CN109674516A - A kind of puncture core assembly and the puncture outfit with it - Google Patents

A kind of puncture core assembly and the puncture outfit with it Download PDF

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Publication number
CN109674516A
CN109674516A CN201710976286.0A CN201710976286A CN109674516A CN 109674516 A CN109674516 A CN 109674516A CN 201710976286 A CN201710976286 A CN 201710976286A CN 109674516 A CN109674516 A CN 109674516A
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CN
China
Prior art keywords
core assembly
suture
puncture
assembly according
puncturing
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Granted
Application number
CN201710976286.0A
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Chinese (zh)
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CN109674516B (en
Inventor
孙宝峰
马猛
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Jiangsu Fengh Medical Equipment Co Ltd
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Jiangsu Fengh Medical Equipment Co Ltd
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Priority to CN201710976286.0A priority Critical patent/CN109674516B/en
Publication of CN109674516A publication Critical patent/CN109674516A/en
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Publication of CN109674516B publication Critical patent/CN109674516B/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive 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
    • A61B17/0469Suturing 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
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • 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
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06061Holders for needles or sutures, e.g. racks, stands
    • 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
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062Needle manipulators
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3474Insufflating needles, e.g. Veress needles

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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)
  • Pathology (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention discloses a kind of puncture core assemblies, including piercing assembly, suturing assembly and adjusting unit;The piercing assembly includes cutting tip and puncturing lever;The suturing assembly is located in the puncturing lever, and at least part of the suturing assembly can move in the puncturing lever;Accommodating space, the height for adjusting unit and controlling the accommodating space are formed between the cutting tip and the puncturing lever;By the movement of the suturing assembly, one end of suture is passed through into the tissue in the accommodating space.Puncture core assembly according to the present invention and the puncture outfit with it, it does not need to expand puncturing hole, had been able to achieve the effect of puncture not only to establish channel, but also can realize the suture of puncturing hole in narrow puncturing hole, and suture height can be adjusted according to the individual difference of destination organization;Puncturing hole hernia caused by effectively avoiding because of Minimally Invasive Surgery puncturing hole, conducive to the postoperative rehabilitation of patient.

Description

A kind of puncture core assembly and the puncture outfit with it
Technical field
The present invention relates to a kind of surgical instruments to belong in particular to a kind of puncture core assembly and with its puncture outfit In area of medical devices.
Background technique
Check, in abdominal operation and other minimally invasive or surgical operations that puncture outfit is essential surgical instrument in abdominal cavity. Puncture outfit can be established in the stomach wall of human body enters channel, so that for stapler or other surgical instruments, (such as endoscope is cut Knife, seal wire, conduit, filter, bracket etc.) enter it is intraperitoneal, and provide gas disengaging channel, with control operation needed for gas Abdomen, to carry out inspection or surgical procedure.
In the operation of minimally invasive laparoscopic medical, find that lesion needs to perform the operation or cut off such as in body, then surgical procedure In need to be to carrying out pneumoperitoneum in human abdominal cavity.The important operation process that pneumoperitoneum is laparoscopic surgery is established, in the situation of pneumoperitoneum abundance Under, the distance between abdominal cavity and internal organs have not only been strutted, the distance between internal organs and internal organs have also been strutted, is provided relatively for patient The broad visual field and easily operated surgical environments.After completing pneumoperitoneum, doctor is general first to scratch one small cut in patient abdomen Mouthful, then by small notch that the alignment of the cutting tip of puncture outfit is scratched or so reciprocating rotation while move down puncture outfit, make to puncture Core assembly guiding puncture casing passes through patient abdomen cortex;Then it extracts and punctures core assembly, stapler or other surgical instruments are Abdominal cavity of patients can be passed in and out by puncture cannula to be operated.The existing effect for puncturing core assembly and only serving puncture, is drawing It leads after the puncture cannula enters patient's body from the notch of human abdomen, that is, is dropped.
After lesion is removed, puncture cannula component is taken out, operation terminates.The wound of puncture does not suture generally, only by suffering from Person heals automatically;Because the puncturing hole of Minimally Invasive Surgery is small and deep, the stomach wall of especially obese patient is thicker, and the visual field of suture is small, only After surgery by the skin closure of patient surface, it is difficult to by the peritoneal stitches on the inside of stomach wall.Patient is easy to produce wears after surgery in this way The serious complication such as acanthopore hernia needs further to treat.Existing puncture outfit generally only has the function of to puncture, in the abdomen of human body Wall establishes the channel of instrument disengaging, can not suture to puncturing hole;And there is the puncture outfit of suture function, structure is complicated, behaviour It is inconvenient to make, and the size of Oversewing space is fixed value, and the size of Oversewing space can not be adjusted according to individual difference, be unfavorable for The postoperative rehabilitation of patient.
Summary of the invention
In view of the deficiencies of the prior art, the present invention is intended to provide a kind of not only have the function of to puncture, but also puncturing hole can be sutured Core assembly and the puncture outfit with it are punctured, the invention is realized by the following technical scheme:
A kind of puncture core assembly, including piercing assembly, suturing assembly and adjusting unit;The piercing assembly includes cutting tip And puncturing lever;The suturing assembly is located in the puncturing lever, and at least part of the suturing assembly can be in the puncture It is moved in bar;Accommodating space is formed between the cutting tip and the puncturing lever, the adjusting unit controls the accommodating space Height;By the movement of the suturing assembly, one end of suture is passed through into the tissue in the accommodating space.
Preferably, the adjusting unit includes the first blocking element and the second blocking element, and first blocking element can Mobile relative to second blocking element, first blocking element and second blocking element cooperate to control State the height of accommodating space.
