CN113520542A

CN113520542A - Laparoscope puncture outfit with fascia closing function

Info

Publication number: CN113520542A
Application number: CN202110706543.5A
Authority: CN
Inventors: 夏大卫; 李宏博; 张家智; 王卫东; 王桃红
Original assignee: Zhejiang Youyi Medical Equipment Co Ltd
Current assignee: Zhejiang Youyi Medical Equipment Co Ltd
Priority date: 2021-06-24
Filing date: 2021-06-24
Publication date: 2021-10-22
Anticipated expiration: 2041-06-24
Also published as: CN113520542B

Abstract

The invention provides a laparoscope puncture outfit with a fascia closing function, which comprises a puncture rod, wherein a suture positioning mechanism comprises two wing parts and a driving part, wherein the wing parts are pivoted to the far end of the puncture rod; the puncture thread hooking mechanism comprises a first hook needle, a second hook needle and an actuating piece, and the first hook needle and the second hook needle have an initial state of being restricted in the inner cavity of the puncture rod and a thread hooking state of being respectively inserted into the two wing needle penetrating grooves; the first crochet hook and the second crochet hook are respectively provided with a first crochet hook groove and a second crochet hook groove, the first crochet hook groove and the second crochet hook groove are respectively provided with an opening back to the central axis of the puncture rod, and the actuating piece controls the first crochet hook and the second crochet hook to be switched from the initial state to the crochet hook state.

Description

Laparoscope puncture outfit with fascia closing function

Technical Field

The invention relates to a medical instrument for fascia suture, in particular to a laparoscopic puncture outfit with a fascia closing function.

Background

Laparoscopic surgery is a newly developed minimally invasive method and is a necessary trend for the development of future surgical methods. Compared with the traditional operation, the laparoscopic operation is popular with patients, especially has small postoperative scar and meets the aesthetic requirements, young patients are more acceptable, and the minimally invasive operation is the general trend and pursuit target of surgical development. Currently, the golden standard of laparoscopic surgery is cholecystectomy, and most of the general surgical operations, laparoscopic surgery, are generally performed. Such as appendectomy, gastric and duodenal ulcer perforation repair, hernia repair, colectomy, splenectomy, adrenal gland resection, ovarian cyst removal, extrauterine pregnancy, hysterectomy and the like. In the laparoscopic surgery, a doctor firstly uses 3-5 laparoscopic puncture outfits with the size of about 5-12mm to penetrate through the abdominal wall of a patient in advance, and then pulls out a puncture rod on the puncture outfits. Finally, the doctor uses the puncture cannula left on the abdominal wall of the patient as a passage for the surgical instrument to enter and exit the human body to carry out the operation. After the operation is completed, the doctor needs to suture the puncture holes and the epidermis after removing the puncture cannula. The current commonly used suturing method is suturing using a reversible needle. The abdominal wall skin is roughly divided into an epidermal layer, a subcutaneous fat layer, a muscle layer, a fascia layer and the like from top to bottom. Because the muscle layer and the fascia layer are deeper, the Reverdin needle is difficult to operate, and the suture operation is very difficult, so that postoperative bleeding, puncture hernia and other conditions caused by incomplete suture often occur, and the healing is affected and other pains are caused to patients.

Currently, there is an instrument specifically targeted for fascia suturing on the market, which is called: the minimally invasive fascia closer comprises a positioner and a suture guide needle, wherein the positioner comprises a body, a pair of wings and a guide core, the body is provided with a first channel and a second channel, and the first channel and the second channel are respectively provided with an inlet and an outlet along the outer surface of the body; one end of each of the pair of fins is connected with the body, and the other end of each of the pair of fins is provided with a through hole; the guide core is arranged in the body, the upper end of the guide core is exposed out of the body, the pair of fins can move between an open state and a closed state through the guide core, in the open state, the pair of fins are respectively positioned at two sides of the body, the through holes on the fins are positioned on the extension line of the first channel or the second channel, in the closed state, the pair of fins are folded and coincide with the axis of the body, and one ends of the pair of fins, which are not connected with the body, are in mutual contact. A round hole is formed in the fin and filled with silica gel. An opening groove for guiding a suture is formed in the position of the needle tip on the suture guiding needle, and the opening direction of the opening groove faces to the needle tip I. The using method comprises the following steps: when suturing is required after surgery, the surgeon inserts the locator into the puncture channel while the wings are opened by the guide core. The surgeon then snaps the suture into an open slot on the suture guide needle and then inserts the suture guide needle into the first or second channel on the positioner. Until the suture guide needle opening groove passes through the wing piece, the guide needle is pulled out at the moment, and the silica gel in the circular hole of the wing piece can clamp the suture. Then the guide core closes the wing panel and then the positioner is pulled out. Finally, the doctor ties the suture line which is pulled out according to the specification. Finally, simple sewing is carried out on the epidermis layer. The above operation mode has several disadvantages: 1. when using a minimally invasive fascia closer for suturing, the puncture cannula needs to be removed and the closer placed. The patient's wound is stimulated while the obturator is inserted. 2. The open slots on the suture guide needle are too small, the distance is only 0.5-0.8mm, and the suture guide needle is not beneficial to a doctor to clamp the suture thread into the open slots. 3. Silica gel in the holes on the wing pieces can not well clamp the suture line, the suture guiding needle cannot be inserted into the holes too shallow to complete the suture line clamping operation, and the suture guiding needle can stab internal organs to cause internal bleeding if the suture guiding needle is too deep, so that the patient can die seriously. The doctor can carry out the next operation only after observing and confirming through other observation channels; 4. due to the fact that the principle of silica gel line clamping is adopted, the reserved length of the suture guiding needle is long, if a doctor uses the minimally invasive fascia closer for the first time, the specific position of the inserted suture guiding needle cannot be estimated, and visceral hemorrhage is likely to be caused when the doctor is inserted to the bottom.

