CN103637824B - By the device heart window device for posting of the heart window merging chambers of the heart - Google Patents

Abstract

Auricle is cut safely under the conditions of minimally invasive the present invention relates to a series of, and heart window is sent into auricle, and the heart window device for posting for the device that is fixed.Window device for posting includes the cutter for cutting auricle and its adjusting portions point；Sheath part；With implantation material propeller.The cutter of the heart window device for posting includes combination incision knife, three leaf knives and three kinds of monomer knife with three edges.Their effect is to cut auricle for different size of auricle and be expanded to sufficiently large notch.Its extension rod can not only be collected cutter by sheath, and heart window is sent into the chambers of the heart and covers auricle in heart window outer surface by the guide rail that the laying outside sheath extension rod and sheath is also used as the merging of heart window.Implantation material propeller generates the power of equably centripetal intracavitary promotion, and heart window is steadily pushed into the chambers of the heart.

Description

By the device heart window device for posting of the heart window merging chambers of the heart

Technical field

The present invention relates to field of medical technology, more particularly to one kind to cut auricle safely under the conditions of minimally invasive, will be by external The medical device for carrying out heart transluminal operation is sent into auricle, and the heart window device for posting for the device that is fixed.

Technical background

The operative treatment of heart comes into the minimally invasiveization epoch at present.The brainstrust of the inside and outside section of heart is all in respective neck Domain is made that effort, and also all achieves gratifying achievement.

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.

Therefore, the present invention has started a kind of completely new Minimally Invasive Surgery approach, by means of video-assisted thoracoscope, establishes one in auricle A medical device (ZL201010514767.8 hereinafter referred to as heart window) by carrying out heart transluminal operation in vitro with check valve.This Sample can be safe and accurately implantation heart specific under conditions of being detached from extracorporal circulatory system by some biggish implantation materials Position.

According to previous method, the merging in this channel can be under thoracoscope monitoring, by means of classical surgical instrument Auricle is cut, notch is retracted by channel 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, surgical procedure is complicated, and any one link is made a fault, and can all cause to perform the operation out Blood.In this case, on the one hand operative incision increasing damage will be expanded by carrying out rescue, while also increasing the risk of operation.

For this purpose, the invention one kind can safely cut auricle, and the guide rail as the merging of heart window, surely It is fixed and heart window is safely placed in auricle between sheath extension rod and sheath laying, and by its than more securely with the heart The fixed heart window device for posting of ear.

Summary of the invention

The present invention, which provides one group, can accurately cut auricle, and can be used as guide rail, will have check valve Pass in and out the doctor that the channel (ZL201010514767.8 hereinafter referred to as heart window) of heart is placed in auricle safely and fixes it with auricle Treat device-heart window device for posting.

The heart window device for posting includes that the cutter for cutting auricle and its adjusting part, sheath part and implantation material promote Device.

The cutter of heart window device for posting and its function of adjusting part are that auricle is made three in auricle privileged site to be in 120 ° of radial incisions being spaced apart, and notch is expanded to degree required for operation.

The cutter of heart window device for posting includes combination incision knife, three leaf knives and three kinds of monomer knife with three edges.Each group of incision knife needle Different size of auricle is cut, and incision knife method is also different.

Combination incision knife is used to cut the auricle of larger (the especially biggish adult of figure).

Combination incision knife is divided into center cutter incision knife, lateral incision knife, sheath portion, center incision knife regulation platform and lateral Incision knife calibrates 5 part of frame composition:

Center cutter incision is divided into head, body portion and tail portion

Center incision knife head is triangular pyramid.Its tip attenuate for trigone it is needle-shaped.Knife rib caudad continues up to 5-6mm. Knife with three edges tail end central part is connect with pull rod.

The body portion of center incision knife be it is rod-shaped, connect at its end with control handle.

Three pull rods of cutter hub portion pull rod and following lateral incision knifes are cut at center, are concealed in the same cone rod shape jointly In the sheath of body.The body rod of center incision knife is located in the central duct of sheath.

It is known as center incision knife regulation platform in the platform that the tail end sheath adjutage of sheath constitutes a tripod.Center Therefrom anxious regulation platform centre bore of operating on passes through incision knife body rod, and incision knife handle and incision knife retraction spring are from tail end to head End is successively socketed in center incision knife body rod end, adjusts socket length of the incision knife handle on body rod, can be with inverse proportion Adjusting center incision knife (or lateral incision knife) stretches out the length of sheath, and such length not only guarantees incision knife whole blade Auricle is cut, but also can guarantee that the cutter head of incision knife is unlikely to too long and enters the chambers of the heart and injury of myocardium.Be socketed in sheath and Spring between incision knife handle guarantee incision knife cut auricle after, immediately by incision knife rebound sheath guarantee will not damage the heart Flesh.

Lateral incision knife divides head body portion and tail portion.

The head of lateral incision knife:

The head of lateral incision knife and knife with three edges continue, and the blade that is separated by three and its strut bar and form.Each knife The head end of piece is connected with corresponding center cutter rib with rivet joint, and tail end is with rivet joint and struts pole interlinking.

The head end bifurcated of three corresponding lateral incision knife pull rods, respectively there is an axis hole in two diverging arms, be used to The axis mother for strutting the tail end of bar forms axis joint connection.

Lateral incision knife and its strut bar accordingly, occupy additional space intrathecal, these spaces are formed three A conduit.Conduit where these conduits knife rib corresponding to knife with three edges is in identical plane.Lateral incision knife and corresponding Strutting bar can free to slide in these slots and part stretching sheath.

The outer surface of sheath has sheath laying.When sheath push enters notch, the spongy layer of laying is pressed Be forced to two sides expansion, can part closing sheath cutter groove front end, play anastalsis.When being cut to auricle, liner Layer is not affected by pressure, incision knife and struts bar in the cutter groove of sheath and can be free to slide and stretches out sheath.

The body portion of lateral incision knife:

The body portion of lateral incision knife is three pull rods.The bifurcated axle of three pull rod head ends is wider, for bifurcated axle in sheath The position of operation forms corresponding slideway.

The tail portion of lateral incision knife:

The corresponding pull rod of three lateral incision knifes structure on being distally fixed on common tripod together with center cutter pull rod Frame is calibrated at lateral incision knife.

The centre bore of lateral incision knife calibration frame passes through center incision knife；In addition three feet are each passed through three side cuts The pull rod operated on.

Lateral incision knife pull rod is pushed when three lateral incision knifes collapse head-end, its head end is made to reach the termination of slideway head end Point is simultaneously fixed with calibration frame.Fixed sheath, caudad pulls center cutter pull rod, opens lateral incision knife to outside sheath side wall It opens, it, will be corresponding to the centre bore tail end plane of lateral incision knife calibration frame when lateral incision knife blade is Chong Die with sheath surface Center incision knife pull rod position mark be 0 point；Continue caudad to pull center incision knife pull rod, when lateral incision knife is to knife It is 1 in the corresponding position mark of center incision knife pull rod when opening 1mm outside sheath side wall；When lateral incision knife is to outside sheath side wall It is 2 in corresponding position mark when opening 2mm；3,4,5...... are marked in the same way.There are these to mark, so that it may To carry out quantitative control to the degree of cutting of lateral incision knife in lateral incision knife calibration frame.

Equally, adjust three groups of lateral incision knifes so that 0 point of center incision knife pull rod with calibrate frame tail end plane pair It answers, calibration frame is fixed with center incision knife pull rod.The pull rod of lateral incision knife and lateral incision knife are calibrated into frame tail end at this time Position mark corresponding to plane is 0, and head-end pushes lateral incision knife pull rod, makes to open 1mm with the lateral incision knife organized, Calibrating position mark corresponding to frame tail end plane is 1；Continue to push away the pull rod, lateral incision knife opens 2mm and is labeled as 2；With same Sample loading mode mark 3,4,5.......

