WO2022121647A1 - Dispositif de coupe de suture chirurgicale et procédé de réparation de valve - Google Patents

Dispositif de coupe de suture chirurgicale et procédé de réparation de valve Download PDF

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Publication number
WO2022121647A1
WO2022121647A1 PCT/CN2021/131255 CN2021131255W WO2022121647A1 WO 2022121647 A1 WO2022121647 A1 WO 2022121647A1 CN 2021131255 W CN2021131255 W CN 2021131255W WO 2022121647 A1 WO2022121647 A1 WO 2022121647A1
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WIPO (PCT)
Prior art keywords
medical
wire
cutting device
fixing member
thread cutting
Prior art date
Application number
PCT/CN2021/131255
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English (en)
Chinese (zh)
Inventor
李阳
梁伟林
张庭超
Original Assignee
杭州德晋医疗科技有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from CN202022998275.2U external-priority patent/CN215129317U/zh
Priority claimed from CN202011459556.9A external-priority patent/CN114617591A/zh
Application filed by 杭州德晋医疗科技有限公司 filed Critical 杭州德晋医疗科技有限公司
Publication of WO2022121647A1 publication Critical patent/WO2022121647A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials

Definitions

  • the present disclosure generally relates to the technical field of medical devices, and more particularly, to a medical tangential device and a method of repairing a valve.
  • the medical thread cutting device involved in the present disclosure includes a thread cutting assembly and a fitting.
  • the thread cutting assembly includes a fixing piece and a blade connected to the fixing piece.
  • the fitting includes a base and a guide.
  • the base is provided with a tangent mating surface
  • the fixing member is movably sleeved on the guide portion
  • the blade has a cutting edge
  • the medical wire is at least partially located between the cutting edge and the tangent mating surface ;
  • the guide portion is provided with a wire hole passing through the distal surface of the guide portion and a side hole passing through the wire hole, and the medical wire is passed through the wire hole into and out from the side hole, and the part of the medical wire that goes out from the side hole is located between the cutting edge and the tangent line mating surface.
  • the width of the cutting edge of the blade is a
  • the width of the side hole is b
  • the number of strands of the medical wire is n
  • the diameter of the medical wire is d
  • the fixing member is provided with an inner cavity extending in the axial direction, and the guide portion is movably passed through the inner cavity of the fixing member.
  • the thread cutting assembly further includes at least one driving wire group, the distal end of the driving wire group is fixedly connected to the fixing member, and the driving wire group moves to drive the fixing member relative to the guide wire Lead movement.
  • the tangential mating surface is located proximal of the fixture, and the drive wire set moves proximally in the axial direction to pull the fixture relative to the guide.
  • the base is provided with a guide groove along the axial direction, and the driving wire group is in clearance fit with the guide groove, so that the driving wire group slides axially along the guide groove.
  • the fixing member is axially slidably fitted with the guide portion, and at least a pair of mutually adapted guide sliding surfaces are provided between the guide portion and the fixing member.
  • the guide portion extends axially from the distal end of the base portion, the tangential mating surface is disposed at the distal end of the base portion, and the tangential mating surface surrounds the guide portion Sets the roughly circular face.
  • the guide portion extends axially from the distal end of the base portion, the tangential mating surface is disposed at the distal end of the base portion, and the bottom end of the tangential mating surface is connected to the base portion.
  • the central axis of the tangent line is flush with or close to, and the tangent mating surface intersects with the outer peripheral surface of the base.
  • the distal end of the base is further connected with an axially extending section, the axially extending section covers the guide section, and the tangent component is located between the axially extending section and the guide between the departments.
  • the fixing member and the guide portion are rotated in an axial direction around the guide portion, the base portion is arranged around the axial extension of the guide portion, and the tangential mating surface is convex Out of the outer peripheral surface of the guide portion and extending along the axial direction of the guide portion.
  • the medical thread cutting device further comprises a flexible inner core and an outer support tube assembly
  • the distal end of the flexible inner core is connected to the fixing piece, and the flexible inner core, the tangent component and the matching piece are accommodated in the outer support tube component.
  • the outer support tube assembly includes:
  • the sleeve is provided with a wire inlet hole and a wire outlet hole, the wire tangent component and the matching piece are accommodated in the sleeve, and the matching piece is fixedly connected to the sleeve;
  • a flexible outer tube the distal end of the flexible outer tube is fixedly connected to the proximal end of the sleeve, and the flexible inner core is movably penetrated in the flexible outer tube.
