CN109674516B - Puncture core subassembly and have its puncture ware - Google Patents

Puncture core subassembly and have its puncture ware Download PDF

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Publication number
CN109674516B
CN109674516B CN201710976286.0A CN201710976286A CN109674516B CN 109674516 B CN109674516 B CN 109674516B CN 201710976286 A CN201710976286 A CN 201710976286A CN 109674516 B CN109674516 B CN 109674516B
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puncture
rod
suture
assembly
core assembly
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CN109674516A (en
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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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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06061—Holders for needles or sutures, e.g. racks, stands
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3474—Insufflating 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 puncture core assembly, which comprises a puncture assembly, a suture assembly and an adjusting unit, wherein the puncture assembly comprises a puncture core and a suture core; the puncture assembly comprises a puncture end and a puncture rod; the suturing assembly is positioned within the puncture rod and at least a portion of the suturing assembly is movable within the puncture rod; an accommodating space is formed between the puncture end and the puncture rod, and the height of the accommodating space is controlled by the adjusting unit; one end of a suture is passed through the tissue in the receiving space by movement of the suturing assembly. According to the puncture core assembly and the puncture outfit with the same, puncture holes do not need to be enlarged, a puncture function can be realized to establish a channel, suture of the puncture holes can be realized in narrow puncture holes, and the suture height can be adjusted according to individual difference of target tissues; effectively avoid because of the puncture hole hernia that the minimal access surgery puncture hole caused, do benefit to patient's postoperative rehabilitation.

Description

Puncture core subassembly and have its puncture ware
Technical Field
The invention relates to a surgical instrument, in particular to a puncture core assembly and a puncture outfit with the same, and belongs to the field of medical equipment.
Background
In abdominal cavity examination, abdominal cavity operation and other minimally invasive or surgical operations, a puncture outfit is an indispensable surgical instrument. The puncture instrument may establish an access channel in the abdominal wall of the body for the entry of a stapler or other surgical instrument (e.g., endoscope, scissors, guide wire, catheter, filter, stent, etc.) into the abdominal cavity and provide a passage for the ingress and egress of gas to control the pneumoperitoneum required for the procedure to be performed for examination or surgical procedures.
In the minimally invasive laparoscopic medical operation, if the focus is found in a human body and needs to be operated or cut, pneumoperitoneum needs to be performed in the abdominal cavity of the human body in the operation process. The establishment of pneumoperitoneum is an important operation process of laparoscopic surgery, and under the condition of sufficient pneumoperitoneum, the distance between an abdominal cavity and an organ is expanded, the distance between the organ and the organ is also expanded, and a relatively wide visual field and an operation environment which is easy to operate are provided for an operator. After the pneumoperitoneum is completed, a doctor generally firstly cuts a small incision on the abdomen of a patient, then aligns the puncture end of the puncture outfit with the cut small incision to reciprocate and simultaneously moves the puncture outfit downwards, so that the puncture core assembly guides the puncture sleeve to pass through the cortex of the abdomen of the patient; then the puncture core component is pulled out, and the anastomat or other surgical instruments can enter and exit the abdominal cavity of the patient through the puncture cannula to carry out surgical operation. The existing puncture core assembly only plays a role of puncture, and the puncture cannula is discarded after being guided into a patient body from an incision of the abdomen of the human body.
And (4) removing the focus, taking out the puncture cannula assembly, and finishing the operation. The punctured wound is generally not sutured and is automatically healed only by the patient; because the puncture hole of the minimally invasive surgery is small and deep, particularly, the abdominal wall of an obese patient is thick, the visual field of the suture is small, the skin on the surface of the patient is only sutured after the surgery, and the peritoneum on the inner side of the abdominal wall is difficult to suture. Such patients are prone to serious complications such as hernia in the puncture hole after surgery, and require further treatment. The existing puncture outfit only has a puncture function, a channel for the instrument to enter and exit is established on the abdominal wall of a human body, and the puncture hole cannot be sutured; and the puncture outfit with suture function, the structure is complicated, the operation is inconvenient, and the size of sewing up the space is the fixed value, can't adjust the size of sewing up the space according to individual difference, is unfavorable for patient's postoperative rehabilitation.
Disclosure of Invention
Aiming at the defects of the prior art, the invention aims to provide a puncture core assembly with a puncture function and capable of suturing a puncture hole and a puncture outfit with the same, and the invention is realized by the following technical scheme:
a puncture core assembly comprises a puncture assembly, a suture assembly and an adjusting unit; the puncture assembly comprises a puncture end and a puncture rod; the suturing assembly is positioned within the puncture rod and at least a portion of the suturing assembly is movable within the puncture rod; an accommodating space is formed between the puncture end and the puncture rod, and the height of the accommodating space is controlled by the adjusting unit; one end of a suture is passed through the tissue in the receiving space by movement of the suturing assembly.
Preferably, the adjusting unit includes a first locking member and a second locking member, the first locking member being movable relative to the second locking member, the first locking member and the second locking member cooperating with each other to control the height of the accommodating space.
Preferably, the first locking member includes a locking portion and an adjusting portion, the locking portion and the adjusting portion are integrally formed, and the width of the locking portion is larger than that of the adjusting portion; the second locking member includes a plurality of rectangular teeth and rectangular grooves arranged alternately.