Preferably, first blocking element includes locking part and adjustment portion, and the locking part and the adjustment portion are integrated Molding, the width of the locking part are greater than the width of the adjustment portion;Second blocking element includes that several are arranged alternately Rectangular teeth and rectangular channel.
Preferably, the height of the locking part is equal to the height of the adjustment portion.
Preferably, the height of the rectangular teeth and the rectangular channel is equal.
Preferably, the adjustment portion can be moved along second blocking element, and the locking part can be limited in the square In shape slot.
Preferably, first blocking element includes adjusting rod, if axially extending to be formed in one end of the adjusting rod Dry blade, the blade are circumferentially uniformly distributed along described one end of the adjusting rod.
Preferably, the outer surface of the blade is equipped with protrusion.
Preferably, the suturing assembly includes first element and second element, the first element and the second element Separatably it is connected, the first element after connection is worn one end of the suture by mobile with the second element Cross the tissue in the accommodating space.
Preferably, the first element has tip, and the tip may pass through the second element and from described second yuan Part exposes.
Preferably, one end system of the suture connects in the second element.
Preferably, the second element includes the channel of perforation, and the channel is for accommodating the first element at least A part, so that the first element is separatably connected with the second element.
Preferably, described at least part of the first element includes tip, the tip pass through the channel and from Expose in channel.
Preferably, the suturing assembly further comprises the first interior bar, and the first element is connect with first interior bar, First interior bar can move in the puncturing lever, to drive the first element mobile.
Preferably, the adjusting unit further comprises connecting rod, and one end of the connecting rod is connect with the cutting tip, And the cross-sectional area of the connecting rod is less than the cross-sectional area of the cutting tip and the puncturing lever, and the connecting rod can be Movement and its at least part stretching puncturing lever in the puncturing lever, with common with the cutting tip, the puncturing lever Form the accommodating space.
Preferably, the adjusting unit further comprises bar body in second, bar body and the connection in described second The other end of bar is connected or is integrally formed.
Preferably, the proximal end of bar body is equipped with adjusting rod channel in described second.
Preferably, after the tissue that described one end of the suture passes through in the accommodating space, the adjusting unit The described one end for being able to drive the suture continues to move to.
Preferably, the adjusting component includes first stroke and second stroke, and the first stroke is to adjust the accommodating The stroke of the height in space, the second stroke are to pass through the tissue in the accommodating space in described one end of the suture Afterwards, the stroke for adjusting component and described one end of the suture being driven to continue to move to.
Preferably, second blocking element has at least two marks: first identifier indicates to adjust the accommodating space Height stroke, second identifier indicates the stroke for driving described one end of the suture to continue to move to.
Preferably, the cutting tip is provided with accommodation groove, and the accommodation groove and the second element cooperate.
The invention also includes a kind of puncture outfit, the puncture outfit includes any of the above-described kind of puncture core assembly, further includes puncturing Sheath assembly, the puncture core assembly can protrude into the puncture cannula component.
Puncture core assembly according to the present invention and the puncture outfit with it, can realize puncturing hole in narrow puncturing hole Suture, and can adjust the height of Oversewing space according to the individual difference of destination organization, effectively to suture destination organization, avoid Because of puncturing hole hernia caused by Minimally Invasive Surgery puncturing hole, and of the invention puncture core assembly and can be when puncturing with its puncture outfit Gapless between cutting tip and puncturing lever, forms Oversewing space after piercing, the wound of patient will not be scratched when puncturing, effectively Patient suffering is reduced, conducive to the postoperative rehabilitation of patient.
Detailed description of the invention
Fig. 1 is the structural schematic diagram according to an embodiment of the present invention for puncturing core assembly;
Fig. 2 is the cross-sectional view according to an embodiment of the present invention for puncturing core assembly;
Fig. 3 is the partially exploded diagram according to an embodiment of the present invention for puncturing core assembly;
Fig. 4 is the structural schematic diagram of the first interior bar according to an embodiment of the present invention;
Fig. 5 is the structural schematic diagram of the second interior bar according to an embodiment of the present invention;
Fig. 6 is the suture needle structural schematic diagram according to an embodiment of the present invention for puncturing core assembly;
Fig. 7 is the suture fixed-block-architecture (FBA) schematic diagram according to an embodiment of the present invention for puncturing core assembly;
Fig. 8 is the structural schematic diagram of handle according to an embodiment of the present invention;
Fig. 9 is the partial enlarged view at the A in Fig. 8;
Figure 10 is the structural schematic diagram of the first blocking element according to an embodiment of the present invention;
Figure 11 is the schematic diagram of the first blocking element and the second blocking element cooperation according to an embodiment of the present invention;
Figure 12 is the structural schematic diagram according to an embodiment of the present invention for puncturing core assembly original state;
Figure 13 is that puncture core assembly according to an embodiment of the present invention forms the structural schematic diagram after Oversewing space;
Structural schematic diagram when Figure 14 is the suture according to an embodiment of the present invention for puncturing core assembly;
Figure 15 is the schematic diagram of the first blocking element and the second blocking element cooperation in accordance with another embodiment of the present invention;
Figure 16 is the structural schematic diagram after destination organization according to an embodiment of the present invention is sewn;
Figure 17 is the structural schematic diagram of puncture outfit according to an embodiment of the present invention.
