WO2021135347A1

WO2021135347A1 - Anchor delivery device and artificial-tendon implant apparatus

Info

Publication number: WO2021135347A1
Application number: PCT/CN2020/113435
Authority: WO
Inventors: 李阳; 徐澧; 张庭超
Original assignee: 杭州德晋医疗科技有限公司
Priority date: 2019-12-31
Filing date: 2020-09-04
Publication date: 2021-07-08

Abstract

Provided is an anchor delivery device (2000), used for delivering an anchor (1000) and driving the anchor (1000) to anchor onto a tissue, lock an artificial tendon (3000) passing through the anchor (1000), and cut off one side of the artificial tendon (3000); the anchor delivery device (2000) comprises an outer tube (2100), an inner tube (2200) movably mounted in the outer tube (2100), and a handle (2400) connecting the outer tube (2100) with the inner tube (2200); the handle (2400) comprises a front handle (2410) fixedly connected to the proximal end of the outer tube (2100), and a rear handle (2420) movably connected to the front handle (2410) in the axial direction, the proximal end of the inner tube (2200) being movably connected to the rear handle (2420); the distal end of the inner tube (2200) comprises a lock (2210), the lock (2210) connecting to the anchor (1000) when in the outer tube (2100), and the lock (2210) being separated from the anchor (1000) when exposed to the outer tube (2100). Also provided is an artificial tendon implantation apparatus (100). The provided anchor delivery device (2000) can easily complete operations of anchoring and locking the anchor (1000) and cutting the artificial tendon (3000), reducing the quantity of instruments, and simplifying the operation steps.

Description

锚钉输送器及人工腱索植入装置Anchor conveyor and artificial tendon implant device

技术领域Technical field

本发明涉及医疗器械技术领域，具体涉及一种锚钉输送器及人工腱索植入装置。The invention relates to the technical field of medical devices, in particular to an anchor conveyer and an artificial tendon implant device.

背景技术Background technique

在治疗二尖瓣反流(mitral regurgitation，MR)的修复手术中，传统外科手术创伤大、风险高，现在临床上对微创修复二尖瓣反流的手术有很大的需求。二尖瓣反流介入微创治疗技术具有创伤小、并发症少等优势。人工腱索植入是介入式二尖瓣修复术的一种，其手术原理是：将缝线经导管途径送入左心室，使得缝线的一端与二尖瓣瓣叶固定，缝线的另一端通过锚钉与左心室心肌壁或***肌连接，形成人工腱索。但目前还存在着以下技术问题：人工腱索植入所用到的锚钉功能单一，一般仅用于锚入心室壁或***肌，后续还需要导入额外的器械将人工腱索与锚钉锁紧，即使用现有的锚钉实施经导管途径腱索修复时，锚定、锁线、及切线分别需要相应的输送器或切断导管来执行，因此手术过程中需要更换及导入不同的器械，操作较复杂，需使用的器械数量较多，成本较高。In the treatment of mitral regurgitation (mitral regurgitation, MR) repair surgery, traditional surgical procedures are traumatic and high-risk. Nowadays, there is a great demand for minimally invasive mitral regurgitation surgery in clinical practice. Interventional minimally invasive treatment of mitral regurgitation has the advantages of less trauma and fewer complications. Artificial chordal implantation is a kind of interventional mitral valve repair. The operating principle is: the suture is fed into the left ventricle through the catheter, so that one end of the suture is fixed to the mitral valve leaflet, and the other suture One end is connected with the left ventricular myocardial wall or papillary muscle through an anchor to form an artificial chordae. However, there are still the following technical problems: the anchors used for artificial chordal implantation have a single function, and are generally only used to anchor the ventricular wall or papillary muscles. Later, additional instruments need to be introduced to lock the artificial chords and anchors. , That is, when the existing anchor is used for transcatheter chordal repair, the anchoring, locking, and cutting require corresponding conveyors or cutting catheters to perform respectively. Therefore, different instruments need to be replaced and introduced during the operation. It is more complicated, requires a large number of instruments, and the cost is high.

发明内容Summary of the invention

为解决上述技术问题，本申请一方面提供一种锚钉输送器。In order to solve the above technical problems, one aspect of the present application provides an anchor conveyor.

具体技术方案为：一种锚钉输送器，所述锚钉输送器用于输送锚钉并驱动所述锚钉锚定于组织上、锁紧穿过所述锚钉的人工腱索并切断所述人工腱索一侧；所述锚定输送器包括外管、活动穿装于所述外管内的内管以及连接所述外管与内管的手柄；所述手柄包括固定连接所述外管近端的前手柄、及沿轴向活动连接所述前手柄的后手柄，所述内管的近端活动连接在所述后手柄上；所述内管的远端包括一锁扣，所述锁扣处于所述外管内时连接所述锚钉，所述锁扣暴露于所述外管外时与所述锚钉分离。The specific technical solution is: an anchor conveyor, which is used to transport anchors and drive the anchors to be anchored to the tissue, lock the artificial tendons passing through the anchors, and cut off the One side of the artificial chord; the anchoring conveyor includes an outer tube, an inner tube movably installed in the outer tube, and a handle connecting the outer tube and the inner tube; the handle includes a fixed connection to the outer tube The front handle at the end and the rear handle movably connected to the front handle in the axial direction, the proximal end of the inner tube is movably connected to the rear handle; the distal end of the inner tube includes a lock, the lock The buckle is connected to the anchor when it is in the outer tube, and the buckle is separated from the anchor when it is exposed outside the outer tube.

本发明另一方面提供一种人工腱索植入装置。Another aspect of the present invention provides an artificial chord implant device.

具体技术方案为：一种人工腱索植入装置包括所述锚钉输送器及锚钉；所述锚钉包括锁杆、套装在锁杆外的锁套及锚定件，所述锚定件与所述锁杆或者所述锁套的远端连接；所述锁杆与所述锁套之间具有径向间隙，所述锁杆上设有穿线孔用于穿装人工腱索，且所述穿线孔至少一端连通所述锁杆与所述锁套之间的径向间隙；所述锁杆或/和锁套上设有刃口；The specific technical solution is: an artificial chord implant device includes the anchor conveyor and an anchor; the anchor includes a lock rod, a lock sleeve sleeved on the lock rod, and an anchor, the anchor Connected with the distal end of the lock rod or the lock sleeve; there is a radial gap between the lock rod and the lock sleeve, and the lock rod is provided with threading holes for inserting artificial tendons, and At least one end of the threading hole communicates with the radial gap between the lock rod and the lock sleeve; the lock rod or/and the lock sleeve are provided with a cutting edge;

所述锁套上设有与所述锁扣适配的锁扣位，所述手柄驱动所述内管轴向移动，以带动所述锁扣、所述锁扣位及所述锁套相对所述锁杆轴向移动，至少位于所述穿线孔一侧的部分所述人工腱索被挤压进所述锁杆和所述锁套之间的径向间隙中，直至所述位于所述穿线孔一侧的部分所述人工腱索被所述刃口切断。The lock sleeve is provided with a lock catch position adapted to the lock catch, and the handle drives the inner tube to move axially to drive the lock catch, the lock catch position, and the lock sleeve to move relative to each other. The lock rod moves axially, and at least a part of the artificial tendon at one side of the threading hole is squeezed into the radial gap between the lock rod and the lock sleeve until the threading hole A part of the artificial chord on one side of the hole is cut by the cutting edge.

本申请的有益效果：本申请提供的锚钉输送器，包括外管、活动穿装于外管内的内管以及连接外管与内管的手柄；手柄包括固定连接外管近端的前手柄、及沿轴向活动连接前手柄的后手柄，内管的近端活动连接在后手柄上；内管的远端包括一锁扣，锁扣处于外管内时连接锚钉，锁扣暴露于外管外时与锚钉分离，锚钉输送器通过锁扣来实现与锚钉的连接与分离，可用于输送锚钉并驱动锚钉锚定于组织上、锁紧穿过锚钉的人工腱索并切断人工腱索一侧。当应用于介入式人工腱索植入术时，仅需通过一个本申请的锚钉输送器便可完成导入锚钉、锚定、锁紧及切断人工腱索的操作，从而简化了操作步骤，减少了器械数量，降低了成本。本申请提供的人工腱索植入装置，包括所述锚钉输送器及锚钉，该锚钉集成了锚定、锁紧及切断人工腱索的功能，锚钉与锚钉输送器配合，仅需通过该一个锚钉输送器便可完成导入锚钉、锚定、锁紧及切断人工腱索的操作，简化了操作步骤，减少了器械数量，降低了成本。The beneficial effects of the present application: the anchor conveyor provided in the present application includes an outer tube, an inner tube movably installed in the outer tube, and a handle connecting the outer tube and the inner tube; the handle includes a front handle fixedly connected to the proximal end of the outer tube, And the rear handle movably connected to the front handle in the axial direction, the proximal end of the inner tube is movably connected to the rear handle; the distal end of the inner tube includes a lock, when the lock is in the outer tube, the anchor is connected, and the lock is exposed on the outer tube Separate from the anchor when outside, the anchor conveyor realizes the connection and separation with the anchor through the lock, which can be used to transport the anchor and drive the anchor to anchor on the tissue, and lock the artificial chord through the anchor. Cut off one side of the artificial tendon. When applied to interventional artificial chordal implantation, only one anchor conveyor of the present application can complete the operation of introducing the anchor, anchoring, locking and cutting the artificial chord, thus simplifying the operation steps. Reduce the number of equipment and reduce costs. The artificial tendon implant device provided by the present application includes the anchor conveyor and the anchor. The anchor integrates the functions of anchoring, locking and cutting the artificial tendon. The anchor is matched with the anchor conveyor. The operation of introducing anchors, anchoring, locking and cutting artificial tendons can be completed through the one anchor conveyor, which simplifies the operation steps, reduces the number of instruments, and reduces the cost.

附图说明Description of the drawings

为了更清楚地说明本发明实施例中的技术方案，下面将对实施例中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图仅仅是本发明的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动性的前提下，还可以根据这些附图获得其他的附图。In order to explain the technical solutions in the embodiments of the present invention more clearly, the following will briefly introduce the drawings that need to be used in the embodiments. Obviously, the drawings in the following description are only some embodiments of the present invention. For those of ordinary skill in the art, without creative labor, other drawings can be obtained from these drawings.

图1为本发明第一实施例提供的一种锚钉输送器的结构示意图。Fig. 1 is a schematic structural diagram of an anchor conveyor provided by the first embodiment of the present invention.

图2为图1的剖面结构示意图。FIG. 2 is a schematic cross-sectional structure diagram of FIG. 1.

图3a为图1的立体分解图。Fig. 3a is an exploded perspective view of Fig. 1.

图3b为图3a中M部分的局部放大图。Fig. 3b is a partial enlarged view of part M in Fig. 3a.

图4a为本发明提供的一种推杆的结构示意图，图4b为图4a的一种截面结构示意图。Fig. 4a is a schematic structural diagram of a push rod provided by the present invention, and Fig. 4b is a schematic cross-sectional structural diagram of Fig. 4a.

图5a为本发明提供的另一种推杆的结构示意图，图5b为图5a的一种截面结构示意图。Fig. 5a is a schematic structural diagram of another push rod provided by the present invention, and Fig. 5b is a schematic cross-sectional structural diagram of Fig. 5a.

图6a为本发明提供的又一种推杆的结构示意图，图6b为图6a的一种截面结构示意图。Fig. 6a is a schematic structural diagram of another push rod provided by the present invention, and Fig. 6b is a schematic cross-sectional structural diagram of Fig. 6a.

图7为锚钉输送器中手柄的立体分解图。Figure 7 is a perspective exploded view of the handle in the anchor conveyor.

图8为图1中手柄部分的立体结构示意图。Fig. 8 is a schematic diagram of the three-dimensional structure of the handle part in Fig. 1.

图9为本发明提供的一种内管的结构示意图。Fig. 9 is a schematic structural diagram of an inner tube provided by the present invention.

图10为本发明提供的一种锁扣的立体结构示意图。FIG. 10 is a schematic diagram of a three-dimensional structure of a lock provided by the present invention.

