CN108245212A - A kind of medical instrument - Google Patents

A kind of medical instrument Download PDF

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Publication number
CN108245212A
CN108245212A CN201810152994.7A CN201810152994A CN108245212A CN 108245212 A CN108245212 A CN 108245212A CN 201810152994 A CN201810152994 A CN 201810152994A CN 108245212 A CN108245212 A CN 108245212A
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CN
China
Prior art keywords
needle
stitching unstrument
internal
suture
internal stitching
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Application number
CN201810152994.7A
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Chinese (zh)
Inventor
万平
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Individual
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Individual
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Priority to CN201810152994.7A priority Critical patent/CN108245212A/en
Publication of CN108245212A publication Critical patent/CN108245212A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0474Knot pushers

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The present invention relates to a kind of medical instruments, more particularly to a kind of internal stitching unstrument, the internal stitching unstrument by bio-compatible material preparation, the internal stitching unstrument at least one into needle, the internal stitching unstrument can enter internal through natural cavity or/and opening, in mucomembranous surface or deep, organ surface or deep, other tissue surfaces or deep are sutured and be closed or the suture of other positions and mode and closure, and adjustable inserting needle depth, metering needle pitch-row from, it can be interrupted or continuously suture and be closed, in parallel or series or it can intersect or repeat or pitch of the laps and other or their arbitrary combination.

