CN101355906A - Stopper and surgery instrument as well as implantation/transplantation method thereof - Google Patents

Abstract

The invention relates to an occlusion device which consists of an interlaced structure (2) of thin wires or threads (2), the ends of the wires or threads (4) converging in a holder (10). The aim of the invention is to allow the occlusion device to be retrieved or repeatedly coupled to a surgical instrument. For this purpose, the holder (10), on its free end, has a top section (14) with an eyelet (16) in the form of a crossbore which can be received and retained by an implantation or explantation instrument (100, 200) in a form-fit manner. The invention also relates to a surgical instrument (100) for implanting or explanting an implant having said holder (10) . The surgical instrument has gripping pliers (102) the jaws (103, 104, 105) of which can be opened or closed by a push-pull system and the inside of which is configured in such a manner as to encircle the top section (14) of the holder (10) of the implant in a form-fit manner.

Description

Stopper and surgery instrument and implantation/transplantation method thereof

Technical field

The present invention relates to a kind of stopper, it is made up of the filament fabric that forms suitable shape by molded and heat treatment step, and it is tapered to and is used for blood vessel and is implanted into/conduit diameter of transplant operation, and having near-end keeps district, far-end to keep the district, the end of filament or fine rule is focused in the support on far-end keeps distinguishing, it also has the round spreader that is arranged between described near-end maintenance district and the described far-end maintenance district, thereby these two keep the district to be arranged on the siphunculus both sides for the treatment of shutoff in barrier film after the implantation, and spreader passes siphunculus.The invention still further relates to a kind of surgery instrument that is used to implant and transplant implant, particularly aforesaid stopper.At last, the present invention relates to a kind of method that the particularly aforesaid stopper of implant is repeated to be connected to this surgery instrument.

Background technology

Attempt can be by the operation of non-surgery transvenous catheter for medical skill for a long time, in other words needn't carry out the operation on the letter and the shutoff barrier film is damaged, for example atrial septal defect.Proposed various plugging system, every kind of system has the pluses and minuses of himself for this reason, but without any a kind of concrete widely accepted plugging system.With reference to these different systems the time, hereinafter will use term " plugging device " or " stopper ".In all intervention plugging systems, all be to place barrier film to treat in shutoff damaged through vein self-expanding umbrella system.This system can comprise two umbrella; For example, one is positioned at barrier film distally (promptly apart from health/heart midplane side farthest), and one is positioned at barrier film nearside (promptly nearest apart from health midplane side), thereby these two umbrella prostheses are fixed to the two umbrella of barrier film in damaged subsequently.Therefore, when being in assembled state, plugging system crosses interconnective two of damaged short screw and clamps umbrella and form by passing usually.But the shortcoming of the prior art stopper is complicated, big, the comprehensive implant surgery of difficulty.Except the implantation of this plugging system in the barrier film for the treatment of shutoff is damaged than complexity, the umbrella of being utilized is easily along with fatigue of materials appears in the fragment crack.And, usually thrombus complication can appear.

For stopper of the present invention is placed in the body by surgery insertion instrument and/or conduit, keep the end, district that support is set at far-end, so that insert instrument and/or catheter abutment.Therefore expectation be stopper is arranged on damaged in after this joint of releasing easily.For example, can keep end design fabric in district's at the far-end of stopper, in support, to be provided with and to insert the interior fabric that instrument engages.

Formerly known by in the Nitinol lead fabric stopper that for example AGA or JEN.meditec Nitinol lead fabric are made, the connection of inserting lead is constructed to screw thread.Inserting lead makes stopper can advance forward or backward in conduit.After in stopper is placed in heart diaphragm, outwards winding and insert lead and the last stopper that discharges.Can not revise after this.

Because it is harder to insert lead and adapter, and conduit owing to the Minimally Invasive Surgery of anatomy reason by stopper through leg arteries with the straight angle near heart diaphragm, so stopper keeps inclination and umbrella can not contact the siphunculus both sides when opening.For example in this case, in case can surgical doctor can not be distinguished stopper untie it and keep predetermined and cooperate.This point produces great uncertainty to the doctor, particularly because its sole mode of resetting unfolded stopper is a Minimally Invasive Surgery.

The present invention is intended to reduce this major defect of known system as far as possible, promptly, in stopper is arranged at heart diaphragm and after the insertion point discharges, the permission stopper moves freely, thereby stopper independently launches and is fit to treat that the barrier film of shutoff is damaged, and, be not to force it to be in the position that can not occupy automatically, and by inserting instrument it can be reorientated and fetch in case of necessity by inserting instrument.

Certainly, other embodiment here also is possible.Another kind of stopper, promptly so-called Lock-Clamshell umbrella system is provided with two and is preferably the rustless steel umbrella that is coated with dacron, and each umbrella is fixed by four arms.This stopper intravascular is implanted in patient's body.But, as can be seen the existing problem of Lock-Clamshell stopper be to implant the size of the needed insertion instrument of stopper must be bigger.Other system for example " Amplatz stopper " existing defective need to be many different stopper sizes to adapt to the damaged corresponding size of the barrier film for the treatment of shutoff.Thereby confirm that if length or the diameter insert damaged cross bar do not have optimum matching, then umbrella can not thoroughly flatten when the state of insertion.This point has caused endothelialization incomplete.Also show,, implant the intravital many systems of patient and fatigue of materials and metal structure fracture have occurred owing to be subjected to huge mechanical stress effect for a long time.When being subjected to permanent stress between implant and the barrier film especially above-mentioned phenomenon can appear.

For overcoming these defectives, developed by Minimally Invasive Surgery, for example adopt conduit and lead to insert in patient's body and be placed in and treat the self-centering stopper of shutoff barrier film in damaged.Its design is based on stopper can taper to the principle that is used for the insertion instrument/conduit size of operation in the blood vessel.Place the barrier film for the treatment of shutoff damaged this tapered stopper by conduit then, and correspondingly place in the damaged siphunculus of the barrier film for the treatment of shutoff.Discharge stopper from conduit then, self-expanding umbrella thereon, holding plate launch contact barrier film both sides subsequently respectively.This umbrella comprises that conversely the fabric for example being made or covered by dacron inserts body, by its shutoff damaged/siphunculus.Through organizing in the insert that progress stays in the body fully more or less of several weeks or several months health oneself.

From the specified type of the known beginning of WO99/12478A1 and according to the example of the automatic location stopper of claim 1 preamble, it has further improved according to U.S. Patent number 5,725,552 the stopper that is known as " Amplatz stopper " type.It is made up of the fabric a plurality of meticulous, the Nitinol lead chain that twines of yo-yo (yo-yo) shape equally.Every kind of fabric forms circular knit with its primitive form, and it all has the arbitrary routing of line end at front end (correspondingly being its nearside) and tail end (correspondingly being its distally).In to circular knit processing subsequently, each this free end must be bound in the collar and weld together.Through after this suitable processing, all lobed axle collar in the nearside of the stopper of finishing and distally.The dacron sheet is sewed up far-end and keeps umbrella and closely keep umbrella and put into spreader between the two.The memory effect of coming out owing to employed nickel-titanium alloy material is shown, two keep umbrella to launch (being in the interstage of balloon-like when it begins) automatically when leaving conduit, and the maintenance umbrella that is positioned at the barrier film both sides whereby at last finally presents proximate flat pattern.When umbrella was launched, spreader was the center with the siphunculus for the treatment of shutoff automatically.Because axle collar protrusion keeps the district through the near-end of stopper, so following problem can occur: the implant of insertion produces the particularly continuous thromboembolism of thrombosis relevant issues.In addition, usually hinder the complete endothelialization of stopper implant.

Also from the known stopper of making by the lead fabric of WO95/27448A1.But thereby this stopper does not have support can not can not---to relatively poor laying---withdraw once more before untiing by inserting instrument to guide this stopper with the identical mode of operation stopper when putting into.

