CN107714116A - Stitching instrument for laparoscope - Google Patents
Stitching instrument for laparoscope Download PDFInfo
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- CN107714116A CN107714116A CN201710799715.1A CN201710799715A CN107714116A CN 107714116 A CN107714116 A CN 107714116A CN 201710799715 A CN201710799715 A CN 201710799715A CN 107714116 A CN107714116 A CN 107714116A
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- 239000008280 blood Substances 0.000 claims description 11
- 210000004369 blood Anatomy 0.000 claims description 11
- 238000003780 insertion Methods 0.000 claims description 5
- 230000037431 insertion Effects 0.000 claims description 5
- 244000273618 Sphenoclea zeylanica Species 0.000 claims 1
- 210000002421 cell wall Anatomy 0.000 claims 1
- 238000009958 sewing Methods 0.000 abstract description 35
- 210000000683 abdominal cavity Anatomy 0.000 abstract description 7
- 230000009286 beneficial effect Effects 0.000 abstract description 2
- 238000002357 laparoscopic surgery Methods 0.000 description 6
- 238000005516 engineering process Methods 0.000 description 4
- 238000000034 method Methods 0.000 description 3
- 230000000740 bleeding effect Effects 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 238000009297 electrocoagulation Methods 0.000 description 2
- 238000002350 laparotomy Methods 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 208000015943 Coeliac disease Diseases 0.000 description 1
- 230000003187 abdominal effect Effects 0.000 description 1
- 230000007812 deficiency Effects 0.000 description 1
- 238000003745 diagnosis Methods 0.000 description 1
- 238000007599 discharging Methods 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000017074 necrotic cell death Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000000659 thermocoagulation Effects 0.000 description 1
- 238000009966 trimming Methods 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0483—Hand-held instruments for holding sutures
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0491—Sewing machines for surgery
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Abstract
一种腹腔镜缝合器，包括缝针(1)、主杆(3)、手柄(4)，主杆(3)为空心杆，主杆(3)的尾部固定在手柄上；主杆(3)的前端端面上设有第一缝针固定孔(31)，主杆(3)的前端侧面设有第二缝针固定孔(32)，第二缝针固定孔(32)横向贯穿主杆(3)；主杆(1)设有内固定杆(5)；缝针(1)为W形针，高度小于5mm，缝针的尾部段设有平遍节；在手柄(4)上贴近主杆(3)的下方设置线轮安置槽，线轮安置槽中设置线轮固定轴，线轮安置槽壁上设有贯穿手柄的穿线孔。本发明有利于缝针机动灵活的进出腹腔，并使腹腔镜手术中的缝针能在体内各方位进行灵活的缝合、打结。
A laparoscopic stapler, comprising a sewing needle (1), a main rod (3), and a handle (4), the main rod (3) is a hollow rod, and the tail of the main rod (3) is fixed on the handle; the main rod (3) ) is provided with a first sewing needle fixing hole (31) on the front end face, and a second sewing needle fixing hole (32) is provided on the front side of the main rod (3), and the second sewing needle fixing hole (32) runs through the main rod horizontally (3); the main rod (1) is provided with an internal fixing rod (5); the sewing needle (1) is a W-shaped needle, and the height is less than 5mm, and the tail section of the sewing needle is provided with a flat joint; it is close to the handle (4) The bottom of the main rod (3) is provided with a wire wheel placement groove, a wire wheel fixed shaft is arranged in the wire wheel placement groove, and a threading hole through the handle is provided on the wire wheel placement groove wall. The invention is beneficial for the suture needles to move in and out of the abdominal cavity flexibly, and enables the suture needles in the laparoscopic operation to be sutured and knotted flexibly in various positions in the body.
Description
技术领域technical field
本发明涉及治疗腹腔疾病的手机器械，特别涉及可在手术中机动灵活进行缝合操作的腹腔镜缝合装置。The invention relates to a mobile phone instrument for treating celiac disease, in particular to a laparoscopic suturing device which can flexibly perform suturing operations during surgery.
