CN103654884B - Minimally invasive auricle traction device, that is, auricle tractor - Google Patents

Abstract

The present invention relates to one kind will be bonded under the conditions of minimally invasive with cardiac muscular tissues such as auricles, and traction auricle is put the auricle tractor at suitable position.Different in a manner of being bonded from auricle, auricle tractor is divided into two kinds of attraction fitting and bonding fitting.The oval groove and auricle secure fit for attracting fit type to make head that there is step with negative pressure suction force.The bottom of oval groove rigid mesh, so that cardiac muscular tissue will not generate serious damage under biggish negative pressure；The knife nets of 90 ° of intersections can cut preset two kinds biological poly-bags in mesh enclosure and make two kinds of biogums mixing and auricle and be adhesively fixed in length and breadth on bonding fit type tractor head.After the head of two kinds of tractors is bonded with auricle.Outside thoracic cavity control handle can pull put auricle be allowed to be exposed in operating field with the sharp heart window merging.In addition, heart window bounding wire can also be limited to notch proximal end auricle root thus will not bleeding after guaranteeing the merging of heart window in the step that auricle surface is formed by the head of retractor.

Description

Minimally invasive auricle traction device, that is, auricle tractor

Technical field

The device auricle that auricle is pulled under the conditions of minimally invasive the present invention relates to the field of medical instrument technology, more particularly to one kind is led Lead device.

Technical background

Currently, many heart diseases still need operative treatment, in order to avoid huge damage brought by traditional thoracotomy Wound, the inside and outside section of heart all are attempting to reduce surgical injury using minimally invasive method.

Cardiologists by means of percutaneous puncture intervention approach, so that it may complete large quantities of scripts and heart needed to follow in vitro The operation that could be completed under the conditions of ring.But due to longer catheter manipulation approach, some complicated hands for needing accurate operation again Art and pediatric operation, intervention approach are also unable to complete.

Cardiac surgeon also in the case where being assisted by means of video-assisted thoracoscope, reduces tissue damage, so that outside traditional heart Section's operation minimally invasiveization.But these minimally invasive surgical operations still cannot be detached from extracorporal circulatory system, although wound reduces, due to Extensive injuries caused by extracorporal circulatory system still do not accomplish real minimally invasiveization.

In order to start a kind of completely new minimally invasiveization truly, patent ZL201010514767.8 invented it is a kind of by The external device for carrying out heart transluminal operation (this invention simply if referred to as heart windows).By means of heart window can under the conditions of O ff-pump it is complete It is blocked at such as defect, the operation such as valve replacement, heart intraluminal ablation, Electrophysiological mapping.

According to previous method, the merging of heart window can be cut under thoracoscope monitoring by means of classical surgical instrument Auricle retracts notch for channel heart window and is placed in the chambers of the heart.But this method needs more instrument to help, therefore just need compared with More operative incisions and biggish damage.And many random surgical procedures, operating procedure is complicated, any one link is lost Accidentally, operative hemorrhage can all be led to.In this case, on the one hand operative incision increasing damage will be expanded by carrying out rescue, while also increasing Add the risk of operation.

In order to which heart window safe is placed in the chambers of the heart, it is necessary to which the position that the needs such as auricle are placed in is emerging in operating field The fixed incision in position that is interior, merging heart window will being planned to implement.After the merging of heart window, heart window is fixed with auricle.The present invention devises one kind Fixation will be bonded with cardiac muscular tissues such as auricles under the conditions of minimally invasive, traction auricle is put suitable position, sufficiently The position for being placed in heart window is planned to implement in exposure, so it is safe and reliable auricle is cut, the auricle of the heart window merging chambers of the heart is pulled into dress Set i.e. auricle tractor.After the merging of heart window, by auricle, in the heart, fixation is tied up in face outside window, establishes a firm cardiac window.Make Operator can complete the surgical procedure in many chambers of the heart under conditions of safe and reliable by heart window.

Summary of the invention

The object of the present invention is to provide one kind under video-assisted thoracoscope auxiliary, is bonded and is integrated with cardiac muscular tissue, for leading Draw the tractor of myocardium device, the tractor is divided into two kinds of tractor of attraction fitting tractor and bonding fitting.