The label of lateral incision knife has effect: after the completion of three groups of lateral incision knifes are adjusted jointly, head-end push Some lateral incision knife pull rod reaches a certain scale, can make the lateral incision knife than other two lateral incision knifes in this way, The notch cut increases.The incision length quantity more cut is equal to the lateral incision knife pull rod head-end and pushes the scale reached.

Regulation so is done in lateral incision knife, effect is when notch deviates ideal position, it is necessary to some Direction expands notch.After the completion of lateral incision knife is adjusted jointly, regulation needs to expand the lateral incision knife of notch side, so that it may Notch to be expanded to the side, plays the role of correction in subsequent cutting.

After the incision distance setting of lateral incision knife, push sheath is allowed to sufficiently expand original auricle notch, fixed sheath. Tail end incision knife handle is pressed, lateral incision knife will stretch out sheath and cut auricle, expand original notch.

Combination incision knife sheath part is head, body portion and tail portion

It is round table-like for combining incision knife sheath head.There is the channel of center incision knife pull rod in the center portion thereof position；At three 120 Degree identical section in there are three identical open conduit, this be center incision knife head knife with three edges knife rib and with corresponding knife rib The channel of connected lateral incision knife movement.

There are the channel of center knife bar and the channel of three lateral incision knife pull rods in the body portion of sheath.

The bifurcated axle of three pull rod head ends is wider, forms corresponding slideway for the position of bifurcated axle operation in sheath.

Each slideway has head end terminating point and tail end terminating point.Head end terminating point can both make center incision knife cutter head abundant Ground stretches out the stretching sheath that sheath can prevent cutter head excessive again and accidentally injures cardiac muscle.Distance of the head end terminating point away from sheath head end= Strut length+lateral incision knife length of bar；Tail end terminating point can guarantee three lateral incision knifes and its strut bar After closing up completely (at this moment overall blade longest), center cutter can all be collected into sheath.Calculation: sheath head end is away from pull rod Length+lateral incision knife length+center incision knife cutter head length of bifurcated axle ways-end distance=strut bar.

The endpiece of sheath is thinner, wherein center cutter and lateral incision knife pull rod can be accommodated.Its end have for The screw of sheath extension rod connection.After the completion of cutting operation, the test tube sample distal end extension rod with nut is attached thereto, with regard to structure The support rod being placed at heart window.Heart window is placed in by the guide rail that sheath and sheath extension rod can be used as heart window merging auricle Auricle.

Three leaf knives are used to cut the auricle of median size (adult children and the lesser adult of figure).

Three leaf knives are made of knife leaf, interior adjusting rod, outer adjusting rod and sheath.

Knife leaf is divided into blade, neck and pedestal.

Blade is triangle, and after three blades close up, knife spine is fitted closely, and three knifes edge are in the distribution of 120 ° of interval.Its point End becomes trigone point of a knife, and three blades form knife with three edges.

The knife spine portion of neck is in arc-shaped defect, only retains the knife edge and portion blade body portion.After three blades close up, neck Three defects in portion form a vacancy, this vacancy can accommodate head end free-running operation when regulating and controlling knife leaf of interior adjusting rod.

The pedestal of knife leaf is double-vane shape.Each alar part is seen from side as 3/4 circle.At the position of the circle of tail end 1/2 of knife leaf For half gear.

Interior adjusting rod is divided into head, body portion and tail portion.

The head of interior adjusting rod be it is cylindric, outer surface be the tooth road mutually chimeric with the gear of the pedestal of knife leaf.Work as knife After leaf and the assembly of interior adjusting rod and outer adjusting rod are complete, the tooth road and the gear of knife tea residue seat of interior adjusting rod are mutually twisted, to Head end pushes interior adjusting rod that knife leaf is opened, and becomes the three leaf knives that three knife leaves are in 120 ° of openings；Caudad adjusted in drawing Bar holds together knife hinge, becomes the knife with three edges of standard.

The body portion of interior adjusting rod is elongated rod shape, passes through the overall length of outer adjusting rod and connect with the tail portion of interior adjusting rod.

The tail portion thickening of interior adjusting rod, inner containment are used to change the sliding of interior adjusting rod and outer adjusting rod socket length Tooth.

Slide teeth is U-shaped, long-armed with one, outside the long-armed wall for stretching out adjusting rod, can press and adjust slide teeth collection In in the slot of interior adjusting rod, referred to as adjusting knob.The galianconism end of slide teeth has tooth engaged.

There is a columned chamber in long-armed body central, it is intracavitary to accommodate columned guidance pin.

Have an arciform spring leaf in the bottom of guidance pin, the center at spring leaf bow top have one for guidance pin across Hole.

The internal cavities long-armed across slide teeth are sold in guidance, while again through the centre bore of spring leaf, and therefore, guidance pin is just Slide teeth and spring leaf are connected as one.

Long-armed done in the U slot of interior adjusting rod with interior adjusting rod long axis of guidance pin guidance is in 90 ° of movement.

It is long-armed to press slide teeth, movement in the inside adjusting rod body of this slide teeth, and then the tooth engaged of galianconism is also inwardly adjusted Pole internal contraction.At this moment the tooth engaged of galianconism is just separated with the tooth road (seeing below) of outer adjusting rod inner wall.At this moment interior adjusting rod It can be free to slide between outer adjusting rod.

Unclamp slide teeth it is long-armed, spring leaf bounces, push the inside adjusting rod of slide teeth outer surface movement, slide teeth it is short The tooth engaged of arm is engaged with the tooth road of outer adjusting rod inner wall, so that interior adjusting rod and outer adjusting rod can only move together.

Outer adjusting rod is made of head, body portion and tail portion.

Outer adjusting rod is the pipeline between sheath and interior adjusting rod.

There are three groups of knife leaf brackets on the head of outer adjusting rod.So-called knife leaf bracket is substantially the special convex of outer adjusting rod head end The support rod risen, support rod have axis hole and knife tea residue seat to form axis joint.

The head end of cylindric outer adjusting rod, respectively there is a notch, such notch in the two sides of each knife leaf bracket Two arms of knife tea residue seat can be accommodated, after knife tea residue seat and knife leaf bracket form axis joint, knife leaf can surround knife leaf bracket Rotation.

Three groups of knife leaf brackets adjust the bit distributions such as 120 ° of rod head end interval outside, and the position between knife leaf bracket is by outer adjusting The tube wall of bar extends.Knife leaf forms axis joint with knife leaf bracket by means of pedestal and connect.Such three groups of knife tea residues seat, knife leaf The extension of bracket and outer adjusting rod forms a circular functional area.

Each knife tea residue seat in the region and the interior tooth road for adjusting club head are chimeric mutually.Interior adjusting rod is in outer adjusting rod Inside do the movement of head-end, each knife leaf opens, when the blade of knife leaf and outer adjusting rod are presented close to 90 °, be set as in The limit of rod head end movement is adjusted, the slide teeth of interior adjusting rod is long-armed when reaching this limit is exactly in contact with outer adjusting rod tail end； Interior adjusting rod does movement caudad in outer adjusting rod, and three knife leaves to closing up together, when the knife spine of three knife leaves closely pastes After conjunction, three knife leaves constitute knife with three edges.

The body portion of outer adjusting rod is the long tubular structure being socketed in outside interior adjusting rod.Body portion connects caudal a distance, The outside of outer adjusting rod is socketed retraction spring.

The tail end caliber of outer adjusting rod expands, and internal diameter is equal to interior adjusting rod tail end caliber, and outer diameter is equal to internal diameter and adds tube wall 2 times of thickness.

Due to the expansion of transferring pole caliber, a step is formed at the position.The tail end pair of the step and retraction spring It connects.

The length of retraction spring is determined by the maximum length that the compression minimum length and knife leaf of spring stretch out sheath.Spring Maximum extension length=spring compression minimum length+knife leaf stretches out the maximum length of sheath.

