CN103462668B - A kind of left auricle ligation device - Google Patents
A kind of left auricle ligation device Download PDFInfo
- Publication number
- CN103462668B CN103462668B CN201310417188.5A CN201310417188A CN103462668B CN 103462668 B CN103462668 B CN 103462668B CN 201310417188 A CN201310417188 A CN 201310417188A CN 103462668 B CN103462668 B CN 103462668B
- Authority
- CN
- China
- Prior art keywords
- sheath
- knot
- hole
- ligature
- diameter
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
Landscapes
- Surgical Instruments (AREA)
Abstract
The present invention provides a kind of left auricle ligation device, is made up of outer sheath, interior sheath, push rod, lock tube and ligature, and wherein ligature is made into " jade pendant rope " shape, makes a call to a knot every one section, is through in lock tube, and forms annulus in lock tube one end.Using the left auricle ligation device ligaturing left atrial appendage of the present invention, without opening chest, ligation is solid and reliable, and complete blocking blood flow.
Description
Technical field
The invention belongs to medical instruments field, relates in particular to a kind of left auricle ligation device.
Background technology
Auricular fibrillation（Atrial fibrillation）Caused thrombus breaks loose is to cause one of Etiological of cerebral apoplexy.Non-valvular heart disease
The incidence of patient's cerebral embolism is 5 times of normal person, and the cerebral embolism incidence of disease is normal person in valve characteristic of disease chronic atrial fibrillation patient
17 times.The treatment of oral anticoagulation thing is the important component of atrial fibrillation therapy.Trouble of the guideline recommendation for non-orphaned atrial fibrillation
Person, it should Long-term Oral Anticoagulation of Warfarin.But because warfarin needs to monitor INR（INR）, treatment
Window is narrow, and patient compliance is poor, and its clinical practice is restricted.Left auricle of heart is the predilection site of cardiogenic thrombus, 60%
The cardiogenic thrombus of rheumatic heart disease patients with atrial fibrillation is come from left auricle of heart, rather than valvular patients with atrial fibrillation more than 90%.Thus may be used
Infer, patients with atrial fibrillation risk of stroke will be greatly reduced by carrying out closure to left auricle of heart.Closed by surgical operation or interventional method
Plug left auricle of heart may have warfarin to avoid or be reluctant that the patient of Long-term Oral Anticoagulation of Warfarin provides new selection for those.
1st, warfarin method
The registration of the progress such as Stafford is shown, although the treatment that Anticoagulation of Warfarin prevention atrial fibrillation cerebral apoplexy occurs
Effect affirmative, but the clinical practice rate of warfarin is low, and only 1/3 patients with atrial fibrillation for having anti-freezing idicatio receives the magnificent method of effective dose
Woods.It is as follows to analyze reason：（1）Safely and effectively therapeutic window is narrow, and hemorrhage complication incidence is about 1.0%-1.3%, the age>75
The patient in year is up to 1.8%；SPORTIF researchs H1 shows the only 60% oral warfarin dose of patient in the range of therapeutic window；（2）
A variety of medication contraindications be present：Such as merge serious liver and kidney dysfunction, anaemia（Hb<1009/L）, refractory hypertension, blood pressure
>180/100mm Hg（1 mm Hg=0.133 3 kPa）, once have cerebral hemorrhage or cranial injury etc..（3）Patient compliance is poor：Have
38% patient is because needing long term monitoring INR to be voluntarily discontinued；Some another patient need to be forced to interrupt China because of reasons such as wound, operations
Method woods is treated, and is up to 50% in drug withdrawal interval cerebral apoplexy.
