CN109044427B - Defect closure assembly and method of intervention - Google Patents
Defect closure assembly and method of intervention Download PDFInfo
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- CN109044427B CN109044427B CN201811058435.6A CN201811058435A CN109044427B CN 109044427 B CN109044427 B CN 109044427B CN 201811058435 A CN201811058435 A CN 201811058435A CN 109044427 B CN109044427 B CN 109044427B
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- puncture needle
- defect
- lead structure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00592—Elastic or resilient implements
Abstract
The application provides a defect closer assembly and an intervention method thereof, wherein the defect closer assembly comprises a closer and a puncture needle, and the closer comprises: the head of the rod body can be bent, the outlet of the first channel in the rod body is positioned at the inner side of the rod body when the head of the rod body is bent, and the outlet of the second channel in the rod body is positioned below the outlet of the first channel; the lead structure is movably arranged at the outlet of the first channel; the suture thread penetrates into the first channel and is connected with the lead structure, the closer can enter a human body through a blood vessel and the like, after the closer is inserted into the organ defect hole, the head of the rod body is bent, the puncture needle penetrates through the second channel and tissues around the organ defect hole and is connected with the lead structure, and when the puncture needle is withdrawn, the puncture needle drives the lead structure to move together, so that the suture thread penetrates through the tissues around the organ defect hole along the path of withdrawing the puncture needle. The technical scheme of the application can solve the problems that the intervention plugging operation is implanted into the metal plugging device and long-term retention can bring a plurality of risks.
Description
Technical Field
The application relates to the technical field of biomedical appliances, in particular to a defect closer assembly and an intervention method thereof, which are mainly used for treating patent foramen ovale and atrial septal defects.
Background
Foramen ovale occlusion is an early applied treatment measure for interventional congenital heart disease, and more mature experience is accumulated in China at present. In the existing patent foramen ovale occlusion, an umbrella-shaped metal occluder is generally used for clamping tissues around a defect, so that occlusion of the defect part is realized. However, the occluder is a large foreign body, not only risking detachment, but also thrombus formation after implantation in the body, and patients need to take at least half a year of aspirin, and even so, some patients still have poor endothelialization and continuously develop thrombus. On the other hand, metallic occluders remain in the patient for life, with long periods of time at risk of abrading surrounding tissue, leading to complications such as cardiac perforation.
Disclosure of Invention
The main object of the present application is to provide a defect closer assembly and an intervention method thereof, which are used for solving the problems that the intervention plugging operation in the prior art needs to be implanted with a metal plugging device and is remained for a long time, thus bringing a plurality of risks.
In order to achieve the above object, according to one aspect of the present application, there is provided a defect closer assembly including a closer and a puncture needle, the closer comprising: the rod body is internally provided with a first channel and a second channel, the head of the rod body can be bent, the inlet of the first channel and the inlet of the second channel are both positioned at the tail part of the rod body, the outlet of the first channel is positioned at the inner side of the bent head of the rod body, and the outlet of the second channel is positioned below the outlet of the first channel; the lead structure is movably arranged at the outlet of the first channel; the suture thread is absorbable suture thread or non-absorbable suture thread, the suture thread penetrates into the first channel from the inlet of the first channel and is connected with the lead structure, after the closer is inserted into the organ defect hole, the head of the rod body is bent, the puncture needle sequentially penetrates through the second channel and tissues around the organ defect hole and is connected with the lead structure, and when the puncture needle is withdrawn, the puncture needle drives the lead structure to move together, so that the suture thread penetrates through the tissues around the organ defect hole along the withdrawing path of the puncture needle.
Further, the first channel is provided with a bending section at a position close to the outlet of the first channel and the second channel is provided with a bending section at a position close to the outlet of the second channel, so that the outlet of the second channel can be aligned with the lead structure when the head of the rod body is bent.
Further, the lead structure is a buckle, a groove is formed in the buckle, a barb is arranged on the inner wall of the groove, and when the head of the puncture needle stretches into the groove, the barb hooks the head of the puncture needle so that the puncture needle can drive the buckle to move together.
Further, the longitudinal section of the barb is triangular, the head of the puncture needle is provided with a pointed end, and the head of the puncture needle protrudes out of the rest of the puncture needle along the radial direction of the head of the puncture needle.
Further, the head part of the puncture needle and the lead structure are both provided with a metal part, and a bubble structure is arranged in the metal part, so that the metal part can be clearly developed under ultrasound, and positioning can be performed under ultrasound guidance without using radioactive rays.