The position corresponding with interior adjusting rod slide teeth in the caudal end of outer adjusting rod, tube wall, has for embedding with tooth engaged The road He Chi.The slide teeth of adjusting rod is long-armed in internal pressure, the inner wall of the pointed tooth of the galianconism head end of slide teeth and outer adjusting rod it The separation of tooth road, can be such that interior adjusting rod moves in outer adjusting rod；The slide teeth of adjusting rod is long-armed in unclamping, slide teeth galianconism head The pointed tooth at end is engaged with the tooth road of the inner wall of outer adjusting rod, is fixed to each other between interior adjusting rod and outer adjusting rod, therebetween not It can be mobile.

The sheath of three leaf knives is the outermost layer pipeline configuration of incision knife.The head end of pipeline is round table-like.In round table-like head Holding the corresponding position of three knife leaves, there are three open windows.

The endpiece of rotary table does not have window, and the internal diameter of the position rotary table lumen is larger, can store three knife leaves, the knives closed up Tea residue seat, and the head end of outer adjusting rod.

Knife hinge is held together as knife with three edges, and head-end pushes adjusting rod, the cutter head of knife with three edges stretch out sheath can to auricle into The preliminary cutting of row；Due to the long-armed inhibition with outer adjusting rod end of slide teeth, prevent knife leaf is from being transitioned into stretching sheath Except.

Knife leaf can stretch out sheath when opening by window, and window also provides operation channel for the movement of knife leaf. After the completion of preliminary cutting, pressing slide teeth is long-armed, separates interior adjusting rod with outer adjusting rod.Head-end pushes interior adjusting rod, makes It obtains knife leaf and opens three leaf knives of formation in the chambers of the heart.It is long-armed to unclamp slide teeth, is engaged slide teeth with the tooth road of outer adjusting rod, it is inside and outside Adjusting rod fixation is integrally formed, and caudad pulls adjusting rod, and three leaf knives can caudad move in the window of sheath, while Auricle just has been cut, has expanded preliminary notch.

Monomer knife with three edges, which is used to cut lesser auricle, is particularly suitable for pediatric patient.

Monomer knife with three edges collapses sheath by trigone center cutter, cutter head, cutter head collapses pinion stand and sheath forms.

Trigone center cutter divides head, body portion and tail portion.

The head of trigone center cutter is made of three bow-shaped arms, trigone point of a knife and three groups of blades.

The head end of three bow-shaped arms is integrated to be connect with the tail end of trigone point of a knife, and the tail end of three bow-shaped arms is integrated It is connect with the body portion of trigone center cutter, three bow-shaped arm equipotentials are spaced apart in 120 °, and its center line and trigone point of a knife Corresponding blade is in approximately the same plane.

With the identical plane of blade of corresponding trigone point of a knife on the center line of bow-shaped arm, three groups of same knives are installed Piece.Every group of blade is in a rectangular trapezoid, successively caudad arranges from head end.And the knife edge of the knife edge of trapezoidal blade and knife with three edges exists On same straight line.Each group of blade is made of 2-3 blade.There is the gap of 1mm between each blade.Therefore, in arch When the arch radian of arm changes, blade will not all generate resistance.

The body portion of trigone center cutter is elongated rod shape, and head end connects the tail end of bow-shaped arm, and tail end is connect with tail portion.

The tail portion of trigone center cutter is the continuity of body rod.Have at the position close to tail end for the annular tooth with engaged gears Road.Tooth road is greater than the diameter of tail end body rod, and the diameter of tail end body rod is equal to the diameter of two sides tooth road bottommost body rod.In tail portion Compared with some orientation of front end, there is the hoodle that can pass in and out body rod surface on body rod surface.

It is the long tubular structure being socketed in outside trigone center cutter body rod that cutter head, which collapses sheath,.Its head end and trigone center cutter phase There is corresponding sliding groove at the position for the bow-shaped arm answered.Its caudal part and trigone center cutter body rod tail end hoodle to corresponding position, The track for having hoodle to slide, the tube wall that the tail end of track collapses sheath open a tail end pull rod hoodle deck.The tail end pull rod hoodle The position of deck the case where the gathering of trigone center cutter head by determining: when the knife edge of trigone point of a knife and three groups of blades is all stowed to In sheath, the hoodle on trigone center cutter tail portion body rod surface is just embedded in tail end pull rod hoodle deck.

It is the cylinder spline structure for being socketed in trigone center cutter tail portion that cutter head, which collapses pinion stand, has a tooth in the side of cylinder Window is taken turns, taking turns outside window is gear storehouse, and a gear is installed in gear storehouse.

The cylindrical portion that cutter head collapses pinion stand is socketed on the body rod of trigone center cutter, forward end promotes, so that gear Gear in storehouse is engaged with the road body rod Shang Chi.Gear handle is rotated, cylindrical portion end motion forward is pushed, pushes cutter head accordingly The movement of sheath head-end is collapsed, the head end that cutter head collapses sheath will squeeze three bow-shaped arms to closing up together.When trigone point of a knife and three The knife edge of group blade is all stowed in sheath, and the hoodle on trigone center cutter tail portion body rod surface is just embedded in the tail end drawing for collapsing sheath In bar hoodle deck.At this moment trigone center cutter is just all taken within sheath.It, can be with after trigone center cutter is concealed in sheath Cutter head is collapsed pinion stand to remove from trigone center cutter tail end body rod.

When needing using trigone center cutter, pressing cutter head collapses the hoodle in the tail end pull rod hoodle deck of sheath tail end, gently Micro- head-end pushes the body rod of trigone center cutter, and hoodle enters cutter head and collapses in the hoodle track of sheath.By means of trigone center The elastic force of three bow-shaped arms of knife, cutter head shape skid off sheath.Head-end pushes the tail end body rod of trigone center cutter, trigone center Knife can cut auricle.

The sheath of monomer knife with three edges is identical as the sheath of three leaf knives, and head end opens the going out for blade there are three window Enter, body portion and tail end are socketed in cutter head and collapse on sheath.

The sheath part of various incision knifes is the boxroom and regulation main body of incision knife.

When without cutting action, cutter is all concealed in sheath.There is provided the receipts of cutter first for the effect of sheath Space is hidden to guarantee that cutter will not accidentally injure auricle.

Before being cut, it needs to be determined with sheath at the position that auricle is cut.It can guarantee that the setting of auricle notch exists in this way The appropriate position of auricle.

Auricle notch timely can also be blocked to protect by the sealing structure of sheath itself and the laying on its surface Demonstrate,proving auricle notch will not bleeding.

Has laying in the outer surface of sheath.The inner surface of the laying be steel wire, sheath tail portion laying with Sheath separation, steel wire extend for sheath laying and extend steel wire.The middle section of laying is plastic sponge.Its outer surface It is covered by nylon gauze.

The steel wire and sheath of laying are connected with thread gluing, (it can be plastics thread gluing, it can also be by steel wire middle line pressing mold In conduit as U-shaped ring card people's sheath), therefore heart window fixator is inserted between laying and sheath, head-end promotes the heart Window fixator, the strength that head end is applied, so that it may so that the two separates.

Sheath is in addition to the above-described functions or the main body that depends on of incision knife regulation device.Sheath is to manipulate cutter hub most Put forth effort position eventually.Sheath is after auricle positioning, and fixed sheath makes it not change with auricle position, this is subsequent operation Basis.Only on this basis, controllable cutting can be carried out to auricle, and heart window safe is placed in the chambers of the heart.

There is one section of screw for connecting with sheath extension rod in the end of sheath.The sheath of beaker sample extend rod head end with The connection of the tail end of nut and sheath.There is the tooth road with the engaged gears of heart window propeller on the surface of sheath extension rod tail end.

The screw window that there is the tail end of sheath extension rod fixed sheath laying to extend steel wire.