Description

A kind of medical instrument
Technical field
The present invention relates to a kind of medical instrument more particularly to a kind of internal stitching unstruments.
Background technology
Through scope by natural cavity and opening, some previous abdominals or laparoscopic surgery or Minimally Invasive Surgery can be avoided Caused damage.
According to scope, it can be diagnosed, cut off, be drained, but be sutured(Use routine operation suture needle)It is still problem:(It is soft) Scope does not have the stiffness of laparoscopic surgery operating parts, and the tissue to be sewn in vivo has soft and is not fixed, it is difficult to accurate True inserting needle pulls out needle, knots, even if inserting needle, and be difficult to accurately control the depth of inserting needle to wear with too deep to prevent excessively shallow loosening Thoroughly(It is penetrated in digestive tract cavity and organizes and pollute outside tube chamber)Even if inserting needle, and be difficult to pull out needle or continuously pull out needle or continuous acupuncture, Even if pulling out needle, and it is difficult securely to knot.
The report of low manufacture cost, the endoscopic surgery suturing skill that easy to operate, degree of safety is high and its instrument, still belongs at present It is rare.
Invention content
Above-mentioned of the prior art at least one to solve the problems, such as, the present invention provides a kind of internal stitching unstrument, and biofacies Hold and at least one into needle internal stitching unstrument.
The internal stitching unstrument of bio-compatible is prepared, at least one there can be needle track into needle(Gap), line storehouse, push away bolt, draw Bolt, ear bar, linear slit, external manipulation unit etc. can use conventional suture needle during use, can also adjust depth of needle, metering needle pitch-row From organizing to swell therewith between, pitch-row, enter mounted on soft scope internal, also can install or split in special pusher On, whole or part is foldable or/and torsion or/and overturning or/and bending or/and other deformations and its arbitrary combination, through machine Body natural cavity or/and opening enter it is internal, can be also placed in by known technology capsule body enter in vivo, remote control intelligent operation, Mucomembranous surface or deep, organ surface or deep, other tissue surfaces or deep are sutured and be closed or other positions and side The suture of formula and closure, such as side-to-side neurorrhaphy, end end suture, End-to-side coaptation, stoma closing, blood vessel closing, vascular suture, intestines system Film suture, thin tissue etc. are sutured and are closed, suture way can be interrupted or continuously suture and be closed, in parallel or series or intersect or It repeats or pitch of the laps and other or their arbitrary combination;Existed by suture knotting guide structure and/or direct and/or default knot It knots in vivo, internal part is directed to after can also knotting in vitro, it is also possible to pre-knotted suture, self-adhesion bad mold joint, self-styled suture Deng.The movement of internal stitching unstrument and its needlework may originate from moment and/or soft slow and/or interruption and/or continue or/and other and its Arbitrarily combine have an effect or/and push-pull device at fixed;Internal stitching unstrument can also direct needlework or/and wire or/and various polymer Or/and all kinds of adhesives or/and medical adhesive or/and spring element or/and antitorque muscle or/and other and its arbitrary combination, it can use and beat Tie device or/and ligaturing forceps or/and manipulator or/and metal clip or/and high molecular polymer folder or/and bonding or/and heat seal or/ With other physics or/and chemistry or/and biological method fix or/and be closed needlework.
Beneficial effects of the present invention include can through natural cavity or/and opening surface or deep are sutured in vivo(Into Needle pulls out needle, knots), conventional operation needle can be used, and depth of needle and pin hole distance can be controlled, especially only relied on soft Formula endoscopic technic.
Description of the drawings:
Fig. 1 is structure diagram.
Component or position in Fig. 1 represented by label are:1- needle tracks;2- lines storehouse;3- pushes away bolt;4- pulling plugs;5- ear bars;6- is small Foot;7- big feet;8- scopes.
Specific embodiment:
With reference to specific example, the invention will be further described:
Embodiment 1
The operation needle size of matching convention agrees with buckle conventional endoscopic distal end(First end cap)Or scope is oriented near joint (Take into account operation and the visual field and its adjustment)And the use of conventional endoscopic determines the diameter of cylindrical type or class Cubic or horse-hof shape(It can Make the non-damaging protuberance of local organization)Width and length, and bio-compatible, if endoscope distal diameter is less than this stitching unstrument width, Also can be set to can 90 ° or other angles turn back, into vivo also can c-type plane indulge diameter perpendicular to scope apex with from side Side monitors;3D printing(Metal material also can laser carve), inside have inserting needle and needle outlet road, duct depth is determined comprising suture needle The tail portion of suture needle is still in the lower edge in needle outlet road when head enters needle outlet road lower edge.Inserting needle can rely on into needle(Band line;It can plate Shape, can be cylindric, can be cubic, can inside camber), spring element, the two-fold fastener snapping endoscopic forceps channel of spring element are riveted into needle In repacking biopsy forceps(Or do not reequip, as long as stretchy and discharging and pushing back spring element), enter in vivo through oesophagus, work as stitching unstrument Bottom, which is put, is attached to stomachus pyloricus or duodenum when tissue surfaces, and biopsy forceps pulls a folded fastener, i.e. elastic force discharges, spring element Moment promote suture needle enter inserting needle duct, across tissue, go back into needle outlet road, biopsy forceps pulls two folded fasteners, i.e. back pressure bullet Power part, in case the suture of next needle.Continue out needle in another pincers road of scope(The biopsy forceps of repacking is not reequiped, also can be pre- If knot), go out needle proximal end and preset knot, seam needle is kissed in distal end, if interrupted suture, goes out needle and extracts suture needle, across preset Knot takes out and tightly knots, if continuous suture, estimates displacement by scope, suture needle is entered by going out needle into pin hole, then discharges elastic force Part starts the suture of next needle, and so on, until last needle passes through knot, takes out tight knot.By micro-slip or folding or Torsion or overturning or bending etc., the depth of inserting needle, the distance into needle outlet may be designed to it is adjustable, between pitch-row tissue can be therewith Protuberance.Needle track(Gap)Radian, diameter, length, width etc. can also be adjusted according to actual needs, while prepare the corresponding tune Whole suture needle.