Preferably, the height of the locking portion is equal to the height of the adjusting portion.
Preferably, the height of the rectangular tooth and the rectangular groove are equal.
Preferably, the adjustment portion is movable along the second locking member, and the locking portion is restrained within the rectangular groove.
Preferably, the first locking member comprises an adjusting rod, a plurality of blades are formed at one end of the adjusting rod in an axially extending manner, and the blades are uniformly distributed along the circumferential direction of the one end of the adjusting rod.
Preferably, the outer surface of the blade is provided with a protrusion.
Preferably, the suturing assembly comprises a first element and a second element, the first element and the second element are detachably connected, and the connected first element and the second element move to enable one end of the suture to penetrate through tissues in the accommodating space.
Preferably, the first element has a pointed end which is passable through and exposable from the second element.
Preferably, said one end of said suture is tied to said second member.
Preferably, the second element comprises a through passage for receiving at least a portion of the first element such that the first element is releasably connectable with the second element.
Preferably, said at least a portion of said first element includes a tip which passes through said passage and emerges therefrom.
Preferably, the suturing assembly further comprises a first inner rod, the first member is connected to the first inner rod, and the first inner rod is movable within the puncture rod to move the first member.
Preferably, the adjusting unit further comprises a connecting rod, one end of the connecting rod is connected with the puncture end, the cross-sectional area of the connecting rod is smaller than that of the puncture end and the puncture rod, the connecting rod can move in the puncture rod, and at least one part of the connecting rod extends out of the puncture rod to form the accommodating space together with the puncture end and the puncture rod.
Preferably, the adjusting unit further includes a second inner rod body connected to or integrally formed with the other end of the connecting rod.
Preferably, the proximal end of the second inner rod body is provided with an adjusting rod channel.
Preferably, after the one end of the suture thread passes through the tissue in the accommodating space, the adjusting unit can drive the one end of the suture thread to move continuously.
Preferably, the adjusting assembly includes a first stroke and a second stroke, the first stroke is a stroke for adjusting the height of the accommodating space, and the second stroke is a stroke for driving the one end of the suture thread to move continuously by the adjusting assembly after the one end of the suture thread passes through the tissue in the accommodating space.
Preferably, the second locking member has at least two designations: the first mark represents a stroke for adjusting the height of the accommodating space, and the second mark represents a stroke for driving the one end of the suture line to move continuously.
Preferably, the piercing end is provided with a receiving groove, and the receiving groove is matched with the second element.
The invention also comprises a puncture outfit which comprises any puncture core assembly and a puncture cannula assembly, wherein the puncture core assembly can extend into the puncture cannula assembly.
According to the puncture core assembly and the puncture outfit with the same, the puncture hole can be sutured in a narrow puncture hole, the height of a suturing space can be adjusted according to the individual difference of target tissues, so that the target tissues can be sutured effectively, and the puncture hole hernia caused by the puncture hole of a minimally invasive surgery can be avoided.
Drawings
FIG. 1 is a schematic structural view of a piercing core assembly according to an embodiment of the present invention;
FIG. 2 is a cross-sectional view of a piercing core assembly according to an embodiment of the present invention;
FIG. 3 is a partially exploded schematic view of a piercing core assembly according to an embodiment of the present invention;
figure 4 is a schematic structural view of a first inner rod according to an embodiment of the present invention;
fig. 5 is a schematic structural view of a second inner rod according to an embodiment of the invention;
FIG. 6 is a schematic view of a needle configuration of a core piercing assembly according to an embodiment of the present invention;
FIG. 7 is a schematic view of a suture fixation block configuration of a core piercing assembly in accordance with an embodiment of the present invention;
FIG. 8 is a schematic structural view of a handle according to an embodiment of the present invention;
fig. 9 is a partial enlarged view at a in fig. 8;
FIG. 10 is a schematic structural view of a first locking member according to an embodiment of the present invention;
FIG. 11 is a schematic view of a first locking member engaged with a second locking member according to an embodiment of the present invention;
FIG. 12 is a schematic structural view of an initial state of the piercing core assembly according to an embodiment of the present invention;
FIG. 13 is a schematic structural view of the puncture core assembly after forming a suture space in accordance with an embodiment of the present invention;
FIG. 14 is a schematic representation of the configuration of the puncture core assembly upon suturing in accordance with an embodiment of the present invention;
FIG. 15 is a schematic view of a first locking member engaged with a second locking member according to another embodiment of the present invention;
FIG. 16 is a schematic view of a target tissue after being sutured, according to an embodiment of the invention;
fig. 17 is a schematic structural view of a puncture instrument according to an embodiment of the present invention.
Detailed Description
Reference will now be made in detail to embodiments of the present invention, examples of which are illustrated in the accompanying drawings. In the description of the present invention, it is to be understood that the terms "central," "longitudinal," "lateral," "length," "width," "thickness," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," "clockwise," "counterclockwise," "axial," "radial," "circumferential," and the like are used in the orientations and positional relationships indicated in the drawings for convenience in describing the invention and to simplify the description, and are not intended to indicate or imply that the referenced devices or elements must have a particular orientation, be constructed and operated in a particular orientation, and are therefore not to be considered limiting of the invention.
Furthermore, the terms "first", "second" and "first" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include at least one such feature. In the description of the present invention, "a plurality" means at least two, e.g., two, three, etc., unless specifically limited otherwise.