Specific embodiment
The embodiment of the present invention is described below in detail, examples of the embodiments are shown in the accompanying drawings.It is retouched in of the invention In stating, it is to be understood that term " center ", " longitudinal direction ", " transverse direction ", " length ", " width ", " thickness ", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom" "inner", "outside", " clockwise ", " counterclockwise ", " axis To ", " radial direction ", the orientation or positional relationship of the instructions such as " circumferential direction " be to be based on the orientation or positional relationship shown in the drawings, be only for Convenient for the description present invention and simplify description, rather than the device or element of indication or suggestion meaning there must be specific side Position is constructed and operated in a specific orientation, therefore is not considered as limiting the invention.
In addition, term " first ", " second " are used for descriptive purposes only and cannot be understood as indicating or suggesting relative importance Or implicitly indicate the quantity of indicated technical characteristic.Define " first " as a result, the feature of " second " can be expressed or Implicitly include at least one this feature.In the description of the present invention, the meaning of " plurality " is at least two, such as two, three It is a etc., unless otherwise specifically defined.
The embodiments described below with reference to the accompanying drawings are exemplary, it is intended to be used to explain the present invention, and cannot understand For limitation of the present invention.As shown in Figure 1, the puncture core assembly 200 of the embodiment of the present invention include piercing assembly, suturing assembly and Adjust unit.Piercing assembly includes cutting tip 1 and puncturing lever 2.It punctures core assembly 200 from the inside to the outside, is followed successively by and adjusts unit, seam Seaming element and puncturing lever 2.Suturing assembly is located in puncturing lever 2, refers to the positional relationship of the two, not all groups of suturing assembly At being partially respectively positioned in puncturing lever 2.For the convenience of describing the present invention and simplifying the description, in embodiments of the present invention, it sets close One end of clinician is " proximal end " or " top ", and it is " remote that one end far from clinician, which is close to one end of patient body, End " or " lower section ".Based on attached orientation or positional relationship shown in FIG. 1, will be close to handle 6 one end be considered as " proximal end " or " on Side ", the one end that will be close to cutting tip 1 is considered as " distal end " or " lower section ";The axial direction for puncturing core assembly 200 is known as " height " The radial direction for puncturing core assembly 200 is known as " width " direction by direction;It is " interior by being considered as towards the direction of 6 central axis of handle Side ", the direction that will be far from 6 central axis of handle are considered as " outside ", as shown in Figure 1, puncture core assembly 200 include core bar component, The cutting tip 1 of the core bar component remote is set and the handle 6 of core bar component proximal end is set.In the initial state, Core assembly 200 is punctured to be inserted in sheath assembly 300.
Fig. 2 to Fig. 3 depicts the composition and assembly relation of core bar component.The core bar component includes in puncturing lever 2, first Bar assembly 4 in bar 3 and second.Bar assembly 4 is at least partially disposed in the first interior bar 3 in second, and the first interior bar 3 is located at puncturing lever 2 It is interior;And the central axis of puncturing lever 2 and the central axis of the first interior bar 3 are overlapped.The main part of puncturing lever 2 is hollow circular-tube, The hollow circular-tube forms the channel for the movement of the first interior bar 3, and the first interior bar 3 can move up and down in puncturing lever 2, and when first When interior bar 3 moves downward, puncturing lever 2 can be stretched out from the distal end in the channel.The distal end of puncturing lever 2 is symmetrically arranged with U-lag 22, the lower end of U-lag 22 extends to the lower end of puncturing lever 2, and the length of U-lag 22 is equal or slightly larger than the length of sewing needle 7.It wears The proximal end of thorn stick 2 is fixedly connected with handle 6.The center of the central axis of first interior bar 3, the central axis of handle 6 and puncturing lever 2 Axis is overlapped.
With reference to Fig. 4, the proximal end of the first interior bar 3 is equipped with suture key 31, for controlling the movement of the first interior bar 3.In first The inside of bar 3 forms chamber 32, and bar body 40 is located in the chamber 32 of the first interior bar 3 in second, and bar body 40 can be in chamber in second It moves up and down in 32.The distal end of first interior bar 3 be symmetrically arranged with mutually matched first mounting portion 33 of sewing needle 7, in first After bar 3 protrudes into the distal end of puncturing lever 2, the first interior bar 3 of adjustment is directed at it with mutually matched first mounting portion 33 of sewing needle 7 to wear The U-lag 22 of thorn stick 2, in order to match first mounting portion 33 interference of the sewing needle 7 from U-lag 22 with 3 distal end of the first interior bar It closes or transition fit is incorporated in U-lag 22 after sewing needle 7 is fixedly connected with the first interior bar 3.The distal end of third spring 47 It is abutted with the distal end 23 of puncturing lever 2, proximal end is abutted with the distal end of the first interior bar 3.As shown in figure 3, bar assembly 4 includes in second Bar body 40 and connecting rod 45 in second, the distal end of bar body 40 and the proximal end of connecting rod 45 are integrally formed or fixed connect in second It connects, the distal end of connecting rod 45 is fixedly connected with the proximal end of cutting tip 1.The stage portion 46 of evagination, step are additionally provided in connecting rod 45 The diameter in portion 46 is greater than diameter of the connecting rod 45 in addition to stage portion 46, and the internal perisporium of 2 distal end of puncturing lever is equipped with limited block 23, even Extension bar 45 can move up and down from the inner cavity of limited block 23, when connecting rod 45, which moves to stage portion 46, to abut with limited block 23, because The internal diameter of limited block 23 is less than the diameter of stage portion 46, and limited block 23 prevents stage portion 46 from continuing to move downward.Positioned at cutting tip 1 Connecting rod 45 between stage portion 46 is cylindrical body or cuboid, and when it is cylindrical body, diameter is less than the straight of puncturing lever 2 Diameter, cross-sectional area are less than the cross-sectional area of puncturing lever 2, to form space between cutting tip 1 and puncturing lever 2.When it is rectangular When body, width and length are respectively less than the diameter of puncturing lever 2;Under the premise of the intensity needed for meeting, it is located at cutting tip 1 and step The cross-sectional area of connecting rod 45 between portion 46 is the smaller the better, in this way, shape between the proximal end of cutting tip 1 and the distal end of puncturing lever 2 At space it is larger, further, the central axis of connecting rod 45 is overlapped with the central axis of puncturing lever 2.Cutting tip 1 can be opposite It is more than or equal to the thickness of patient's hypodermis in the distance of the distal movement of puncturing lever 2.Preferably, 45 distal end of connecting rod with Cutting tip 1 is fixedly connected.Cutting tip 1 substantially refers to cutting tip 1 in cone or similar circular cone substantially in cone in cone Shape, the i.e. bus of cutting tip 1 can be linear, can also be in convex outer curve or the curve in indent.Puncturing lever 2 is open circles Pipe, the diameter for proximally arriving distal end is all the same, and the maximum gauge of cutting tip 1 is substantially equal to the diameter of puncturing lever 2.