Embodiment 2
It is accordingly molded by existing operation needle size, is installed in the distal end of class conventional digestion road pusher, inside there is inserting needle duct With needle outlet road, boots are moved at bottom You Ka angles, and inserting needle can rely on into needle(Band line;It can pendulum-type), spring element is riveted into needle, is gone out Pin hole is to picking out needle(Default knot), the proximal end of pusher, pusher are placed in into needle, spring element, the lever that goes out needle Other than distal end, it is the metal of bio-compatible or the small bore high molecular polymer of bio-compatible, also allows for postposition Enter the Synchronous of conventional endoscopic(Or it will operate bright mounted on scope proximal lateral).Per rectum or cervix enter internal, bottom It puts to be attached to put in vivo and is attached to the tissue surfaces such as transverse colon or colon descendens or fallopian tubal, discharge elastic force, is i.e. moment promotes suture needle to enter Inserting needle duct, across tissue, go back into needle outlet road, go out needle extract suture needle, across preset knot(It is predeterminable to be beaten in suture It ties in guide structure), you can take out it is tight knot, if continuous suture, block pressure Ka Jiao and move boots, accurately move stitching unstrument, suture needle or by Pendulum is pushed into pin hole into needle or is embedded into pin hole by going out needle, then discharge spring element, and so on, until last needle is worn Knot is crossed, tight knotting is taken out, internal part is directed to after also can in vitro knotting by the prior art.Also robotic arm knots.
Embodiment 3
The arc needle track of the conventional suture needle of corresponding operation is arranged at stitching unstrument top(Also it can adjust, and prepare the suture needle of the corresponding adjustment)With Line storehouse, needle track veutro or avris have wavy linear slit(Wavy amplitude and size be suitable for suture export and needle track but suture needle not It drops out), the bipod of lower part, inserting needle side can be clinohedral class taper bound feet(So as to vertical inserting needle), it can be big foot to go out needle side(Central loudspeaker Mouth, to go out needle when, pick up needle).Needle track is nearby set as typhon shape by needle track stage casing, and center can have several unidirectional horn-like Sharp stamen enters needle track convenient for suture needle, and typhon shape bottom, which is continued, invaginates to be more conducive to out picking up after needle into the toy trumpet behind needle Needle.Inserting needle duct inserting needle can rely on into needle(Push away bolt), pushing away bolt can be located in needle track, suture needle be pushed to pass through inserting needle duct along needle track Into in-vivo tissue, across tissue, go back into needle outlet road;Inserting needle end, predeterminable knot.Pushing away bolt center has pin hole, after pushing away bolt There is toy trumpet shape invagination in face, and pushing away bolt can control(Or up and down)It splits, pushes away the upper and lower of bolt(Or left and right)Respectively there is an ear bar, ear bar connects drawing Line when tensing bracing wire, clamps, initial operation person will can push away bolt and lean on to be more conducive to inserting needle toward needle point as possible into needle.Needle outlet It says needle and can rely on out needle(Pulling plug), there is pin hole in pulling plug center, and pulling plug can control(Or up and down)It splits, above and below pulling plug(Or Left and right)Respectively have an ear bar, ear bar connects bracing wire, and can external manipulation unit, when tensing bracing wire, pulling plug clamps, and also can rely on back The multiple bolt that pushes away clamps needle tip, continues and pulls out suture needle, goes out the predeterminable knot in needle end, and suture needle passes through preset knot with suture, Take out tight knot.Wired storehouse between needle end and needle track typhon shape is gone out is fallen after rise through needle track typhon shape bottom into pushing away when picking up needle After bolt, pulling plug continues to go out back and forth needle end to pull out suture, and suture is placed in line storehouse.Line storehouse is alternatively open(Can not have to yet Line storehouse).The moment that the power for pushing away bolt and pulling plug may be from elastic component, have an effect also can be according to pendulum model into needle or the pulling force of biopsy forceps Deng other power-assisteds.It can be mounted on scope during operation, also can combine or split on special pusher or whole is installed On special pusher, class capsule body can be also placed in by known technology and enters internal, remote control intelligent operation, if with soft interior Stitching unstrument is buckled into the pincers road 1 of Shuan Qian roads scope, in question mark shape by mirror;Endoscopic forceps channel 2 has bracing wire control to push away bolt, separately there is bracing wire Control pulling plug;Scope enters in vivo through esophagus, and suture site, slides stitching unstrument in vivo, and scope is made to be located at stitching unstrument needle track top Portion center, in laundry hanging fork shape(The bracing wire adjustment for pushing away bolt and pulling plug can be relied on), also can c-type plane indulge diameter perpendicular to scope leading end portion It is sutured with being monitored from stitching unstrument avris, other angles are conducive to visual field eyesight and operation.Enter internal, big foot elder generation through oesophagus It falls, until stomach bottom local organization slightly falls bound feet after protuberance again, the bottom surface local slope of bound feet is just with tissue close to vertical, just In inserting needle.External bracing wire, pushing away bolt makes suture needle enter inserting needle end along needle track, breaks through tissue surface, continues to push pin;When going out needle end When appearing suture needle, near mobile pulling plug to suture needle, suture needle is vised, is moved to and pushes away near bolt, unclamped, suture needle is taken advantage of a situation into needle track; After suture needle enters needle track, then pulling plug is retracted to going out needle end, until after going out needle end, then suture clamping is pulled to line storehouse, horn-like point stamen Make suture can only be toward a direction(Front)It is mobile;If continuous suture, and so on moves, can gradually pull in tail end suture tightly It suffers the line storehouse of needle track or in continuous suture, after next needle pulls out needle, first carries torsion bound feet, suture