Disclosure of Invention

In view of the above-mentioned disadvantages of the existing minimally invasive fascia closer, the present invention provides a laparoscopic puncture instrument with a fascia closing function, characterized in that the puncture instrument comprises

The puncture rod is internally provided with an axially extending inner cavity;

the suture positioning mechanism comprises two wing parts which are pivoted to the far end of the puncture rod and a driving part which is used for controlling the two wing parts to be switched between a folded state and an unfolded state, the wing parts are provided with a first wing part and a second wing part which are oppositely arranged, a needle threading groove with an opening at a free end is formed between the first wing part and the second wing part, and threading holes for the suture to be pivoted are respectively arranged on the first wing part and the second wing part; the puncture rod is provided with a slot A which allows the two wing parts to be unfolded outwards from the puncture rod;

the puncture thread hooking mechanism comprises a first hook needle, a second hook needle and an actuating piece, the first hook needle and the second hook needle extend at intervals, the extending tracks of the first hook needle and the second hook needle are crossed, and the first hook needle and the second hook needle have an initial state of being restricted in the inner cavity of the puncture rod and a thread hooking state of being respectively inserted into the two wing part needle penetrating grooves; the first crochet hook and the second crochet hook are respectively provided with a first crochet hook groove and a second crochet hook groove, the first crochet hook groove and the second crochet hook groove are respectively provided with an opening back to the central axis of the puncture rod, the actuating piece controls the first crochet hook and the second crochet hook to be converted from the initial state to the crochet hook state, and the first crochet hook and the second crochet hook are configured to be capable of guiding suture threads of two wing parts converted from the unfolding state to the folding state to the first crochet hook groove and the second crochet hook groove; the puncture rod is provided with a perforation A which allows the first crochet hook and the second crochet hook to extend out of the puncture rod;

the puncture sleeve is sleeved outside the puncture rod, and the puncture sleeve is provided with a notch B allowing the two wing parts to be unfolded outwards from the puncture sleeve and a through hole allowing the first crochet hook and the second crochet hook to extend out of the puncture sleeve B.

In some embodiments, the puncture thread hooking mechanism comprises a needle seat and a guide seat which are positioned in the inner cavity, and the first crochet needle and the second crochet needle are elastic pieces;

the guide seat is provided with a first oblique channel positioned on the front side and a second oblique channel positioned on the reverse side, the first oblique channel and the second oblique channel extend obliquely from the near end to the far end, and the extending tracks of the first oblique channel and the second oblique channel are crossed;

the near end of the needle seat is connected with an actuating piece, the near end parts of the first hooked needle and the second hooked needle are respectively fixed on the two sides of the needle seat, the far end parts of the first hooked needle and the second hooked needle penetrate through the first oblique channel and the second oblique channel, and the actuating piece drives the first hooked needle and the second hooked needle to respectively slide in the first oblique channel and the second oblique channel through the needle seat.

In some embodiments, the driving member includes a knob rotatably engaged with the puncture rod holder and a pull rod positioned in the inner cavity and threadedly engaged with the knob, the pull rod has rack segments on left and right sides of a distal end portion thereof, and the two wing portions have gear segments engaged with the rack segments, respectively.

In some embodiments, the puncture rod has a first pivot shaft and a second pivot shaft on the left and right sides of the inner wall of the distal end, and the first wing and the second wing are pivotally connected to the puncture rod via the first pivot shaft and the second pivot shaft, respectively.

In some embodiments, the guide seat further has a limiting cover covering the first inclined passage and the second inclined passage.

In some embodiments, the tie rod has an end seat at a proximal end portion, a transmission portion at a distal end portion, an outer wall of the end seat being threadedly coupled to an inner wall of the knob, and a frame-shaped rail axially extending between the end seat and the transmission portion, the transmission portion having a rod and rack segments formed on both sides of the rod.

