CN107997798B - Meniscus stitching instrument - Google Patents

Meniscus stitching instrument Download PDF

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Publication number
CN107997798B
CN107997798B CN201711331375.6A CN201711331375A CN107997798B CN 107997798 B CN107997798 B CN 107997798B CN 201711331375 A CN201711331375 A CN 201711331375A CN 107997798 B CN107997798 B CN 107997798B
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suture
needle
meniscus
sleeve
push
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CN107997798A (en
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罗鸿
高华琳
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0464Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0472Multiple-needled, e.g. double-needled, instruments

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention discloses a meniscus suture device in the field of medical equipment, which comprises a sleeve, wherein one end of the sleeve is connected with a push needle tube, one end of the push needle tube, which is far away from the sleeve, is connected with a handle, a push needle rod is connected in the sleeve in a sliding manner, a push needle handle is connected in the push needle tube in a sliding manner, a suture needle is arranged in the sleeve, which is far away from the outer side of one end of the push needle rod, the suture needle comprises two needle heads, and a suture thread is connected between the two needle heads. According to the scheme, the double-needle head design of the suture needle and the design of the sleeve, the push needle rod and the push needle handle can achieve single puncture in the meniscus suture operation, and secondary damage to the meniscus caused by repeated puncture of the suture needle on the meniscus in the suture process can be avoided.