Bonding fitting tractor is made of head, body portion and tail portion.

The head of bonding fitting tractor is oval plate-like, which is the position being bonded with auricle, the head of oval plate-like Portion is made of the mesh enclosure of the 90 ° in length and breadth knife nets intersected, oval groove.The knife edge of knife net faces centripetal facing towards mesh enclosure, knife net tool arm Muscular tissue, in knife edge face, there are four knife net draught line attachment points.

The most head end of mesh enclosure has a bounding wire threading hole, for placing bounding wire.

Under stand-by state, knife net is located at except the oval groove of mesh enclosure, preset two bags of biogums in mesh enclosure oval groove.Work as head After being bonded with auricle, the end hand grip for tractor of holding with a firm grip is led knife net in the oval groove of mesh enclosure by knife net draught line, knife net Biological poly-bag in slot can be cut, biogum flows into oval groove and oval groove is overflowed in part.Rubbing head can make Biogum mixes and generates the bonding of head and auricle.Auricle, knife net, mesh enclosure are just bonded and are integrated at this time.It is pulled by handle Body rod and head, so that it may which the auricle of bond site is put into suitable position.Three tractors are distributed from equilateral triangle Three angles draw simultaneously, so that it may the cardiac muscle at triangle center position is unfolded, makes the plane not swung.This The subsequent incision cutter head of sample can accurately be seated in the position, cut to selected position.

The head handle at the head mesh enclosure back side forms axis joint with the head of body portion body rod and connect.The head side of head handle is dispersed with knife net Threading hole, knife net draught line are pierced by from the position by the oval groove of mesh enclosure, body rod are penetrated in the head side of joint of head axis, by body rod Tail end is drawn.The caudal on head has a mesh enclosure tail end draught line attachment point, mesh enclosure tail end draught line with this as the starting point, through head handle joint The caudal of axis penetrates body rod, is pierced by by body rod tail end.

Drawing knife net draught line enters knife net in mesh enclosure oval groove, cuts biological poly-bag, while going back drawing head Portion is rearwardly rotated around mesh enclosure head handle around joint shaft, when the long axis on head is in 100 ° of angles with body rod, head handle and body rod head The head side angle degree control platform at end contacts, and head is prevented to further rotate.Such angle enables knife network plane and auricle More strict fitting, biogum are coated with more evenly.

Pull mesh enclosure tail end draught line so that head handle is rotated around the direction of joint axial direction mesh enclosure mouth, when head long axis with When body rod is in 190 ° of angles, head handle is contacted with the caudal angle control platform of body rod head end, prevents head further to mesh enclosure mouth Direction rotates.Such angle can further spread out auricle notch, in favor of the merging of heart window.

Body rod end manipulation handle connector dock with the lower control handle of tail portion, upper control handle and lower control handle by means of Axis joint connects in parallel, and the head end of upper control handle is docked with draught line conversion platform.Traction line card people draught line conversion is put down Platform, holds the caudal of manipulation handle, and the manipulation button side of Xiang Yiqi extrusion handle, joint shaft opposite side is opened, so that it may so that draught line It is mobile to the tail end of body rod, to change the angle on head and body rod.

After the angle on head is fixed, corresponding draught line is fixed on gripper, so that it may so that head with this angle with Body rod is fixed as one and is conducive to complete the operation under this angle.

The step for after the completion of, another draught line is connect with draught line conversion platform, hold and to together squeeze behaviour Head and body rod can be changed into another angle by control handle, to complete the operation under another angle conditions.

Attract fitting retractor structures fairly simple.

The main structure body for attracting fitting tractor is a hollow rigid conduit.It is curved in 45 ° of camber lines in the head end of pipeline The angle of the tangent line of song, the truncation of bending section head end, section and pipe bending arc is 120 °.Section forms an oval suction tube Mouthful.

Nozzle plane of 1.5-2mm depth into lumen is attracted to be lined with rigid mesh in ellipse.Therefore, attract nozzle to rigidity A slot spline structure is formed between net.The slot bottom of this slot is exactly rigidity net.

