JPS6157778B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a surgical device, i.e., a device for applying staple sutures, which involves the application of relatively long staple sutures one at a time, and thus covers very small areas of surgical wounds. It can be used in surgical practice for suturing deep and shallow cavities, as well as for suturing the stomach, intestines, with heavy loads on the stitching mechanism of the device.

Several surgical devices for applying staples or multi-staple sutures are known in the art (see, eg, US Pat. No. 3,315,863). These devices include a frame formed as a hook with a jaw carrying a die with a recess into which the staples are bent, a staple head, a magazine with a slot for the staples, a staple ejector, and a staple head. and Ezeta mechanical actuator. However, these devices have the disadvantage that the frame formed as a hook does not have a suitably rigid structure;
Heavy loads are placed on the device when applying long multi-staple sutures (as is the case when sewing double-row sutures), resulting in deformation of the hooks and unacceptable changes in the distance from the magazine to the die. As a result, the proper mutual alignment of the die recesses and their respective magazine slots is affected, so that the staples cannot be bent tightly enough and the resulting sutures are poorly sealed, thus preventing bleeding. It happens.
In order to increase the stiffness of the frame and obtain high-quality durable sutures, a considerable increase in the cross-sectional dimensions of the frame elements increases the overall weight of the device and increases the weight of the device within the restricted confines of the surgical field. This adversely affects the operation and functional capabilities of the device, resulting in a very rough suture as the distance from the suture to the tissue cut increases abnormally.

The above disadvantages can be solved by the
It is largely removed by other devices for suturing human tissue. The device includes a body having a closed rectangular frame adapted to interact with a staple head having a staple magazine and an ejector each having a mechanical actuator.

The frame consists of a portal member, one of the legs carrying the die, and a separable rod connecting the legs of the portal member. A functional convenience of the construction of the device is that the closed frame can be opened beside the leg carrying the die, thereby allowing the device to be attached to the organ being sutured, for example in the case of gastric resection. It's convenient because I can take it with me.

The device has several drawbacks, the main one being that the foot structure does not provide sufficient rigidity to the stitching mechanism to handle the heavy loads applied in three mutually perpendicular directions when suturing tissues or organs. It is something that cannot be done. Furthermore, the frame of this device is too complicated, inconvenient, and has a short lifespan.

The above drawbacks are due to the construction of the frame of the known device. In this case, the separable rod of the frame is a cylindrical rod with a thread at one end and a head at the other end. To connect this rod to the leg of the portal, it must be screwed into a threaded hole in the leg that carries the die and a threaded hole that has an external thread and is provided at the other end of the portal frame. This is done with an additional intermediate sleeve. A separable cylindrical rod is fitted into the hole in the intermediate sleeve and screwed into the threaded hole in the leg carrying the die.

In order for the cylindrical rod to also serve to lock the separable staple magazine and disposable die in place, said rod runs through special centering holes in the magazine and die; It therefore has a cross-sectional diameter that is smaller than the width of the magazine or die located at the staple head. On the other hand, the cylindrical rod surface and the magazine or die centering holes are
The thread at the rod end always has a diameter that is much smaller than the diameter of the rod restriction part, since it must be accurately restricted to achieve the required fit accuracy.

In such a construction of a separable bar, which is actually one of the sides of the closing frame, connects the legs of the portal as a permanent joint and the other side which does not run through the magazine or the die. than the stiffness of
It is quite clear that the frame is characterized by lower tensile stiffness and lower lateral stiffness in the plane of the frame and in the plane perpendicular to this. Moreover, the hinge joint of the cylindrical rod and the leg of the portal frame member, the magazine and the die cannot compensate for torsional moments due to bending of said components in a plane perpendicular to the plane of the frame.

Significant forces are applied to the stitching mechanism of the device in the process of compressing the tissue being sutured and deforming multiple staples at once. Thus, for example, when placing two rows of 100-150 mm long sutures with staples made of 0.3 mm diameter wire, the force applied to the stitching mechanism is 100 mm.
Or reach 140kgf. Because the rigidity of the entire structure is low, and the cylindrical rod and the leg of the portal frame member,
Due to the hinged connection of the magazine and die, the magazine-to-die gap increases in the direction of sewing, and the magazine and die move relative to each other in the plane of the frame and in a direction perpendicular to said plane. This results in axial misalignment of the staple recess and the staple slot, causing the staple to bend inappropriately tightly and distort its shape after suturing, thus affecting suture tightness and hemostasis, and causing blood flow. It becomes an unstoppable stitch.