图11a、图11b、图11c为本发明提供的三种内管主体的横截面结构示意图。11a, 11b, and 11c are schematic diagrams of the cross-sectional structure of three inner tube main bodies provided by the present invention.

图12为本发明提供的一种外管的结构示意图。Fig. 12 is a schematic structural diagram of an outer tube provided by the present invention.

图13为本发明提供的一种护套的结构示意图。Fig. 13 is a schematic structural diagram of a sheath provided by the present invention.

图14为图13中的H-H剖面结构示意图。Fig. 14 is a schematic diagram of the H-H cross-sectional structure in Fig. 13.

图15为本发明第一实施例中提供的一种锚钉的立体结构示意图。15 is a schematic diagram of a three-dimensional structure of an anchor provided in the first embodiment of the present invention.

图16a为图15的立体分解图。Fig. 16a is an exploded perspective view of Fig. 15.

图16b为图16a中的锁套的立体结构示意图。Fig. 16b is a schematic diagram of the three-dimensional structure of the lock sleeve in Fig. 16a.

图17a为图16a中的锚定件的立体结构示意图。Fig. 17a is a schematic diagram of the three-dimensional structure of the anchor in Fig. 16a.

图17b为另一种锚定件的立体结构示意图。Fig. 17b is a schematic diagram of a three-dimensional structure of another anchoring member.

图18a为图17a中锚定子件和限位弹片单独成型的结构示意图。Fig. 18a is a schematic diagram of the structure of the anchor stator and the limiting elastic piece in Fig. 17a being separately formed.

图18b为图17b中锚定子件和限位弹片单独成型的结构示意图。Fig. 18b is a schematic structural diagram of the anchor stator and the limiting elastic piece in Fig. 17b being separately formed.

图19为图16a中的锁杆的立体结构示意图。Fig. 19 is a schematic diagram of the three-dimensional structure of the lock lever in Fig. 16a.

图20为将锚定件安装在锁杆上的结构示意图。Figure 20 is a schematic view of the structure of installing the anchor on the lock rod.

图21为本发明第一实施例提供的锚钉的初始状态的立体结构示意图。FIG. 21 is a three-dimensional schematic diagram of the initial state of the anchor provided by the first embodiment of the present invention.

图22为本发明第一实施例提供的锚钉的初始状态的剖面结构示意图。22 is a schematic cross-sectional structure diagram of the anchor provided by the first embodiment of the present invention in the initial state.

图23为本发明第一实施例提供的锚钉的锁紧状态的立体结构示意图。FIG. 23 is a three-dimensional schematic diagram of the locked state of the anchor provided by the first embodiment of the present invention.

图24为本发明第一实施例提供的锚钉的锁紧状态的剖面结构示意图。24 is a schematic cross-sectional structure diagram of the anchor bolt provided in the first embodiment of the present invention in a locked state.

图25为本发明提供一种锚钉输送器和锚钉组合的结构示意图。Fig. 25 is a structural schematic diagram of an anchor conveyer and an anchor combination provided by the present invention.

图26为锚钉输送器和锚钉组装后的局部结构示意图。Figure 26 is a partial structural diagram of the anchor conveyor and anchor nails after assembly.

图27为锚钉输送器和锚钉组装后的剖面结构示意图。Figure 27 is a schematic cross-sectional structure diagram of the anchor transporter and the anchor after being assembled.

图28为图27中N部分的局部放大图。Fig. 28 is a partial enlarged view of part N in Fig. 27.

图29为锚钉输送器和锚钉组装后将人工腱索穿过锚钉和锚钉输送器的结构示意图。Fig. 29 is a schematic structural diagram of the artificial tendon passing through the anchor nail and the anchor nail conveyor after the anchor nail conveyor and the anchor nail are assembled.

图30为图29中L部分的局部放大图。Fig. 30 is a partial enlarged view of part L in Fig. 29.

图31为将锚钉推出护套的结构示意图。Figure 31 is a schematic diagram of the structure of pushing the anchor out of the sheath.

图32为图31中P部分的局部放大图。Fig. 32 is a partial enlarged view of part P in Fig. 31.

图33为将锚钉锚入组织的结构示意图。Figure 33 is a schematic diagram of the structure of anchoring the anchor into the tissue.

图34为图33中Q部分的局部放大图。Fig. 34 is a partial enlarged view of part Q in Fig. 33.

图35为图34的一种剖面结构示意图。FIG. 35 is a schematic diagram of a cross-sectional structure of FIG. 34.

图36为将锚钉从锚钉输送器中解脱的结构示意图。Figure 36 is a schematic view of the structure for releasing the anchor from the anchor conveyor.

图37为图36中W部分的局部放大图。Fig. 37 is a partial enlarged view of part W in Fig. 36;

图38至图41为本发明中将锚钉输送器经下腔静脉、房间隔路径进行二尖瓣腱索修复手术的示意图。Figures 38 to 41 are schematic diagrams of performing mitral valve chordal repair surgery via the inferior vena cava and atrial septal path with the anchor conveyor in the present invention.

图42至图45为本发明中将锚钉输送器经主动脉路径进行二尖瓣腱索修复手术的示意图。Figures 42 to 45 are schematic diagrams of performing mitral valve chordal repair surgery with the anchor transporter through the aortic path in the present invention.

图46为本发明第三实施例提供的一种锚钉中的锁杆的立体结构示意图。FIG. 46 is a schematic diagram of a three-dimensional structure of a lock rod in an anchor provided by the third embodiment of the present invention.

图47a为本发明第三实施例提供的锚钉的初始状态的立体结构示意图。Fig. 47a is a three-dimensional schematic diagram of the initial state of the anchor provided by the third embodiment of the present invention.

图47b为本发明第三实施例提供的锚钉的初始状态的剖面结构示意图。Fig. 47b is a schematic cross-sectional structure diagram of the anchor provided by the third embodiment of the present invention in the initial state.

图48为本发明第三实施例提供的锚钉的锁紧状态的立体结构示意图。Fig. 48 is a three-dimensional structural schematic diagram of the locked state of the anchor provided by the third embodiment of the present invention.

图49为本发明第三实施例提供的锚钉的锁紧状态的剖面结构示意图。FIG. 49 is a schematic cross-sectional structure diagram of the anchor bolt provided in the third embodiment of the present invention in a locked state.

图50为本发明第四实施例提供的一种锚钉的立体分解图。Fig. 50 is a three-dimensional exploded view of an anchor provided by the fourth embodiment of the present invention.

图51为本发明第四实施例提供的锚钉的初始状态的结构示意图。Fig. 51 is a schematic structural diagram of the anchor provided in the fourth embodiment of the present invention in the initial state.

图52为本发明第四实施例提供的锚钉的锁紧状态的结构示意图。FIG. 52 is a schematic structural diagram of the anchor bolt provided in the fourth embodiment of the present invention in a locked state.

图53为本发明第五实施例提供的一种锚钉的立体分解图。Fig. 53 is a three-dimensional exploded view of an anchor provided by the fifth embodiment of the present invention.

图54为本发明第五实施例提供的锚钉的初始状态的结构示意图。Fig. 54 is a schematic structural diagram of the initial state of the anchor provided by the fifth embodiment of the present invention.

图55为本发明第五实施例提供的锚钉的锁紧状态的结构示意图。Fig. 55 is a schematic structural diagram of a locked state of an anchor provided by the fifth embodiment of the present invention.

图56为本发明第六实施例提供的一种锚钉的立体结构示意图。FIG. 56 is a schematic diagram of a three-dimensional structure of an anchor provided by the sixth embodiment of the present invention.

图57a为图56中的锁杆的立体结构示意图。Fig. 57a is a schematic diagram of the three-dimensional structure of the lock lever in Fig. 56.

图57b为图56中的锁杆的剖面结构示意图。FIG. 57b is a schematic cross-sectional structure diagram of the lock rod in FIG. 56.

图58为本发明第六实施例提供的锚钉的初始状态的立体结构示意图。FIG. 58 is a three-dimensional schematic diagram of the initial state of the anchor provided by the sixth embodiment of the present invention.

图59为本发明第六实施例提供的锚钉的初始状态的剖面结构示意图。Fig. 59 is a schematic cross-sectional structure diagram of the anchor provided by the sixth embodiment of the present invention in the initial state.

图60为本发明第六实施例提供的锚钉的锁紧状态的一角度的剖面结构示意图。Fig. 60 is a schematic cross-sectional structural diagram of an anchor in a locked state provided by the sixth embodiment of the present invention.

图61为本发明第六实施例提供的锚钉的种锁紧状态的另一角度的剖面结构示意图。Fig. 61 is a schematic cross-sectional structure diagram of another locking state of the anchor provided by the sixth embodiment of the present invention.

图62为本发明提供的一种人工腱索植入装置的结构示意图。Fig. 62 is a schematic structural diagram of an artificial tendon implantation device provided by the present invention.

具体实施方式Detailed ways

下面将结合本发明实施例中的附图，对本发明实施例中的技术方案进行清楚、完整地描述，显然，所描述的实施例仅是本发明一部分实施例，而不是全部的实施例。基于本发明中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本发明保护的范围。The following will clearly and completely describe the technical solutions in the embodiments of the present invention with reference to the accompanying drawings in the embodiments of the present invention. Obviously, the described embodiments are only a part of the embodiments of the present invention, rather than all the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those of ordinary skill in the art without creative work shall fall within the protection scope of the present invention.

本发明的说明书和权利要求书及所述附图中的术语“第一”、“第二”等是用于区别不同对象，而不是用于描述特定顺序。此外，术语“包括”和“具有”以及它们任何变形，意图在于覆盖不排他的包含。例如包含了一系列步骤或单元的过程、方法、***、产品或设备没有限定于已列出的步骤或单元，而是可选地还包括没有列出的步骤或单元，或可选地还包括对于这些过程、方法、产品或设备固有的其它步骤或单元。The terms "first", "second", etc. in the specification and claims of the present invention and the drawings are used to distinguish different objects, rather than to describe a specific sequence. In addition, the terms "including" and "having" and any variations of them are intended to cover non-exclusive inclusions. For example, a process, method, system, product, or device that includes a series of steps or units is not limited to the listed steps or units, but optionally includes unlisted steps or units, or optionally also includes Other steps or units inherent to these processes, methods, products or equipment.

在本文中提及“实施例”意味着，结合实施例描述的特定特征、结构或特性可以包含在本发明的至少一个实施例中。在说明书中的各个位置出现该短语并不一定均是指相同的实施例，也不是与其它实施例互斥的独立的或备选的实施例。本领域技术人员显式地和隐式地理解的是，本文所描述的实施例可以与其它实施例相结合。Reference to "embodiments" herein means that a specific feature, structure, or characteristic described in conjunction with the embodiments may be included in at least one embodiment of the present invention. The appearance of the phrase in various places in the specification does not necessarily refer to the same embodiment, nor is it an independent or alternative embodiment mutually exclusive with other embodiments. Those skilled in the art clearly and implicitly understand that the embodiments described herein can be combined with other embodiments.

方位定义：在医疗器械技术领域，通常将靠近操作者的方位定义为近端，远离操作者的方位定义为远端，径向是指沿直径或半径的方向，轴向是指沿中心轴线的方向，径向与轴向相互垂直，周向是指绕中心轴线的圆周方向。除非另有定义，本发明所使用的所有的技术和科学术语与属于本发明的技术领域的技术人员通常理解的含义相同。本发明在说明书中所使用的惯用术语只是为了描述具体实施例的目的，并不能理解为对本发明的限制。Definition of orientation: In the field of medical device technology, the orientation near the operator is usually defined as the proximal end, and the orientation far away from the operator is defined as the distal end. The radial direction refers to the direction along the diameter or radius, and the axial direction refers to the direction along the central axis. The direction, the radial direction and the axial direction are perpendicular to each other, and the circumferential direction refers to the circumferential direction around the central axis. Unless otherwise defined, all technical and scientific terms used in the present invention have the same meaning as commonly understood by those skilled in the technical field of the present invention. The conventional terms used in the specification of the present invention are only for the purpose of describing specific embodiments, and should not be construed as limiting the present invention.