In some embodiments, the puncture rod has a hollow tube and a puncture tip communicating with the hollow tube, the inner wall of at least the proximal portion of the hollow tube is circumferentially provided with a plurality of axially extending limiting guide grooves,

the frame-shaped guide rail is at least provided with a first sliding plate and a second sliding plate which are opposite, the near ends of the first sliding plate and the second sliding plate are connected with the end seat, and the first sliding plate and the second sliding plate can be respectively clamped into the limiting guide grooves in an axially sliding manner.

In some embodiments, the actuator includes a push rod that cooperates with the needle hub to urge the needle hub to slide axially within the lumen.

In some embodiments, the actuating member comprises a push rod and a handle located at the head end of the push rod, the push rod is provided with a first push plate and a second push plate which are oppositely arranged, the inner walls of the first push plate and the second push plate are respectively provided with a first protrusion and a second protrusion, the far sides of the first push plate and the second push plate are respectively provided with a first limiting block and a second limiting block, a first movable clamping block which can swing relative to the central axis of the puncture rod is arranged below the upper right side of the needle base, and a second movable clamping block which can swing relative to the central axis of the puncture rod is arranged above the opposite side of the needle base; and a first limit matching block and a second limit matching block are respectively arranged on the front side and the back side of the needle base above the first movable clamping block and the second movable clamping block.

In some embodiments, the frame-shaped guide rail has an upper frame-shaped guide rail located on the upper side and a lower frame-shaped guide rail located on the lower side, the planes of the upper frame-shaped guide rail and the lower frame-shaped guide rail are perpendicular, the upper frame-shaped guide rail is in sliding fit with the limiting guide groove in the hollow tube body, and sliding grooves in sliding fit with the lower frame-shaped guide rail are arranged on two opposite sides of the guide seat.

When the wound suture is not needed, the puncture rod is placed into the sleeve again and then corresponding operation is carried out to suture the wound. Because the cannula is punctured to isolate the wound tissue, the post-inserted puncture rod does not re-stimulate the wound of the patient.

Compared with the suture clamping groove of only 0.5-0.8mm in the minimally invasive fascia closer on the market, the clamping groove of the laparoscope puncture outfit with the fascia closer is about 2mm, so that the suture clamping is facilitated.

The mode of hooking the thread is adopted to replace the mode of clamping the thread by using silica gel, so that the problem that the thread guide device is inserted too deeply or too shallowly is solved; the sewing efficiency is improved.

The reserved length is short, and the protection measures are matched, so that the internal organs cannot be damaged by inserting the suture guide needle to the bottom in time.

In one operation, a plurality of puncture outfits can be commonly used. If need use the puncture ware mentioned in this patent to sew up to the puncture hole of other brand puncture wares, can also sew up to the puncture hole of other brand puncture wares.

Compared with the traditional minimally invasive fascia closer, the minimally invasive fascia closer has the following advantages:

The mode of hooking the lines is adopted to replace the mode of using silica gel to clamp the lines, so that the problem that the suture guide is inserted too deeply or too shallowly is solved. The sewing efficiency is improved.

Drawings

FIG. 1 is a schematic structural view of a laparoscopic puncture instrument provided in the present invention;

FIG. 2 is a schematic view of the abdominal cavity puncture rod and puncture cannula according to the present invention;

FIG. 3 is a schematic view of the puncture rod according to the present invention;

fig. 4 is a schematic structural view of a first crochet hook and a second crochet hook provided by the invention;

FIG. 5 is a schematic structural view of a puncture cannula provided in accordance with the present invention;

fig. 6 is a schematic structural view of a needle holder provided by the present invention;

FIG. 7 is a schematic view of a push rod structure provided by the present invention;

FIG. 8 is a schematic view of the working process of the push rod and the needle seat provided by the present invention;

FIG. 9 is a schematic structural view of a position-limiting cover according to the present invention;

FIGS. 10 to 11 are sectional views showing a partial structure of a puncture instrument provided for the present invention;

fig. 12-24 are schematic views illustrating a method of using the puncture instrument provided by the present invention.

Detailed Description

In the description of the present invention, it is to be understood that the terms "upper", "lower", "inside", "outside", and the like, indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, are only for convenience in describing the present invention and simplifying the description, and do not indicate or imply that the referred device or element must have a specific orientation, be constructed in a specific orientation, and be operated, and thus, should not be construed as limiting the present invention. In the description of the present invention, "a plurality" means at least two, e.g., two, three, etc., unless specifically limited otherwise.

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.

Referring to fig. 1-3, the present embodiment provides a laparoscopic puncture instrument with fascia closing function, which includes a puncture rod 1, a suture positioning mechanism 2, a puncture thread hooking mechanism 3 and a puncture cannula 5,

an inner cavity extending axially is formed in the puncture rod 1, so that a suture device can be arranged in the laparoscopic puncture outfit to realize the function of automatically suturing fascia on the puncture outfit; in the present embodiment, referring to fig. 2, the puncture rod has a fixing base 11, a hollow tube 12 and a puncture tip 13 communicating with the hollow tube 12, and is snap-fitted with a mounting base 51 of the puncture cannula through the fixing base.