  • the medical tangent device further comprises a handle
  • the proximal end of the flexible outer tube is fixedly connected to the distal end of the handle, the handle is provided with a manipulation member, and the manipulation member is connected to the proximal end of the flexible inner core to control the flexible inner core Move or rotate in the axial direction.
  • an elastic member is further provided in the handle, and the elastic member is compressed between the manipulation member and the inner wall of the handle, so as to reset the manipulation member.
  • the present disclosure relates to a method of repairing a valve, comprising:
  • a plurality of medical wires which have been implanted on the valve leaflets and secured by a locking staple, are passed through the medical tangential device of any one of claims 1 to 17 outside the individual in need of the method, such that the A plurality of medical wires are at least partially located between the cutting edge of the medical wire cutting device and the cutting wire mating surface;
  • the distal end of the medical thread cutting device is moved closer to the valve leaflet and the locking pin through the cardiac intervention path, until the distal end of the medical thread cutting device reaches a predetermined distance.
  • the medical thread cutting device and the excess medical thread are withdrawn from the outside of the individual.
  • the individual is a human.
  • valves include, but are not limited to, mitral and tricuspid valves.
  • Certain embodiments of the medical thread cutting device involved in the present disclosure are easy to cut the medical thread, and avoid the situation of thread squeezing between the blade and the thread cutting mating surface during the thread cutting process.
  • the fixing member moves relative to the guide portion of the fitting member, thereby driving the cutting edge of the blade to press against the tangent mating surface of the fitting member.
  • the mating surface provides abutment for the medical wire, and provides a force point for the cutting edge of the blade, so that the medical wire is easy to be cut off; at the same time, because the cutting edge of the blade and the tangent mating surface are pressed against each other, there will be no similar Due to the staggered relationship like scissors, there is no abnormal situation of thread extrusion between the blade and the tangent mating surface, which ensures that the medical thread tangent device can be withdrawn smoothly and avoids the risk of pulling the organ tissue due to the extrusion thread.
  • FIG. 1 is a schematic diagram of the overall structure of the medical thread cutting device according to the first embodiment of the disclosure
  • FIG. 2 is a schematic cross-sectional view showing the structure of the distal end of the medical thread cutting device and the routing of the medical thread according to the first embodiment of the present disclosure
  • FIG. 3 is a cross-sectional view showing the structure of the distal end of the medical thread cutting device according to the first embodiment of the present disclosure and when the medical thread is cut;
  • FIG. 4 is a schematic three-dimensional structural diagram of the matching of the tangent component and the stopper in the first embodiment of the present disclosure
  • FIG. 5 is a schematic top view of the tangent component and the fitting in FIG. 4;
  • FIG. 6 is a schematic diagram of the connection between the tangent wire assembly and the driving wire assembly in the first embodiment of the disclosure
  • FIG. 7 is a schematic three-dimensional structural diagram of the tangent component in the first embodiment of the disclosure.
  • FIG. 8 is a schematic three-dimensional structural diagram of a fitting in Embodiment 1 of the present disclosure.
  • FIG. 9 is a schematic diagram of the three-dimensional structure in the handle according to the first embodiment of the disclosure.
  • FIG. 10 is a schematic diagram of the connection between the middle and outer support tube assemblies and the outer tube fixing member according to the first embodiment of the disclosure
  • FIG. 11 is a schematic diagram of the connection between the flexible inner tube and the inner tube fixing member in the first embodiment of the disclosure
  • FIG. 12 is a schematic cross-sectional view showing the structure of the distal end of the medical thread cutting device and the routing of the medical thread according to the second embodiment of the present disclosure
  • FIG. 13 is a schematic cross-sectional view showing the structure of the distal end of the medical thread cutting device according to the second embodiment of the present disclosure and when the medical thread is cut;
  • FIG. 15 is a schematic three-dimensional structure diagram of a fitting in Embodiment 2 of the present disclosure.
  • 16 is a schematic three-dimensional structural diagram of the coordination of the tangent component and the driving wire set in the second embodiment of the disclosure
  • 17 is a schematic diagram of a first blade structure in the disclosed medical thread cutting device
  • FIG. 18 is a schematic structural diagram of a second type of blade in the disclosed medical thread cutting device.