As shown in Fig. 3 or Fig. 5, in second the proximal end of bar body 40 be equipped with adjusting rod channel 41, the one of adjusting rod channel 41 End cooperates with baffle 48, is equipped with the through-hole for the operation of the first blocking element 5 inside adjusting rod channel 41, and the through-hole is from adjusting rod The one end in channel 41 extends to the side of baffle 48.The proximal end of second interior bar 4 is equipped with boss 42, and boss 42 is located at adjusting rod channel Under 41;One end of second spring 43 is abutted with boss 42, and the other end is abutted with the bottom of handle 6.Bar body 40 is gone back in second Including limited post 44, for the cooperation of limiting slot 21 with puncturing lever 2, the diameter of limited post 44 is slightly less than the width of limiting slot 21, Limited post 44 can only move up and down in limiting slot 21 and can not circumferentially rotate in this way, to guarantee that bar assembly 4 is only being worn in second It moves up and down in thorn stick 2;The stroke that limited post 44 moves up and down is defined by the flute length of limiting slot 21, and then defines second The stroke that interior bar assembly 4 moves in puncturing lever 2.
The suturing assembly is located in the puncturing lever 2, and at least part of the suturing assembly can be in the puncture It is moved in bar 2;The suturing assembly includes sewing needle 7 and suture fixed block 8, and sewing needle 7 and suture fixed block 8 can be detached from Ground is connected, and the sewing needle 7 and suture fixed block 8 after connection pass through the accommodating sky by mobile one end by suture 9 Interior tissue.
As shown in fig. 6, sewing needle 7 includes the second mounting portion 71 and needle point 72.Sewing needle 7 passes through the second mounting portion 71 and the First mounting portion 33 of one interior bar 3 is interference fitted or transition fit achieves a fixed connection, and the distance between two sewing needles 7 are equal to Or it is slightly less than the diameter of puncturing lever 2.With reference to Fig. 7, suture fixed block 8 includes the suture needle passageway 82 being arranged up and down, is used It is connect in sewing needle 7, needle point 72 passes through needle point suture needle passageway 82 and exposes from needle point suture needle passageway 82, needle point 72 and seam The connection type for closing needle passageway 82 is clearance fit;The side wall of suture fixed block 8 is equipped with winding slot 81, the line of suture 9 Tail 91 be wrapped on winding slot 81 and at winding slot 81 formed knot, two line tails 91 of suture 9 respectively with a suture Fixed block 8 cooperates, and the proximal end 92 of suture 9 is along the limited post 44 that the outer wall of puncturing lever 2 hangs over the second interior bar 4;If any extra Suture 9 can take up rear slip-knot formed here, to prevent suture 9 to be scattered between puncturing lever 2 and interior bar 5, Referring again to Fig. 3 or Fig. 5, accommodation groove 11 is provided on cutting tip 1, for cooperating with suture fixed block 8;Suture fixed block 8 with the fit system of accommodation groove 11 be interference fit;Accommodation groove 11 is the mounting groove being adapted to 8 profiling of suture fixed block, this Sample, after suture fixed block 8 enters accommodation groove 11, the outer surface of suture fixed block 8 is bonded completely with accommodation groove 11, connection It is stronger.Further, size of the accommodation groove 11 at 1 periphery of cutting tip is minimum, and this avoid work as suture fixed block 8 After being installed into accommodation groove 11, the risk that radially falls off out of accommodation groove 11.
The line tail 91 of suture 9 is wrapped on winding slot 81 and forms knot, two line tails of suture 9 at wire casing 81 After 91 respectively cooperate with a suture fixed block 8, suture fixed block 8 is mounted on the needle point 72 of sewing needle 7, and make needle point 72 expose from suture fixed block 8, and sewing needle 7 and suture fixed block 8 are set in U-lag 22, and the length of U-lag 22 is equal to Or the length slightly larger than sewing needle 7;And the outer surface of sewing needle 7 and suture fixed block 8 is without departing from the outer surface of puncturing lever 2, In this way sewing needle 7 in suture apart from puncturing hole farther out, the distance between two sewing needles 7 are equal to or slightly less than puncturing lever 2 Diameter provides maximum suture size to guarantee under the premise of not expanding puncturing hole.