In the tail end of rigid conduit, suction is bent to doing one 120 ° towards direction at 180 ° with head end bending section Lead device connector.There is attractive device connector disconnecting prevention structure to be used to connect with silicone tube.

Anti-skidding and overstriking a antiskid bar is connected with 0 ° of direction of main body steel pipe in the root of bending section.In use, Antiskid bar and attractive device connector manipulate tractor together as handle.

By means of the attraction strength of the head end of tractor, auricle can be fitted in the head end of tractor.Due to tractor In the port of head end, rigid mesh is padded, although aspirator is applied with biggish negative pressure to tractor lumen, since negative pressure is logical It crosses many meshes and acts on auricle, so auricle not will receive serious damage.

Head end port due to rigid mesh apart from tractor has the depth of 1.5-2mm, this has resulted in the suction of a slot sample Lead plate.The presence of disk is attracted on the one hand to make auricle muscle and attract that there is biggish binding face between disk, so inhaling in head end Drawing mouth will not loosen because of gas leakage, on the other hand attract between disk and auricle, since the effect auricle muscle of negative pressure is being inhaled Lead plate mouth forms a step.Step, which is formed such that between tractor head end port and auricle, to change position because of sliding It sets.

Either using the mode of bonding or attraction fitting, tractor head end is after the suitable position fitting of auricle, just The position can be fixed, which just becomes the impetus of tractor.For impetus tractor can by auricle towards The position traction needed.Three tractors are worked in coordination can be by the position flattening that auricle needs be cut, and is placed in operating field It is most suitable for the position cut, to be cut auricle with the auricle incision knife of minimally invasive heart window device for posting, and then by heart window safe Ground is placed in auricle.

After the merging of heart window, the head end of mesh enclosure is attached to auricle surface and is higher by auricle surface, forms platform on auricle surface Rank.The bounding wire for being used to tie up auricle can be limited in auricle root in fixed auricle by such step, auricle notch Proximal part.To which auricle to be effectively fixed on to the outside of heart window.

Bounding wire is the nylon wire for heart window and auricle are fixed together, and the root of auricle will other than auricle notch Nylon wire to tie up auricle covers snare on auricle surface, and snare is tied up in tightening can be banded in auricle the outer of heart window Face.

Because the diameter of auricle proximal end is greater than distal end, when tying up, nylon wire may be slided to auricle cut-out direction, at this moment be led Lead device head end prevents from auricle bounding wire in the step that auricle surface is formed and slides to auricle cut-out direction, so as to keep away Notch and the proximal part that will be tied up snare and be placed in notch, can play anastalsis and auricle is securely fixed in the heart The head of window.

So far, can be accurate by means of the present invention and heart window be safely placed in auricle, become can from vitro into The channel of row heart transluminal operation.It since the channel has many advantages, such as that operating distance is short, is open big, so can be complete by the channel (especially neonatal defect blocks), valve replacement, valve repair, Electrophysiological mapping, RF ablation are blocked at such as defect Etc. more complicated operation.Can make these operation can from extracorporal circulatory system so that openheart surgery accomplish it is veritably minimally invasive Change.

The implanting of certain heart window is also possible to the apex of the heart.In this case, it needs to open a small window in costal cartilage, several It is completed under direct vision, but this surgical approach has still resulted in the damage of function cardiac muscle.

Figure of description: the present invention can be more clearly understood that in conjunction with attached drawing.

Detailed description of the invention

Fig. 1 be the general assembly drawing (all draught lines are in relaxed state) of auricle retractor wherein:

1 is the head of auricle retractor.

2 be the body portion of auricle retractor.

3 be the tail portion of auricle retractor.

Fig. 2 is the main view, top view and left view of mesh enclosure.Wherein:

4 be mesh enclosure threading hole, and four threading holes overleaf merge into one outlet.

5 be the side view of knife net threading hole, and each knife net threading hole is the right angle covering of the fan at bottom in knife wire side, works as traction in this way Knife net when being moved into mesh enclosure will not because of knife net drag wire angle opening and by resistance.