The low stiffness of the separable rods due to the frame structure makes the deformation of the rods unacceptable. Description of the device according to U.S. Pat. No. 3,494,533 (14
Column, line 74), ``The rod must be discarded after use because it is easily deformed when exposed to bending forces and will disturb the center alignment of the magazine if reused.'' This is why the separable cylindrical rod used in the device has to be made disposable, so that a new rod must be obtained for each subsequent suturing operation, which is economically costly. It is.

The reason why cylindrical rods are less durable and unsuitable for many uses is that the construction of this known device requires the use of small diameter screws, which can cause considerable damage when repeatedly screwed in and out. This is also because abnormal play is likely to occur in the threaded joints due to wear and deformation. Furthermore, such rods are not practically applicable to small devices intended for use with preschool children. because,
In this case, the screw diameter is so small that such screws cannot be used for heavy-duty screws.

In order to compensate for the aforementioned drawbacks of the construction of the known device, which become apparent under the heavy loads applied to the stitching mechanism of the known device, the legs and sides of the portal frame members (relative to the legs) are ) and by increasing the cross-sectional dimensions of the cylindrical rod, the stiffness of the structural members of the mechanism must also be increased. However, doing so makes the device more bulky and requires suture staples to be made along the legs of the portal frame members. The space between the cut and the tissue being sutured becomes increasingly large, so that the resulting suture becomes increasingly coarse and characterized by large tissue bulges.

The complexity of the construction and the inconvenience of use of the known device is such that the separable cylindrical rod of the frame is connected to the free end of the leg of the portal member, so that the rod and the portal This is explained by having to have another intermediate piece made as a sleeve provided between one leg of the frame member. Thus, the sleeve described above must be secured to the leg, and then the cylindrical rod is attached to the sleeve,
It must fit into several holes in the magazine, the die and the leg carrying the die, and these elements must be closely aligned with each other. To do this, the rod must be rotated several times. The rod end has a tapered surface which, when the rod is set in the working position, presses as a cam against a special projection in the centering hole of the magazine and against the cylindrical surface of the hole in the die. do.

Another disadvantage of the known device is that the magazine and die can only be replaced after the cylindrical rod has been disassembled and completely removed from the device, and the device itself can be removed from the surgical wound. Unless you obtain a new set of magazines, dies, and rods and install these components in their respective working positions,
The device cannot be applied repeatedly. This limits the functional ability of the device, in particular to apply two parallel sutures to the organ and then cut the tissue between the suture points with a scalpel (this is because the remaining tissue of the instrumented organ cannot be removed). e.g. when suturing the stomach) and for placing a tube through the wall of large curvature of the stomach in the case of esophagoplasty. The device cannot be used conveniently without being removed from the surgical wound.

Furthermore, it is difficult to clean the small diameter screw holes in the intermediate sleeve and the legs of the portal frame member.

The purpose of the invention is to increase the structural stiffness of the separable rods of the frame and to compensate for the torsional moments that tend to occur due to the effects of lateral loads on the legs carrying the die. To provide a surgical device for applying staples, featuring a split frame of a high rigidity body as close as possible to the rigidity of a solid frame by providing a joint of said bar and a portal frame member such that That's true.

The above object comprises a split frame having a portal member in which one of the legs carries a recessed die and a separable bar adapted to connect the free ends of the legs of the portal member. a main body; a staple head having a staple magazine and an ejector;
In a surgical device for applying staples, comprising a staple head and a mechanical actuator of a staple ejector, this is accomplished according to the invention as follows. That is, the separable rod has a stop that surrounds the free end of the leg of the portal member from the outside, and at the free end of each leg there is a retainer for the rod position made as a shoulder; The free ends of the legs are adapted to move towards each other by the elasticity of the portal over a length that depends on the size of the holding shoulder, and the separable rod and leg and the free ends of the legs can be engaged by mutually moving into each other along the legs in a reciprocal manner via flat spots provided on the legs.