Description

Meniscus stitching instrument
Technical Field
The invention relates to the field of medical equipment, in particular to a meniscus suture instrument.
Background
The meniscus is a layer of fibrocartilage between the femur and tibia of the knee joint, belongs to the necessary structure of the knee joint, and plays an important role in maintaining joint function. Meniscus injury is a common athletic injury in orthopaedics that can lead to pain in walking or exercising and joint movement disorders, severely affecting the quality of life of the patient. Meniscus damage is mostly caused by torsional external forces, resulting in a meniscus tear, which can occur at the anterior, posterior and somatic corners of the meniscus. Because of poor meniscus blood circulation, the damaged meniscus is not easy to heal by itself, and the torn meniscus can damage other structures of the knee joint, thereby causing traumatic arthritis. Conventional treatments are arthroscopic meniscectomy or partial excision, where a meniscectomy that preserves the morphology of the meniscus is the most desirable procedure for treating a meniscal injury.
Currently, a sleeve-line type meniscus suture instrument is adopted for meniscus suture, the operation is carried out under the cooperation of an arthroscope, and two methods are basically adopted for meniscus suture under the arthroscope: the external-to-internal and total internal suturing, and the external-to-internal suturing technique is suitable for barrel handle-shaped, longitudinal, oblique, horizontal and transverse tears of meniscus anterior corners and body parts. During operation, a meniscus puncture needle is adopted to penetrate through the inner side of a meniscus tear, a suture passes through the skin outside the joint, the joint capsule and the front corner of the meniscus, then penetrates through the inner side edge of the meniscus tear, pulls the suture into the joint, pulls the suture outside the joint through another meniscus puncture needle, and then knots and fixes the suture.
The suturing device used at present is a fast-fix suturing system produced by Shihui corporation, which is suitable for barrel handle-shaped and longitudinal tearing of the rear corner and body of meniscus. Two needles are required to be penetrated in the suture process, two suture anchors are placed on the outer edge of the meniscus, the torn meniscus is fixed by pulling a line for knotting, the suture process needs better operation skills, the suture indication is relatively narrow, the suture process is relatively complex, the suture needle is relatively thick, and the damage is relatively large when the meniscus tissue is penetrated.
The above-mentioned suture mode all adopts single needle to sew up, and the shortcoming is that the art needs to wear the needle many times and tie down on the meniscus, need set up the tip that the line knot was used for fixed suture on the meniscus, perhaps the tip was tied down when the suture was fixed and is formed the knot on the meniscus, and line knot and knot lead to the fact vice damage to the meniscus easily, and in order to make the suture can be used for a long time, corresponding line knot and knot are made for the material that the human body can not absorb, lead to the fact the foreign matter reaction of human body like this easily. Therefore, the prior suture technology and suture instruments have certain defects, and the surgical requirements cannot be met increasingly.
Disclosure of Invention
The invention aims to provide a meniscus suture device, which solves the problem that the conventional meniscus suture device is easy to cause side damage to meniscus due to repeated puncture on meniscus in the use process.
In order to achieve the above purpose, the basic technical scheme of the invention is as follows: the meniscus stitching instrument comprises a sleeve, wherein one end of the sleeve is connected with a push needle tube, one end of the push needle tube, far away from the sleeve, is connected with a handle, a push needle rod is connected in the sleeve in a sliding manner, the push needle tube is connected with a push needle handle in a sliding manner, a suture needle is arranged in the sleeve, far away from the outer side of one end of the push needle handle, of the push needle rod, the suture needle comprises two needle sleeves, and a suture thread is connected between the two needle sleeves.
The principle of the scheme is as follows: during practical application, the sleeve is used for loading the suture needle and the push needle rod, guiding and supporting the suture needle, the push needle rod is used for loading the push needle handle, the handle is used for holding and operating the suture device, the push needle rod is used for transmitting power to push the suture needle to move so as to suture the meniscus, the push needle handle is used for transmitting external power to push the push needle rod to move, the suture needle is used for suturing the split on the meniscus, the needle sleeve is used for puncturing the meniscus and guiding the suture to suture, and the suture is used for tensioning two ends of the split on the meniscus to realize the suture of the split on the meniscus. When the split suture needle is used, the suture needle is placed in the sleeve, the needle sleeve of the suture needle faces the opening end of the sleeve, the hand-held handle pushes the push needle handle to push the suture needle to the meniscus through the push needle rod, the two needle sleeves of the suture needle are used for puncturing and pulling the suture thread from one side to the other side of the split on the meniscus to tighten and attach the two sides of the split, the split is closed, and the single puncture suture of the split on the meniscus can be realized by fixing the two ends of the suture thread on the two needle sleeves.
The advantage of this scheme is: the double needle sleeve design of the suture needle and the design of the sleeve, the push needle rod and the push needle handle can realize that suture can be completed through single puncture in the meniscus suture operation, and secondary damage to meniscus caused by repeated puncture of the suture needle on meniscus in the suture process can be avoided.
According to the first preferred scheme, as an improvement of the basic scheme, barbs are arranged on the suture, the barbs are obliquely arranged, the inclination directions of the barbs at two ends of the suture are opposite, one ends of the barbs are fixed on the suture, and one ends of the barbs connected with the suture are close to the end parts of the suture. Therefore, the suture can be fixed in the human body through the clamping connection between the barbs on the suture and the human tissues, the end part of the suture does not need to be fixed or knotted and fixed through the thread buckle, the abrasion of the thread buckle and the thread knot to the meniscus and the joint surface is avoided, and the foreign body reaction of the human body caused by the thread buckle and the like is avoided.