背景技术Background technique
腹腔镜在腹部疾病的诊断及治疗中发挥着重大的作用，但在腹腔镜手术中如剖腹手术基本缝合的那种机动灵活性却大部分失掉。为了弥补不足，在腹腔镜下止血或对合组织，采用简单但较危险的热凝、电凝、激光、夹子、U形钉等，但操作不慎可引起严重出血或周围组织的坏死，致使患者死亡。也有对应的缝合装置就此做相应的改进，如公开号为CN1729939A、名称为“腹腔镜缝合器”的发明申请以及公开号为CN101449989A、名称为“腹腔镜缝合打结器”的发明申请，都是为了提高缝合的机动灵活性，但是结构较为复杂，操作不顺手。Laparoscopy plays an important role in the diagnosis and treatment of abdominal diseases, but in laparoscopic surgery such as the basic suturing of laparotomy, most of the flexibility is lost. In order to make up for the deficiency, simple but dangerous thermocoagulation, electrocoagulation, laser, clips, staples, etc. are used to stop bleeding or align tissues under laparoscopy, but careless operation may cause severe bleeding or necrosis of surrounding tissues, resulting in The patient died. Corresponding suturing device also has corresponding improvement at this point, as publication number is CN1729939A, the application for the invention that is called " laparoscopic suturing device " and publication number is CN101449989A, the name is called the invention application of " laparoscopic suturing knotter ", all are In order to improve the maneuverability of suturing, but the structure is relatively complicated, and the operation is not smooth.
发明内容Contents of the invention
本发明的目的在于提供一种在腹腔内可机动灵活地进行缝合、打结的腹腔镜缝合器。The object of the present invention is to provide a laparoscopic stapler that can flexibly suture and tie knots in the abdominal cavity.
本发明的目的可以这样实现，设计一种腹腔镜缝合器，包括缝针、主杆、手柄，主杆为空心杆，主杆的尾部固定在手柄上；The purpose of the present invention can be achieved like this, design a kind of laparoscopic stapler, comprise sewing needle, main rod, handle, main rod is hollow rod, and the afterbody of main rod is fixed on the handle;
主杆的前端端面上轴心处设有第一缝针固定孔，主杆的前端侧面设有第二缝针固定孔，第二缝针固定孔横向贯穿主杆；主杆设有内固定杆，内固定杆的尾端设有旋转把握头，内固定杆的尾段设有外螺纹，主杆的尾端设有与内固定杆外螺纹配合的内螺纹；The front end surface of the main rod is provided with a first needle fixing hole at the axis, the front side of the main rod is provided with a second needle fixing hole, and the second needle fixing hole runs through the main rod transversely; the main rod is provided with an inner fixing rod , the tail end of the inner fixing rod is provided with a rotating grasping head, the tail section of the inner fixing rod is provided with an external thread, and the tail end of the main rod is provided with an internal thread cooperating with the external thread of the inner fixing rod;
缝针为W形针，高度小于5mm，缝针的尾部段设有平遍节；The sewing needle is a W-shaped needle, the height is less than 5mm, and the tail section of the sewing needle is provided with a flat joint;
在手柄上贴近主杆的下方设置线轮安置槽，线轮安置槽中设置线轮固定轴，线轮安置槽壁上设有贯穿手柄的穿线孔。A wire wheel placement groove is arranged close to the bottom of the main rod on the handle, a wire wheel fixed shaft is arranged in the wire wheel placement groove, and a threading hole through the handle is provided on the wire wheel placement groove wall.
进一步地，第二缝针固定孔的插入端口呈喇叭口，二缝针固定孔的固定端口略大于缝针的尾径。Further, the insertion port of the second needle fixing hole is bell-mouthed, and the fixing port of the second needle fixing hole is slightly larger than the tail diameter of the needle.
进一步地，缝针的针眼下方设有导线槽，针眼与针底部的高度差大于1mm。Further, a wire groove is provided under the eye of the sewing needle, and the height difference between the eye of the needle and the bottom of the needle is greater than 1 mm.
进一步地，导线槽延伸至缝针的弯位处。Further, the wire groove extends to the bent position of the sewing needle.
进一步地，缝针的针长3.5cm、针直径1.1mm。Further, the needle length of the sewing needle is 3.5 cm, and the needle diameter is 1.1 mm.
进一步地，主杆处于手柄上方位处设有排气排血孔座，排气排血孔座设有通孔与主杆的空心通孔相通联，排气排血孔座上设有盖帽。Further, the main rod is above the handle with an exhaust and blood hole seat, the exhaust and blood hole seat is provided with a through hole communicating with the hollow through hole of the main rod, and the exhaust and blood hole seat is provided with a cap.
