WO2022193951A1 - ***、输送器、隧道式过线***及其操作方法 - Google Patents

***、输送器、隧道式过线***及其操作方法 Download PDF

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Publication number
WO2022193951A1
WO2022193951A1 PCT/CN2022/078814 CN2022078814W WO2022193951A1 WO 2022193951 A1 WO2022193951 A1 WO 2022193951A1 CN 2022078814 W CN2022078814 W CN 2022078814W WO 2022193951 A1 WO2022193951 A1 WO 2022193951A1
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WO
WIPO (PCT)
Prior art keywords
positioning rod
tunnel
suture
channel
distal end
Prior art date
Application number
PCT/CN2022/078814
Other languages
English (en)
French (fr)
Inventor
秦丹
李泳龙
葛亮
尤明哲
Original Assignee
上海竞微扶生医学科技有限公司
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Filing date
Publication date
Application filed by 上海竞微扶生医学科技有限公司 filed Critical 上海竞微扶生医学科技有限公司
Priority to US18/550,909 priority Critical patent/US20240156502A1/en
Priority to EP22770306.3A priority patent/EP4309591A1/en
Priority to CA3211583A priority patent/CA3211583A1/en
Priority to IL305569A priority patent/IL305569A/en
Publication of WO2022193951A1 publication Critical patent/WO2022193951A1/zh

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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
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8861—Apparatus for manipulating flexible wires or straps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0482—Needle or suture guides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1714—Guides or aligning means for drills, mills, pins or wires for applying tendons or ligaments
    • A—HUMAN NECESSITIES
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1796—Guides or aligning means for drills, mills, pins or wires for holes for sutures or flexible wires
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
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    • A61B17/0485—Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
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    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06114—Packages or dispensers for needles or sutures
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    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
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    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0464—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
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    • A61B2090/0807—Indication means
    • A61B2090/0811—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument

Definitions

  • the invention relates to the technical field of medical devices, in particular to a positioner, a conveyor, a tunnel-type wire-passing system and an operation method thereof.
  • a safer surgical option is to forgo the anchor, form a tunnel in the bone, and pass sutures through the bone tunnel to complete the suture binding of the soft tissue.
  • the only choice is open surgery or suture passing through a dural puncture needle under the guidance of arthroscopy, and the surgical operation is extremely difficult.
  • the purpose of the present invention is to provide a positioner, a conveyor, a tunnel-type suture passing system and an operation method thereof, so as to solve the existing problems of fixing sutures through anchors.
  • the present invention provides a positioner, which includes: a first positioning rod, a second positioning rod, a guide wire and a driving part;
  • the first positioning rod has a first channel penetrating along its axial direction
  • the second positioning rod is connected with the first positioning rod, and the distal end of the second positioning rod exceeds the distal end of the first positioning rod; Two channels, the distal extension direction of the second channel intersects with the distal extension direction of the first channel;
  • the guide wire is movably passed through the second channel along the axial direction of the second positioning rod, and the distal end of the guide wire has a connecting portion;
  • the driving part is connected with the guide wire, and is used for driving the guide wire to move along the axial direction of the second positioning rod.
  • an angle formed between the extension direction of the distal end of the second channel and the extension direction of the distal end of the first channel ranges from 10° to 180°.
  • the connecting portion includes a mechanical butt or adhesive.
  • the mechanical butt joint is a hook.
  • the first positioning rod is movably connected to the second positioning rod along its own axis.
  • the locator further includes a locating rod sleeve, the locating rod sleeve has a rod sleeve channel passing through in its axial direction, and the inner contour shape of the rod sleeve channel is the same as the outer contour shape of the first locating rod.
  • the first positioning rod is movably penetrated through the rod sleeve channel along the axial direction of the positioning rod sleeve; the second positioning rod is fixedly connected with the positioning rod sleeve.
  • the second positioning rod includes a curved section and a straight section connected to the proximal end of the curved section; the straight section is parallel to the axial direction of the first positioning rod.
  • the distal end of the first positioning rod has an abutting surface, and the abutting surface is adapted to match the shape of the predetermined object and abut against the surface of the predetermined object.
  • the distal end of the first positioning rod further has an engaging portion, and the engaging portion is used for being inserted into the surface of the predetermined object to engage with the predetermined object.
  • the positioning device further includes a handle, which is wrapped around the proximal end of the first positioning rod and extends linearly.
  • the guide wire is flexible, and the edge of the connecting portion is rounded.
  • the present invention also provides a conveyor, which includes: a conveying rod and a conveying head;
  • the delivery head is arranged at the distal end of the delivery rod, and is used for accommodating the coil or implant formed by the suture;
  • the delivery rod is used to movably pass through the first channel of the above-mentioned positioner, and the delivery head is used to extend from the distal end of the first positioning rod for the connection of the positioner
  • the portion is connected to a coil or implant housed on the delivery head.
  • the delivery rod has a suture cavity passing through in its axial direction, and the suture cavity is used for accommodating a part of the suture.
  • the conveyor includes a suture receptacle connected to a proximal end of the delivery rod for accommodating a proximal portion of the suture.
  • the conveyor further includes a limiting part, the limiting part is fixedly connected with the conveying rod; the limiting part is used to abut against a part corresponding to the positioner to limit the Displacement of the delivery rod toward the distal end relative to the first channel; wherein, when the limiting portion abuts against the position corresponding to the locator, the delivery head extends at the distal end of the second channel the intersection of the direction with the distal extension of the first channel.
  • the delivery head includes a first slot for accommodating the coil, and a second slot for the connecting portion to pass through.
  • the delivery head includes a fork-shaped card
  • the distal end of the fork-shaped card includes a positioning card and at least two branches, at least two of the branches are connected by the positioning card to form a closed card slot hole, the card Slots are used to retrieve coils of sutures or to accommodate implants.
  • the delivery head includes two fork-shaped cards, and the two fork-shaped cards are arranged opposite to each other.
  • the present invention also provides a tunnel-type wire passing system, which includes: the above-mentioned positioner and the above-mentioned conveyor; the conveying rod of the conveyor is used to penetrate the positioner The first channel of the locator is used to connect with the coil or the implant accommodated on the delivery head.
  • the present invention also provides an operation method of a tunnel-type wire-passing system, which utilizes the above-mentioned tunnel-type wire-passing system; the operation method of the tunnel-type wire-passing system includes:
  • the driving part to drive the connecting part to move toward the proximal end, and connect with the coil or the implant accommodated on the delivery head;
  • the operation method of the tunnel-type wire-passing system further includes:
  • the coil or the implant is disengaged from the connection portion to separate the coil or the implant from the positioner.
  • the positioner includes a first positioning rod, a second positioning rod, a guide wire and a driving part; the The first positioning rod has a first channel that penetrates through its own axial direction; the second positioning rod is connected with the first positioning rod, and the distal end of the second positioning rod exceeds the distal end of the first positioning rod ; the second positioning rod has a second channel extending through its own axial direction, and the extension direction of the distal end of the second channel intersects with the extension direction of the distal end of the first channel; the guide wire is along the second channel.
  • the axial direction of the positioning rod is movably passed through the second channel, and the distal end of the guide wire has a connecting part; the driving part is connected with the guide wire, and is used for driving the guide wire along the second channel. The axial movement of the two positioning rods.
  • the distal end of the second positioning rod can be inserted into the second tunnel, and then the first tunnel is opened on the predetermined object along the direction of the first channel;
  • the extension direction of the distal end of the second channel intersects with the extension direction of the distal end of the first channel, so the first tunnel must intersect the second tunnel.
  • the tunnel does not cross, and the line cannot be hooked.
  • the connecting portion at the distal end of the guide wire can be used to connect with the suture extending into the first tunnel, and the suture can be drawn out from the second tunnel, that is, the suture can be passed through the tunnel of the predetermined object, and the suture can be passed through the tunnel.
  • the fixation of the wire is reliable, and the risk of the anchor pin falling off is avoided; the use of the locator is simple, the cost is low, and the safety is high.
  • the opening tool of the first tunnel can be used to discharge the debris when the second tunnel is opened, which can ensure the smooth flow of the tunnel and prevent the debris from hindering the hooking of the suture.
  • FIG. 1 is a schematic diagram of a tunnel-type wire-passing system according to Embodiment 1 of the present invention.
  • FIG. 2 is an axial cross-sectional schematic diagram of a tunnel-type wire-passing system according to Embodiment 1 of the present invention
  • FIG. 3 is a partial schematic diagram of a tunnel-type wire-passing system according to Embodiment 1 of the present invention.
  • FIG. 4 is an axial cross-sectional view of the positioner according to the first embodiment of the present invention.
  • FIG. 5 is a schematic diagram of a positioning rod sleeve according to Embodiment 1 of the present invention.
  • FIG. 6 is a schematic diagram of a hook portion of Embodiment 1 of the present invention.
  • Fig. 7 is the schematic diagram of the conveyor according to the first embodiment of the present invention.
  • Fig. 8 is a partial enlarged view of the distal end of the delivery device shown in Fig. 7;
  • FIG. 9 is a schematic diagram of a usage scenario of the tunnel-type wire-passing system according to Embodiment 1 of the present invention.
  • FIG. 10 is a schematic diagram of the locking portion of the first embodiment of the present invention.
  • FIG. 11 is a schematic diagram of a delivery head of another preferred example of Embodiment 1 of the present invention.
  • FIG. 12 is a schematic diagram of a longitudinal positioning rod according to Embodiment 2 of the present invention.
  • FIG. 13 is a schematic diagram of the first knob of Embodiment 2 of the present invention.
  • FIG. 14 is a schematic diagram of a second knob and a rack in Embodiment 2 of the present invention.
  • FIG. 16 is a schematic diagram of an outer wire hub group according to Embodiment 3 of the present invention.
  • FIG. 17 is a schematic diagram of an indicator part of Embodiment 3 of the present invention.
  • FIG. 18 is a schematic diagram of a torsion spring according to Embodiment 3 of the present invention.
  • FIG. 19 is a schematic diagram of a conveyor according to Embodiment 4 of the present invention.
  • Fig. 20 is a partial enlarged view of the conveyor shown in Fig. 19;
  • Fig. 21 is a partial schematic diagram of the conveyor according to the fifth embodiment of the present invention.
  • FIG. 22 is an overall schematic diagram of a suture accommodating portion according to Embodiment 5 of the present invention.
  • FIG. 23 is a schematic diagram of the internal structure of the suture accommodating portion according to Embodiment 5 of the present invention.
  • FIG. 24 is a schematic diagram of a two-leaf hook according to Embodiment 6 of the present invention.
  • 25 is a schematic diagram of the connection between the two-leaf hook and the anchor with wire according to Embodiment 6 of the present invention.
  • Fig. 26 is the schematic diagram of the connection between the two-leaf hook and the titanium plate with the loop according to the sixth embodiment of the present invention.
  • FIG. 27 is a schematic diagram of a two-leaf hook hooking a suture according to Embodiment 6 of the present invention.
  • Fig. 28 is the schematic diagram of the flat screw hook of Embodiment 6 of the present invention.
  • 29 is a schematic diagram of the connection between the flat screw hook and the interface screw according to the sixth embodiment of the present invention.
  • FIG. 30 is a schematic diagram of a loop hook according to Embodiment 6 of the present invention.
  • features defined as “first”, “second”, “third” may expressly or implicitly include one or at least two of these features, the term “proximal” is generally the end close to the operator, the term “proximal” “Distal” is usually the end close to the patient, that is, close to the lesion, "one end” and “the other end” and “proximal end” and “distal end” usually refer to the corresponding two parts, which not only include the end point, the term “installation” , “connected” and “connected” should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or an integrated; it can be a mechanical connection or an electrical connection; it can be directly connected, or it can be connected through The intermediate medium is indirectly connected, which can be the internal communication of two elements or the interaction relationship between the two elements.
  • the arrangement of one element on another element generally only means that there is a connection, coupling, cooperation or transmission relationship between the two elements, and the relationship between the two elements may be direct or indirect through intermediate elements connection, coupling, cooperation or transmission, and should not be construed as indicating or implying the spatial positional relationship between two elements, that is, one element can be in any position inside, outside, above, below or on one side of the other element, unless the content Also clearly stated.
  • the specific meanings of the above terms in the present invention can be understood according to specific situations.
  • the purpose of the present invention is to provide a positioner, a conveyor, a tunnel-type suture passing system and an operation method thereof, so as to solve the existing problems of fixing sutures through anchors.
  • the tunnel-type wire-passing system provided in this embodiment is mainly used to open a bone tunnel on the bone, and pass sutures or implants (such as interface screws and titanium plates with loops) through the bone tunnel.
  • sutures or implants such as interface screws and titanium plates with loops
  • the application scenario of the tunnel-type wire-passing system is not limited to the bone-tunnel wire-passing, and the tunnel-style wire-passing can also be performed on other objects.
  • the bone tunnel is opened on the bone as an example for description with reference to the accompanying drawings.
  • the following description will take the lateral positioning rod as an example of the first positioning rod, the longitudinal positioning rod as an example of the second positioning rod, the lateral tunnel as an example of the first tunnel, and the longitudinal tunnel as an example of the second tunnel.
  • Those skilled in the art can also swap the horizontal and vertical directions according to the above-mentioned idea, which is not limited in the present invention.
  • FIG. 1 is a schematic diagram of a tunnel-type wire-passing system according to Embodiment 1 of the present invention
  • FIG. 2 is an axial cross-sectional schematic diagram of the tunnel-type wire-passing system according to Embodiment 1 of the present invention
  • Figure 4 is an axial cross-sectional view of the positioner according to the first embodiment of the present invention
  • Figure 5 is a schematic diagram of the positioning rod sleeve according to the first embodiment of the present invention
  • Figure 7 is a schematic diagram of a conveyor according to Embodiment 1 of the present invention
  • Figure 8 is a partial enlarged view of the distal end of the conveyor shown in Figure 7
  • Figure 9 is an embodiment of the present invention
  • Figure 10 is a schematic diagram of the locking part of the first embodiment of the present invention
  • Figure 11 is a schematic diagram of another preferred example of the delivery head of the first embodiment of the present invention.
  • Embodiment 1 of the present invention provides a tunnel-type wire-passing system, which includes a positioner 1 and a conveyor 2 .
  • the conveyor 2 is detachable relative to the positioner 1 .
  • the positioner 1 includes: a lateral positioning rod 11 , a longitudinal positioning rod 12 and a connecting piece; the lateral positioning rod 11 has a lateral channel 110 extending through its own axial direction;
  • the longitudinal positioning rod 12 is connected with the lateral positioning rod 11, and the distal end of the longitudinal positioning rod 12 extends beyond the distal end of the lateral positioning rod 11;
  • the longitudinal positioning rod 12 has a longitudinal direction extending through its own axial direction A channel 120, the extension direction of the distal end of the longitudinal channel 120 intersects with the extension direction of the distal end of the transverse channel 110; the connecting piece is movably penetrated through the longitudinal channel along the axial direction of the longitudinal positioning rod 12 120.
  • the connector is used to connect sutures or implants.
  • the positioning device 1 further includes a driving part 14 connected with the proximal end of the connecting piece for driving the connecting piece to move along the axial direction of the longitudinal positioning rod 120 .
  • the connector is a guide wire 13
  • the distal end of the guide wire has a connecting portion for connecting with a suture or an implant.
  • the connecting part includes a mechanical butt joint or an adhesive part, the mechanical butt way to connect with sutures or implants.
  • the mechanical docking member is a hook portion 131, which can hook sutures or implants.
  • the axial direction of the lateral positioning rod 11 and the longitudinal positioning rod 12 is not limited to a straight direction. If the lateral positioning rod 11 or the longitudinal positioning rod 12 itself is curved, it should be understood that their respective axes are also curved.
  • the axial direction is the direction of the curve. Therefore, the transverse channel 110 and the longitudinal channel 120 are not limited to be linear.
  • the extension direction of the distal end of the transverse channel 110 and the longitudinal channel 120 refers to the extension direction of the axis of the transverse channel 110 and the longitudinal channel 120 at the distal end, if the transverse channel 110 and the longitudinal channel 120 are linear at the distal end.
  • the distal extension direction is the tangential extension of the distal end of the axis, that is is the tangent direction at the distal end of its axis.
  • the extension direction of the distal end of the longitudinal channel 120 and the extension direction of the distal end of the transverse channel 110 intersect means that the extension direction of the distal end of the longitudinal channel 120 and the extension direction of the distal end of the transverse channel 110
  • the conveyer 2 includes: a conveying rod 21 and a conveying head 22 ; the conveying head 22 is disposed at the distal end of the conveying rod 21 for accommodating the suture 32 wound around it.
  • the coil 31 or the implant; the delivery rod 21 is used to movably pass through the lateral channel 110 of the positioner 1 , the delivery head 22 is used to protrude from the distal end of the lateral positioning rod 11 ,
  • the hook portion 131 of the positioner 1 can hook the coil 31 or the implant accommodated on the delivery head 22 .
  • the delivery rod 21 has a suture cavity 210 arranged along its own axis, and the suture cavity 210 is used to accommodate a part of the suture 32; preferably, the delivery head 22 has a first groove 221 and a second slot 222, the first slot 221 is used for accommodating and clamping the coil 31, and the second slot 222 is used for the connecting part (such as the hook part 131, etc.) to pass through.
  • the present invention does not limit the shape of the delivery head 22.
  • the distal end of the delivery head 22 has a rounded and blunt shape to prevent scratching the bone tunnel.
  • the coil 31 is formed by bending the distal end of the suture 32 , which can be wound around the delivery head 22 .
  • the suture lumen 210 is disposed along the axial direction of the delivery rod 21.
  • the suture lumen 210 may be a tubular lumen extending through the delivery rod 21.
  • the suture cavity 210 may also be a radially open groove opened on the delivery rod 21 .
  • the present invention does not limit the specific arrangement form of the suture cavity 210 .
  • the conveying rod 21 of the conveyer 2 is used for passing through the transverse channel 110 of the positioner 1 , and the connecting part of the positioner 1 is used for connecting with the coil 31 accommodated on the conveying head 22 of the conveyer 2 connect.
  • the distal end of the longitudinal positioning rod 12 can be inserted into the longitudinal tunnel 41, and then the predetermined object 4 can be inserted in the direction of the transverse channel 110 in the predetermined object 4.
  • a transverse tunnel 42 is opened on the top; since the distal extension direction of the longitudinal channel 120 of the positioner 1 intersects with the distal extension direction of the transverse channel 110, the transverse tunnel 42 must intersect with the longitudinal tunnel 41, so that the percutaneous positioning cannot be realized. It avoids the problem that the line cannot be hooked because the horizontal tunnel 42 and the vertical tunnel 41 do not cross.
  • the connecting portion can be used to connect with the coil 31 extending into the transverse tunnel 42, and the suture 32 can be drawn out from the longitudinal tunnel 41, that is, the suture 32 can be passed through the tunnel of the predetermined object 4, and the suture 32
  • the fixing is reliable, and the risk of the anchor nail falling off is avoided; the use of the locator 1 is simple, the cost is low, and the safety is high.
  • the opening tool of the horizontal tunnel 42 can be used to discharge the debris when the vertical tunnel 41 is opened, which can ensure the smooth flow of the tunnel and prevent the debris from hindering the hooking of the suture 32 .
  • the guide wire 13 is flexible, and the edge of the connecting portion is rounded.
  • the following description takes the hook portion 131 as an example of the connecting portion. Since the hook portion 131 can be directly used to hook the loop 31 of the suture 32, and the suture 32 is generally soft, the edge of the hook portion 131 needs to be configured in a smooth shape , to avoid cutting the suture 32 .