Therefore thereby the present invention's problem to be solved self-centering stopper of being to improve known braiding in the medical skill will overcome above-mentioned shortcoming.Special target is to provide a kind of and is suitable for the damaged stopper of different size shutoff, thereby the implantation of stopper becomes simple problem, and can transplant; For example to proofread and correct inappropriate laying.

Summary of the invention

Based on above-mentioned problem, task of the present invention is to provide a kind of stopper, and is flat as much as possible and contact with barrier film at the damaged near-end of barrier film when it is in the insertion state, and if the expression location is improper then it can be retrieved unclamping the back.

Another task of the present invention is the method that the corresponding surgical instrument is provided and is used for stopper can repeatedly be connected to this surgery instrument.

By when beginning specified type stopper of the present invention address these problems, it is provided at the support that free end has head, and comprises the eyelet of punch format, this perforation can with implant or transplant the instrument interference fit and by its maintenance.Here selectively, stopper with specified type when beginning creatively addresses this problem, it is provided at the support that its free end has head, this free end is constructed to hemispherical center collar on longitudinal cross-section, and comprising the eyelet of punch format, this perforation can remain on the implantation/transplantation instrument by the dead ring that utilization is passed it.

Perhaps, implant by will having support particularly stopper can repeatedly be connected to the method for surgery instrument, solve the listed program task of the present invention, before wherein in the beginning blood vessel, performing the operation, insert the eyelet that filament or conductor loop are conducted through the implant support, and be hooked on because certain purpose is arranged on the fixing point on the clamp, and first and second free ends that insert filament or lead are held or are fixed in first pinch zones, are caught the head of implant support here by clamp; Second free end of tightening the insertion filament/lead with nipple is in the clamp up to head fully; Discharge second free end then and then discharge clamp, and check laying of implant from the head of implant with nipple; Here inserting filament/lead makes clamp at any time to reconnect with the implant support.

In addition, the implant that will the have a support particularly stopper method that can repeatedly be connected to surgery instrument comprises: insert filament or conductor loop before the operation and be conducted through skewed slot in the implant support eyelet in the beginning blood vessel, and first and second free ends that insert filament or lead are held or are fixed in first pinch zones; Here catch the head of implant support by clamp; Here, second free end of tightening the insertion filament/lead with nipple is in the clamp up to head; Here, discharge second free end and then promote to discharge clamp, and check laying of implant from the head of implant with nipple; Here inserting filament/lead makes clamp at any time to reconnect with the implant support.

At last, the implant that will have a support particularly the stopper method that can repeatedly be connected to surgery instrument comprise: the dead ring of length-specific is fixed to the eyelet of implant support; Thereby described dead ring is inserted into the knot of the translot dead ring of round collar is then passing through convex center, and the dead ring that is arranged in translot partly is maintained on the diametric(al); Here when moving forward hook according to the rules, the dead ring in the translot partly slips over the hook in second cannelure and is fixed on the there; Wherein, the action of drawing back described hook is pulled to the support of implant and be clamped in the nearly face side of collar; Wherein, hook limits again moves forward and will loosen dead ring once more and the side nearby of collar discharges and can check laying of implant from support; Wherein, adopt dead ring at any time collar is reconnected support to implant.

Therefore disclosed as the scheme that realizes task of the present invention here is whole system, comprise the stopper form implant, applicable to this surgery instrument and use the correlation method of described surgery instrument.

Stopper has shown advantage of the present invention especially in the blood vessel by providing, particularly for the damaged advantage of treatment barrier film, this stopper can keep when implanting by the surgery instrument of relative configurations reliably, and how to lay for confirming stopper, can discharge this stopper from surgery instrument, ben whereby is to hold stopper easily subsequently once more for example to change its position or to realize directly transplanting.

Therefore three selection embodiment that are used for stopper support constructed according to the invention here are provided.

At first, the head of support can be constructed to spherical, thereby and the clamp inside of the surgery clamp of ball head shape correspondence be constructed to guarantee that the surgery clamp holds the form fit of described ball head.Thereby after the connection that breaks away between surgery instrument and the stopper, again hold ball head easily subsequently, surgery instrument has in delivery status with insertion filament or the lead of ring-type from surgery instrument clamp near-end projection, and two free end is held or before had been fixed near the operating forceps on the surgery instrument.Described insertion filament or lead make the clamp of surgery instrument for example also therefore hold stopper again in order to reorientate or transplant the head that can be connected to the stopper support easily and accurately again.

According to second embodiment of stopper support, the oblique incision of the eyelet of head is to perforation, thereby the end of skewed slot is overlapping in perforation vertically.Therefore this point makes in delivery status, with the insertion filament/thread hook of the clamp projection of ring-type from the surgery instrument near-end to the skewed slot of stopper bracket holes ophthalmic, can not be easily thereby the overlapping ends of skewed slot guarantees to insert filament/lead, particularly after the doctor tightens described insertion filament/lead, be not intended to break away from, and can not leave eyelet by the diagonal of this ring intentionally from eyelet.

The two-sided otch release surface of perforation preferably is constructed to assemble to the outer surface of the free end of support and ball head.This point has the advantage that does not comprise the sharp edge that can destroy insertion filament or lead, and it helps to make insertion filament/lead to pass the eyelet of the first embodiment support in addition.Last but be not least important, less to material and weight thereof that the convergence structure of perforation cutting release surface needs.

According to the 3rd embodiment of stopper support, head forms hemispherical center collar and has punch format equally on the longitudinal cross-section eyelet.For linking to each other with the corresponding surgical instrument, for example the dead ring of being made by surgical sutures is by eyelet and remain the specific width of dead ring, and two end knotting also is hooked on the hook of corresponding surgery instrument.Though first and second embodiment by the support head, behind one or two free end of described insertion filament of drawing or lead, tighten insertion filament or lead in succession by the doctor, but in the 3rd embodiment, in surgery instrument, tighten dead ring in succession behind the withdrawal hook.

In first and second embodiment, the push-pull system of surgery instrument preferably includes following parts: wind spring, extend axially the driver by wind spring inside, this device is axially enough hard but still be flexible and have and be connected to first on its near-end and the far-end and hold clamp axle partly.This push-pull system also comprises the taper collar that is used for holding at its near-end the axle that can move axially clamp, and by with its far-end on obstacle in abutting connection with holding the wind spring near-end.Comprise also that here second holds part, wherein by with obstacle in abutting connection with holding the far-end of wind spring, thereby clamp is because wind spring is applied to the power closure on the outside adjoining front end of taper collar, and owing to driver is advanced forward and opened.The advantage of this push-pull system is the stability of its simplicity and wherein relevant its parts necessarily, and the implant support is held reliably and discharged.

In first embodiment of support, equally arrive first on the surgery instrument far-end and holding the insertion filament of part or conductor loop through the eyelet of implant support and before the implantable graft body, be fixed on the clamp by taper collar inside and wind spring are inner from the clamp projection and by two free ends guiding at its near-end under the delivery status of surgery instrument.Tighten the support that insertion filament or lead can be connected to surgery instrument stopper, this point can repeat when keeping this connection.

Therefore, can break away from laying to the connection of inserting filament/lead when for example initial between surgery instrument and the stopper with the checking implant, if and changed laying then can adopting insertion filament/lead to recover easily of implant, therefore surgery instrument need hold the support of implant again.And, transplant implant if necessary once more, then can rebulid the connection between surgery instrument and the implant simply.On the contrary, the annulus among second embodiment hangs by the skewed slot in the eyelet, and is conducted through eyelet unlike first embodiment.

In first and second embodiment of support, first free end that inserts filament or lead can be fastened to first grip region, and second free ending tool that inserts filament or lead be useful on assist the implant connection status tighten insert filament or lead or the connection that breaks away from first end from grip area after from the nipple of surgery instrument extraction.In second embodiment of support, can after unclamping at least one free end that inserts filament or lead, shift out insertion filament or lead annulus from eyelet by by chute.