本发明有利于缝针机动灵活的进出腹腔，并使腹腔镜手术中的缝针能在体内各方位进行灵活的缝合、打结；手柄与主杆构成一体，由手柄操作各种缝合及打结，缝线从缝针前后两端进出两次，缝线的另一端由操作者握在手中，并且所需缝线为剖腹手术所需的普通缝线，可取代目前腹腔镜所采用的套圈技术、缝合技术以及电凝等技术，节省了大量材料费。The invention is beneficial to the flexible and flexible entry and exit of suture needles into and out of the abdominal cavity, and enables the suture needles in laparoscopic surgery to be sutured and knotted flexibly in various positions in the body; the handle and the main rod are integrated, and various sutures and knots are operated by the handle , the suture goes in and out twice from the front and rear ends of the needle, the other end of the suture is held in the operator's hand, and the suture required is the common suture required for laparotomy, which can replace the ferrule currently used in laparoscopy Technology, suture technology and electrocoagulation and other technologies have saved a lot of material costs.
附图说明Description of drawings
图1是本发明较佳实施例的示意图；Fig. 1 is the schematic diagram of preferred embodiment of the present invention;
图2是本发明较佳实施例之第二缝针固定孔32的剖面示意图；Figure 2 is a schematic cross-sectional view of the second needle fixing hole 32 in a preferred embodiment of the present invention;
图3是本发明较佳实施例之缝针的示意图。Fig. 3 is a schematic diagram of a sewing needle in a preferred embodiment of the present invention.
具体实施方式detailed description
以下结合实施例对本发明作进一步的描述。Below in conjunction with embodiment the present invention is further described.
如图1所示，一种腹腔镜缝合器，包括缝针1、主杆3、手柄4，主杆3为空心杆，主杆3的尾部固定在手柄4上；主杆3前端端面上设有第一缝针固定孔31，主杆3的前端侧面设有第二缝针固定孔32，第二缝针固定孔32横向贯穿主杆3。如图2所示，第二缝针固定孔32的插入端口321呈喇叭口，第二缝针固定孔的固定端口322略大于缝针1的尾径，操作时，可以较为方便地将缝针1插入第二缝针固定孔32内。As shown in Figure 1, a kind of laparoscopic stapler comprises sewing needle 1, main rod 3, handle 4, and main rod 3 is a hollow rod, and the afterbody of main rod 3 is fixed on the handle 4; There is a first needle fixing hole 31 , a second needle fixing hole 32 is provided on the front side of the main rod 3 , and the second needle fixing hole 32 runs through the main rod 3 transversely. As shown in Figure 2, the insertion port 321 of the second sewing needle fixing hole 32 is a trumpet mouth, and the fixing port 322 of the second sewing needle fixing hole is slightly larger than the tail diameter of the sewing needle 1. During operation, the sewing needle can be inserted more conveniently. 1 into the second needle fixing hole 32.
主杆1设有内固定杆5，内固定杆5的尾端设有旋转把握头，内固定杆5用于固定缝针1，内固定杆5的尾段设有外螺纹，主杆1的尾端设有与内固定杆外螺纹配合的内螺纹；或者是将主杆3的尾端焊接固定在手柄4上，手柄4上设置与主杆3内孔同一轴心并可容纳内固定杆5通过的配合孔，配合孔尾端设有与内固定杆外螺纹配合的内螺纹。The main rod 1 is provided with an internal fixing rod 5, and the tail end of the internal fixing rod 5 is provided with a rotating grasping head. The internal fixing rod 5 is used for fixing the sewing needle 1. The tail end is provided with an internal thread that matches the external thread of the inner fixing rod; or the tail end of the main rod 3 is welded and fixed on the handle 4, and the handle 4 is set on the same axis as the inner hole of the main rod 3 and can accommodate the inner fixing rod 5 through the matching hole, the tail end of the matching hole is provided with an internal thread that cooperates with the external thread of the inner fixing rod.