In a second preferred embodiment, as an improvement of the first preferred embodiment, the barb includes a left piercing strip and a right piercing strip, the left piercing strip and the right piercing strip are positioned at two sides of the suture, and the left piercing strip and the right piercing strip are arranged in parallel on the suture. As the contact between the suture and the tissues can be increased through the left barb and the right barb, the suture of the suture to the meniscus laceration is tighter, the suture stress is more uniform, suture failure caused by small suture force of the suture to the laceration due to the stress of the suture single side can be avoided, and the deformation of the meniscus caused by the stress of surrounding meniscus tissues can be avoided. The parallel arrangement makes the stress of the left thorn piece and the right thorn piece even, makes the stress of the suture more even, has better suture effect on the meniscus breach, and the cut suture end after suture is more neat, and can not influence surrounding tissues.
In a third preferred embodiment, as an improvement of the second preferred embodiment, the middle part of the suture is provided with a smooth section. Preferably, the smooth segment is positioned on the medial side of the meniscus after suturing, the smooth segment does not cause wear to the medial and articular surfaces of the meniscus.
In a fourth preferred embodiment, as an improvement of the third preferred embodiment, the end portion of the suture is detachably connected to the tail end of the needle sheath. The needle sleeve is separated from the suture after the suture is conveniently arranged, so that the thread end of the suture is buried under the skin instead of being exposed on the surface of the skin, and the wound is healed.
In a fifth preferred embodiment, as an improvement of the fourth preferred embodiment, two needle sleeves are arranged side by side, the inner sides of the two needle sleeves are respectively provided with a needle head, the needle heads are detachably connected in the needle sleeves, the suture is connected with the end part of the needle heads, and the needle sleeves are positioned on the inner sides of the sleeves. The needle sleeves arranged side by side are convenient for puncturing two ends of the split, the needle sleeve can protect the needle head, when the push needle rod is used, the tail end of the needle sleeve is provided with a space for containing a suture, the push needle rod is used for puncturing and sewing the needle sleeve by pushing the push needle rod, and the push needle rod can not squeeze the suture; even if the needle pushing rod is not used, the needle can be clamped by forceps to perform puncture and suture, so that the application range is wider.
In a sixth preferred embodiment, as an improvement of the fifth preferred embodiment, the barbs and the suture are integrally formed of a material absorbable by the human body. The suture is buried under the skin after suturing, so that the suture after healing can be absorbed by a human body, the suture removing treatment is not needed, and the possibility of infection of the wound caused by the secondary operation is reduced.
The seventh preferred scheme is an improvement of the sixth preferred scheme, the needle pushing tube is provided with an open slot along the length direction, the needle pushing handle is integrally formed with a push block, the upper end of the push block penetrates through the open slot, the upper end of the push block is obliquely arranged close to the sleeve at a high end, and the upper end of the push block is provided with anti-skid patterns. The open slot makes the push block exposed outside for convenient operation, and the push block upper end with anti-slip lines is more labor-saving and stable when in use, so that the stitching instrument is more convenient to use.
In a eighth preferred embodiment, as a modification of the seventh preferred embodiment, the cross section of the needle pushing tube is larger than the cross section of the sleeve. The convenient sleeve is connected with the push needle tube, the push needle handle is conveniently limited in the push needle tube, and the size of the convenient control handle is favorable for holding.
A ninth preferred embodiment is a modification of the eighth preferred embodiment, wherein the push rod extends circumferentially near one end of the needle to form a push plate. The arrangement of the push plate increases the area of the end part of the push rod, is favorable for pushing the needle stably, and avoids the needle pushing failure caused by dislocation between the needle and the push rod.
Drawings
FIG. 1 is a schematic diagram of an embodiment of the present invention;
FIG. 2 is a schematic view of a needle structure according to an embodiment of the present invention;
FIG. 3 is a schematic cross-sectional view of a needle within a cannula in accordance with an embodiment of the present invention;
FIG. 4 is a schematic view of a suture instrument according to an embodiment of the present invention;
FIG. 5 is a schematic view of the use of a needle in accordance with an embodiment of the present invention.
Detailed Description
The following is a further detailed description of the embodiments:
Reference numerals in the drawings of the specification include: needle 1, suture 2, barb 3, left thorn piece 4, right thorn piece 5, smooth section 6, needle cover 7, meniscus 8, push plate 9, push rod 10, sleeve 11, push tube 12, push handle 13, handle 14, push block 15.