6 be mesh enclosure head handle, and head handle and mesh enclosure are in 100 ° of angles, the tail end of head handle have axis mother for and body rod head end composition Axis joint.

7 be mesh enclosure tail end draught line attachment point.

8 be the axis mother hole of mesh enclosure head handle.

9 be mesh enclosure head end auricle tightening line constrained port.

Fig. 3 is the main view, top view and left view of knife net.Wherein:

10 be the knife net drag wire attachment point of 4 distributed rectangulars.

Fig. 4 is the main view, top view and left view of body rod.Wherein:

11 be the joint axis hole of body rod head end since body rod head end is divided into two arms, so there are two such joint shafts Hole.

12 be the pivot pin of axis joint, for the axis hole of mesh enclosure head handle and body rod to link together.

13 be the head side angle degree control platform positioned at pivot pin head side for being used to control the angle on head and body rod in 100 °.

14 be the caudal angle control platform positioned at pivot pin caudal for being used to control the angle on head and body rod in 190 °.

15 be control handle connector, for connecting body rod and lower control handle.

16 be a side threading hole, positioned at the head side of pivot pin, for across knife net draught line.

17 be caudal threading hole, positioned at the caudal of pivot pin, for across caudal draught line.

Fig. 5 is the main view, top view and left view of lower control handle.Wherein:

18 be lower control handle.

19 be the hollow of lower control handle head end, is connect for the manipulation handle connector with body rod tail end.

20 be the support arm joint axis hole of lower control handle, is used for and the support arm of upper control handle forms axis joint.

Fig. 6 is the main view, top view and left view of upper control handle.Wherein:

21 be upper control handle.

22 be the support arm joint axis hole of upper control handle, is used for and the support arm of lower control handle forms axis joint.

23 be a hollow of upper control handle head end, for connecting with draught line transfer table.

Fig. 7 is draught line transfer table.Wherein:

24 be draught line transfer table.

25 be cable clamping interface, for converting knife net draught line or mesh enclosure caudal draught line.

26 be upper control handle connector, and when use is inserted into the hollow of upper control handle head end.

Fig. 8 is the general assembly drawing of auricle retractor.Wherein:

27 be knife net draught line.

28 be caudal draught line.

The tensioning of knife net draught line, caudal draws line relaxation, therefore head is opened to back side, and knife net and body rod are in 100 ° of folders Angle.

29 be body rod gripper, the bracing wire clamping for that will tense to fixing head and body rod angle.

30 be axis joint support arm, is that control handle connects hinge up and down.

Fig. 9 is the general assembly drawing of auricle retractor.Wherein:

Knife net draws line relaxation, and caudal draught line is nervous, and knife net and body rod are in 190 ° of angles.

Figure 10 is the general assembly drawing for attracting fitting tractor.Wherein:

31 be the head for attracting fitting tractor.

32 be the body portion for attracting fitting tractor.

33 be the tail portion for attracting fitting tractor.

Figure 11 is the head schematic diagram for attracting fitting tractor.Wherein:

34 be the curved bend tune (nearly 45 ° of crooked radian) of tractor head pipeline.

35 be the head port for attracting fitting tractor (tangent line with arc of curvature is in nearly 120 ° of angles).

Figure 12 is the schematic three dimensional views for attracting the head notch of fitting tractor.Wherein:

36 be the bottom of notch, is rigid net.

37 be the side wall of notch.

Figure 13 is the structural schematic diagram of pocket bottom rigid mesh.

38 be the mesh on rigid mesh, and mesh is arranged in linear array sample on rigid mesh.

Figure 14 is the tail portion installation diagram for attracting fitting tractor.Wherein:

39 be attractive device connector (with body rod in 120 °, bending section is contrary with head-bent).

40 be tail end handle, takes anti-skid structure, is used with attractive device connector together as handle.

Figure 15 is the schematic three dimensional views of suction aspirator tip.

41 be attractive device connector and body rod bending section, it is seen that the two inner cavity communicates.

Figure 16 is attractive device connector schematic diagram.

42 be round table-like with retaining connector.