如图3所示，缝针1为W形针，高度小于5mm，缝针的尾部段设有平遍节11；平遍节11便于内固定杆5顶压缝针1，将缝针1固定在第二缝针固定孔32上并防止缝针1固定后转动。缝针1的针眼下方设有导线槽，针眼与针底部的高度差大于1mm；导线槽的设置便于穿针眼和引线；针眼与针底部的高度差便于在手术过程中提拉缝线。导线槽延伸至缝针1上接近针眼的内侧弯位处，便于缝针1进针穿透缝合部，减少缝线对进针的影响。本实施例中，缝针1的针长3.5cm、针直径1.1mm，针眼采用8号针的针眼。现有技术中的弧形针在实际操作中，进针后人体组织将缝线挤至紧贴缝针针体，在手术过程中难于提拉缝线，增加手术操作难度和手术时间。W形针的构造可以使人体组织不易将缝线挤至紧贴缝针针体，手术过程中提拉缝线较为容易，减少缝合时间。As shown in Figure 3, the sewing needle 1 is a W-shaped needle with a height less than 5mm, and the tail section of the sewing needle is provided with a flat joint 11; the flat joint 11 is convenient for the internal fixing rod 5 to press the sewing needle 1, and the sewing needle 1 is fixed. On the second sewing needle fixing hole 32 and prevent the sewing needle 1 from rotating after being fixed. A wire groove is provided below the eye of the sewing needle 1, and the height difference between the eye of the needle and the bottom of the needle is greater than 1mm; the setting of the wire groove is convenient for threading the eye of the needle and the lead thread; The wire groove extends to the inside bend of the needle 1 close to the eye of the needle, which facilitates the insertion of the needle 1 and penetrates the suture, and reduces the influence of the suture on the insertion of the needle. In this embodiment, the needle length of the sewing needle 1 is 3.5 cm, the needle diameter is 1.1 mm, and the needle eye is the eye of a No. 8 needle. In the actual operation of the arc-shaped needle in the prior art, after the needle is inserted, the human tissue squeezes the suture to be close to the needle body, which makes it difficult to lift the suture during the operation, which increases the difficulty of the operation and the operation time. The structure of the W-shaped needle can make it difficult for human tissue to squeeze the suture close to the needle body, and it is easier to lift the suture during the operation, reducing the suturing time.
如图1所示，在手柄4上贴近主杆3的下方设置线轮安置槽41，线轮安置槽中设置线轮固定轴42，线轮安置槽壁上设有贯穿手柄的穿线孔43。使用时，由缝线线轮上抽出缝线，通过穿线孔43将缝线引出手柄4外，将缝线线轮放置在线轮安置槽41内，缝线线轮的轴孔套在线轮固定轴42上，线轮固定轴42的轴径小于缝线线轮轴孔的孔径，缝线线轮可在线轮安置槽41内自由地转动。As shown in Figure 1, a wire wheel placement groove 41 is set close to the bottom of the main rod 3 on the handle 4, a wire wheel fixing shaft 42 is set in the wire wheel placement groove, and a threading hole 43 through the handle is provided on the wire wheel placement groove wall. During use, the suture is drawn out from the suture reel, the suture is drawn out of the handle 4 through the threading hole 43, the suture reel is placed in the reel placement groove 41, and the shaft hole of the suture reel is covered with the fixed shaft of the wire reel 42, the shaft diameter of the thread wheel fixed shaft 42 is less than the aperture of the thread wheel shaft hole, and the thread wheel can rotate freely in the thread wheel placement groove 41.
主杆3处于手柄上方位处设有排气排血孔座33，排气排血孔座33设有通孔与主杆的空心通孔相通联，排气排血孔座33上设有盖帽34。排气排血孔座便于排出主杆3内的血气。The main rod 3 is provided with an exhaust and blood discharge hole seat 33 at the position above the handle, and the exhaust and blood discharge hole seat 33 is provided with a through hole to communicate with the hollow through hole of the main rod, and the exhaust and blood discharge hole seat 33 is provided with a cap 34. The exhaust and blood hole seat is convenient for discharging the blood gas in the main rod 3 .
本发明的缝合、打结技巧：The suturing and knotting skills of the present invention:
1、进入腹腔：将穿上缝线的缝针1插入主杆3上的第一缝针固定孔31中，使缝针1与主杆3呈直线，通过6～7mm套管进入腹腔后，通过夹线钳将缝针1从第一缝针固定孔31中取下，将缝针1插入第二缝针固定孔32中，转动内固定杆5将缝针1牢固固定在第二缝针固定孔32中，缝针1与主杆3呈90°角，以利于顺利缝合。1. Enter the abdominal cavity: insert the suture needle 1 into the first needle fixing hole 31 on the main rod 3, make the suture needle 1 and the main rod 3 in a straight line, enter the abdominal cavity through a 6-7mm cannula, Remove the sewing needle 1 from the first sewing needle fixing hole 31 through the wire clamp, insert the sewing needle 1 into the second sewing needle fixing hole 32, and turn the inner fixing rod 5 to firmly fix the sewing needle 1 on the second sewing needle In the fixing hole 32, the suture needle 1 and the main rod 3 are at an angle of 90°, so as to facilitate suturing smoothly.