  • 19 is a schematic structural diagram of a third type of blade in the disclosed medical thread cutting device.
  • 20 is a schematic three-dimensional structural diagram of the coordination of the thread cutting assembly and the fitting in the medical thread cutting device according to the third embodiment of the disclosure;
  • FIG. 21 is a schematic perspective view showing the distal end structure of the medical thread cutting device and the routing of the medical thread according to the third embodiment of the present disclosure.
  • FIG. 22 is a perspective view showing the distal end structure of the medical thread cutting device according to the third embodiment of the present disclosure and the time when the medical thread is cut.
  • the proximal end refers to the end closer to the operator, while the distal end refers to the end farther away from the operator;
  • the axial direction refers to the end parallel to the medical device.
  • the direction of the line connecting the center of the distal end and the center of the proximal end of the instrument, the radial direction refers to the direction perpendicular to the axial direction, and the circumferential direction refers to the direction surrounding the axial direction.
  • the present embodiment provides a medical thread cutting device, which includes a thread cutting assembly 100 , a stopper 200 , a driving wire set 300 , a connecting sleeve 500 , a flexible inner core 400 , an outer support tube assembly 600 and a handle 700 .
  • the tangent assembly 100 , the stopper 200 and the driving wire assembly 300 are respectively disposed in the outer support tube assembly 600 , and the proximal end of the flexible inner core 400 passes through the outer support tube assembly 600 and is connected to the manipulation member 710 on the handle 700 .
  • the thread cutting assembly 100 includes a fixing member 110 and a blade 120 fixedly connected to the fixing member 110 .
  • the fitting 200 includes a base portion 220 and a guide portion 210 , and the distal end of the base portion 220 is provided with a tangential mating surface 221 .
  • the fixing member 110 is movably sleeved on the guide portion 210 , and the tangential mating surface 221 is located at the proximal side of the fixing member 110 .
  • the distal end of the flexible inner core 400 is fixedly connected to the proximal end of the connecting sleeve 500 , the distal end of the connecting sleeve 500 is fixedly connected to the proximal end of the driving wire group 300 , and the distal end of the driving wire group 300 is fixedly connected to the fixing member 110 .
  • the medical thread 800 goes out of the guide part 210 , and the part of the medical thread 800 that goes out of the guide part 210 is located between the cutting edge of the blade 120 and the thread tangent mating surface 221 , and the operator operates the manipulation member 710 Control the movement of the thread cutting assembly 100 relative to the guide part 210, so that the cutting edge of the blade 120 presses the cutting thread mating surface 221, the part of the medical wire 800 passing through the guide part 210 abuts the cutting thread matching surface 221, and the cutting edge of the blade 120 is cut off Medical Line 800.
  • the fixing member 110 is provided with an axially extending inner cavity 111 , and the inner cavity 111 axially penetrates the fixing member 110 .
  • An installation groove 113 is provided on the side surface of the fixing member 110 in the axial direction, and the installation groove 113 extends from the proximal end of the fixing member 110 toward the distal end of the fixing member 110 .
  • the distal end of the blade 120 is fixedly connected with the fixing member 110 , the proximal end of the blade 120 is provided with a sharp edge, and the cutting edge of the blade 120 protrudes toward the proximal end relative to the fixing member 110 .
  • connection method between the blade 120 and the fixing member 110 is not limited, and may be welding, clamping or the like.
  • the distal end of the blade 120 may be provided with a protrusion
  • the fixing member 110 defines a recess matched with the protrusion, and the protrusion is snapped into the recess.
  • the base portion 220 is located at the proximal end of the fitting member 200 , and the guide portion extends from the base portion 220 toward the distal end of the fitting member 200 in the axial direction.
  • the guide portion 210 and the fixing member 110 at least a pair of guide sliding surfaces that are adapted to each other are arranged.
  • the opposite sides of the guide portion 210 in the axial direction are flat surfaces, and the surface located between the two flat surfaces is an arc surface. Connect with the plane.
  • the guide portion 210 may also be other structures capable of allowing the fixing member 110 to move in the axial direction thereon.
  • the distal end of the base 220 is generally cylindrical.
  • the proximal end of the base 220 is generally conical, and the radial dimension gradually decreases from far to near.