  • the guide wire 13 is flexible and can be bent with the bending of the longitudinal channel 120 , which is beneficial to reduce the overall radial dimension of the distal end of the positioner 1 , improve the passability, and reduce the wound.
  • the flexible guide wire 13 can be easily pulled, and the tensile and compressive stress of the guide wire 13 can be greater than 450MPa.
  • the hardness of the hook portion 131 is preferably not less than 45HRC. Hardened by heat treatment.
  • the hook portion 131 with a hardness of not less than 45HRC can also be used to hook up hard guide wires or implants, such as nickel-titanium alloy wires or titanium plates with loops.
  • the material of the hook portion 131 can be consistent with the material of the guide wire 13, but the part of the guide wire 13 is not subjected to heat treatment to maintain its original toughness.
  • the side view of the hook portion 131 is shown in FIG. 6 .
  • the hook portion 131 also has a space height along the direction perpendicular to the paper surface, that is, the hook portion 131 roughly presents a shape similar to a spring, The coil 31 can be easily inserted into the middle of the hook portion 131 .
  • the above description of the guide wire 13 and the hook portion 131 is only a preferred example rather than a limitation on the guide wire 13 and the hook portion 131, and those skilled in the art can adopt other configuration guide wires according to the prior art. 13 and the hook portion 131, which is not limited in the present invention.
  • the lateral positioning rod 11 is movably connected to the longitudinal positioning rod 12 along its own axial direction, so that after the longitudinal positioning rod 12 is inserted into the longitudinal tunnel 41, the lateral positioning rod 11 can be moved with the longitudinal positioning rod 11 through its own axial movement.
  • the predetermined object 4 is abutted.
  • the positioner 1 further includes a positioning rod sleeve 15 , and the positioning rod sleeve 15 has a rod sleeve channel penetrating along its own axis.
  • the inner contour shape of the rod sleeve channel 150 is adapted to the outer contour shape of the lateral positioning rod 11, and the lateral positioning rod 11 is movably passed through the The rod cover channel 150; the longitudinal positioning rod 12 is fixedly connected with the positioning rod cover 15.
  • the arrangement of the positioning rod sleeve 15 limits the radial freedom of the lateral positioning rod 11 , which can prevent the lateral positioning rod 11 from swinging uncontrollably.
  • the longitudinal positioning rod 12 includes a curved section 121 and a straight section 122 connected to the proximal end of the curved section 121 ; the straight section 122 is parallel to the axial direction of the lateral positioning rod 11 .
  • the entire positioner 1 should extend in a straight line to avoid interference with other parts of the patient's body.
  • the straight section 122 of the longitudinal positioning rod 12 is configured to be parallel to the axial direction of the transverse positioning rod 11 .
  • the positioning rod sleeve 15 also has a longitudinal positioning rod accommodating channel 151 arranged along its own axial direction.
  • the inner contour shape of the longitudinal positioning rod accommodating channel 151 is the same as the outer contour shape of the longitudinal positioning rod 12.
  • the longitudinal positioning rod accommodating channel 151 is used for accommodating the proximal end of the longitudinal positioning rod 12 .
  • the straight section 122 can be inserted into the longitudinal positioning rod accommodating channel 151, and after adjusting and confirming that the extension direction of the distal end of the longitudinal channel 120 intersects with the extension direction of the distal end of the lateral channel 110, the straight section 122 and the longitudinal positioning rod are accommodated
  • the track 151 is secured (eg welded or pressed). Of course, this step can be performed during the production of the positioner 1 or when the positioner 1 is about to be used, which is not limited in the present invention.
  • the shape of the curved section 121 can be adapted according to different predetermined objects 4 .
  • the distal end of the curved section 121 has a small straight section, so as to facilitate insertion into the longitudinal tunnel 41 of the predetermined object 4 , it is also beneficial to reduce the opening diameter of the longitudinal tunnel 41 .
  • the shaft portion of the positioner 1 needs to have a certain length, and for ease of assembly, the straight section 122 of the longitudinal positioning rod 12 should not be set too long.
  • the positioning rod sleeve 15 also A section of longitudinal channel extension channel 153 is provided.
  • the longitudinal channel extension channel 153 is coaxial with the longitudinal positioning rod accommodating channel 151 and is located at the proximal end of the longitudinal positioning rod accommodating channel 151 .
  • the proximal extension direction of the longitudinal channel 120 in the inner section coincides with the axial direction of the longitudinal channel extension channel 153, and the guide wire 13 can extend from the longitudinal channel extension channel 153 to the longitudinal direction. Proximal extension.
  • the angle formed by the extension direction of the distal end of the longitudinal channel 120 and the extension direction of the distal end of the transverse channel 110 ranges from 10° to 180°. This included angle range is suitable for many application scenarios.
  • the positioner 1 further includes a handle 16 , the handle 16 is wrapped around the proximal end of the lateral positioning rod 11 and extends linearly.
  • the handle 16 can be fixedly connected with the positioning rod sleeve 15 .
  • the handle 16 includes two parts that are detachable from each other, the two parts being connected by snaps positioned relative to each other.
  • the handle 16 has a positioning protrusion 161
  • the positioning rod cover 15 has a positioning depression 152 . After the positioning protrusion 161 is inserted into the positioning depression 152 , the handle 16 can be fixedly connected to the positioning rod cover 15 .
  • the distal end of the handle 16 is in conformity with the outer peripheral contour of the positioning rod sleeve 15 , so that the positioning rod sleeve 15 can be stably fixed in the handle 16 .
  • the handle 16 may be integrated with the positioning rod cover 15, or the outer contour of the positioning rod cover 15 may be configured as the handle 16, which is not limited in the present invention.
  • the driving part 14 may include a push button 141
  • the handle 16 has a push button groove for the push button 141 to slide, and the push button 141 and the push button
  • the groove is adapted to the groove, and the push button groove extends along the axial direction of the lateral positioning rod 11.
  • the push button 141 can be restricted by the push button groove and can only move along the axial direction of the positioning rod 11, so as to avoid the occurrence of radial diameters. shaking in the direction.
  • the push button 141 can be fixedly connected with the proximal end of the guide wire 13 , and the operator pushes the push button 141 to drive the guide wire 13 to move forward and backward in the axial direction of the longitudinal channel 120 .
  • the positioner 1 further includes a locking portion 17, and the locking portion 17 is used to drive the lateral positioning rod 11 to move toward the distal end, so that the lateral positioning rod 11 and the The longitudinal positioning rods 12 are clamped together on the predetermined object 4 .
  • FIG. 9 it can be understood that when the longitudinal positioning rod 12 is inserted into the longitudinal tunnel 41 of the predetermined object 4, the lateral positioning rod 11 is moved toward the distal end relative to the longitudinal positioning rod 12.
  • the lateral positioning rod 11 and the longitudinal positioning rod 12 can clamp the predetermined object 4 together.
  • the operator's hands can be detached from the positioner 1, and the operator does not need to hold the positioner 1 all the time.
  • the locking portion 17 includes: a rotating wheel 171 and a pushing member 172 , the rotating wheel 171 has an inner thread, and the pushing member 172 has a thread corresponding to the inner thread.
  • the adapted external thread, the internal thread of the runner 171 and the external thread of the pusher 172 are connected; the pusher 172 is fixedly connected with the lateral positioning rod 11, and the runner 171 can be It is rotatably connected with the positioning rod sleeve 15 , and is restricted from axial displacement relative to the positioning rod sleeve 15 . Since the positions of the longitudinal positioning rod 12 and the positioning rod sleeve 15 are fixed after they are assembled, when the runner 171 rotates, the lateral positioning rod 11 can be driven to move forward and backward along its own axis.
  • the positioning device 1 can be fixed on the predetermined object 4 by the locking portion 17, so that the operator's hands can be disengaged from the positioning device 1, and the operator does not need to keep Hand-held, on the one hand, the lateral positioning rod 11 can stably abut against the predetermined object 4, so that the extending direction of the lateral channel 110 can accurately intersect the longitudinal tunnel 41, which is beneficial to further use tools such as bone drills to open a lateral tunnel along the lateral channel 110 42, accurate positioning can be achieved; on the other hand, it is also convenient for the operator to operate tools such as a bone drill to open a transverse tunnel 42 after his hands are released from the positioner 1 .
  • the runner 171 is rotatably disposed at the proximal end of the handle 16 and is restricted from axial displacement relative to the handle 16 . Since the relative positional relationship between the handle 16 and the positioning rod sleeve 15 is fixed after assembly, the handle 16 can limit the axial position of the runner 171 relative to the longitudinal positioning rod 12 . In the example shown in FIG.
  • the runner 171 includes a runner body 1710 , a rotating shaft segment 1711 and a limit stand 1712 , the rotating shaft segment 1711 is arranged at the distal end of the runner body 1710 in the axial direction, and the limit stand 1712 is arranged on the The distal end of the rotating shaft segment 1711, wherein the outer diameter of the rotating shaft segment 1711 is smaller than the radial outer dimension of the stop table 1712, and also smaller than the radial outer dimension of the runner body 1710; A ring 162 is placed.
  • the inner diameter of the shaft accommodating ring 162 is adapted to the outer diameter of the shaft section 1711.
  • the shaft section 1711 is rotatably inserted into the shaft accommodating ring 162.
  • the main body 1710 and the limiting platform 1712 abut against each other, and in this configuration, the handle 16 can limit the axial position of the runner 171 but not limit its circumferential rotation.
  • the above exemplary example is only a preferred example of the runner 171 rather than a limitation on the runner 171, and those skilled in the art can make modifications according to the above ideas.
  • the thread lead of the runner 171 and the pusher 172 has a self-locking feature, that is, the ratio of the thread lead to the diameter of the pusher 172 is within a certain preset range.
  • the rotating wheel 171 can push the lateral positioning rod 11 to advance and retreat, but the lateral positioning rod 11 cannot drive the rotating wheel 171 to rotate, that is, self-locking is formed.
  • the thread lead can be set according to the operator's habit of using torsional instruments.
  • the runner 171 can be configured to complete the push-out of the lateral positioning rod 11 when the runner 171 rotates for 1.5 rotations but not more than 2 rotations, so that the lateral positioning rod 11 abuts against the predetermined object 4 .
  • the pusher 172 is fixed to the proximal end of the lateral positioning rod 11, and the pusher 172 has a channel passing through in its axial direction, and the channel is kept in communication with the lateral channel 110, so as to facilitate the passage of components such as the delivery rod 21 or the drill bit.
  • the distal end of the lateral positioning rod 11 has an abutment surface 111 , and the abutment surface 111 is adapted to match the shape of the predetermined object 4 and abut against the surface of the predetermined object 4 .
  • the distal end of the lateral positioning rod 11 also has an engaging portion 112 , and the engaging portion 112 is used to be inserted into the surface of the predetermined object 4 to engage with the predetermined object 4 .
  • the engaging portion 112 may be a protruding sharp corner disposed on the edge of the abutting surface 111 .
  • the rotating wheel 171 can be rotated slightly so that the engaging portion 112 bites into the bone slightly, and this configuration can increase the stability of the connection between the locator 1 and the predetermined object 4 . This ensures that the subsequent opening process of the transverse tunnel 42 is not affected by the vibration of external power, thereby realizing precise positioning.
  • the conveyor 2 further includes a suture accommodating portion 23, and the suture accommodating portion 23 is connected to the proximal end of the delivery rod 21 for accommodating the The proximal portion of the suture 32, eg for coiling of the suture 32.
  • the suture accommodating portion 23 includes a wire hub 231 and a housing 232, the housing 232 is fixedly connected with the proximal end of the delivery rod 21, and the inner cavity of the housing 232 is connected to the suture
  • the wire cavity 210 communicates with each other, and the wire hub 231 is rotatably disposed in the housing 232 .
  • the suture 32 extends from the suture cavity 210 into the inner cavity of the housing 232 and is coiled on the wire hub 231 .
  • the wire hub 231 can rotate about its own axis, and the suture 32 coiled thereon is then extended distally.
  • the wire hub 231 can rotate at an angle around its own axis, so that it is restricted by the housing 232 and cannot continue to rotate, and the suture 32 coiled on it continues to be pulled out distally. , sliding relative to the wire hub 231 occurs.
  • the delivery head 22 includes a fork-shaped card, and the distal end of the fork-shaped card includes a positioning card 251 and at least two branches 252 , and at least two of the branches 252 A closed card slot hole 250 is formed by connecting the positioning card 251 , and the card slot hole 250 is used for taking the coil 31 of the suture 32 or for accommodating the implant. Further, the delivery head 22 includes two fork-shaped cards, and the two fork-shaped cards are arranged opposite to each other.
  • the card slot holes 250 of the two fork-shaped clips can form a plate surface positioning with some implants (such as a titanium plate with a loop), so as to realize the holding of the implants, and the implants can be fed through the transverse channel 110 in use. in the transverse tunnel 42 . Further, the gap between the two fork-shaped clips can allow the hook portion 131 to pass through, so as to realize the hooking of the implant or the suture 32 .
  • the materials of the handle 16, the runner 171, the driving part 14 and other components are medical plastic materials, preferably polyvinyl chloride PVC, acrylonitrile-butadiene-propylene ABS, polyethylene PE, polypropylene PP or polycarbonate Ester PC, etc.
  • the materials of the transverse positioning rod 11, the longitudinal positioning rod 12, the positioning rod sleeve 15 and other components are medical metals, which can be independently selected from 12Cr13, 20Cr13, 05Cr17NiCu4Nb, 32Cr13Mo, 40Cr13, Y10Cr17 and 06Cr19Ni10.
  • the above-mentioned materials are only examples and not limitations on the materials of each component, and those skilled in the art can select other suitable materials according to the prior art.
  • the conveyor 2 further includes a limiting portion 24 that is fixedly connected with the conveying rod 21 ; the limiting portion 24 is used for abutting against a portion corresponding to the positioner 1 , so as to limit the displacement of the delivery rod 21 relative to the lateral channel 110 toward the distal end; wherein, when the limiting portion 24 abuts against the position corresponding to the positioner 1 , the delivery head 22 is located at The intersection of the distal extension direction of the longitudinal channel 120 and the distal extension direction of the transverse channel 110 .
  • a limiting portion 24 that is fixedly connected with the conveying rod 21 ; the limiting portion 24 is used for abutting against a portion corresponding to the positioner 1 , so as to limit the displacement of the delivery rod 21 relative to the lateral channel 110 toward the distal end; wherein, when the limiting portion 24 abuts against the position corresponding to the positioner 1 , the delivery head 22 is located at The intersection of the distal extension direction of the longitudinal channel 120 and the distal extension direction of
  • the connection between the housing 232 and the delivery rod 21 can be configured as the limit part 24 , and if it is adapted, the proximal end of the handle 16 of the positioner 1 or the wheel 171 can be configured As the corresponding part abutting against the housing 232 .
  • the limiting portion 24 and the corresponding parts of the positioner 1 can be independently set in a matched manner, for example, a corresponding stopper, stopper, etc. are provided. Those skilled in the art can configure it according to the actual situation. There is no restriction on this.
  • the conveyor 2 provided in this embodiment is a disposable consumable, and a suture 32 is preset inside.
  • the suture 32 of round, flat or round and flat shape (that is, round at both ends and flat in the middle) can be preset.
  • the material of the suture 32 can be: natural fibers, synthetic fibers, or metal wires. Natural fibers such as silk, etc.; synthetic fibers such as ultra-high molecular weight polyethylene, polyamide 6/6, polypropylene, polyethylene terephthalate, polyamide 6, etc. 3-0 ⁇ 5 round sutures and 0.1mm ⁇ 5mm flat sutures can be preset.
  • the positioner 1 can be used repeatedly. After the operator completes the tunnel-type thread-passing preset of a suture 32, the operator can discard the conveyor 2 and continue to select a new conveyor 2 for the preset of other sutures. .
  • the humerus is taken as the predetermined object 4 to describe the operation method of the tunnel-type wire-passing system.
  • the operation method of the tunnel-type wire-passing system includes:
  • Step S1 opening a longitudinal tunnel 41 on the humerus; since there are few muscle groups in the longitudinal tunnel 41 , the operator can quickly and accurately determine the approach of the longitudinal tunnel 41 through a trial method, and prepare the longitudinal tunnel 41 with a circuit opener or a bone drill.
  • Step S2 inserting the distal end of the longitudinal positioning rod 12 of the positioner 1 into the longitudinal tunnel 41, so that the extension direction of the distal end of the longitudinal channel 120 coincides with the axial direction of the longitudinal tunnel 41; further optional , after step S2, step S21 may also be included: using the locking portion 17 to drive the lateral positioning rod 11 to move towards the distal end, so that the lateral positioning rod 11 and the longitudinal positioning rod 12 are jointly clamped on the humerus, thereby Lock the positioner 1 to the humerus.
  • the distal end of the lateral positioning rod 11 can be pressed against the greater tuberosity of the humerus, and then the runner 171 can be rotated slightly, so that the engaging part 112 is slightly bitten into the humerus, so that the longitudinal positioning rod 12 and the lateral positioning rod 11 can be slightly bitten into the humerus. It is locked against each other with the humerus.
  • Step S3 opening a transverse tunnel 42 on the humerus along the extending direction of the transverse channel 110 of the positioner 1, so that the transverse tunnel 42 intersects the longitudinal tunnel 41; Drill to execute.
  • the bone drill is passed through the distal end of the transverse channel 110, and the transverse tunnel 42 is prepared along the extending direction of the transverse channel 110. Since the bone drill has a spiral groove, the bone chips (including the longitudinal tunnel 41 can be drilled while rotating). The resulting bone chips) are discharged, so as to ensure the smoothness of the bone tunnel.
  • the drilling depth of the bone drill should be such that the transverse tunnel 42 intersects the longitudinal tunnel 41 .
  • a limit block can be provided on the bone drill to ensure that the drilling of the bone drill will not be too deep.
  • Step S4 Insert the conveying rod 21 of the conveyor 2 into the transverse channel 110, and make the distal end of the conveying rod 21 extend into the transverse tunnel 42, so that the conveyor 2 is located in the longitudinal direction The intersection of the tunnel 41 and the transverse tunnel 42; before or after this step S4, the push button 141 of the driving part 14 may be pushed distally to extend the connecting part.
  • the delivery rod 21 of the delivery device 2 is moved to the distal end (eg, the limiting portion 24 abuts against the positioner 1 )
  • the coil 31 on the delivery head 22 should be able to connect with the connecting portion, such as being sleeved into the hook portion 131 .
  • Step S5 using the driving part 14 to drive the connecting part to move towards the proximal end and connect with the coil 31 or the implant accommodated on the delivery head 22 ; optionally, after this step, the connecting part can be moved towards the proximal end Gently pull the conveyor 2 back, if there is a stretch feeling, it cannot be pulled back easily, indicating that the connection is successful.
  • Step S6 Pulling the delivery device 2 proximally, so that the coil 31 or the implant is left in the longitudinal tunnel 41; in this step, the delivery device 2 can be pulled out with a little force until the inner suture 32 Or the implant is completely detached from the conveyor 2.
  • Step S7 Pull the positioner 1 towards the proximal end, and pull the coil 31 or a part of the implant (such as the implant's traction wire, etc.) out of the longitudinal tunnel 41; optionally, in this step S7 Before, the wheel 171 can be reversely rotated to release the locking between the locator 1 and the humerus.
  • the implant such as the implant's traction wire, etc.
  • Step S8 Push the push button 141 to the distal end to extend the connection part, and then the coil 31 or the implant is pulled out from the connection part, so that the coil 31 or the implant is aligned with the positioning device 1 is separated. This completes the placement of a suture or implant in the bone tunnel.
  • Embodiment 2 of the present invention The positioner, conveyor, tunnel-type wire-passing system and operation method thereof in Embodiment 2 of the present invention are basically the same as those in Embodiment 1, and the same parts will not be described, and only different points will be described below.