2nd, surgery Closure
Cardiac operation is cut off simultaneously or closing left auricle of heart is simple and easy, therefore many doctors are advocated for such patient
Need openheart surgery that left auricle of heart is cut off or closed while treatment.Odell in 1966 etc. reports pre- through thoracoscope closing left auricle of heart
The technology of anti-atrial fibrillation embolism, because the technology greatly reduces the wound and risk of operation so that close left auricle of heart through thoracoscope
Obtain extensive concern.If the effect that left auricle of heart is closed in the technology can be improved further, it is pre- to close left auricle of heart through thoracoscope
Anti- atrial fibrillation embolism has good development prospect.But for the current state of the art, only cut off or close left auricle of heart
For surgical operation wound face it is too big, have the danger of complication, therefore surgical operation should not be implemented.
3rd, transcatheter occlusion
Interventional method wound is small, is one of the focus of Jie's popular feeling popular name for research in recent years, the left auricle of heart reported at present
Plugging device has three kinds：PLAATOTM（Ev3 companies）、WATCHMAN（Atritech companies）Blocked with Amplazer atrial septums
Device.PLAATOTM apparatus systems are made up of release catheter and plugging device two parts.Plugging device is using self-expanding Nitinol as skeleton
（Diameter 15-32mm）, surface covers distensible polytetrafluoroethylene（ePTFE）Film.There are several anchors on plugging device skeleton, help
In fixing plugging device in left auricle of heart opening, whole interventional procedure is carried out under TEE guidances.The closure of WATCHMAN devices
Device is made up of thick 160um polyethylene filtration membrane and nickel-titanium alloy framework, has multiple anchors in the equatorial plane of plugging device with profit
In fixation.Implantation is also to wear long what atrial septum approach was carried out.Amplatzer device category atrial septal defect umbrellas, the operation of this method
It is easier, without ultrasonic guidance and general anesthesia.Although small using percutaneous transcatheter closure wound, relatively easy easy, percutaneous transcatheter closure of performing the operation
A variety of shortcomings being present, such as current plugging device is simultaneously immature, the complication such as apparatus embolism, cardiac tamponade easily occurs, and
It is also possible to there is residual shunt phenomenon, so as to influence therapeutic effect.
The content of the invention
The present invention provides a kind of left auricle ligation device, it using ligature type to avoid percutaneous transcatheter closure the shortcomings that, and
Using invasive manner, without opening chest.Technical scheme is as follows：
A kind of left auricle ligation device, it is made up of outer sheath 5, interior sheath 6, push rod 9, lock tube 2 and ligature 1, epitheca
The near-end 7 of pipe 5 is equipped with external screw thread female Luer, and distal end 4 forms with interior sheath 6 and is fitted close；In the near-end 8 of interior sheath 6 connects
Screw thread female Luer, interior sheath 6 is loaded on inside outer sheath 5, and junction portion forms spiral connection, and interior sheath 6 is than outer sheath 5 slightly
Long, the distal end 3 of interior sheath 6 exposes to outer sheath；Push rod 9 passes through interior sheath 6, and its distal end is welded with screw 23, and near-end has behaviour
Make handle 10, it is characterised in that lock tube 2 is a cylinder, and one end diameter of cylinder is slightly larger to form step 13 with other parts,
There is inner bolt hole 14 at slightly larger one end center, there are two through holes 12,16, one of through hole in the both sides parallel with inner bolt hole 14
Tangented position be equipped with a wire casing 15, the width of wire casing 15 slightly larger than ligature 1 diameter but be less than the diameter of knot 19, wire casing
15 length exceedes the position of step 13；Ligature 1 is made into " jade pendant rope " shape, and a knot 19, knot 19 are made a call to every one section
Diameter be slightly smaller than the diameter of through hole 12,16, the distance between knot and knot are two times of knot diameters, first knot 20
Diameter is more than the diameter of through hole 12, and the never slotted through hole 12 of the end of a thread passes through, and after the other end forms annulus 21, has been then passed through
The through hole 16 of fluting.
Preferably, lock tube 2 is a metal cylinder, and the opening of two through holes of lock tube 2 has chamfering 11,17, wire casing 15
There is chamfering 18 with through hole intersection.
