncturing part of the anvil pull rod 5 drives the second end 22 of the first guide 2 to puncture the tissue and expose the tissue, and at this time, a pulling force toward the distal side direction is applied to the second end 22 of the first guide 2, so that the first guide 2 can be separated from the cartridge 1 and the anvil pull rod 5, and the state shown in fig. 5 is entered. At this point, the anvil pull rod 5 can be docked with the anvil assembly, thanks to the absence of the blocking of the first guide 2, and the firing of the stapler can then be carried out.

In this embodiment, the second guide 3 may be detachably sleeved outside the cartridge 1. When the second guide 3 is not installed on the outer side of the nail barrel 1, the second guide 3 can be of a simple hollow cylindrical structure, and the production process is simpler. Before the operation, the second guide 3 and the first guide 2 are installed together on the outer side of the cartridge 1, and the first end 21 of the first guide 2 and the second guide 3 are both in an expanded state to improve the fitting strength with the cartridge 1. After the second guide 3 is removed from the tissue together with the cartridge 1 after the procedure is completed, the second guide 3 can be removed from the cartridge 1.

In this embodiment, in order to avoid the influence of the second guide 3 on the visibility of the window 14, a second opening 33 may be further provided at a position of the second guide 3 corresponding to the window 14, and a distance from a distal side surface of the second opening 33 to the distal end side of the cartridge 1 is larger than a distance from a distal side surface 141 of the window 14 to the distal end side of the cartridge 1, so as to ensure that the second guide 3 can cover the distal side surface of the window 14.

As shown in fig. 1, the outer diameter of the first tubular portion 11 is larger than that of the second tubular portion 13, and the outer surface of the connecting portion 12 is a smooth transition curved surface. In order to better adapt to the structure of the outside of the cartridge 1, when the second guide 3 is sleeved on the outside of the cartridge 1, since the distal end side 31 of the second guide 3 is located on the outside of the first tubular part 11, the proximal end side 32 of the second guide 3 is located on the outside of the connecting part 12, and the inner diameter of the distal end side 31 of the second guide 3 is larger than the inner diameter of the proximal end side 32 of the second guide 3, the second guide 3 can be ensured to be better attached to the outer side surface of the cartridge 1, and the cartridge 1 can be more smoothly taken out from the tissue.

As shown in fig. 6, in this embodiment, the length of the first guide member 2 may be further increased, the first end 21 of the first guide member 2 has an overlapping region with the distal end side 31 of the second guide member 3, and the first end 21 of the first guide member 2 covers the outer side surface of the distal end side 31 of the second guide member 3 at the overlapping region. Therefore, the matching strength of the first guide 2 and the second guide 3 and the nail barrel 1 can be enhanced through the matching of the first end 21 of the first guide 2 and the distal end side 31 of the second guide 3, and the nail cartridge assembly is prevented from falling off accidentally before reaching the operation position. The outer surface of the portion of the second guide 3 covered by the first guide 2 is not coated with a lubricating layer.

In this embodiment, as shown in fig. 7 and 8, a connecting rib 6 may be further disposed between the first end 21 of the first guide 2 and the distal end side 31 of the second guide 3, so as to enhance the fitting strength of the first guide 2 and the second guide 3 with the cartridge 1, and prevent the cartridge assembly from falling off accidentally before reaching the surgical site. When the first guide 2 is subjected to an external force in the direction of the distal side, the first guide 2 can move towards the distal side to break the connecting ribs 6, so that the second guide 3 can be left on the outer side surface of the cartridge 1 when the first guide 2 is removed.

Fig. 9 to 13 are schematic views showing the structure of the guide assembly and the cartridge assembly according to the second embodiment of the present invention. This embodiment differs from the first embodiment in that the second end 22 of the first guide 2 is provided with a first opening 23. In the initial state, as shown in fig. 9, the first guide 2 is not fixedly connected to the anvil pull rod 5, and the diameter of the first opening 23 is smaller than the diameter of the puncturing part of the distal side 51 of the anvil pull rod 5. As shown in fig. 10, when the staple cartridge assembly moves to the surgical position, in the process that the anvil pull rod 5 moves to protrude from the distal end side of the staple cartridge 1 toward the distal end side of the stapler, the anvil pull rod 5 is inserted into the first opening 23 to protrude from the first guide 2 to pierce tissue, and the anvil pull rod 5 opens the first opening 23, so that the first opening 23 clamps the anvil pull rod 5, and the anvil pull rod 5 drives the second end 22 of the first guide 2 to be exposed out of the tissue, thereby facilitating the operation and removal of the first guide 2 by the surgeon. In this embodiment, the portion of the first guide 2 at the distal end of the cartridge 1 comprises a tapered portion having a diameter that increases from its side near the second end 22 of the first guide 2 to its side near the first end 21 of the first guide 2 to form a tapered structure that better serves to guide the cartridge assembly into the tissue. In other alternative embodiments, the first guide 2 may be arranged such that the diameters of the first end 21 and the second end 22 are substantially the same, and fall within the scope of the present invention. In the state of fig. 10, the first guide 2 is removed by pulling it in the distal direction, and the structure shown in fig. 5 is obtained. As shown in fig. 11 and 12, the state of the first guide 2 is shown when it is fitted to the distal end side of the cartridge 1 and when it is detached from the cartridge 1, respectively, the first end 21 of the first guide 2 is elastically expanded when it is fitted to the outside of the cartridge 1, and the first end 21 of the first guide 2 is contracted to a state before the expansion after it is detached from the cartridge 1, so that it can be more easily taken out from the tissue. As shown in fig. 13, the second guide 2 may be a simple hollow cylindrical structure when not fitted outside the cartridge 1, and the manufacturing process is more convenient, and the second guide 2 is preferably an elastic structure which is outwardly spread to fit outside the cartridge 1 when mounted outside the cartridge 1.