  • FIG. 12 is a schematic diagram of the longitudinal positioning rod in the second embodiment of the present invention
  • FIG. 13 is a schematic diagram of the first knob in the second embodiment of the present invention
  • FIG. 14 is the second embodiment of the present invention. Schematic diagram of two knobs and racks.
  • the specific structure of the positioner 1 is different from that of the first embodiment.
  • the material of at least a part of the longitudinal positioning rod 12 is a shape memory material.
  • the shape memory material can be, for example, a memory metal, which can switch its strength according to changes in temperature.
  • the longitudinal positioning rod 12 can be prefabricated into various angles and shapes in real time according to requirements, so as to be attached to the structure of the predetermined object 4 individually.
  • the proximal end of the longitudinal positioning rod 12 is fixedly connected to the longitudinal positioning rod accommodating channel 151 of the positioning rod cover 15
  • the longitudinal positioning rod 12 may also be detachable relative to the positioning rod cover 15 , in use, when the longitudinal positioning rod 12 is assembled into the longitudinal positioning rod accommodating channel 151 of the positioning rod sleeve 15, the longitudinal positioning rod accommodating channel 151 can be interference fit with the longitudinal positioning rod 12 or reliably through other connecting structures.
  • the two can be relatively closely matched, so as to facilitate the subsequent locking of the positioning device 1 by the locking portion 17 .
  • the material of the curved section 121 of the longitudinal positioning rod 12 is a shape memory material
  • the straight section 122 can be made of a shape memory material, preferably a common non-shape memory material.
  • the longitudinal positioning rod 12 is used for softening in the environment of the first preset temperature, and then for bending to fit the shape of the predetermined object 4, and for hardening at the second preset temperature.
  • the first preset temperature and the second preset temperature may be selected according to the use environment.
  • the first preset temperature may be 60° C.
  • the second preset temperature may be 40° C.
  • the shape memory The material softens and deforms when it is above 60 °C, and when it is cooled to below 40 °C, it will solidify and restore its original strength and hardness.
  • the operator may first place the part of the shape memory material of the longitudinal positioning rod 12 in hot water to soften, and then position the longitudinal position according to the shape of the predetermined object 4 , especially according to the shape of the prefabricated longitudinal tunnel 41 .
  • the rods 12 are bent, and the longitudinal positioning rods 12 are naturally cooled and solidified or immersed in cold water to solidify and form.
  • cold water and hot water are only examples of providing a preset temperature, and those skilled in the art can also use a hot air gun or an incubator to provide a preset temperature that meets requirements.
  • the structure of the driving part 14 is different from that in the first embodiment.
  • the driving part 14 includes a first knob 142 , the proximal end of the guide wire 13 is fixedly connected to the first knob 142 through the connecting rod 132 , and the guide wire 13 is used for The rotation of the first knob 142 moves forward and backward along its own axial direction.
  • the positioner 1 further includes a second knob 181 and a rack 182 , the outer circumference of the second knob 181 has teeth, and the rack 182 is fixedly connected with the lateral positioning rod 11 , the rack 182 is used to engage with the teeth; the rotation of the second knob 181 is converted into the rotation of the lateral positioning rod 11 along its own axis through the engagement of the rack 182 and the teeth move.
  • the first knob 142 includes two sub-sections arranged opposite to each other, the two sub-sections are sandwiched on both sides of the second knob 181 along the axial direction of the second knob 181 , the first knob 142 and the second knob 181 .
  • the two knobs 181 can be rotated independently of each other.
  • a limiting structure can be designed to ensure that the two move independently of each other, that is, the first knob is restricted from rotating with the second knob, and the second knob is restricted from rotating with the first knob.
  • the second knob 181 When the second knob 181 is rotated in one direction, it can drive the lateral positioning rod 11 to move to the distal end.
  • the rotation direction of the second knob 181 when the lateral positioning rod 11 is driven to move to the distal end is called the forward direction (in FIG. 14 . Clockwise direction).
  • Rotating the second knob 181 in the advancing direction drives the lateral positioning rod 11 to move to the distal end.
  • the first knob 142 does not move, and the guide wire 13 does not extend to the distal end.
  • the second knob 181 is locked and cannot be rotated.
  • the first knob 142 is rotated in the forward direction (clockwise in FIG.
  • the guide wire 13 is driven to extend to the distal end by the connecting rod 132 .
  • the operation method further includes:
  • Step S20 Place at least part of the longitudinal positioning rod 12 in an environment with a first preset temperature to soften, and then bend the longitudinal positioning rod 12 to fit the shape of the predetermined object 4; The at least part of the positioning rod 12 is exposed to a second predetermined temperature to harden.
  • step S21 the lateral positioning rod 11 may be moved to the distal end by rotating the second knob 181 .
  • steps S4 to S8 it can be understood that the advancing and retreating of the guide wire 13 is driven by rotating the first knob 142 .
  • Embodiment 3 of the present invention The positioner, conveyor, tunnel-type wire-passing system and operation method thereof in Embodiment 3 of the present invention are basically the same as those in Embodiment 1, and the same parts will not be described, and only different points will be described below.
  • FIG. 15 is an exploded schematic diagram of the conveyor according to the third embodiment of the present invention
  • FIG. 16 is a schematic diagram of the outer line hub set according to the third embodiment of the present invention
  • FIG. 17 is the indication of the third embodiment of the present invention
  • Figure 18 is a schematic diagram of the torsion spring of the third embodiment of the present invention.
  • the specific structure of the conveyor 2 is different from that in the first embodiment.
  • the conveyor 2 includes: a conveying rod 21, a conveying head 22 and at least two wire hubs 231; each of the wire hubs 231 is used for coiling a suture 32;
  • the delivery rod 21 has a suture cavity 210 arranged along its own axis, and the suture cavity 210 is used for accommodating the part of the suture 32 coiled on the wire hub 231 extending to the distal end;
  • the delivery head 22 is arranged at the distal end of the delivery rod 21, for accommodating the coil 31 formed by the part of the suture 32 in the suture cavity 210 extending to the distal end;
  • the delivery rod 21 is used for movable
  • the delivery head 22 is used to protrude from the distal end of the positioner 1, so that the positioner 1 can hook all the parts accommodated on the delivery head 22.
  • the coil 31 is described.
  • At least two sutures 32 can be preset in the conveyor 2, and after the tunnel-type thread-passing preset of one suture 32 is completed, the conveyor can continue to use the suture.
  • the device 2 performs the tunnel-type thread-passing preset of the next suture 32 without having to replace the conveyor 2, which is beneficial to improve the continuity of the operation and also reduces the total cost of using the conveyor 2 in one operation.
  • this embodiment also provides a thread passing device, which includes the conveyor 2 and at least two sutures 32 , and each thread hub 231 of the conveyor 2 is coiled with a thread One of the sutures 32; the sutures 32 coiled on the adjacent wire hubs 231 are connected end to end in turn; a part of one of the sutures 32 is also accommodated in the suture of the conveyor 2 In the cavity 210 , the distal end of the suture 32 is wound into a coil 31 and received on the delivery head 22 of the delivery device 2 .
  • at least two identical or different sutures 32 are connected end to end, wherein the head of each suture 32 forms a loop 31 .
  • the coil 31 can be prefabricated before the suture 32 leaves the factory, or it can be wound by the operator during the operation.
  • the thread guide integrates the suture 32 for feeding the suture 32 into the transverse tunnel 42 of the intended object 4 .
  • the suture 32 is coiled on the wire hub 231 , and does not limit the connection between the end (ie, the proximal end) of the suture 32 and the wire hub 231 .
  • the suture 32 is only coiled on the wire hub 231 and does not form a fixed connection with the wire hub 231 . In this configuration, the suture 32 can slide relative to the wire hub 231, and the suture 32 can be withdrawn distally when the wire hub 231 is secured.
  • the thread-passing device further includes a suture connection section 33 , and the suture connection section 33 is connected between the adjacent sutures 32 ; the suture connection section 33
  • the tensile strength is lower than the tensile strength of the suture 32 .
  • the suture connection section 33 is a point-break type connection section, which can be made of the same material as the suture 32, and mechanically removes part of the material at the suture connection section 33, so that the suture connection section 33 forms a point-break
  • the connecting section is convenient for the operator to directly tear it off during the operation.
  • Each suture 32 can be set to be 1 meter long according to the usual amount of surgery.
  • the suture connecting section 33 can also be made of a material different from that of the suture 32 to achieve its lower tensile strength.
  • At least two of the wire hubs 231 are arranged side by side along an axis direction. At least two sutures 32 connected end to end are wound on different wire hubs 231 in sequence, and the winding order of all sutures 32 is preferably the same. In order to avoid mutual interference and knotting between different sutures 32 during the operation, at least two of the wire hubs 231 are arranged side by side along an axis direction, and the sutures 32 can be distinguished.
  • the conveyor 2 includes a suture partition 233, and the suture partition 233 is arranged between the two adjacent wire hubs 231 in the axial direction, and is used to block the threads on different wire hubs 231.
  • Suture 32 can be a ridge-like protrusion, and its outer diameter is larger than the outer diameter of the wire hub 231 , so as to block the sutures 32 coiled on different wire hubs 231 .
  • the suture partition 233 has a first thread-passing hole 234, and the first thread-passing hole 234 is used for the suture 23 to pass through, so that the slits on the adjacent thread hubs 231 in the axial direction can be passed through.
  • Lines 32 are connected to each other.
  • the first thread-passing hole 234 is preferably obliquely penetrated through the suture partition 233 to reduce the resistance of the suture 32 being pulled out from the thread hub 231 .
  • the thread passing through the first thread hole 234 may be the suture connection section 33 or any one of the two sutures 32 blocked by the suture partition 233 , and the sutures are connected to each other.
  • the segment 33 is disposed on one side of the first wire hole 234 .
  • At least two of the wire hubs 231 are nested inside and outside around an axis.
  • the parallel arrangement of the plurality of wire hubs 231 will be too wide, so the number of sutures 32 that can be integrated in the method of arranging in parallel in the axial direction will be restricted.
  • at least two of the wire hubs 231 can be configured to be nested inside and outside about an axis.
  • the wire hub 231 of each layer can be coiled with at least one suture 32 .
  • the above two solutions can be used in combination, that is, the wire hubs 231 are nested inside and outside around the axis at the same time, and arranged side by side along the axis.
  • two wire hubs 231 are arranged side by side along an axial direction to form an outer wire hub group 2315; the other two wire hubs 231 are arranged side by side along the axial direction to form an inner wire hub group 2316; an outer wire hub group
  • the 2315 is sleeved on the outer side of the inner wire hub group 2316 around the axis, and the outer wire hub group 2315 and the inner wire hub group 2316 can rotate independently of each other.
  • the inner wire hub group 2316 can prevent the outer wire hub group 2315 from coming out by cooperating with the baffle plate 2317 .
  • the two wire hubs 231 of the outer wire hub group 2315 are fixedly connected to each other, and the two wire hubs 231 of the inner wire hub group 2316 are also fixedly connected to each other.
  • the conveyor 2 can accommodate four sutures 32 . It can be understood that those skilled in the art can set different numbers and arrangements of the wire hubs 231 according to the above-mentioned idea, such as adopting double-layer wire hubs, three parallel wire hubs per layer, etc., to meet actual needs.
  • the wire hub 231 located on the outer side has a second wire hole 235, and the second wire hole 235 is used for the suture 32 to pass through, so that the inner and outer adjacent said The sutures 32 on the hub 231 are connected to each other.
  • a second wire hole 235 may be opened on a certain wire hub 231 of the outer wire hub group.
  • the second wire passing hole 235 passes through the outer wire hub group inwardly, and then continues to be coiled on the wire hub 231 of the inner wire hub group.
  • the sutures 32 coiled on each wire hub 231 of the inner and outer wire hub groups can be continuous, which is convenient for sequential extraction and use during the operation.
  • the wire hub 231 located on the outer side here does not only refer to the wire hub 231 in the outermost layer of wire hub groups in each layer of wire hub groups, but should be understood to have other wire hubs inside. That is to say, the wire hubs 231 located on the outer side here should be understood as the wire hubs in the non-innermost wire hub group.
  • the wire hub group in the middle layer is also located on the outside relative to the innermost wire hub group, so it can also be provided with a second wire-passing hole 235, so that The suture 32 can be traversed continuously.
  • the second wire-passing hole 235 is disposed at the end of the wire hub 231 at the most edge of each layer of wire hub groups, so as to prevent the suture 32 from being entangled.
  • the conveyor 2 includes an indicator portion 26 , and the wire hub 231 is rotated under the driving of the suture 32 , which drives the end of the indicator portion 26 connected to the wire hub 231 to be opposite to each other.
  • the displacement of the housing 232 thereby forming an indication.
  • the inventor found that since the bone tunnel (ie the longitudinal tunnel 41 and the lateral tunnel 42 opened on the predetermined object 4) belong to the blind area of this type of operation, the operator cannot see what happens inside the bone tunnel. Operators often can only judge the situation of device intervention based on hand feel and experience, and the surgical risk is high.
  • the setting of the indication portion 26 can provide an indication on the outside of the osseous tunnel of the conveyor 2 to prompt the operator whether the suture 32 is successfully hooked by the hook portion 131 .
  • the indicating portion 26 includes a torsion spring 261 and an indicating mark 262 , one end of the torsion spring 261 is connected to the wire hub 231 , and the other end is connected to the housing 232 ;
  • the indicator 262 and the torsion spring 261 are connected to one end of the wire hub 231 ;
  • the housing 232 has an observation area 236 for observing the indicator 262 .
  • the housing 232 forms a hub 237 around which the first end 2611 of the torsion spring 261 is embedded and constrained from rotation.
  • the bobbin shaft 237 has a certain circumferential gap 2370 at the second end 2612 of the torsion spring 261, and the second end 2612 of the torsion spring 261 can move in the circumferential gap 2370.
  • the second end 2612 of the torsion spring 261 abuts against one side edge (the upper edge in FIG. 18 ) of the circumferential gap 2370 under the action of its own elastic force.
  • the wire hub 231 is rotatably arranged around the wire hub shaft 237, and a raised lever 2311 is formed on the wire hub 231.
  • the wire hub 231 abuts against the second end 2612 of the torsion spring 261 through the lever 2311 connect.
  • the suture 32 When the suture 32 is successfully hooked by the hook portion 131 , the suture 32 will be pulled out to the distal end by the hook portion 131 , thereby driving the wire hub 231 to rotate in the first direction.
  • the wire hub 231 rotates around its own axis in the first direction (counterclockwise in FIG. 18 ), so as to push the second end 2612 of the torsion spring 261 to generate a displacement relative to the housing 232 ;
  • the first direction here can be one of a clockwise direction or a counterclockwise direction, and is not limited to the counterclockwise direction in the above exemplary example.
  • the indicator mark 262 is connected with the second end 2612 of the torsion spring 261.
  • the indicator mark 262 will follow the displacement relative to the housing 232, and the operator can pass the observation area. Displacement of indicator 262 is observed at 236 .
  • the casing 232 has a substantially cylindrical shape, and the viewing area 236 is opened on a bottom surface of the cylindrical shape, such as being hollowed out or covered with a transparent material, such as the cylindrical shape of the casing 232 .
  • the bottom surface or the entire casing is made of transparent material. If the position on the casing 232 close to the observation area 236 can be marked with an “OK” prompt, when the indicator 262 moves to the observation area 236, it means that the suture 32 has been removed. Tick successfully.
  • the above-mentioned indicator portion 26 can already be adapted to the conveyor 2 that only accommodates a single suture 32 , for example, it can be combined with the conveyor 2 provided in the first embodiment.
  • the housing 232 has a rotation limiting portion 2371 , and the rotation limiting portion 2371 is used for connecting with the lever 2311 or the torsion spring 261 abutting, so as to limit the continuous rotation of the wire hub 231 in the first direction after being rotated by a predetermined angle in the first direction. Please continue to refer to FIG.
  • the rotation limiting portion 2371 is an edge of one side of the circumferential gap 2370 of the bobbin shaft 237 , and the edge is a side edge away from the second end 2612 of the torsion spring 261 against which the second end 2612 abuts when no external force is applied.
  • the edge is a side edge away from the second end 2612 of the torsion spring 261 against which the second end 2612 abuts when no external force is applied.
  • the suture 32 After one suture 32 is completely drawn out and separated from the next suture 32, the suture 32 no longer generates torque in the first direction to the thread hub 231, and the thread hub 231 is driven by the elastic force of the torsion spring 261, Returning to the initial position shown in FIG. 18 , the indicator mark 262 is moved out of the observation area 236 , and the prompt mark of “OK” is no longer displayed, waiting for the next hooking. It can be understood that in the above example, a part of the bobbin shaft 237 is used as the rotation limiting portion 2371.
  • the rotation limiting portion 2371 may also be a component provided independently on the housing 232, and the rotation limiting portion 2371 may also be The rotation of the wire hub 231 is restricted by abutting against the lever 2311, which is not limited in the present invention.
  • step S9 it further includes:
  • Step S91 Continue to pull the previous suture where the coil is pulled out of the longitudinal tunnel 41 in step S7 toward the proximal end, until the distal end of the latter suture connected to the previous suture exceeds the delivery head 22;
  • Step S92 separating the previous suture and the latter suture, and accommodating the coil at the distal end of the latter suture on the delivery head 22 for repeating the next time on the predetermined object 4 Tunnel crossing.
  • the distal end of the latter suture 32 is wound into a coil 31, which may be pre-formed when the suture 32 is shipped from the factory, or may be wound on site by the operator in step S92.
  • the positioner, the conveyor, the tunnel-type wire-passing system and the operation method thereof in the fourth embodiment of the present invention are basically the same as those in the first embodiment, and the same parts will not be described, and only the differences will be described below.
  • FIG. 19 is a schematic diagram of the conveyor according to the fourth embodiment of the present invention
  • FIG. 20 is a partial enlarged view of the conveyor shown in FIG. 19 .
  • the specific structure of the conveyor 2 is different from that of the first embodiment.
  • the conveyor 2 includes: a sleeve 27 , a push rod 28 and a delivery head 22 ;
  • the sleeve 27 has a push rod channel 270 penetrating through its own axial direction and a radial Toward the opening 271, the notch 271 communicates with the push rod channel 270; a part of the push rod 28 is movably penetrated through the push rod channel 270 along the axial direction of the sleeve 27;
  • the delivery head 22 is connected with the distal end of the push rod 28 ;
  • the notch 271 is used for passing the coil 31 wound by the suture 32
  • the push rod 28 is used for passing through the push rod channel 270 to the The proximal side of the notch 271 moves to the distal side, and the delivery head 22 is used to take out the notch 271 and extend into the push rod during the process of the push rod 28 moving
  • the coil 31 of the channel 270 is used to extend from the distal end of the cannula 27; the cannula 27 is used to movably pass through the positioner 1, and the delivery head 22 is used to self- The distal end of the positioner 1 protrudes so that the positioner 1 can hook the coil 31 accommodated on the delivery head 22 .
  • the push rod 28 can be easily moved to the distal end to take the coil 31 , so that the process of installing the coil 31 on the delivery head 22 No additional tools are required, and the coil 31 can be easily installed on the delivery head 22 , which also brings convenience to the continuous presetting of a plurality of sutures 32 .
  • the delivery head 22 is switched between the first state and the second state.
  • the delivery head 22 penetrates the push rod channel 270 , it is restricted by the sleeve 27 and is in the first state. state; after the delivery head 22 protrudes from the distal end of the sleeve 27 , it expands along the radial direction of the sleeve 27 to switch to the second state to tension the coil 31 .
  • the material of the delivery head 22 is a shape memory material.