The embodiments described below with reference to the drawings are illustrative and intended to be illustrative of the invention and are not to be construed as limiting the invention. As shown in fig. 1, the puncture core assembly 200 of the embodiment of the present invention includes a puncture assembly, a suture assembly, and an adjusting unit. The puncture assembly comprises a puncture end 1 and a puncture rod 2. The puncture core assembly 200 is an adjusting unit, a suture assembly and a puncture rod 2 in sequence from inside to outside. The suturing member is located within the puncture rod 2, which means that the suturing member and the puncture rod are not located in the same position, and not all components of the suturing member are located within the puncture rod 2. For convenience of description and simplicity of description, in embodiments of the present invention, the end closer to the clinician is designated as "proximal" or "above", and the end further from the clinician, i.e., the end closer to the patient, is designated as "distal" or "below". Based on the orientation or position relationship shown in fig. 1, the end close to the handle 6 is regarded as the "proximal end" or "upper", and the end close to the puncture end 1 is regarded as the "distal end" or "lower"; the axial direction of the puncture core assembly 200 is referred to as the "height" direction, and the radial direction of the puncture core assembly 200 is referred to as the "width" direction; considering the direction toward the central axis of the handle 6 as "inside" and the direction away from the central axis of the handle 6 as "outside", as shown in FIG. 1, the plunger assembly 200 includes a plunger assembly, a piercing end 1 disposed at the distal end of the plunger assembly, and a handle 6 disposed at the proximal end of the plunger assembly. In the initial state, the puncture core assembly 200 is inserted into the cannula assembly 300.
Fig. 2-3 depict the composition and assembly of the core rod assembly. The core bar assembly comprises a puncture rod 2, a first inner rod 3 and a second inner rod assembly 4. The second inner rod assembly 4 is at least partially located within the first inner rod 3, the first inner rod 3 being located within the puncture rod 2; and the central axis of the puncture rod 2 coincides with the central axis of the first inner rod 3. The main body part of the puncture rod 2 is a hollow round tube, the hollow round tube forms a channel for the first inner rod 3 to move, the first inner rod 3 can move up and down in the puncture rod 2, and when the first inner rod 3 moves downwards, the first inner rod 3 can extend out of the puncture rod 2 from the far end of the channel. The distal end of the puncture rod 2 is symmetrically provided with a U-shaped groove 22, the lower end of the U-shaped groove 22 extends to the lower end of the puncture rod 2, and the length of the U-shaped groove 22 is equal to or slightly greater than that of the suture needle 7. The proximal end of the puncture rod 2 is fixedly connected with a handle 6. The central axis of the first inner lever 3 and the central axis of the handle 6 coincide with the central axis of the puncture rod 2.
Referring to fig. 4, the proximal end of the first inner rod 3 is provided with a suture key 31 for controlling the movement of the first inner rod 3. The interior of the first inner rod 3 forms a cavity 32, the second inner rod body 40 is located within the cavity 32 of the first inner rod 3, and the second inner rod body 40 is movable up and down within the cavity 32. The distal end symmetry of first interior pole 3 is equipped with the first installation department 33 of mutually supporting with suture needle 7, stretch into puncture rod 2's distal end with first interior pole 3 after, adjust first interior pole 3 make its first installation department 33 of mutually supporting with suture needle 7 aim at puncture rod 2's U-shaped groove 22 to in follow U-shaped groove 22 with suture needle 7 with the first installation department 33 interference fit or the transition fit of first interior pole 3 distal end, suture needle 7 is taken in U-shaped groove 22 with first interior pole 3 fixed connection back. The distal end of the third spring 47 abuts on the distal end 23 of the puncture rod 2, and the proximal end thereof abuts on the distal end of the first inner rod 3. As shown in fig. 3, the second inner rod assembly 4 includes a second inner rod body 40 and a connecting rod 45, the distal end of the second inner rod body 40 is integrally formed or fixedly connected with the proximal end of the connecting rod 45, and the distal end of the connecting rod 45 is fixedly connected with the proximal end of the puncture tip 1. Still be equipped with evagination step portion 46 on the connecting rod 45, the diameter of step portion 46 is greater than the diameter of connecting rod 45 except that step portion 46, and the internal perisporium of puncture rod 2 distal end is equipped with stopper 23, and connecting rod 45 can follow the inner chamber up-and-down motion of stopper 23, and when connecting rod 45 moved step portion 46 and stopper 23 butt, because of the internal diameter of stopper 23 is less than the diameter of step portion 46, stopper 23 prevents step portion 46 from continuing the downstream. The connection rod 45 between the puncture tip 1 and the stepped portion 46 is a cylindrical body or a rectangular parallelepiped, and when the connection rod is a cylindrical body, the diameter thereof is smaller than the diameter of the puncture rod 2, and the cross-sectional area thereof is smaller than the cross-sectional area of the puncture rod 2, so that a space is formed between the puncture tip 1 and the puncture rod 2. When the puncture rod is a cuboid, the width and the length of the puncture rod are both smaller than the diameter of the puncture rod 2; on the premise of satisfying the required strength, the smaller the cross-sectional area of the connecting rod 45 between the puncture tip 1 and the stepped portion 46, the better, and thus, the larger the space formed between the proximal end of the puncture tip 1 and the distal end of the puncture rod 2, and further, the central axis of the connecting rod 45 coincides with the central axis of the puncture rod 2. The distal end of the puncture tip 1 is movable relative to the puncture rod 2 a distance greater than or equal to the thickness of the patient's subcutaneous tissue. Preferably, the distal end of the connecting rod 45 is fixedly connected with the puncture tip 1. The puncture end 1 is generally conical, and generally conical means that the puncture end 1 is conical or similar to a cone, namely, a generatrix of the puncture end 1 can be a straight line, and also can be an outward convex curve or an inward concave curve. The puncture rod 2 is a hollow circular tube with the same diameter from the proximal end to the distal end, and the maximum diameter of the puncture tip 1 is approximately equal to the diameter of the puncture rod 2.