  • Two sides of the base portion 220 are respectively provided with a guide groove 22 which is axially symmetrical with respect to the base portion.
  • the tangential mating surface 221 is located at the distal end of the base 220 .
  • the guide portion 210 is provided with a wire hole 222 and a side hole 223.
  • the wire hole 222 extends from the distal end of the guide portion 210 toward the proximal end of the guide portion 210. In some embodiments, the wire hole 222 is along the shaft.
  • the side hole 223 passes through the line hole 222 , and the axis of the side hole 223 is parallel to the tangent line matching surface 221 .
  • the axial direction of the wire-passing hole 222 and the side hole 223 can also be changed, as long as the two holes are connected to each other and the side hole 223 passes through the plane on the guide portion 210 .
  • the width of the cutting edge of the blade 120 is a
  • the width of the side hole 223 is b
  • the number of strands of the medical wire to be cut is n
  • the diameter of the medical wire is d.
  • the tangential mating surface 221 is a substantially annular plane surrounding the guide portion 210 . It can be understood that the present disclosure does not limit the specific shape of the tangential mating surface 221 , and in some embodiments, the tangential mating surface 221 may also have a shape similar to a rectangle, a trapezoid, or a rhombus. On the basis of satisfying the matching between the tangent mating surface 221 and the cutting edge of the blade 120, the shape of the tangent mating surface 221 can be changed according to the shape of the cutting edge of the blade 120.
  • the tangent mating surface 221 can be surface hardened, the surface hardening treatment can be quenching or surface coating, and the coating can be nickel titanium coating or diamond coating, etc., so as to improve the surface hardness and wear resistance of the tangent mating surface 221, It provides a solid and reliable force point for the cutting edge of the blade 120 and prolongs the service life of the tangent mating surface 221 .
  • the stopper 200 can be made of stainless steel, nickel-titanium alloy, cobalt-chromium alloy, or tungsten alloy, and the like. In this embodiment, the material of the stopper 200 is stainless steel. It is worth noting that the tangential mating surface 221 should be able to provide a force point for each point on the cutting edge of the blade 120 to cut all the medical wires 800 .
  • the guide portion 210 is inserted through the inner cavity 111 of the fixing member 110 , and the guide portion 210 is axially slidably engaged with the fixing member 110 .
  • the arc surface on the guide portion 210 serves as a sliding surface between the guide portion 210 and the fixing member 110
  • the flat surface on the guiding portion 210 serves as both a sliding surface and a rotation stop surface to limit the fixing member 110 and the guide member 110 . relative rotation between parts 210 .
  • the blade 120 is located above the plane of the guide portion 210 , the cutting edge of the blade 120 faces the tangent mating surface 221 , and the blade 120 can be perpendicular or nearly perpendicular to the tangent mating surface 221 .
  • the distal end of the driving wire group 300 is fixedly connected to the installation groove 113 on the fixing member 110 , the driving wire group 300 extends toward the proximal end and passes through the guide groove 224 on the fitting member 200 , and the driving wire group 300 has a gap between the guide groove 224 Matching, so that the driving wire group 300 can slide axially along the guide groove 224 .
  • the driving wire group 300 When the thread is cut, the driving wire group 300 is controlled to move toward the proximal end in the axial direction, and the driving wire group 300 pulls the fixing member 110 to move axially toward the guide portion 210 .
  • two driving wire groups 300 may be provided, and the two driving wire groups 300 are arranged symmetrically with respect to the axial direction of the fixing member 110 and the fitting member 200 .
  • the installation grooves 113 There are two guide grooves 224 respectively, the two installation grooves 113 are symmetrically arranged on both sides of the fixing member 110 in the axial direction, and the two guide grooves 224 are symmetrically arranged on both sides of the base 220 in the axial direction.
  • the proximal ends of the two driving wire groups 300 are fixedly connected with the connecting sleeve 500 .
  • the handle 700 further includes an upper shell 720 , a lower shell 730 , an outer tube fixing member 740 , an inner tube fixing member 750 , an inner core connecting member 760 and an elastic member 770 ; a control 710 It includes a button connector 712 and a control button 711 ; the outer support tube assembly 600 includes a sleeve 610 , a flexible outer tube 620 and a limit pin 630 .