is made to drop out needle track through linear slit, then Torsion big foot is carried, suture is made to drop out line storehouse and needle track other parts.Also can be respectively coronal separated by seat piece bipod, when stitching unstrument is transferred It separates, closes up when lifting, that is, clamp the end of a thread at both ends.Go out the big foot at needle end, cut with line.Big foot, which lifts, clamps suture needle point Needle is pulled out in portion;Big foot recovery is covered in mucous membrane, i.e., slightly opens big foot, suture needle enters needle track by line storehouse.First needle and last needle it Between each needle suture distance, can be estimated and shifted by scope, can also combined and move the continuous suture of boots displacement.C-type or horse-hof shape go out The foot at needle end, cuts with line, and when being pulled to suitable, big foot inside cord cuts short suture;It also can be coronal by the bipod of c-type or horse-hof shape Line separates, and when decentralization separates, and closes up when lifting, that is, clamps the end of a thread at both ends, clamped respectively by big foot and bound feet, rotates 180 °, It knots in this way.Metal clip also can be used or/and high molecular polymer presss from both sides or/and needlework are fixed or/and be closed to other methods.Also may be used It is directed to after knotting in vitro in vivo.
Embodiment 4
Double paddle pendulums are into needle(Band line).Needle tail part or whole are buckled in into needle by pendulum model into the A ends of needle Face, pendulum model is into the B ends of needle(Another leaf paddle of similar two blade propeller, the center of two leaves is located adjacent to the interior of suture needle arc Side centre point)The endoscopic forceps of repacking are connected, transcervical enters in vivo, pulls biopsy forceps, make pendulum model into the B ends of needle Movement, is agitated, the A ends of pendulum model into needle, which just take advantage of a situation to push arc-shapedly, is buckled in inserting needle part by pendulum model into needle B ends In suture needle, then suture needle by setting accurately enter oviduct tissue.Go out needle and extract suture needle, across preset knot, you can take out It is tight to knot.The movement of pendulum model into needle may also rely on micro machine.Double paddle pendulums can also connect into needle uses spring element.
Embodiment 5
Single-blade formula pendulum is into needle(Band line).Needle tail part or whole are buckled in inside into needle pendulum model into needle, pendulum Formula is into the centrifugation end of needle(Pendulum model is located adjacent to the inside centre point of suture needle arc into the support end of needle), connection repacking Endoscopic forceps, transtracheal enters internal, pulls biopsy forceps, pendulum model is made with regard to arc-shaped to be pushed into needle and is buckled in inserting needle Suture needle in part, then suture needle accurately enter tracheae or lung or its hetero-organization by setting.Go out needle and extract suture needle, across preset Knot(It is predeterminable in suture knotting guide structure), you can take out tight knot.Also can be set as single-blade formula pendulum into needle can It slides, after pendulum model pushes suture needle into needle, pendulum model slides to center-side into the centrifugation end of needle, at this time pendulum model inserting needle The former centrifugation end of part is with regard to the center-side of Cheng Xin, and for former center-side with regard to the centrifugation end of Cheng Xin, new centrifugation end, which is just continued, extracts suture needle, wears Cross preset knot, you can take out tight knot.It completes after knotting, centrifugation end and center-side can be restored again, then carry out the seam of next needle Needle promotes.The movement of pendulum model into needle may also rely on micro machine.Single-blade formula pendulum can also connect into needle and use spring element.
Embodiment 6
The suture at inserting needle end is through knotting guide structure(Intaglio plate is carved similar to the moon)Suture is made to form surgery one hand and knot and partly covers side, is gone out Needle end partly covers side across the knotting, and both ends are with the biopsy forceps or special pusher of biopsy forceps or repacking and using seat piece as branch Point tenses suture to knot, and equally, go out the suture at needle end makes suture form half set of surgery one hand knotting through knotting guide structure Side, inserting needle end partly cover side across the knotting, and both ends are again with the biopsy forceps or special pusher of biopsy forceps or repacking and with seat piece For fulcrum, tense suture and knot again, during which, also can seat piece all 180 ° of 180 ° of rotation or partition part rotation in favor of urgent the Two knots(Avoid Slipped Clove Hitch, false knot etc.).Using seat piece as fulcrum, so that it may suture is tensed to knot, without dissociating, will not be individually straight It connects and involves tissue.Through dynamics measurement, in the case where soaking suture with physiological saline, the pulling force>150N.
Embodiment 7
Special culture media is prepared, the cell of toxicity test is V79 cells, is added into 6 orifice plates, is cultivated for 24 hours to logarithmic growth, The leaching liquor of this sample is prepared, extraction ratio is 0.1g/mL, and MEM05 culture mediums dilute, and prepare 4 concentration groups of large span, if Positive control and negative control are put, prepares 33.3/mL cell suspensions, is added in 6 orifice plates with every hole 3mL cell suspensions amount, is incubated For 24 hours, it inhales and abandons culture medium, 2mL leaching liquors are added in per hole, 3 holes of parallel preparation are incubated 6d, and culture medium, PBS washings, first are abandoned in 8d suctions Alcohol is fixed, 5% Giemsa dyeing, colony-forming efficiency >=control group 70%.
Embodiment 8
With 3 male and healthy albefaction rabbits of strain, 2.57 ± 0.43kg of weight wipes out both sides backbone hair for 24 hours before experiment, prepare this Sample polarity and nonpolar leaching liquor are provided to inject, observe each injection point surrounding skin, remember by standard by GB/T 16886.10 Subsystem judges Test sites and control position erythema and oedema score value, and as a result display is finally scored<1.0.
Embodiment 9
10 week old CBA/Ca female mices, 35 are randomly divided into 5 groups(Every group 7):Each 1 group of 2 kinds of leaching liquors, 2 kinds of positive controls Each 1 group, 1 group of blank group.25 μ L/d mouse ears back sides continue 3d, and weight is recorded in last 1 time, and iv markers measure cell Proliferation.As a result laboratory sample SI is shown<3.0, positive control >=3.0.
Part that the present invention does not relate to includes the identical prior art or the prior art can be used and realized.