As shown in fig. 3 or 5, the proximal end of the second inner rod body 40 is provided with an adjusting rod channel 41, one end of the adjusting rod channel 41 is engaged with the baffle 48, and a through hole for the first locking member 5 to move is provided inside the adjusting rod channel 41 and extends from one end of the adjusting rod channel 41 to one side of the baffle 48. The near end of the second inner rod 4 is provided with a boss 42, and the boss 42 is positioned below the adjusting rod channel 41; one end of the second spring 43 abuts against the boss 42, and the other end abuts against the bottom of the handle 6. The second inner rod body 40 further comprises a limiting column 44, which is used for matching with the limiting groove 21 of the puncture rod 2, and the diameter of the limiting column 44 is slightly smaller than the width of the limiting groove 21, so that the limiting column 44 can only move up and down in the limiting groove 21 and cannot rotate circumferentially, and the second inner rod assembly 4 can only move up and down in the puncture rod 2; the stroke of the up-and-down movement of the limit post 44 and thus the stroke of the movement of the second inner rod assembly 4 in the puncture rod 2 is limited by the length of the limit groove 21.
The suturing assembly is positioned within the puncture rod 2 and at least a portion of the suturing assembly is movable within the puncture rod 2; the suture assembly comprises a suture needle 7 and a suture line fixing block 8, the suture needle 7 and the suture line fixing block 8 are detachably connected, and one end of a suture line 9 penetrates through tissues in the accommodating space through the connected suture needle 7 and the suture line fixing block 8 through movement.
As shown in FIG. 6, the suture needle 7 includes a second mounting portion 71 and a needle tip 72. The suture needles 7 are fixedly connected with the first mounting part 33 of the first inner rod 3 through interference fit or transition fit of the second mounting part 71, and the distance between the two suture needles 7 is equal to or slightly smaller than the diameter of the puncture rod 2. Referring to fig. 7, the suture fixing block 8 includes a suture needle passage 82 disposed to penetrate up and down for being connected with the suture needle 7, the needle point 72 passes through the needle point suture needle passage 82 and is exposed from the needle point suture needle passage 82, and the needle point 72 is connected with the suture needle passage 82 in a clearance fit manner; the side wall of the suture fixing block 8 is provided with a winding groove 81, the tail 91 of the suture 9 is wound on the winding groove 81 and forms a knot at the winding groove 81, two tail 91 of the suture 9 are respectively matched with one suture fixing block 8, and the proximal end 92 of the suture 9 is hung on the limiting column 44 of the second inner rod 4 along the outer wall of the puncture rod 2; if the excessive suture thread 9 exists, the suture thread can be tensioned to form a slip knot at the position so as to prevent the suture thread 9 from scattering between the puncture rod 2 and the inner rod 5, and referring to fig. 3 or fig. 5 again, the puncture end 1 is provided with a containing groove 11 for matching with the suture thread fixing block 8; the suture line fixing block 8 is in interference fit with the accommodating groove 11; the mounting groove of storage tank 11 for with 8 profile modeling adaptations of stylolite fixed block, like this, after stylolite fixed block 8 got into storage tank 11, stylolite fixed block 8's surface and storage tank 11 laminated completely, and it is more firm to connect. Further, the size of the outer periphery of the puncture end 1 close to the accommodating groove 11 is the smallest, so that the risk that the suture fixing block 8 is radially dropped from the inside of the accommodating groove 11 after being installed in the accommodating groove 11 is avoided.
The tail 91 of the suture 9 is wound on the winding groove 81 and forms a knot at the position of the wire groove 81, after two tail 91 of the suture 9 are respectively matched with one suture fixing block 8, the suture fixing block 8 is arranged on the needle point 72 of the suture needle 7, the needle point 72 is exposed out of the suture fixing block 8, the suture needle 7 and the suture fixing block 8 are arranged in the U-shaped groove 22, and the length of the U-shaped groove 22 is equal to or slightly greater than that of the suture needle 7; and the outer surfaces of the suture needles 7 and the suture line fixing blocks 8 do not exceed the outer surface of the puncture rod 2, so that the suture needles 7 are far away from the puncture hole during suture, and the distance between the two suture needles 7 is equal to or slightly smaller than the diameter of the puncture rod 2, thereby ensuring that the maximum suture range is provided on the premise of not enlarging the puncture hole.