  • the upper shell 720 and the lower shell 730 are snap-connected to form a shell of the handle 700; the outer tube fixing member 740, the inner tube fixing member 750, the inner core connecting member 760 and the elastic member 770 are all mounted on the casing Inside; the proximal end of the flexible outer tube 620 is connected to the outer tube fixing member 740, and the connection method can be but not limited to bonding; the flexible inner core 400 protrudes into the casing after passing through the flexible outer tube 620, and the proximal end of the flexible inner core 400
  • the inner core connector 760 is fixedly connected; the button connector 712 is sleeved on the proximal end of the inner core connector 760, and the button connector 712 is fixedly connected with the inner core connector 760; the control button 711 is fixedly connected to the button connector 712, the control button 711 protrudes from the upper shell 720; the elastic member 770 is compressed between the button connecting member 712 and the inner wall of the lower shell 730, the elastic member
  • the elastic member 770 can be arranged on the proximal side of the control button 711 or on the distal side of the control button 711.
  • the elastic member 770 can be a spring, one end of the spring is connected to the button connecting member 712, and the other One end abuts against the inner wall of the lower case 730 .
  • the flexible inner core 400 is a flexible body with torsional supporting force, which can be a flexible body such as a laser-cut tube, a spring, and a multi-layer solid mandrel.
  • the flexible inner core 400 is made of multi-layer flexible wire Winding solid mandrel.
  • the thread cutting assembly 100 and the fitting 200 are accommodated in the sleeve 610, and the base 220 of the fitting 200 partially protrudes from the sleeve 610 toward the proximal direction;
  • the sleeve 610 is provided There are wire inlet holes 611 and wire outlet holes 612, the wire inlet holes 611 are communicated with the wire passage holes 222, and the wire outlet holes 612 are communicated with the side holes 223 correspondingly;
  • the distal end of the flexible outer tube 620 is fixedly connected to the proximal end of the sleeve 610;
  • the base 220 is provided with a pin hole (not shown), the limit pin 630 passes through the pin hole, the sleeve 610 has a fixing hole corresponding to the position of the limit pin 630 , and the two ends of the limit pin 630 are inserted into the sleeve 610 for fixing
  • the hole is fixed to the sleeve 610 by welding or the like, so as to realize
  • the flexible outer tube 620 can be a spring tube, and the material of the flexible outer tube 620 can be selected from stainless steel, nickel-titanium alloy, cobalt-chromium alloy or tungsten alloy. In this embodiment, the material of the flexible outer tube 620 can be selected from stainless steel.
  • a smooth flexible inner tube 410 can be sheathed outside the flexible inner core 400 , and the distal end of the flexible inner tube 410 extends to be close to the connecting sleeve 500
  • the proximal end of the flexible inner tube 410 protrudes from the flexible outer tube 620 and extends into the housing, and the proximal end of the flexible inner tube 410 is fixedly connected with the inner tube fixing member 750 .
  • the flexible inner tube 410 can be made of a polymer material with a small friction coefficient, such as PEEK tube, Pebax tube and PTFE tube. segment polyamide, PTFE refers to polytetrafluoroethylene.
  • the medical wire 800 can be passed through the wire inlet hole 611 and the wire passing hole 222 , and the medical wire 800 can be passed through the side hole 223 and the wire outlet hole 612 Out, the part of the medical wire 800 passing through the side hole 223 is located between the cutting edge of the blade 120 and the tangent mating surface 221; when tangent, the operator pulls the control button 711 to the proximal end, and the control button 711 transmits the pulling force to the flexible inner core 400, the flexible inner core 400 pulls the fixing member 110 toward the proximal end through the connecting sleeve 500 and the driving wire set 300, and the blade 120 presses the medical wire 800 against the tangent mating surface 221, and then further pulls the control button 711 towards the proximal end , so that the cutting edge of the blade 120 cuts the medical wire 800 on the tangent mating surface 221; after the pulling
  • the cutting edge of the blade 120 presses the medical wire 800 against the tangent mating surface 221 to cut off the tangent mating surface 221
  • it provides abutment for the medical wire 800
  • it provides a force point for the cutting edge of the blade 120, so that the medical wire 800 is easy to be cut;
  • There is no staggered relationship similar to scissors so there is no abnormal situation of thread extrusion between the blade 120 and the tangent mating surface 221, which ensures that the medical thread tangent device can be withdrawn smoothly and avoids pulling the organ due to the extrusion thread. organizational risk.