Specific embodiment

Surgical instrument of the invention be it is a kind of used in video-assisted thoracoscope it is minimally invasive under the conditions of carry out auricle and effectively control, can be with Auricle pulled, fixed under video-assisted thoracoscope auxiliary, put suitable position, so as to easily to auricle into The device auricle tractor of row surgical procedure.Auricle tractor is divided into bonding fitting tractor and attracts two kinds of tractor of fitting.

Bonding fitting tractor forms (Fig. 1) by the head (1) of plate-like, body portion (2) and tail handle (3) three parts:

Head is oval plate-like (1), and body portion is elongated rod shape (2), and tail portion is control handle (3).Exercise different in each position Function.

The head of plate-like by knife net (Fig. 3), mesh enclosure (Fig. 2), form.It can be with preset two bags of lifes in the mesh enclosure (Fig. 2) of plate-like Object glue.The oral area of disk is covered by knife net (Fig. 3), and the knife edge of knife net is facing towards mesh enclosure, and knife net tool arm is facing towards cardiac muscular tissue, in knife There are four knife net draught line attachment points on sharp side.

Knife net is located at outside the Pan Kou of mesh enclosure before not applying external force, and drawing knife net draught line (27) can pass through four knives Net drag wire attachment point (10) makes knife net enter in the disk of mesh enclosure the biological poly-bag of (Fig. 2) incision, overflows biogum.Sliding snout So that two kinds of biogum mixing, generate bonding force.

There are four knife net bracing wire attachment points (10) of distributed rectangular, coupled four bracing wires difference on knife net (Fig. 2) Enter body rod (2) across the corresponding hole (4) of mesh enclosure (Fig. 2), merges into a knife net traction in (2) three knife net bracing wires of body rod Line (27), knife net draught line (27) passes through the head side threading hole (16) of body rod head end, by the tubulose body rod (2) in body portion and tail portion Handlebar conversion traction seat (24) connect (Fig. 4).

There is a rectangular-shape metallic rod at the back side of mesh enclosure, name is mesh enclosure head handle (6), mesh enclosure head handle (6) and mesh enclosure Mouth plane (2) be in 100 ° of angles (Fig. 2), by means of two of the axis of mesh enclosure head handle (6) end female (8) and body rod head end Axis joint hole (11) forms axis joint connection.

The most head end of mesh enclosure has a bounding wire threading hole (9), for placing bounding wire.

There are one bracing wire attachment point (7) for the tail end of mesh enclosure, therefore occur being located at head handle (6) in the left view of Fig. 2 The knife net bracing wire hole (4) of head side, and it is located at the caudal bracing wire attachment point (7) of head handle (6) caudal, the two positions have accordingly respectively Knife net draught line (Fig. 8) (27) and caudal draught line (Fig. 9) (28) thus draw, and respectively by body rod head side threading hole (16) and caudal threading hole (17) penetrates body rod (2).

Body rod (2) and its accessory structure constitute the body portion of tractor.

The tail end of head handle (6) is connect with the joint axis hole (11) of body rod (2) by means of pivot pin (12) by means of axis female (8) (Fig. 4), which forms two bracing wire holes for being located at the axis two sides.It can be according to the head or tail portion of its corresponding plate-like by two Bracing wire hole is divided into a side threading hole (16) and caudal threading hole (17).

A knife net draught line (27) is merged into four knife net bracing wires after being pierced by from the mesh enclosure back side, entered by the head side of pivot pin The head side threading hole (16) of body rod (2) simultaneously passes through body rod by the end extraction of body rod；

Positioned at the caudal draught line (28) of head handle (6) tail end, the pipe of body rod (2) is entered through by caudal threading hole (17) Chamber is drawn in its end.

This two draught lines can be by means respectively of the conversion traction seat (24) of handlebar and the upper control handle of tail portion (21) it connects.

Control handle connector (15) are docked with lower control handle (18) there are one the caudals of body rod (2) end.

Upper control handle (21) connects with lower control handle (18) by means of axis joint support arm (30) are parallel.Due to this Parallel connection structure to be allowed under conditions of closing up together to the manipulation arm for squeezing two control handles up and down together, It can be so that the draft arm of control handle opens, so that draught line be made to move to the tail end of body rod.Therefore tail end control handle Just have the function of caudad tightening drag wire, so tractor head can be manipulated in tail end manipulation handlebar.