Referring to fig. 3, the suture positioning mechanism 2 comprises two

wings

21,22 pivotally connected to the distal end of the puncture shaft and a driving member 23 for controlling the two

wings

21,22 to switch between a folded state and an unfolded state, wherein the folded state means that the wings are overlapped with the central axis of the puncture shaft at zero degrees, and the unfolded state means that the wings are unfolded outwards and form an angle of 90 degrees with the central axis of the puncture shaft; in this embodiment, the two wing parts are arranged on two opposite sides of the puncture rod, and when the two wing parts are in the unfolded state, the two wing parts form an included angle of 180 degrees; the two wings are identical in structure, so that only one of the wings is described in detail below, the wing 21 has a first wing 211 and a second wing 212 which are opposite to each other, a needle passing groove 213 with an open free end is formed between the first wing 211 and the second wing 212, and

thread holes

215 and 216 for the suture to pass through are respectively formed in the first wing 211 and the second wing 212, and the suture passes through the thread holes 215 and 216 to position the suture.

The puncture thread hooking mechanism 3 includes a first crochet hook 31, a second crochet hook 32 and an actuating member 33, the first crochet hook 31 and the second crochet hook 32 have an initial state of being restricted in the puncture rod inner cavity and a thread hooking state of being respectively inserted into the two wing part needle passing grooves 213, and the initial state is that the first crochet hook 31 and the second crochet hook are accommodated in the puncture rod inner cavity, and at this time, the first crochet hook 31 and the second crochet hook 32 accommodated in the puncture rod inner cavity do not interfere with the puncture function of the puncture rod; the "thread hooking state" refers to that the first crochet hook 31 and the second crochet hook 32 extend outwards from the inner cavity of the puncture rod to penetrate into abdominal tissues and then are inserted into the needle penetrating grooves of the wing parts, and the actuating part 33 controls the first crochet hook and the second crochet hook to be switched from the initial state to the thread hooking state; further, in order to guide the suture thread threaded on the wing portions to the first crochet hook and the second crochet hook, the first crochet hook 31 and the second crochet hook 32 have a first crochet hook groove 311 and a second crochet hook groove 321, respectively, the first crochet hook groove 311 and the second crochet hook groove 321 have openings 310,320 facing away from the central axis of the puncture rod, respectively, the openings 310,320 are located inside the threading hole suture thread when the first crochet hook 31 and the second crochet hook 32 are inserted in the both wing portion threading grooves 213, up to this point, it can be understood that the first crochet hook and the second crochet hook inserted in the threading groove can hook the suture thread passing through the threading groove into the first crochet hook groove and the second crochet hook groove during the transition of the both wing portions from the expanded state to the folded state, and thus, the suture function can be obtained by pulling the first crochet hook and the second crochet hook out of the abdominal tissue and then tying the knot.

Specifically, referring to fig. 4, the first and second bearded needles have an extended length of about 50 to 150mm and a bearded needle diameter D of about 0.8 to 1.5 mm; the widths of the first hooking line slot 311 and the second hooking line slot 321L2 are about 0.6-1.2mm, the opening directions of the open slots are arranged in a back-to-back manner, and the larger opening widths of the first hooking line slot 311 and the second hooking line slot 321 can be more favorable for line clamping;

in this embodiment, the first crochet hook 31 and the second crochet hook 32 have tips at distal ends, the first crochet hook groove 311 and the second crochet hook groove 321 are arranged above the tips 312,322 of the first crochet hook 31 and the second crochet hook 32, and each of them has an

opening

3110,3210 and a

card groove

3111,3211 longitudinally extending far from the opening, so that after the suture thread enters the card groove along the opening, the suture thread is difficult to get out from the far end of the card groove due to the upward penetration of the first crochet hook and the second crochet hook, and the card thread is more firm.

Referring to fig. 2, two opposite sides of the puncture rod are respectively provided with a slot a 15 allowing two wing portions to be unfolded outwards from the puncture rod, and two sides of the puncture rod are respectively provided with a through hole a 17 allowing a first crochet hook and a second crochet hook to extend out of the puncture cannula;

the puncture cannula 5 is sleeved on the outer side of the puncture rod 1, the puncture cannula is used for blocking wound tissues, and in order to realize that the wing part 21, the first crochet hook 31 and the second crochet hook 32 act on abdominal cavity tissues; referring to fig. 5, two opposite sides of the puncture cannula are respectively provided with a slot B52 allowing two wings to extend outward from the puncture cannula, and two sides of the puncture cannula are respectively provided with a through hole B52 allowing a first crochet hook and a second crochet hook to extend out of the puncture cannula; in this embodiment, the positions of the slot a, the through hole a, the slot B and the through hole B are rounded to prevent the puncture cannula from injuring the patient during the operation.