  • the flexible inner core 400 will bend in accordance with the bending of the human body lumen due to the need to be inserted into the body.
  • the driving mode of the blade 120 is set as a back-pulling type toward the proximal end, and the pulling force on the flexible inner core 400 is stronger. Easy to transmit and less loss, the driving force required by the blade 120 to cut the thread is smaller and labor-saving.
  • the use process of the medical tangent device in this embodiment is as follows:
  • Step 1 Take a plurality of medical wires that have been implanted on the three leaflets of the tricuspid valve and fixed by a locking nail from the wire inlet hole 611 of the sleeve 610 of the medical tangent device and the guide part 210 outside the patient's body.
  • the wire-passing hole 222 passes through, and passes through the side hole 223 of the guide portion 210 and the wire outlet hole 612 of the sleeve 600;
  • Step 2 Following the guidance of the medical thread, the distal end of the medical thread tangent device is delivered to the right atrium of the heart through the femoral vein and superior vena cava, and moves closer to the leaflet and locking pin of the tricuspid valve until the The far end reaches the predetermined position;
  • Step 3 Pull back the control button 711 on the handle 700, the fixing member 110 drives the blade 120 to move proximally in the axial direction, presses all the medical wires on the tangent mating surface 221, then cuts the medical wires, and then releases the control button 711, under the elastic force of the elastic member 770, the control button 711 is automatically reset, and the fixing member 110 and the blade 120 are automatically moved to the distal end along the axial direction; and
  • the fourth step withdraw the medical tangent device and the redundant medical thread out of the patient's body.
  • the locking nails indwelling in the right atrium make the three sets of sutures passing through the anterior lobe, posterior lobe and septal lobe to be fixed together.
  • Part of the edges of the anterior leaflet, posterior leaflet and septal leaflet of the valve are joined to each other to complete edge-to-edge repair.
  • the medical thread cutting device of this embodiment can also be applied to cutting the medical thread in the edge-to-edge repair operation of the mitral valve. It can also be applied to the cutting of medical thread in valve chordae tendineae repair.
  • the valve is not limited to mitral valve and tricuspid valve.
  • the medical thread as artificial chordae tendineae is partially sutured on the valve and partially anchored into the ventricular wall or papillary muscle. After the upper anchor is fixed, referring to the above steps, use the medical thread cutting device to intervene in the heart to cut the medical thread.
  • the medical thread can also be a suture that is simply used to suture an incision or a breach, a suture that is implanted on human internal tissues such as the valve annulus, etc.
  • the material of the medical thread includes but is not limited to PTFE , e-PTFE, PET, UHMWPE, etc.
  • the medical thread cutting device of this embodiment is suitable for cutting sutures for various purposes as described above.
  • the medical thread cutting device of the second embodiment of the present disclosure is compared with the medical thread cutting device of the first embodiment in that the structures of the thread cutting assembly and the fitting are changed.
  • the thread cutting assembly includes a fixing member 110 and a blade 120 .
  • the fixing member 110 is provided with an inner cavity 111 , and the inner cavity 111 is no longer closed, but has a lower gap 112 , and the lower gap 112 axially penetrates the fixing member 110 .
  • the fitting includes a base portion 220 and a guide portion 210 , and the guide portion 210 extends from the base portion 220 toward the distal end in the axial direction.
  • the fixing member 110 is axially slidably fitted with the guide portion 210 .
  • the guide portion 210 is provided with a wire hole 222 penetrating the distal end surface of the guide portion 210 and a side hole 223 passing through the wire hole 222 .
  • the distal end of the base portion 220 is also connected with an axially extending portion 225 , which covers the guide portion 210 above.
  • the distal end of the base portion 220 is provided with a tangential mating surface 221 in a planar shape, the tangential mating surface 221 is located between the axially extending section 225 and the guide portion 210, and the bottom end of the tangential mating surface 221 is close to or flush with the central axis of the base portion 220, The tangential mating surface 221 intersects the outer peripheral surface of the base 220 .
  • the blade 120 is located between the axially extending section 225 and the guide portion 210.
  • the width of the tangent mating surface 221 is increased, and the width of the cutting edge of the blade 120 can be correspondingly increased.
  • the reliability of the tangent is improved; under the condition that the number of the medical wires 800 to be cut is the same, the outer diameter of the distal end of the base 220 can be reduced, which is more conducive to the delivery in the human body lumen.