Knife net draught line is connect with draught line conversion platform, so that it may which extension knife net draught line draws the knife net on head Into mesh enclosure, and then the poly-bag stored in mesh enclosure is cut, so that auricle and head are bonded together by the mixing of two different glue, Play the role of being bonded tractor head and auricle.At the same time, the traction action of knife net draught line is also possible that head With the angle of body rod.

Traction body portion mesh enclosure caudal draught line tail end is connect with draught line conversion platform, control handle of holding with a firm grip can change Become head (1) and body rod (2) and another angle is presented.

(Fig. 1) knife net draught line (27) and caudal draught line (28) are all in free state, head (1) and body under natural conditions The angle of bar (2) is between 100 ° -190 °.

It is 100 ° that knife net draught line (27), which tenses occiput and the angle of body rod,.

It is 190 ° that mesh enclosure caudal draught line (28), which tenses occiput and the angle of body rod,.

On the one hand such angle is the strength generation change by the draught line formed end to end, on the other hand limit angle It is the angle control platform (13,14) by body rod (2) head end (Fig. 4) come what is controlled in two fixed angles.

There are a side control platform (13) and caudal control flat by the angle control platform of the left view visible volume rod head end of Fig. 4 Platform (14) composition.Head side control platform (13) is to be used to control the angle on head Yu body rod (2) when tightening knife net draught line (27) Degree is equal to 100 °；Caudal angle control platform (14) is to be used to control head and body rod (2) when tightening caudal draught line (28) Angle be equal to 190 °.

There is a manipulation handle connector (15) in the caudal part of body rod (2), for connecting lower control handle (18).

The tail end of body rod is used to the bracing wire clamping that will be tensed there are one gripper (29), so that head (1) and body The angle of bar (2) will not change.

Control handle and its accessory structure constitute the tail portion of tractor.

Control handle by upper (Fig. 6), under (Fig. 5) two shear arms (21,18) it is parallel by means of axis joint support arm (30) It connects (Fig. 8).

As seen from Figure 5: lower control handle (18) head end has a hollow (19) to be used to connect with the manipulation handle of body rod (2) tail end Head (15) docking；Lower control handle (18) is used to the axis joint with upper control handle (21) there are one axis joint support arm (20) Support arm (22) constitutes axis joint (Fig. 6).

The head end of upper control handle (21) equally has a hollow (23) to be used to dock with transfer table (24) as seen from Figure 6.

As seen from Figure 7, transfer table (24) is a Y type frame, and head end has a groove (25) to be used to be embedded in bracing wire, two Bracing wire can be used to phase double replacement and be embedded in the groove (25).The tail end of transfer table (24) has a connector (26) to be used to be inserted into behaviour The hollow (23) for controlling handle (21) head end is interfaced.

After head, body portion, the tail portion of tractor are all completed, the knife net draught line (27) and tail end draught line on head (28) it is in free state (Fig. 1), the angle of such state head portion (1) and body rod (2) is between 100 ° -190 °

In operating process, head (1) is bonded with auricle surface, knife net draught line (27) is blocked into people's transfer table, is then held The handle section of tight handlebar, the other end draft arm of the handle will pull knife net draught line (27), by means of relative displacement by knife Net pull in body rod (2) relatively-stationary mesh enclosure in, to be cut (Fig. 8) to the biological poly-bag prestored in mesh enclosure.

After poly-bag is cut, biogum overflows poly-bag, gently sliding snout, two kinds of biogum mixing, therefore biogum has Bonding force is bonded so that head be bonded with cardiac muscular tissue.Knife net draught line (27) is moved on into card from handlebar transfer table (24) Line device (29).By means of three identical tractors that three equilateral triangle corner positions are placed, auricle is retracted, will be needed Do the position flattening of notch.Heart window device for posting (see other patent) sheath is directed at the position, triggers incision knife handle for auricle Preliminary to cut, auricle notch is expanded to the length of needs by adjustment incision knife.