Preferably, outer sheath is made of polytetrafluoroethylene PTFE, and interior sheath is made of high density polyethylene, Shandong
Your joint material is ABS；Seal wire of the push rod by stainless steel material SUS304 windings as spring-like；Lock tube using it is medical not
Rust steel 316L is made；Ligature is using conventional surgical sutures.
Preferably, the 4 tapered closing in of distal end of outer sheath 5, its taper close up to be formed with interior sheath 6 and are fitted close；Interior sheath
The distal end 3 of pipe 6 is in tip configurations, and the tip configurations expose to outer sheath 5.
Beneficial effect：
Using the left auricle ligation device of the present invention, following beneficial effect can be obtained：
1. wound is small：Due to using through thoracoscope ligation, without opening chest, preventing from scar.
2. risk is small：Easily there are the complication such as apparatus embolism, cardiac tamponade in percutaneous transcatheter occlusion, and the ligation of the present invention
Art effect is reliable, without other complication.
It is 3. fixed：According to left auricle of heart anatomical structure, left auricle of heart forms neck with atrium sinistrum junction, using ligation side
Formula can be solid and reliable.
4. significant effect：Using ligature type, blood flow is set to block completely, in the absence of residual shunt phenomenon in percutaneous transcatheter closure.
Brief description of the drawings
Fig. 1 is the left auricle ligation device schematic diagram of the present invention；
Fig. 2 is the perspective view at a visual angle of lock tube；
Fig. 3 is the perspective view with Fig. 2 visual angle into 90 degree of another visual angle of lock tube；
Fig. 4 is the bottom view of lock tube；
Fig. 5 is ligature schematic diagram；
Fig. 6 is the installation diagram of ligature and lock tube；
Fig. 7 is the schematic diagram of push rod；
Fig. 8 is apparatus for ligating tightening state schematic diagram；
Fig. 9 is the state diagram of ligaturing left atrial appendage.
In figure：1 ligature；2 lock tubes；Sheath distal end in 3；4 outer sheaths distal end；5 outer sheaths；Sheath in 6；7 outer sheaths
Near-end；Sheath near-end in 8；9 push rod；10 operating handles；11 chamferings；12 through holes；13 steps；14 inner bolt holes；15 wire casings；16 is logical
Hole；17 chamferings；18 chamferings；19 knots；20 first knots；21 annulus；22 ligation the end of a thread；23 screws.
Embodiment
The present invention is further described below in conjunction with accompanying drawing.It will be appreciated that accompanying drawing and description are only with the side of example
Formula description of a preferred embodiment thereof, and should not be construed as being construed as limiting protection scope of the present invention, protection model of the invention
Enclose and only limited by claims.
1. structure explanation
Referring to Fig. 1, left auricle ligation device of the invention is by outer sheath 5, interior sheath 6, push rod 9, lock tube 2 and ligature
1 composition.The near-end 7 of outer sheath is equipped with external screw thread female Luer, the distal end tapered closing in of 4 conduits, and its taper closes up and interior sheath
Formed and be fitted close；Interior sheath near-end 8 connects internal thread female Luer, and distal end 3 is in tip configurations, and interior sheath 6 is loaded on outer sheath 5
Inside, junction portion form spiral connection, and interior sheath 6 is slightly longer than outer sheath 5, and the tip configurations of interior sheath 6 expose to outer sheath
5；Push rod 9 passes through interior sheath, and its distal end is welded with precision screw 23, and near-end has operating handle 10, as seen in Figure 7；Lock tube 2 is
One metal cylinder, one end diameter of cylinder is slightly larger to form step 13 with other parts, has interior spiral shell at slightly larger one end center
There are two through holes 12,16 on hole 14, the both sides parallel with inner bolt hole 14, and the opening of two through holes has chamfering 11,17, one of them
The Tangented position of through hole is equipped with a wire casing 15, and wire casing 15 has chamfering 18 with the intersection of through hole 16, and wire casing width is slightly larger than ligature
Diameter, wire casing length exceed stepped locations；Ligature 1 is conventional surgical sutures, is fabricated to " jade pendant rope " shape, is beaten every one section
One knot 19, knot diameter are slightly smaller than through-hole diameter and are more than wire casing diameter, and the distance between knot and knot are two times of knot diameters,
First knot 20 is more than through-hole diameter, and the never slotted through hole 12 of the end of a thread passes through, and after the other end forms annulus 21, then wears
Cross slotted through hole 16.In use, interior sheath 6 is loaded in outer sheath 5, female Luer screws, and push rod 9 passes through interior sheath
6, the precision screw 23 of the distal end of push rod 9 is connected with the spiral of inner bolt hole 14 of lock tube, and ligation the end of a thread 22 is through interior sheath 6 in near-end
Female Luer expose outside.