It is the structural schematic diagram of the handle 6 of one embodiment of the invention with reference to Fig. 8 to Fig. 9, Fig. 8.The side of handle 6 is ring Shape wall, internal includes suture key channel 62, to provide the moving conduit of suture key 31;Perforation, which is equipped with, in its annular wall lacks Mouthful, the notch is symmetrical arranged along the central axis of handle 6, is formed and the mutually matched second locking structure of the first blocking element 5 Part 61.Fig. 9 is the partial enlarged view at the A in Fig. 8, and the second blocking element 61 includes several rectangular teeths 612, each rectangular teeth 612 height is H2, the distance between two neighboring rectangular teeth 612 in the same side is H2, the two neighboring rectangular teeth 612 in the same side it Between formed rectangular channel 611, that is to say, that the height of rectangular channel 611 is also H2.The rectangular teeth 612 ' of rectangular teeth 612 and opposite side, The second blocking element 61 is collectively formed in rectangular channel 611 and the rectangular channel 611 ' of opposite side, passes through or locks for the first blocking element 5 Only.
The adjusting unit includes the first blocking element 5 and the second blocking element 6, and the first blocking element 5 can be relative to the Two blocking elements 6 are mobile;The adjusting unit further comprises connecting rod 45, and one end of connecting rod 45 is connect with cutting tip 1, and And the cross-sectional area of connecting rod 45 be less than cutting tip 1 cross-sectional area, connecting rod 45 can be moved in puncturing lever 2 and its extremely Few a part stretches out puncturing lever 2, the accommodating space is collectively formed with cutting tip 1, puncturing lever 2.The adjusting unit also wraps Bar body 40 in second are included, bar body 40 is connected or is integrally formed with the other end of connecting rod 45 in second.
Figure 10 is the structural schematic diagram of the first blocking element 5 of one embodiment of the invention.First blocking element 5 includes adjusting Key 56 and adjusting rod 53 are saved, the two is generally perpendicular to each other.One end of adjusting rod 53 is circumferentially uniformly distributed several blades 54, leaf For piece 54 along the axially extending formation of outer wall of adjusting rod 53, the end of blade 54 is equipped with protrusion 541;Preferably, the first blocking element 5 It is integrally formed.First 55 sets of spring is on the outer wall in adjusting rod channel 41, the regulating key 56 of one end and the first blocking element 5 It abuts, the other end is abutted with baffle 48.It is straight that the adjusting rod 53 of first blocking element 5 from the one end in adjusting rod channel 41 protrudes into through-hole It is stretched out to the protrusion 541 of its blade 54 from baffle 48;Blade 54 is released after the stretching of baffle 48 and is unfolded, and protrusion 541 is blocked The firmly another side of baffle 48 realizes that the first blocking element 5 can phase to prevent bar assembly 4 in the first blocking element 5 from second to be detached from Bar assembly 4 in second is moved.Adjusting rod 53 further comprises the locking part 51 and adjustment portion 52 radially extended;It is preferred that Ground, locking part 51 is equal with the height of adjustment portion 52 to be denoted as H1, H1Less than H2.The width of locking part 51 is W1, opposite side, same The distance between two rectangular channels 611 of one height are D1, the width W of adjustment portion 522Equal to or less than opposite side, same The distance between two rectangular teeths 612 of height D2, and D1> D2.The width W of locking part 511Equal to D1Or locking part 51 Width W1Less than D1, and it is greater than D2, i.e. D1> W1> D2
When operation, after completing pneumoperitoneum, doctor first scratches a small notch in patient abdomen, then by puncture outfit of the present invention 1000 cutting tip 1 moves down puncture outfit 1000 while being directed at the small notch scratched or so reciprocating rotation, until casing group Part 300 passes through patient abdomen cortex;Then it extracts and punctures core assembly 200, stapler or other surgical instruments can pass through puncture Sheath assembly 300 passes in and out abdominal cavity of patients and is operated.When original state, the first blocking element 5 is located at the second blocking element 61 proximal end, further, locking part 51 are located in two 61 sustained height of the second blocking element, opposite rectangular channels 611; The proximal end of cutting tip 1 is abutted with the distal end of puncturing lever 2, gapless between such cutting tip 1 and puncturing lever 2, and when puncture will not press from both sides To the tissue of patient.The skin ecto-entad of human body is followed successively by epidermis, skin corium, subcutaneous tissue, as long as by patient's puncturing hole The subcutaneous tissue at place sutures, and can effectively prevent the generation of puncturing hole hernia.Because the subcutaneous tissue of patient has sutured, puncturing hole is just not It can open, be easy to epidermis and skin corium heals automatically.