The tail end draught line (28) for being attached to the tail end of head mesh enclosure is transformed into handlebar transfer table (24).It holds with a firm grip manipulation Handle handle section pulls tail end draught line (28), so that it may so that the angle of the network interface plane of head (1) and body rod portion (2) at 190 ° (Fig. 9).Then after tail end draught line (28) being blocked with gripper (29), head (1) and body rod (2) will be with almost straight line Position is fixed.Tractor head is in such angle, so that auricle notch is sufficiently spread out.

The sheath of motive window blocks notch.Complete subsequent heart window merging operation.

The main body for attracting fitting tractor is a rigid conduit (Figure 10).It can be divided into sucking head (31), body rod (32) With manipulation handle (33) three parts of tail end.

It is a curved pipeline by scheming (11) visible head for attracting fitting tractor, in the head end of bending section, pipeline Being truncated becomes an inclined-plane.The camber of pipe bending section is 45 ° (34), the angle of the tangent line in the section and bending camber line of pipeline For 120 ° (35).Section forms an oval mouth.

By scheming the oval oral area on (12) the visible head for attracting fitting tractor, the 1.5-2mm(37 into lumen) depth has One rigid mesh (36) liner forms a head oval groove mouth in spout part.

Scheme the aperture (38) of (13) rigid mesh surface line formation arrangement, these apertures have gas permeability, one side of these apertures Face ensure that the negative pressure of aspirator can be in notch effect and auricle.Even on the other hand guarantee to be applied with biggish negative again Pressure, serious damage will not be caused to auricle, will not more inhale brokenly auricle.

The presence of net is padded, not only can be to avoid the damage to auricle, while an oval notch is formd in spout part. The presence of oval notch makes a part of auricle enter nozzle and fit closely with the tube wall of nozzle.It, on the one hand can be with after fitting Prevent nozzle gas leakage, slip tractor will not: the oval notch tube wall of another aspect is bonded with auricle, forms one in auricle A ellipse step, can also prevent tractor head end from sliding on auricle surface, play fixed function.

By scheme (14) as it can be seen that tractor proximal end, 120 ° of presentation of bending of suction tube becomes attractive device connector (39).Anti-slip handle (40) are mounted on the tail end extended line of tractor body rod.By means of Anti-slip handle (40) and attract Device connector (39) can more firmly carry out three-dimensional manipulation to tractor head end.

It is contrary with the bending section of head end and in approximately the same plane (41) by scheming (15) visible bending section.

By scheming (16) as it can be seen that attractive device connector uses segment rotary table spline structure (42), to prevent suction tube from slipping from connector.

Concrete operations are as follows: the attractive device connector of suction pipe and tractor is connected.It adjusts and attracts negative pressure.It is hand-held to lead The head end of tractor is protruded into the through auricle in thoracic cavity by the endpiece of lead device.The position for needing to retract is determined on auricle surface.It will traction The head end of device is bonded with the position determined, by means of attracting the effect of negative pressure, tractor head end is made to be bonded fixation with auricle.

By means of three identical tractors that three equilateral triangle corner positions are placed, auricle is retracted, will be needed The position flattening for doing notch, is placed in the position cut conducive to incision knife.The incision knife of motive window device for posting cuts auricle.

After the completion of preliminary cutting, tractor prevents bleeding there is still a need for control auricle muscle piece.Incision knife is adjusted by auricle Cut the length for being expanded to needs.

The sheath of motive window blocks notch.Complete subsequent heart window merging operation.

After the completion of notch, auricle bounding wire snare is placed in the root of tractor head end auricle, adjustment tractor head end Position, so that bounding wire lasso is in the auricle root of auricle notch proximal part.Then the both ends end to end of bounding wire are closed up, together It is passed through out of flexible elongated tubular auricle fastener.

Heart window is placed in auricle and auricle turns up by motive window device for posting is placed on heart window outer surface.

After taking care window merging auricle, Xiang Xiner fastener tail end pulls bounding wire, while head-end pushes auricle fastener, This relative strength can be such that the bounding wire of auricle fastener head end shortens, and then become smaller around the wire loop of auricle, by auricle On heart window.