  • the shape memory material is a material with reversible deformation, so the delivery head 22 will be automatically retracted by the sleeve 27 in the push rod channel 270, in the first state, it is adapted to the inner diameter of the push rod channel 270, and when the delivery head 22 After the sleeve 27 is extended, it can be automatically opened and expanded to the second state.
  • the delivery head 22 has elasticity along the radial direction of the sleeve 27 , and when the delivery head 22 passes through the push rod channel 270 , the delivery head 22 is held by the sleeve 27 .
  • the elastic potential energy is limited and stored, and is in the first state; after the delivery head 22 protrudes from the distal end of the sleeve 27, the elastic potential energy is released to expand to the second state along the radial direction of the sleeve 27 to stretch Tighten the coil 31.
  • the delivery head 22 has a guide slope 223 , and the guide slope 223 is gradually inclined inward toward the axis of the push rod 28 along the direction from the distal end to the proximal end.
  • the setting of the guide slope 223 can make the push rod 28 retract into the sleeve 27 toward the proximal end, so that the sleeve 27 can exert an inward contracting force on the delivery head 22, and it is convenient for the delivery head 22 to shrink from the second state to the first state. state.
  • the conveyor 2 includes a pull-back driving part 29 , the pull-back driving part 29 is connected with the push rod 28 , and the pull-back driving part 29 is configured to When the push rod 28 is pulled by an external force and moves to the proximal end (the pullback driving part 29 is stretched), potential energy is stored, and when the push rod 28 is not subjected to external force, the potential energy is released to drive the push rod 28 to move to the distal end , until the delivery head 22 moves to the distal end of the sleeve 27 , and the delivery head 22 protrudes from the distal side of the push rod channel 270 .
  • the setting of the pull-back driving part 29 enables the push rod 28 to automatically retract to the distal end of the push rod channel 270 when no external force is applied, which is convenient for continuously pushing the suture 32 to the distal end, and is also convenient for one-handed operation when the thread is hooked. (One-handed control of conveyor 2 is not required).
  • the pull-back driving part 29 includes an elastic member, one end of the elastic member is connected with the push rod 28 , and the other end is connected with the sleeve 27 .
  • the pull-back driving part 29 may also include a magnetic member or the like, which uses magnetic force to store and release potential energy.
  • the pull-back driving part 29 includes an elastic member, the elastic member is a spring, and the spring is sleeved outside the push rod 28 ;
  • the end has an expanded section 281 , one end of the spring is abutted and connected with the expanded section 281 , and the other end is abutted with the proximal end of the sleeve 27 .
  • the delivery head 22 of the push rod 28 is located at the distal end of the push rod channel 270 .
  • a restricting member such as an oppositely arranged buckle, is further provided between the push rod 28 and the sleeve 27 to restrict the push rod 28 from being pulled out from the proximal end of the sleeve 27 for ease of use.
  • the conveyor 2 includes a suture accommodating portion 23 for accommodating at least two of the sutures 32; the suture accommodating portion 23 has at least two Suture preset holes 238, each of the suture preset holes 238 is used for passing one of the sutures 32; at least two of the suture preset holes 238 are used to sequentially connect with the notch 271 alignment.
  • the specific structure of the suture accommodating portion 23 is not particularly limited in this embodiment, for example, the inner and outer nested wire hubs as in the third embodiment above, or the axially parallel wire hubs, etc. may be used.
  • the at least two suture presetting holes 238 are preferably evenly distributed around the circumference of the suture receiving portion 23 . In the example shown in FIG.
  • the suture accommodating portion 23 has six suture preset holes 238 , and meanwhile, the suture accommodating portion 23 accommodates six sutures 32 , and the distal ends of each suture 32 are respectively
  • the coil 31 is passed through the six different suture preset holes 238, and is hardened and bent into a suitable angle with the notch 271 by glue or other means, so that the coil 31 can easily pass through the notch 271. into the push rod channel 270 .
  • the next suture preset hole 238 can be aligned with the notch 271 by rotating the suture accommodating part 23 so as to push the next suture 32 .
  • the rotating suture accommodating portion 23 can be rotated manually, or can be automatically rotated through a mechanical structure or the like, which is not limited here.
  • the delivery head 22 can be arranged in the opposite manner as in the first embodiment, so that the coils 31 can be easily retracted.
  • the coils 31 can be easily retracted.
  • the present embodiment also provides a thread-passing device, which includes: the above-mentioned conveyor 2 and at least two sutures 32; Then, it extends into the push rod channel 270 through the notch 271 in sequence, so that the delivery head 22 can be sequentially retracted and pushed out of the distal end of the sleeve 27 along with the delivery head 22 .
  • the tunnel-type wire-passing system provided in this embodiment includes: the above-mentioned wire-passing device and the positioner 1 , and the delivery head 22 of the conveyor 2 is at a distance from which the coil 31 is retracted and pushed out of the sleeve 27 . After the end, the sleeve 27 is used to penetrate the lateral channel 110 of the positioner 1 , and the connection part of the positioner 1 is used to connect with the coil 31 accommodated on the delivery head 22 of the conveyor 2 .
  • the operation method of the tunnel-type wire-passing system further includes:
  • Step SA The coil 31 wound by the suture 32 is inserted into the push rod channel 270 through the notch 271 of the conveyor 2, and the push rod 28 is pushed to the distal end, so that the conveyor head 22 can take the position.
  • the coil 31 extends from the distal end of the sleeve 27 .
  • step S5 the operation method of the tunnel-type wire-passing system further includes:
  • Step SB1 move the cannula 27 to the proximal end to withdraw the lateral channel 110;
  • Step SB2 Pass the coil 31 wound by the last suture 32 into the push rod channel 270 through the slot 271 of the conveyor 2, push the push rod 28 to the distal end, and make the delivery head 22 cover
  • the coil 31 of the latter suture 32 is taken and protruded from the distal end of the cannula 27 for repeating the next tunneling of the thread on the predetermined object 4 .
  • step SB3 is further included: inserting the push rod 28 is moved proximally until the delivery head 22 is on the proximal side of the slot 271 .
  • the conveyor 2 and the thread-passing device provided in this embodiment can realize automatic burrowing and changing the suture 32 , which is beneficial to provide the continuity of the operation, and also simplifies the steps of installing the coil 31 of the suture 32 on the delivery head 22 .
  • Embodiment 5 of the present invention The positioner, conveyor, tunnel-type wire-passing system and operation method thereof in Embodiment 5 of the present invention are basically the same as those in Embodiment 1, and the same parts will not be described, and only different points will be described below.
  • FIG. 21 is a partial schematic diagram of the conveyor according to the fifth embodiment of the present invention
  • FIG. 22 is the overall schematic diagram of the suture accommodating part according to the fifth embodiment of the present invention
  • FIG. 23 is an embodiment of the present invention Five schematic diagrams of the internal structure of the suture accommodating portion.
  • the specific structure of the conveyor 2 is different from that in the first embodiment.
  • the conveyor 2 includes: a conveying rod 21 , a conveying head 22 and a suture accommodating part 23 ; the suture accommodating part 23 is connected to the conveying rod 21 , for accommodating at least two sutures 32; the suture accommodating part 23 has at least two suture preset holes 238, each of which is used for one suture The thread 32 is passed out; at least two of the suture preset holes 238 are used to be aligned with the suture cavity 210 respectively, so that different sutures 32 can pass through the suture cavity 210 .
  • the suture accommodating portion 23 of the present embodiment is used to accommodate at least two sutures 32 , which can be selected to use different sutures 32 accommodated therein.
  • the suture accommodating portion 23 has at least two suture preset holes 238 for aligning with the suture cavity 210 respectively.
  • the suture accommodating portion 23 of this embodiment can selectively align the required suture preset holes 238 with the suture cavity 210, so that the operator can select different suture preset holes 238 according to needs. Different sutures 32 are pierced to better suit the needs of the surgery.
  • the operator can actively move the suture accommodating portion 23 as required, align the selected suture preset hole 238 with the suture cavity 210, and then pull out the suture 32 therein, and the suture
  • the coil 31 of 32 is accommodated on the delivery head 22 for the hook portion 131 of the positioner 1 to be hooked.
  • the suture accommodating portion 23 includes an outer hub 2312 and an inner hub 2313 , and the outer hub 2312 is rotatably disposed on the inner hub around the axis of the inner hub 2313 2313, and the outer hub 2312 has only one-way rotational freedom relative to the inner hub 2313; the suture 32 is used to be coiled and arranged on the outer hub 2312, and the outer hub 2312 is configured as The inner hub 2313 is rotated in one direction, so that the different suture preset holes 238 are respectively aligned with the suture cavity 210 .
  • the housing 232 has a window 2320 , through which the operator can extend into the housing 232 and move the outer hub 2312 to rotate, and the window 2320 can be used to observe the coil on the outer hub 2312
  • the specific shape of the suture 32 is convenient for the selection of the suture 32.
  • the inner wall of the outer hub 2312 and the outer wall of the inner hub 2313 have corresponding ratchet teeth 2314 , and the ratchet teeth 2314 are used to limit the outer hub 2312 to have only a single position relative to the inner hub 2313 .
  • rotational degrees of freedom In the example shown in FIG. 23 , the arrangement of the ratchet teeth 2314 can limit the rotation of the outer hub 2312 relative to the inner hub 2313 only in the clockwise direction in the figure, but not in the counterclockwise direction. So configured, the operator can toggle the outer hub 2312 clockwise to select a different suture 32 .
  • the winding direction of the suture 32 on the outer hub 2312 is opposite to the unidirectional rotation direction of the outer hub 2312 relative to the inner hub 2313 .
  • the unidirectional rotation direction of the outer hub 2312 relative to the inner hub 2313 is clockwise, and the winding direction of the suture 32 on the outer hub 2312 is counterclockwise.
  • the arrangement direction of the ratchet teeth 2314 is only an example and not a limitation on the arrangement direction of the ratchet teeth 2314.
  • Those skilled in the art can reverse the arrangement of the ratchet teeth 2314 as required, so that the outer hub 2312 is relatively inner.
  • the unidirectional rotation direction of the hub 2313 is reversed, and will not be described here.
  • the inner hub 2313 may be fixedly disposed on the housing 232 .
  • the suture 32 can be selected, but it cannot indicate whether the suture 32 is successfully hooked by the hook portion 131 .
  • the inner hub 2313 is rotatably disposed in the housing 232 around its own axis.
  • the conveyor 2 includes an indicator portion 26, and the outer hub 2312 rotates under the driving of the suture 32, which drives the inner hub 2313 to rotate in the same direction, thereby driving the indicator portion 26 and the inner hub 2313 to rotate.
  • One end of the connection is displaced relative to the housing 232, forming an indication.
  • the indicating portion 26 includes a torsion spring 261 and an indicating mark 262, the first end 2611 of the torsion spring 261 is connected to the housing 232, and the second end 2612 of the torsion spring 261 is connected to the inner hub 2313 Connection; the indicator 262 and the torsion spring 261 are connected with one end (ie, the second end 2612 ) of the inner hub 2313 ; the housing 232 has an observation area 236 for observing the indicator 262 .
  • the housing 232 has a rotation limiting portion 2371
  • the inner hub 2313 has a lever 2311
  • the inner hub 2313 is abutted and connected to the second end 2612 of the torsion spring 261 through the lever 2311;
  • the inner hub 2313 rotates around its own axis in the first direction, and pushes the second end 2612 of the torsion spring 261 to generate displacement relative to the housing 232;
  • the torsion spring 261 abuts against, so as to limit the inner hub 2313 to continue to rotate in the first direction after being rotated by a predetermined angle in the first direction.
  • the settings of the torsion spring 261 , the lever 2311 , the rotation limiting portion 2371 and the indicator 262 are similar to those in the third embodiment, and will not be repeated here.
  • the operator can select the desired suture 32 by turning the outer hub 2312 clockwise.
  • the inner hub 2313 does not rotate.
  • the suture 32 will drive the outer hub 2312 to rotate in the counterclockwise direction because the winding direction of the suture 32 is opposite to the unidirectional rotation direction of the outer hub 2312.
  • the outer hub 2312 drives the inner hub 2313 to rotate counterclockwise together through the ratchet teeth 2314, and the lever 2311 provided on the inner hub 2313 drives the second end 2612 of the torsion spring 261 to move, thereby making the indicator 262 move for indication.
  • the observation area 236 is opened on the circumference of the cylindrical casing 232, and the indicator 262 may include, for example, a red segment and a green segment circumferentially arranged around the casing 232, in the initial state , the red segment of the indicator 262 is aligned with the observation area 236, and when the suture 32 is successfully hooked, the green segment of the indicator 262 is driven to align with the observation area 236, indicating that the hooking is successful. Further, after a suture 32 is completely drawn out, the indicator mark 262 can be reset to the initial state under the elastic force of the torsion spring 261, so that the red segment is aligned with the observation area 236 for the next indication.
  • the conveyor 2 in this embodiment can push the selected suture 32 by using the sleeve 27 and the push rod 28 similar to the fourth embodiment, or the suture cavity 210 can be configured to
  • the radial opening of the delivery rod 21 that is, the delivery rod 21 is not tubular, but groove-shaped, so as to facilitate the placement of the selected suture 32 into the suture cavity 210 .
  • the present embodiment provides a thread-passing device, which includes the above-mentioned conveyor 2 and at least two sutures 32; the at least two sutures 32 are respectively coiled and arranged on the outer hub of the conveyor 2 2312 on.
  • the tunnel-type wire-passing system provided in this embodiment includes: the above-mentioned wire-passing device and the positioner 1 .
  • the operation method of the tunnel-type wire-passing system further includes:
  • Step SC Select a certain suture preset hole 238 of the suture accommodating part 23 to be aligned with the suture cavity 210 , and align the suture preset hole 238 of the suture cavity 210 to pass through
  • the suture 32 is wound into a coil 31 and accommodated on the delivery head 22 .
  • Embodiment 6 of the present invention The positioner, conveyor, tunnel-type wire-passing system and operation method thereof in Embodiment 6 of the present invention are basically the same as those in Embodiment 1, and the same parts will not be described, and only different points will be described below.
  • FIG. 24 is a schematic diagram of the two-leaf hook according to the sixth embodiment of the present invention
  • FIG. 25 is a schematic diagram of the connection between the two-leaf hook and the wire anchor according to the sixth embodiment of the present invention
  • FIG. 27 is the schematic diagram of the two-leaf hook hooking the suture according to the sixth embodiment of the present invention
  • FIG. 28 is the schematic diagram of the flat screw hook according to the sixth embodiment of the present invention.
  • 29 is a schematic diagram of the connection between the flat screw hook and the interface screw according to the sixth embodiment of the present invention
  • FIG. 30 is the schematic diagram of the ring hook according to the sixth embodiment of the present invention.
  • the specific structure of the positioner 1 is different from that of the first embodiment.
  • the positioning device 1 includes: a lateral positioning rod 11 , a longitudinal positioning rod 12 , a guide wire 13 , a hook portion 131 and a driving portion 14 ; the hook portion 131 is detachably connected to the distal end of the guide wire 13 .
  • the structures and configuration principles of the lateral positioning rod 11 , the longitudinal positioning rod 12 and the driving part 14 are similar to those in the first embodiment, and will not be repeated here.
  • the guide wire 13 of the sixth embodiment is different from the first embodiment in that the distal end of the guide wire 13 does not have an integrated hook portion 131 , and the hook portion 131 is independently provided with respect to the guide wire 13 and is removable.
  • the corresponding adapted hooks 131 can be quickly disassembled and replaced, which facilitates intraoperative application.
  • the hook portion 131 includes two-leaf hooks 133 , and the two-leaf hooks 133 have two extending portions 1331 extending toward the proximal end, and the extending portions 1331 gradually extend toward the proximal end. Expand outwards; the extension 1331 is used to hook the suture 32 or the traction wire of the implant.
  • the two extending portions 1331 extend in a spiral shape, so as to reduce the scraping between the extending portions 1331 and the bone tunnel.
  • wire anchor 34 as an example of the implant, an example of hooking the wire anchor 34 with the two-leaf hook 133 is shown.
  • the wire anchor 34 is a commonly used orthopaedic implant, which can be sent into the transverse tunnel 42 through the delivery head 22 of the conveyor 2, and then the two-leaf hook 133 of the hook portion 131 can be hooked through the two extension portions 1331. Pull wire 341 with wire anchor 34.
  • a titanium plate 35 with a loop is used as an example of an implant, and an example of hooking the anchor 34 with wire by using the two-leaf hook 133 is shown.
  • the titanium plate 35 with a loop has a titanium plate body 351 and a plurality of traction wires 352 passing through the titanium plate body.
  • the titanium plate 35 with a loop can be sent into the transverse tunnel 42 through the conveying head 22 of the conveyor 2, for example, as shown in FIG. 11 .
  • the fork-shaped card which can hold the titanium plate body 351 with the looped titanium plate 35, so as to send the looped titanium plate 35 into the transverse tunnel 42, and make the belted titanium plate 35 reach the intersection of the transverse tunnel 42 and the longitudinal tunnel 41 place.
  • the two extending portions 1331 of the two-leaf hooks 133 can hook the pulling wire 352 of the titanium plate with loop 35 .
  • the two-leaf hook 133 can also directly hook the loop 31 formed by the suture 32 .
  • the two-leaf hook 133 further has a fitting portion 1332 extending toward the distal end, and the fitting portion 1332 is used for fitting and connecting with the implant.
  • the fitting portion 1332 has a blunt taper tapered toward the distal end.
  • the proximal end of the implant such as the wire anchor 34 or the interface screw often has a concave structure for the operation of the connecting component, such as a concave inner hexagon, etc., and the blunt tapered adapter portion 1332 is sufficient.
  • the recessed structure of the implant is inserted to form a mating connection with the implant.
  • the blunt taper here means that the tip portion of the taper has an obtuse angle to reduce accidental scratching of the bone tunnel.
  • the hook portion 131 includes a flat screw hook 134 , the flat screw hook 134 is spirally wound, and the winding direction is perpendicular to the axial direction of the hook portion 131 ;
  • the screw hook 134 is used to hook the suture 32 or the traction wire of the implant.
  • the coiling direction of the flat screw hook 134 is perpendicular to the axial direction of the hook portion 131, so it is in the shape of an enlarged end relative to the hook portion 131, which is convenient for hooking various types of sutures or implant traction wires.
  • the entire hook portion 131 is integrally formed to improve firmness.
  • the guide wire 13 is rotatable relative to the longitudinal channel 120 around its own axis.
  • the hook portion 131 can be driven to rotate relative to the longitudinal tunnel 41 .
  • the flat screw hook 134 can also be drilled into some flexible material implants, such as the absorbable interface screw 36, etc. by rotating.
  • the guide wire 13 can be rotated to cause rotation of the flat screw hook 134 connected to its distal end, so as to achieve drilling into implants such as the absorbable interface screw 36 .
  • the guide wire 13 can also be used to rotate to drive the two-leaf hook 133 to rotate, so as to improve the success rate of thread hooking.
  • the hook portion 131 includes a loop hook 135 , the loop hook 135 is coiled in a spiral shape, and the winding direction is parallel to the axial direction of the hook portion 131 ; the loop hook 135 is used to hook the suture 32 or the traction wire of the implant.
  • the winding direction of the ring hook 135 is parallel to the axial direction of the hook portion 131 , so its radial outer dimension may be slightly smaller than that of the flat screw hook 134 , which is favorable for operation in narrow tunnels.
  • the success rate of its hooking is high.
  • the entire hook portion 131 is integrally formed to improve firmness.
  • the hook portion 131 is connected with the guide wire 13 through threads.
  • the proximal end of the hook portion 131 has a threaded connection portion 1333, and the hook portion 131 can be easily and quickly assembled or disassembled with the corresponding part of the guide wire 13 through the threaded connection portion 1333. In practice, it can be quickly replaced as required. Different hooks 131 to accommodate different implants or sutures 32 .