Claims (10)

1. a kind of internal stitching unstrument, which is characterized in that the internal stitching unstrument is by the material preparation of bio-compatible, the internal seam Clutch at least one into needle, the internal stitching unstrument enter through body natural cavity or/and opening it is internal, in mucomembranous surface Or deep, organ surface or deep, other tissue surfaces or deep are sutured and are closed.
2. internal stitching unstrument according to claim 1, which is characterized in that the internal stitching unstrument is mounted on soft scope Operation or installation are split on special pusher.
3. internal stitching unstrument according to claim 1, which is characterized in that the internal stitching unstrument is carried out using conventional suture needle Suture and closure.
4. internal stitching unstrument according to claim 1, which is characterized in that the internal stitching unstrument adjustable inserting needle depth, Metering needle pitch-row from tissue between, pitch-row can swell, can be interrupted or continuously suture and be closed therewith, can in parallel or series or intersect or Repetition or pitch of the laps and its arbitrary combination.
5. internal stitching unstrument according to claim 1, which is characterized in that the internal stitching unstrument can be knotted by suture to be drawn Guide structure and/or direct and/or default knot knot in vivo, and internal part is directed to after can also knotting in vitro, it is also possible to Pre-knotted suture, self-adhesion bad mold joint, self-styled suture etc..
6. internal stitching unstrument according to claim 1, which is characterized in that the internal stitching unstrument is foldable or/and reverses Or/and overturning or/and bending and its arbitrary combination, can also be placed in capsule body enter in vivo, remote control intelligent operation.
7. internal stitching unstrument according to claim 1, which is characterized in that the internal stitching unstrument can have needle track(Gap), line Storehouse pushes away bolt, pulling plug, ear bar, linear slit, external manipulation unit etc..
8. internal stitching unstrument according to claim 1, which is characterized in that the mobile company of the internal stitching unstrument and its needlework It connects moment and/or soft slow and/or interruption and/or continues and its having an effect of arbitrarily combining or/and push-pull device at fixed.
9. internal stitching unstrument according to claim 1, which is characterized in that the internal stitching unstrument guiding needlework or/and gold Belong to silk or/and various polymer or/and all kinds of adhesives or/and medical adhesive or/and spring element or/and antitorque muscle and its arbitrary group It closes.
10. internal stitching unstrument according to claim 1, which is characterized in that the internal stitching unstrument knotter or/and beat Knot pincers or/and manipulator or/and metal clip or/and high molecular polymer folder or/and bonding or/and heat seal or/and other physics Or/and chemistry or/and biological method fix or/and be closed needlework.
CN201810152994.7A 2018-02-21 2018-02-21 A kind of medical instrument Withdrawn CN108245212A (en)