Example 1, substantially as shown in fig. 1 and 2: the utility model provides a meniscus suture instrument, including sleeve pipe 11, the one end integrated into one piece of sleeve pipe 11 has push pin pipe 12, the cross-section of push pin pipe 12 is greater than the cross-section of sleeve pipe 11, the one end that sleeve pipe 11 was kept away from to push pin pipe 12 is as handle 14, sliding connection has push pin pole 10 in sleeve pipe 11, sliding connection has push pin handle 13 in push pin pipe 12, push pin pole 10 is connected with push pin handle 13, the open slot has been seted up along length direction on push pin pipe 12, integrated into one piece has push block 15 on push pin handle 13, the upper end of push block 15 passes the open slot, the upper end slope of push block 15 sets up, the high end of push block 15 upper end is close to sleeve pipe 11, push block 15 up end is equipped with the anti-skidding line, be equipped with the needle in sleeve pipe 11 that push pin pole 10 kept away from push pin handle 13 one end outside, push pin pole 10 is close to the one end circumference extension of needle and forms push pedal 9. The sewing needle comprises two needles 1 which are arranged side by side, a suture 2 is connected between the two needles 1, barbs 3 are arranged on the suture 2 in an inclined mode, one ends of the barbs 3 are fixed on the suture 2, one ends of the barbs 3 connected with the suture 2 are close to the end portions of the suture 2, the inclined directions of the barbs 3 at the two ends of the suture 2 are opposite, and a smooth section 6 is arranged in the middle of the suture 2. The barb 3 comprises a left thorn piece 4 and a right thorn piece 5, the left thorn piece 4 and the right thorn piece 5 are positioned at two sides of the suture line 2, the left thorn piece 4 and the right thorn piece 5 are arranged on the suture line 2 in parallel, and the barb 3 and the suture line 2 are formed integrally by polyglycolide or polycaprolactone. As shown in fig. 3, the outer sides of the two needles 1 are respectively provided with a needle sleeve 7, the needle sleeve 7 is positioned at the inner side of the sleeve 11, one end of the needle sleeve 7 is conical, the other end of the needle sleeve 7 is opened, the opening end of the needle sleeve 7 is provided with a cutting seam along the length direction, the suture 2 slides in the cutting seam, and the needle sleeve 7 and the needles 1 can be detachably connected and also can be fixedly connected. The suture 2 and the needle head 1 can be detachably connected and also can be fixedly connected.
In this embodiment, during practical application, the push pin handle 13 may be connected to a hydraulic or pneumatic device, and the push pin handle 13 is pushed by hydraulic or pneumatic pressure, so that the labor is saved.
In this embodiment, before use, the push block 15 of the push needle handle 13 is near one end of the handle 14 in the opening groove, the push needle handle 13 pulls the push needle rod 10 to be located near one side of the handle 14, the needle is placed in the sleeve 11 on one side of the push needle rod 10 far away from the handle 14, the needle head 1 of the needle is directed to the opening of the sleeve 11, two needle heads 1 in the needle are located in the needle sleeve 7, the suture 2 between the two needle heads 1 is clamped in the slit on the needle sleeve 7, the smooth section 6 on the suture 2 is located between the two needle sleeves 7, and the opening end of the needle sleeve 7 abuts against one end of the push needle rod 10 far away from the handle 14. When in use, as shown in fig. 4, the open end of the sleeve 11 faces the inner side of the meniscus 8 and aims at the seam to be sewn, the holding handle 14 pushes the push block 15 to push the push needle handle 13 to the open end of the sleeve 11, the push needle handle 13 pushes the push needle rod 10 to move to the open end of the sleeve 11, the push plate 9 on the push needle rod 10 props against the open end of the needle sleeve 7 to push the needle sleeve 7 to move to the inner side surface of the meniscus 8 with the needle head 1 and the seam 2, and the needle sleeve 7 punctures from the inner side to the outer side of the meniscus 8 under the action of the push needle rod 10. As shown in fig. 5, the needle sleeve 7 is used for synchronously pulling two ends of the suture 2 from the inner side to the outer side of the meniscus 8 with the two needles 1, after the needle sleeve 7 is used for penetrating the meniscus 8 with the needles 1, the suture 2 is also penetrated through the meniscus 8 from the two ends of the split, the barbs 3 on the suture 2 are clamped with the meniscus 8, the smooth sections 6 on the suture 2 cross the split at the inner side of the meniscus 8, the suture 2 is fixed in the tissue by tightening the barbs 3, the split is synchronously tightened and closed from two places by tightening the two ends of the suture 2, the clamping joint between the barbs 3 and the tissue is used for preventing the suture 2 from being split again due to the split pulling, then the suture 2 is sheared or the suture 2 is taken off from the needle 1, the split sewing on the meniscus 8 can be completed by embedding the thread ends of the suture 2 under the skin, and the barbs 3 are made of polyglycolide or polycaprolactone which can be absorbed by a human body, the suture 2 and the barbs 3 can be absorbed by the human body, the suture 2 can be removed again without performing an operation, and foreign body reaction due to residues of the suture 2 can not occur. The larger split can be sewn at a plurality of positions in the process repeatedly, so that the split is closed. Through two syringe needles 1 at the split both ends of meniscus 8, smooth section 6 of suture 2 is located the inboard of meniscus 8, barb 3 is located meniscus 8 tissue, fix suture 2 through barb 3, make the outside of meniscus 8 need not set up the line knot of fixed suture 2 tip, the inboard of meniscus 8 also does not have the line knot that suture 2 knotd and forms, can stitch the split on meniscus 8 through single puncture, can not cause the auxiliary damage to meniscus 8 because of multiple repetition on meniscus 8, can not cause wearing and tearing to meniscus 8 or joint face after sewing, wireless knot, the line knot can not produce human foreign matter reaction after sewing up, make meniscus 8 sew up the quality higher, patient's treatment impression is better, more be suitable for meniscus 8 damage treatment.
Embodiment 2 differs from embodiment 1 in that the barbs 3 comprise a left piercing tab 4 and a right piercing tab 5, the left piercing tab 4 and the right piercing tab 5 being spaced apart on the suture 2.
Example 3, this example differs from example 1 in that the barb 3 is conically shaped, the cone tip of the barb 3 being integrally formed with the suture 2.
The foregoing is merely exemplary of the present application and the specific structures and/or characteristics of the present application that are well known in the art have not been described in detail herein. It should be noted that modifications and improvements can be made by those skilled in the art without departing from the structure of the present application, and these should also be considered as the scope of the present application, which does not affect the effect of the implementation of the present application and the utility of the patent. The protection scope of the present application is subject to the content of the claims, and the description of the specific embodiments and the like in the specification can be used for explaining the content of the claims.