2. material explanation
Outer sheath uses polytetrafluoroethylene (PTFE)（PTFE）It is made, interior sheath uses high density polyethylene (HDPE)（HDPE）It is made, Rule
Joint material is ABS；Push rod is wound in the seal wire of spring-like by stainless steel material SUS304；Lock tube uses medical stainless steel
316L is made by micro machining；Ligature is using conventional surgery polyester suture line.
3. description of the process
The distal end of outer sheath is mechanically connected through thermoplastic tapering closing in shape, near-end thermoplastic into horn-like with female Luer；
Interior sheath distal end is through thermoplastic into tip configurations, near-end and the gluing connection of female Luer；Push rod is spring-like seal wire, and distal end is welded
There is precision screw, near-end is equipped with handle；Lock tube is processed into stainless steel bars through precision optical machinery；Ligature can by hand knot and obtain
.
4. operation principle
The present invention uses the threading mode of the special construction and " jade pendant is restricted " ligature of lock tube, under the guiding of thoracoscope,
The garden ring that ligature is formed is placed on left auricle of heart, be at left auricle of heart by push rod adjustment ligature is connected with atrium sinistrum
Neck, pull one end of exposed ligature, larger knot is stuck in outside through hole because diameter is more than through hole internal diameter, other
Knot diameter is less than through hole internal diameter, and with tightening up ligature, and there is chamfering through hole front end, it is easy into through hole, knot
By through hole and after exposing, because wire casing incision has chamfering, ligature is put into wire casing, because wire casing width is less than knot
Diameter, and there is step at wire casing end, and knot, which is stuck in groove, will not delay pine, and so as to tighten by bundle object, push rod can aid in grabbing
Left auricle of heart is caught, and plays a part of adjustment position, force balance during ligature is tightened up, is tightened up after ligature reversely
Rotation push rod exits in vitro, then exits interior outer sheath, cuts unnecessary ligature.
5. the application method of the present apparatus
1st step, first by interior sheath loaded in outer sheath, female Luer screws；
2nd step, surgical sutures are fabricated to " jade pendant rope " ligature, ligature is installed on lock tube；
3rd step, ligature is passed through into interior sheath, the end of a thread is exposed to outside female Luer, and drawing exposed the end of a thread will push
Bar passes through interior sheath, and push rod distal end precision screw is connected with lock tube inner bolt hole spiral, and elastic appropriateness, spinning in and out are several times；
4th step, lung cancer import sheath, and under thoracoscope guiding, the annulus of ligature is placed on left auricle of heart, adjusted
The position of ligature is at root；
5th step, push rod is balanced, reels ligature, knot enters through hole one by one, until after tightening up, knot is stuck in wire casing
It is interior and there is step to block, pine can not be delayed, so as to ligature left auricle of heart；
6th step, rotate counterclockwise push rod, lock tube separate with push rod, exit push rod and interior outer sheath, and it is unnecessary to cut off
Ligature, complete the operating process of whole device.