Auricle and heart window it is fixed it is satisfied after, by bounding wire and auricle fastener clamp be fixed together can be lasting will Auricle is fixed on heart window.Auricle fastener is placed in safe place and is fixed.

So far, one is just successfully established with the channel by carrying out heart transluminal operation in vitro-heart window that auricle is fixed together. Heart window fixator is fixed with operating table, heart window both can be used as operating table in the fulcrum at auricle position, while heart window and auricle The additional access way for constituting heart together, the surgical procedure in the chambers of the heart is carried out for operator in vitro.

Claims (7)

1. a kind of tractor can be bonded with cardiac muscular tissue and be integrated under the conditions of minimally invasive, described for drawing myocardium device Tractor is bonding fitting tractor；It is characterized in that, bonding fitting tractor is made of head, body portion and tail portion, bonding patch The head for closing tractor is oval plate-like, this is the position being bonded with auricle, and the head of oval plate-like is made of knife net, mesh enclosure, The body portion of bonding fitting tractor is elongated rod shape, referred to as body rod, and there are two the joint arms with joint hole, head end angle for head end Control platform, tail end angle control platform are spent, tail end has control handle connector and gripper, the tail portion of bonding fitting tractor It is made of lower control handle, upper control handle and conversion platform.

2. tractor as described in claim 1, which is characterized in that bonding fitting tractor head knife net was intersected by 90 ° in length and breadth Blade composition, the knife edge of knife net is facing towards mesh enclosure, and knife net tool arm is facing towards cardiac muscular tissue, and in knife edge face, there are four knife net draught lines Attachment point.

3. tractor as described in claim 1, which is characterized in that bonding fitting tractor head mesh enclosure is oval channel-shaped, oval For the oral area of slot towards knife net, the back of oval groove is attached with auricle bounding wire threading hole, mesh enclosure threading hole, tool from head end to tail end There are the mesh enclosure head handle and mesh enclosure tail end draught line attachment point in joint shaft hole.

4. tractor as described in claim 1, which is characterized in that the mesh enclosure head handle joint hole and body portion of bonding fitting tractor are closed Joint arm joint hole is joined together to form axis joint by pivot pin, and head can change head and body portion around joint shaft rotation Angle.

5. tractor as described in claim 1, which is characterized in that the manipulation handle of tail portion two of bonding fitting tractor is with axis joint Parallel connection.

6. tractor as described in claim 1, which is characterized in that bonding fitting tractor: attached originating from head end knife net draught line Four knife net draught lines of point pass through tractor head mesh enclosure threading hole, the head end through body rod axis joint and enter body rod, by body The tail end of bar is drawn, and end can be connect with conversion platform；Mesh enclosure tail originating from head mesh enclosure tail end draught line attachment point It holds tail end of the draught line Jing Guo body rod axis joint to enter body rod, drawn by the tail end of body rod, tail end can connect with conversion platform It connects.

7. tractor as described in claim 1, which is characterized in that the knife net draught line and conversion platform for drawing body rod tail end connect It connects, handle tail end of holding with a firm grip, upper control handle drawing knife net draught line caudad moves, and knife net enters preset in mesh enclosure incision mesh enclosure Two kinds of biogums poly-bag, while making mesh enclosure and body rod in 100 ° of angles, it is viscous that pico- rubbing head generates biogum mixing Cooperation is used, therefore head and auricle are just bonded and be integrated, and the head for hereafter putting tractor can draw auricle to needs Position, three tractor cooperations can will need cutting part to be unfolded, be cut with incision knife to auricle, auricle notch is completed Afterwards, knife net draught line is removed from handle conversion platform, the mesh enclosure tail end draught line that body rod tail end is drawn is connect with conversion platform, It holds with a firm grip handle tail end, upper control handle pulls that mesh enclosure tail end draught line is mobile to body rod tail end, and drawing mesh enclosure is revolved to knife net direction It goes to body rod in 190 °, at this moment mesh enclosure shank and the control platform clamping of body rod tail end angle, such angle can be by auricle Incision is fully unfolded, and in favor of the merging of heart window, after the completion of operation, control handle can be removed from body rod.