  • the above examples of the hooks 131 are only examples of the hooks 131 rather than limitations on the structure of the hooks 131 .
  • the hooks 131 may also include other components, and those skilled in the art can make the hooks 131 according to the actual situation. Reasonable improvement.
  • the positioner 1 provided in this embodiment can be used in conjunction with the conveyor 2 provided in the above-mentioned several embodiments to form a tunnel-type wire passing system, and the description of this embodiment is not repeated here.

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Abstract

一种***（1）、输送器（2）、隧道式过线***及其操作方法。***（1）包括第一定位杆（11）、第二定位杆（12）、导丝（13）以及驱动部（14）；第一定位杆（11）具有沿自身轴向贯通的第一通道（110）；第二定位杆（12）与第一定位杆（11）连接，且第二定位杆（12）的远端超出第一定位杆（11）的远端；第二定位杆（12）具有沿自身轴向贯通的第二通道（120），第二通道（120）的远端延伸方向与第一通道（110）的远端延伸方向相交；导丝（13）沿第二定位杆（12）的轴向可活动地穿设于第二通道（120），导丝（13）的远端具有连接部（131）；驱动部（14）与导丝（13）连接，用于驱动导丝（13）沿第二定位杆（12）的轴向移动。

Description

***、输送器、隧道式过线***及其操作方法 技术领域
本发明涉及医疗器械技术领域，特别涉及一种***、输送器、隧道式过线***及其操作方法。
背景技术
对于肩袖、膝、足踝等部位的软组织撕裂的修复，除了需要缝合软组织本身，一般还需要通过缝线将软组织压向骨骼(将软组织绑在骨骼上)，才能促使其愈合。目前通常采用带线锚钉进行修复手术，将金属锚钉锚定在骨骼中，再通过锚钉上连接的缝线来捆绑软组织，从而将软组织压向骨骼。然而由于锚钉的体积相比缝线较为粗大，对于骨骼尺寸较小或骨质疏松的患者不友好。如果锚钉选择不当或在术中固定位置偏差，就会存在锚钉脱落和牵拉力不足等风险，容易对患者患处造成二次损伤，且该方案手术成本高、难度大，术后如不慎破坏，翻修难度极高。
更为安全的手术方案是放弃锚钉，在骨骼内形成隧道，将缝线穿过骨隧道完成软组织的缝合绑定。然而目前没有合适的手术工具，只能选择开放式手术或通过硬膜穿刺针在关节镜引导下完成缝线过线，手术操作极为困难。
发明内容
本发明的目的在于提供一种***、输送器、隧道式过线***及其操作方法，以解决现有通过锚钉固定缝线所存在的问题。
为解决上述技术问题，本发明提供一种***，其包括：第一定位杆、第二定位杆、导丝以及驱动部；
所述第一定位杆具有沿自身轴向贯通的第一通道；
所述第二定位杆与所述第一定位杆连接，且所述第二定位杆的远端超出所述第一定位杆的远端；所述第二定位杆具有沿自身轴向贯通的第二通道，所述第二通道的远端延伸方向与所述第一通道的远端延伸方向相交；
所述导丝沿所述第二定位杆的轴向可活动地穿设于所述第二通道，所述 导丝的远端具有连接部；
所述驱动部与所述导丝连接，用于驱动所述导丝沿所述第二定位杆的轴向移动。
可选的，所述第二通道的远端延伸方向与所述第一通道的远端延伸方向所成夹角的范围为10°～180°。
可选的，所述连接部包括机械对接件或粘合件。
可选的，所述机械对接件为勾部。
可选的，所述第一定位杆沿自身轴向可活动地与所述第二定位杆连接。
可选的，所述***还包括定位杆套，所述定位杆套具有沿自身轴向贯通的杆套通道，所述杆套通道的内轮廓形状与所述第一定位杆的外轮廓形状相适配，所述第一定位杆沿所述定位杆套的轴向可活动地穿设于所述杆套通道；所述第二定位杆与所述定位杆套固定连接。
可选的，所述第二定位杆包括弯曲段以及与所述弯曲段的近端连接的平直段；所述平直段平行于所述第一定位杆的轴向。
可选的，所述第一定位杆的远端具有抵合面，所述抵合面用于与预定对象的形状相适配，并用于抵靠于所述预定对象的表面。
可选的，所述第一定位杆的远端还具有啮合部，所述啮合部用于***所述预定对象的表面，以与所述预定对象相啮合。
可选的，所述***还包括手柄，所述手柄包裹于所述第一定位杆的近端，呈直线形延伸。
可选的，所述导丝呈柔性，所述连接部边缘圆滑。
为解决上述技术问题，本发明还提供一种输送器，其包括：输送杆以及输送头；
所述输送头设置于所述输送杆的远端，用于容置缝线所绕成的线圈或植入物；
所述输送杆用于可活动地穿设于如上所述的***的第一通道，所述输送头用于自所述第一定位杆的远端伸出，以供所述***的连接部与容置于所述输送头上的线圈或植入物连接。
可选的，所述输送杆具有沿自身轴向贯通的缝线腔，所述缝线腔用于容置缝线的一部分。
可选的，所述输送器包括缝线容置部，所述缝线容置部与所述输送杆的近端连接，用于容置所述缝线的近端部分。
可选的，所述输送器还包括限位部，所述限位部与所述输送杆固定连接；所述限位部用于与所述***相对应的部位相抵靠，以限制所述输送杆相对于所述第一通道朝向远端的位移；其中，当所述限位部与所述***相对应的部位相抵靠时，所述输送头位于所述第二通道的远端延伸方向与所述第一通道的远端延伸方向的相交处。
可选的，所述输送头包括用于容置所述线圈的第一槽，以及用于供所述连接部通过的第二槽。
可选的，所述输送头包括叉形卡，所述叉形卡的远端包括定位卡与至少两个分支，至少两个所述分支通过定位卡连接形成闭合的卡槽孔，所述卡槽孔用于套取缝线的线圈或用于容置植入物。
可选的，所述输送头包括两个所述叉形卡，两个所述叉形卡相对布置。
为解决上述技术问题，本发明还提供一种隧道式过线***，其包括：如上所述的***以及如上所述的输送器；所述输送器的输送杆用于穿入所述***的第一通道，所述***的连接部用于与容置于所述输送头上的线圈或植入物连接。
为解决上述技术问题，本发明还提供一种隧道式过线***的操作方法，其利用如上所述的隧道式过线***；所述隧道式过线***的操作方法包括：
在一预定对象上开设第二隧道；
将所述***的第二定位杆的远端***所述第二隧道，使所述第二通道的远端延伸方向与所述第二隧道的轴向重合；
沿所述***之第一通道的延伸方向在所述预定对象上开设第一隧道，使所述第一隧道与所述第二隧道相交；
将所述输送器的输送杆穿入所述第一通道，并使所述输送杆的远端伸入所述第一隧道内，使所述输送器的输送头位于所述第二隧道与所述第一隧道 的相交处；
利用驱动部驱动所述连接部向近端移动，与容置于所述输送头上的线圈或植入物连接；
向近端拉动撤去所述输送器，使所述线圈或所述植入物留置于所述第二隧道中；
向近端拉动所述***，将所述线圈或所述植入物的一部分拉出所述第二隧道。
可选的，在将所述线圈拉出所述第二隧道后，所述隧道式过线***的操作方法还包括：
利用驱动部驱动所述连接部向远端移动；
将所述线圈或所述植入物从所述连接部中脱出，使所述线圈或所述植入物与所述***分离。
综上所述，在本发明提供的***、输送器、隧道式过线***及其操作方法中，所述***包括第一定位杆、第二定位杆、导丝以及驱动部；所述第一定位杆具有沿自身轴向贯通的第一通道；所述第二定位杆与所述第一定位杆连接，且所述第二定位杆的远端超出所述第一定位杆的远端；所述第二定位杆具有沿自身轴向贯通的第二通道，所述第二通道的远端延伸方向与所述第一通道的远端延伸方向相交；所述导丝沿所述第二定位杆的轴向可活动地穿设于所述第二通道，所述导丝的远端具有连接部；所述驱动部与所述导丝连接，用于驱动所述导丝沿所述第二定位杆的轴向移动。
如此配置，在预定对象上预先开设好第二隧道后，可将第二定位杆的远端***第二隧道，进而沿第一通道的方向在预定对象上开设第一隧道；由于***的第二通道的远端延伸方向与所述第一通道的远端延伸方向相交，因此第一隧道必然与第二隧道相交，实现了经皮定位无法实现的精度，避免了由于第一隧道与第二隧道不交叉，而无法勾线的问题。进一步的，可利用导丝远端的连接部与沿第一隧道伸入的缝线连接，并将缝线自第二隧道中引出，即实现了在预定对象的隧道中穿过缝线，缝线的固定可靠，避免了锚钉脱落等产生的风险；***的使用简单、成本低、安全性高。此外，由于第一隧 道晚于第二隧道的开设，可利用第一隧道的开设工具将第二隧道开设时的碎屑排出，可保证隧道内畅通，防止碎屑阻碍勾取缝线。
附图说明
本领域的普通技术人员将会理解，提供的附图用于更好地理解本发明，而不对本发明的范围构成任何限定。其中：
图1是本发明实施例一的隧道式过线***的示意图；
图2是本发明实施例一的隧道式过线***的轴向剖面示意图；
图3是本发明实施例一的隧道式过线***的局部示意图；
图4是本发明实施例一的***的轴向剖面图；
图5是本发明实施例一的定位杆套的示意图；
图6是本发明实施例一的勾部的示意图；
图7是本发明实施例一的输送器的示意图；
图8是图7所示的输送器的远端的局部放大图；
图9是本发明实施例一的隧道式过线***的使用场景的示意图；
图10是本发明实施例一的锁定部的示意图；
图11是本发明实施例一的另一优选示例的输送头的示意图；
图12是本发明实施例二的纵向定位杆的示意图；
图13是本发明实施例二的第一旋钮的示意图；
图14是本发明实施例二的第二旋钮和齿条的示意图；
图15是本发明实施例三的输送器的分解示意图；
图16是本发明实施例三的外线毂组的示意图；
图17是本发明实施例三的指示部的示意图；
图18是本发明实施例三的扭簧的示意图；
图19是本发明实施例四的输送器的示意图；
图20是图19所示的输送器的局部放大图；
图21是本发明实施例五的输送器的局部示意图；
图22是本发明实施例五的缝线容置部的整体示意图；
图23是本发明实施例五的缝线容置部的内部结构的示意图；
图24是本发明实施例六的两叶勾的示意图；
图25是本发明实施例六的两叶勾与带线锚钉连接的示意图；
图26是本发明实施例六的两叶勾与带袢钛板连接的示意图；
图27是本发明实施例六的两叶勾勾取缝线的示意图；
图28是本发明实施例六的平螺勾的示意图；
图29是本发明实施例六的平螺勾与界面螺钉连接的示意图；
图30是本发明实施例六的圈勾的示意图。
附图中：
1-***；11-横向定位杆；110-横向通道；111-抵合面；112-啮合部；12-纵向定位杆；120-纵向通道；121-弯曲段；122-平直段；13-导丝；131-勾部；132-连接杆；133-两叶勾；1331-延伸部；1332-适配部；134-平螺勾；135-圈勾；14-驱动部；141-推钮；142-第一旋钮；15-定位杆套；150-杆套通道；151-纵向定位杆容置道；152-定位凹陷；153-纵向通道延伸通道；16-手柄；161-定位凸起；162-转轴容置环；17-锁定部；171-转轮；1710-转轮本体；1711-转轴段；1712-限位台；172-推进件；181-第二旋钮；182-齿条；
2-输送器；21-输送杆；210-缝线腔；22-输送头；221-第一槽；222-第二槽；223-导引坡面；23-缝线容置部；231-线毂；2311-拨杆；2312-外毂；2313-内毂；2314-棘齿；2315-外线毂组；2316-内线毂组；2317-挡板；232-壳体；2320-窗口；233-缝线隔断；234-第一过线孔；235-第二过线孔；236-观察区；237-线毂轴；238-缝线预置孔；2370-周向缺口；2371-限转部；24-限位部；250-卡槽孔；251-定位卡；252-分支；26-指示部；261-扭簧；262-指示标志；27-套管；270-推杆通道；271-槽口；28-推杆；281-膨大段；29-回拉驱动部；
31-线圈；32-缝线；33-缝线连接段；34-带线锚钉；341-牵引线；35-带袢钛板；351-钛板本体；352-牵引线；36-界面螺钉；
4-预定对象；41-纵向隧道；42-横向隧道。
具体实施方式
为使本发明的目的、优点和特征更加清楚，以下结合附图和具体实施例对本发明作进一步详细说明。需说明的是，附图均采用非常简化的形式且未按比例绘制，仅用以方便、明晰地辅助说明本发明实施例的目的。此外，附图所展示的结构往往是实际结构的一部分。特别的，各附图需要展示的侧重点不同，有时会采用不同的比例。
如在本发明中所使用的，单数形式“一”、“一个”以及“该”包括复数对象，术语“或”通常是以包括“和/或”的含义而进行使用的，术语“若干”通常是以包括“至少一个”的含义而进行使用的，术语“至少两个”通常是以包括“两个或两个以上”的含义而进行使用的，此外，术语“第一”、“第二”、“第三”仅用于描述目的，而不能理解为指示或暗示相对重要性或者隐含指明所指示的技术特征的数量。由此，限定有“第一”、“第二”、“第三”的特征可以明示或者隐含地包括一个或者至少两个该特征，术语“近端”通常是靠近操作者的一端，术语“远端”通常是靠近患者即靠近病灶的一端，“一端”与“另一端”以及“近端”与“远端”通常是指相对应的两部分，其不仅包括端点，术语“安装”、“相连”、“连接”应做广义理解，例如，可以是固定连接，也可以是可拆卸连接，或成一体；可以是机械连接，也可以是电连接；可以是直接相连，也可以通过中间媒介间接相连，可以是两个元件内部的连通或两个元件的相互作用关系。此外，如在本发明中所使用的，一元件设置于另一元件，通常仅表示两元件之间存在连接、耦合、配合或传动关系，且两元件之间可以是直接的或通过中间元件间接的连接、耦合、配合或传动，而不能理解为指示或暗示两元件之间的空间位置关系，即一元件可以在另一元件的内部、外部、上方、下方或一侧等任意方位，除非内容另外明确指出外。对于本领域的普通技术人员而言，可以根据具体情况理解上述术语在本发明中的具体含义。
本发明的目的在于提供一种***、输送器、隧道式过线***及其操作方法，以解决现有通过锚钉固定缝线所存在的问题。
本实施例提供的隧道式过线***主要用于在骨上开设骨隧道，并将缝线 或植入物(如界面螺钉和带袢钛板等)穿过骨隧道。当然所述隧道式过线***的应用场景也不限于为骨隧道过线，也可以是在其它的对象上进行隧道式过线。
以下结合附图，以于骨上开设骨隧道作为示例进行描述。为便于叙述，下面以横向定位杆作为第一定位杆的示例，纵向定位杆作为第二定位杆的示例，横向隧道作为第一隧道的示例，纵向隧道作为第二隧道的示例进行说明。本领域技术人员也可以根据上述思想，将横向与纵向对换，本发明对此不限。
【实施例一】
请参考图1至图11，其中，图1是本发明实施例一的隧道式过线***的示意图；图2是本发明实施例一的隧道式过线***的轴向剖面示意图；图3是本发明实施例一的隧道式过线***的局部示意图；图4是本发明实施例一的***的轴向剖面图；图5是本发明实施例一的定位杆套的示意图；图6是本发明实施例一的勾部的示意图；图7是本发明实施例一的输送器的示意图；图8是图7所示的输送器的远端的局部放大图；图9是本发明实施例一的隧道式过线***的使用场景的示意图；图10是本发明实施例一的锁定部的示意图；图11是本发明实施例一的另一优选示例的输送头的示意图。
如图1至图3所示，本发明实施例一提供一种隧道式过线***，其包括***1以及输送器2。输送器2相对***1为可拆卸的。
请参考图4，并结合图2和图3，所述***1包括：横向定位杆11、纵向定位杆12以及连接件；所述横向定位杆11具有沿自身轴向贯通的横向通道110；所述纵向定位杆12与所述横向定位杆11连接，且所述纵向定位杆12的远端超出所述横向定位杆11的远端；所述纵向定位杆12具有沿自身轴向贯通的纵向通道120，所述纵向通道120的远端延伸方向与所述横向通道110的远端延伸方向相交；所述连接件沿所述纵向定位杆12的轴向可活动地穿设于所述纵向通道120，所述连接件用于连接缝线或植入物。进一步的，所述***1还包括驱动部14，所述驱动部14与所述连接件的近端连接，用于驱动所述连接件沿所述纵向定位杆120的轴向移动。在一个示范例中，所述 连接件为导丝13，所述导丝的远端具有连接部，所述连接部用于与缝线或植入物连接。可选的，所述连接部包括机械对接件或粘合件，所述机械对接件用于通过机械的方式勾取缝线或植入物，而所述粘合件则用于通过粘合的方式与缝线或植入物连接。优选的，所述机械对接件为勾部131，其可以勾取缝线或植入物。
需要说明的，横向定位杆11与纵向定位杆12的轴向并非限定为一直线的方向，若横向定位杆11或纵向定位杆12本身呈曲线形，应理解其各自的轴线亦为曲线，其轴向亦即呈曲线形的方向。因此，横向通道110与纵向通道120亦不限定为直线形。进一步的，横向通道110与纵向通道120的远端延伸方向是指，横向通道110与纵向通道120在远端处的轴线的延伸方向，若横向通道110与纵向通道120在远端处为直线形延伸，则其远端延伸方向为其轴线的直线延伸；若横向通道110与纵向通道120在远端处为曲线形延伸，则其远端延伸方向为其轴线之远端的切向延伸，即为其轴线远端端点处的切线方向。此处“所述纵向通道120的远端延伸方向与所述横向通道110的远端延伸方向相交”是指，所述纵向通道120的远端延伸方向与所述横向通道110的远端延伸方向上有共同的点，包括几何意义上的相交，也包括在同一条直线上的情况，但不包括平行或异面的情况。
请参考图7和图8，所述输送器2包括：输送杆21以及输送头22；所述输送头22设置于所述输送杆21的远端，用于容置缝线32所绕成的线圈31或植入物；所述输送杆21用于可活动地穿设于所述***1的横向通道110，所述输送头22用于自所述横向定位杆11的远端伸出，以供所述***1的勾部131勾取容置于所述输送头22上的线圈31或植入物。在一个示范例中，所述输送杆21具有沿自身轴向设置的缝线腔210，所述缝线腔210用于容置缝线32的一部分；优选的，输送头22具有第一槽221和第二槽222，第一槽221用于容置和卡住线圈31，第二槽222用于供连接部(如勾部131等)通过。本发明对输送头22的形状不作限制，优选的，输送头22的远端呈圆润钝化的形状，以防刮伤骨隧道。线圈31是由缝线32的远端弯曲形成的，其能够绕设在输送头22上。缝线腔210沿输送杆21的轴向设置，在一些实施 例中，缝线腔210可以是贯通于输送杆21中的管状腔。当然在另外的一些实施例中，缝线腔210也可以是开设于输送杆21上的沿径向开放的槽。本发明对缝线腔210的具体设置形式不作限制。