After intraperitoneal operation, the puncture core assembly 200 of the embodiment of the present invention is inserted into patient from sheath assembly 300 In vivo.With reference to Figure 12, when original state, locking part 51 is located at 61 sustained height of the second blocking element, opposite two rectangles It in slot 611, is limited by upper and lower rectangular teeth 612, locking part 51 can not move up and down, the first blocking element 5 and the second locking structure Part 61 is opposing stationary.It is moved down while holding 6 or so reciprocating rotation of handle, makes the distal end of puncturing lever 2 from sheath assembly 300 Distal end stretch out.After cutting tip 1 reaches suitable position, because 55 one end of second spring and locking part 51 against and the other end and gear Plate 48 is against when pressing inward against regulating key 56, regulating key 56, adjusting rod 53 are transported along adjusting rod channel 41 to 48 direction of baffle Dynamic, 55 stress of second spring is compressed, after being detached from locking part 51 out of two rectangular channels 611 of opposite side, sustained height, Adjustment portion 52 slide into the second blocking element 61 in, because adjustment portion 52 width less than the second blocking element 61 minimum spacing D2, Adjustment portion 52 can move back and forth between 61 proximal end of the second blocking element and distal end.As shown in figure 11, when needs adjust suture When the height in space, pressing inward against slide downward regulating key 56 after regulating key 56 can be increased the height of Oversewing space, to Slidable adjustment key 56 can reduce the height of Oversewing space upwards after interior pressing regulating key 56.As shown in figure 13, when reaching When required Oversewing space, regulating key 56 is unclamped, second spring 55 is released, and elastic restoring force drives locking part 51 outside Movement, adjustment portion 52 are detached from the second blocking element 61, and above and below behind the position of fine tuning regulating key 56, locking part 51 moves to phase In opposite side, sustained height two rectangular channels 611, so that the first blocking element 5 be driven to move out;At this point, blade 54 End bosses 541 block baffle 48, to prevent the first blocking element 5 to be detached from from the second interior bar 4;The opposite lock of first blocking element 5 Only, so that required Oversewing space height be fixed, because the cross-sectional area of connecting rod 45 is less than the cross-sectional area of puncturing lever 2, even Space is formed between the distal end of extension bar 45, the proximal end of cutting tip 1 and puncturing lever 2.Core assembly 200 will be punctured upwards by holding handle 6 It is mobile, until the clamping face of 1 proximal end of cutting tip and the subcutaneous tissue lower layer contacts of patient.Due to the elasticity of tissue, patient Tissue at puncturing hole can be full of the Oversewing space, i.e. tissue encapsulation at patient's puncturing hole lives connecting rod 45, fills up puncture Space between the proximal end at end 1 and the distal end of puncturing lever 2.When reaching maximum suture height, the first blocking element 5 slides into the The distal end of two blocking elements 61, while connecting rod 45 moves to stage portion 46 and abuts with limited block 23, because of the internal diameter of limited block 23 Less than the diameter of stage portion 46, limited block 23 prevents stage portion 46 from continuing to move downward.
Then, as shown in Fig. 3, Figure 14, downwards by suture key 31, suture key 31 successively pushes the first interior bar 3, suture Needle 7 and suture fixed block 8 move downward, and two respective needle points 72 of sewing needle 7 guide suture fixed block 8, in turn respectively Two end line tails 91 of suture 9 are driven to move downward.
Figure 16 illustrates the process that the destination organization of the embodiment of the present invention is sewn.As long as by most lower at patient's puncturing hole F layers of subcutaneous tissue suture of layer, can effectively prevent the generation of puncturing hole hernia;Preferably, in the epidermis E of patient's puncturing hole or Skin corium knots, in this way, knot is located in puncturing hole, not from the exposing of the skin of patient, with prevent it is postoperative encounter knot, because of patient Subcutaneous tissue sutured, puncturing hole just will not open, and be easy to epidermis or skin corium heals automatically.Preferably, suture 9 For the absorbable suture of human body.Unlock the slip-knot that the proximal end 92 of suture 9 is formed at limited post 44, the proximal end of suture 9 92 be in free state.Two respective needle points 72 of sewing needle 7 guide suture fixed block 8 respectively and then drive the two of suture 9 End line tail 91 is respectively out of, A, B two o'clock of subcutaneous tissue F comes into contact with and pierce that cutting tip 1 and puncturing lever 2 are formed space Patient tissue, and in the accommodation groove 11 for guiding suture fixed block 8 to be installed on cutting tip 1, two end line tails 91 of suture 9 divide Subcutaneous tissue F is not penetrated from D, C two o'clock.Because the line tail 91 of suture 9 forms knot at winding slot 81 in advance, suture is fixed Block 8 introduces the line tail 91 of suture 9 below the subcutaneous tissue of patient.
The outer surface of second blocking element 61 is equipped with mark, and as shown in figure 15, the second blocking element 61 arrives the vertical height of N point Degree is the maximum value of the thickness of subcutaneous tissue F, and the vertical height of the second blocking element 61 to M point is the thickness of subcutaneous tissue F Average value.Less than the stroke of mark shown in N point, i.e. regulating key 56 moves to the stroke of N point for adjusting institute from initial position State the height of accommodating space.Greater than the stroke of mark shown in N point, i.e. regulating key 56 moves to the second blocking element 61 from N point The stroke of distal end is used to increase the travel distance of suture 9, convenient for pulling out suture;For being less than the thickness of subcutaneous tissue F Maximum value destination organization, the stroke of M point to N point is also used for increasing the travel distance of suture 9, further convenient for will suture Line pulls out.Specifically, it after two end line tails 91 of suture 9 penetrate subcutaneous tissue F from D, C two o'clock respectively, presses inward against again Slide downward regulating key 56 after regulating key 56, because suture fixed block 8 has been inserted into the accommodation groove 11 of cutting tip 1, And line tail 91 is wrapped on the winding slot 81 of suture fixed block 8 and forms knot at winding slot 81, and then single by adjusting Member continues the line tail 91 of suture 9 to intraperitoneal movement a trip;Then, regulating key 56 is unclamped, second spring 55 obtains To release, elastic restoring force drives locking part 51 to move out, and adjustment portion 52 is detached from the second blocking element 61, upper and lower to finely tune Behind the position of regulating key 56, locking part 51 is moved in opposite side, sustained height two rectangular channels 611, the first locking Component 5 is with respect to locking, to continuing line tail 91 to intraperitoneal movement a trip, the distance of the stroke is greater than subcutaneous tissue The thickness of F, can compensate for subcutaneous tissue F even include skin corium and epidermis thickness, continue movement stroke make line tail 91 It is being diverted and while moving upwards can be drawn out from subcutaneous tissue F and even be drawn out out of abdominal wall, while making suture 9 Distal end progresses into patient's body.(show to stitch when in the accommodation groove 11 that suture fixed block 8 has been fixed on cutting tip 1 Close the subcutaneous tissue that needle 7 has pierced patient completely), suture key 31 is unclamped, because the distal end of third spring 47 is remote with puncturing lever 2 End abuts, and proximal end is abutted with the distal end of the first interior bar 3, and third spring 47 is released and extends, the elasticity of third spring 47 Tension pushes the first interior bar 3 to move upwards, and the first interior bar 3 drives sewing needle 7 to move upwards, due to the clamping of 1 proximal end of cutting tip Face is located at below the subcutaneous tissue of patient, and the tissue of patient prevents the clamping face of 1 proximal end of cutting tip from moving up, and then prevents to wear Barbed end 1 moves up;Because the fit system of suture fixed block 8 and the accommodation groove 11 of cutting tip 1 is interference fit, stitched after cooperation Zygonema fixed block 8 is difficult to separate with accommodation groove 11, and sewing needle 7 and 8 clearance fit of suture fixed block;It is pressed so unclamping suture After key 31, the first interior bar 3 drives sewing needle 7 gradually to separate with suture fixed block 8, and sewing needle 7 is retracted to the proximal end of puncturing lever 2 U-lag 22 in, suture fixed block 8 is located in the accommodation groove 11 of cutting tip 1.