When centripetal intracavitary push heart window, heart window and its fixator and heart window propeller sequence are socketed in sheath and prolonged first On stocks, three sheath layings are extended into Wire pulling and are placed in its tail end in the screw window of sheath extension rod tail end, The extension fixation with steel wire that also will just tense while screwing in window with screw is in window.

In addition, it is connected to the propulsion tooth road and matched propeller of sheath extension rod end after completing cutting, it can be with Channel with check valve is placed in the chambers of the heart along this track of sheath extension rod.

Implantation material propeller is made of the body portion of tubular, gears and gears handle.

Promoting body portion is cylindrical shape, and the outer diameter of internal diameter and sheath extension rod agrees with.

Promote the head end in body portion that 90 ° of cross-section planes are presented, which is bonded with the tail end plane of heart window fixator, makes The propulsion strength for obtaining propeller can balancedly pass to heart window fixator, push the latter, while push heart window to enter auricle again.

The endpiece of propeller opens a rectangular window, and the two sides of window respectively have a pedestal to be referred to as pinion stand.Window and The distance between pinion stand, which can accommodate, promotes gear to be freely rotated therebetween.Each pinion stand has an axis hole to wear for gear shaft It crosses.After pinion stand is fixed, the tooth of gear is engaged with the tooth road of sheath extension rod gear just.

There is a gear control handle with gear axis connection.

The head of propeller is socketed on sheath extension rod, the tooth road pairing of gear and sheath extension rod.Rotate gear Control handle, propeller are moved along sheath extension rod head-end, while promoting heart window fixator and heart window head-end mobile, will Heart window is sent into auricle notch.

After heart window is placed in the chambers of the heart, the screw of the screw window of sheath extension rod end, the knife mesh liner loosened in window are unclamped Bed course extends steel wire, is allowed to separate with sheath extension rod.

Sheath is withdrawn, has also just withdrawn incision knife at the same time.

Fixed heart window fixator, so that the heart window in the merging chambers of the heart will not shift.Merge three sheath layings again to prolong Long steel wire caudad pulls sheath laying.When the laying of sheath pulls outward, the nylon gauze of outer surface and auricle Rub strength, drives the tail end of the centripetal window of auricle mobile, and due to the draw of auricle root, the auricle of notching edge is towards the heart Heart window outer surface is close in the tail end of window, chambers of the heart face, and presentation auricle, which turns up, is wrapped in heart face outside window.

The heart outside window the root auricle retractor of auricle head end place bounding wire, tightening bounding wire auricle can be tied Prick the surface for being fixed on heart window.

Detailed description of the invention

Heart window center window device for posting can be put it more precisely by means of heart window center window device for posting attached drawing and Detailed description of the invention.

The assembly side profile schematic diagram of Fig. 1 incision knife.Wherein:

1 is the cutter groove portion of sheath sectional view.

2 be lateral incision knife blade, shares three groups, each blade the head and tail end its respectively with corresponding knife with three edges and side Arm is strutted to incision knife to be connected.

3 be the arm that struts of lateral incision knife, also there is three groups, each head end for strutting arm is connected to same group and laterally cuts The tail end of knife, tail end are connected to the corresponding pull rod of rear end.

4 be center incision knife, and cutter head is knife with three edges, and body rod is elongated rod shape, and body rod tail end is connected with control handle.

5 be the cushioning surface layer of sheath.

6 be lateral incision knife pull rod.

7 be sheath body portion adjutage.

8 be center incision knife regulation platform.

9 be lateral incision knife calibration frame.

10 be incision knife regulation handle.

Fig. 2 is center incision knife diagrammatic cross-section.Wherein:

11 be the blade of center incision knife.

12 be the body rod of center incision knife.

13 be center incision knife axis hole.

Fig. 3 is lateral incision knife blade schematic diagram.Wherein:

14 be lateral incision knife bit end axis hole.

15 be lateral incision knife blade tail end axis hole.

Fig. 4 is that lateral incision knife struts arm schematic diagram.Wherein:

16 be that lateral incision knife struts arm headend axis hole.

17 be that lateral incision knife struts arm tail end axis hole.

Fig. 5 is lateral incision knife pull rod main view, left view and top view.Wherein:

18 be lateral incision knife drawhead end diverging arms.

19 be lateral incision knife drawhead end diverging arms axis hole.

20 be lateral incision knife drag link body bar.

Fig. 6 is main view, left view and the top view of lateral incision knife calibration frame.Wherein:

21 be center incision knife body rod punched out.

22 be lateral incision knife pull rod punched out.

23 be lateral incision knife pull rod and center incision knife body rod regulation nut.

Fig. 7 is center incision knife regulation platform.Wherein:

24 be center incision knife body rod punched out.

25 be sheath body portion adjutage attachment point.

Fig. 8 is incision knife control handle general assembly drawing.Wherein:

26 be incision knife handle.

27 be incision knife running length control screw.

28 be incision knife retraction spring.

Fig. 9 is sheath longitudinal section sectional view and varying cross-section sectional view.Wherein:

29 be sheath longitudinal section sectional view.

30 be center incision knife traffic coverage sectional view.

31 be lateral incision knife cutter head traffic coverage sectional view.

32 be lateral incision knife pull rod front end diverging arms traffic coverage sectional view.

33 be lateral incision knife pull rod traffic coverage sectional view.

34 be sheath tail end cross-sectional view.

Figure 10 is that sheath and heart window propeller are always equipped with figure.Wherein:

35 be sheath.

36 be sheath laying.

37 be sheath extension rod.

38 be heart window propeller rack.

39 be that heart window propeller promotes dry and heart window and heart window fixator.

40 be that sheath laying extends steel wire.

Figure 11 is the general assembly drawing of three leaf knives.

41 be the interior adjusting rod of three leaf knives.

42 be slide teeth.

43 be guidance pin.

44 be spring leaf.

45 be knife leaf bracket.

46 be knife leaf.

47 be outer adjusting rod.

48 be sheath.

49 be regulation spring.

Figure 12 is the general assembly drawing of adjusting rod in three leaf knives (interior adjusting rod is connected with center-pole).

50 be the long-armed channel of slide teeth.

51 be slide teeth galianconism channel.

52 be center-pole, and head end has multiple tracks ring tooth.

Figure 13 is slide teeth general assembly drawing.

53 be that slide teeth is long-armed.

54 be slide teeth galianconism.

55 be guidance cotter way road.

Figure 14 is guidance pin.

56 be guidance pin main view.

Figure 15 is spring leaf general assembly drawing.

57 be spring leaf main view.

58 be guidance pin channel.

Figure 16 is knife leaf bracket general assembly drawing.

59 be knife leaf bracket main view.

60 be knife leaf bracket side view.

61 be knife leaf joint axis hole.

Figure 17 is knife leaf general assembly drawing.

62 be the blade of three leaf knives.

63 be the pedestal of three leaf knives.

64 be the joint axis hole of three leaf knife pedestals.

65 be the gear of three leaf knife pedestals.

66 be the shank of three leaf knives.

Figure 18 is the general assembly drawing of outer adjusting rod (outer adjusting rod and knife leaf bracket continue).

67 be center-pole channel.

68 be outer adjusting rod inner wall tooth road.

Figure 19 is three leaf knife sheath general assembly drawings.

69 be the head of sheath.

70 be knife leaf channel.

Figure 20 is three leaf knives regulation spring.

Figure 21 is monomer knife with three edges general assembly drawing.

71 be trigone center cutter tail end pull rod.

72 be trigone center cutter leaf.

73 be that cutter head collapses sheath.

74 be the pinion stand that cutter head collapses sheath.

75 be tail end pull rod hoodle deck.

76 be monomer knife with three edges sheath.

Figure 22 is the general assembly drawing of trigone center cutter tail end pull rod.

77 be the ring tooth of tail end pull rod.

78 be tail end pull rod hoodle.

Figure 23 is monomer trigone center cutter cutter head general assembly drawing.

79 be trigone center cutter tool arm.

80 be trigone center cutter leaf.