如图1至图3b所示，本发明第一实施例提供一种锚钉输送器2000，锚钉输送器2000用于输送锚钉1000并驱动锚钉1000锚定于组织上、锁紧穿过锚钉1000的人工腱索3000并切断人工腱索3000一侧(如图40和图41所示)；锚定输送器2000包括外管2100、活动穿装于外管2100内的内管2200以及连接外管2100与内管2200的手柄2400。手柄2400包括固定连接外管2100近端的前手柄2410、及沿轴向活动连接前手柄2410的后手柄2420，内管2200的近端活动连接在后手柄2420上。内管2200的远端包括一锁扣2210(如图9所示)，锁扣2210处于外管2100内时连接锚钉1000，锁扣2210暴露于外管2100外时与锚钉1000分离。在本实施例中，将内管2200相对外管2100向近端运动时，使锁扣2210处于外管2100内，将外管2100相对内管2200向近端运动时，而使锁扣2210暴露于外管2100外。As shown in Figures 1 to 3b, the first embodiment of the present invention provides an anchor transporter 2000. The anchor transporter 2000 is used to transport the anchor 1000 and drive the anchor 1000 to anchor on the tissue and lock it through The artificial tendon 3000 of the anchor 1000 and cut off one side of the artificial tendon 3000 (as shown in Figure 40 and Figure 41); the anchoring conveyor 2000 includes an outer tube 2100, an inner tube 2200 movably installed in the outer tube 2100, and A handle 2400 connecting the outer tube 2100 and the inner tube 2200. The handle 2400 includes a front handle 2410 fixedly connected to the proximal end of the outer tube 2100 and a rear handle 2420 movably connected to the front handle 2410 in the axial direction. The proximal end of the inner tube 2200 is movably connected to the rear handle 2420. The distal end of the inner tube 2200 includes a lock 2210 (as shown in FIG. 9 ). The lock 2210 is connected to the anchor 1000 when in the outer tube 2100, and the lock 2210 is separated from the anchor 1000 when exposed outside the outer tube 2100. In this embodiment, when the inner tube 2200 is moved proximally relative to the outer tube 2100, the lock 2210 is in the outer tube 2100, and when the outer tube 2100 is moved proximally relative to the inner tube 2200, the lock 2210 is exposed Outside the outer tube 2100.

本发明提供的锚钉输送器2000能便捷地完成锚钉1000的锚定、锁紧人工腱索3000和切断人工腱索3000操作，减少器械数量，缩短手术时间，节约成本。The anchor conveyor 2000 provided by the present invention can conveniently complete the operations of anchoring the anchor 1000, locking the artificial tendon 3000, and cutting the artificial tendon 3000, thereby reducing the number of instruments, shortening operation time, and saving costs.

在进一步的实施例中，锚钉输送器2000还包括活动穿装在内管2200内的推杆2300，推杆2300的近端活动连接在后手柄2420上(如图2和图3所示)。In a further embodiment, the anchor transporter 2000 further includes a push rod 2300 movably installed in the inner tube 2200, and the proximal end of the push rod 2300 is movably connected to the rear handle 2420 (as shown in FIGS. 2 and 3) .

在本实施例中，推杆2300具有一定的柔性和抗压缩性能。其可以由单根线材组成，也可以是多根线材通过加捻绕制而成(如图4a和图4b所示)，还可以是单根线材外部加捻绕制而成(如图5a和图5b所示)，或者是内部加捻后再在其外部加捻绕制而成(如图6a和图6b所示)。其材质可以是金属或者是高分子材料，如304不锈钢、PA、PE等。In this embodiment, the push rod 2300 has certain flexibility and compression resistance. It can be composed of a single wire, multiple wires can be twisted and wound (as shown in Figure 4a and Figure 4b), or a single wire can be twisted and wound externally (as shown in Figures 5a and 4b). Figure 5b), or internally twisted and then externally twisted and wound (as shown in Figure 6a and Figure 6b). The material can be metal or polymer material, such as 304 stainless steel, PA, PE, etc.

如图7所示，在进一步的实施例中，手柄2400还包括与内管2200的近端固定连接的内管滑块2440、与内管滑块2440螺接的内管驱动轮2460、与推杆2300的近端固定连接的推杆滑块2450及与推杆滑块2450螺接的推杆驱动轮2470。内管驱动轮2460和推杆驱动轮2470均转动连接在后手柄2420上。As shown in Figure 7, in a further embodiment, the handle 2400 further includes an inner tube slider 2440 fixedly connected to the proximal end of the inner tube 2200, an inner tube drive wheel 2460 screwed with the inner tube slider 2440, and a push A push rod slider 2450 fixedly connected to the proximal end of the rod 2300 and a push rod driving wheel 2470 screwed to the push rod slider 2450. The inner tube driving wheel 2460 and the push rod driving wheel 2470 are both rotatably connected to the rear handle 2420.

如图7所示，所述内管滑块2440上设有外螺纹2441，所述内管驱动轮2460的内壁上设有内螺纹2461，所述外螺纹2441与所述内螺纹2461适配，而使内管滑块2440与内管驱动轮2460螺旋连接。所述推杆滑块2450上设有外螺纹2451，所述推杆驱动轮2470的内壁上设有内螺纹2471，所述外螺纹2451与所述内螺纹2471适配，而使推杆滑块2450与推杆驱动轮2470螺旋连接。As shown in Figure 7, the inner tube slider 2440 is provided with an external thread 2441, the inner tube driving wheel 2460 is provided with an internal thread 2461 on the inner wall, and the external thread 2441 is adapted to the internal thread 2461, The inner tube slider 2440 is screwed to the inner tube driving wheel 2460. The push rod slider 2450 is provided with an external thread 2451, and the inner wall of the push rod driving wheel 2470 is provided with an internal thread 2471. The external thread 2451 is adapted to the internal thread 2471, so that the push rod slider 2450 is screwed to the push rod driving wheel 2470.

在进一步的实施例中，后手柄2420上包括第一安装位2424和第二安装位2425，第一安装位2424开设有第一限位槽2422，第二安装位2425开设有第二限位槽2423，内管滑块2440自第一限位槽2422穿出后手柄2420，推杆滑块2450自第二限位槽2423穿出后手柄2420，内管驱动轮2460和推杆驱动轮2470轴向限位在第一安装位2424和第二安装位2422上。In a further embodiment, the rear handle 2420 includes a first mounting position 2424 and a second mounting position 2425. The first mounting position 2424 is provided with a first limiting slot 2422, and the second mounting position 2425 is provided with a second limiting slot. 2423, the inner tube slider 2440 passes through the rear handle 2420 from the first limit slot 2422, the push rod slider 2450 passes through the rear handle 2420 from the second limit slot 2423, the inner tube drive wheel 2460 and the push rod drive wheel 2470 shaft The direction limit is on the first installation position 2424 and the second installation position 2422.

所述内管驱动轮2460可在第一安装位2424上原位旋转，所述推杆驱动轮2470可在第二安装位2422上原位旋转，旋转内管驱动轮2460、推杆驱动轮2470可分别驱动内管滑块2440及内管2200、推杆滑块2450及推杆2300轴向前后运动。The inner tube driving wheel 2460 can be rotated in-situ on the first installation position 2424, the push rod driving wheel 2470 can be rotated in the second installation position 2422, and the inner tube driving wheel 2460 and the push rod driving wheel 2470 can be rotated. The inner tube slider 2440 and the inner tube 2200, the push rod slider 2450 and the push rod 2300 can be driven to move axially back and forth, respectively.

在进一步的实施例中，手柄2400还包括止血阀2430，止血阀2430与外管2100的近端密封连接(如图3a所示)，外管2100和止血阀2430固定安装在前手柄2410的内腔中，内管2200和推杆2300穿过止血阀2430延伸至后手柄2420内。In a further embodiment, the handle 2400 further includes a hemostatic valve 2430, and the hemostatic valve 2430 is hermetically connected to the proximal end of the outer tube 2100 (as shown in FIG. 3a), and the outer tube 2100 and the hemostatic valve 2430 are fixedly installed inside the front handle 2410 In the cavity, the inner tube 2200 and the push rod 2300 extend through the hemostatic valve 2430 into the rear handle 2420.

在本实施例中，所述止血阀2430包括固定座2431、垫片2432以及密封盖2433，固定座2431与外管2100的近端固定连接，密封盖2433与固定座2431固定连接，垫片2432安装在固定座2431与密封盖2433之间，垫片2432上具有中空的小孔可供内管2200通过并延伸至后把手2420内。所述密封盖2433与固定座2431通过螺纹固定连接。所述前手柄2410的远端的内壁上设有第三限位槽2412，所述止血阀2430固定安装在第三限位槽2412中。所述止血阀2430还连接一置于手柄2400外的三通2434。In this embodiment, the hemostatic valve 2430 includes a fixing seat 2431, a gasket 2432, and a sealing cover 2433. The fixing seat 2431 is fixedly connected to the proximal end of the outer tube 2100, the sealing cover 2433 is fixedly connected to the fixing seat 2431, and the gasket 2432 is fixedly connected to the proximal end of the outer tube 2100. Installed between the fixing seat 2431 and the sealing cover 2433, the gasket 2432 has a hollow hole for the inner tube 2200 to pass through and extend into the rear handle 2420. The sealing cover 2433 and the fixing seat 2431 are fixedly connected by threads. The inner wall of the distal end of the front handle 2410 is provided with a third limiting groove 2412, and the hemostatic valve 2430 is fixedly installed in the third limiting groove 2412. The hemostatic valve 2430 is also connected to a three-way 2434 placed outside the handle 2400.

前手柄2410、外管2100、止血阀2430所组成的整体可与后手柄2420、内管2440、推杆2450、内管滑块2460、推杆滑块2470所组成的整体轴向相对运动。The front handle 2410, the outer tube 2100, and the hemostatic valve 2430 can move with the rear handle 2420, the inner tube 2440, the push rod 2450, the inner tube slider 2460, and the push rod slider 2470.

如图7和图8所示，在进一步的实施例中，后手柄2420的远端设有滑杆2421，前手柄2410的近端设有滑槽2411；滑杆2421滑动套设于滑槽2411内。后手柄2420与前手柄2410组装时，后手柄2420上的滑杆2421与前手柄2410上的滑槽2411同轴组装，滑杆2421可在滑槽2411内轴向前后滑动。As shown in Figures 7 and 8, in a further embodiment, the distal end of the rear handle 2420 is provided with a sliding rod 2421, and the proximal end of the front handle 2410 is provided with a sliding groove 2411; the sliding rod 2421 is slidably sleeved in the sliding groove 2411 Inside. When the rear handle 2420 is assembled with the front handle 2410, the sliding rod 2421 on the rear handle 2420 and the sliding groove 2411 on the front handle 2410 are assembled coaxially. The sliding rod 2421 can slide axially forward and backward in the sliding groove 2411.

如图8所示，在进一步的实施例中，滑杆2421与滑槽2411的内壁上分别设有卡位凸起2426及限位凹陷2413；当卡位凸起2426与限位凹陷2413卡合时，前手柄2410与后手柄2420锁止。具体的，在本实施例中前手柄2410上的滑槽2410内具有向内凹陷的3处限位凹陷2413，当滑杆2421在滑槽2411内轴向前后滑动时，卡位凸起2426可分别与3处限位凹陷2413相互卡合，当卡位凸起2426与限位凹陷2413卡合时，前手柄2410与后手柄2420可进行锁止，当卡位凸起2426与限位凹陷2413脱开时，前手柄2410与后手柄2420可进行前后轴向移动。As shown in FIG. 8, in a further embodiment, the inner wall of the sliding rod 2421 and the sliding groove 2411 are respectively provided with a locking protrusion 2426 and a limiting recess 2413; when the locking protrusion 2426 is engaged with the limiting recess 2413 When the time, the front handle 2410 and the rear handle 2420 are locked. Specifically, in this embodiment, the sliding groove 2410 on the front handle 2410 has three inward limiting recesses 2413. When the sliding rod 2421 slides axially back and forth in the sliding groove 2411, the locking protrusion 2426 can be Respectively engage with the three limiting recesses 2413. When the locking protrusion 2426 is engaged with the limiting recess 2413, the front handle 2410 and the rear handle 2420 can be locked. When the locking protrusion 2426 and the limiting recess 2413 are engaged, the front handle 2410 and the rear handle 2420 can be locked. When disengaged, the front handle 2410 and the rear handle 2420 can move forward and backward axially.