According to the split frame having such a structure, the rigidity of the separable rod can be increased in three mutually perpendicular directions, and the rigidity of the joint between the rod and the leg of the portal frame member can be increased. According to the locking joint between the separable rod and the leg, the free end of the leg rotates relative to the separable rod in a plane perpendicular to the plane of the frame, during the process of suturing the frame. A mutual displacement of these under the action of a load applied to them is virtually eliminated, whereas in known devices such rotation occurs. Thanks to this, the components of the device are less likely to deform, other things being equal, and ensure proper mutual alignment of the magazine slot and die recess while being subjected to the compressive forces of the organ and the forces of staple deformation during suturing. When so favorable conditions are established for holding. This then results in the formation of a high quality suture stitch, increases the tightness of the suture and therefore its strength, and provides better hemostasis.

The increased stiffness of the structure allows the width of the device's stitching mechanism to be reduced to more closely space the space between the suture stitch and the tissue cut made along the frame leg that carries the die. This makes it possible to obtain very "fine" sutures. On the other hand, incorporating a large number of staples that can be bent at once to create sutures of very long lengths reduces the total load applied to the device without increasing the cross-sectional dimensions of the frame or the stitching mechanism of the device. given the possibility of increase.

Thus, according to the structure of the invention, a device for suturing the stomach with two rows of sutures with a length of 100 to 150 mm, for example with staples made of wire with a diameter of 0.3 mm, or with a relatively large cross section. Apparatus can be provided for stitching relatively stiff and muscular muscle tissue with staples made of wire of size eg 0.4 mm or larger.

The ability to reduce the cross-sectional dimensions of the frame components, ie the legs of the portal and the frame sides lateral to said legs, increases the maneuverability of the device and reduces its weight. Therefore,
The structure of the present invention can be used in devices for applying staples in deep and narrow cavities, and in pediatric surgery in closely bordering surgical wound conditions, especially in preschool children. For use in devices designed to It is convenient for use in devices designed to sew up missing organs. In the last case, the most important thing is whether the cell tissue required to set the working position of the device to the suturing position can be preserved in millimeter units, and whether the device can be applied to the given surgery. This is the deciding factor.

Since the stiffness of the separable rod of the frame has been increased considerably, the possibility of its unacceptable deformation and disposability is also eliminated. The practical durability of the separable rod is unlimited, thus increasing the service life of the device as a whole.

A distinguishing structural feature of the device proposed in the invention is a separable rod connected directly to the leg of the portal, thus, as in the case of the known device, the rod and the portal. Separable rods can be provided without additional intermediate pieces inserted between them. Thanks to this, the construction of the frame consisting of only two parts becomes very simple and technically feasible, and a convenient disassembly and reassembly of the device is guaranteed.

The free end of each leg of the portal member has a slot opening towards the end face of the leg, the side of the slot has a retaining shoulder, and the rod has a slot for receiving into the slot of the corresponding leg. It is desirable that there is a recess in the range.

With this structural arrangement, there are no confined spaces or small diameter screw holes, which is convenient for cleaning and washing the frame components.

Other embodiments of the frame of the device are also possible, in which the separable rods advantageously have flat-sided openings, which openings are provided with retaining shoulders. It is located within the range of the rod that engages the free end of the leg.

The outer surface of the free end of the leg may have a cutout forming a shoulder.

The retaining shoulder at the free end of one leg and the separable rod stop have beveled edges on the surfaces adapted to interact when the rod is being snapped into place. It is conveniently located. This achieves automatic approximation of the free ends of the legs of the portal frame element and facilitates setting the separable rod into the working position.

Preferably, at one end of the rod there is a rectangular section forming a handle, and at the other end a flange adapted to enter a cutout in the free end of the leg carrying the die. .

Hereinafter, the present invention will be explained with reference to embodiments with reference to the accompanying drawings.

The device comprises a body (FIG. 1) with a closed rectangular frame 2, consisting of a portal member 3 with legs 4, 5, the free ends of which are separable. They are interconnected by rods 6.
The leg 4 carries a die 7 which has a recess into which the staple is bent. A staple head 8 (FIG. 2) is adapted to interact with the frame 2 and is also adapted to interact with the frame 2.
has a mandrel 9 accommodated in a slot 10 made in the body 1.

The staple head 8 has a projection 11 (FIG. 3) which engages the rod 6 and the side 12 of the frame 2 laterally with respect to the die 7 (the separable rod 6 is actually located on the side of the frame 2). The reference numeral 6 hereinafter refers to both the separable rod and the side of the frame 2). The sides 6 and 12 limit the staple head 8 and the frame 2 from mutual displacement in the plane of the frame 2 and in a direction perpendicular to the plane of the frame 2. The mandrel 9 has projections 13 and 14 which, when in the working position, are accommodated in longitudinal grooves 15 and 16 made in the body 1.