It holds handle 6 and is moved up core assembly 200 is punctured, puncturing lever 2, connecting rod 45, cutting tip 1 are detached from the body of patient Interior, suture fixed block 8 is fixedly connected with the accommodation groove 11 of cutting tip 1, and cutting tip 1 is detached from trouble with suture fixed block 8 together Person's is internal, and because the line tail 91 of suture 9 is connect with suture fixed block 8, the line tail 91 of suture 9 is located at patient's hypodermis Lower section, during cutting tip 1 leaves patient's body, two line tails 91 of suture 9 move up from puncturing hole, band The proximal end 92 of dynamic suture 9 progresses into patient's body and contacts with subcutaneous tissue F, consequently facilitating passing through cutting tip 1 for line tail 91 Pull out abdominal cavity.Cutting tip 1 be detached from patient it is internal after, tense suture 9 two line tails 91 and knot after, remove extra seam Zygonema 9 completes the suture of puncturing hole.As long as can effectively prevent puncturing because suturing the subcutaneous tissue at patient's puncturing hole The generation of hole hernia;Preferably, it knots in the epidermis of patient or skin corium, in this way, knot is located in puncturing hole, does not leak out patient Skin, with prevent it is postoperative encounter knot, because the subcutaneous tissue of patient has sutured, puncturing hole just will not open, and be easy to epidermis Or skin corium heals automatically.Preferably, suture 9 is the absorbable suture of human body.
Core assembly 200 is punctured based on as described above, the present invention also provides a kind of puncture outfits 1000 to puncture with reference to Figure 17 Device 1000 further includes sheath assembly 300, when puncture, punctures core assembly 200 and is inserted into puncture cannula component 300, and guiding sleeve Component 300 enters in abdominal cavity of patients, is operated so that other surgical operating instruments enter patient's body, sutures in cutting After operation, puncture outfit 1000 of the invention can also suture puncturing hole.
In conclusion puncture core assembly according to the present invention and the puncture outfit with it, do not need to expand puncturing hole, not yet It needs to increase additional surgical instrument, has both been able to achieve the effect of puncture to establish channel, for stapler or other surgical operation devices Tool enters patient's body;The suture of puncturing hole can be realized in narrow puncturing hole again, and can be according to the individual difference of destination organization It is different, suture height is adjusted, sewing effect is good;Puncturing hole hernia caused by capable of effectively avoiding because of Minimally Invasive Surgery puncturing hole, and the present invention Puncture core assembly and with its puncture outfit can puncture when cutting tip and puncturing lever between gapless, after piercing formed seam Space is closed, the wound of patient will not be scratched when puncturing, patient suffering is effectively reduced, conducive to the postoperative rehabilitation of patient.
In the present invention unless specifically defined or limited otherwise, term " installation ", " connected ", " connection ", " fixation " etc. Term shall be understood in a broad sense, for example, it may be being fixedly connected, may be a detachable connection, or integral;It can be mechanical connect It connects, is also possible to be electrically connected or can communicate each other;It can be directly connected, can also indirectly connected through an intermediary, it can be with It is the interaction relationship of the connection or two elements inside two elements, unless otherwise restricted clearly.For this field For those of ordinary skill, the specific meanings of the above terms in the present invention can be understood according to specific conditions.
In the present invention unless specifically defined or limited otherwise, fisrt feature in the second feature " on " or " down " can be with It is that the first and second features directly contact or the first and second features pass through intermediary mediate contact.Moreover, fisrt feature exists Second feature " on ", " top " and " above " but fisrt feature be directly above or diagonally above the second feature, or be merely representative of First feature horizontal height is higher than second feature.Fisrt feature can be under the second feature " below ", " below " and " below " One feature is directly under or diagonally below the second feature, or is merely representative of first feature horizontal height less than second feature.
In the description of this specification, reference term " one embodiment ", " some embodiments ", " example ", " specifically show The description of example " or " some examples " etc. means specific features, structure, material or spy described in conjunction with this embodiment or example Point is included at least one embodiment or example of the invention.In the present specification, schematic expression of the above terms are not It must be directed to identical embodiment or example.Moreover, particular features, structures, materials, or characteristics described can be in office It can be combined in any suitable manner in one or more embodiment or examples.In addition, without conflicting with each other, the skill of this field Art personnel can tie the feature of different embodiments or examples described in this specification and different embodiments or examples It closes and combines.