  • the shape of the tangent mating surface 221 can be changed according to the shape of the cutting edge of the blade 120 on the basis of satisfying the matching between the tangent mating surface 221 and the cutting edge of the blade 120, for example, the cutting edge of the blade 120 can be set as an arc
  • the tangent mating surface 221 is set as an arc surface that matches the cutting edge of the blade 120 to ensure that the cutting edge of the blade 120 can completely press against the tangent mating surface 221 .
  • the structure of the fixing member 110 in the second embodiment is flatter than that of the fixing member 110 in the first embodiment.
  • the upper end of the fixing member 110 is in plane fit with the lower end of the axially extending section 225 , and the lower end of the fixing member 110 is open and movable.
  • the guide portion 210 is provided on the guide portion 210 , and the guide portion 210 and the axially extending section 225 respectively restrict the degrees of freedom of the downward movement and the upward movement of the fixing member 110 .
  • TCM thread cutting device in the second embodiment are the same as those in the first embodiment, and will not be repeated here.
  • the use of the TCM thread cutting device in the second embodiment is the same as that in the first embodiment, and will not be repeated here.
  • the shape of the cutting edge of the blade 120 in the first and second embodiments can be symmetrical, eccentric or unilateral, wherein the angle of the symmetrical cutting edge is ⁇ 1 ,
  • the angle of the edge of the eccentric type is ⁇ 2
  • the angle of the edge of the unilateral type is ⁇ 3
  • the angle range of ⁇ 1 , ⁇ 2 and ⁇ 3 can be between 10° and 150°, the smaller the angle of the edge is. , the sharper the cutting edge of the blade 120 is.
  • the blade 120 has a symmetrical cutting edge, which may be angled at 30°.
  • the stopper 200 includes a guide portion 210 and a base portion 220 , the guide portion 210 is substantially cylindrical, and the base portion 220 extends around the axial direction of the guide portion 210 to cover part of the outer circumference of the guide portion 210
  • the tangential mating surface 221 protrudes from the outer peripheral surface of the guide portion 210 and extends along the axial direction of the guide portion 210 .
  • the thread cutting assembly 100 includes a fixing member 110 and a blade 120 fixedly connected with the fixing member 110. Both the fixing member 110 and the blade 120 are arranged around the axial extension of the guide portion 210.
  • the fixed part 110 is movably sleeved on the guide part 210 , and the fixed part 110 and the guide part 210 are rotatably matched.
  • the fixing member 110 is provided with an arc-shaped notch 114 extending around the axis of the guide portion 210 , a portion of the limiting pin 630 is inserted into the guide portion 210 , and the other portion extends radially from the arc-shaped notch 114 and is fixed to the sleeve 610 connected to fix the guide portion 210 and the sleeve 610 .
  • the guide portion 210 is provided with a wire hole 222 penetrating the distal surface of the guide portion 210 and a side hole 223 passing through the wire hole 222.
  • the wire hole 222 passes through the side hole 223 , and the portion of the medical wire 800 that passes through the side hole 223 is located between the cutting edge of the blade 120 and the tangent mating surface 221 .
  • the rotation of the fixing member 100 relative to the guide portion 210 can be controlled by the driving wire group, the flexible inner core and the manipulation member on the handle.
  • one driving wire group may be provided, the distal end of the driving wire group is connected to the fixing member 110, the proximal end of the driving wire group is connected to the flexible inner core, and the flexible inner core is connected to the manipulation member on the handle, and the flexible inner core is driven by the rotating manipulation member.
  • an elastic member can also be arranged in the handle, and the elastic member is compressed between the control member and the inner wall of the handle, so as to reset the control member, so as to make the tangent line After completion, the blade 120 automatically leaves the tangent mating surface 221 .
  • the rotation matching structure of the tangent assembly 100 and the stopper 200 in the third embodiment is more conducive to increasing the width of the tangent matching surface 221 and the width of the cutting edge of the blade 120, which is more effective in increasing the Tangent reliability.
  • the driving mode of the blade 120 is set as a rotary type, the torsional force is also easier to transmit on the curved flexible inner core, the force loss is smaller, and the driving force required for tangent is smaller and less labor-saving.