Embodiments of the present invention are described in detail above in conjunction with accompanying drawing, but the invention is not restricted to above-mentioned implementation
Mode, in art those of ordinary skill's possessed knowledge, present inventive concept can also not departed from
Under the premise of make a variety of changes.
Claims (2)
- A kind of 1. left auricle ligation device, by outer sheath（5）, interior sheath（6）, push rod（9）, lock tube（2）And ligature（1）Group Into outer sheath（5）Near-end（7）Equipped with external screw thread female Luer, distal end（4）With interior sheath（6）Formed and be fitted close；Interior sheath （6）Near-end（8）Connect internal thread female Luer, interior sheath（6）Loaded on outer sheath（5）Inside, junction portion form spiral and connected Connect, interior sheath（6）Compare outer sheath（5）It is slightly long, interior sheath（6）Distal end（3）Expose to outer sheath；Push rod（9）Through interior sheath Pipe（6）, its distal end is welded with screw（23）, near-end has operating handle（10）, it is characterised in that lock tube（2）For a cylinder, circle One end diameter of cylinder forms step slightly larger than other parts（13）, have inner bolt hole at slightly larger one end center（14）, with interior spiral shell Hole（14）There are two through holes on parallel both sides（12、16）, the Tangented position of one of through hole is equipped with a wire casing（15）, wire casing （15）Width be slightly larger than ligature（1）Diameter but be less than knot（19）Diameter, wire casing（15）Length exceed step （13）Position；Ligature（1）" jade pendant rope " shape is made into, a knot is made a call to every one section（19）, knot（19）Diameter slightly Less than through hole（12、16）Diameter, the distance between knot and knot are two times of knot diameters, first knot（20）Diameter More than through hole（12）Diameter, the never slotted through hole of the end of a thread（12）Pass through, annulus is formed in the other end（21）Afterwards, it is then passed through Slotted through hole（16）, wherein, lock tube（2）For a metal cylinder, lock tube（2）The openings of two through holes have chamfering （11、17）, wire casing（15）There is chamfering with through hole intersection（18）, outer sheath（5）Distal end（4）Tapered closing in, its taper are received Mouth and interior sheath（6）Formed and be fitted close；Interior sheath（6）Distal end（3）In tip configurations, the tip configurations expose to outer sheath （5）.
- 2. left auricle ligation device as claimed in claim 1, it is characterised in that outer sheath uses polytetrafluoroethylene (PTFE)（PTFE）System Into interior sheath uses high density polyethylene (HDPE)（HDPE）It is made, female Luer material is ABS；Push rod is by stainless steel material SUS304 windings turn into the seal wire of spring-like；Lock tube is made of medical stainless steel 316L；Ligature is using conventional surgical stapling Line.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310417188.5A CN103462668B (en) | 2013-09-13 | 2013-09-13 | A kind of left auricle ligation device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310417188.5A CN103462668B (en) | 2013-09-13 | 2013-09-13 | A kind of left auricle ligation device |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN103462668A CN103462668A (en) | 2013-12-25 |
| CN103462668B true CN103462668B (en) | 2018-03-23 |
Family
ID=49787884
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201310417188.5A Active CN103462668B (en) | 2013-09-13 | 2013-09-13 | A kind of left auricle ligation device |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN103462668B (en) |
Families Citing this family (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP6249824B2 (en) * | 2014-02-28 | 2017-12-20 | オリンパス株式会社 | Atrial ligation instrument and atrial ligation system |
| CN103932792A (en) * | 2014-03-28 | 2014-07-23 | 郝博 | Lasso for holding and positioning rectal |