The actuating element 33 controls the first crochet hook and the second crochet hook to switch from the initial state to the thread hooking state, and the structure realization forms are various, for example, the actuating element is a push rod, the proximal ends of the first crochet hook and the second crochet hook are fixed on the push rod, and the first crochet hook and the second crochet hook can be driven to axially move by the push-pull action of the push rod; in some preferred embodiments, referring to fig. 3, the puncture hooking mechanism comprises a needle seat 34 and a guide seat 35 positioned in the inner cavity, and the first hooked needle 31 and the second hooked needle 32 have elasticity; the guide seat 35 has a first inclined channel 351 on the front side and a second inclined channel 352 on the opposite side, the first inclined channel 351 and the second inclined channel (not shown) extend from the proximal end to the distal end, and the extending tracks of the first inclined channel and the second inclined channel are crossed, namely the first inclined channel and the second inclined channel are positioned on the front side and the back side of the needle seat, but the extending directions of the first inclined channel and the second inclined channel are crossed, so that the vertically parallel first hooked needle 31 and second hooked needle 32 are deformed into a crossed state but are not actually in crossed contact through the action of the first inclined channel and the second inclined channel; the proximal end of the needle seat 34 is connected with the actuating element 33, the proximal end parts of the first hooked needle 31 and the second hooked needle 32 are respectively fixed on two sides of the needle seat 34, the distal end parts of the first hooked needle 31 and the second hooked needle 32 are arranged through the first inclined channel 351 and the second inclined channel 352, and the actuating element 33 drives the first hooked needle 31 and the second hooked needle 32 to respectively slide in the first inclined channel 351 and the second inclined channel 352 through the needle seat; in this way, the first hooked needle and the second hooked needle with elasticity are guided by the first inclined channel 351 and the second inclined channel 352 to be changed from vertical to cross arrangement, and since the first inclined channel 351 and the second inclined channel 352 are respectively positioned at the front side and the reverse side of the needle seat, the two hooked needles are arranged in a cross manner but do not intersect; the two hooked needles which are crossed but not intersected do not interfere with each other, so that the functions of puncturing tissues and obliquely inserting the hooked needles into the needle passing grooves 23 to hook the threads can be better completed; in the present embodiment, the directions of the first oblique channel 351 and the second oblique channel 352 are from top to bottom, one of the directions X is from left to right, and the other direction X is from right to left; the two oblique channels have eccentricity and are larger than the diameters of the oblique channels, so that the 2 oblique channels cannot interfere with each other.

In some embodiments, the actuating component 33 is a push rod, the push rod is inserted into the lumen of the puncture rod and provided with a handle 331 at its proximal end, the push rod is fixedly connected with the needle seat, and the push rod drives the first crochet needle and the second crochet needle to slide obliquely in the first oblique channel and the second oblique channel through the needle seat; however, most abdominal puncture outfits are disposable products, if the mode is adopted, the pushing-out height needs to be reserved on the handle, at the moment, the handle can protrude out of the puncture fixing seat, and at the moment, an operator easily collides the handle, so that the problem that the first crochet hook and the second crochet hook are pushed out by mistake due to errors can occur; in view of this, in some preferred embodiments, referring to fig. 6 and 7, the actuating member 33 includes a pushing rod 331 and a pull handle 330 at the head end of the pushing rod 331, the proximal portion and the distal portion of the pushing rod are respectively provided with a limiting device which is in limiting engagement with the needle seat, when the distal portion of the pushing rod is in limiting engagement with the needle seat limiting device, the pull handle and a part of the pushing rod are extended outwards compared with the proximal end of the puncture rod, so that an operator can push the pushing rod downwards to push out the first crochet hook and the second crochet hook; when the proximal part of the push rod is in limit fit with the limit device of the needle seat, the push rod is wholly positioned in the inner cavity, namely, an operator cannot push out the push rod; the stop device provided by this embodiment is configured to disengage its stop engagement with the proximal portion of the pusher bar and to engage the proximal portion of the pusher bar in a stop engagement; specifically, in the present embodiment,

the push rod is provided with a first push plate 3311 and a second push plate 3312 which are oppositely arranged, the inner walls of the first push plate 3311 and the second push plate 3312 are respectively provided with a first protrusion 3313 and a second protrusion 3314, and the far sides of the first push plate 3311 and the second push plate 3312 are respectively provided with a first stopper 3315 and a second stopper 3316;

the front and back sides of the needle seat 34 are respectively provided with a first limit fitting block 3411 and a second limit fitting block 3413 which are in limit fitting with the first protrusion 3313 and the second protrusion 3314,

a first movable fixture block 3412 which can swing relative to the central axis of the puncture rod is arranged below the upper front side of the needle seat 34, and a second movable fixture block 3414 which can swing relative to the central axis of the puncture rod is arranged above the reverse side of the needle seat 34; a first limit matching block 3411 and a second limit matching block 3413 are respectively arranged above the first movable clamping block 3412 and the second movable clamping block on the front side and the back side of the needle base;