Figure 24 is the general assembly drawing that cutter head collapses sheath.

81 be that cutter head collapses pinion stand (built-in cutter head adjustment gear).

Figure 25 is cutter head adjustment gear.

82 be cutter head adjustment gear (gear is engaged with the ring tooth of tail end pull rod).

83 be manipulation handle.

Figure 26 is the sheath of knife with three edges.

84 be knife leaf channel.

Figure 27 is the cross-sectional view of sheath extension rod.

85 be that sheath extends bar section.

86 be the road sheath extension rod Shang Chi.

Figure 28 is the schematic diagram of implantation material propeller.

87 be the handle of the rack of implantation material propeller.

88 be the body portion of the rack of implantation material propeller.

89 be the tooth of implantation material propeller rack.

Specific embodiment

The object of the present invention is to provide a series of a kind of heart window mergings installed to heart window being made of surgical instruments Heart window safely can be installed to auricle under conditions of minimally invasive by means of heart window device for posting by device, and then by heart window micro- The fine and complicated openheart surgery that cannot still complete at present is completed under the conditions of wound.

(present invention is by three kinds of combination incision knife, three leaf knives and monomer knife with three edges differences by incision knife for the heart window device for posting Incision knife), sheath, cutter adjusting part and merging object propeller composition.

After being positioned with sheath, auricle is cut with incision knife.

Auricle cuts process, and the specific embodiment of three kinds of incision knifes is different.

The incision method of combination incision knife is:

After sheath (1) positioning, fixed sheath makes its head end be close to auricle.Auricle can be carried out by following steps Controllable preliminary cutting.

The regulation that center incision knife is pierced into auricle depth first is realized by following approach.

Referring to Fig. 1, the head end of center incision knife (4) is the 120 ° of three knife ribs (11) being angularly distributed in interval, knife rib Tail end connects center incision knife body rod (12).In the distal end of center incision knife regulation platform (8), center incision knife body rod (12) is outside It covers incision knife rebound spring (28), the tail end of the distal side center incision knife body rod (12) of incision knife rebound spring (28), which is set with, to be cut Knife handle (26).

Center incision knife regulation platform (8) is a tripod structure, three of them foot is attached by means of sheath body portion adjutage Point (25) be connected and fixed with sheath body portion adjutage (7).Center incision knife regulation platform is also possible to the extension of sheath tail end Arm is constituted.The body rod (12) of center incision knife passes through the center incision knife body rod punched out (24) of incision knife regulation platform.

Incision knife handle (26) be socketed body rod (12) length it is adjustable so that incision knife handle (26) head end with The distance between incision knife regulation platform (8) (t1) can regulate and control, and thus can adjust the length that incision knife stretches out sheath (c1).Shortest length (s1) after length (c1)=(the t1)-spring-compressed.After the length of handle belled body bar is fixed, with cutting Operate on running length control screw (27) handle (26) and center incision knife body rod (12) are fixed.

Head-end pushes incision knife handle, so that it may center incision knife (4) are pierced into auricle, done at the preset position of auricle Out-it is a to three directions radiate notch.

Incision knife handle is unclamped, by means of the elastic force of incision knife retraction spring (28), center incision knife is withdrawn into sheath.To Auricle notch pushes sheath, blocks incision hemostasis.

Under normal circumstances, the notch that center incision knife is cut is not big enough.At this moment it just needs with lateral incision knife into one Step expands notch.

Notch is expanded to the degree of operator's satisfaction by auricle after tentatively cutting, completed by lateral incision knife.

Lateral incision knife is made of identical three groups of components.Blade (2) the head end axis hole (14) of lateral incision knife with The axis hole (13) of center incision knife knife rib tail end forms joint by means of rivet；The tail end axis hole (15) of lateral incision knife and lateral Incision knife struts arm headend axis hole (16) and forms the connection of rivet joint；Lateral incision knife struts arm tail end axis hole (17) and side cut It operates on pull rod head end diverging arms (18) axis hole (19) and forms axis joint connection.When lateral incision knife pull rod (20) head-end movement, Arm (3) can be strutted by lateral incision knife makes lateral incision knife (2) to opening on the outside of sheath.The degree of opening can lead to Cross sheath (35) tail end is that lateral incision knife report control platform (9) is regulated and controled.

Three lateral incision knife pull rods (20) and center incision knife body rod (12) are distally being fixed on three common feet together Lateral incision knife report control platform (9) is just constituted on frame.

The centre bore of tripod passes through center incision knife body rod；In addition the hole on three feet is each passed through three side cuts Operate on pull rod (20).

Three lateral incision knifes are collapsed, head-end pushes lateral incision knife pull rod (20), makes the lateral incision of its head end Knife pull rod head end diverging arms (18) reaches slideway head end terminating point and fixes with calibration frame.Fixed sheath, center cutter pull rod (12) it caudad pulls, opens lateral incision knife to outside sheath side wall, when lateral incision knife blade (2) is Chong Die with sheath surface When, the position mark by center incision knife pull rod corresponding to the centre bore tail end plane of lateral incision knife calibration frame is 0 point；After It is continuous caudad to pull center incision knife pull rod (12), it is anxious in when lateral incision knife (2) opens 1mm to outside sheath side wall Operating on the corresponding position mark of pull rod is 1；When lateral incision knife opens 2mm to outside sheath side wall, in corresponding position mark It is 2；3,4,5...... are marked in the same way.

When expanding notch, anxious body rod punched out (24) of operating on is tightened among center incision knife regulation platform (8) Screw, so that it may fixed sheath (35) and incision knife handle (26).Head-end pushes lateral incision knife calibration frame (9) and reaches corresponding Scale, so that it may comparably open three lateral incision knifes, so can with lateral incision knife calibrate frame (9) set millimeter It is several that three auricle notch are carried out with quantitative expansion simultaneously.

Equally, adjust three groups of lateral incision knifes so that 0 point of center incision knife pull rod with calibrate frame (9) tail end plane It is corresponding, calibration frame and center incision knife pull rod (12) is fixed.It is at this time that lateral incision knife pull rod (20) and lateral incision knife is fixed Position mark corresponding to frame tail end plane is 0, and head-end pushes the lateral incision knife pull rod of certain side, is made lateral with what is organized Incision knife (2) opens 1mm, and the position mark corresponding to calibration frame tail end plane is 1；Continue to push away the pull rod, lateral incision knife It opens 2mm and is labeled as 2；Mark 3,4,5...... in the same way.

The label of lateral incision knife has effect: after the completion of three groups of lateral incision knifes are adjusted jointly, head-end push Some lateral incision knife pull rod reaches a certain scale, can make the lateral incision knife than other two lateral incision knifes in this way, The notch cut increases.The incision length quantity more cut is equal to the lateral incision knife pull rod head-end and pushes the scale reached.

Regulation so is done in lateral incision knife, effect is when notch deviates ideal position, it is necessary to some Direction expands notch.After the completion of lateral incision knife is adjusted jointly, regulation needs to expand the lateral incision knife of notch side, so that it may Notch to be expanded to the side, plays the role of correction in subsequent cutting.

After the incision distance regulation of lateral incision knife is suitable, anxious among center incision knife regulation platform (8) operate on is unclamped Body rod punched out (24) fixing screws.It as center incision knife does initial incision, presses incision knife handle (26), so that it may will Lateral incision knife releases sheath to expand notch.

The handle (26) cut is unclamped, by means of the elastic force of incision knife retraction spring (28), lateral incision knife is withdrawn into knife Sheath.Then sheath is pushed into notch, can block notch to stop blooding.

It is round table-like for combining incision knife sheath (35) head.There is the channel (4) of center knife bar in the center portion thereof position；At three There are three identical open conduit (30,31) in 120 degree of identical section, this be knife with three edges knife rib (14) and with corresponding knife rib The channel of connected lateral incision knife (2,3) movement.