所述输送器2的输送杆21用于穿入所述***1的横向通道110，所述***1的连接部用于与容置于所述输送器2之输送头22上的线圈31连接。请参考图9，如此配置，在预定对象4(如肱骨)上预先开设好纵向隧道41后，可将纵向定位杆12的远端***纵向隧道41，进而沿横向通道110的方向在预定对象4上开设横向隧道42；由于***1的纵向通道120的远端延伸方向与所述横向通道110的远端延伸方向相交，因此横向隧道42必然与纵向隧道41相交，实现了经皮定位无法实现的精度，避免了由于横向隧道42与纵向隧道41不交叉，而无法勾线的问题。进一步的，可利用连接部与沿横向隧道42伸入的线圈31连接，并将缝线32自纵向隧道41中引出，即实现了在预定对象4的隧道中穿过缝线32，缝线32的固定可靠，避免了锚钉脱落等产生的风险；***1的使用简单、成本低、安全性高。此外，由于横向隧道42晚于纵向隧道41的开设，可利用横向隧道42的开设工具将纵向隧道41开设时的碎屑排出，可保证隧道内畅通，防止碎屑阻碍勾取缝线32。
请参考图6，可选的，所述导丝13呈柔性，所述连接部边缘圆滑。下面以勾部131作为连接部的示例进行说明，由于勾部131可直接用于勾取缝线32的线圈31，而缝线32一般较为柔软，因此勾部131的边缘需配置为圆滑的形态，避免割断缝线32。导丝13呈柔性，其可以随纵向通道120的弯曲而弯曲，有利于减小***1之远端的整体径向尺寸，有利于提高通过性，减小创口。此外，柔性的导丝13可以方便地进行牵引，导丝13的拉压应力如可大于450MPa，导丝13如可采用如可采用30Cr13、40Cr13、12Cr18Ni9、12Cr18Ni10或12Cr17Ni7等医用金属制成。进一步的，由于勾部131需要在纵向隧道41中顺畅运动，因此勾部131的硬度优选不小于45HRC，如可采用0.1～2mm(优选0.5～0.6mm)的不锈钢丝弯制成型，并进行热处理硬化制成。当然硬度不小于45HRC的勾部131也可以用于勾取硬质引导丝或植入物，如镍钛合金丝或带袢钛板等。较佳的，勾部131的材料可与导丝13的材料保持 一致，但导丝13部分的不进行热处理，保持其原有韧性。需要说明的，图6中示出的为勾部131的侧视图，实际中，该勾部131还具有沿垂直于纸面方向的空间高度，亦即勾部131大致呈现如类似弹簧的形态，线圈31能够轻易地被套入勾部131的中间。需理解，上述对于导丝13和勾部131的说明仅为一较佳的示范例而非对导丝13和勾部131的限定，本领域技术人员可根据现有技术采用其它配置的导丝13和勾部131，本发明对此不限。
进一步的，所述横向定位杆11沿自身轴向可活动地与所述纵向定位杆12连接，以使纵向定位杆12在***纵向隧道41后，横向定位杆11可以通过自身的轴向移动与预定对象4抵靠。请参考图5，并结合图3和图4，在一个示范性的实施例中，所述***1还包括定位杆套15，所述定位杆套15具有沿自身轴向贯通的杆套通道150，所述杆套通道150的内轮廓形状与所述横向定位杆11的外轮廓形状相适配，所述横向定位杆11沿所述定位杆套15的轴向可活动地穿设于所述杆套通道150；所述纵向定位杆12与所述定位杆套15固定连接。定位杆套15的设置限制了横向定位杆11的径向自由度，可避免横向定位杆11不受控地偏摆。
可选的，所述纵向定位杆12包括弯曲段121以及与所述弯曲段121的近端连接的平直段122；所述平直段122平行于所述横向定位杆11的轴向。为了便于使用，整个***1应沿直线形延伸，以避免与患者身体的其它部位产生干涉。由此，纵向定位杆12的平直段122被配置为与横向定位杆11的轴向平行。较佳的，所述定位杆套15还具有沿自身轴向设置的纵向定位杆容置道151，所述纵向定位杆容置道151的内轮廓形状与所述纵向定位杆12的外轮廓形状相适配，所述纵向定位杆容置道151用于容置所述纵向定位杆12的近端。平直段122可***纵向定位杆容置道151，并在调整并确认纵向通道120的远端延伸方向与横向通道110的远端延伸方向相交后，将平直段122与纵向定位杆容置道151进行固定(如焊接或压紧)。当然该步骤可以在***1的生产时进行，也可以于***1即将使用时进行，本发明对此不作限制。需要说明的，弯曲段121的形态可根据不同的预定对象4而进行适配性地改变，较佳的，弯曲段121的远端具有一小段直线段，以便于***预定对象4 的纵向隧道41，也有利于减小纵向隧道41的开设直径。
可选的，为便于使用，***1的杆身部分需具有一定的长度，而为了便于装配，纵向定位杆12的平直段122不应设置得太长，基于此，定位杆套15还设有一段纵向通道延伸通道153，纵向通道延伸通道153与纵向定位杆容置道151同轴设置，位于纵向定位杆容置道151的近端。平直段122在***纵向定位杆容置道151后，其内部的纵向通道120的近端延伸方向与纵向通道延伸通道153的轴向相重合，导丝13能够自纵向通道延伸通道153中向近端延伸。
优选的，所述纵向通道120的远端延伸方向与所述横向通道110的远端延伸方向所成夹角的范围为10°～180°。该夹角范围适合于较多的应用场景。
请参考图1和图2，较佳的，所述***1还包括手柄16，所述手柄16包裹于所述横向定位杆11的近端，呈直线形延伸。手柄16可与定位杆套15固定连接。在一个示范例中，手柄16包括可相互拆卸的两个部分，两个部分通过相互定位的卡扣连接。优选的，手柄16具有定位凸起161，相适配的，定位杆套15上具有定位凹陷152，定位凸起161***定位凹陷152后，手柄16可实现与定位杆套15的固定连接。进一步的，手柄16的远端与定位杆套15的外周轮廓相吻合，如此配置，可使定位杆套15能稳定地固定在手柄16中。当然在其它的一些实施例中，手柄16可以与定位杆套15合成一体，或将定位杆套15的外轮廓配置为手柄16，本发明对此不限。
请继续参考图1和图2，在一个可替代的实施例中，驱动部14如可包括一推钮141，手柄16具有供推钮141滑动的推钮槽，该推钮141与该推钮槽相适配，推钮槽沿横向定位杆11的轴向延伸，推钮141在装配入推钮槽后，能被推钮槽所限制只能沿定位杆11的轴向移动，避免产生径向的晃动。推钮141可与导丝13的近端固定连接，操作者推动推钮141，即可驱动导丝13沿纵向通道120的轴向进退运动。
在一个可选的实施例中，所述***1还包括锁定部17，所述锁定部17用于驱动所述横向定位杆11朝向远端移动，以使所述横向定位杆11与所述纵向定位杆12共同夹固于预定对象4上。请参考图9，可以理解的，当纵向 定位杆12***预定对象4的纵向隧道41后，相对纵向定位杆12将横向定位杆11朝向远端移动，当横向定位杆11的远端与预定对象4抵靠后，横向定位杆11能够与纵向定位杆12一同，夹住预定对象4。由此，操作者双手可脱离***1，不需要一直手持。
请参考图10，在一个示范性的实施例中，所述锁定部17包括：转轮171和推进件172，所述转轮171具有内螺纹，所述推进件172具有与所述内螺纹相适配的外螺纹，所述转轮171的所述内螺纹和所述推进件172的所述外螺纹连接；所述推进件172与所述横向定位杆11固定连接，所述转轮171可转动地与所述定位杆套15连接，且被限制相对于所述定位杆套15的轴向位移。由于纵向定位杆12与定位杆套15装配后，两者的位置即被固定，因此当转轮171转动时，即可驱动横向定位杆11沿其自身的轴向进退移动。
如此配置，在沿横向通道的方向在预定对象上开设横向隧道42之前，可利用锁定部17将***1固定于预定对象4上，使操作者双手可脱离***1，不需要操作者一直手持，一方面，横向定位杆11能够稳定地与预定对象4相抵靠，使得横向通道110的延伸方向能准确地与纵向隧道41相交，有利于进一步利用骨钻等工具沿横向通道110开设横向隧道42，可以实现精准的定位；另一方面也便于操作者双手脱离***1后，操作骨钻等工具开设横向隧道42。
可选的，所述转轮171可转动地设置于所述手柄16的近端，且被限制相对于所述手柄16的轴向位移。由于手柄16与定位杆套15在装配后两者的相对位置关系是固定的，因此手柄16即可限制转轮171相对于纵向定位杆12的轴向位置。在图10示出的示范例中，转轮171包括转轮本体1710、转轴段1711和限位台1712，转轴段1711沿轴向设置于转轮本体1710的远端，限位台1712设置于转轴段1711的远端，其中转轴段1711的外径小于限位台1712的径向外尺寸，也小于转轮本体1710的径向外尺寸；相适配地，手柄16的近端具有转轴容置环162，转轴容置环162的内径适配于转轴段1711的外径，转轴段1711可转动地穿设于转轴容置环162中，而转轴容置环162的两端面分别与转轮本体1710和限位台1712相抵靠，如此配置，手柄16即可限制转 轮171的轴向位置，而不限制其周向的转动。当然上述示范例仅为转轮171的一个优选示例而非对转轮171的限定，本领域技术人员可根据上述思想进行变通。
可选的，转轮171与推进件172的螺纹导程具有自锁特性，即螺纹导程与推进件172的直径的比值在一定的预设范围内。如此配置，可实现旋动转轮171可以推动横向定位杆11进退，而横向定位杆11的进退无法带动转轮171产生转动，即形成了自锁。实际中，可根据操作者对扭转型器械的使用习惯来设定螺纹导程。在一个示范例中，转轮171可被配置为转动1.5圈而不超过2圈时，完成横向定位杆11的推出，使横向定位杆11与预定对象4相抵靠。优选的，推进件172固定于横向定位杆11的近端，且推进件172具有沿自身轴向贯通的通道，该通道与横向通道110保持贯通，以便于输送杆21或钻头等部件通过。
可选的，所述横向定位杆11的远端具有抵合面111，所述抵合面111用于与预定对象4的形状相适配，并用于抵靠于所述预定对象4的表面。进一步的，所述横向定位杆11的远端还具有啮合部112，所述啮合部112用于***所述预定对象4的表面，以与所述预定对象4相啮合。啮合部112如可为设置于抵合面111边缘的突出尖角。使用中，当抵合面111贴附于预定对象4的表面后，可微微旋动转轮171，以便啮合部112微量地咬入骨内，如此配置可增加***1与预定对象4连接的稳定性，保证后续横向隧道42的开设过程不受到外部动力的震动影响，从而实现精准定位。
请参考图7和图8，优选的，所述输送器2还包括缝线容置部23，所述缝线容置部23与所述输送杆21的近端连接，用于容置所述缝线32的近端部分，如用于供所述缝线32盘绕。在图7和图8示出的示范例中，缝线容置部23包括线毂231和壳体232，壳体232与输送杆21的近端固定连接，壳体232的内部腔体与缝线腔210连通，线毂231可转动地设置于壳体232中。缝线32自缝线腔210延伸入壳体232的内部腔体，并盘绕于线毂231上。在一些实施例中，缝线32在被向远端拉出时，线毂231可以围绕自身的轴线转动，随之盘绕于其上的缝线32即向远端伸出。在另一些实施例中，线毂231可以 围绕自身的轴线转动一个角度，进而即被壳体232所限制而无法继续转动，随之盘绕于其上的缝线32在继续被向远端拉出时，产生相对于线毂231的滑动。
请参考图11，在一个可替代的实施例中，所述输送头22包括叉形卡，所述叉形卡的远端包括定位卡251与至少两个分支252，至少两个所述分支252通过定位卡251连接形成闭合的卡槽孔250，所述卡槽孔250用于套取缝线32的线圈31或用于容置植入物。进一步的，所述输送头22包括两个所述叉形卡，两个所述叉形卡相对布置。两个叉形卡的卡槽孔250能够与一些植入物(如带袢钛板)形成板面定位，从而实现对植入物的把持，使用中可以将植入物通过横向通道110送入横向隧道42中。进一步的，两个叉形卡之间的空隙则可供勾部131通过，以便于实现对植入物或缝线32的勾取。
可选的，手柄16、转轮171、驱动部14等部件的材料为医用塑料材质，优选聚氯乙烯PVC、丙烯腈-丁二烯-丙乙烯ABS、聚乙烯PE、聚丙烯PP或聚碳酸酯PC等。横向定位杆11、纵向定位杆12、定位杆套15等部件的材料为医用金属，可相互独立地选自12Cr13、20Cr13、05Cr17NiCu4Nb、32Cr13Mo、40Cr13、Y10Cr17以及06Cr19Ni10等。当然上述材料仅为示例而非对各部件材料的限定，本领域技术人员可根据现有技术选择其它合适的材料。
优选的，所述输送器2还包括限位部24，所述限位部24与所述输送杆21固定连接；所述限位部24用于与所述***1相对应的部位相抵靠，以限制所述输送杆21相对于所述横向通道110朝向远端的位移；其中，当所述限位部24与所述***1相对应的部位相抵靠时，所述输送头22位于所述纵向通道120的远端延伸方向与所述横向通道110的远端延伸方向的相交处。在图7示出的示范例中，可将壳体232与输送杆21的连接处配置为限位部24，而相适配的，可将***1之手柄16的近端或转轮171作为与壳体232相抵靠的对应部位。如图1和图2所示，当输送器2的输送杆21***横向通道110并朝向远端移动，至限位部24与转轮171相抵靠时，即无法再继续向远端推动输送器2。当然在其它的一些实施例中，限位部24以及***1的对应部位可配套地独立设置，例如设置相对应的挡台、挡圈等，本领域技术人员可 根据实际进行配置，本发明对此不作限制。
可选的，本实施例提供的输送器2为一次性使用耗材，其内部预置一根缝线32。根据肌腱修复手术需要的缝线类型，可预置圆形、扁形或圆扁形(即两头圆中间扁)的缝线32。缝线32的材质可以是：天然纤维、合成纤维或金属丝等。天然纤维如蚕丝等；合成纤维如超高分子量聚乙烯、聚酰胺6/6、聚丙烯、聚对苯二甲酸乙二酯、聚酰胺6等。可预置3-0～5号圆形缝线和0.1mm～5mm扁线。而***1则可重复多次使用，操作者在完成一根缝线32的隧道式过线预置后，可将输送器2废弃，继续选用新的输送器2进行其它缝线的预置。
下面基于上述隧道式过线***，以肱骨作为预定对象4，对该隧道式过线***的操作方法进行说明。所述隧道式过线***的操作方法包括：
步骤S1：在肱骨上开设纵向隧道41；由于纵向隧道41位置的肌群较少，操作者可通过试触法快速精准的确定纵向隧道41的入路，用开路器或骨钻制备纵向隧道41。
步骤S2：将所述***1的纵向定位杆12的远端***所述纵向隧道41，使所述纵向通道120的远端延伸方向与所述纵向隧道41的轴向重合；进一步可选的，在步骤S2之后，还可包括步骤S21：利用锁定部17驱动所述横向定位杆11朝向远端移动，使所述横向定位杆11与所述纵向定位杆12共同夹固于肱骨上，从而将***1与肱骨进行锁定。如可通过转动转轮171，使横向定位杆11的远端抵至肱骨大结节上，进而微微转动转轮171，使啮合部112微量咬入肱骨，使纵向定位杆12、横向定位杆11与肱骨三者相互抵紧锁定。
步骤S3：沿所述***1之横向通道110的延伸方向在所述肱骨上开设横向隧道42，使所述横向隧道42与所述纵向隧道41相交；在一个示范例中，该步骤可由骨钻来执行。具体的，将骨钻从横向通道110的远端穿出，沿着横向通道110的延伸方向制备横向隧道42，由于骨钻有螺旋形槽，旋转的同时可将骨屑(包括打纵向隧道41时产生的骨屑)排出，从而可保证骨隧道内通畅。骨钻的钻入深度应满足使横向隧道42与纵向隧道41相交。优选的，实际中可通过在骨钻上设置限位块的方式，来保证骨钻的钻入不会太深。横 向隧道42制备完成后，取出骨钻。
步骤S4：将所述输送器2的输送杆21穿入所述横向通道110，并使所述输送杆21的远端伸入所述横向隧道42内，使所述输送器2位于所述纵向隧道41与所述横向隧道42的相交处；在该步骤S4之前或之后，可选先向远端推送驱动部14的推钮141，以伸出连接部。在输送器2的输送杆21向远端移动到位(如限位部24与***1相抵靠)后，输送头22上的线圈31应能与连接部实现连接，如被套入勾部131。
步骤S5：利用驱动部14驱动所述连接部向近端移动，与容置于所述输送头22上的线圈31或植入物连接；可选的，在该步骤后，可选向近端轻轻回拽输送器2，如有拉伸感，不能轻易拉回，说明连线成功。
步骤S6：向近端拉动撤去所述输送器2，使线圈31或所述植入物留置于所述纵向隧道41中；该步骤中，可稍微用力拉出输送器2直至内部的缝线32或植入物完全与输送器2脱离。
步骤S7：向近端拉动所述***1，将所述线圈31或植入物的一部分(如植入物的牵引线等)拉出所述纵向隧道41；可选的，在该步骤S7前，可先逆向转动转轮171，解除***1与肱骨的锁定。
步骤S8：向远端推送推钮141，伸出连接部，将所述线圈31或所述植入物从所述连接部中脱出，使所述线圈31或所述植入物与所述***1分离。如此即完成了一条缝线或植入物在骨隧道中的预置。
【实施例二】
本发明实施例二的***、输送器、隧道式过线***及其操作方法与实施例一基本相同，对于相同部分不再叙述，以下仅针对不同点进行描述。
请参考图12至图14，其中，图12是本发明实施例二的纵向定位杆的示意图；图13是本发明实施例二的第一旋钮的示意图；图14是本发明实施例二的第二旋钮和齿条的示意图。
在本实施例二中，***1的具体结构与实施例一不同。具体的，如图12所示，所述***1中，纵向定位杆12的至少一部分的材料为形态记忆材 料。形态记忆材料如可为记忆性金属，其可以根据温度的变化而转换自身的强度。可将纵向定位杆12根据需求实时预制成各种角度和各种形态，以个性化地贴附预定对象4的结构。在一些实施例中，纵向定位杆12的近端与定位杆套15的纵向定位杆容置道151固定连接，而在另一些实施例中，纵向定位杆12也可以相对定位杆套15可拆卸，使用中，在将纵向定位杆12装配入定位杆套15的纵向定位杆容置道151时，纵向定位杆容置道151可与纵向定位杆12过盈配合或通过其它的连接结构可靠地固定连接，在将纵向定位杆12***纵向定位杆容置道151后，两者可较为紧密地配合，以便于后续锁定部17对***1的锁定。
优选的，所述纵向定位杆12的弯曲段121的材料为形态记忆材料，而平直段122可以由形态记忆材料制成，较佳的也可由普通的非形态记忆材料制成。
可选的，所述纵向定位杆12用于在第一预设温度的环境中软化，进而用于弯折以与预定对象4的形状相适配，并用于在第二预设温度下硬化。第一预设温度和第二预设温度可根据使用环境进行选取，在一个示范例中，第一预设温度如可为60℃，第二预设温度如可为40℃，所述形态记忆材料在60℃以上时软化可变型，当其冷却到40℃以下时会固化定型，恢复其原本强度和硬度。在一个示范例中，操作者可先将纵向定位杆12的形态记忆材料构成的部分置于热水中软化，进而根据预定对象4的形态，特别是根据预制的纵向隧道41的形态对纵向定位杆12进行弯折，待纵向定位杆12自然冷却固化定型或浸入冷水中固化定型。当然冷水、热水仅为提供预设温度的一种示例，本领域技术人员也可以利用热风枪或恒温箱等方式来提供满足需求的预设温度。