the first limit fitting block 3411 and the second limit fitting block 3413 have a first state of limit fitting with the first protrusion 3313 and the second protrusion 3314 respectively and a second state of limit fitting with the first limit block 3315 and the second limit block 3316 respectively; the first stopper 3315 and the second stopper 3316 have an initial state at the distal side of the needle holder and an activated state in limit fitting with the needle holder, respectively;

the first limiting block 3315 and the second limiting block 3316 move upwards to drive the first movable clamping block and the second movable clamping block to rotate towards the central axis of the puncture rod so as to release the locking of the first movable clamping block and the second movable clamping block, and the limiting matching force of the first protrusion 3313 and the second protrusion 3314 and the first limiting matching block 3411 and the second limiting matching block 3413 is weaker so that the limiting matching is released by upward pushing force; the first protrusion 3313 and the second protrusion 3314 are protruded strips extending in the transverse direction, and the first limit fitting block 3411 and the second limit fitting block 3413 can quickly release the limit fitting with the protruded strips under the action of external force; therefore, the push rod can be easily turned from the initial state to the excitation state;

referring to fig. 8, the first and

second stoppers

3315 and 3316 have a proximal stopper surface a and a distal stopper surface B; the push rod is pulled to move upwards, the first limit matching block 3411 and the second limit matching block 3413 are released from the limit matching with the first protrusion 3313 and the second protrusion 3314, the first stopper 3315 and the second stopper 3316 move upwards to push the first movable block 3412 and the second movable block 3414 open, the first stopper 3315 and the second stopper 3316 are fitted to the first stopper 3411 and the second stopper 3413 on the upper side, the limiting surfaces B of the first limiting block 3315 and the second limiting block 3316 are in limiting fit with the first movable fixture block 3412 and the second movable fixture block 3414 at the lower sides thereof, thus, the first and second limiting

blocks

3315, 3316 of the push rod are engaged with the needle base by two parts, and the push rod and the needle base are stably fixed together, so that the first and second crochet needles can slide obliquely and downwards at a predetermined distance;

in this embodiment, in order to facilitate releasing the locking of the first and second movable blocks to the first and

second stoppers

3315 and 3316, the first and second movable blocks have a swingable inclined surface interacting with the first and

second stoppers

3315 and 3316 and a horizontal limiting surface in limiting fit with the first and

second stoppers

3315 and 3316, and the limiting surfaces a and B of the first and

second stoppers

3315 and 3316 are both horizontal surfaces, so that the locking of the first and second movable blocks to the first and

second stoppers

3315 and 3316 can be quickly released by the cooperation of the limiting surfaces a of the first and

second stoppers

3315 and 3316 and the inclined surfaces of the first and second

movable blocks

3315 and 3316; and the horizontal planes of the spacing surface a and the spacing surface B make the spacing fitting force of the first spacing block 3315 and the second spacing block 3316, the first spacing fitting block 3411 and the second spacing fitting block 3413, and the first movable fixture block and the second movable fixture block stronger.

In some embodiments, referring to fig. 9, the guiding base further has a limiting cover 353,354 covering the first oblique passage and the second oblique passage respectively, and the limiting cover limits the crochet hook from falling out of the first oblique passage and the second oblique passage; specifically, the structure form of the limit cover is as follows: in detail, as shown in fig. 2, a pressing piece 3531 for covering the second inclined channel is arranged on the limiting cover 353, the pressing piece 3531 and the second inclined channel are in the same shape and correspondingly accommodate the second crochet hook, and a plurality of limiting

shafts

3532,3533,3544 are arranged on the limiting cover 353 and are fixedly connected with shaft holes on the guide holder, so that the first crochet hook and the second crochet hook slide in the first inclined channel and the second inclined channel in a preset direction and are prevented from falling off from the first inclined channel and the second inclined channel.

In some embodiments, referring to fig. 8 again, the driving member 23 includes a knob 231 and a pull rod 232, the knob 231 is screwed with the proximal portion of the pull rod 232, the pull rod 232 has

rack sections

2335, 2336 on the left and right sides of the distal portion, and the two

wings

21,22 have

gear sections

210, 220 engaged with the

rack sections

2335, 2336, respectively; therefore, the pull rod 232 can be driven to axially slide by the rotation of the knob 231, and the two wing parts are driven to swing relative to the central axis of the puncture rod by the meshing transmission of the

rack sections

2335 and 2336 and the gear sections of the two

wing parts

21 and 22; in some embodiments, the wing portion is pivotally connected to the inner wall of the puncture rod by a first pivot 1211 and a second pivot 1212 respectively disposed at the left and right sides of the inner wall of the distal end of the puncture rod, and the first wing portion and the second wing portion are pivotally connected to the puncture rod by the first pivot 1211 and the second pivot 1212 respectively.