| CN104939887B (en) * | 2014-03-28 | 2019-03-26 | 上海微创电生理医疗科技有限公司 | Pericardium endoscope, lasso trick device and heart left auricle of heart closed system |
| JP6345465B2 (en) * | 2014-03-31 | 2018-06-20 | オリンパス株式会社 | Atrial ligation instrument |
| CN106137292B (en) * | 2015-04-10 | 2019-02-22 | 上海市同济医院 | A kind of device for left auricle of heart ligation operation |
| CN106491134A (en) * | 2016-10-18 | 2017-03-15 | 宁波市第医院 | Left auricle of heart measuring method in left atrial appendage occlusion art |
| JP6669926B1 (en) * | 2019-07-22 | 2020-03-18 | フォースエンジニアリング株式会社 | Ligator |
| CN111631775A (en) * | 2020-06-10 | 2020-09-08 | 昆山市锦溪人民医院(昆山市老年医院) | Left auricle ligation closing device |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101057789A (en) * | 2006-04-21 | 2007-10-24 | 深圳市先健科技股份有限公司 | Device for ligaturing left atrial appendage and using method thereof |
| CN103118605A (en) * | 2010-06-26 | 2013-05-22 | 瓦索斯蒂奇股份有限公司 | Method and apparatus for transapical access and closure |
| CN203539402U (en) * | 2013-09-13 | 2014-04-16 | 徐州亚太科技有限公司 | Left atrial appendage ligation device |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8109968B2 (en) * | 2003-05-07 | 2012-02-07 | Anpa Medical, Inc. | Suture lock |
| US20080312664A1 (en) * | 2007-05-21 | 2008-12-18 | Epitek, Inc. | Left atrial appendage closure |
-
2013
- 2013-09-13 CN CN201310417188.5A patent/CN103462668B/en active Active
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101057789A (en) * | 2006-04-21 | 2007-10-24 | 深圳市先健科技股份有限公司 | Device for ligaturing left atrial appendage and using method thereof |
| CN103118605A (en) * | 2010-06-26 | 2013-05-22 | 瓦索斯蒂奇股份有限公司 | Method and apparatus for transapical access and closure |
| CN203539402U (en) * | 2013-09-13 | 2014-04-16 | 徐州亚太科技有限公司 | Left atrial appendage ligation device |
Also Published As
| Publication number | Publication date |
|---|---|
| CN103462668A (en) | 2013-12-25 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CN103462668B (en) | A kind of left auricle ligation device | |
| US10940006B2 (en) | Mitral cerclage annuloplasty apparatus | |
| WO2012163257A1 (en) | Left atrial appendage occluder | |
| US20180146964A1 (en) | Cinch and post for tricuspid valve repair | |
| CN105943215B (en) | A kind of overlay film frame conveying and its remotely located release system | |
| CN204246182U (en) | A kind of novel umbrella occluder for left auricle | |
| CN100453053C (en) | Device for ligaturing left atrial appendage and using method thereof | |
| CN206852642U (en) | A kind of device for taking cerebrovascular thrombus | |
| WO2016049991A1 (en) | Left atrial appendage occlusion apparatus | |
| JP2014525809A (en) | Mitral valve circular surgery device | |
| CN103889339A (en) | Devices and methods for occluding abnormal openings in a patient's vasculature | |
| US20190336114A1 (en) | Internal jugular carotid closure device | |
| JP6332889B2 (en) | Achilles tendon suture device | |
| CN201394038Y (en) | Hepatic portal occlusion device | |
| WO2023231186A1 (en) | Bending-adjustable delivery system | |
| JP6469134B2 (en) | Convertible renal ureteral catheter | |
| CN203539402U (en) | Left atrial appendage ligation device | |
| WO2022068202A1 (en) | Medical lock catch and medical locking device | |
| CN102028510A (en) | Conveyor device | |
| JP7258890B2 (en) | knot delivery device | |
| CN217907855U (en) | Device for closing tissue | |
| US20230048179A1 (en) | Edge to edge repair of the mitral valve | |
| CN109224255A (en) | Gall bladder bile inner drainage tube and embedded device | |
| CN107019530A (en) | A kind of across valve device | |
| CN106137292B (en) | A kind of device for left auricle of heart ligation operation |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| GR01 | Patent grant | ||
| GR01 | Patent grant |