Insert filament or lead and preferably made by the Nitinol lead, the fabric of stopper itself also can be formed thus.Nitinol is the material that proved in this surgical operation.

The 3rd embodiment for the stopper support, surgery instrument has can be along the axially movable back and forth hook of eyelet by push/pull system, extend through eyelet and the dead ring that can be hooked on the hook thereby adopt, when hook leaves eyelet, can implant be remained on the surgery instrument by tightening dead ring by this ring.The advantage of this embodiment of surgery instrument is paid special attention to replace into inserting the fastened ring of filament or lead, thereby does not need to pull on the free end of described insertion filament or lead to tighten entire equipment as described in other two embodiment; Drive surgery instrument suitably and after next retracting hook successive generations for tightening.

In the 3rd embodiment of surgery instrument, push/pull system comprises following parts necessarily: wind spring, extend axially driver by wind spring inside, this device axially enough hard but still be flexibility and have the hook axle that is connected to its near-end and be fixed on first on its far-end and hold part; The circle collar, its hold the near-end of wind spring by the obstacle on its distal portion and hold can axially movable hook axle; Second holds part, axially leaves eyelet thereby its far-end hook that holds wind spring by the adjacency obstacle is subjected to the wind spring applied force, and it also moves to eyelet by moving forward driver.This push-pull system can be operated stopper with the centre equally very easily and reliably before surgical operation.

In order further to simplify being connected between the dead ring that extends through stopper support eyelet and the push-pull system, the circle collar preferably have on side nearby successive first cannelure, therein be used on one side of heart zone to prevent second cannelure that in collar distortion guiding can axially movable hook, on a side with the vertically disposed translot of second cannelure, this translot extend through the collar longitudinal axis and therein the heart have the projection of holding fastening loops.Wherein, the projection that is used to hold fastening loops guarantees that also dead ring is placed in the translot securely.

For guaranteeing that this hook can hold dead ring securely, it is flat about 1/3rd that the cross section of hook part forward preferably is constructed to cross section than axle, and demonstrate motion when time in second cannelure that is installed in round collar.

Be the separately connection between the surgery instrument and implant support, provide blade being configured on the gap far-end at hook rear portion.

Though the material of surgery instrument driver is preferably lead, really also can adopt any other enough hard in the axial direction but still soft enough material.

Therefore summarized some features consistent very widely understanding next detailed description better, and understood the contribution of the present invention better this area with the present invention.Certainly will be described below in addition consistent and formation is additional to the further feature of this claim theme with the present invention.

At this on the one hand, before explaining at least one embodiment consistent in detail, understanding be the invention is not restricted to it to the application of structure detail and the element setting listing in the following description or be described in the drawings with the present invention.The method and apparatus consistent with the present invention can be realized other embodiment and can and carry out with the whole bag of tricks practice.And, be to describe purpose and should not be understood that restriction with understanding employed word and term and following included summary here.

Equally, it will be appreciated by those skilled in the art that the disclosure content based on thought easily as other structure of carrying out several purposes of the present invention, the design basis of method and system.Therefore importantly only otherwise depart from the essence of the method and apparatus consistent and scope with the present invention then claim should be counted as comprising such equivalent constructions.

Description of drawings

Describe three embodiment and three kinds of different methods that implant, stopper can be repeated to be connected to the corresponding surgical instrument respectively of three preferred embodiments and the relative surgery instrument of stopper below with reference to the accompanying drawings more accurately in detail.Be incorporated into this, Fig. 1 to 7 represents embodiment 1, and Fig. 8 to 14 represents embodiment 2, and Figure 15 to 24 expression embodiment 3.

Fig. 1 shows the side view that has according to stopper first embodiment of embodiment 1 relative surgery instrument;

Fig. 2 shows the viewgraph of cross-section that the part " A " according to Fig. 1 is amplified;

Fig. 3 shows the perspective view of stopper embodiment;

Fig. 4 shows the side view of the amplification of stopper support first embodiment;

Fig. 5 shows the perspective views of supports according according to Fig. 4;

Fig. 6 shows the enlarged partial view of the stopper clamp that comprises lead and support;

Fig. 7 shows surgery instrument and has and stretches by its stopper of ring to the view of forward part;

Fig. 8 shows according to second embodiment and is inserting the side view that has the surgery instrument of stopper on filament/lead;

Fig. 9 shows the partial view to forward part that has the surgery instrument of stopper on insertion filament/lead that has according to Fig. 8;

Figure 10 shows the enlarged side view according to the stopper support of embodiment 2;

Figure 11 shows the perspective views of supports according according to Figure 10;

Figure 12 shows to have clamp, inserts the simplification view of the surgery instrument of filament/lead and stopper to forward part;

Figure 13 shows the partial enlarged drawing according to " A " part of Figure 12;

Figure 14 shows stopper that surgery instrument with clamp and conductor loop the hooked view to forward part;

Figure 15 shows the compression sectional view of the surgery instrument that the stopper according to embodiment 3 hooked;

Figure 16 shows the cross section partial view of Figure 15 " B ";

Figure 17 shows the cross section to forward part with the surgery instrument that connects stopper;

Figure 18 shows the side view according to the amplification of the stopper support of embodiment 3;

Figure 19 shows the perspective views of supports according according to Figure 18;

Figure 20 shows the enlarged perspective according to the round collar of embodiment 3;

Figure 21 shows the enlarged perspective according to the hook of Figure 17;

Figure 22 shows the stopper that has according to the 3rd embodiment and connects the perspective view of the surgery instrument of support to forward part;

Figure 23 shows the perspective view similar with Figure 22; And

Figure 24 shows the connection that is used to describe through dead ring, have according to the surgery instrument of the stopper of the 3rd embodiment enlarged perspective to forward part.

The specific embodiment

Fig. 1 and Fig. 2 show side view and the partial view of surgery instrument 100 first embodiment that are used to implant and transplant implant, and here implant is as the implant example that is connected to stopper 1.Surgery instrument 100 has clamp 102, and its clamp 103,104,105 can be opened and seal by push/pull system.The interior zone of clamp 103,104,105 is constructed to it can interference fit connect the bulbous configuration head 14 of holding implant support 10.Push/pull system comprises following element necessarily: wind spring 106, and driver 107 extends through its inside, and it is harder in the axial direction, but still enough soft; Be fixed in the clamp 102 of axle 111 near-ends, and be arranged on axle 111 far-ends first hold part 108.Push-pull system also comprises taper collar 109, by with obstacle 114 adjacency, and its close end 112 hold can axially movable clamp 102 axle 111, hold wind spring 106 near-ends in its distal portion 113.Push-pull system comprises that in addition and necessarily second holds part 110, the far-end that holds wind spring 106 thereon by the adjacency obstacle, thereby clamp 103,104,105 is because wind spring 106 is applied to power on the taper collar 109 outside adjoining front ends 115 and closure, and owing to driver 107 is advanced forward and opened.As necessary especially element, described surgery instrument 100 has the filament of insertion or lead 116, when it transmits at surgery instrument 100, stretch out clamp 102 from the near-end of annulus 117 shapes, and arrived first on surgery instruments 100 far-ends and hold part 108 by taper collar 109 inside and wind spring 106 are inner by two free ends 118,119 guiding, thereby can implant implant and before fixing point 101 is attached to clamp 102 guiding annulus 117 by the eyelet 16 of support 10.Insertion filament or lead 116 have can be connected first second free end 118 of holding first free end 119 in part 108 zones and having nipple 120, inserts filament/lead 116 by means of this after breaking away from first end 119 and first connection of holding between the part 108 and can launch under the state that implant connects or draw back from surgery instrument 100.Up to the stopper that inserts such as the doctor is desired when accurately laying, could draw back insertion filament/lead from surgery instrument 100.If not so, then inserting filament/lead 116 makes the doctor clamp 102 of surgery instrument 100 is connected to again the head 14 of stopper 1 support 10 easily; That is the clamp 103,104,105 of clamp 102 spherical head 14 that can firmly hold support 10 with the form fit form.