在其他实施例中，所述卡位凸起2426可设在滑槽2411的内壁上，所述限位凹陷2413设在滑杆2421上。In other embodiments, the locking protrusion 2426 may be provided on the inner wall of the sliding groove 2411, and the limiting recess 2413 is provided on the sliding rod 2421.

如图9和图10所示，内管2200包括内管主体2220和固定连接于内管主体2220的远端的锁扣2210，锁扣2210包括位于其远端的扣件2211、位于其近端的连接部2213以及位于扣件2211和连接部2213之间的限位部2212，扣件2211自限位部2212的内侧向内突出，扣件2211的形状与锚钉1000上设置的锁扣位的形状相适配；连接部2213与内管主体2220固定连接并相连通。其中，所述扣件2211和所述限位部2212可以是将与连接部2213一体的圆筒状部分削切形成。As shown in Figures 9 and 10, the inner tube 2200 includes an inner tube main body 2220 and a lock 2210 fixedly connected to the distal end of the inner tube main body 2220. The lock 2210 includes a fastener 2211 located at its distal end. The connecting portion 2213 and the limiting portion 2212 located between the fastener 2211 and the connecting portion 2213, the fastener 2211 protrudes inward from the inner side of the limiting portion 2212, and the shape of the fastener 2211 is consistent with the locking position provided on the anchor 1000 The connecting portion 2213 is fixedly connected to and communicated with the inner tube main body 2220. Wherein, the fastener 2211 and the limiting portion 2212 may be formed by cutting a cylindrical part integral with the connecting portion 2213.

在本实施例中，锁扣2210由金属或者高分子材料制成，如304不锈钢、PA、PE、PC等具有一定的刚性的材料。内管主体2220为中空结构，可以是高分子材料或者金属制成，如304不锈钢、PA、PE、Pebax等具有一定的柔性和抗拉伸性能的材料，优选为金属弹簧管结构，其弹簧线可以是规则圆形或者其他异型结构，如图11a至图11c示出了三种内管主体2220的截面图。内管主体2220与锁扣2210通过连接部2213通过焊接、粘接等方式进行固定连接。In this embodiment, the lock 2210 is made of metal or polymer materials, such as 304 stainless steel, PA, PE, PC and other materials with certain rigidity. The inner tube main body 2220 is a hollow structure, which can be made of polymer material or metal, such as 304 stainless steel, PA, PE, Pebax and other materials with certain flexibility and tensile properties, preferably a metal spring tube structure, and its spring wire It may be a regular circle or other special-shaped structures. Figs. 11a to 11c show cross-sectional views of three inner tube main bodies 2220. The inner tube main body 2220 and the lock catch 2210 are fixedly connected through the connecting portion 2213 by welding, bonding, or the like.

在进一步的实施例中，锁扣2210上还设有沿轴向延伸的通槽2215及限位凸起2214，通槽2215供人工腱索3000穿过，限位凸起2214用于与外管2100限位。In a further embodiment, the lock 2210 is further provided with a through groove 2215 extending in the axial direction and a limiting protrusion 2214. The through groove 2215 allows the artificial tendon 3000 to pass through, and the limiting protrusion 2214 is used to communicate with the outer tube. 2100 limit.

如图12至图14所示，在进一步的实施例中，外管2100包括外管主体2120以及固定连接于外管主体2120远端的护套2110，护套2110的两侧对称分布有两个限位槽2113、2114，人工腱索3000穿过两个限位槽2113、2114。在本实施例中，限位凸起2114与限位槽2114相适配，限位凸起2114限位在限位槽2114中。As shown in Figures 12 to 14, in a further embodiment, the outer tube 2100 includes an outer tube main body 2120 and a sheath 2110 fixedly connected to the distal end of the outer tube main body 2120. Two sides of the sheath 2110 are symmetrically distributed. Limiting

slots

2113, 2114, and artificial tendon 3000 pass through the two limiting

slots

2113, 2114. In this embodiment, the limiting protrusion 2114 is matched with the limiting groove 2114, and the limiting protrusion 2114 is limited in the limiting groove 2114.

在本实施例中，护套2110由金属或者高分子材料制成，如304不锈钢、PA、PE、PC等具有一定的刚性的材料，所述护套2110为中空结构。外管主体2120为中空结构，可以是304不锈钢金属材料、高分子材料PA、PE、pebax等制成，具有一定的柔性，能够顺畅的弯曲。所述护套2110包括位于远端的通孔2111和位于近端的连接位2112，所述两个限位槽2113、2114分布在通孔2111的两侧，且与通孔2111连通。外管主体2120通过连接位2112与护套2110通过粘接、焊接方式形成固定连接。In this embodiment, the sheath 2110 is made of metal or polymer materials, such as 304 stainless steel, PA, PE, PC and other materials with certain rigidity, and the sheath 2110 has a hollow structure. The outer tube main body 2120 has a hollow structure, which can be made of 304 stainless steel metal material, polymer materials PA, PE, pebax, etc., has a certain degree of flexibility and can be bent smoothly. The sheath 2110 includes a through hole 2111 at the distal end and a connecting position 2112 at the proximal end. The two limiting

grooves

2113 and 2114 are distributed on both sides of the through hole 2111 and communicate with the through hole 2111. The outer tube main body 2120 is fixedly connected with the sheath 2110 through the connecting position 2112 by bonding and welding.

如图15至图25所示，本发明的锚钉输送器2000输送的锚钉1000包括锁杆1300、套装在锁杆1300外的锁套1100及锚定件1200，锚定件1200与锁杆1300或者锁套1100的远端连接；锁杆1300与锁套1100之间具有径向间隙，锁杆1300上设有穿线孔1321供人工腱索3000(如图19和图22所示)穿过，且穿线孔1321至少一端连通锁杆1300与锁套110之间的径向间隙；锁杆1300或/和锁套1100上设有刃口1130。在本实施例中，锚定件1200与锁杆1300的远端连接，所述刃口1130设置在所述锁套1100的近端上(如图24所述)。As shown in Figures 15 to 25, the anchor 1000 delivered by the anchor conveyor 2000 of the present invention includes a lock rod 1300, a lock sleeve 1100 sheathed outside the lock rod 1300, and an anchor 1200, the anchor 1200 and the lock rod 1300 or the distal end of the lock sleeve 1100; there is a radial gap between the lock rod 1300 and the lock sleeve 1100, and the lock rod 1300 is provided with a threading hole 1321 for the artificial chord 3000 (as shown in Figure 19 and Figure 22) to pass through , And at least one end of the threading hole 1321 communicates with the radial gap between the lock rod 1300 and the lock sleeve 110; the lock rod 1300 or/and the lock sleeve 1100 are provided with a cutting edge 1130. In this embodiment, the anchor 1200 is connected to the distal end of the lock rod 1300, and the cutting edge 1130 is provided on the proximal end of the lock sleeve 1100 (as shown in FIG. 24).

锁套1100上设有与锁扣2210适配的锁扣位1120(如图16b所示)，手柄2400驱动内管2200轴向移动，以带动锁扣2210、锁扣位1120及锁套1100相对锁杆1300轴向移动，至少位于穿线孔1321一侧的部分人工腱索3000被挤压进锁杆1300和锁套1100之间的径向间隙中，直至位于穿线孔1321一侧的部分人工腱索3000被刃口1130切断。如图16b所示，锁套1100大体为中空的圆筒型结构，具有中空内腔1110，锁杆1300收容于所述锁套1100的中空内腔1110中。The lock sleeve 1100 is provided with a lock position 1120 adapted to the lock buckle 2210 (as shown in Fig. 16b). The handle 2400 drives the inner tube 2200 to move axially to drive the lock buckle 2210, the lock position 1120 and the lock sleeve 1100 to oppose each other. The lock rod 1300 moves axially, and at least a part of the artificial tendon 3000 located on the side of the threading hole 1321 is squeezed into the radial gap between the lock rod 1300 and the lock sleeve 1100 to the part of the artificial tendon located on the side of the threading hole 1321 The cord 3000 is severed by the cutting edge 1130. As shown in FIG. 16b, the lock sleeve 1100 is generally a hollow cylindrical structure with a hollow inner cavity 1110, and the lock rod 1300 is received in the hollow inner cavity 1110 of the lock sleeve 1100.

人工腱索3000优选医用缝线，其它可用作人工腱索的丝、线、绳等也可采用。The artificial tendon 3000 is preferably a medical suture, and other silk, thread, rope, etc. that can be used as an artificial tendon may also be used.

请参照图23至图24，预先缝入瓣叶的人工腱索3000，穿过所述穿线孔1321，所述穿线孔1321一侧是指穿线孔1321远离人工腱索3000与瓣叶的缝合点的一侧，或者所述人工腱索3000的自所述穿线孔1321的穿出侧。值得注意的是，所述锁杆1300和锁套1100之间的径向间隙应略小于人工腱索3000的直径值，以能够在锁套1100与锁杆1300相对运动时夹紧人工腱索3000。Please refer to Figures 23 to 24, the artificial chordae 3000 pre-sewn into the valve leaflet passes through the threading hole 1321, and the side of the threading hole 1321 refers to the threading hole 1321 away from the suture point of the artificial chordae 3000 and the valve leaflet Or the side of the artificial chord 3000 that exits from the threading hole 1321. It is worth noting that the radial gap between the lock rod 1300 and the lock sleeve 1100 should be slightly smaller than the diameter of the artificial tendon 3000, so that the artificial tendon 3000 can be clamped when the lock sleeve 1100 and the lock rod 1300 move relative to each other. .

在进一步的实施例中，锁扣位1120包括向锁套1100内凹陷的缺口(如图16b所示)；锁扣2210包括与缺口适配的凸出结构。所述凸出结构即为前面所述锁扣2210中的扣件2211。本实施例中，所述锁扣位1120通过切割锁套1100一端形成，其两侧具有向锁套1100内凹陷的缺口，缺口自其近端向其远端的轴向轮廓形状大体呈倒“Z”形，所述扣件2211的形状大体相同，两者相适配，采用这种结构，当外管2100移除后，轴向后撤内管2200即可解除与锁套1100的连接，无需先在垂直于轴向的方向移动，使得扣件2211从缺口中出来。In a further embodiment, the lock catch 1120 includes a notch recessed into the lock sleeve 1100 (as shown in FIG. 16b); the lock 2210 includes a protruding structure that fits with the notch. The protruding structure is the fastener 2211 in the lock 2210 described above. In this embodiment, the lock position 1120 is formed by cutting one end of the lock sleeve 1100, and its two sides have notches recessed into the lock sleeve 1100, and the axial contour shape of the notch from its proximal end to its distal end is generally inverted. Z" shape, the shape of the fastener 2211 is roughly the same, and the two are matched. With this structure, when the outer tube 2100 is removed, the inner tube 2200 can be withdrawn axially to release the connection with the lock sleeve 1100. There is no need to move in the direction perpendicular to the axial direction first, so that the fastener 2211 comes out of the gap.

在进一步的实施例中，锚钉1000还包括限位结构，限位结构用于在人工腱索3000被锁紧在锁杆1300与锁套1100之间的径向间隙后保持锁杆1300或锁套1100的位置，以保持人工腱索3000被锁紧的状态。In a further embodiment, the anchor 1000 further includes a limiting structure, which is used to maintain the lock rod 1300 or lock after the artificial tendon 3000 is locked in the radial gap between the lock rod 1300 and the lock sleeve 1100 The position of the sleeve 1100 is to keep the artificial tendon 3000 in a locked state.

在进一步的实施例中，限位结构包括数个限位弹片1220(如图17a、图17b所示)及与数个限位弹片1220轴向间隔设置的凸台1322(如图19和图23所示)，在人工腱索3000被锁紧在锁杆1300与锁套1100之间的径向间隙后，锁套1300被限位于数个限位弹片1220与凸台1322之间以保持锁套1300的位置。In a further embodiment, the limiting structure includes a plurality of limiting elastic pieces 1220 (as shown in FIGS. 17a and 17b) and a boss 1322 arranged axially spaced apart from the plurality of limiting elastic pieces 1220 (as shown in FIGS. 19 and 23). (Shown), after the artificial tendon 3000 is locked in the radial gap between the lock rod 1300 and the lock sleeve 1100, the lock sleeve 1300 is limited between a plurality of limit elastic pieces 1220 and the boss 1322 to maintain the lock sleeve 1300 location.