Further, the lead structure is a cloth filled at the outlet of the first channel, the head of the puncture needle is provided with barbs, and after the head of the puncture needle is inserted into the cloth, the barbs hook the cloth so that the puncture needle can drive the cloth to move together.
Further, the lead structure is a first magnet, the head of the puncture needle is provided with a second magnet, and when the head of the puncture needle is close to the first magnet, the first magnet and the second magnet are connected in an attractive manner, so that the puncture needle can drive the first magnet to move together; or, the defect closer assembly further comprises a third magnet and a metal part which can be attracted by the third magnet, one of the third magnet and the metal part forms a lead structure, the other of the third magnet and the metal part is arranged at the head part of the puncture needle, and when the head part of the puncture needle is close to the lead structure, the third magnet attracts the metal part, so that the puncture needle can drive the lead structure to move together.
Further, the rod body comprises a rod body main body and a bending rod rotatably arranged on the rod body main body, the bending rod forms the head of the rod body, and an outlet of the second channel is positioned on the side wall of the rod body main body.
Further, the first channel comprises a main channel section and an auxiliary channel section, the main channel section is arranged in the rod body main body, the auxiliary channel section is arranged in the bending rod, the diameter of one end of the auxiliary channel section, which is close to the rod body main body, is smaller than that of one end of the main channel section, which is close to the bending rod, and the auxiliary channel section rotates along with the bending rod in the rotating process of the bending rod, and is always communicated with the main channel section.
Further, the body of rod still includes the connection structure of connecting between body of rod main part and bending rod, and connection structure and body of rod main part, bending rod are all rotatable to be connected, and connection structure includes at least one section connecting rod, when the connecting rod is the multistage, rotatable connection between each adjacent two sections connecting rods.
Further, a third channel is arranged in the rod body, an inlet of the third channel is positioned at the tail part of the rod body, an outlet of the third channel is positioned at the head part of the rod body, and the third channel is used for passing through the guide wire so that the closer can be sent into the body along the guide wire and inserted into the defect hole of the organ.
According to another aspect of the present application, there is provided an interventional method of a defect closure assembly, comprising the steps of, in order:
puncturing femoral vein, delivering the catheter and the guide wire into the body, introducing into the defect hole of the organ, withdrawing the catheter, and retaining the guide wire; penetrating the guide wire into a third channel inside the rod body of the closer, and delivering the closer into the body along the guide wire and inserting the closer into the defect hole of the organ to withdraw the guide wire; bending the bending rod of the rod body to one side of the organ defect hole, and enabling the puncture needle to penetrate through the second channel, puncture tissues around the organ defect hole and be connected with a lead structure at the inner side of the bending rod; withdrawing the puncture needle, wherein the puncture needle drives the lead structure to move together so that a suture connected with the lead structure passes through tissues around the organ defect hole along a path of withdrawing the puncture needle, withdrawing the closer and penetrating the suture on one side of the organ defect hole; repeating the steps, and penetrating the suture line on the tissue at the other side of the organ defect hole; the suture lines positioned at both sides of the organ defect hole are tied and fastened by the knot tying device 60, thereby closing the organ defect hole.
By applying the technical scheme of the application, after the closer is inserted into the organ defect hole, the head of the rod body is bent towards one side of the organ defect hole, then the puncture needle penetrates through the second channel, pierces the tissues around the organ defect hole and is connected with the lead structure, and then the puncture needle is withdrawn. When the puncture needle is withdrawn, the puncture needle drives the lead structure to move together so that the suture thread passes through the tissue around the organ defect hole along the path along which the puncture needle is withdrawn. Thereafter, the head of the shaft is straightened and the closure is withdrawn, and the suture is threaded through the tissue on one side of the organ defect hole. The closure is installed with a new suture or a new closure is used, and the procedure is repeated to thread the suture through the tissue on the other side of the organ defect hole. The suture lines positioned at both sides of the organ defect hole are tied and fastened by the knotter, so that the organ defect hole is closed. For atrial septal defect, the above operation can be repeated for a plurality of times, and after a plurality of sutures are driven in, the suture is knotted, so that the defect can be completely closed. By adopting the defect closer component, only the defect part is required to be sutured through the suture line, and the metal occluder is not required to be implanted, so that various risks brought by the metal occluder are avoided. In addition, the repair and closure can be carried out on the organ defect holes with different sizes.