Fig. 3 shows the stopper example that can have support 10 of the present invention.This stopper is used for that blood vessel is implanted into or the filament of the diameter of the conduit 5 of spare-part surgery operation or the fabric 2 of fine rule 4 are formed by producing suitable net shape by molded and heat treatment step and being tapered to necessarily.Described stopper comprises that near-end keeps district 6 and far-end to keep district 8, here the end of filament or fine rule 4 is assembled to support 10, and described near-end keeps the round spreader 12 between district 6 and the described far-end maintenance district 8, thereby two keep district 6,8 to be arranged in the siphunculus both sides that implantation is positioned at the barrier film shutoff afterwards, and spreader 1 passes siphunculus.Therefore this stopper is particularly suitable for by putting into the damaged equipment treatment barrier film for the treatment of shutoff through conduit 5 damaged.Because it is monolayer that the near-end of fabric 2 keeps district 6, towards the tabular flattening of stopper near-end, therefore stopper can be---irrelevant---with the thickness of the damaged relative diameter for the treatment of shutoff and septum wall in particularly advantageous mode it is damaged to be adjusted to barrier film automatically, and can not have stopper parts projection to exceed to have under the planar situation of septum wall damaged on the damaged nearside to realize this point.Therefore can not appear at the complication that produces usually in this case.In other words, this point means that the tissue of health oneself grows in stopper, and the known plugging system of comparison prior art is faster.

Use the fabric made by filament or fine rule to be that as other advantage that original material produced of stopper of the present invention it has long mechanical stability.It can prevent structure breaking to a great extent implanting of inserting.This fabric also has enough hardness.Fabric 2 also makes the near-end of stopper launch to contact damaged horizontal stroke edge when keeping district 6 at the state of insertion fully towards the tabular no wheel shaft section of near-end.Therefore, to can be used for the barrier film of multiple different size damaged for stopper.Because fabric 2 is tapered in blood vessel the diameter of employed conduit in the operation, so thereby for example can put into stopper and no longer must carry out open surgery on the letter by vein.Because fabric 2 is made by the material with " memory " effect, so stopper also can be called as " self-expanding equipment ", thereby its two of automatic expansion when leaving conduit keeps district 6,8 can be positioned at damaged nearside/distally.

Fig. 4 shows the enlarged side view of this stopper support 10 first embodiment.This support 10 forms head 14 on it has the free end of eyelet 16 of punch format, thereby can be held and kept head 14 by the surgery instrument 100 of form fit.

Fig. 5 shows the perspective views of supports according according to Fig. 4.How the bilateral otch release surface 18,20 that this view helps to explain perforation is constructed to be focused at towards the free end of support 10 with the outer surface of spherical head.

Fig. 6 shows the enlarged partial view of the surgery instrument 100 with the lead 116 that extends through eyelet 16, this eyelet 16 by annulus 117 be hooked in clamp 102 the axle 111 on (comparison diagram 2, fixing point 101).This view helps to explain that how clamp 102 is set to taper and is divided into three clamps 103,104,105, closure when this groove is located in the front end 115 of taper collar 109 at diminished shaft by cannelure in its front portion.Thereby rotation hold clamp 103,104,105 form bowl-shape with interference fit hold the spherical head 14 of support 10.The axle 111 of clamp 102 is inserted the guiding annulus 117 of filament/lead 116 by taper collar 109 by flat configuration with guiding.Annulus 117 is constructed to it will protrude (referring to Fig. 7) from clamp 102 when transmitting.The free end 118,119 that inserts filament/lead 116 be conducted through in the clamp 102 groove and by wind spring 106 and be fastened to first of clamp and hold on the part 108, thereby first free end 118 has the nipple 120 that helps to hold and tighten insertion filament/lead in addition.

Fig. 7 has described the simplification view to forward part of the surgery instrument 100 that comprises taper collar 109, clamp 102, wind spring 106 and driver 107.The annulus 117 that inserts filament/lead 116 can be in the clamp 102 anterior eyelets 16 that also pass through support 10 heads 14.Represent enlarged partial view with the part emphasized of " A " ring according to Fig. 6.

Be to connect stopper 1, the annulus 117 that inserts filament/lead 116 is stretched by eyelet 16 and is hooked on to certain purpose and is arranged on fixing point 101 (referring to Fig. 2) on the axle 111 of clamp 102.Comprise the filament or the conductor material of insertion filament/lead 116 annulus 117, thus extend through each corresponding groove between clamp 103,104 and 105 and the end returned by the three-flute between the clamp 104,105.When tightening insertion filament/lead 116 recall clamp 102 in taper collar 109, annulus 117 can not suspend in midair again.Then towards nipple 120 traction annulus 117, hold folder 103,104 and 105 up to what the spherical head 14 of support 10 sank to clamp 102.Inserting filament/lead 116 does not remove the other end 119 of nipple 120 and is fastened on second suitably and holds in the zone of part 108.

Use description to below with aforesaid support 10 particularly stopper 1 can repeat to be connected to the method for surgery instrument 100.

The first step, the annulus 117 that inserts filament/lead 116 in the beginning blood vessel, be conducted through before the operation implant support 10 eyelet 16 and be hooked on the fixing point 101 that is arranged on for certain purpose on the clamp 102, and first and second free ends 119,118 that insert filament/lead 116 are held or are fastened on first and hold in the zone of part 108.Second goes on foot, and is held the head 14 of implant support 10 by clamp 102.In the 3rd step, second free end 118 of tightening the insertion filament/lead 116 with nipple 120 is contained in the clamp 103,104,105 fully up to head 14.Second free end 118 that release has nipple 120 impels clamp 102 to discharge from implant head 14, and checks laying of implant.Inserting filament/lead 116 allows clamp 102 can be connected to support 10 again at any time.

Fig. 8 and 9 shows in the second embodiment of the invention, the surgery instrument 200 that stopper 1 will connect simplify side view and partial view, shown the support 10 of second embodiment of the invention.The Reference numeral that repeats Fig. 1 and 2 here once more is with expression and surgery instrument 200 and stopper 100 components identical.Stopper 1 this second embodiment, difference between second embodiment of surgery instrument 200 and the first embodiment similar elements be stopper 1 support 10 head 14 structure and how to use and guide insertion filament/lead 116, this point will be clear when watching Fig. 9: same, do not insert the eyelet 16 of the annulus 117 of filament/lead 116 by head 14 by two filaments or lead guiding, but only a filament by described eyelet 16 and otherwise along two free end 118, inside and the inside of wind spring 106 of 119 guiding by taper collar 109 arrives first on surgery instrument 200 far-ends and holds part 108.Below with reference to Figure 10 and 11 connections of describing between the head 14 that inserts filament/lead 116 and support 10.

Figure 10 and 11 shows the enlarged side view (Figure 10) and the perspective view (Figure 11) of second embodiment of the support 10 of stopper 1 respectively.This second embodiment and the difference according to first embodiment of Figure 4 and 5 are the groove of eyelet 16 for tilting with respect to perforation of head 14, thereby the end of skewed slot 26 22,24 is with respect to the longitudinal overlap of perforation.In addition, this second embodiment of head 14 has spherical head equally, and the two-sided cutting release surface 18,20 of perforation preferably is configured to be focused at together towards the free end of support 10 and the outer surface of spherical head.Because eyelet 16 has skewed slot 26, can move into eyelet 16 so insert the annulus 117 of filament/lead 116, and not need around the free end 118,119 of the insertion filament by eyelet 16 in addition through eyelet 16 by whole annulus 117 with the axle 111 that is hooked in clamp 102 on.Therefore skewed slot 26 can hook annulus 117 especially easily.

The advantage that eyelet 16 produces is, can at any time remove annulus 117 with identical method, is promptly being determined stopper 1 to lay suitably and is finally being broken away from surgery instrument 200 from stopper 1 by the doctor.For realizing this point, the same with first embodiment, by traction free end 118,119 one of them, regain annulus 117 from eyelet 16 with from whole surgery instrument 200, preferred second free end 118 has nipple 120.