Referring to fig. 8 to 9, fig. 8 is a schematic structural view of the handle 6 according to an embodiment of the present invention. The handle 6 is a ring-shaped wall on the side, and the inside of the handle comprises a stitching key channel 62 to provide a moving channel of the stitching key 31; the annular wall of the handle is provided with notches in a penetrating manner, the notches are symmetrically arranged along the central axis of the handle 6, and second locking members 61 matched with the first locking members 5 are formed. FIG. 9 is an enlarged view of a portion A of FIG. 8. the second locking member 61 includes a plurality of rectangular teeth 612. each rectangular tooth 612 has a height H2The distance between two adjacent rectangular teeth 612 on the same side is H2A rectangular groove 611 is formed between two adjacent rectangular teeth 612 on the same side, that is, the height of the rectangular groove 611 is also H2. RectangleThe tooth 612 and the opposite side rectangular tooth 612 ', the rectangular groove 611 and the opposite side rectangular groove 611' together form a second locking member 61 for the passage or locking of the first locking member 5.
The adjustment unit comprises a first locking member 5 and a second locking member 6, the first locking member 5 being movable relative to the second locking member 6; the adjusting unit further comprises a connecting rod 45, one end of the connecting rod 45 is connected with the puncture end 1, the cross-sectional area of the connecting rod 45 is smaller than that of the puncture end 1, the connecting rod 45 can move in the puncture rod 2, and at least one part of the connecting rod 45 extends out of the puncture rod 2 to form the accommodating space together with the puncture end 1 and the puncture rod 2. The adjusting unit further comprises a second inner rod body 40, and the second inner rod body 40 is connected with or integrally formed with the other end of the connecting rod 45.
Fig. 10 is a schematic structural view of the first locking member 5 according to an embodiment of the present invention. The first locking member 5 comprises an adjustment button 56 and an adjustment lever 53, which are substantially perpendicular to each other. A plurality of blades 54 are uniformly distributed at one end of the adjusting rod 53 in the circumferential direction, the blades 54 are formed by extending along the outer wall of the adjusting rod 53 in the axial direction, and the end parts of the blades 54 are provided with protrusions 541; preferably, the first locking member 5 is integrally formed. The first spring 55 is fitted over the outer wall of the adjustment lever passage 41, and has one end abutting against the adjustment button 56 of the first lock member 5 and the other end abutting against the stopper 48. The adjusting rod 53 of the first locking member 5 extends into the through hole from one end of the adjusting rod channel 41 until the protrusion 541 of the blade 54 thereof extends out of the baffle plate 48; the leaves 54 are released from the barrier 48 and deployed, and the projection 541 catches against the other face of the barrier 48 to prevent the first locking member 5 from disengaging from the second inner stem assembly 4, allowing the first locking member 5 to move relative to the second inner stem assembly 4. The adjusting lever 53 further includes a locking portion 51 and an adjusting portion 52 extending in a radial direction thereof; preferably, the locking portion 51 and the adjusting portion 52 are equal in height, denoted as H1，H1Is less than H2. The width of the locking part 51 is W1The distance between two rectangular grooves 611 of the same height on opposite sides is D1Width W of regulating part 522Is equal to or less than the distance D between two rectangular teeth 612 of the same height on opposite sides2And D is1＞D2. Width W of the locking portion 511Is equal to D1Or the width W of the lock portion 511Is less than D1And is greater than D2I.e. D1＞W1＞D2。
During operation, after pneumoperitoneum is finished, a doctor firstly cuts a small incision on the abdomen of a patient, and then the puncture end 1 of the puncture outfit 1000 is aligned with the cut small incision to rotate left and right in a reciprocating manner and simultaneously moves the puncture outfit 1000 downwards until the cannula assembly 300 passes through the cortex of the abdomen of the patient; following withdrawal of the puncture core assembly 200, a stapler or other surgical instrument may be advanced into and out of the patient's abdominal cavity through the puncture cannula assembly 300 for a surgical procedure. In the initial state, the first locking member 5 is located at the proximal end of the second locking member 61, and further, the locking parts 51 are located in two opposite rectangular grooves 611 at the same height as the second locking member 61; the near end of the puncture end 1 is abutted against the far end of the puncture rod 2, so that no gap exists between the puncture end 1 and the puncture rod 2, and the tissue of a patient cannot be clamped during puncture. The skin of a human body is sequentially provided with a epidermis layer, a dermis layer and a subcutaneous tissue from outside to inside, and the occurrence of puncture hole hernia can be effectively prevented as long as the subcutaneous tissue at the puncture hole of a patient is sutured. Because the subcutaneous tissue of the patient is sutured, the puncture hole is not opened, and the epidermal layer and the dermal layer are easy to automatically heal.