Claims (8)

1. A meniscus suture device, characterized in that: the needle comprises two needle sleeves, a suture is connected between the two needle heads, the outer sides of the two needle heads are respectively provided with a needle sleeve, the needle sleeves are positioned on the inner side of the sleeve, one end of each needle sleeve is conical, the other end of each needle sleeve is provided with an opening, a slit along the length direction is formed in the opening end of each needle sleeve, the suture slides in the slits, and the opening end of each needle sleeve abuts against one end of each needle sleeve, which is far away from the handle, of each needle sleeve;
The suture is provided with barbs, the barbs are obliquely arranged, the inclination directions of the barbs at the two ends of the suture are opposite, one ends of the barbs are fixed on the suture, and one ends of the barbs connected with the suture are close to the end part of the suture;
the two needle sleeves are arranged side by side, the needles are arranged in the two needle sleeves, the needles are detachably connected in the needle sleeves, the suture is connected with the end parts of the needles, and the needle sleeves are positioned on the inner sides of the sleeves.
2. The meniscus suture apparatus of claim 1, wherein: the barbs comprise a left thorn piece and a right thorn piece, the left thorn piece and the right thorn piece are positioned at two sides of the suture, and the left thorn piece and the right thorn piece are arranged in parallel on the suture.
3. The meniscus suture apparatus of claim 2, wherein: the middle part of the suture is provided with a smooth section.
4. The meniscus suture apparatus of claim 3, wherein: the end part of the suture line is detachably connected to the tail end of the needle sleeve.
5. The meniscus suture apparatus of claim 4, wherein: the barbs and the suture are integrally formed by materials which can be absorbed by human bodies.
6. The meniscus suture apparatus of claim 5, wherein: the upper end of the push block is obliquely arranged near the sleeve, and anti-skid patterns are arranged at the upper end of the push block.
7. The meniscus suture apparatus of claim 6, wherein: the section of the pushing needle tube is larger than that of the sleeve.
8. The meniscus suture apparatus of claim 7, wherein: the push rod circumferentially extends to form a push plate at one end close to the needle.
CN201711331375.6A 2017-12-13 2017-12-13 Meniscus stitching instrument Active CN107997798B (en)

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Publication number Priority date Publication date Assignee Title
CN111557701A (en) * 2019-05-10 2020-08-21 华中科技大学同济医学院附属协和医院 Meniscus repair suture puncture needle
CN114587457B (en) * 2022-03-18 2023-09-19 湖南省人民医院 Meniscus stitching instrument
CN115869029B (en) * 2023-02-08 2024-04-26 南京栖霞科技产业发展有限公司 Meniscus stitching instrument

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JP2005058431A (en) * 2003-08-11 2005-03-10 Olympus Corp Puncturing needle
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JP2013070862A (en) * 2011-09-28 2013-04-22 Nihon Covidien Kk Medical suturing tool
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CN204379333U (en) * 2014-12-04 2015-06-10 中南大学湘雅医院 A kind of meniscus injury surgical stapler with spine
CN206080590U (en) * 2016-06-28 2017-04-12 倪博文 Ware is sewed up to meniscus for arthroscopic surgery
CN206714790U (en) * 2016-12-30 2017-12-08 罗鸿 A kind of orthopaedics perforating device
CN208851546U (en) * 2017-12-13 2019-05-14 罗鸿 A kind of meniscus stitching unstrument

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