Figure 12 shows according to the surgery instrument 200 of second embodiment simplification view to forward part, and this surgery instrument has the annulus 117 that protrudes from clamp 102 ends and stopper 1 to be connected.

Figure 13 shows the enlarged partial view (can't see clamp 104,105 this view) of the clamp 102 of the annulus 117 with the insertion filament/lead 116 that protrudes between clamp 103,104,105.

Figure 14 shows the view similar with Figure 12, and wherein Figure 14 shows the surgery instrument 200 that is connected to stopper 1.

The push/pull system of second embodiment of surgery instrument 200 is by forming with reference to the aforesaid similar elements of first embodiment.

To describe below according to second embodiment be used for will have second embodiment support 10 implant particularly stopper 1 can repeatedly be connected to the method for surgery instrument 200: the first step, the annulus 117 that inserts filament/lead 116 is conducted through the skewed slot 26 in the eyelet 16 of support 10 of implant before the operation in the beginning blood vessel, and first and second free ends 119,118 that insert filament/lead 116 are held or are fastened on first and hold in the zone of part 108.Ensuing one goes on foot, and is held the head 14 of support 10 by clamp 102.Second free end 118 of tightening the insertion filament/lead 116 with nipple 120 then is contained in the clamp 103,104,105 fully up to head 14.Second free end 118 that release has nipple 120 can discharge clamp 102 from implant head 14, and can check laying of implant.Inserting filament/lead 116 allows clamp 102 can be connected to support 10 again at any time.If finally break away from stopper 1, then draw back insertion filament/lead 116 from surgery instrument by pulling on second free end 118 with nipple 120 from surgery instrument 200.When extracting, importantly annulus 117 is enough soft being wrapped on the tight radius, and the deflection point on eyelet 16 or clamp 102 does not have sharp edge.About eyelet 16, the same with foregoing reliable be the perforation two-sided cutting release surface 18,20 be constructed to be focused at together towards the free end of support 10 and the outer surface of spherical head.And, even also can adopt surgical sutures, serve as that to insert filament/lead 116 also suitable especially with resilient Nitinol lead carefully and very.

Figure 15,16 and 17 shows the sectional view (Figure 15) of the compression that all is the 3rd embodiment, according to the perspective partial view of Figure 15 " B " circle and the surgery instrument 300 by having stopper 1 viewgraph of cross-section to forward part.Surgery instrument 300 comprises hook 302 necessarily, it can move axially and axially leave by push-pull system and dead ring 301 eyelet 16 towards support 10 heads 14 of stopper 1, wherein dead ring 301 extend through eyelet 16 and at hook 302 for flexible, when hook 302 moves away eyelet 16, implant can be remained on the surgery instrument 300 by tightening dead ring 301.In this case, push/pull system is made up of following element necessarily: wind spring 106, and driver 107, hard in the axial direction but still enough soft, extend through wind spring inside, the axle 303 of hook 302 is connected its near-end, and first holds part 108 is connected in its far-end.Push-pull system also comprises round collar 304 necessarily, its by with obstacle 114 in abutting connection with and hold wind spring 106 near-ends in its distal portion 113, wherein the axle 303 of hook 302 holds in axially movable mode.At last, this push-pull system of this described the 3rd embodiment comprises that another second holds part 110, the far-end that holds wind spring 106 thereon by the adjacency obstacle, leave eyelet 16 thereby the power that hook 302 applies owing to wind spring 106 moves axially, wind spring 106 can move to eyelet 16 by moving forward driver 107.

Figure 18 and 19 shows the enlarged side view of support 10 the 3rd embodiment of stopper 1 and the perspective view of amplification respectively.The difference of the 3rd embodiment and two other embodiment is that support 10 has the head 14 that is configured to the center collar at its free end, it has the eyelet 16 of hemispherical punch format on the longitudinal cross-section, and can support 10 be remained on (relatively Figure 16 and 17) on the surgery instrument 300 by the dead ring 301 that extends through eyelet 16.

Figure 20 shows the perspective view according to the round collar 304 of the surgery instrument 300 of third embodiment of the invention.Circle collar 304 has successive first cannelure 306 in side 304 nearby, has second cannelure 307 on heart part one side therein, be used to prevent that axially movable hook 302 from twining guiding in collar, on a side that extends through collar 304 longitudinal axis, have and second cannelure, 307 vertical translots 308, and the heart has the projection 309 of the knot 311 that is used to hold dead ring 301 therein.Therefore second cannelure 307 is constructed to it and cuts circumference by collar 304 from outside to inside.

Figure 21 shows the perspective view of the hook 302 with axle 303.It is flat about 1/3rd that hook 302 is constructed to cross section than axle 303 to the cross section of forward part, and it is with Reference numeral 314 expressions.Therefore what hook 302 was flat cooperates (Figure 20) with second cannelure 307 of circle collar 304 movably to forward part.After empty gap 315 is built into the tip of hook 302, has blade 310 at its far-end.

Figure 22 shows the perspective view of surgery instrument 300 to forward part, by dead ring 301 it is connected on the support 10 of stopper 1 with loosening.Thereby therefore dead ring 301 inserts the knot 311 of translot 308 dead rings 301 is positioned on the projection 309 of translot 308, and the filament of dead ring 301 radially passes the round collar 304 in the translot 308.Therefore being constructed to tie 311 can not laterally break away from the dead ring 301 that is hooked to translot 308.

Figure 23 shows the perspective view similar with Figure 22, thereby describes the hook 302 that inserts circle collar 304 with dotted line.When hook 302 moved forward in accordance with regulations, dead ring 301 slipped over the tip of hook basically from cannelure 307, and stayed in the gap 315 that is configured in thereafter.The knot of dead ring 301 is positioned at one of them side intracavity that the flat part 314 by hook 302 forms.Drawing back hook 302 makes and tightens between the front side 305 of stopper 1 with support 10 and circle collar and the surgery instrument 300.Thereby dead ring 301 is being positioned at both sides and is breaking away from first cannelure 306 of the circumference of collar 304 continuity, up to its once more along hook 302 inwardly and translots 308 backward be directed.Therefore stopper 1 is connected to the push/pull system of surgery instrument 300 stiffly and can inserts conduit 5 (not illustrating) here.

For at last stopper 1 being separated with surgery instrument 300, then release is arranged on second obstacle of holding in the part 110 312,313, thereby hook 302 can be advanced the distance of regulation forward again.Be enabled in the blade 310 on 315 far-ends of gap, hook 302 most advanced and sophisticated back then.By drawing back surgery instrument, radially tighten the dead ring 301 in the translot 308, and can separate hook 302 displacement forward by blade 310.Therefore, the end of knot that does not have a dead ring 301 when drawing back surgery instrument 300 and the eyelet 16 of support 10 separate, thereby the other end with dead ring 301 of knot 311 is finally stayed in the translot 308 and therefore and is on the hook 302.

Figure 24 shows the view similar with Figure 23, thereby also shows stopper 1 on support 10, and it is connected with collar 304 translots 308 interior dead rings 301 by support 10.

To describe more accurately below the implant that is used for having a support 10 particularly stopper 1 repeat to be connected to the 3rd embodiment method of surgery instrument 300.