The staple head 8 includes a staple magazine 17 (FIG. 4) having a slot 18 and an ejector 19 having a lamina 20 corresponding to the slot 18 of the magazine 17. The ejector 19 has a mandrel 21 which is received in the slot 10 of the body 1 below the mandrel 9 of the staple head 8. Magazine 17
and ejector 19 are held against the staple head 8 by a removable cover 22, the cover 22
is slidable relative to the magazine 17 in a direction away from the die 7 by an extent exceeding the height of the magazine 17. Thanks to this, the magazine 17 can be released after suturing, and the magazine 17 can be detached from the staple head 8 by applying a force to the staple head 8 in a direction perpendicular to the plane of the frame 2, and the staple can be loaded instead. A replacement magazine can be attached.

The staple head shaft 9 is provided with a hollow tail piece 23 having an external thread 24 and an internal thread 25. The nut 26 is actually threaded onto the external thread 24 which is the mechanical actuator of the staple head 8, causing the staple head 8 with the magazine 17 to undergo a translational (advance) movement relative to the die 7 when setting the feed gap. give. The nut 26 is locked in the body 1 against longitudinal displacement by an annular groove 27 adapted to interact with a projection 28 of the body 1.

In threaded engagement with the female thread 25 of the tail piece 23 is a screw 29 which provides the translational movement relative to the magazine 17 and die 7 necessary for bending the staples to form the suture on the ejector 19. is the mechanical actuator of the ejector.
The screw 29 has an annular groove 30 in which the axle 21 of the ejector 19 is engaged by a fork 31 (FIG. 5) provided at its end, and the screw 29 has a removable groove 30. A handle 32 is provided.

The separable rod 6 (FIG. 1) of the frame 2 includes:
The outer surfaces 35, 3 of the free ends of the legs 4 and 5 of the portal 3
There are stops 33, 34 (FIGS. 2 and 6) surrounding 6. This prevents the free ends of the legs 4 and 5 from moving apart in the direction of suturing, and thus makes it possible to compress the organ being sutured and to bend a number of staples one at a time during suturing. , which tends to occur under the action of load, die 7 (Fig. 1)
The change in the suture gap between the magazine 17 and the magazine 17 is eliminated.

A separable rod 6 (FIGS. 2 and 6) with stops 33, 34 forms, together with the free ends of the legs 4, 5 of the portal 3, a locking joint, which in practice includes a rod position retainer, which is a shoulder 37, 38 at the free end of each leg 4,5. The shoulders 37, 38 hold the bar 6 against displacement along the legs 4, 5 and against it coming off the portal 3 of the frame 2.

In order to allow the frame to be opened beside the die 7 for better access of the device to the organ being sutured and then to be able to lock the legs 4, 5 after the organ has been placed in the suturing position. , the free ends of the legs 4, 5, within the elastic limits of the portal 3 of the frame 2, are directed towards each other by an extent equal to or beyond the height of the retaining shoulders, i.e. 38. Can move sideways. Thanks to this, the surgeon can touch the ends of the legs 4, 5 with his fingers at the arrow 39 (point 7).
When pressed towards each other in the direction of FIG. 1, the separable rods 6 are released from the retaining shoulders 38. These structural features of the frame 2 allow the rod 6 to be removed instantly in a single motion.

The separable rod 6 and the free ends of the legs 4, 5 of the portal 3 intersect along the legs 4, 5, and the rod 6
flat points 40, 41 (second, sixth,
8) and the flat points 42, 43 provided at the free ends of the legs 4, 5.

In one embodiment of the device, the legs 4, 5 of the portal 3
Flat points 42, 43 at the free end of (Fig. 2)
are actually the walls of the slots 44, 45 which open towards the end faces 46, 47 of the legs. The holding shoulders 37, 38 in this case are located on the sides of the slots 44, 45, whereas the flat points 4 of the rod 6
0,41 are actually the legs 4,5 of the U-shaped member 3
The bottom surface of the recesses 48, 49 in the surface of the rod 6 to the extent that they engage the slots 44, 45 of the rod 6.