  • the tangent mating surface 221 can still be a plane, but in some embodiments, on the basis of satisfying the mating between the tangent mating surface 221 and the cutting edge of the blade 120 , the tangent mating can be changed according to the shape of the cutting edge of the blade 120
  • the shape of the surface 221, such as: the cutting edge of the blade 120 can be set as an arc, and the tangential mating surface 221 is set as an arc surface that matches the cutting edge of the blade 120 to ensure that the cutting edge of the blade 120 can be completely pressed against the tangential matching surface. on the surface 221.

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

Abstract

La présente invention concerne un dispositif de coupe de suture chirurgicale, comprenant un composant de coupe de suture (100) et un raccord (200). Le composant de coupe de suture (100) comprend un élément de fixation (110) et une lame (120) reliée à l'élément de fixation (110). L'élément de raccord (200) comprend une partie de base (220) et une partie de guidage (210). La partie de base (220) est pourvue d'une surface d'adaptation de coupe de suture (221). L'élément de fixation (110) est emmanché mobile sur la partie de guidage (210). La lame ((120) comprend un bord de coupe. Une suture chirurgicale (800) est au moins partiellement située entre le bord de coupe et la surface d'adaptation de coupe de suture (221). L'élément de fixation (110) se déplace par rapport à la partie de guidage (210) pour amener le bord de coupe de la lame (120) à venir en butée contre la surface d'adaptation de coupe de suture (221), et la suture chirurgicale (800) vient au moins partiellement en butée contre la surface d'adaptation de coupe de suture (221), et est coupée par le bord de coupe.
PCT/CN2021/131255 2020-12-11 2021-11-17 Dispositif de coupe de suture chirurgicale et procédé de réparation de valve WO2022121647A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
CN202022998275.2 2020-12-11
CN202011459556.9 2020-12-11
CN202022998275.2U CN215129317U (zh) 2020-12-11 2020-12-11 医用切线装置
CN202011459556.9A CN114617591A (zh) 2020-12-11 2020-12-11 医用切线装置

Publications (1)

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WO2022121647A1 true WO2022121647A1 (fr) 2022-06-16

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Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6254620B1 (en) * 1997-02-07 2001-07-03 Karl Storz Gmbh & Co. Kg Surgical thread cutter
US20030181926A1 (en) * 2001-12-07 2003-09-25 Michael Dana Suture trimmer
US20050234481A1 (en) * 2004-03-31 2005-10-20 Wilson-Cook Medical Inc. Suture cutting device
CN101242785A (zh) * 2005-06-20 2008-08-13 苏图诺有限公司 用于将结应用到缝线的方法和设备
US20080228198A1 (en) * 2007-03-13 2008-09-18 Mitralign, Inc. Suture cutter and method of cutting suture
US20110313430A1 (en) * 2010-06-18 2011-12-22 Linvatec Corporation Disposable suture cutter
DE102015111815A1 (de) * 2015-07-21 2017-01-26 Jakoubek Medizintechnik Gmbh Chirurgischer Fadenschneider
CN110167457A (zh) * 2016-09-09 2019-08-23 特鲁莫医疗公司 用于缝合线修剪的***
US20200330116A1 (en) * 2019-04-22 2020-10-22 Medos International Sarl Bone and tissue resection devices and methods

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6254620B1 (en) * 1997-02-07 2001-07-03 Karl Storz Gmbh & Co. Kg Surgical thread cutter
US20030181926A1 (en) * 2001-12-07 2003-09-25 Michael Dana Suture trimmer
US20050234481A1 (en) * 2004-03-31 2005-10-20 Wilson-Cook Medical Inc. Suture cutting device
CN101242785A (zh) * 2005-06-20 2008-08-13 苏图诺有限公司 用于将结应用到缝线的方法和设备
US20080228198A1 (en) * 2007-03-13 2008-09-18 Mitralign, Inc. Suture cutter and method of cutting suture
US20110313430A1 (en) * 2010-06-18 2011-12-22 Linvatec Corporation Disposable suture cutter
DE102015111815A1 (de) * 2015-07-21 2017-01-26 Jakoubek Medizintechnik Gmbh Chirurgischer Fadenschneider
CN110167457A (zh) * 2016-09-09 2019-08-23 特鲁莫医疗公司 用于缝合线修剪的***
US20200330116A1 (en) * 2019-04-22 2020-10-22 Medos International Sarl Bone and tissue resection devices and methods

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