In first step, the dead ring 301 of specific length is secured to the eyelet 16 of implant support 10.Thereby dead ring 301 is inserted into the knot 311 of translot 308 dead rings 301 of round collar 304 then and matches with projection 309 at the center, and radially remains in dead ring 301 parts in the translot 308.When moving forward hook 302 in accordance with regulations, dead ring 301 parts in the translot 308 slip over the hook 302 in second cannelure 307 and are fixed on the there.By drawing back hook 302, the support 10 of implant is pulled and is clipped in the surface 305 of collar 304.Moving forward that hook 302 carries out once more will be unclamped dead ring 301 once more, and the side nearby 305 of collar 304 will unclamp from support 10, and check laying of implant.Adopt dead ring 301 can at any time collar 304 be connected to once more the support 10 of implant.Prevent to be not intended to discharge stopper 1 from surgery instrument 300 by following measure: at first, dead ring 301 can not slip over hook 302 automatically at tensioned state.Secondly, because seal the hook opening around opening, so dead ring 301 can not slide from hook 302 under relaxation state by collar 304.The 3rd, hook 302 is fixed in second cannelure 307 of collar 304 preventing and twines, thereby the hook opening can not be positioned at translot 308 fronts.The 4th, because obstacle 312,313, blade 310 is after stationary state remains on second translot of holding in the part 110 308, and therefore neither dead ring 301 not lax or that tighten is not isolated in contact yet.At last, can by and the driving element of surgery instrument 300 between consciously and intentionally effect and by drawing back so that it is cut from the dead ring of tightening 301 a little, and only blade 310 is imported the slit 315 of hooks 302.Only small just the recalling of surgery instrument 300 will radially be tightened dead ring 301 by translot 308, and only have the moving forward of hook 302 regulation of blade 310, and promptly the machinable dead ring 301.

Because can carry out some variation and not depart from related scope of the present invention here, so be desirably in that all the elements included in the superincumbent description shown in accompanying drawing, description and claims will be understood that descriptive explanation and nonrestrictive to the said equipment.

Claims (according to the modification of the 19th of treaty)

1. stopper comprises:

By the fabric (2) of a formation in filament and the fine rule (4), it forms suitable net shape by molded and heat treatment step and is tapered to and is used for that blood vessel is implanted into or the conduit of transplant operation (5) diameter, comprising:

Near-end keeps district (6);

Far-end keeps district (8), thereon the end of filament or fine rule (4) assemble to support (10) and

Circle spreader (12) is arranged on described near-end and keeps district (6) and described far-end to keep between the district (8);

Wherein said two keep district (6,8) be located at after the implantation will shutoff in barrier film the siphunculus both sides, and described spreader (12) passes described siphunculus; And

Wherein said support (10) has head (14) at the free end that it has the eyelet of perforation shape, and described perforation (16) can or be transplanted instrument (100 with implantation; 200) interference fit and by its maintenance.

2. according to the stopper of claim 1, wherein:

Described head (14) is constructed to spherical head.

3. according to the stopper of claim 1 or 2, wherein:

The two-sided cutting release surface (18,20) of described perforation is constructed to be focused at together towards the free end of support (10) and the outer surface of spherical head.

4. the stopper any according to claim 1 to 3, wherein: described eyelet (16) is the groove that described relatively perforation is tilted, thus the end (22,24) of skewed slot (26) is relative and the longitudinal overlap of perforation.

5. stopper comprises:

By the fabric (2) of a formation in filament and the fine rule (4), it forms suitable net shape by molded and heat treatment step and is tapered to and is used for that blood vessel is implanted into or the conduit of transplant operation (5) diameter, comprising:

Near-end keeps district (6);

Far-end keeps district (8), and the end of filament or fine rule (4) is assembled to support (10) thereon, and has the round spreader (12) that is arranged between described near-end maintenance district (6) and the described far-end maintenance district (8);

Wherein said two keep district (6,8) be located at after the implantation will shutoff in barrier film the siphunculus both sides, and described spreader (12) passes described siphunculus; And

Wherein said support (10) has head (14) at its free end, it is constructed to the hemispherical center collar on the longitudinal cross-section, it comprises the eyelet (16) of punch format, and can remain on the implantation/transplantation instrument (300) by described eyelet (16) by making dead ring (301).

6. one kind is used for implanting and implant that transplanting has a support (10) surgery instrument (100 of stopper particularly; 200), comprising:

By a fabric that constitutes in filament and the fine rule, it forms suitable net shape by molded and heat treatment step and is tapered to and is used for that blood vessel is implanted into or the conduit diameter of transplant operation, comprising:

Near-end keeps the district;

Far-end keeps the district, and the end of filament or fine rule is assembled to support thereon, and

The circle spreader is arranged on described near-end and keeps district and described far-end to keep between the district;

Wherein said two keep the district be located at after the implantation will shutoff in barrier film the siphunculus both sides, and described spreader passes described siphunculus; And

Wherein said support has head at the free end of eyelet that it has the perforation shape, described perforation can with implant or transplant the instrument interference fit and by its maintenance;

Also comprise:

Clamp (102), it has the clamp (103,104,105) that can open and close by push/pull system and can be constructed to hold the head (14) of implant support (10) with interference fit; And

Insert filament or lead (116), it is when the delivery status of described surgery instrument, stretch out clamp (102) from its near-end with annulus (117) form, and by two free ends (118,119) guiding is by the inside and wind spring (106) inside of taper collar (109), arrive described first on the surgery instrument far-end and hold part (108), thereby before implanting described implant, described annulus (117) is conducted through the eyelet (16) of implant support (10) and is fixed in clamp (102).

7. according to the surgery instrument (100 of claim 6; 200), wherein push/pull system comprises following element:

Wind spring (106) extends axially the driver (107) by wind spring inside, and it is axially enough firmly but still be flexible;

Be connected to the axle (111) of the clamp (102) of its near-end, and be fixed on first on its far-end hold the part (108);

Circle collar (109), its by in abutting connection with obstacle (114) and its close end (112) hold can axially movable clamp (102) spool (111), and hold the near-end of wind spring (106) in its distal portion (113); With

Second holds part (110), it holds the far-end of wind spring (106) by the adjacency obstacle, thereby clamp (103,104,105) be applied to the power of the outside adjoining front end of taper collar (109) (115) and closure owing to be subjected to wind spring (106), and open by moving forward driver (107).

8. according to the surgery instrument (100) of claim 6 or 7, first free end (119) of wherein said insertion filament or lead (116) can be attached to first grip area (108), and second freedom (118) of described insertion filament or lead (116) end has nipple (120), by means of this, this joint inserts filament or lead (116) can launch under the connection status of implant, perhaps recalls from surgery instrument after disconnection first end (119) and first is held being connected of part (108) support.

9. according to the surgery instrument (200) of claim 6 or 7, wherein be used to implant and transplant implant (10) stopper particularly with support, wherein said eyelet is the groove that tilts with respect to perforation, thereby the end of described skewed slot is with respect to the longitudinal overlap of perforation; And

First free end (119) of wherein said insertion filament or lead (116) can be attached to first grip area (108), and second free end (118) of described insertion filament or lead (116) has nipple (120), by means of this, this joint insert filament or lead (116) can annulus (117) move through in the eyelet (16) skewed slot (26) afterwards, under the connection status of implant, launch, perhaps when disconnecting implant and surgical apparatus, very the pine, to such an extent as to described annulus (117) but by chute (26) shifts out eyelet (16).

10. the surgery instrument (100 any according to claim 6 to 9; 200), wherein said insertion filament or lead (116) are made by the Nitinol lead.

11. one kind is used for implanting and implant that transplanting has a support (10) surgery instrument of stopper (300) particularly, comprises:

By a fabric that constitutes in filament and the fine rule, it forms suitable net shape by molded and heat treatment step and is tapered to and is used for that blood vessel is implanted into or the conduit diameter of transplant operation, comprising:

Near-end keeps the district;

Far-end keeps the district, and the end of filament or fine rule is assembled to support thereon, and has the round spreader that is arranged between described near-end maintenance district and the described far-end maintenance district;

Wherein said two keep the district be located at after the implantation will shutoff in barrier film the siphunculus both sides, and described spreader passes described siphunculus; And

Wherein said support has head at its free end, and it is constructed to the hemispherical center collar on the longitudinal cross-section, and comprises the eyelet of punch format, and can remain on the implantation/transplantation instrument by described eyelet by making dead ring;

Also comprise:

Hook (302), it can and extend through described eyelet (16) and can be hooked in dead ring (301) on the hook (302) and axially be moved to described eyelet (16) and move apart from described eyelet by push/pull system, can implant be remained on the surgery instrument (300) by tightening dead ring (301) when hook (302) is moved apart described eyelet (16) by means of this.