There are the channel of center knife bar and leading to for three lateral incision knife pull rods in the body portion (32,33) of combination incision knife sheath Road.The head in the pull rod channel of three lateral incision knifes is because rod head bifurcated axle passes through presentation rectangular duct (31,32).

The bifurcated axle of three lateral incision knife pull rod (20) head ends is wider, is formed in sheath for the position of bifurcated axle operation Corresponding slideway.

Each slideway has head end terminating point and tail end terminating point.Head end terminating point can both make center incision knife cutter head abundant Ground stretches out the stretching sheath that sheath can prevent cutter head excessive again and accidentally injures cardiac muscle.Head end terminating point away from sheath (35) head end away from From=strut the length of bar+lateral incision knife length；Tail end terminating point can guarantee in three lateral incision knifes and its support After opening lever is closed up completely (at this moment overall blade longest), center cutter can all be collected into sheath.Calculation: sheath head end away from Length+lateral incision knife length+center incision knife cutter head length of pull rod bifurcated axle ways-end distance=strut bar.

The endpiece of sheath is thinner, wherein center cutter and lateral incision knife pull rod can be accommodated.Its end have for The screw of sheath extension rod (37) connection.After the completion of cutting operation, therewith by the test tube sample distal end extension rod (37) with nut Connection just constitutes the support rod of heart window merging.Sheath and sheath extension rod (37) can be used as the guidance of heart window merging auricle Heart window is placed in auricle by track

Three leaf knives are used to cut the auricle of biggish children and lesser adult.

The incision method of three leaf knives is:

After sheath is accurately positioned on auricle surface, the preliminary cutting of auricle is carried out first.It is to be realized by following approach:

Referring to figure (11), three leaf knives are three blades that can regulate and control to the most direct component that auricle is cut.

Three knife leaves (46) form axis joint, the pedestal of three knife leaves by means of knife tea residue seat (63) and knife leaf bracket (45) On gear (65) can be engaged with the multiple tracks ring tooth (52) on the center-pole of the intracavitary operation of knife leaf stand tube, center-pole head-end Knife leaf opens the incision knife for becoming three knife leaves when promotion, and knife hinge is held together as knife with three edges when center-pole is caudad pulled back.

The adjusting of three leaf knives depends on interior adjusting rod (41) outer adjusting rod (47) and its attached regulating member.

It is connected referring to the center-pole of the interior adjusting rod of figure (12) and head end.The connection of the tubulose knife leaf bracket of outer adjusting rod and head end See figure (11).

Slide teeth (42) on interior adjusting rod whether protrude interior adjusting rod surface be it is controllable, slide teeth protrude when, with The tooth road (68) of outer adjusting rod inner wall at end is engaged.Inside and outside adjusting rod is integrated, common to retreat.Slide teeth is pressed into interior adjusting After in bar, do not connected between inside and outside adjusting rod, interior adjusting rod can be in the intracavitary sliding of outer adjusting rod.

It is long-armed (53) that slide teeth (42) is pressed inward against in the tail end of interior adjusting rod, slide teeth (42) and outer adjusting rod tooth road (68) it separates, interior adjusting rod (41) can the sliding in outer adjusting rod (47).Caudad pull adjusting rod (41) in three leaf knives Three knife leaves (46) are closed up, adjusting rod slide teeth is long-armed (53) in release, and slide teeth galianconism (54) will be with outer adjusting rod (47) inner teeth road (68) are engaged, and inside and outside adjusting rod is integrated, while three leaf cutter head ends are fixed as knife with three edges.

Sheath (48) fixes sheath after auricle surface positions, and is transferred in the tail end head-end of interior adjusting rod pushes simultaneously Pole (fixes inside and outside adjusting rod since slide teeth (42) is engaged with outer adjusting rod tooth road (68)), and the knife with three edges of head end will be stretched The head end of sheath cuts cardiac muscle in turn out, forms preliminary notch.

The finger of adjusting rod tail end in unclamping, the bullet of the spring (49) by means of being connected to heart window and outer adjusting rod simultaneously Power, so that it may which knife with three edges is withdrawn into sheath.

Sheath is pushed into notch completes incision hemostasis.

Fixed sheath and outer adjusting rod (47) press inward against in slide teeth (42) long-armed (53) makes in the tail end of interior adjusting rod Outer adjusting rod separation.Head-end push three leaf knives in adjusting rod (41), by means of it is interior adjust rod head end annular tooth road (52) with The transmitting between gear (65) on knife tea residue seat (63), knife leaf (such case cuts leaf in auricle inner face) open around As three leaf knives.Adjusting rod slide teeth is long-armed in unclamping, and slide teeth is engaged with outer adjusting rod inner wall tooth road, and inside and outside adjusting rod is again It is integrated, and becomes the three leaf knives with knife handle together with knife leaf.

Fixed sheath.Adjusting rod in caudad pulling, so that it may which three leaf knives of drawing, three leaf knives are centripetal from auricle inner face outward Movement outside ear, cuts auricle, expands auricle notch.

Sheath is pushed into notch carries out closure hemostasis.

Referring to figure (11), the slide teeth (42) for adjusting inside and outside adjusting rod is embedded in the intracavitary of interior adjusting rod tail end, by It is linked together in guidance pin (43) with spring leaf (44).

Its galianconism (54) enters the intracavitary of interior adjusting rod, the tooth engaged of galianconism and outer adjusting when pushing slide teeth long-armed (53) The internal tooth road (68) of bar separates.The long-armed of slide teeth is unclamped, by means of the elastic force of spring leaf (44), in the tooth engaged of galianconism is stretched out Adjusting rod surface, the tooth engaged of galianconism are engaged with the internal tooth road of outer adjusting rod, inside and outside adjusting rod are fixed as one.

There are a more narrow position, referred to as knife petiole portion between the blade (62) and pedestal (63) of knife leaf (66), the head of interior adjusting rod can be accommodated by forming a space after three knife hinges are held together, between three shanks；Three knife leaves This space further expansion after opening, to keep the operation of interior adjusting rod unobstructed.

Sheath (69) head end be it is round table-like, by three identical open conduits (70) in three 120 ° of section, this is The channel that three knife leaves are opened and run when cutting.

The use when doing compared with small notch of monomer knife with three edges, is more used in pediatric patient.

The incision method of monomer knife with three edges is fairly simple:

After auricle positioning, monomer knife with three edges is cut sheath by the following method:

Referring to figure (23), the head of trigone center cutter is by three bow-shaped arms (79), trigone point of a knife and three groups of knife (80) piece groups At

The head end of three bow-shaped arms (79) is integrated to be connect with the tail end of trigone point of a knife, and the tail end of three bow-shaped arms is combined into One is connect with the body portion (71) of trigone center cutter, and three bow-shaped arm equipotentials are spaced apart in 120 °, and its center line and three The corresponding blade of rib point of a knife is in approximately the same plane.

With the identical plane of blade of corresponding trigone point of a knife on the center line of bow-shaped arm, three groups of same blades are installed (80).Every group of blade is in a rectangular trapezoid, successively caudad arranges from head end.And the knife edge of the knife edge of trapezoidal blade and knife with three edges On same straight line.Each group of blade is made of 2-3 blade.There is the gap of 1mm between each blade.Therefore, bending When the arch radian of shape arm (79) changes, resistance will not be all generated between each group of blade (80).

The body portion of trigone center cutter is elongated rod shape (71), and head end connects the tail end of bow-shaped arm (79), tail end and tail portion Connection.

The tail portion of trigone center cutter is the continuity of body rod.Have at the position close to tail end for the annular tooth with engaged gears Road (77).Tooth road outer diameter is greater than the diameter of tail end pull rod (71), and the diameter of tail end pull rod (71) is equal to two sides tooth road bottommost body The diameter of bar.In some orientation of the relatively front end of tail portion, there is the tail end pull rod hoodle that can pass in and out body rod surface on body rod surface.