在进一步的实施例中，部分限位结构上设有避位面1331(如图19所示)，且避位面1331与锁扣位1120位于同侧。在本实施例中，如图19所示，避位面1331位于所述凸台1322的一侧面，将凸台1322的部分切割掉形成，当锁扣2210与锁扣位1120脱离时，不会阻碍、卡滞锁扣2210。In a further embodiment, part of the limiting structure is provided with an avoiding surface 1331 (as shown in FIG. 19), and the avoiding surface 1331 and the locking position 1120 are located on the same side. In this embodiment, as shown in FIG. 19, the avoidance surface 1331 is located on one side of the boss 1322, and the boss 1322 is cut away. When the lock 2210 is separated from the lock 1120, it will not Obstacle, stuck lock 2210.

在进一步的实施例中，锚定件1200包括设置于锁杆1300远端的锚定件主体1201和设于锚定件主体上的数个弹性子件1210，数个限位弹片1220设置在锚定件主体1201的近端(如图17a所示)，凸台1322设置在锁杆1300的近端。其中，限位弹片1220可以是相对锚定件主体1201的中心轴线向外展开(如图17a所示)，也可以沿圆周方向向外展开(如图17b所示)。锚定件1200可由镍钛合金切割后经热处理定型，弹性子件1210和限位弹片1220具有一定的弹性，可以在解除外力作用后恢复成初始形状。锚定件1200也可由其他金属材料加工成型，如不锈钢、钴锘合金等。在其他实施例中，弹性子件1210可以是与限位弹片1220在锚定件主体1201上整体切割加工成型，也可以是如图18a和图18b所示：分别单独成型后通过焊接、粘接、压接等方式固定连接至锚定件主体1201上。In a further embodiment, the anchor 1200 includes an anchor body 1201 arranged at the distal end of the lock rod 1300 and a plurality of elastic sub-members 1210 arranged on the anchor body, and a plurality of limit elastic pieces 1220 are arranged on the anchor At the proximal end of the fixed body 1201 (as shown in FIG. 17a), the boss 1322 is provided at the proximal end of the lock rod 1300. Wherein, the limiting elastic piece 1220 can be expanded outward relative to the central axis of the anchor body 1201 (as shown in FIG. 17a), or it can expand outward in the circumferential direction (as shown in FIG. 17b). The anchor 1200 can be cut by nickel-titanium alloy and then heat-treated and shaped. The elastic sub-member 1210 and the limiting elastic piece 1220 have certain elasticity and can be restored to the original shape after the external force is released. The anchor 1200 can also be processed and formed by other metal materials, such as stainless steel, cobalt-nosium alloy, and the like. In other embodiments, the elastic sub-component 1210 can be integrally cut and formed on the anchor body 1201 with the limiting elastic piece 1220, or as shown in Figure 18a and Figure 18b: separately formed by welding or bonding. It is fixedly connected to the anchor body 1201 by means such as crimping.

初始状态时，锁套1100套设在数个限位弹片1220及数个弹性子件1210外以聚拢数个限位弹片1220及数个弹性子件1210(如图21和图22所示)。在锁套1100未套设至锚定件1200上之前，锚定件1200固定套装在锁杆1300的远端，且锚定件1200上的弹性子件1210及限位弹片1220向外展开(如图20所示)。In the initial state, the lock sleeve 1100 is sleeved on the plurality of limiting elastic pieces 1220 and the plurality of elastic sub-components 1210 to gather the plurality of limiting elastic pieces 1220 and the plurality of elastic sub-components 1210 (as shown in FIG. 21 and FIG. 22). Before the lock sleeve 1100 is sleeved on the anchor 1200, the anchor 1200 is fixedly sleeved on the distal end of the lock rod 1300, and the elastic sub-member 1210 and the limiting elastic piece 1220 on the anchor 1200 expand outward (such as Shown in Figure 20).

锁套1100相对锁杆1300向锁杆1300的近端运动至人工腱索3000被锁紧在锁杆1300与锁套1100之间的径向间隙后，锁套1100抵接凸台1322并释放数个限位弹片1220及数个弹性子件1210，数个限位弹片1220及数个弹性子件1210向外展开(如图23和图24所示)。向外展开的数个限位弹片1220与凸台1322将锁套1300限位在两者之间以保持锁套1300的轴向位置固定。The lock sleeve 1100 moves relative to the lock rod 1300 toward the proximal end of the lock rod 1300 until the artificial tendon 3000 is locked in the radial gap between the lock rod 1300 and the lock sleeve 1100, the lock sleeve 1100 abuts the boss 1322 and releases the number. A limit elastic piece 1220 and a plurality of elastic sub-components 1210, a plurality of limit elastic pieces 1220 and a plurality of elastic sub-components 1210 expand outward (as shown in FIG. 23 and FIG. 24). A plurality of positioning elastic pieces 1220 and a boss 1322 that are spread out restrict the lock sleeve 1300 between them to keep the axial position of the lock sleeve 1300 fixed.

在其他实施例中，锚定件1200也可以是螺旋钉、卡爪等其他锚固构型。In other embodiments, the anchor 1200 may also be a screw nail, a claw and other anchoring configurations.

在进一步的实施例中，锁杆1300包括锁定段1320及连接于锁定段1320远端的连接段1310(如图19所示)；凸台1322和数个限位弹片1220将锁套1100限位在锁杆1300的锁定段1320上；连接段1310的直径小于锁定段1320的直径；锚定件主体1201为中空结构(如图17a所示)，锚定件主体1201固定套接在锁杆1300的连接段1310上(如图20所示)。连接段1310外径小于锁定段1320外径，锁定段1320外径略小于或等于锚定件1100的近端筒状部的外径，连接段1310外径与锚定件1200内径相匹配，当锚定件主体1201固定套接在锁杆1300的连接段1310上，且数个弹性子件1210被收拢在锁套1300内时，所述锚定件1200的外径与锁套1300内径向匹配，以使锁套1300能够在套设有锚定件1200的锁杆1300的连接段1310和锁杆1300的锁定段1320之间相对运动(如图21和图22所示)。连接段1310的前端具有尖锐的尖端1311(如图19所示)，以便于锚钉1000更方便的刺入心室壁组织中。如图20所示，锚定件1200与锁杆1300组装时，锚定件1200插装在连接段1310上，通过焊接、粘接、压接等方式与锁杆1300形成固定连接。In a further embodiment, the lock rod 1300 includes a locking section 1320 and a connecting section 1310 connected to the distal end of the locking section 1320 (as shown in FIG. 19); a boss 1322 and a plurality of limiting spring pieces 1220 limit the locking sleeve 1100 On the locking section 1320 of the lock rod 1300; the diameter of the connecting section 1310 is smaller than the diameter of the locking section 1320; the anchor body 1201 is a hollow structure (as shown in Figure 17a), and the anchor body 1201 is fixedly sleeved on the lock rod 1300 On the connecting section 1310 (as shown in Figure 20). The outer diameter of the connecting section 1310 is smaller than the outer diameter of the locking section 1320, the outer diameter of the locking section 1320 is slightly smaller than or equal to the outer diameter of the proximal cylindrical portion of the anchor 1100, and the outer diameter of the connecting section 1310 matches the inner diameter of the anchor 1200. When the anchor body 1201 is fixedly sleeved on the connecting section 1310 of the lock rod 1300, and several elastic sub-elements 1210 are folded in the lock sleeve 1300, the outer diameter of the anchor 1200 matches the inner diameter of the lock sleeve 1300 , So that the lock sleeve 1300 can move relatively between the connecting section 1310 of the lock rod 1300 with the anchor 1200 and the locking section 1320 of the lock rod 1300 (as shown in FIGS. 21 and 22). The front end of the connecting section 1310 has a sharp tip 1311 (as shown in FIG. 19), so that the anchor 1000 can penetrate the ventricular wall tissue more conveniently. As shown in FIG. 20, when the anchor 1200 is assembled with the lock rod 1300, the anchor 1200 is inserted into the connecting section 1310, and is fixedly connected with the lock rod 1300 by welding, bonding, crimping, or the like.

在进一步的实施例中，穿线孔1321的两端分别穿通锁杆1300的锁定段1310的一侧的外周面以及锁杆1300的近端面(如图19所示)。In a further embodiment, the two ends of the threading hole 1321 respectively penetrate through the outer peripheral surface of one side of the locking section 1310 of the lock rod 1300 and the proximal surface of the lock rod 1300 (as shown in FIG. 19).

在其他实施例中，穿线孔1321的两端分别穿通锁杆1300的锁定段1310的两侧的外周面，穿线孔1321的轴向相对锁杆1300的锁定段1310的轴向垂直或倾斜。In other embodiments, the two ends of the threading hole 1321 respectively penetrate through the outer peripheral surfaces of both sides of the locking section 1310 of the lock rod 1300, and the axial direction of the threading hole 1321 is perpendicular or inclined relative to the axial direction of the locking section 1310 of the lock rod 1300.

在进一步的实施例中，锁套1100的近端面或/和凸台1322的远端面上远离所述锁扣位1120的一侧设置刃口1130(如图24所示)，锁套1100相对锁杆1300向近端运动至抵接凸台1322时，刃口1130切断位于穿线孔1321一侧的部分人工腱索3000。在本实施例中，刃口1130设置在锁套1100的近端面(如图24所示)。在其他实施例中，刃口1130设置在凸台1322的远端面。在另一些实施例中，在锁套1100的近端面和凸台1322的远端面同时设有刃口1130，当锁套1100的近端抵接凸台1322的远端时，两者的刃口1130相抵接而切断人工腱索3000。In a further embodiment, the proximal surface of the locking sleeve 1100 or/and the distal surface of the boss 1322 are provided with a cutting edge 1130 (as shown in FIG. 24) on the side away from the locking position 1120, and the locking sleeve 1100 When moving proximally with respect to the lock rod 1300 to abut the boss 1322, the cutting edge 1130 cuts off a part of the artificial chord 3000 on the side of the threading hole 1321. In this embodiment, the cutting edge 1130 is provided on the proximal surface of the lock sleeve 1100 (as shown in FIG. 24). In other embodiments, the cutting edge 1130 is provided on the distal surface of the boss 1322. In other embodiments, a cutting edge 1130 is provided on the proximal surface of the locking sleeve 1100 and the distal surface of the boss 1322 at the same time. When the proximal end of the locking sleeve 1100 abuts the distal end of the boss 1322, the two The cutting edge 1130 abuts to cut the artificial tendon 3000.

本实施例中锚钉1000的工作过程如下：如图21和图22所示，初始状态时，锁套1100套装在锚定件1200与锁杆1300上，数个弹性子件1210和数个限位弹片及1220被压缩进锁套1100的内腔中，锁套1100的近端面与穿线孔1321边缘平齐，人工腱索3000可沿穿线孔1321穿过锁杆1320。The working process of the anchor 1000 in this embodiment is as follows: as shown in Figure 21 and Figure 22, in the initial state, the lock sleeve 1100 is sleeved on the anchor 1200 and the lock rod 1300, and several elastic sub-components 1210 and several limiters The position elastic piece and 1220 are compressed into the inner cavity of the lock sleeve 1100, the proximal surface of the lock sleeve 1100 is flush with the edge of the threading hole 1321, and the artificial tendon 3000 can pass through the lock rod 1320 along the threading hole 1321.