In this embodiment, the pull rod 232 has an end seat 2321 located at the proximal end portion, a transmission portion 2323 located at the distal end portion, and a frame-shaped guide 2322 axially extending between the end seat and the transmission portion, the outer wall of the end seat 2321 is screwed with the inner wall of the knob, the frame-shaped guide defines a receiving channel, the knob 231 and the end seat 2321 have an opening, so that the push rod penetrates through the opening into the inner cavity of the puncture rod, and the lower end of the pull handle abuts against the upper side of the knob in the initial state; the transmission part is provided with a rod piece and rack sections formed on two opposite sides of the rod piece;

specifically, there are various ways of screwing the knob 231 and the pull rod 232, and in this embodiment, the end seat of the pull rod is screwed with the knob; in this embodiment, the knob 231 is screwed to the pull rod 232: two spiral guide grooves 23211 are oppositely arranged on the end seat 2321, and a guide post sliding in the spiral guide groove 23211 is arranged on the knob 2321, so that the rotation of the knob is converted into the axial movement of the pull rod through the matching of the guide post of the knob and the spiral guide groove of the pull rod end seat.

In this embodiment, the frame-shaped guide 2322 has an upper frame-shaped guide 23220 located at the upper side and a lower frame-shaped guide 23221 located at the lower side, the lower frame-shaped guide 23221 is fixedly connected with the upper frame-shaped guide 23220, the plane where the lower frame-shaped guide 23221 and the upper frame-shaped guide 23220 are located is perpendicular, and the plane where the needle seat is located is perpendicular to the plane where the push rod is located; the inner wall of at least the near side part of the hollow tube body is circumferentially provided with a plurality of axially extending limiting guide grooves,

the upper frame-shaped guide rail 23220 is in sliding fit with the limiting guide groove in the hollow tube body, sliding grooves 3541 in sliding fit with the lower frame-shaped guide rail 23221 are arranged on two opposite sides of the guide seat 35, and specifically, the sliding grooves 3541 are formed on the limiting cover 354, so that the frame-shaped guide rail is prevented from moving in the circumferential direction of the inner cavity of the puncture rod;

the upper frame-shaped guide 23220 is provided with a first sliding plate 23222 and a second sliding plate 23223 which are opposite, the proximal ends of the first sliding plate 23222 and the second sliding plate 23223 are connected with the end seat 2321, and the first sliding plate 23222 and the second sliding plate 23223 are respectively clamped in a puncture rod limiting guide groove in an axially slidable manner;

the lower frame-shaped guide 23221 is provided with a third sliding plate 23225 and a fourth sliding plate 23226 which are opposite, and the third sliding plate 23225 and the fourth sliding plate 23226 are in sliding fit with sliding grooves 3541 on the limiting covers on the front side and the back side of the guide seat 35;

more specifically, the line connecting the first sliding plate 23221 and the second sliding plate 23222 perpendicularly intersects the line connecting the first push plate 3311 and the second push plate 3312; the inner wall of at least the near side part of the hollow pipe body is circumferentially provided with four axially extending limiting guide grooves, and the first push plate, the first sliding plate, the second push plate and the second sliding plate are circumferentially distributed in the four axially extending limiting guide grooves;

through the sliding fit of the upper frame-shaped guide rail 23220, the push rod and the inner wall of the puncture rod and the sliding fit of the lower frame-shaped guide rail and the guide seat, the circumferential rotation of the push rod, the needle seat and the pull rod is avoided, and the whole device can work more stably and smoothly.

In addition, the hollow tube of the puncture rod provided by the present embodiment has an upper tube 1200 and a lower tube 1201, the lower tube 1201 is formed by two

half shells

121 and 122 being snapped together, and the guide seat is positioned in the lower tube, specifically, may be positioned in the lower tube by other fixing forms such as snapping, bonding, etc.;

the piercing tip 13 is also snap-fit to the lower segment body 1201.

Referring to fig. 10-11, the annular buckle 111 on the puncture rod fixing seat 11 is clamped with the annular groove on the upper sleeve, and meanwhile, the vertical buckle on the upper sleeve is clamped with the vertical groove on the puncture rod fixing seat, and the guide seat is fixed with the inner wall of the puncture rod.

The knob is rotationally installed on the puncture rod fixing base, specifically, knob circumference is equipped with annular convex body, puncture rod fixing base's opening inner circle forms the annular groove with annular convex rotary fit.

Referring to fig. 3, for stable assembly of the whole device, the plane of the lower frame-shaped guide 23221 and the plane of the upper frame-shaped guide 23220 are perpendicular, the plane of the needle seat is perpendicular to the plane of the push rod, the action mechanisms stably operate, and the puncture rod, the puncture suture mechanism and the puncture positioning mechanism are definitely separated and simultaneously supplement each other during operation.

In addition, the center of the end seat 2321 is provided with a square hole so that the push rod can axially and slidably extend into the square hole, and the arrangement of the square hole avoids the circumferential movement of the push rod.