After the intra-abdominal procedure is completed, the puncture core assembly 200 according to the embodiment of the present invention is inserted into the patient from the cannula assembly 300. Referring to fig. 12, in the initial state, the locking portion 51 is located in two opposing rectangular grooves 611 at the same height as the second locking member 61, and the locking portion 51 cannot move up and down due to the restriction of the upper and lower rectangular teeth 612, and the first locking member 5 and the second locking member 61 are relatively stationary. The handle 6 is held and moved downward while being reciprocated left and right, so that the distal end of the puncture rod 2 is projected from the distal end of the cannula assembly 300. After the puncture tip 1 reaches a proper position, because one end of the second spring 55 abuts against the locking part 51 and the other end abuts against the baffle 48, when the adjusting key 56 is pressed inward, the adjusting key 56 and the adjusting rod 53 move along the adjusting rod channel 41 towards the baffle 48, the second spring 55 is stressed and compressed, so that the locking part 51 is separated from the two rectangular grooves 611 at the opposite sides and at the same heightThereafter, the adjustment portion 52 slides into the second locking member 61 because the width of the adjustment portion 52 is smaller than the minimum distance D of the second locking member 612The regulating portion 52 is reciprocable between the proximal and distal ends of the second locking member 61. As shown in FIG. 11, when the height of the suturing space is required to be adjusted, the height of the suturing space can be increased by pressing the adjusting button 56 inward and then sliding the adjusting button 56 downward, and the height of the suturing space can be decreased by pressing the adjusting button 56 inward and then sliding the adjusting button 56 upward. When the required suturing space is reached, as shown in fig. 13, the adjusting button 56 is released, the second spring 55 is released, the elastic restoring force thereof drives the locking part 51 to move outwards, the adjusting part 52 is disengaged from the second locking member 61, and after the position of the adjusting button 56 is finely adjusted up and down, the locking part 51 moves into two rectangular grooves 611 at the opposite sides and at the same height, thereby driving the first locking member 5 to move outwards; at this time, the end projection 541 of the vane 54 catches the shutter 48 to prevent the first locking member 5 from being disengaged from the second inner bar 4; the first locking member 5 is locked relatively to fix the desired suture space height, and since the cross-sectional area of the connecting rod 45 is smaller than that of the puncture rod 2, a space is formed between the connecting rod 45, the proximal end of the puncture tip 1 and the distal end of the puncture rod 2. Handle 6 is grasped to move puncture core assembly 200 upward until the proximal grasping surface of puncture tip 1 contacts the subcutaneous tissue layer of the patient. Due to the elasticity of human tissue, the tissue at the puncture hole of the patient can fill the suture space, namely, the tissue at the puncture hole of the patient wraps the connecting rod 45 and fills the space between the near end of the puncture end 1 and the far end of the puncture rod 2. When the maximum suture height is reached, the first locking member 5 slides to the distal end of the second locking member 61, and simultaneously the connecting rod 45 moves to the step portion 46 to abut against the stopper 23, and the stopper 23 prevents the step portion 46 from moving further downward because the inner diameter of the stopper 23 is smaller than the diameter of the step portion 46.
Next, as shown in fig. 3 and 14, the suture button 31 is pressed downward, the suture button 31 sequentially pushes the first inner rod 3, the suture needles 7 and the suture fixing block 8 to move downward, and the needle tips 72 of the two suture needles 7 respectively guide the suture fixing block 8 and further drive the two end tails 91 of the suture thread 9 to move downward.
FIG. 16 illustrates a process by which target tissue is sutured, in accordance with an embodiment of the present invention. Only the subcutaneous tissue F layer at the lowest layer of the puncture hole of the patient is sewed, so that the hernia of the puncture hole can be effectively prevented; preferably, the epidermal layer E or the dermal layer of the puncture hole of the patient is tied off, so that the thread knot is positioned in the puncture hole and is not exposed out of the skin of the patient, the thread knot is prevented from being touched after the operation, the puncture hole is not opened because the subcutaneous tissue of the patient is sutured, and the epidermal layer or the dermal layer is easy to automatically heal. Preferably, the suture 9 is a human absorbable suture. The knot formed at the stop post 44 by the proximal end 92 of the suture 9 is undone and the proximal end 92 of the suture 9 is free. The needle points 72 of the two suture needles 7 respectively guide the suture line fixing block 8, further drive the two end line tails 91 of the suture line 9 to gradually contact and pierce through the patient tissue in the space formed by the puncture end 1 and the puncture rod 2 from A, B two points of the subcutaneous tissue F, guide the suture line fixing block 8 to be installed in the accommodating groove 11 on the puncture end 1, and respectively lead the two end line tails 91 of the suture line 9 to pierce through the subcutaneous tissue F from D, C two points. Since the tail 91 of the suture 9 is previously knotted at the winding groove 81, the suture fixing block 8 introduces the tail 91 of the suture 9 under the subcutaneous tissue of the patient.