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Application Number Priority Date Filing Date Title
CN201810152994.7A CN108245212A (en) 2018-02-21 2018-02-21 A kind of medical instrument

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN201810152994.7A CN108245212A (en) 2018-02-21 2018-02-21 A kind of medical instrument

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CN108245212A true CN108245212A (en) 2018-07-06

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CN201810152994.7A Withdrawn CN108245212A (en) 2018-02-21 2018-02-21 A kind of medical instrument

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112401957A (en) * 2020-11-10 2021-02-26 李成 Single-needle convenient positioning and suturing device for herniated intervertebral disc fibrous ring
CN112568951A (en) * 2021-02-02 2021-03-30 山东省千佛山医院 Cavity organ scope communicating pipe suturing mechanism

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112401957A (en) * 2020-11-10 2021-02-26 李成 Single-needle convenient positioning and suturing device for herniated intervertebral disc fibrous ring
CN112401957B (en) * 2020-11-10 2021-09-24 田纪伟 Single-needle positioning and suturing device for intervertebral disc herniation fibrous ring
CN112568951A (en) * 2021-02-02 2021-03-30 山东省千佛山医院 Cavity organ scope communicating pipe suturing mechanism
CN112568951B (en) * 2021-02-02 2021-11-09 山东省千佛山医院 Hollow organ scope communicating tube suturing mechanism

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Application publication date: 20180706