It is the long tubular structure being socketed in outside trigone center cutter body rod that cutter head, which collapses sheath (73),.Its head end and trigone center There is corresponding sliding groove at the position of the corresponding bow-shaped arm of knife (79).Its caudal part and trigone center cutter body rod tail end pull rod hoodle to Corresponding position, the track for having hoodle to slide, the tube wall that the tail end of track collapses sheath open a tail end pull rod hoodle deck (75). The position of the tail end pull rod hoodle deck the case where gathering of trigone center cutter head by determining: when trigone point of a knife and three groups of blades The knife edge be all stowed in sheath, the hoodle on trigone center cutter tail portion body rod surface is just embedded in tail end pull rod hoodle deck.

Referring to figure (22), the back segment of tail end pull rod (71) has ring tooth road (77) and cutter head to collapse the gear in sheath pinion stand Common regulation cutter head stretches；Head end in ring tooth road has tail end pull rod hoodle (78), and function is to take in cutter head in cutter head Card people, which collapses in the tail end pull rod elastic bead seat (75) of sheath, after gathering sheath collapses fixation for cutter head.

It is socketed from head end to endian order referring to the pinion stand (74) that figure (21) cutter head collapses sheath (73) and cutter head gathering sheath On tail end pull rod (71).Gear (82) and the ring tooth road of tail end pull rod in pinion stand is engaged, and rotation gear can be with Drawing tail end pull rod to collapse sheath tail end move so that rod-shaped tool arm close up and enter gathering it is intrathecal so that blade receipts It is hidden in sheath.

When carrying out auricle incision, tail end pull rod hoodle (75) is to knife with three edges tail end pull rod (71) internal pressure, so that knife with three edges is drawn Bar collapses sheath (73) with cutter head and separates, and by means of the elastic force of three arms of cutter head, cutter head skids off gathering sheath, opens up into initial shape naturally State, the length that at this moment knife leaf is cut are maximum.

Fixed sheath (76), head-end push knife with three edges tail end pull rod (71), and cutter head will cut auricle.Forward by sheath It promotes, blocks notch.

Rotary cutter collapses the cutter head adjustment gear (82) in intrathecal pinion stand, caudad pulls knife with three edges, so that three Arciform tool arm enters knife with three edges and collapses sheath, while three blades are also taken in sheath.

It needs to complete following operation after the completion of auricle notch and heart window is placed in the chambers of the heart.

Remove the operating element of sheath tail end.The sheath endpiece (33) of various incision knifes is relatively thin, and inner cavity is merely capable of holding Receive incision knife pull rod, and the screw having at its end for connecting with sheath extension rod.

After the completion of cutting operation, the test tube sample sheath extension rod (37) with nut is connect with sheath end, is just constituted The support rod of heart window propeller.

Have laying (5) in the outer surface of sheath portion.The inner surface of the laying is steel wire, in the tail portion laying of sheath (36) are separated with sheath and extend for sheath laying extends steel wire (40).

The steel wire and sheath of laying are connected with thread gluing, (can also can be compression molded into steel wire middle line with plastics thread gluing In conduit for U-shaped ring card people's sheath), therefore be inserted into heart window fixator (38) head-end between in laying and sheath and push away Into the strength applied, so that it may so that the two separates.

Figure 10 is the heart window propeller general assembly drawing that heart window is sent into auricle between mesh and sheath.

Heart window and heart window fixator are placed on sheath extension rod (37)；Dry (39), heart window are promoted to push away in heart window propeller Be placed on sheath extension rod (37) into the body portion (45) of the rack of device, and make the gear (46) of heart window propeller rack with The road sheath extension rod Shang Chi (43) is mutually twisted.

Laying is extended steel wire (40) to tense.The steel wire tail end of tension is fixed on to the end of sheath extension rod (37), And guarantee enough tension.

The handle (44) of heart window propeller rear end rack is rotated, rack (45) will be with the body portion (39) one of rack It rises and move to the head end of sheath, and then push heart window (38) head-end movement between laying and sheath, heart window (38) is to head The motive force at end can remove laying steel wire from sheath.Heart window is between sheath (37) and laying (36) along knife Sheath enters auricle.

After laying (36) and sheath (37) are kept completely separate, fixed heart window fixator makes the head end of heart window be maintained at the chambers of the heart It is interior.Three layings are extended steel wire (40) tail end to be combined, laying (36) are pulled to outside the chambers of the heart, due to laying surface Terylene gauze and auricle between have biggish frictional force, laying can pull auricle and move outside window towards tail end in the heart, Until laying thoroughly withdraws from the chambers of the heart.Auricle is just also placed on heart window (38) during auricle centripetal window tail end movement Outer surface.

Then, sheath (35) are removed together with incision knife from the intracavitary of heart window (38).

The heart outside window the root auricle retractor of auricle head end place bounding wire, tightening bounding wire auricle can be tied Prick the surface for being fixed on heart window.

Heart window is put into the position conducive to surgical procedure.Be tightened the drag wire of device, and heart window fixator just has just Property.

So far, heart window fixator and heart window together form rigid structure.After heart window fixator and operating table are fixed, heart window Just become operating table in the extension fulcrum at auricle position.Heart window, which just becomes, is fixed on auricle discrepancy chambers of the heart channel.

Pass through the Vomitory, so that it may accurately by implantation material merging the chambers of the heart privileged site, can also from vitro into Operation in the row chambers of the heart.

Due to the biggish opening of heart window and compared with short operation distance, biggish implantation material can be placed in the heart by heart window Chamber；It can also complete the children's Minimally Invasive Surgery that cannot still complete at present.

Due to biggish window, make it possible to be placed in ultrasonic probe by heart window instead of current x-ray fluoroscopy, it is more smart The position of true ground positioning operation operation and the position of implantation material merging.Keep operation more accurate, surgical procedure is more accurate.Together When, damage of the ray to patient and patient can also be reduced.

Claims (6)

1. a kind of heart window device for posting can will be placed in auricle by the medical device for carrying out heart transluminal operation in vitro under the conditions of minimally invasive Device, the heart window device for posting are made of incision knife, sheath and implantation material propeller, and sheath is nested with incision knife, and implantation material pushes away The rear end of sheath is set into device, it is characterised in that: incision knife is to combine knife, one in three kinds of knives of three leaf knives or monomer knife with three edges Kind, three kinds of knives are respectively intended to the cutting to different size auricle, and the surface of sheath has sheath laying, the medial surface of laying It is chimeric with sheath surface embeded slot by means of steel wire laying for steel wire, it is gauze, steel wire and gauze on the outside of laying Between be spongy elastic layer, notch can be blocked for incision hemostasis by means of the elasticity of elastic layer, implantation material propeller by Pedestal and gear composition；After the cutting for completing auricle, it is socketed sheath extension rod in the end of sheath, implantation material propeller is used for Medical device is placed in auricle and covers auricle between incision knife sheath extension rod and the steel wire of sheath outer gasket layers and is being cured Treat apparatus surface；Implantation material propeller pedestal is socketed in sheath extension rod tail end, makes the tooth road of its gear Yu sheath extension rod Occlusion rotates the gear of implantation material propeller, and implantation material propeller pedestal can be moved along sheath extension rod head-end, indirectly Ground pushes medical device to enter the chambers of the heart between sheath cushioning surface layer and sheath.