12. according to the surgery instrument (300) of claim 11, wherein push/pull system comprises:

Wind spring (106);

Driver (107), it extends axially by wind spring inside, and enough hard but still soft in the axial direction, has:

Be connected to the axle (303) of the described hook (302) of its near-end; And

Be fixed on first on its far-end and hold part (108);

Circle collar (304), it holds the near-end of described wind spring (106) by the obstacle (114) in abutting connection with its distal portion (113), and hold can axially movable described hook (302) axle (303); With

Second holds part (110), its hold wind spring (106) by the adjacency obstacle thus far-end hook (302) axially leave described eyelet (16) owing to be subjected to the power that wind spring (106) applies, and move to described eyelet (16) by moving forward driver (107).

13. surgery instrument (300) according to claim 12, the side (305) that has wherein round collar (304) nearby go up successive first cannelure (306), therein heart part one side be used for preventing axially movable hook (302) second cannelure (307) of the winding guiding of collar, on a side with the vertically disposed translot of second cannelure (307) (308), this translot extend to the longitudinal axis of described collar (304) and therein the heart have the projection (309) of the knot (311) that is used to hold dead ring (301).

14. surgery instrument (300) according to claim 13, the cross section to forward part of wherein said hook (302) is constructed to approximately more flat 1/3rd than the cross section of described axle (303), and removable when time in second cannelure (307) of the round collar (304) of packing into.

15. the surgery instrument any according to claim 11 to 14 (300) wherein is provided with blade (310) in the gap (315) of the hook on being formed at far-end (302) back.

16. the surgery instrument (100 any according to claim 7 to 15; 200; 300), wherein said driver (107) is a lead.

17. an implant that is used for having a support (10) particularly stopper can repeat to be connected to method according to claim 6 to 9 or 17 any one surgery instruments (100), comprising:

(a) the beginning blood vessel in the operation or be hooked on since certain purpose be arranged on the clamp (102) fixing point (101) before, the eyelet (16) of the ring (117) of filament or lead (116) by implant support (10) inserted in guiding, and first and second free ends (119,118) that insert filament or lead (116) are held or are fixed in first pinch zones (108);

(b) catch the head (14) of implant support (10) by clamp (102);

(c) tighten have nipple second free end (118) of insertion filament/lead (116) of (120), be in fully up to described head (14) in the clamp (103,104,105) of described clamp;

(d) discharge second free end (118) with nipple (120), its described head (14) from implant discharges described clamp (102), and checks laying of implant;

(e) make insertion filament/lead (116) at any time reconnect the described support (10) of described clamp (102) and implant.

18. an implant that is used for having a support (10) particularly stopper can repeat to be connected to method according to the surgery instrument (200) of claim 10 or 17, comprising:

(a) in the beginning blood vessel, guide the ring (117) of insertion filament or lead (116) by the skewed slot (26) in the eyelet (16) of the described support of implant (10) before the operation, and first and second free ends (119,118) that insert filament or lead (116) are held or are fixed in first pinch zones (108);

(b) catch the head (14) of implant support (10) by clamp (102);

(c) tightening the insertion filament of (120) that has nipple or second free end (118) of lead (116) is in the clamp (103,104,105) of described clamp up to described head (14);

(d) discharge second free end (118) with nipple (120), its described head (14) from implant discharges described clamp (102), and checks laying of implant;

(e) make insertion filament/lead (116) at any time reconnect the described support (10) of described clamp (102) and implant.

19. an implant that is used for having a support (10) particularly stopper can repeat to be connected to the method for the surgery instrument any according to claim 12 to 17 (300), comprising:

(a) dead ring (301) of length-specific is fixed to the eyelet (16) of the described support of implant (10);

(b) described dead ring (301) is inserted the translot (308) of justifying collar (304), by projection (309), and thereby described dead ring (301) part that is arranged in described translot (308) is maintained on the diametric(al) knot (311) of described dead ring (301) at the center;

(c) when moving forward described hook (302) according to the rules, described dead ring (301) part in the translot slips over the described hook (302) in second cannelure (307) and is fixed on the there;

(d) draw back the described hook (302) that the support (10) of implant is pulled to and is clamped in the nearly face side (305) of described collar (304);

(e) loosen dead ring (301) by moving forward of limiting again of described hook (302), and loosen the side nearby (305) of described collar (304), and check laying of implant from described support (10);

(f) adopt described dead ring (301) can at any time described collar (304) be reconnected described support (10) to implant.

Claims (20)

1. stopper comprises:

By the fabric (2) of a formation in filament and the fine rule (4), it forms suitable net shape by molded and heat treatment step and is tapered to and is used for that blood vessel is implanted into or the conduit of transplant operation (5) diameter, comprising:

Near-end keeps district (6);

Far-end keeps district (8), thereon the end of filament or fine rule (4) assemble to support (10) and

Circle spreader (12) is arranged on described near-end and keeps district (6) and described far-end to keep between the district (8);

Wherein said two keep district (6,8) be located at after the implantation will shutoff in barrier film the siphunculus both sides, and described spreader (12) passes described siphunculus; And

Wherein said support (10) has head (14) at the free end that it has the eyelet of perforation shape, and described perforation (16) can or be transplanted instrument (100 with implantation; 200) interference fit and by its maintenance.

2. according to the stopper of claim 1, wherein:

Described head (14) is constructed to spherical head.

3. according to the stopper of claim 1 or 2, wherein:

The two-sided cutting release surface (18,20) of described perforation is constructed to be focused at together towards the free end of support (10) and the outer surface of spherical head.

4. the stopper any according to claim 1 to 3, wherein: described eyelet (16) is the groove that described relatively perforation is tilted, thus the end (22,24) of skewed slot (26) is relative and the longitudinal overlap of perforation.

5. stopper comprises:

By the fabric (2) of a formation in filament and the fine rule (4), it forms suitable net shape by molded and heat treatment step and is tapered to and is used for that blood vessel is implanted into or the conduit of transplant operation (5) diameter, comprising:

Near-end keeps district (6);

Far-end keeps district (8), and the end of filament or fine rule (4) is assembled to support (10) thereon, and has the round spreader (12) that is arranged between described near-end maintenance district (6) and the described far-end maintenance district (8);

Wherein said two keep district (6,8) be located at after the implantation will shutoff in barrier film the siphunculus both sides, and described spreader (12) passes described siphunculus; And

Wherein said support (10) has head (14) at its free end, it is constructed to the hemispherical center collar on the longitudinal cross-section, it comprises the eyelet (16) of punch format, and can remain on the implantation/transplantation instrument (300) by described eyelet (16) by making dead ring (301).

6. one kind is used for implanting and implant that transplanting has a support (10) surgery instrument (100 of stopper particularly; 200), comprising:

By a fabric that constitutes in filament and the fine rule, it forms suitable net shape by molded and heat treatment step and is tapered to and is used for that blood vessel is implanted into or the conduit diameter of transplant operation, comprising:

Near-end keeps the district;

Far-end keeps the district, and the end of filament or fine rule is assembled to support thereon, and

The circle spreader is arranged on described near-end and keeps district and described far-end to keep between the district;

Wherein said two keep the district be located at after the implantation will shutoff in barrier film the siphunculus both sides, and described spreader passes described siphunculus; And

Wherein said support has head at the free end of eyelet that it has the perforation shape, described perforation can with implant or transplant the instrument interference fit and by its maintenance;

Also comprise:

Clamp (102), it has the clamp (103,104,105) that can open and close by push/pull system and can be constructed to hold the head (14) of implant support (10) with interference fit.