The outer surface of the second locking member 61 is provided with a mark, and as shown in fig. 15, the vertical height of the second locking member 61 from the point N is the maximum value of the thickness of the subcutaneous tissue F, and the vertical height of the second locking member 61 from the point M is the average value of the thickness of the subcutaneous tissue F. The stroke smaller than the mark shown by the point N, that is, the stroke of the adjusting button 56 moving from the initial position to the point N, is used for adjusting the height of the accommodating space. A stroke greater than the indication indicated by point N, i.e., a stroke of the adjustment button 56 from point N to the distal end of the second locking member 61, serves to increase the travel distance of the suture 9, facilitating the pulling out of the suture; for target tissues smaller than the maximum value of the thickness of the subcutaneous tissue F, the stroke from point M to point N also serves to increase the travel distance of the suture thread 9, further facilitating the pulling out of the suture thread. Specifically, after the two end tails 91 of the suture thread 9 penetrate the subcutaneous tissue F from D, C at two points, respectively, the adjustment key 56 is pressed inward again and then the adjustment key 56 is slid downward, because the suture thread fixing block 8 has been inserted into the accommodating groove 11 of the puncture tip 1, and the tails 91 are wound on the winding grooves 81 of the suture thread fixing block 8 and form knots at the winding grooves 81, the tails 91 of the suture thread 9 are further moved into the abdominal cavity by a stroke through the adjustment unit; then, the adjusting button 56 is released, the second spring 55 is released, the elastic restoring force drives the locking part 51 to move outwards, the adjusting part 52 is disengaged from the second locking member 61, after the position of the upper and lower fine adjustment adjusting button 56 is adjusted, the locking part 51 moves into the two rectangular grooves 611 at the opposite sides and at the same height, the first locking member 5 is locked relatively, so that the string tail 91 continues to move towards the abdominal cavity for a stroke, the stroke is larger than the thickness of the subcutaneous tissue F, the thickness of the subcutaneous tissue F even including the dermis and epidermis can be compensated, and the stroke of the continuous movement enables the string tail 91 to be pulled out of the subcutaneous tissue F even being pulled out of the abdominal cavity wall when being turned to move upwards, and simultaneously, the distal end of the suture line 9 gradually enters the body of the patient. When the suture fixing block 8 is fixed in the accommodating groove 11 on the puncture end 1 (i.e. indicating that the suture needle 7 has completely punctured the subcutaneous tissue of the patient), the suture key 31 is released, because the distal end of the third spring 47 abuts against the distal end of the puncture rod 2, the proximal end of the third spring 47 abuts against the distal end of the first inner rod 3, the third spring 47 is released and extends, the elastic tension of the third spring 47 pushes the first inner rod 3 to move upwards, the first inner rod 3 drives the suture needle 7 to move upwards, and because the clamping surface of the proximal end of the puncture end 1 is positioned below the subcutaneous tissue of the patient, the tissue of the patient prevents the clamping surface of the proximal end of the puncture end 1 from moving upwards, and further prevents the puncture end 1 from moving upwards; because the suture line fixing block 8 is in interference fit with the accommodating groove 11 of the puncture end 1, the suture line fixing block 8 is difficult to separate from the accommodating groove 11 after the suture line fixing block is matched with the accommodating groove 11, and the suture needle 7 is in clearance fit with the suture line fixing block 8; therefore, after the suture key 31 is released, the first inner rod 3 drives the suture needle 7 to gradually separate from the suture line fixing block 8, the suture needle 7 is retracted into the U-shaped groove 22 at the proximal end of the puncture rod 2, and the suture line fixing block 8 is located in the accommodating groove 11 at the puncture end 1.
Handle 6 is held and puncture core subassembly 200 upward movement, puncture rod 2, connecting rod 45, puncture end 1 breaks away from the internal of patient, suture line fixed block 8 and puncture end 1's storage tank 11 fixed connection, puncture end 1 breaks away from the internal of patient with suture line fixed block 8 together, because of suture line 9's line tail 91 is connected with suture line fixed block 8, suture line 9's line tail 91 is located the below of patient's subcutaneous tissue, in puncture end 1 leaves the internal in-process of patient, two line tails 91 of suture line 9 upwards remove from puncture hole, drive suture line 9's near-end 92 and get into the internal and subcutaneous tissue F contact of patient gradually, thereby be convenient for pull out the abdominal cavity with line tail 91 through puncture end 1. After the puncture tip 1 is separated from the body of the patient, the two tail ends 91 of the suture thread 9 are tightened and knotted, and then the redundant suture thread 9 is removed, thereby completing the suture of the puncture hole. The occurrence of puncture hernia can be effectively prevented only by suturing the subcutaneous tissue at the puncture hole of the patient; preferably, the patient is tied to the epidermis layer or dermis layer so that the knot is located within the puncture hole and does not leak out of the patient's skin to prevent post-operative contact with the knot, and the puncture hole does not open because the patient's subcutaneous tissue has been sutured, thereby facilitating automatic healing of the epidermis layer or dermis layer. Preferably, the suture 9 is a human absorbable suture.
Based on the puncture core assembly 200 as described above, the present invention further provides a puncture device 1000, referring to fig. 17, the puncture device 1000 further comprises a cannula assembly 300, during puncturing, the puncture core assembly 200 is inserted into the puncture cannula assembly 300, and the cannula assembly 300 is guided into the abdominal cavity of the patient, so that other surgical instruments can enter the body of the patient for performing a surgical operation, and after the cutting and suturing operation is completed, the puncture device 1000 of the present invention can also suture the puncture hole.
In conclusion, according to the puncture core assembly and the puncture outfit with the same, the puncture hole does not need to be enlarged, and additional surgical instruments do not need to be added, so that the puncture function can be realized to establish a channel for an anastomat or other surgical instruments to enter a patient body; the suture of the puncture hole can be realized in the narrow puncture hole, the suture height can be adjusted according to the individual difference of the target tissue, and the suture effect is good; the puncture core assembly and the puncture outfit with the puncture core assembly can effectively avoid puncture hole hernia caused by a puncture hole of a minimally invasive surgery, and the puncture core assembly and the puncture outfit with the puncture core assembly can form a suture space between a puncture end and a puncture rod during puncture, can not scratch a wound of a patient during puncture, effectively reduce pain of the patient and are beneficial to postoperative rehabilitation of the patient.
In the present invention, unless otherwise expressly stated or limited, the terms "mounted," "connected," "secured," and the like are to be construed broadly and can, for example, be fixedly connected, detachably connected, or integrally formed; may be mechanically coupled, may be electrically coupled or may be in communication with each other; they may be directly connected or indirectly connected through intervening media, or they may be connected internally or in any other suitable relationship, unless expressly stated otherwise. The specific meanings of the above terms in the present invention can be understood by those skilled in the art according to specific situations.