在实施例二中，驱动部14的结构与实施例一不同。具体的，请参考图13，所述驱动部14包括第一旋钮142，所述导丝13的近端通过连接杆132与所述第一旋钮142固定连接，所述导丝13用于在所述第一旋钮142的转动下沿自身的轴向进退移动。
请参考图14，优选的，所述***1还包括第二旋钮181和齿条182， 所述第二旋钮181的外周具有齿牙，所述齿条182与所述横向定位杆11固定连接，所述齿条182用于与所述齿牙相啮合；所述第二旋钮181的转动通过所述齿条182与所述齿牙的啮合转换为所述横向定位杆11沿自身轴向的移动。
在一个可替代的实施例中，第一旋钮142包括相对布置的两个子部分，该两个子部分沿第二旋钮181的轴向夹设在第二旋钮181的两侧，第一旋钮142和第二旋钮181可相互独立转动。可选的，可设计限位结构，保证二者相互独立运动，即限制第一旋钮跟随第二旋钮转动，并限制第二旋钮跟随第一旋钮转动。第二旋钮181沿一个方向转动时可驱动横向定位杆11向远端移动，为便于叙述，称驱动横向定位杆11向远端移动时第二旋钮181的转动方向为前进方向(图14中为顺时针方向)。沿前进方向转动第二旋钮181，驱动横向定位杆11向远端移动，此时第一旋钮142不动，导丝13不会向远端伸出。进而当锁定部17将横向定位杆11的移动锁定后，第二旋钮181即被连带着锁定而无法转动，此时沿前进方向(图14中为顺时针方向)转动第一旋钮142，即可通过连接杆132带动导丝13向远端伸出。
基于本实施例二提供的***1，在所述隧道式过线***的操作方法中，于步骤S2之前，所述操作方法还包括：
步骤S20：将所述纵向定位杆12的至少部分置于第一预设温度的环境中软化，而后弯折所述纵向定位杆12以与预定对象4的形状相适配；进而将所述纵向定位杆12的所述至少部分置于第二预设温度下硬化。
相适配地，在步骤S21中，可利用转动第二旋钮181的方式，使横向定位杆11向远端移动。此外，在步骤S4至步骤S8中，可以理解的，采用转动第一旋钮142的方式来实现对导丝13的进退进行驱动。
【实施例三】
本发明实施例三的***、输送器、隧道式过线***及其操作方法与实施例一基本相同，对于相同部分不再叙述，以下仅针对不同点进行描述。
请参考图15至图18，其中，图15是本发明实施例三的输送器的分解示 意图；图16是本发明实施例三的外线毂组的示意图；图17是本发明实施例三的指示部的示意图；图18是本发明实施例三的扭簧的示意图。
在本实施例三中，输送器2的具体结构与实施例一不同。具体的，如图15所示，所述输送器2包括：输送杆21、输送头22以及至少两个线毂231；每个所述线毂231用于供一根缝线32盘绕设置；所述输送杆21具有沿自身轴向设置的缝线腔210，所述缝线腔210用于容置盘绕于所述线毂231上的缝线32向远端延伸出的部分；所述输送头22设置于所述输送杆21的远端，用于容置所述缝线腔210中的缝线32向远端延伸出的部分所绕成的线圈31；所述输送杆21用于可活动地穿设于所述***1中，所述输送头22用于自所述***1的远端伸出，以供所述***1勾取容置于所述输送头22上的所述线圈31。
由于一台手术往往需要用到多根缝线，如此配置，输送器2可预置至少两根缝线32，在完成一根缝线32的隧道式过线预置后，可继续利用该输送器2进行下一根缝线32的隧道式过线预置，而不必更换输送器2，有利于提高手术的连续性，也降低了一台手术中使用输送器2的总成本。
基于所述输送器2，本实施例还提供一种过线器，其包括所述输送器2以及至少两根缝线32，所述输送器2的每个所述线毂231上盘绕设置有一根所述缝线32；相邻的所述线毂231上盘绕设置的所述缝线32依次首尾相连；其中一根所述缝线32的一部分还容置于所述输送器2的缝线腔210中，且该缝线32的远端绕成线圈31容置于所述输送器2的输送头22上。实际中，至少两根相同或不同的缝线32首尾相接，其中每根缝线32的头部形成一个线圈31。可理解的，该线圈31可于缝线32出厂前即预制成型，也可以是在术中由操作者绕成。该过线器集成了缝线32，用于将缝线32输送入预定对象4的横向隧道42。需要说明的，缝线32盘绕于线毂231上，并不限制缝线32的末端(即近端)与线毂231的连接关系。在一个较佳的实施例中，缝线32仅盘绕于线毂231上而并不与线毂231形成固定连接。如此配置，缝线32可相对线毂231产生相对滑动，缝线32可以在线毂231被固定时向远端抽出。
如图16所示，可选的，所述过线器还包括缝线连接段33，所述缝线连接 段33连接于相邻的所述缝线32之间；所述缝线连接段33的抗拉强度低于所述缝线32的抗拉强度。优选的，缝线连接段33为点断式连接段，其可以是与缝线32的材质相同，并于缝线连接段33处采用机械方式去除部分材料，使得缝线连接段33形成点断式连接段，方便操作者于手术中直接扯断。每根缝线32根据手术通常用量，如可设定为1米长。当然在其它的一些实施例中，缝线连接段33也可以采用与缝线32不同的材料，来实现其较低的抗拉强度。
请参考图16，在一个实施例中，至少两个所述线毂231沿一轴线方向并列布置。首尾相接的至少两根缝线32依次缠绕在不同的线毂231上，所有缝线32的缠绕顺序优选相同。为避免手术中不同的缝线32之间相互干扰、打结，将至少两个所述线毂231沿一轴线方向并列布置，可以对缝线32形成区分。
优选的，所述输送器2包括缝线隔断233，所述缝线隔断233设置于沿轴向相邻的两个所述线毂231之间，用于阻隔不同的所述线毂231上的缝线32。缝线隔断233如可为脊状凸起，其外径大于线毂231的外径，从而能够阻隔不同的线毂231上盘绕的缝线32。
进一步的，所述缝线隔断233具有第一过线孔234，所述第一过线孔234用于供缝线23穿过，以使沿轴向相邻的所述线毂231上的缝线32相互连接。第一过线孔234优选为斜向地穿设于缝线隔断233，以减小缝线32从线毂231上抽出的阻力。可以理解的，穿设于第一过线孔234中的，可以是缝线连接段33，也可以是缝线隔断233所阻隔的两根缝线32的其中任意一根，而将缝线连接段33配置于第一过线孔234的一侧。
请继续参考图15，在另一个实施例中，至少两个所述线毂231围绕一轴线内外嵌套布置。如上所述的沿轴向并列设置线毂231的方式，若缝线32数量较多，会导致多个线毂231并列过宽，因此沿轴向并列设置的方式可集成的缝线32的数量会受到限制。为此，可将至少两个所述线毂231配置为围绕一轴线内外嵌套布置。每一层的线毂231可盘绕设置至少一根缝线32。优选的，可结合使用上述两个方案，即同时将线毂231围绕轴线内外嵌套布置，以及沿所述轴线并列布置。在一个可替代的示范例中，两个线毂231沿一轴 线方向并列布置，形成外线毂组2315；另两个线毂231沿所述轴线方向并列布置，形成内线毂组2316；外线毂组2315围绕所述轴线套设于内线毂组2316的外侧，外线毂组2315与内线毂组2316之间相互可独立地转动。可选的，内线毂组2316可通过与挡板2317的配合，防止外线毂组2315脱出。
优选的，外线毂组2315的两个线毂231相互固定连接，内线毂组2316的两个线毂231亦相互固定连接。如此配置，则输送器2可以容置四根缝线32。可以理解的，本领域技术人员可根据上述思想，对线毂231的数量和排布方式进行不同的设定，例如采用双层线毂、每层三个并列线毂等，以满足实际需要。
请继续参考图16，优选的，位于外侧的所述线毂231具有第二过线孔235，所述第二过线孔235用于供缝线32穿过，以使内外相邻的所述线毂231上的缝线32相互连接。在一个示范性的实施例中，可在外线毂组中的某一个线毂231上开设第二过线孔235，缝线32在依次盘绕于外线毂组的各个线毂231上后，从该第二过线孔235向内穿过外线毂组，进而继续盘绕于内线毂组的线毂231上。如此配置，内外线毂组的各线毂231上所盘绕的缝线32可以是连续的，便于术中依次抽取使用。需要说明的，这里位于外侧的线毂231，并非仅指各层线毂组中位于最外侧的一层线毂组中的线毂231，而应理解为其内部还具有其它的线毂。亦即这里位于外侧的线毂231应理解为非最内层的线毂组中的线毂。例如当输送器2设置有三层线毂组，则对于中间层的线毂组，其相对于最内层的线毂组而言亦位于外侧，因此其亦可设置第二过线孔235，使得缝线32可以连续地穿越。较佳的，第二过线孔235设置于每层线毂组中最边缘的一个线毂231的端部，以避免缝线32产生缠绕。
请参考图17，可选的，所述输送器2包括指示部26，所述线毂231在缝线32的驱动下转动，带动所述指示部26与所述线毂231连接的一端产生相对所述壳体232的位移，从而形成指示。发明人发现，由于骨道(即开设于预定对象4上的纵向隧道41和横向隧道42)内属于该型手术的盲区，操作者无法看到骨道内部发生的情况。操作者常只能完全凭借手感和经验判断器械介入的情况，手术风险大。针对此问题，指示部26的设置即可以在输送器2 于骨道的外部提供指示，以提示操作者缝线32是否被勾部131成功勾取。
请参考图17和图18，优选的，所述指示部26包括扭簧261和指示标志262，所述扭簧261的一端与所述线毂231连接，另一端与所述壳体232连接；所述指示标志262和所述扭簧261与所述线毂231连接的一端连接；所述壳体232具有供观察所述指示标志262的观察区236。
在一个示范例中，壳体232形成线毂轴237，扭簧261的第一端2611嵌入线毂轴237并被线毂轴237限制，无法围绕线毂轴237转动。线毂轴237于扭簧261的第二端2612处具有一定的周向缺口2370，扭簧261的第二端2612可以在该周向缺口2370中移动。在不受外力时，扭簧261的第二端2612在自身弹力的作用下，抵靠于周向缺口2370的一侧边缘(图18中为上边缘)。线毂231围绕线毂轴237可转动地设置，线毂231上形成有凸起的拨杆2311，所述线毂231通过所述拨杆2311与所述扭簧261的第二端2612抵靠连接。当缝线32被勾部131勾取成功时，缝线32会被勾部131向远端拉出，从而带动线毂231沿第一方向转动。所述线毂231围绕自身的轴线沿第一方向(图18中为逆时针方向)转动，即可推动所述扭簧261的第二端2612产生相对所述壳体232的位移；需要说明的，这里的第一方向，可以是顺时针或逆时针方向中的一个，并不局限于上述示范例中的逆时针方向。进一步的，指示标志262与扭簧261的第二端2612连接，在扭簧261的第二端2612被推动时，指示标志262跟随产生相对所述壳体232的位移，操作者可以通过观察区236观察到指示标志262的位移。在一个可替代的实施例中，壳体232大致为圆柱形的形态，观察区236开于圆柱形的一个底面上，如可为镂空，或利用透明材料覆盖，又如壳体232的圆柱形的底面或整个壳体由透明材料构成，壳体232上靠近观察区236的位置如可标注有“OK”的提示标志，当指示标志262移动至观察区236中，则代表缝线32已被勾取成功。
可以理解的，上述的指示部26已能够适应于仅容置单缝线32的输送器2，如其可结合设置于实施例一提供的输送器2上。为应对于容置至少两根缝线32的输送器2，优选的，所述壳体232具有限转部2371，所述限转部2371用于与所述拨杆2311或所述扭簧261抵靠，以限制所述线毂231在沿所述第一 方向转动预定角度后继续沿所述第一方向的转动。请继续参考图18，限转部2371为线毂轴237的周向缺口2370一侧边缘，且该边缘为远离扭簧261的第二端2612在不受外力时所抵靠的一侧边缘。图18示出的示范例中，当拨杆2311沿第一方向(即逆时针方向)推动扭簧261的第二端2612围绕线毂轴237的轴线转动，至与限转部2371相抵靠时，限转部2371即限制了扭簧261的第二端2612和拨杆2311继续沿第一方向的转动，由此线毂231即无法继续沿第一方向转动。此时，向远端继续抽拉缝线32，缝线32将产生相对线毂231的滑动，此时指示标志262持续位于观察区236中，显示“OK”的提示标志。至一根缝线32被完全抽出，与下一根缝线32分离后，缝线32不再对线毂231产生沿第一方向的扭矩，线毂231在扭簧261的弹力的带动下，恢复至图18所示的初始位置，指示标志262从观察区236中移出，不再显示“OK”的提示标志，等待下一次的勾线。可以理解的，上述示范例中利用线毂轴237的一部分作为限转部2371，在其它的实施例中，限转部2371也可以是壳体232上独立设置的部件，限转部2371也可以通过抵靠拨杆2311，来限制线毂231的转动，本发明对此不限。
基于上述的输送器2及过线器，在本实施例的所述隧道式过线***的操作方法中，在步骤S9之后，还包括：
步骤S91：继续向近端拉动步骤S7中线圈被拉出所述纵向隧道41的前一缝线，直至与该前一缝线相连接的后一缝线的远端超出所述输送头22；
步骤S92：分离所述前一缝线与所述后一缝线，将后一缝线的远端的线圈容置于所述输送头22上，以供于所述预定对象4上重复下一次隧道式过线。
同样的，后一缝线32的远端绕成线圈31，可以是缝线32在出厂时即已预置成型，也可以是由操作者在步骤S92中现场绕制。
【实施例四】
本发明实施例四的***、输送器、隧道式过线***及其操作方法与实施例一基本相同，对于相同部分不再叙述，以下仅针对不同点进行描述。
请参考图19和图20，其中，图19是本发明实施例四的输送器的示意图； 图20是图19所示的输送器的局部放大图。
在本实施例四中，输送器2的具体结构与实施例一不同。具体的，如图19和图20所示，所述输送器2包括：套管27、推杆28以及输送头22；所述套管27具有沿自身轴向贯通的推杆通道270以及沿径向开设的槽口271，所述槽口271与所述推杆通道270连通；所述推杆28的一部分沿所述套管27的轴向可移动地穿设于所述推杆通道270；所述输送头22与所述推杆28的远端连接；所述槽口271用于供缝线32绕成的线圈31通过，所述推杆28用于自所述推杆通道270于所述槽口271的近端一侧向远端一侧移动，所述输送头22用于在所述推杆28向远端移动的过程中套取通过所述槽口271伸入所述推杆通道270的所述线圈31，并用于自所述套管27的远端伸出；所述套管27用于可活动地穿设于所述***1中，所述输送头22用于自所述***1的远端伸出，以供所述***1勾取容置于所述输送头22上的所述线圈31。
如此配置，将缝线32的线圈31通过槽口271置入推杆通道270后，可以方便地利用推杆28向远端移动来套取线圈31，使得将线圈31安装于输送头22的过程不再需要额外的工具，可以很方便地将线圈31安装于输送头22上，由此也为多根缝线32的连续预置带来了便利。
可选的，所述输送头22在第一状态与第二状态间转换，所述输送头22穿设于所述推杆通道270中时，被所述套管27限制而处于所述第一状态；所述输送头22自所述套管27的远端伸出后，沿所述套管27的径向扩张而转换至所述第二状态，以张紧所述线圈31。在一个可替代的实施例中，所述输送头22的材料为形态记忆材料。形态记忆材料是一种形变可逆的材料，因此输送头22在推杆通道270中会被套管27限制而自动收缩，处于第一状态，适配于推杆通道270的内径，而当输送头22伸出套管27后可以自动张开，扩张至第二状态。
在另一个可选的实施例中，所述输送头22沿所述套管27的径向具有弹性，所述输送头22穿设于所述推杆通道270中时，被所述套管27限制而存储弹性势能，处于第一状态；所述输送头22自所述套管27的远端伸出后，释放弹性势能而沿所述套管27的径向扩张至第二状态，以张紧所述线圈31。
优选的，如图11所示，所述输送头22具有导引坡面223，所述导引坡面223沿远端朝向近端的方向逐渐向所述推杆28的轴线方向内倾。导引坡面223的设置，可以使推杆28向近端退入套管27时，便于套管27向输送头22施加向内的收缩力，便于输送头22由第二状态收缩至第一状态。
继续参照图19，可选的，所述输送器2包括回拉驱动部29，所述回拉驱动部29与所述推杆28连接，所述回拉驱动部29被配置为，在所述推杆28受外力拉动向近端移动(回拉驱动部29被拉伸)的过程中存储势能，在所述推杆28不受外力时，释放势能而驱动所述推杆28向远端移动，至所述输送头22移至所述套管27的远端，所述输送头22从推杆通道270的远端一侧伸出。回拉驱动部29的设置，能使推杆28在不受外力时自动回退至推杆通道270的远端，便于连续地向远端推送缝线32，也便于在钩线时单手操作(不需一手控制输送器2)。在一些实施例中，所述回拉驱动部29包括弹性件，所述弹性件的一端与所述推杆28连接，另一端与所述套管27连接。当然在其它的一些实施例中，回拉驱动部29也可以包括磁性件等，利用磁力存储和释放势能。
请参考图19，在一个可替代的示范例中，回拉驱动部29包括弹性件，所述弹性件为弹簧，所述弹簧套设于所述推杆28外；所述推杆28的近端具有膨大段281，所述弹簧的一端与所述膨大段281抵靠连接，另一端与所述套管27的近端抵靠连接。推杆28在不受外力时，在弹簧的弹力作用下，推杆28的输送头22位于推杆通道270的远端。较佳的，推杆28与套管27之间还设置有限制部件，如相对设置的卡扣等，以限制推杆28从套管27的近端脱出，便于使用。
可选的，所述输送器2包括缝线容置部23，所述缝线容置部23用于容置至少两根所述缝线32；所述缝线容置部23具有至少两个缝线预置孔238，每个所述缝线预置孔238用于供一根所述缝线32穿出；至少两个所述缝线预置孔238用于依次与所述槽口271对准。本实施例对缝线容置部23的具体结构不作特别的限定，例如可采用如上实施例三的内外嵌套线毂，或轴向并列线毂等。至少两个缝线预置孔238优选围绕缝线容置部23周向均匀地分布。图 20示出的示范例中，缝线容置部23具有六个缝线预置孔238，同时，缝线容置部23内容置有六根缝线32，每根缝线32的远端分别从六个不同的缝线预置孔238中穿出，并通过胶水或其它手段硬化并弯曲成与槽口271相适配角度的线圈31，由此，线圈31可以方便地穿过槽口271进入推杆通道270中。当一根缝线32被推杆28推出套管27后，可通过转动缝线容置部23，使下一个缝线预置孔238与槽口271对准，以便推送下一根缝线32。转动缝线容置部23可以手动转动，也可以通过机械结构等实现自动转动，此处不做限制。
较佳的，在本实施例中，输送头22可选用如实施例一的双叉形卡相对布置的方案，以便于套取线圈31，具体请参考图11及实施例一。
基于上述输送器2，本实施例还提供一种过线器，其包括：如上所述的输送器2以及至少两根缝线32；至少两根所述缝线32所绕成的线圈31用于依次通过所述槽口271伸入所述推杆通道270，以供所述输送头22依次套取而随所述输送头22推出所述套管27的远端。进一步的，本实施例提供的隧道式过线***包括：如上所述的过线器以及***1，所述输送器2的输送头22在套取线圈31并推出所述套管27的远端后，所述套管27用于穿入所述***1的横向通道110，所述***1的连接部用于与容置于所述输送器2之输送头22上的线圈31连接。