In another embodiment of the device, flat points 40, 41
(FIG. 6) shows through openings 50, 51 made in the separable rod 6 to the extent that the rod 6 fits into the free end of each leg 4, 5 with a retaining shoulder 37, 38.
This is the aspect of

According to the system in which the flat areas 40, 41 of the separable rod 6 and the flat areas 42, 43 at the free ends of the legs 4, 5 of the portals 3 of the frame 2 are interconnected, the frame A reliable mutual locking of the legs is obtained in a plane perpendicular to the plane of The legs 4, 5 are removed so that they cannot pivot relative to the rod 6.

By adopting the structure of the separable rod 6 and the legs 4, 5 of the portal member 3, the rigidity of the structure featuring permanent joints of the arms of the rectangular frame is close to the maximum possible and high relative to the frame 2. Gives stiffness. Thanks to this structural feature, a stable mutual alignment of the recesses of the die 7 and the staple slots of the magazine 17 is achieved during suturing, thus resulting in a relatively close spacing of the suture stitches, a hermetic connection and a secure connection of the sutures. A complete hemostasis effect is achieved. Because of the high stiffness of this structure, the cross-sectional dimensions of the stitching mechanism can be reduced considerably, other things being equal.

The rod 6 is provided with a restricted area 52 in order to prevent the portal 3 of the frame 2 from being subjected to residual strains due to excessive pressure when the ends of the legs 4, 5 are brought to the position where the rod 6 is removed. , 53 (FIGS. 7, 2, 6), which eliminates the possibility of the free ends of the legs 4, 5 approaching beyond the elastic limits of the portals 3 of the frame 2.

surrounding the legs 4, 5 of the portal 3 of the frame 2;
Stops 33, 34 of separable rod 6 (Fig. 2)
and the regions 52, 53 which limit the amount by which the ends of the legs 4, 5 move towards each other are in fact the surfaces of the exposed recesses 48, 49 in the former embodiment of the device. , in the latter embodiment, are the surfaces of the through openings 50, 51 (FIG. 6). With this feature, frame 2
The frame components are structurally and technically simple, and there are no narrow space enclosing hollows or slots, making it convenient to clean and wash the frame components.

The rod 6 (FIG. 9) can be connected to the legs 4, 5 of the portal 3 of the frame 2 at the die 7 rather than at the top as in the known device protected by U.S. Pat. No. 3,494,533. Since it can be connected to the staple head 2 at the side of the staple head 8, the rod 6
, the shape and cross-section of the section confined within the legs 4, 5 of the portal 3 of the frame 2 corresponds to the legs 4, 5.
It can be made as a bar corresponding to the side part 12 of the frame made in one piece. Thus, frame 2
Separable rod 6 (first
The deformation resistance of FIG. 2 is substantially equal to the deformation resistance of the other side 12 of the frame 2, excluding unacceptable deformation of the rod 6 and its replacement with a new rod after each suture.

Unlike conventional constructions, the separable rod 6 of the frame 2 does not engage the die 7 and the magazine 17.
This allows the magazine 17 to be replaced directly at the surgical wound without temporarily removing the rod 6 and removing the device from the surgical wound. For this reason, when two parallel sutures are placed and then the tissue between the sutures is cut with a scalpel, as in the case of gastric resection, where sutures are placed between the base of the stomach and the removed part of the stomach, or when the tissue between the sutures is cut with a scalpel, or It becomes advantageous when placing the tube from the wall of the stomach with a large radius of curvature in case of formation.

The cross-sectional dimensions of the legs 4, 5 (FIG. 1) of the frame 2, starting from their rigidity to lateral bending, throughout their length during compression and suturing of the organ, the die 7 and the magazine 17. is chosen high enough to ensure stability of the gap between. Advantageously, therefore, the possibility of the free ends of the legs 4, 5 approaching each other within the elastic limits of the portals 3 of the frame 2 is provided by the elasticity of the frame sides 12. The length of the legs 4 and 5 of the frame 2 is made relatively large (100 or 150 mm with a device for suturing the stomach).
mm), and by reducing the lateral bending of the side parts 12 within the elastic limits, it is possible to obtain the approximate required amount of the free ends of the legs 4, 5 (i.e. 1 or 2 mm) and the retention The corresponding height of the shoulders 37, 38 can be selected to be large enough to reliably lock the separable rod 6 of the frame 2 in the working position. The cross-sectional dimensions of the frames 6 and 12 can be reduced considerably, yet provide adequate resistance to tension under the loads applied to the frame 2.