Although the embodiments of the present invention has been shown and described above, it is to be understood that above-described embodiment is example Property, it is not considered as limiting the invention, those skilled in the art within the scope of the invention can be to above-mentioned Embodiment is changed, modifies, replacement and variant.

Claims (22)

1. a kind of puncture core assembly, including piercing assembly, suturing assembly and adjusting unit;It is characterized in that,
The piercing assembly includes cutting tip and puncturing lever;The suturing assembly is located in the puncturing lever, and the suture group At least part of part can move in the puncturing lever;Accommodating space, institute are formed between the cutting tip and the puncturing lever It states and adjusts the height that unit controls the accommodating space;By the movement of the suturing assembly, one end of suture is passed through into institute State the tissue in accommodating space.
2. puncture core assembly according to claim 1, which is characterized in that the adjusting unit include the first blocking element and Second blocking element, first blocking element can be mobile relative to second blocking element, first blocking element with Second blocking element cooperates to control the height of the accommodating space.
3. puncture core assembly according to claim 2, which is characterized in that first blocking element includes locking part and adjusts Section portion, the locking part and the adjustment portion are integrally formed, and the width of the locking part is greater than the width of the adjustment portion;It is described Second blocking element includes the rectangular teeth and rectangular channel that several are arranged alternately.
4. puncture core assembly according to claim 3, which is characterized in that the height of the locking part is equal to the adjustment portion Height.
5. puncture core assembly according to claim 3, which is characterized in that the height phase of the rectangular teeth and the rectangular channel Deng.
6. puncture core assembly according to claim 3, which is characterized in that the adjustment portion can be along second blocking element Mobile, the locking part can be limited in the rectangular channel.
7. puncture core assembly according to claim 2, which is characterized in that first blocking element includes adjusting rod, One end of the adjusting rod axially extends to form several blades, and the blade is circumferentially equal along described one end of the adjusting rod Even distribution.
8. puncture core assembly according to claim 7, which is characterized in that the outer surface of the blade is equipped with protrusion.
9. puncture core assembly according to claim 1, which is characterized in that the suturing assembly includes first element and second Element, the first element are separatably connected with the second element, the first element after connection and described second Element passes through the tissue in the accommodating space by mobile one end by the suture.
10. puncture core assembly according to claim 9, which is characterized in that the first element has tip, the tip It may pass through the second element and expose from the second element.
11. puncture core assembly according to claim 10, which is characterized in that one end system of the suture connects in institute It states in second element.
12. puncture core assembly according to claim 9, which is characterized in that the second element includes the channel of perforation, institute Channel is stated for accommodating at least part of the first element, so that the first element and the second element are separatably It is connected.
13. puncture core assembly according to claim 12, which is characterized in that described at least part of the first element Including tip, the tip passes through the channel and exposes from channel.
14. puncture core assembly according to claim 9, which is characterized in that the suturing assembly further comprises in first Bar, the first element are connect with first interior bar, and first interior bar can move in the puncturing lever, described in driving First element is mobile.
15. puncture core assembly according to claim 1, which is characterized in that the adjusting unit further comprises connecting rod, One end of the connecting rod is connect with the cutting tip, and the cross-sectional area of the connecting rod is less than the cutting tip and described The cross-sectional area of puncturing lever, the connecting rod can move in the puncturing lever and its at least part stretches out the puncture Bar, the accommodating space is collectively formed with the cutting tip, the puncturing lever.
16. puncture core assembly according to claim 15, which is characterized in that the adjusting unit further comprises in second Bar body, bar body is connected or is integrally formed with the other end of the connecting rod in described second.
17. puncture core assembly according to claim 16, which is characterized in that the proximal end of bar body, which is equipped with, in described second adjusts Pole channel.
18. puncture core assembly according to claim 1, which is characterized in that pass through institute in described one end of the suture After stating the tissue in accommodating space, described one end that the adjusting unit is able to drive the suture is continued to move to.
19. puncture core assembly according to claim 1, which is characterized in that the adjusting component includes first stroke and Two strokes, the first stroke are the stroke for adjusting the height of the accommodating space, and the second stroke is in the suture Described one end pass through the accommodating space in tissue after, the adjusting component drive described one end of the suture to continue Mobile stroke.
20. puncture core assembly according to claim 2, which is characterized in that second blocking element has at least two Mark: first identifier indicates to adjust the stroke of the height of the accommodating space, the institute of the second identifier expression drive suture State the stroke that one end continues to move to.
21. puncture core assembly according to claim 9, which is characterized in that the cutting tip is provided with accommodation groove, the appearance It sets slot and the second element cooperates.
22. a kind of includes such as the described in any item puncture outfits for puncturing core assembly of power 1 to 21, which is characterized in that the puncture outfit It further include puncture cannula component, the puncture core assembly can protrude into the puncture cannula component.
CN201710976286.0A 2017-10-18 2017-10-18 Puncture core subassembly and have its puncture ware Active CN109674516B (en)

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CN109984810A (en) * 2017-12-29 2019-07-09 江苏风和医疗器材股份有限公司 A kind of puncture core assembly and the puncture outfit with it

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US4319576B1 (en) * 1980-02-26 1986-02-25
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Publication number Priority date Publication date Assignee Title
CN109984810A (en) * 2017-12-29 2019-07-09 江苏风和医疗器材股份有限公司 A kind of puncture core assembly and the puncture outfit with it
CN109984810B (en) * 2017-12-29 2020-08-25 江苏风和医疗器材股份有限公司 Puncture core subassembly and have its puncture ware

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