2. the heart window device for posting as described in claim 1, which is characterized in that the combination knife is lateral to cut by center incision knife Knife, center incision knife regulation platform, lateral incision knife calibration frame composition；

The center incision knife by trigone center incision knife cutter head, center incision knife body rod and manipulation incision knife handle group At by means of the regulation of center incision knife regulation platform and incision knife handle, center incision knife can be completed to the preliminary of auricle Cutting；

The center incision knife regulation platform is the platform that sheath end is fixed on tripod, and center incision knife body rod is from center Incision knife regulation platform centre bore passes through, and incision knife handle and incision knife retraction spring are successively socketed in center from tail end head-end Incision knife body rod end adjusts socket length of the incision knife handle on body rod, can with the adjusting center incision knife of inverse proportion or Lateral incision knife stretches out the length of sheath, and such length not only guarantees that incision knife whole blade cuts auricle, but also can be with Guarantee that the cutter head of incision knife is unlikely to too long and enters the chambers of the heart and injury of myocardium, the spring being socketed between sheath and the handle of incision Guarantee after the completion of cutting, incision knife is rebounded sheath guarantee immediately will not injury of myocardium；

The lateral incision knife shares three groups, and each group struts arm, lateral incision knife by lateral incision knife cutter head, lateral incision knife Pull rod three parts composition, each group of cutter head are connected to the corresponding knife rib of center incision knife, and with other two components to close Section is linked in sequence；

Three lateral incision knife pull rods and center incision knife body rod connection are one group by lateral incision knife calibration frame, and lateral incision knife is fixed Frame is a tripod structure, and center incision knife body rod passes through the centre bore of calibration frame, and three lateral incision knife pull rods are from position It passes through and fixes in the hole of three feet, when calibration, push calibration frame along center incision knife body rod cephalad, calibrate three feet of frame Lateral incision knife will be pushed, which to strut arm, is flared out lateral incision knife cutter head, and the angle of opening is different, so that it may control Three lateral incision knifes cut the length of cardiac muscular tissue；Calibration frame is fixed in body rod, regulates and controls the length that single pull rod head-end is stretched out Degree can control the length that the side cardiac muscle is cut more than other two sides；

The sheath have collecting center's incision knife and lateral incision knife and its attachment conduit, without cutting when, in it is anxious It operates on lateral incision knife and to be concealed in that combination incision knife is intrathecal, and triggering center incision knife handle releases center incision knife cutter head Sheath cuts auricle and completes preliminary cutting, and sheath blocks preliminary notch and fixes in notch, regulates and controls lateral incision knife, triggers center Lateral incision knife release sheath can be expanded preliminary notch by incision knife handle, and sheath is completed in cutting and sheath extension rod connects It connects and constitutes implantation material guide rail, medical device can be sent into the chambers of the heart between sheath and sheath laying inner face steel wire.

3. the heart window device for posting as described in claim 1, which is characterized in that three leaf knives are by outer adjusting rod, knife leaf, interior adjusting rod group At；

The outer adjusting rod is cylinder spline structure, and the rod-shaped knot of protrusion is distributed at interval of 120 degree in the head end of outer adjusting rod The shaft head end of structure, protrusion can form axis joint, referred to as knife leaf bracket with two arms of knife leaf tail end pedestal；

The knife leaf is made of blade, shank and pedestal, and blade is triangle；Pedestal with axis joint and corresponding outer adjusting rod it Knife leaf bracket forms axis joint, and for knife tea residue seat there are two arm, there is the tooth on 1/2 gear and interior adjusting rod in the tail portion of two arms Road occlusion；The shank of knife leaf is the isthmus for connecting blade and pedestal, and three knife hinges hold together rear shank and form a notch, which stays Space out, when interior adjusting rod manipulates knife leaf just at the traffic coverage on head；

The interior adjusting rod is elongated rod shape, is mounted in the cylinder of outer adjusting rod, head end road with teeth and knife tea residue seat tail portion Engaged gears are to regulate and control the opening and closing angle of knife leaf, and the minimum opening angle of three knife leaves is 0 degree, in this case three knife leaves It is combined, tip forms knife with three edges；The maximum opening angle of three knife leaves be 90 degree, in this case three knife leaves to Outer open forms the three leaf knives for being spaced 120 degree；

The sheath is the long tubular that head end is rotary table, has three conduits at 120 degree of interval that can make three knives on its head Leaf passes in and out sheath, and sheath is completed in cutting and sheath extension rod connects and composes implantation material guide rail.

4. the heart window device for posting as described in claim 3, which is characterized in that three leaf knife tail end regulation platforms are by outer adjusting rod and interior Adjusting rod extends, their diameter all expands compared with head；Outer adjusting rod is cylindrical shape, and outer adjusting rod diameter is greater than its head end Position formed periphery platform, the platform with regulate and control spring tail end dock, the head end for regulating and controlling spring is docked with the tail end of sheath, outside The inner wall of adjusting rod has and a toothrow road；Interior adjusting rod and head end continue, and diameter expands compared with head end and agrees with outer adjusting rod, Interior adjusting rod proximal end installs slide teeth, and slide teeth is that L shape manipulates slot, long-armed by means of being mounted on it in the inner cavity of the arm Guidance pin is linked together with spring leaf, and compressing slide teeth is long-armed inside inside adjusting rod, receives in the tooth engaged of galianconism side, interior, Just there is no resistance between outer adjusting rod, knife leaf can be adjusted by pushing or pulling on interior adjusting rod in intracavitary do relative motion of outer adjusting rod The angle opened；Release slide teeth is long-armed, and the tooth engaged of galianconism side will be engaged with the tooth road of outer adjusting rod inner wall, inside and outside adjusting rod It will be fixed as one, common Attended Operation.

5. the heart window device for posting as described in claim 1, which is characterized in that monomer knife with three edges is collapsed by trigone center cutter, cutter head Sheath, cutter head collapse pinion stand composition；

The trigone center cutter is made of the main body of cutter head three arch tool arms that elasticity is opened, and the head end of three tool arms is combined into one Body is connect with the tail portion of trigone point of a knife, and the tail end of three tool arms is integrated to be connect with trigone center cutter hub portion pull rod, in trigone Heart cutter hub portion pull rod has annular tooth road close to tail end, and the front end in tooth road has fixed trigone center cutter and cutter head to collapse the bullet of sheath Pearl；

The cutter head collapses sheath and is made of cylindric cutter head gathering sheath and pinion stand, and the head end inner cavity that cutter head collapses sheath is rotary table There is the sliding groove of tool arm at shape, position corresponding with the arch tool arm of trigone center cutter；

The gear collapses seat and is made of pinion stand and the gear being mounted in pinion stand, when regulating and controlling trigone center cutter, gear with The tooth road of trigone center cutter hub portion pull rod endpiece is mutually twisted, and rotation gear caudad pulls trigone center cutter pull rod, cutter head Three tool arms collapse in sheath tail end sliding process to cutter head, as round table-like intracavity diameter caudad reduces, oppress three Arm to closing up together；After entire tool arm is concealed in gathering sheath, the bullet between sheath and trigone center cutter pull rod is collapsed by means of cutter head Pearl fixes the two；Trigone center cutter can be slided by means of elastic force head-end after opening hoodle, and tool arm stretches out cutter head and collapses Sheath, three tool arms open to form 3-edge surgical knife；

The sheath is that head end is round table-like long tubular, is that knife leaf enters and leaves in three conduits that there is 120 degree of interval on its head The channel of sheath, sheath is completed in cutting and sheath extension rod connects and composes implantation material guide rail.

6. heart window device for posting as described in claim 1, which is characterized in that after the completion of notch that medical device, medical device is solid Determine device, implantation material propeller is sequentially placed on sheath and sheath extension rod on, then will be connect with steel wire on the inside of sheath laying Extension Wire pulling and be fixed on the end of sheath extension rod, medical device push is entered into the chambers of the heart, withdraws sheath, fixed doctor Device fixator is treated, the sheath cushioning surface layer that then oneself warp of drawing is detached from sheath outward, due to the outer surface line of laying The frictional force of net can affect auricle inner surface to slide and turn up to medical device tail end, can thus cover auricle and fill in medical treatment The outside set, outside medical device the root of auricle, auricle retractor head end place bounding wire, tightening bounding wire can will Auricle ties up the surface for being fixed on medical device, and medical device fixator operating bed is fixed, and heart window will become operating bed and exist The extension fulcrum that auricle portion and auricle are fixed, plays a supportive role in subsequent operative process.