Legs 4, for installing retaining shoulders 37, 38;
Cutouts 54 and 55 are provided on the outer surface of the free end of 5. Retaining shoulder 38 at the free end of the leg 5 of the portal 3
(FIG. 9) has a beveled edge 56 and the stop 34 of the separable rod 6 is located within the range of interaction when the rod 6 is installed in the working position. There is a beveled edge 57 that looks like this. According to the beveled edges 56, 57, after the rod 6 has been engaged with the retaining shoulder 37 of the leg 4, while rotating the rod 6 in the direction of the arrow 58, it is attached to the free end of the leg 4, 5. The shoulder 38 automatically approaches and holds the rod 6 by the elasticity of the resilient portal member 3.
It can be locked with. According to such a structural arrangement, after the organ to be sutured has been placed between the die 7 and the magazine 17, the rod 6 is engaged with the legs 4, 5 of the portal frame member 3, thereby closing the frame. 2 can be assembled as easily as possible.

To facilitate handling of the separable rod 6 (FIG. 1) when assembling or disassembling the frame 2, the rod 6 has a rectangular handle 59 at one end and a flange 60 at the other end. The flange 60 is adapted to enter the cut-out 54 at the free end of the leg 4 carrying the die 7, so as not to go beyond the loop of the leg 4.

There are cutouts 61 in the frame sides 6 and 12 to facilitate removing the staple heads 8 from the frame 2 or assembling them without first removing the rods 6.

The device of the invention operates as follows.

Before operation, the ejector 19 (FIG. 4) is set to its rearmost position and the magazine 17 loaded with staples (not shown) is held in the staple head 8. Stitch 6 and screw 29 of frame 2 (Fig. 1)
The handle 32 is in an external position of the device. After the staple head 8 has been retracted to its rearmost position, it is set to its initial position, where the nut 26 is pivoted to engage the protrusion 11 (FIG. 3) of the staple head 8 with the side 12 of the frame 2. .

organs to be sutured according to customary and routine procedures;
For example, after preparing the stomach for resection, the legs 4 (FIG. 9) must be brought under the organ to be sutured so as to place the organ between the die 7 and the magazine 17. Then, grasping the handle 59, insert the bottom end of the separable rod 6 into the slot 44 of the leg 4.
(Fig. 2) to engage the flange 60 (Fig. 9) with the retaining shoulder 37, whereupon the bar 6 is pivoted until it meets the stop. As a result, the stop 34 of the rod 6
the beveled edge 57 of the leg 5 interacts with the beveled edge 56 of the retaining shoulder 38 at the free end of the leg 5, thereby bringing said end closer to the free end of the leg 4;
Elastic strain is exerted on the portal member 3 of the frame 2. Once the stop 34 has passed over the shoulder 38, the legs 4, 5 are returned to their initial position by elastic forces, thus automatically locking the bar with the holding shoulder 38 (FIG. 1). .

The frame 2 is then positioned correspondingly to the suture application site and the organ wall is compressed between the die 7 and the magazine 17 by rotating the nut 26 to set the required suture gap.

Next, the handle 32 is screwed into the screw 29, and the screw 29 is rotated to eject the staples from the magazine 17 by the ejector 19 (FIG. 4). When pushed out of the magazine, the staples penetrate the wall of the organ, enter the recesses of the die 7 and bend to form a suture.

After cutting the removed portion of the organ along the legs 4 (FIG. 1), the nut 26 must be rotated to move the die 7 some distance from the magazine 17 and release the sutured organ.

To remove the rod 6 (FIG. 7) of the frame 2, place your middle finger on the free end of the leg 4 near the flange 60 of the rod 6 and place your thumb on the leg 5 so that it touches the handle 59 of the rod 6. must be placed. Legs 4 and 5 are then pressed toward each other in the direction facing arrow 39 to release bar 6 from retaining shoulder 38 of leg 5 and to push bar 6 against retaining shoulder 37 of leg 4. It must be rotated. Next, handle 5
9 and the rod 6 must be removed from the portal 3 of the frame 2.

As in the case of gastric resection, which involves applying staple sutures both at the base after the gastric cut and at the resected portion of the stomach, two parallel sutures are applied to the organ, and then the sutures between the applied sutures are When cutting tissue, one suture must first be applied as described above. Once the walls of the organ have been sutured, the nut 26 is rotated to retract the staple head 8 (FIG. 1) together with the magazine 17 to its initial position;
Compressive forces must be removed from the walls of the organ. Then, the magazine 17 is removed by shifting the cover 22 (FIG. 4) in the opposite direction to the die 7. after that,
A new magazine 17 loaded with staples is placed in the staple head 8 and held in place by the cover 22. After the first suture has been applied, the operation of replacing the empty magazine 17 with a loaded magazine is carried out without removing the rod 6 from the portal 3 of the frame 2 and without removing the leg 4 with the die 7. It is performed without having to bring the surgical organ out from under the affected organ, and without removing the device from the surgical wound.