进一步的，在所述隧道式过线***的操作方法中，在步骤S4之前，所述隧道式过线***的操作方法还包括：
步骤SA：将缝线32绕成的线圈31通过所述输送器2的槽口271穿入所述推杆通道270，向远端推送所述推杆28，使所述输送头22套取所述线圈31并自所述套管27的远端伸出。
进一步的，在步骤S5之后，所述隧道式过线***的操作方法还包括：
步骤SB1：将所述套管27向近端移动，撤出所述横向通道110；
步骤SB2：将后一缝线32绕成的线圈31通过所述输送器2的槽口271穿入所述推杆通道270，向远端推送所述推杆28，使所述输送头22套取所述后一缝线32的线圈31并自所述套管27的远端伸出，以供于所述预定对象4上重复下一次隧道式过线。可选的，在“将后一缝线32绕成的线圈31通过 所述输送器2的槽口271穿入所述推杆通道270”之前或之后，还包括步骤SB3：将所述推杆28向近端移动至所述输送头22位于所述槽口271的近端一侧。
本实施例提供的输送器2和过线器可实现自动回膛换缝线32，有利于提供手术的连续性，也简化了将缝线32的线圈31安装于输送头22上的步骤。
【实施例五】
本发明实施例五的***、输送器、隧道式过线***及其操作方法与实施例一基本相同，对于相同部分不再叙述，以下仅针对不同点进行描述。
请参考图21至图23，其中，图21是本发明实施例五的输送器的局部示意图；图22是本发明实施例五的缝线容置部的整体示意图；图23是本发明实施例五的缝线容置部的内部结构的示意图。
在本实施例五中，输送器2的具体结构与实施例一不同。具体的，如图21和图22所示，所述输送器2包括：输送杆21、输送头22以及缝线容置部23；所述缝线容置部23与所述输送杆21连接，用于容置至少两根所述缝线32；所述缝线容置部23具有至少两个缝线预置孔238，每个所述缝线预置孔238用于供一根所述缝线32穿出；至少两个所述缝线预置孔238用于分别与所述缝线腔210对准，以供不同的所述缝线32穿入所述缝线腔210。
与实施例一不同的，本实施例的缝线容置部23至少用于容置两根缝线32，其可以供选择使用其中容置的不同的缝线32。缝线容置部23上具有至少两个缝线预置孔238，用于分别与缝线腔210对准。缝线容置部23的具体结构可参考上述若干实施例，其可以与本实施例结合使用，此处不再展开赘述。特别的，本实施例的缝线容置部23可以选择将需要的缝线预置孔238对准缝线腔210，由此，操作者可根据需要选择不同的缝线预置孔238中所穿设的不同的缝线32，以更好地适应手术的需求。实际中，操作者可根据需要，主动地拨动缝线容置部23，将所选择的缝线预置孔238对准缝线腔210，进而将其中的缝线32抽出，将该缝线32的线圈31容置于输送头22上，以供***1的勾部131勾取。
请参考图23，在一个示范例中，所述缝线容置部23包括外毂2312与内毂2313，所述外毂2312围绕所述内毂2313的轴线可转动地设置于所述内毂2313之外，且所述外毂2312相对所述内毂2313仅具有单向的转动自由度；所述缝线32用于盘绕设置于所述外毂2312上，所述外毂2312被配置为相对所述内毂2313单向转动，以使不同的所述缝线预置孔238分别与所述缝线腔210对准。
请参考图21，相适配的，壳体232具有窗口2320，操作者可通过该窗口2320伸入壳体232内拨动外毂2312转动，同时可通过窗口2320观察到盘绕于外毂2312上的缝线32的具体形态，以便于对缝线32进行选择。
可选的，所述外毂2312的内壁与所述内毂2313的外壁具有相适配的棘齿2314，所述棘齿2314用于限制所述外毂2312相对所述内毂2313仅具有单向的转动自由度。在图23示出的示范例中，棘齿2314的设置可限制外毂2312相对内毂2313仅可沿图中的顺时针方向转动，而不可沿逆时针方向转动。如此配置，操作者可拨动外毂2312顺时针转动，以选择不同的缝线32。
进一步的，所述缝线32于所述外毂2312上的盘绕方向与所述外毂2312相对所述内毂2313单向转动的方向相反。例如在图23示出的示范例中，外毂2312相对内毂2313单向转动的方向为顺时针方向，则缝线32于外毂2312上的盘绕方向为逆时针方向，如此配置，缝线32在被向远端抽拉时，不会同步地带动外毂2312相对内毂2313产生转动。可以理解的，上述棘齿2314的设置方向仅为一示例而非对棘齿2314的设置方向的限定，本领域技术人员可根据需要将棘齿2314的设置进行反转，使得外毂2312相对内毂2313的单向转动方向反转，此处不再展开说明。
在一些实施例中，内毂2313可以固定设置于壳体232上。内毂2313固定设置于壳体232上的方案，可供选择缝线32，但无法指示缝线32是否成功地被勾部131所勾取。
较佳的，在另一些实施例中，所述内毂2313围绕自身的轴线可转动地设置于所述壳体232中。进一步的，所述输送器2包括指示部26，所述外毂2312在缝线32的驱动下转动，带动所述内毂2313同向转动，进而带动所述指示 部26与所述内毂2313连接的一端产生相对所述壳体232的位移，形成指示。
可选的，所述指示部26包括扭簧261和指示标志262，扭簧261的第一端2611与所述壳体232连接，所述扭簧261的第二端2612与所述内毂2313连接；所述指示标志262和所述扭簧261与所述内毂2313连接的一端(即第二端2612)连接；所述壳体232具有供观察所述指示标志262的观察区236。
进一步的，所述壳体232具有限转部2371，所述内毂2313具有拨杆2311，所述内毂2313通过所述拨杆2311与所述扭簧261的第二端2612抵靠连接；所述内毂2313围绕自身的轴线沿第一方向转动，推动所述扭簧261的第二端2612产生相对所述壳体232的位移；所述限转部2371用于与所述拨杆2311或所述扭簧261抵靠，以限制所述内毂2313在沿所述第一方向转动预定角度后继续沿所述第一方向的转动。这里关于扭簧261、拨杆2311、限转部2371和指示标志262的设置，与实施例三相似，这里不再赘述。
如上配置，使用中操作者可通过顺时针拨动外毂2312，选择需要的缝线32。此时由于外毂2312与内毂2313之间的棘齿2314的存在，且内毂2313被壳体232所限制，内毂2313不产生转动。进一步的，当缝线32的线圈31被勾部131所勾取时，缝线32由于盘绕方向与外毂2312的单向转动方向相反，因此将带动外毂2312沿逆时针方向转动，此时外毂2312通过棘齿2314带动内毂2313一同沿逆时针转动，内毂2313上设置的拨杆2311带动扭簧261的第二端2612移动，从而使指示标志262移动进行指示。在一个可替代的实施例中，观察区236开设于圆柱形的壳体232的圆周上，指示标志262如可包括围绕壳体232周向设置的红色区段和绿色区段，在初始状态下，指示标志262的红色区段对准观察区236，当缝线32被成功勾取时，带动指示标志262的绿色区段对准观察区236，表示勾线成功。进一步的，在一根缝线32被完全抽出后，指示标志262能够在扭簧261的弹力作用下复位至初始状态，使红色区段对准观察区236，以供下一次指示。
可以理解的，本实施例中的输送器2，可以采用与实施例四类似的利用套管27和推杆28的方式推送所选择的缝线32，也可以是将缝线腔210配置为沿输送杆21的径向开放，即输送杆21并非为管状，而是呈槽状，以便于将 所选择的缝线32置入缝线腔210中。
基于上述输送器2，本实施提供一种过线器，其包括如上所述的输送器2以及至少两根缝线32；至少两根缝线32分别盘绕设置于所述输送器2的外毂2312上。进一步的，本实施例提供的隧道式过线***包括：如上所述的过线器以及***1。
进一步的，在所述隧道式过线***的操作方法中，在步骤S4之前，所述隧道式过线***的操作方法还包括：
步骤SC：选择所述缝线容置部23的某一缝线预置孔238对准所述缝线腔210，将对准所述缝线腔210的缝线预置孔238中所穿设的缝线32绕成线圈31，容置于所述输送头22上。
【实施例六】
本发明实施例六的***、输送器、隧道式过线***及其操作方法与实施例一基本相同，对于相同部分不再叙述，以下仅针对不同点进行描述。
请参考图24至图30，其中，图24是本发明实施例六的两叶勾的示意图；图25是本发明实施例六的两叶勾与带线锚钉连接的示意图；图26是本发明实施例六的两叶勾与带袢钛板连接的示意图；图27是本发明实施例六的两叶勾勾取缝线的示意图；图28是本发明实施例六的平螺勾的示意图；图29是本发明实施例六的平螺勾与界面螺钉连接的示意图；图30是本发明实施例六的圈勾的示意图。
在本实施例六中，***1的具体结构与实施例一不同。具体的，所述***1包括：横向定位杆11、纵向定位杆12、导丝13、勾部131以及驱动部14；所述勾部131可拆卸地与所述导丝13的远端连接。横向定位杆11、纵向定位杆12以及驱动部14的结构和配置原理与实施例一相似，这里不再赘述。而本实施例六的导丝13与实施例一不同，其远端不具有集成一体设置的勾部131，勾部131是相对于导丝13独立设置而可拆卸的。
如此配置，针对于不同的植入物或不同型号的缝线32，可以快速地拆卸并替换相应的适配的勾部131，方便了术中的应用。
如图24所示，在一个示范例中，所述勾部131包括两叶勾133，所述两叶勾133具有两个朝向近端延伸的延伸部1331，所述延伸部1331朝向近端逐渐向外扩张；所述延伸部1331用于勾取缝线32或植入物的牵引线。优选的，两个所述延伸部1331呈螺旋状延伸，以减少延伸部1331与骨隧道的刮蹭。
请参考图25，以带线锚钉34作为植入物的示范，示出了利用两叶勾133勾取带线锚钉34的示例。带线锚钉34是一种常用的骨科植入物，其可以经由输送器2的输送头22送入横向隧道42，进而勾部131的两叶勾133通过两个延伸部1331，能够勾取带线锚钉34的牵引线341。
请参考图26，以带袢钛板35作为植入物的示范，示出了利用两叶勾133勾取带线锚钉34的示例。带袢钛板35具有钛板本体351以及穿设于钛板本体上的若干牵引线352，经由输送器2的输送头22可以将带袢钛板35送入横向隧道42，例如图11示出的叉形卡，其能够握持带袢钛板35的钛板本体351，从而将带袢钛板35送入横向隧道42，并使带袢钛板35到达横向隧道42与纵向隧道41的相交处。进一步的，两叶勾133的两个延伸部1331即可勾取带袢钛板35的牵引线352。
请参考图27，可以理解的，两叶勾133也可以直接勾取缝线32所形成的线圈31。
请继续参考图24和图25，优选的，两叶勾133还具有朝向远端延伸的适配部1332，所述适配部1332用于与植入物适配连接。较佳的，所述适配部1332呈朝向远端收缩的钝锥形。请参考图26，一般的，带线锚钉34或界面螺钉等植入物的近端常具有供连接部件操作的凹陷结构，如凹陷的内六角等，钝锥形的适配部1332即可***植入物的凹陷结构，从而与植入物形成配合连接。这里的钝锥形是指，锥形的尖端部分呈钝角，以减少对骨隧道产生意外的刮伤。
请参考图28，在一个示范例中，所述勾部131包括平螺勾134，所述平螺勾134呈螺旋形盘绕，且盘绕方向垂直于所述勾部131的轴向；所述平螺勾134用于勾取缝线32或植入物的牵引线。平螺勾134的盘绕方向与勾部131的轴向垂直，因此其相对于勾部131呈末端膨大的形态，便于勾取各个型号 的缝线或植入物的牵引线。优选的，整个勾部131一体成型，以提高坚固性。
进一步的，所述导丝13围绕自身轴线相对所述纵向通道120可转动。由此，可以带动勾部131相对于纵向隧道41转动。请参考图29，平螺勾134还可以通过转动钻入一些柔性材质的植入物中，如可吸收性的界面螺钉36等。在一些情况下，可通过转动导丝13，使得与其远端连接的平螺勾134产生转动，从而实现钻入可吸收性的界面螺钉36等植入物中。当然，也可以利用导丝13转动，驱动两叶勾133转动，以提高勾线的成功率。
请参考图30，在另一个示范例中，所述勾部131包括圈勾135，所述圈勾135呈螺旋形盘绕，且盘绕方向平行于所述勾部131的轴向；所述圈勾135用于勾取缝线32或植入物的牵引线。圈勾135的盘绕方向与勾部131的轴向平行，因此其径向外尺寸可以略小于平螺勾134，有利于在狭小的隧道内操作。其勾线的成功率较高。优选的，整个勾部131一体成型，以提高坚固性。
优选的，所述勾部131与所述导丝13通过螺纹连接。可选的，勾部131的近端具有螺纹连接部1333，勾部131能够通过螺纹连接部1333方便快速地与导丝13相应的部位实现装配或拆卸，实际中，可根据需要，快速地替换不同的勾部131，以适应不同的植入物或缝线32。
需要说明的，上述若干勾部131的示例仅为勾部131的示范而非对勾部131结构的限定，勾部131还可以包括其它的部件，本领域技术人员可根据实际对勾部131进行合理的改进。同样的，本实施例提供的***1可以与上述若干实施例中提供的输送器2配合使用，形成隧道式过线***，本实施例在此亦不再重复说明。
需要说明的，上述若干实施例之间可相互组合。上述描述仅是对本发明较佳实施例的描述，并非对本发明范围的任何限定，本发明领域的普通技术人员根据上述揭示内容做的任何变更、修饰，均属于权利要求书的保护范围。

Claims (21)

  1. 一种***，其特征在于，包括：第一定位杆、第二定位杆、导丝以及驱动部；
    所述第一定位杆具有沿自身轴向贯通的第一通道；
    所述第二定位杆与所述第一定位杆连接，且所述第二定位杆的远端超出所述第一定位杆的远端；所述第二定位杆具有沿自身轴向贯通的第二通道，所述第二通道的远端延伸方向与所述第一通道的远端延伸方向相交；
    所述导丝沿所述第二定位杆的轴向可活动地穿设于所述第二通道，所述导丝的远端具有连接部；
    所述驱动部与所述导丝连接，用于驱动所述导丝沿所述第二定位杆的轴向移动。
  2. 根据权利要求1所述的***，其特征在于，所述第二通道的远端延伸方向与所述第一通道的远端延伸方向所成夹角的范围为10°～180°。
  3. 根据权利要求1所述的***，其特征在于，所述连接部包括机械对接件或粘合件。
  4. 根据权利要求1所述的***，其特征在于，所述机械对接件为勾部。
  5. 根据权利要求1所述的***，其特征在于，所述第一定位杆沿自身轴向可活动地与所述第二定位杆连接。
  6. 根据权利要求1所述的***，其特征在于，所述***还包括定位杆套，所述定位杆套具有沿自身轴向贯通的杆套通道，所述杆套通道的内轮廓形状与所述第一定位杆的外轮廓形状相适配，所述第一定位杆沿所述定位杆套的轴向可活动地穿设于所述杆套通道；所述第二定位杆与所述定位杆套固定连接。
  7. 根据权利要求1所述的***，其特征在于，所述第二定位杆包括弯曲段以及与所述弯曲段的近端连接的平直段；所述平直段平行于所述第一定位杆的轴向。
  8. 根据权利要求1所述的***，其特征在于，所述第一定位杆的远端 具有抵合面，所述抵合面用于与预定对象的形状相适配，并用于抵靠于所述预定对象的表面。
  9. 根据权利要求8所述的***，其特征在于，所述第一定位杆的远端还具有啮合部，所述啮合部用于***所述预定对象的表面，以与所述预定对象相啮合。
  10. 根据权利要求1所述的***，其特征在于，所述***还包括手柄，所述手柄包裹于所述第一定位杆的近端，呈直线形延伸。
  11. 根据权利要求1所述的***，其特征在于，所述导丝呈柔性，所述连接部边缘圆滑。
  12. 一种输送器，其特征在于，包括：输送杆以及输送头；
    所述输送头设置于所述输送杆的远端，用于容置缝线所绕成的线圈或植入物；
    所述输送杆用于可活动地穿设于根据权利要求1～11中任一项所述的***的第一通道，所述输送头用于自所述第一定位杆的远端伸出，以供所述***的连接部与容置于所述输送头上的线圈或植入物连接。
  13. 根据权利要求12所述的输送器，其特征在于，所述输送杆具有沿自身轴向贯通的缝线腔，所述缝线腔用于容置缝线的一部分。
  14. 根据权利要求12所述的输送器，其特征在于，所述输送器包括缝线容置部，所述缝线容置部与所述输送杆的近端连接，用于容置所述缝线的近端部分。
  15. 根据权利要求12所述的输送器，其特征在于，所述输送器还包括限位部，所述限位部与所述输送杆固定连接；所述限位部用于与所述***相对应的部位相抵靠，以限制所述输送杆相对于所述第一通道朝向远端的位移；其中，当所述限位部与所述***相对应的部位相抵靠时，所述输送头位于所述第二通道的远端延伸方向与所述第一通道的远端延伸方向的相交处。
  16. 根据权利要求12所述的输送器，其特征在于，所述输送头包括用于容置所述线圈的第一槽，以及用于供所述连接部通过的第二槽。
  17. 根据权利要求12所述的输送器，其特征在于，所述输送头包括叉形 卡，所述叉形卡的远端包括定位卡与至少两个分支，至少两个所述分支通过定位卡连接形成闭合的卡槽孔，所述卡槽孔用于套取缝线的线圈或用于容置植入物。
  18. 根据权利要求17所述的输送器，其特征在于，所述输送头包括两个所述叉形卡，两个所述叉形卡相对布置。
  19. 一种隧道式过线***，其特征在于，包括：根据权利要求1～11中任一项所述的***以及根据权利要求12～18中任一项所述的输送器；所述输送器的输送杆用于穿入所述***的第一通道，所述***的连接部用于与容置于所述输送头上的线圈或植入物连接。
  20. 一种隧道式过线***的操作方法，其特征在于，利用根据权利要求19所述的隧道式过线***；所述隧道式过线***的操作方法包括：
    在一预定对象上开设第二隧道；
    将所述***的第二定位杆的远端***所述第二隧道，使所述第二通道的远端延伸方向与所述第二隧道的轴向重合；
    沿所述***之第一通道的延伸方向在所述预定对象上开设第一隧道，使所述第一隧道与所述第二隧道相交；
    将所述输送器的输送杆穿入所述第一通道，并使所述输送杆的远端伸入所述第一隧道内，使所述输送器的输送头位于所述第二隧道与所述第一隧道的相交处；
    利用驱动部驱动所述连接部向近端移动，与容置于所述输送头上的线圈或植入物连接；
    向近端拉动撤去所述输送器，使所述线圈或所述植入物留置于所述第二隧道中；
    向近端拉动所述***，将所述线圈或所述植入物的一部分拉出所述第二隧道。
  21. 根据权利要求20所述的隧道式过线***的操作方法，其特征在于，在将所述线圈拉出所述第二隧道后，所述隧道式过线***的操作方法还包括：
    利用驱动部驱动所述连接部向远端移动；
    将所述线圈或所述植入物从所述连接部中脱出，使所述线圈或所述植入物与所述***分离。
PCT/CN2022/078814 2021-03-16 2022-03-02 ***、输送器、隧道式过线***及其操作方法 WO2022193951A1 (zh)

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