如图23和图24所示，驱动锁套1100相对锁杆1300沿轴向近端运动，此时锚定件1200上的弹性子件1210被逐渐释放并展开，实现锚定功能。人工腱索3000被挤压进锁套1100和锁杆1300之间的径向间隙中。锁套1100与锁杆1300之间间隙小于人工腱索3000直径，人工腱索3000受到锁杆1300与锁套1100挤压，三者实现过盈配合，人工腱索3000被锁紧。当锁套1100近端上的刃口1130与凸台1322相抵，刃口1130将人工腱索3000一端切断，此时限位弹片1220展开释放，锁套1100被限位在锁杆1300上，实现了锁紧人工腱索及切断多余人工腱索的功能。As shown in Figs. 23 and 24, the drive lock sleeve 1100 moves axially proximally relative to the lock rod 1300. At this time, the elastic sub-member 1210 on the anchor 1200 is gradually released and expanded to realize the anchoring function. The artificial tendon 3000 is squeezed into the radial gap between the lock sleeve 1100 and the lock rod 1300. The gap between the lock sleeve 1100 and the lock rod 1300 is smaller than the diameter of the artificial tendon 3000. The artificial tendon 3000 is squeezed by the lock rod 1300 and the lock sleeve 1100, and the three achieve an interference fit, and the artificial tendon 3000 is locked. When the cutting edge 1130 on the proximal end of the lock sleeve 1100 is against the boss 1322, the cutting edge 1130 cuts off one end of the artificial tendon 3000. At this time, the limiting spring 1220 is unfolded and released, and the locking sleeve 1100 is limited on the lock rod 1300. The function of locking artificial tendons and cutting off excess artificial tendons.

如图25至图28所示，当锚钉1000与输送器2000组装时，锚钉1000上锁扣位1120与输送器1000内管上锁扣2210上的扣件2211相互扣合，避位面1331与限位部2212相抵(如图25和图26所示)。通槽2215对齐穿线孔1321(如图28所示)。驱动推杆2300直到端面与凸台1330端面相抵。锚钉1000与推杆2300、内管2200组装后，此时固定前手柄2410，再驱动后手柄2420将内管2200、推杆2300及锚钉1000组成的整体收进外管2100内腔中，限位凸起2214滑进外管上的限位槽2114中。穿线孔1321一侧与限位槽2114贯通，另一侧与限位槽2113贯通，人工腱索300可顺利穿过锚钉1000。As shown in Figures 25-28, when the anchor 1000 is assembled with the conveyor 2000, the locking position 1120 on the anchor 1000 and the fastener 2211 on the locking 2210 on the inner tube of the conveyor 1000 are buckled with each other. 1331 conflicts with the limiting portion 2212 (as shown in Figure 25 and Figure 26). The through groove 2215 is aligned with the threading hole 1321 (as shown in FIG. 28). The push rod 2300 is driven until the end face abuts against the end face of the boss 1330. After the anchor 1000 is assembled with the push rod 2300 and the inner tube 2200, the front handle 2410 is fixed at this time, and then the rear handle 2420 is driven to receive the inner tube 2200, the push rod 2300 and the anchor 1000 into the inner cavity of the outer tube 2100. The limiting protrusion 2214 slides into the limiting groove 2114 on the outer tube. One side of the threading hole 1321 is penetrated with the limiting groove 2114, and the other side is penetrated with the limiting groove 2113, and the artificial tendon 300 can pass through the anchor 1000 smoothly.

本实施例提供的锚钉输送器2000的工作过程如下：The working process of the anchor conveyor 2000 provided in this embodiment is as follows:

如图29和图30所示，首先将人工腱索300穿过穿线孔1320并贯穿锚钉1000，然后将锚钉输送器2000沿人工腱索3000(在这之前，人工腱索3000已缝至瓣叶上，且人工腱索3000远离缝合点的一侧伸出体外)送至心室壁或***肌的位置，直到外管2100的护套2110的端面与组织相抵。As shown in Figure 29 and Figure 30, first pass the artificial tendon 300 through the threading hole 1320 and penetrate the anchor 1000, and then move the anchor conveyor 2000 along the artificial tendon 3000 (previously, the artificial tendon 3000 has been sewn to On the valve leaflet, the side of the artificial chordae 3000 protruding out of the body away from the suture point) is sent to the ventricular wall or the position of the papillary muscle until the end surface of the sheath 2110 of the outer tube 2100 abuts the tissue.

如图31和图32所示，保持前手柄2410不动，驱动后手柄2420整体沿轴向向远端移动，将锚钉1000推出外管2100(如图31所示的a方向)，扎入组织内，护套2110起到保护周围组织及原生腱索的作用。As shown in Figure 31 and Figure 32, keep the front handle 2410 still, drive the entire rear handle 2420 to move distally along the axial direction, push the anchor 1000 out of the outer tube 2100 (a direction as shown in Figure 31), and insert it In the tissue, the sheath 2110 plays a role in protecting the surrounding tissue and the native tendon chordae.

如图33至图35所示，然后牵拉人工腱索3000调节人工腱索3000的长度至合适的尺寸，然后驱动内管驱动轮2460(如图33所示的b方向旋转驱动)，带动内管2200向近端移动从而带动锁套1100后撤，锚钉1000上的弹性子件1210展开锚固在组织内，同时锁套1100将人工腱索3000与锚钉1000锁紧并切断一侧人工腱索3000，此过程中，推杆2300保持对锁杆1300端面的推顶作用，防止锁套1100带动锁杆1300及弹性子件1210脱离组织。As shown in Figures 33 to 35, the artificial tendon 3000 is then pulled to adjust the length of the artificial tendon 3000 to a suitable size, and then the inner tube driving wheel 2460 is driven (rotated in the direction b as shown in Figure 33) to drive the inner tube The tube 2200 moves proximally to drive the locking sleeve 1100 to withdraw. The elastic component 1210 on the anchor 1000 is deployed and anchored in the tissue. At the same time, the locking sleeve 1100 locks the artificial tendon 3000 and the anchor 1000 and cuts off one artificial tendon. Cable 3000. During this process, the push rod 2300 maintains the pushing effect on the end surface of the lock rod 1300 to prevent the lock sleeve 1100 from driving the lock rod 1300 and the elastic component 1210 from the tissue.

如图36和图37所示，最后，保持后手柄2420不动，沿轴向朝近端后撤前手柄2410(如图36所示的c方向)，将锚钉1000上的锁扣位1120与锚钉输送器2000上的锁扣2210解锁，撤出锚钉输送器2000及多余人工腱索3000。As shown in Figure 36 and Figure 37, finally, keeping the rear handle 2420 still, retract the front handle 2410 proximally in the axial direction (direction c as shown in Figure 36), and lock the anchor 1000 on the lock position 1120 Unlock with the lock 2210 on the anchor conveyor 2000, and withdraw the anchor conveyor 2000 and the excess artificial tendon 3000.

由于本申请的锚钉输送器2000与集成了锚定、锁紧人工腱索以及切断多余人工腱索功能的锚钉1000相配合，在实施腱索修复手术时，使用一个该锚钉输送器2000即可完成导入锚钉、锚定、锁紧人工腱索及切断多余人工腱索的操作，减少了器械数量，大幅简化了操作步骤，缩短手术时间，节约成本。Since the anchor transporter 2000 of the present application cooperates with the anchor 1000 that integrates the functions of anchoring, locking the artificial tendon cord and cutting off the excess artificial tendon cord, one of the anchor transporter 2000 is used when performing chordal repair operations. The operations of introducing anchors, anchoring, locking artificial tendons and cutting off redundant artificial tendons can be completed, which reduces the number of instruments, greatly simplifies the operation steps, shortens the operation time, and saves costs.

如图38至图41所示，在本发明第一实施例中，锚钉输送器2000的介入路径依次为股静脉—下腔静脉—右心房—房间隔—左心房—左心室。图38为将人工腱索3000穿过锚钉1000的示意图。图39为将锚钉输送器2000沿人工腱索3000导入左心室的示意图。图40为锚钉输送器2000将锚钉1000锚入心肌组织，完成锁紧人工腱索3000和切断人工腱索3000的示意图。图41为解锁锚钉1000，撤出锚钉输送器2000和多余人工腱索3000的示意图。As shown in FIGS. 38 to 41, in the first embodiment of the present invention, the intervention path of the anchor transporter 2000 is femoral vein-inferior vena cava-right atrium-atrial septum-left atrium-left ventricle in sequence. FIG. 38 is a schematic diagram of inserting the artificial tendon 3000 through the anchor 1000. FIG. 39 is a schematic diagram of introducing the anchor transporter 2000 into the left ventricle along the artificial chord 3000. FIG. 40 is a schematic diagram of the anchor transfer device 2000 anchoring the anchor 1000 into the myocardial tissue to complete the locking of the artificial chord 3000 and the cutting of the artificial chord 3000. FIG. 41 is a schematic diagram of unlocking the anchor 1000, withdrawing the anchor conveyor 2000 and the redundant artificial tendon 3000.

如图42至图45所示，本发明第二实施例中，锚钉输送器2000的介入路径依次为股动脉—腹主动脉—胸主动脉—主动脉弓—左心室。图42为将人工腱索3000穿过锚钉1000的示意图。图43为导入锚钉输送器2000的示意图。图44为将锚钉1000植入、锁紧人工腱索3000和切断人工腱索3000示意图。图45为撤出锚钉输送器2000和多余人工腱索3000示意图。As shown in FIGS. 42 to 45, in the second embodiment of the present invention, the intervention path of the anchor transporter 2000 is femoral artery-abdominal aorta-thoracic aorta-aortic arch-left ventricle in sequence. FIG. 42 is a schematic diagram of inserting the artificial tendon 3000 through the anchor 1000. FIG. 43 is a schematic diagram of the introduction of the anchor conveyor 2000. As shown in FIG. Fig. 44 is a schematic diagram of implanting the anchor 1000, locking the artificial tendon 3000, and cutting off the artificial tendon 3000. FIG. 45 is a schematic diagram of withdrawing the anchor transporter 2000 and the redundant artificial tendon 3000.

如图46所示，本发明第三实施例与第一实施例相比，锚钉输送器2000输送的锚钉的结构不同，具体为，锚钉1000a中的穿线孔1321相对轴向倾斜地贯穿锁定段1320(如图46所示)，即穿线孔1321的轴向相对锁杆1300的锁定段1310的轴向倾斜。如图47a至图47b所示，初始状态时，人工腱索3000穿过穿线孔1321，人工腱索3000的两端自锁杆1300的两侧的外周面穿出；如图48至图49所示，锁紧状态时，驱动锁套1100与锁杆1300相对运动，人工腱索3000可被双侧挤压在锁套1100与锁杆1300之间，实现双侧锁紧人工腱索的功能，将更进一步提高锁紧力。当锁套1100近端上的刃口1130与凸台1322端面相抵，刃口1130将人工腱索3000的一端切断，此时限位弹片1220展开释放，限位弹片1220和凸台1322将锁套1100限位在锁杆1300上，保持人工腱索3000的被锁紧状态。As shown in FIG. 46, compared with the first embodiment, the third embodiment of the present invention has a different structure of the anchor conveyed by the anchor conveyor 2000. Specifically, the threading hole 1321 in the anchor 1000a penetrates obliquely with respect to the axial direction. The locking section 1320 (as shown in FIG. 46 ), that is, the axial direction of the threading hole 1321 is inclined relative to the axial direction of the locking section 1310 of the lock rod 1300. As shown in FIGS. 47a to 47b, in the initial state, the artificial tendon 3000 passes through the threading hole 1321, and both ends of the artificial tendon 3000 pass through the outer peripheral surfaces of both sides of the locking rod 1300; as shown in FIGS. 48 to 49 In the locked state, the driving lock sleeve 1100 and the lock rod 1300 move relative to each other, and the artificial tendon 3000 can be squeezed between the lock sleeve 1100 and the lock rod 1300 on both sides to realize the function of locking the artificial tendon on both sides. Will further improve the locking force. When the cutting edge 1130 on the proximal end of the locking sleeve 1100 and the end surface of the boss 1322 abut, the cutting edge 1130 cuts off one end of the artificial tendon 3000, and the limit elastic piece 1220 is unfolded and released, and the limit elastic piece 1220 and the boss 1322 will lock the sleeve 1100 The position is limited on the lock rod 1300 to keep the artificial tendon 3000 in a locked state.