In the present invention, unless otherwise expressly stated or limited, the first feature "on" or "under" the second feature may be directly contacting the first and second features or indirectly contacting the first and second features through an intermediate. Also, a first feature "on," "over," and "above" a second feature may be directly or diagonally above the second feature, or may simply indicate that the first feature is at a higher level than the second feature. A first feature being "under," "below," and "beneath" a second feature may be directly under or obliquely under the first feature, or may simply mean that the first feature is at a lesser elevation than the second feature.
In the description herein, references to the description of the term "one embodiment," "some embodiments," "an example," "a specific example," or "some examples," etc., mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above are not necessarily intended to refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, various embodiments or examples and features of different embodiments or examples described in this specification can be combined and combined by one skilled in the art without contradiction.
Although embodiments of the present invention have been shown and described above, it is understood that the above embodiments are exemplary and should not be construed as limiting the present invention, and that variations, modifications, substitutions and alterations can be made to the above embodiments by those of ordinary skill in the art within the scope of the present invention.

Claims (20)

1. A puncture core assembly comprises a puncture assembly, a suture assembly and an adjusting unit; it is characterized in that the preparation method is characterized in that,
the puncture assembly comprises a puncture end and a puncture rod; the suturing assembly is positioned within the puncture rod and at least a portion of the suturing assembly is movable within the puncture rod; an accommodating space is formed between the puncture end and the puncture rod, and the height of the accommodating space is controlled by the adjusting unit; passing one end of a suture through the tissue in the receiving space by movement of the suturing assembly; the adjusting unit comprises a first locking member and a second locking member, the first locking member can move relative to the second locking member, and the first locking member and the second locking member are matched with each other to control the height of the accommodating space; the first locking member comprises a locking part and an adjusting part, the locking part and the adjusting part are integrally formed, and the width of the locking part is larger than that of the adjusting part; the second locking member includes a plurality of rectangular teeth and rectangular grooves arranged alternately.
2. The puncture core assembly of claim 1, wherein the locking portion has a height equal to the height of the adjustment portion.
3. The puncture core assembly of claim 1, wherein the rectangular teeth and the rectangular slots are equal in height.
4. The puncture core assembly of claim 1, wherein the adjustment portion is movable along the second locking member, the locking portion being captivated within the rectangular slot.
5. The puncture core assembly of claim 1, wherein the first locking member comprises an adjustment rod having a plurality of vanes extending axially at one end of the adjustment rod, the vanes being evenly circumferentially distributed along the one end of the adjustment rod.
6. The puncture core assembly of claim 5, wherein the outer surface of said blade is provided with a protrusion.
7. The puncture core assembly of claim 1, wherein the suture assembly comprises a first element and a second element, the first element and the second element being releasably connectable, the first element and the second element being movable to pass an end of the suture through tissue in the receiving space after connection.
8. The puncture core assembly of claim 7, wherein the first element has a pointed end that is passable through and exposable from the second element.
9. The puncture core assembly of claim 8, wherein said one end of said suture is tied to said second member.
10. The puncture core assembly of claim 7, wherein the second component comprises a passageway therethrough for receiving at least a portion of the first component such that the first component is releasably connectable with the second component.
11. The puncture core assembly of claim 10, wherein said at least a portion of said first element comprises a tip that passes through and emerges from said channel.
12. The puncture core assembly of claim 7, wherein the suturing assembly further comprises a first inner rod, the first member being coupled to the first inner rod, the first inner rod being movable within the puncture rod to move the first member.
13. The puncture core assembly according to claim 1, wherein the adjustment unit further comprises a connecting rod, one end of the connecting rod is connected with the puncture end, and the cross-sectional area of the connecting rod is smaller than the cross-sectional areas of the puncture end and the puncture rod, the connecting rod can move in the puncture rod and at least a part of the connecting rod extends out of the puncture rod to form the accommodating space together with the puncture end and the puncture rod.
14. The puncture core assembly of claim 13, wherein the adjustment unit further comprises a second inner rod body connected to or integrally formed with the other end of the connecting rod.
15. The puncture core assembly of claim 14, wherein the proximal end of the second inner rod body is provided with an adjustment rod channel.
16. The puncture core assembly of claim 1, wherein the adjustment unit is capable of moving the one end of the suture further after the one end of the suture passes through the tissue in the receiving space.
17. The puncture core assembly of claim 1, wherein the first locking member comprises a first stroke and a second stroke, the first stroke being a stroke for adjusting the height of the receiving space, the second stroke being a stroke for the first locking member to move the one end of the suture further after the one end of the suture passes through the tissue in the receiving space.
18. The puncture core assembly of claim 1, wherein the second locking member has at least two designations: the first mark represents a stroke for adjusting the height of the accommodating space, and the second mark represents a stroke for driving the one end of the suture line to move continuously.
19. The puncture core assembly according to claim 7, wherein the puncture tip is provided with a receiving groove, the receiving groove cooperating with the second member.
20. A puncture instrument comprising the puncture core assembly according to any one of claims 1 to 19, wherein the puncture instrument further comprises a puncture cannula assembly into which the puncture core assembly is extendable.
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