To carry out the second suturing, the frame 23
by 4 mm with respect to the line of the staple of the first suture, compressing the wall of the organ between the die 7 and the magazine 17 and performing the other suture, while the device and its components are removed as in the performance of the first suture. must be operated. The wall of the sutured organ between the first suture point and the stitch mechanism must then be cut along the leg 4 with a scalpel. Then, retract the magazine 17 a little from the die 7,
A second suture releases the sewn portion of the organ.

[Brief explanation of the drawing]

1 is a partially cutaway side view of a surgical device for applying staples according to the present invention; FIG. 2 is a perspective view of the device of FIG. 1 with the frame separated; and FIG.
The figure is an enlarged cross-sectional view of Figure 1 taken along the line in Figure 1, Figure 4 is a cross-sectional view taken along the line in Figure 1, and Figure 5 is a cross-sectional view taken along the line in Figure 4. 6 is a perspective view of another embodiment of the separated frame according to the invention; FIG. 7 shows the mutual arrangement of the legs of the portal frame members before the rods are removed; FIG. , FIG. 8 is a sectional view taken along the line - in FIG. 1, and FIG. 9 is a view of the frame when the separable rod is being fitted into the leg of the portal member. 3...Portal member, 4...Legs of the portal member, 5...
...Leg of portal member, 6...Separable rod, 7...
Die, 33, 34... Stop part, 37, 38... Shoulder part, 42, 43... Flat part, 44, 45...
Slot, 46, 47...End face of leg, 48, 4
9... recess, 50, 51... opening, 54, 55...
...Removed portion, 59...Handle, 60...Flange.

Claims (1)

[Scope of Claims] 1. A main body comprising a portal member in which one of the legs carries a recessed die, and a split frame having a separable bar connecting the free ends of the legs of the portal member. , a staple head having a staple magazine and an ejector and slidably mounted on a frame; and a mechanical actuator for the staple head and the staple ejector, comprising:
The separable rod 6 is provided with stops 33, 34, which hold the free ends of the legs 4, 5 of the portal 3 from the outside and which stop 33, 34.
3, 34 and the free ends of the legs 4, 5 together form a locking joint, the free end of each leg 4, 5 having a
A bar-position retainer made as shoulders 37, 38 is provided, the free ends of the legs being reciprocated by the elasticity of the portal 3 over a length that depends on the size of the retainer shoulder. The legs are arranged so that the separable rod 6 and the free ends of the legs 4, 5 interact with each other via flat spots 42, 43 provided on the legs. 1. A surgical device for applying staple sutures, characterized in that they are engageable by interdigitating along the . 2. Slots 44, which open toward the end faces 46, 47 of the legs, are provided at the free ends of the legs 4, 5 of the portal member 3;
45 and the sides of the slot have retaining shoulders 37, 38, and the rod 6 has recesses 48, 49 in the extent to which it enters the slot of the corresponding leg. A surgical device for applying the staple suture according to item 1. 3. The rod 6 has a flat-sided opening 50, 51 adapted to engage the free end of the respective leg 4, 5 with a retaining shoulder 37, 38. A surgical device for applying a staple suture according to claim 1, characterized in that the surgical device is located within the confines of the rod. 4 Cut out the cutout 5 to form shoulders 37 and 38.
4, 55 are made on the outer surface of the free ends of the legs 4, 5. Surgical equipment. 5 Retaining shoulder 38 at the free end of one leg 5
and the stop 34 of the separable rod 6 is characterized by a beveled edge located on the surface that interacts with it when the rod is being put into place. Claims 1 to 4
A surgical device for applying the staple suture according to any one of the items. 6. One end of the rod 6 is formed as a rectangular extension forming a handle 59, and the other end of the rod has a
Claim 1 or 2, characterized in that there is a flange 60 adapted to enter into and be attached to the cutout 54 provided at the free end of the leg 4 carrying the die 7. A surgical device for applying the staple suture according to paragraph 2.