在其他实施例中，穿线孔1321还可垂直于锁杆1300的轴向并贯穿锁定段1320，也就是穿线孔1321的轴向与锁定段1320的轴向相垂直，驱动锁套1100与锁杆1300相对运动，人工腱索3000可被双侧挤压在锁套1100与锁杆1300之间，实现双侧锁紧人工腱索的功能。In other embodiments, the threading hole 1321 may also be perpendicular to the axial direction of the lock rod 1300 and penetrate the locking section 1320, that is, the axial direction of the threading hole 1321 is perpendicular to the axial direction of the locking section 1320, and the driving lock sleeve 1100 and the lock rod With relative movement of 1300, the artificial chord 3000 can be squeezed between the lock sleeve 1100 and the lock rod 1300 on both sides to realize the function of locking the artificial chord on both sides.

如图50至图52所示，本发明第四实施例与第一实施例相比，锚钉输送器2000输送的锚钉的结构不同，具体为，锚钉1000b中的限位结构还包括连接锁套1100远端的第一圆筒部1240(如图50所示)，数个限位弹片1220连接第一圆筒部1240的远端、沿周向间隔分布并相对轴向向内倾斜延伸，锁套1100相对锁杆1300向锁杆1300的近端运动至人工腱索3000被锁紧在锁杆1300与锁套1100之间的径向间隙后，数个限位弹片1220抵接锚定件主体1201的近端面。As shown in Figures 50 to 52, compared with the first embodiment, the fourth embodiment of the present invention has a different structure of the anchor transported by the anchor transporter 2000. Specifically, the limiting structure in the anchor 1000b also includes a connection The first cylindrical portion 1240 at the distal end of the lock sleeve 1100 (as shown in FIG. 50), a plurality of limiting elastic pieces 1220 are connected to the distal end of the first cylindrical portion 1240, are distributed at intervals in the circumferential direction and extend inwardly with respect to the axial direction. , The lock sleeve 1100 moves toward the proximal end of the lock rod 1300 relative to the lock rod 1300 until the artificial tendon 3000 is locked in the radial gap between the lock rod 1300 and the lock sleeve 1100, and then a plurality of limit elastic pieces 1220 abut and anchor The proximal face of the main body 1201.

如图51所示，初始状态时，锁套1100套装在锚定件1200与锁杆1300上，所述第一圆筒部1240及所述数个限位弹片1220套设在所述数个弹性子件1210外以聚拢所述数个弹性子件1210。如图52所示，当锁套1100相对锁杆1300向近端移动，锁紧状态时，所述锁套1100抵接所述凸台1322，所述数个限位弹片1220释放所述数个弹性子件1210并由于所述数个限位弹片1220具有向第一圆筒部1240轴向收拢的弹性力而抵接所述锚定件主体1201的近端面，进而可将锁套1100限位固定在锁杆1300的锁定段1310。As shown in FIG. 51, in the initial state, the lock sleeve 1100 is sleeved on the anchor 1200 and the lock rod 1300, and the first cylindrical portion 1240 and the plurality of limit elastic pieces 1220 are sleeved on the plurality of elastic The sub-component 1210 is used to gather the plurality of elastic sub-components 1210. As shown in FIG. 52, when the lock sleeve 1100 moves proximally relative to the lock rod 1300 and is in the locked state, the lock sleeve 1100 abuts the boss 1322, and the plurality of limit elastic pieces 1220 release the plurality of The elastic sub-member 1210 abuts against the proximal surface of the anchor body 1201 due to the elastic force of the plurality of limiting elastic pieces 1220 that is axially retracted toward the first cylindrical portion 1240, thereby restricting the lock sleeve 1100 The position is fixed to the locking section 1310 of the locking rod 1300.

在本实施例中，限位弹片1220沿锁套1100的周向均匀分布，至少具有两个对称分布的限位弹片1220，当锁套1100轴向向近端移动停止后，限位弹片1220抵接在锚定件1200的近端面上，与所述凸台1322配合以防止锁套1100移位，保证人工腱索3000被可靠锁紧在锁套1100与锁杆1300之间。凸台1322远端面上设置尖锐地刃口1130，当锁套1100轴向运动至抵接刃口1130位置时，刃口1130切断人工腱索3000。In this embodiment, the restricting elastic pieces 1220 are evenly distributed along the circumferential direction of the lock sleeve 1100, and there are at least two symmetrically distributed restricting elastic pieces 1220. When the locking sleeve 1100 stops moving proximally in the axial direction, the restricting elastic pieces 1220 abut It is connected to the proximal surface of the anchor 1200 and cooperates with the boss 1322 to prevent the lock sleeve 1100 from shifting and ensure that the artificial tendon 3000 is reliably locked between the lock sleeve 1100 and the lock rod 1300. A sharp cutting edge 1130 is provided on the distal end of the boss 1322. When the locking sleeve 1100 axially moves to a position abutting the cutting edge 1130, the cutting edge 1130 cuts off the artificial chord 3000.

如图53至图55所示，本发明第五实施例与第一实施例相比，锚钉输送器2000输送的锚钉的结构不同，具体为，锚钉1000c中的锚定件1200与锁杆1300一体成型而与锁杆1300的远端连接。在本实施例中，刃口1322设置在锁杆1300的近端，锚定件1200的远端具有尖端1311，用于方便的刺入组织，穿线孔1321相对轴向倾斜地贯穿锁杆1300。如图54所示，初始状态时，人工腱索3000穿过穿线孔1321，人工腱索3000的两端自锁杆1300的两侧的外周面穿出；如图55所示，锁紧状态时，驱动锁套1100与锁杆1300相对运动，人工腱索3000可被双侧挤压在锁套1100与锁杆1300之间的径向间隙内，实现双侧锁紧人工腱索3000功能。As shown in Figures 53 to 55, compared with the first embodiment, the structure of the anchor conveyed by the anchor conveyor 2000 is different in the fifth embodiment of the present invention. Specifically, the anchor 1200 and the lock in the anchor 1000c are different. The rod 1300 is integrally formed and connected to the distal end of the lock rod 1300. In this embodiment, the cutting edge 1322 is provided at the proximal end of the lock rod 1300, the distal end of the anchor 1200 has a tip 1311 for piercing the tissue conveniently, and the threading hole 1321 penetrates the lock rod 1300 obliquely with respect to the axial direction. As shown in Figure 54, in the initial state, the artificial tendon 3000 passes through the threading hole 1321, and both ends of the artificial tendon 3000 pass through the outer peripheral surfaces of both sides of the locking rod 1300; as shown in Figure 55, in the locked state , The lock sleeve 1100 and the lock rod 1300 are driven to move relative to each other, and the artificial tendon 3000 can be squeezed in the radial gap between the lock sleeve 1100 and the lock rod 1300 on both sides to realize the function of locking the artificial tendon 3000 on both sides.

如图56至图61所示，本发明第六实施例与第一实施例相比，锚钉输送器2000输送的锚钉的结构不同，具体为锚钉1000d中的锚定件1200与锁套1100一体成型而与锁套1100的远端连接，锚定件1200与锁套1100内部相连通以形成中空内腔1110；限位结构包括设于锁套1100远端或近端并向中空内腔1110内部伸张的数个限位弹片1220。在本实施例中，所述数个限位弹片1220设于锁套1100远端并向中空内腔1110内部伸展。As shown in Figures 56 to 61, the sixth embodiment of the present invention is different from the first embodiment in the structure of the anchor transported by the anchor transporter 2000, specifically the anchor 1200 and the lock sleeve in the anchor 1000d 1100 is integrally formed to be connected to the distal end of the lock sleeve 1100, the anchor 1200 is communicated with the inside of the lock sleeve 1100 to form a hollow inner cavity 1110; the limiting structure includes the distal or proximal end of the lock sleeve 1100 and faces the hollow inner cavity Several limiting shrapnel 1220 stretched inside the 1110. In this embodiment, the plurality of limit elastic pieces 1220 are arranged at the distal end of the lock sleeve 1100 and extend into the hollow cavity 1110.

如图57a和图57b所示，锁杆1300包括相互连接的锁定段1310、连接段1320和导向段1330，导向段1330朝向限位弹片1220设置，导向段1330与连接段1320之间形成台阶1340，锁杆1300相对锁套1100向近端或远端运动至人工腱索3000被锁紧在锁杆1300与锁套1100之间的径向间隙后，台阶1340与数个限位弹片1220卡接以保持锁杆1300的位置。在本实施例中，锁杆1300相对锁套1100向远端运动。As shown in FIGS. 57a and 57b, the lock rod 1300 includes a locking section 1310, a connecting section 1320, and a guide section 1330 that are connected to each other. The guide section 1330 is disposed toward the limiting elastic piece 1220, and a step 1340 is formed between the guide section 1330 and the connecting section 1320. , The lock rod 1300 moves proximally or distally relative to the lock sleeve 1100 until the artificial tendon 3000 is locked in the radial gap between the lock rod 1300 and the lock sleeve 1100, and the step 1340 is clamped with a number of limit elastic pieces 1220 To maintain the position of the lock lever 1300. In this embodiment, the lock rod 1300 moves distally relative to the lock sleeve 1100.

在进一步的实施例中，锁套1100上设置引线孔1140(如图56所示)，引线孔1140至少穿通锁套1100的一侧的管壁；初始状态时，锁杆1300套设在锁套1100内，引线孔1140与穿线孔1321连通(如图59所示)，人工腱索3000穿设在引线孔1140与穿线孔1321中。In a further embodiment, the lock sleeve 1100 is provided with a lead hole 1140 (as shown in FIG. 56), and the lead hole 1140 penetrates at least one side of the pipe wall of the lock sleeve 1100; in the initial state, the lock rod 1300 is sleeved on the lock sleeve In 1100, the lead hole 1140 is connected to the threading hole 1321 (as shown in FIG. 59), and the artificial tendon 3000 is threaded in the lead hole 1140 and the threading hole 1321.

在进一步的实施例中，刃口1130位于锁定段1310的外周面的一侧，锁定段1310的外径小于所述中空内腔1110的内径，刃口1130与锁套1100的内壁相接触。In a further embodiment, the cutting edge 1130 is located on one side of the outer circumferential surface of the locking segment 1310, the outer diameter of the locking segment 1310 is smaller than the inner diameter of the hollow cavity 1110, and the cutting edge 1130 is in contact with the inner wall of the locking sleeve 1100.

在进一步的实施例中，穿线孔1321的一端穿通锁杆1300的近端面，另一端穿通锁杆1300的远端面或锁杆1300的外周面的一侧。在本实施例中，穿线孔1321穿通锁杆1300的两端的端面(如图57b所示)。In a further embodiment, one end of the threading hole 1321 penetrates the proximal surface of the lock rod 1300, and the other end penetrates the distal surface of the lock rod 1300 or one side of the outer peripheral surface of the lock rod 1300. In this embodiment, the threading hole 1321 penetrates through the end surfaces of both ends of the lock rod 1300 (as shown in FIG. 57b).

本实施例中，如图58和图59所示，初始状态时，锁杆1300穿装在中空内腔1110中，穿线孔1321与引线孔1140对齐贯通，缝线2000沿穿线孔1321与引线孔穿过锁杆1300与锁套1100。In this embodiment, as shown in Figure 58 and Figure 59, in the initial state, the lock rod 1300 is inserted into the hollow cavity 1110, the threading hole 1321 is aligned with the lead hole 1140, and the suture 2000 runs along the threading hole 1321 and the lead hole. Pass through the lock rod 1300 and the lock sleeve 1100.

锁紧状态时，如图60和图61所示，锁杆1300相对锁套1100沿轴向向锁套1100远端移动(即锁套1100沿轴向向近端移动)，此时导向段1330通过限位弹片1220，限位弹片1220卡入连接段1320中而被台阶1340抵接，限制锁定段1310沿轴向向近端运动以保持人工腱索3000的锁紧状态。人工腱索3000被挤压在锁定段1310外壁与锁套1100的内壁之间而被锁紧，一侧人工腱索3000被挤压在刃口1130和锁套1100内壁之间，由于刃口1130外径与中空内腔 1110的内径相等，无间隙，人工腱索3000被刃口1130切断。In the locked state, as shown in Fig. 60 and Fig. 61, the lock rod 1300 moves axially toward the distal end of the lock sleeve 1100 relative to the lock sleeve 1100 (that is, the lock sleeve 1100 moves axially toward the proximal end), at this time the guide section 1330 Through the restricting elastic piece 1220, the restricting elastic piece 1220 is clamped into the connecting section 1320 and abutted by the step 1340, restricting the locking section 1310 from moving proximally in the axial direction to maintain the locked state of the artificial chord 3000. The artificial tendon 3000 is squeezed between the outer wall of the locking section 1310 and the inner wall of the locking sleeve 1100 to be locked. One side of the artificial tendon 3000 is squeezed between the cutting edge 1130 and the inner wall of the locking sleeve 1100, due to the cutting edge 1130 The outer diameter is equal to the inner diameter of the hollow inner cavity 1110, and there is no gap. The artificial chord 3000 is cut by the cutting edge 1130.