Based on the laparoscope puncture outfit provided by the invention, the invention provides the following using method:

step 1) referring to fig. 12 and 13, according to the using method specified in the laparoscopic surgery, the puncture outfit is placed into the abdominal wall, and the puncture rod is taken out; performing a surgical procedure using the puncture cannula indwelling on the abdominal wall, as prescribed by the procedure; ,

step 2) referring to fig. 14, when the operation is finished and the wound needs to be sutured, 2 sutures 10 are respectively inserted into the threading holes of the wing part and are tensioned upwards;

step 3) referring to fig. 15, the puncture rod is then re-inserted into the puncture cannula; rotating the knob to spread the two wings 180 degrees;

step 4) referring to fig. 16, the handle is pulled to enable the push rod to extend out of the puncture rod, and the needle seat is changed into an excitation state from an initial state;

step 5) referring to fig. 17, the handle is pressed downwards to push the push rod downwards to a predetermined height, so as to push out the first crochet hook 311 and the second crochet hook 312, and the first crochet hook 311 and the second crochet hook 312 penetrate through the abdominal wall after being pushed out from the puncture rod and the puncture cannula and penetrate through the needle passing groove between the two wing parts; the first crochet hook 311 and the second crochet hook 312 are now inside the suture thread;

step 6) turning the knob again, please refer to fig. 18 and 19, folding the two wing parts, and the suture will be clamped into the first and second hooking grooves on the first and second crochet hooks 311 and 312;

step 7) referring to fig. 20, the push rod is pulled out to retract the first crochet hook 311 and the second crochet hook 312;

step 7) referring to fig. 21-23, after the puncture outfit is pulled out, one end of the suture line is taken out of the body together with the puncture outfit; at this time, referring to fig. 24, the suture thread hooked on the puncture crochet needle is pulled down and the wound is closed by a conventional knotting method; finally, the epidermis is simply sutured to complete the operation.

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

1. The laparoscope puncture device with the fascia closing function is characterized by comprising

The puncture rod is internally provided with an axially extending inner cavity;

2. The laparoscopic puncture instrument according to claim 1, wherein said puncture hooking mechanism comprises a needle holder and a guide holder positioned in the inner cavity, said first and second barbed needles being elastic members;

3. The laparoscopic puncture instrument according to claim 1, wherein said driving member comprises a knob rotatably engaged with the puncture rod holder and a pull rod positioned in the inner cavity and threadedly engaged with the knob, said pull rod having rack segments on left and right sides of a distal end portion thereof, and said two wing portions having gear segments engaged with the rack segments, respectively.

4. The laparoscopic puncture instrument according to claim 3, wherein the puncture rod has a first pivot shaft and a second pivot shaft respectively disposed at left and right sides of the inner wall of the distal end thereof, and the first wing and the second wing are pivotally connected to the puncture rod through the first pivot shaft and the second pivot shaft respectively.

5. The laparoscopic puncture instrument according to claim 2, wherein said guide holder further comprises a stopper cap covering said first inclined passage and said second inclined passage.

6. The laparoscopic puncture instrument according to claim 3, wherein said pull rod has an end seat at a proximal end portion, a transmission portion at a distal end portion, and a frame-shaped guide rail axially extending between the end seat and the transmission portion, an outer wall of said end seat being threadedly engaged with an inner wall of the knob, said transmission portion having a rod and rack segments formed at both sides of the rod.

7. The laparoscopic puncture instrument according to claim 3, wherein said puncture rod has a hollow tubular body and a puncture tip communicating with the hollow tubular body, said hollow tubular body having at least a proximal portion having a plurality of axially extending stopper guide grooves circumferentially formed on an inner wall thereof, said frame-shaped guide rail having at least a first slide plate and a second slide plate opposed to each other, said first slide plate and said second slide plate being connected at proximal ends thereof to said end base, said first slide plate and said second slide plate being axially slidably engaged in said stopper guide grooves, respectively.

8. The laparoscopic puncture instrument of claim 7, wherein said actuating member comprises a push rod, said push rod cooperating with said needle hub to push said needle hub to slide axially within said lumen.

9. The laparoscopic puncture outfit according to claim 7, wherein the actuating member comprises a push rod and a handle located at the head end of the push rod, the push rod has a first push plate and a second push plate which are oppositely arranged, the inner walls of the first push plate and the second push plate are respectively provided with a first protrusion and a second protrusion, the far sides of the first push plate and the second push plate are respectively provided with a first limit block and a second limit block, a first movable block which can swing relative to the central axis of the puncture rod is arranged below the upper right side of the needle base, and a second movable block which can swing relative to the central axis of the puncture rod is arranged above the opposite side of the needle base; and a first limit matching block and a second limit matching block are respectively arranged on the front side and the back side of the needle base above the first movable clamping block and the second movable clamping block.

10. The laparoscopic puncture instrument according to claim 7, wherein said frame-shaped guide comprises an upper frame-shaped guide located at the upper side and a lower frame-shaped guide located at the lower side, said upper frame-shaped guide and said lower frame-shaped guide being perpendicular to each other in the plane, said upper frame-shaped guide slidably engaging with the position-limiting guide groove inside the hollow tube, and said guide holder having sliding grooves slidably engaging with the lower frame-shaped guide at opposite sides.