2、缝合：右手持缝合器，使缝针1穿透缝合部位，然后进一步出针，使缝线从针孔露出4～5mm，操作者左手持夹线钳挑起前端缝线并夹紧，缝针退出，缝合穿线完成，夹线钳放开缝线断端。2. Suture: hold the suture device in the right hand, let the suture needle 1 penetrate the suture site, and then pull out the needle further, so that the suture is exposed 4-5 mm from the needle hole, and the operator holds the suture clamp in the left hand to pick up the front suture and clamp it. The sewing needle withdraws, the suture threading is completed, and the clamps let go of the suture stump.
3、打结：带线的缝针1绕夹线钳旋转1周(打方结)或旋转2周(打外科结)后，夹线钳持夹缝线断端，缝合器与夹线钳对应拉紧，完成一个结。同法完成第二个或第三个结。3. Knotting: After the sewing needle 1 with thread rotates around the clamp for 1 circle (for square knot) or 2 circles (for surgical knot), the clamp holds the broken end of the suture, and the stapler corresponds to the clamp Pull tight to complete a knot. Complete the second or third knot in the same way.
4、剪线：缝合器与夹线钳拉直缝线，线剪剪断。缝合器不退出腹腔，进行第二次缝合、打结。4. Thread trimming: the suture device and the clamps straighten the sutures, and the thread scissors cut them off. The stapler does not withdraw from the abdominal cavity, and the second suture and knot are performed.
5、退出：旋松内固定杆5，通过夹线钳将缝针1从第二缝针固定孔32中取下，将缝针1插入第一缝针固定孔31中，然后将主杆3与缝针1一并抽出腹腔。5. Exit: Unscrew the internal fixing rod 5, remove the needle 1 from the second needle fixing hole 32 through the clamp, insert the needle 1 into the first needle fixing hole 31, and then insert the main rod 3 Withdraw the abdominal cavity together with the suture needle 1.
本发明可以进行：The present invention can carry out:
1、递线、打结：非缝合状态时应用缝合器递线、打结，结扎组织断端。方法同上。可取代目前腹腔镜所采用的套圈技术，节省大量材料费。1. Thread delivery and knotting: In the non-suture state, use a stapler to deliver thread, tie knots, and ligate the broken ends of the tissue. The method is the same as above. It can replace the ferrule technology currently used in laparoscopy, saving a lot of material costs.
2、间断缝合：上述缝合、打结技巧，即是间断缝合。2. Intermittent suture: The suture and knotting techniques mentioned above are interrupted suture.
3、8字缝合：缝合器缝合穿线后，打结不剪线，进行第二针缝合穿线，夹线钳穿过针孔处缝线后，夹紧缝线另一断端并拉过牵出，缝针退出组织，缝线两端打结，完成8字缝合。3. Figure 8 suture: After suturing and threading with the stapler, tie the knot without cutting the thread, and perform the second stitch and thread. After the thread clamp passes through the stitch at the pinhole, clamp the other end of the suture and pull it out , the suture needle withdraws from the tissue, the two ends of the suture are knotted, and the figure-eight suture is completed.
4、连续缝合、连锁缝合：同8字缝合，但进出缝针的方向不同。4. Continuous suture and chain suture: same as figure 8 suture, but the direction of the stitches going in and out is different.
Claims (6)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710799715.1A CN107714116B (en) | 2017-09-07 | 2017-09-07 | Laparoscopic stapler |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN109589152A (en) * | 2019-01-14 | 2019-04-09 | 郑州大学第附属医院 | A kind of portable tumor operation wound suture tool |
| CN112089456A (en) * | 2020-08-19 | 2020-12-18 | 广州医科大学附属第五医院 | Surgical suture instrument |
| CN113693656A (en) * | 2021-07-15 | 2021-11-26 | 深圳市第二人民医院(深圳市转化医学研究院) | Needle holding stitching instrument for laparoscope |
| CN114144121A (en) * | 2019-02-22 | 2022-03-04 | 爱惜康股份有限公司 | Suture needle with bendable region |
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| CN109589152A (en) * | 2019-01-14 | 2019-04-09 | 郑州大学第附属医院 | A kind of portable tumor operation wound suture tool |
| CN114144121A (en) * | 2019-02-22 | 2022-03-04 | 爱惜康股份有限公司 | Suture needle with bendable region |
| CN112089456A (en) * | 2020-08-19 | 2020-12-18 | 广州医科大学附属第五医院 | Surgical suture instrument |
| CN113693656A (en) * | 2021-07-15 | 2021-11-26 | 深圳市第二人民医院(深圳市转化医学研究院) | Needle holding stitching instrument for laparoscope |
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