上述第三实施例至第六实施例中所述的锚钉与锚钉输送器2000完成锚定、锁紧人工腱索3000和切断人工腱索3000的操作与第一实施例中的锚钉1000与锚钉输送器2000完成锚定、锁紧人工腱索3000和切断人工腱索3000的操作相类似，在此不再赘述。The anchor and anchor transporter 2000 described in the third embodiment to the sixth embodiment above completes the operations of anchoring, locking the artificial tendon 3000 and cutting off the artificial tendon 3000 are the same as the anchor 1000 in the first embodiment. It is similar to the operations of anchoring and locking the artificial tendon 3000 and cutting off the artificial tendon 3000 by the anchor conveyor 2000, and will not be repeated here.

如图62所示，本发明还提供一种人工腱索植入装置100，包括上述任一实施例所述的锚钉输送器2000及任一实施例所述的锚钉1000。人工腱索植入装置100中锚钉输送器2000和锚钉1000的工作原理如前面所述，在此不再赘述。As shown in FIG. 62, the present invention also provides an artificial chord implant device 100, which includes the anchor transporter 2000 according to any one of the above embodiments and the anchor 1000 according to any one of the embodiments. The working principles of the anchor transporter 2000 and the anchor 1000 in the artificial tendon implant device 100 are as described above, and will not be repeated here.

以上所述实施例仅表达了本发明的几种实施方式，其描述较为具体和详细，但并不能因此而理解为对本发明专利范围的限制。应当指出的是，对于本领域的普通技术人员来说，在不脱离本发明构思的前提下，还可以做出若干变形和改进，这些都属于本发明的保护范围。因此，本发明专利的保护范围应以所附权利要求为准。The above-mentioned embodiments only express several implementation modes of the present invention, and their description is relatively specific and detailed, but they should not be understood as a limitation on the patent scope of the present invention. It should be pointed out that for those of ordinary skill in the art, without departing from the concept of the present invention, several modifications and improvements can be made, and these all fall within the protection scope of the present invention. Therefore, the protection scope of the patent of the present invention should be subject to the appended claims.

Claims

一种锚钉输送器，其特征在于，所述锚钉输送器用于输送锚钉并驱动所述锚钉锚定于组织上、锁紧穿过所述锚钉的人工腱索并切断所述人工腱索一侧；所述锚定输送器包括外管、活动穿装于所述外管内的内管以及连接所述外管与内管的手柄；所述手柄包括固定连接所述外管近端的前手柄、及沿轴向活动连接所述前手柄的后手柄，所述内管的近端活动连接在所述后手柄上；所述内管的远端包括一锁扣，所述锁扣处于所述外管内时连接所述锚钉，所述锁扣暴露于所述外管外时与所述锚钉分离。An anchor conveyor, characterized in that the anchor conveyor is used to transport anchors and drive the anchors to be anchored to the tissue, lock the artificial tendons passing through the anchors, and cut off the artificial tendons. One side of the chordae; the anchoring conveyor includes an outer tube, an inner tube movably installed in the outer tube, and a handle connecting the outer tube and the inner tube; the handle includes a proximal end that is fixedly connected to the outer tube The front handle of the inner tube and the rear handle movably connected to the front handle in the axial direction, the proximal end of the inner tube is movably connected to the rear handle; the distal end of the inner tube includes a lock, the lock The anchor is connected when in the outer tube, and the lock is separated from the anchor when exposed outside the outer tube.
如权利要求1所述的锚钉输送器，其特征在于，还包括活动穿装在所述内管内的推杆，所述推杆的近端活动连接在所述后手柄上。8. The anchor conveyor of claim 1, further comprising a push rod movably installed in the inner tube, and the proximal end of the push rod is movably connected to the rear handle.
如权利要求2所述的锚钉输送器，其特征在于，所述手柄还包括与所述内管的近端固定连接的内管滑块、与所述内管滑块螺接的内管驱动轮、与所述推杆的近端固定连接的推杆滑块及与所述推杆滑块螺接的推杆驱动轮；所述内管驱动轮和所述推杆驱动轮均转动连接在所述后手柄上。The anchor conveyor according to claim 2, wherein the handle further comprises an inner tube slider fixedly connected to the proximal end of the inner tube, and an inner tube drive screw connected to the inner tube slider. Wheel, a push rod slider fixedly connected to the proximal end of the push rod, and a push rod driving wheel screwed to the push rod slider; the inner tube driving wheel and the push rod driving wheel are both rotatably connected to On the rear handle.
如权利要求3所述的锚钉输送器，其特征在于，所述后手柄上包括第一安装位和第二安装位，所述第一安装位开设有第一限位槽，所述第二安装位开设有第二限位槽，所述内管滑块自所述第一限位槽穿出所述后手柄，所述推杆滑块自所述第二限位槽穿出所述后手柄，所述内管驱动轮和所述推杆驱动轮轴向限位在所述第一安装位和所述第二安装位上。The anchor conveyor of claim 3, wherein the rear handle includes a first installation position and a second installation position, the first installation position is provided with a first limiting slot, and the second The installation position is provided with a second limit slot, the inner tube slider passes through the rear handle from the first limit slot, and the push rod slider passes through the rear handle from the second limit slot. The handle, the inner tube driving wheel and the push rod driving wheel are axially limited at the first installation position and the second installation position.
如权利要求3所述的锚钉输送器，其特征在于，所述手柄还包括止血阀，所述止血阀与所述外管的近端密封连接，所述外管和所述止血阀固定安装在所述前手柄的内腔中，所述内管和所述推杆穿过所述止血阀延伸至所述后手柄内。The anchor conveyor according to claim 3, wherein the handle further comprises a hemostatic valve, the hemostatic valve is sealed to the proximal end of the outer tube, and the outer tube and the hemostatic valve are fixedly installed In the inner cavity of the front handle, the inner tube and the push rod extend through the hemostatic valve into the rear handle.
如权利要求1所述的锚钉输送器，其特征在于，所述内管包括内管主体和固定连接于所述内管主体的远端的所述锁扣，所述锁扣包括位于其远端的扣件、位于其近端的连接部以及位于所述扣件和所述连接部之间的限位部，所述扣件自所述限位部的内侧向内突出，所述扣件的形状与所述锚钉上设置的锁扣位的形状相适配；所述连接部与所述内管主体固定连接并相连通。The anchor delivery device according to claim 1, wherein the inner tube includes an inner tube body and the lock catch fixedly connected to the distal end of the inner tube body, and the lock catch includes an inner tube body located at the distal end thereof. The fastener at the end, the connecting part at its proximal end, and the limiting part between the fastener and the connecting part, the fastener protruding inwardly from the inner side of the limiting part, the fastener The shape of is adapted to the shape of the locking position provided on the anchor; the connecting portion is fixedly connected and communicated with the inner tube main body.
如权利要求6所述的锚钉输送器，其特征在于，所述锁扣上还设有沿轴向延伸的通槽及限位凸起，所述通槽供所述人工腱索穿过，所述限位凸起用于与所述外管限位。The anchor conveyor according to claim 6, wherein the lock buckle is further provided with a through groove and a limiting protrusion extending in the axial direction, and the through groove is for the artificial tendon to pass through, The limiting protrusion is used for limiting the outer tube.
如权利要求7所述的锚钉输送器，其特征在于，所述外管包括外管主体以及固定连接于所述外管主体远端的护套，所述护套的两侧对称分布有两个限位槽，所述限位凸起与一所述限位槽适配，所述人工腱索穿过所述两个限位槽。The anchor conveyor according to claim 7, wherein the outer tube includes an outer tube body and a sheath fixedly connected to the distal end of the outer tube body, and two symmetrical distributions on both sides of the sheath There are two limiting grooves, the limiting protrusion is adapted to one of the limiting grooves, and the artificial tendon passes through the two limiting grooves.
如权利要求1所述的锚钉输送器，其特征在于，所述后手柄的远端设有滑杆，所述前手柄的近端设有滑槽；所述滑杆滑动套设于所述滑槽内。The anchor conveyor of claim 1, wherein the distal end of the rear handle is provided with a sliding rod, and the proximal end of the front handle is provided with a sliding groove; the sliding rod is slidably sleeved on the Inside the chute.
如权利要求9所述的锚钉输送器，其特征在于，所述滑杆与所述滑槽的内壁上分别设有卡位凸起及限位凹陷；当所述卡位凸起与所述限位凹陷卡合时，所述前手柄与所述后手柄锁止。9. The anchor conveyor of claim 9, wherein the sliding rod and the inner wall of the sliding groove are respectively provided with a locking protrusion and a limiting recess; when the locking protrusion and the When the limiting recess is engaged, the front handle and the rear handle are locked.
一种人工腱索植入装置，其特征在于，包括如权利要求1-10任一项所述的锚钉输送器及锚钉；An artificial tendon implant device, characterized by comprising the anchor feeder and anchor according to any one of claims 1-10;

所述锚钉包括锁杆、套装在锁杆外的锁套及锚定件，所述锚定件与所述锁杆或者所述锁套的远端连接；所述锁杆与所述锁套之间具有径向间隙，所述锁杆上设有穿线孔用于穿装人工腱索，且所述穿线孔至少一端连通所述锁杆与所述锁套之间的径向间隙；所述锁杆或/和锁套上设有刃口；The anchor includes a lock rod, a lock sleeve sleeved on the lock rod, and an anchor member, the anchor member is connected to the lock rod or the distal end of the lock sleeve; the lock rod and the lock sleeve There is a radial gap therebetween, a threading hole is provided on the lock rod for inserting an artificial tendon, and at least one end of the threading hole communicates with the radial clearance between the lock rod and the lock sleeve; A blade is provided on the lock rod or/and the lock sleeve;

所述锁套上设有与所述锁扣适配的锁扣位，所述手柄驱动所述内管轴向移动，以带动所述锁扣、所述锁扣位及所述锁套相对所述锁杆轴向移动，至少位于所述穿线孔一侧的部分所述人工腱索被挤压进所述锁杆和所述锁套之间的径向间隙中，直至所述位于所述穿线孔一侧的部分所述人工腱索被所述刃口切断。The lock sleeve is provided with a lock catch position adapted to the lock catch, and the handle drives the inner tube to move axially to drive the lock catch, the lock catch position, and the lock sleeve to move relative to each other. The lock rod moves axially, and at least a part of the artificial tendon at one side of the threading hole is squeezed into the radial gap between the lock rod and the lock sleeve until the threading hole A part of the artificial chord on one side of the hole is cut by the cutting edge.
如权利要求11所述的人工腱索植入装置，其特征在于，所述锁扣位包括向所述锁套内凹陷的缺口；所述锁扣包括与所述缺口适配的凸出结构。The artificial chord implant device according to claim 11, wherein the lock position includes a notch recessed into the lock sleeve; and the lock includes a protruding structure that fits with the notch.
如权利要求11所述的人工腱索植入装置，其特征在于，所述锚钉还包括限位结构，所述限位结构用于在所述人工腱索被锁紧在所述锁杆与所述锁套之间的径向间隙后保持所述锁杆或所述锁套的位置。The artificial tendon implant device according to claim 11, wherein the anchor further comprises a limiting structure, and the limiting structure is used to lock the artificial tendon and the locking rod when the artificial tendon is locked. The radial gap between the lock sleeves maintains the position of the lock rod or the lock sleeve.
如权利要求13所述的人工腱索植入装置，其特征在于，部分所述限位结构上设有避位面，且所述避位面与所述锁扣位位于同侧。The artificial chord implant device according to claim 13, wherein part of the limiting structure is provided with an avoiding surface, and the avoiding surface and the locking position are located on the same side.