As shown in fig. 14 and 15, the second guide 3 may also be unfolded into a one-piece structure, and two opposite sides of the one-piece structure are provided with positioning portions 34, and when the second guide 3 is sleeved outside the cartridge 1, the two opposite sides of the one-piece structure are connected by the positioning portions 34. In this embodiment, the second guide 3 may not have elasticity, and the fixing of the second guide 3 to the outside of the cartridge 1 is achieved by the positioning part 34. In this embodiment, the positioning portion 34 includes concave and convex edges disposed on two opposite sides of the one-piece structure, and when the second guide 3 is sleeved on the outside of the nail barrel 1, the concave and convex edges of the two opposite sides of the one-piece structure are engaged with each other. In other alternative embodiments, the positioning portion 34 may also adopt a connecting structure such as a snap.

Fig. 16 is a schematic structural view of a cartridge assembly to which the guide assembly of the third embodiment of the present invention is applied. This embodiment differs from the first embodiment in that: the length of the second guide 3 is longer and the proximal side 32 of the second guide 3 covers the proximal side 142 of the viewing window 14. In this embodiment, in order to avoid the influence of the second guide 3 on the visibility of the window 14, a second opening 33 is provided at a position of the second guide 3 corresponding to the window 14, and the distance from the distal side surface of the second opening 33 to the distal end side of the cartridge 1 is larger than the distance from the distal side surface 141 of the window 14 to the distal end side of the cartridge 1, so that it is ensured that the second guide 3 can cover the distal side surface 141 of the window 14.

As shown in fig. 1, the outer diameter of the first tubular portion 11 is larger than that of the second tubular portion 13, and the outer surface of the connecting portion 12 is a smooth transition curved surface. In order to better adapt to the structure of the outside of the cartridge 1, when the second guide 3 is sleeved on the outside of the cartridge 1, since the distal end side 31 of the second guide 3 is located on the outside of the first tubular portion 11, the proximal end side 32 of the second guide 3 is located on the outside of the second tubular portion 13, and the inner diameter of the distal end side 31 of the second guide 3 is larger than the inner diameter of the proximal end side 32 of the second guide 3, the second guide 3 can be ensured to be better attached to the outer side surface of the cartridge 1, and the cartridge 1 can be more smoothly taken out from the tissue.

Fig. 17 is a schematic structural view of a cartridge assembly to which the guide assembly of the fourth embodiment of the present invention is applied. In this embodiment, the inner side surface of the second guide 3 is further provided with a protruding portion, the protruding portion is a protruding strip 41, and the protruding strip 41 preferably extends along the circumferential direction of the nail barrel 1, but the invention is not limited thereto, and in other alternative embodiments, the protruding strip 41 may also extend along the axial direction of the nail barrel 1, or form an angle with the axial direction, and the like.

Fig. 18 is a schematic structural view of a cartridge assembly to which the guide assembly of the fifth embodiment of the present invention is applied. In this embodiment, the inner side surface of the second guide 3 is further provided with a projection, which is a boss 42. While fig. 18 shows a circular boss, in alternate embodiments, the boss 42 may take on other shapes and arrangements and remain within the scope of the present invention.

The guide assembly provided by the invention can be independently placed and not mounted on the nail barrel part of the anastomat before being used, and can be selectively mounted by a user according to the needs, the operation is simpler, only the first guide part and the second guide part need to be mounted on the outer side of the nail barrel, and in some embodiments, the second end of the first guide part needs to be mounted at the far end of the nail anvil pull rod; can also be directly arranged on the nail barrel part of the anastomat without being arranged by the user. Meanwhile, the first guide piece and the second guide piece are elastic, so that the anastomats of multiple models can be matched, and the universal matching property in production and use is good.

In summary, by adopting the guide assembly of the present invention, the cartridge assembly can be well guided to enter the surgical site to protect the stump tissue and the mucosal layer of the tissue, and after the cartridge assembly reaches the surgical site, an external force towards the distal side direction is applied to the first guide, at least part of the guide can be conveniently removed from the distal side, the surgical operation is simple, no additional burden is added to the surgical process, the surgical effect is not affected by the existence of the guide, and when the cartridge assembly is taken out from the tissue after the surgical operation is completed, the mucosal layer of the tissue can still be protected by the second guide, so as to prevent the tissue mucosa from being damaged, 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.