7. according to the surgery instrument (100 of claim 6; 200), wherein push/pull system comprises following element:

Wind spring (106) extends axially the driver (107) by wind spring inside, and it is axially enough firmly but still be flexible;

Be connected to the axle (111) of the clamp (102) of its near-end, and be fixed on first on its far-end hold the part (108);

Circle collar (109), its by in abutting connection with obstacle (114) and its close end (112) hold can axially movable clamp (102) spool (111), and hold the near-end of wind spring (106) in its distal portion (113); With

Second holds part (110), it holds the far-end of wind spring (106) by the adjacency obstacle, thereby clamp (103,104,105) be applied to the power of the outside adjoining front end of taper collar (109) (115) and closure owing to be subjected to wind spring (106), and open by moving forward driver (107).

8. according to the surgery instrument (100) of claim 6 or 7, also comprise:

Insert filament or lead (116), it is when the delivery status of described surgery instrument, stretch out clamp (102) from its near-end with annulus (117) form, and by two free ends (118,119) guiding is by the inside and wind spring (106) inside of taper collar (109), arrive described first on the surgery instrument far-end and hold part (108), thereby before implanting described implant, described annulus (117) is conducted through the eyelet (16) of implant support (10) and is fixed in clamp (102).

9. according to the surgery instrument (100) of claim 7 or 8, first free end (119) of wherein said insertion filament or lead (116) can be attached to first grip area (108), and second free end (118) of described insertion filament or lead (116) has nipple (120), by means of this, this joint inserts filament or lead (116) can launch under the connection status of implant, perhaps recalls from surgery instrument after disconnection first end (119) and first is held being connected of part (108) support.

10. according to the surgery instrument (200) of claim 7 or 8, wherein be used to implant and transplant implant (10) stopper particularly with support, wherein said eyelet is the groove that tilts with respect to perforation, thereby the end of described skewed slot is with respect to the longitudinal overlap of perforation; And

First free end (119) of wherein said insertion filament or lead (116) can be attached to first grip area (108), and second free end (118) of described insertion filament or lead (116) has nipple (120), by means of this, this joint insert filament or lead (116) can annulus (117) move through in the eyelet (16) skewed slot (26) afterwards, under the connection status of implant, launch, perhaps when disconnecting implant and surgical apparatus, very the pine, to such an extent as to described annulus (117) but by chute (26) shifts out eyelet (16).

11. according to Claim 8 to 10 any one surgery instruments (100; 200), wherein said insertion filament or lead (116) are made by the Nitinol lead.

12. one kind is used for implanting and implant that transplanting has a support (10) surgery instrument of stopper (300) particularly, comprises:

By a fabric that constitutes in filament and the fine rule, it forms suitable net shape by molded and heat treatment step and is tapered to and is used for that blood vessel is implanted into or the conduit diameter of transplant operation, comprising:

Near-end keeps the district;

Far-end keeps the district, and the end of filament or fine rule is assembled to support thereon, and has the round spreader that is arranged between described near-end maintenance district and the described far-end maintenance district;

Wherein said two keep the district be located at after the implantation will shutoff in barrier film the siphunculus both sides, and described spreader passes described siphunculus; And

Wherein said support has head at its free end, and it is constructed to the hemispherical center collar on the longitudinal cross-section, and comprises the eyelet of punch format, and can remain on the implantation/transplantation instrument by described eyelet by making dead ring;

Also comprise:

Hook (302), it can and extend through described eyelet (16) and can be hooked in dead ring (301) on the hook (302) and axially be moved to described eyelet (16) and move apart from described eyelet by push/pull system, can implant be remained on the surgery instrument (300) by tightening dead ring (301) when hook (302) is moved apart described eyelet (16) by means of this.

13. according to the surgery instrument (300) of claim 12, wherein push/pull system comprises:

Wind spring (106);

Driver (107), it extends axially by wind spring inside, and enough hard but still soft in the axial direction, has:

Be connected to the axle (303) of the described hook (302) of its near-end; And

Be fixed on first on its far-end and hold part (108);

Circle collar (304), it holds the near-end of described wind spring (106) by the obstacle (114) in abutting connection with its distal portion (113), and hold can axially movable described hook (302) axle (303); With

Second holds part (110), its hold wind spring (106) by the adjacency obstacle thus far-end hook (302) axially leave described eyelet (16) owing to be subjected to the power that wind spring (106) applies, and move to described eyelet (16) by moving forward driver (107).

14. surgery instrument (300) according to claim 13, the side (305) that has wherein round collar (304) nearby go up successive first cannelure (306), therein heart part one side be used for preventing axially movable hook (302) second cannelure (307) of the winding guiding of collar, on a side with the vertically disposed translot of second cannelure (307) (308), this translot extend to the longitudinal axis of described collar (304) and therein the heart have the projection (309) of the knot (311) that is used to hold dead ring (301).

15. surgery instrument (300) according to claim 14, the cross section to forward part of wherein said hook (302) is constructed to approximately more flat 1/3rd than the cross section of described axle (303), and removable when time in second cannelure (307) of the round collar (304) of packing into.

16. the surgery instrument any according to claim 12 to 15 (300) wherein is provided with blade (310) in the gap (315) of the hook on being formed at far-end (302) back.

17. the surgery instrument (100 any according to claim 7 to 16; 200; 300), wherein said driver (107) is a lead.

18. an implant that is used for having a support (10) particularly stopper can repeat to be connected to method according to claim 6 to 9 or 17 any one surgery instruments (100), comprising:

(a) the beginning blood vessel in the operation or be hooked on since certain purpose be arranged on the clamp (102) fixing point (101) before, the eyelet (16) of the ring (117) of filament or lead (116) by implant support (10) inserted in guiding, and first and second free ends (119,118) that insert filament or lead (116) are held or are fixed in first pinch zones (108);

(b) catch the head (14) of implant support (10) by clamp (102);

(c) tighten have nipple second free end (118) of insertion filament/lead (116) of (120), be in fully up to described head (14) in the clamp (103,104,105) of described clamp;

(d) discharge second free end (118) with nipple (120), its described head (14) from implant discharges described clamp (102), and checks laying of implant;

(e) make insertion filament/lead (116) at any time reconnect the described support (10) of described clamp (102) and implant.

19. an implant that is used for having a support (10) particularly stopper can repeat to be connected to method according to the surgery instrument (200) of claim 10 or 17, comprising:

(a) in the beginning blood vessel, guide the ring (117) of insertion filament or lead (116) by the skewed slot (26) in the eyelet (16) of the described support of implant (10) before the operation, and first and second free ends (119,118) that insert filament or lead (116) are held or are fixed in first pinch zones (108);

(b) catch the head (14) of implant support (10) by clamp (102);

(c) tightening the insertion filament of (120) that has nipple or second free end (118) of lead (116) is in the clamp (103,104,105) of described clamp up to described head (14);

(d) discharge second free end (118) with nipple (120), its described head (14) from implant discharges described clamp (102), and checks laying of implant;

(e) make insertion filament/lead (116) at any time reconnect the described support (10) of described clamp (102) and implant.

20. an implant that is used for having a support (10) particularly stopper can repeat to be connected to the method for the surgery instrument any according to claim 12 to 17 (300), comprising:

(a) dead ring (301) of length-specific is fixed to the eyelet (16) of the described support of implant (10);

(b) described dead ring (301) is inserted the translot (308) of justifying collar (304), by projection (309), and thereby described dead ring (301) part that is arranged in described translot (308) is maintained on the diametric(al) knot (311) of described dead ring (301) at the center;

(c) when moving forward described hook (302) according to the rules, described dead ring (301) part in the translot slips over the described hook (302) in second cannelure (307) and is fixed on the there;

(d) draw back the described hook (302) that the support (10) of implant is pulled to and is clamped in the nearly face side (305) of described collar (304);

(e) loosen dead ring (301) by moving forward of limiting again of described hook (302), and loosen the side nearby (305) of described collar (304), and check laying of implant from described support (10);

(f) adopt described dead ring (301) can at any time described collar (304) be reconnected described support (10) to implant.

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