Drawings
The accompanying drawings, which are included to provide a further understanding of the application and are incorporated in and constitute a part of this specification, illustrate embodiments of the application and together with the description serve to explain the application. In the drawings:
FIG. 1 shows a schematic cross-sectional view of a closure of a first embodiment of a defect closure assembly according to the present application;
FIG. 2 shows an enlarged schematic view of the closure of FIG. 1 at A;
FIG. 3 shows a schematic cross-sectional view of the closure of FIG. 1 with a bending rod bent;
FIG. 4 shows a schematic cross-sectional view of the closure of FIG. 3 mated with a piercing needle;
FIG. 5 shows a schematic view of the structure of the defect closure assembly of FIG. 1 in the repair of an atrial septal defect hole (foramen ovale);
FIG. 6 shows an enlarged schematic view of the defect closure assembly and atrial septal defect hole of FIG. 5 at B; and
FIG. 7 shows a schematic view of the knot tying device of the defect closure assembly of FIG. 1.
Wherein the above figures include the following reference numerals:
10. a puncture needle; 20. a rod body; 21. a first channel; 22. a second channel; 23. a rod body; 24. bending the rod; 25. a third channel; 30. a suture; 40. a buckle; 41. a barb; 50. an organ defect hole; 60. a knotter; 61. a hook portion; 70. bubble structure.
Detailed Description
It should be noted that, without conflict, the embodiments of the present application and features of the embodiments may be combined with each other. The application will be described in detail below with reference to the drawings in connection with embodiments.
As shown in fig. 1-7, the defect closure assembly of the first embodiment is used for the closure repair of an oval foramen (or atrial septal defect of the heart). Specifically, the above-described defect closure assembly includes a closure and a puncture needle 10. The closer includes a shaft 20, a lead structure, and a suture 30. The rod 20 has a first channel 21 and a second channel 22 therein. The head of the rod 20 is bendable. The inlet of the first channel 21 and the inlet of the second channel 22 are both located at the tail of the rod body 20. The outlet of the first passage 21 is located on the side wall of the head of the rod 20, and the outlet of the first passage 21 is located inside when the head of the rod 20 is bent. The outlet of the second channel 22 is located below the outlet of the first channel 21. The lead structure is movably disposed at the outlet of the first channel 21. Suture 30 is threaded into first passageway 21 from the inlet of first passageway 21 and is connected to the lead structure. In addition, the rod 20 has a third passage 25 therein. The inlet of the third passage 25 is located at the rear of the shank 20. The outlet of the third passage 25 is located at the head of the rod 20. The third passageway 25 is used to pass through the guidewire to enable the occluder to be delivered into the body along the guidewire and inserted into the organ defect hole 50.
With the present embodiment of the defect closer assembly, the femoral vein is first punctured, the catheter and guidewire are delivered into the body, and passed into the defect hole 50 of the organ, withdrawn from the catheter, and the guidewire is retained. The guidewire is then threaded into the third passageway 25 and the obturator is advanced into the body along the guidewire and into the organ defect hole 50 and withdrawn from the guidewire. After the sealer is inserted into the organ defect hole 50, the head of the rod body 20 is bent toward one side of the organ defect hole 50, and then the puncture needle 10 is passed through the second channel 22, penetrates the tissue around the organ defect hole 50 and is connected with the lead structure, and then the puncture needle 10 is withdrawn. As the needle 10 is withdrawn, the needle 10 moves the lead structure together to cause the suture 30 to pass through the tissue surrounding the organ defect hole 50 along the path along which the needle 10 is withdrawn. Thereafter, the head of shaft 20 is straightened and a guidewire is again fed along third passageway 25, leaving the guidewire in the body, the obturator is withdrawn, and suture 30 is threaded over the tissue on one side of organ defect hole 50. The closure is installed with a new suture 30 or a new closure is used, inserted along the remaining guidewire into the organ defect hole 50, and the above-described procedure is repeated, with the suture 30 threaded onto the tissue on the other side of the organ defect hole 50. Suture 30 located on both sides of organ defect hole 50 is tied off by knotter 60, thereby closing organ defect hole 50 (the foramen ovale). With the defect closer assembly, only the defect part is sutured through the suture 30, and the metal occluder is not required to be implanted, so that various risks brought by the metal occluder are avoided. In addition, repair closure of organ defect holes 50 of different sizes is also possible.
In this embodiment, the defect closure assembly is used to repair an oval foramen. Of course, in other embodiments, the defect closure assembly may be used with other types of defects, such as for repairing atrial septal defects, where the above-described procedure may be repeated multiple times, multiple sutures may be driven, and tied, to completely close the defect. In addition, in this embodiment, the suture 30 is an absorbable thread that is absorbed by the human body after endocerisation, enabling residue-free treatment of heart disease. Of course, suture 30 may also be a non-absorbable thread.
As shown in fig. 3 and 4, in the defect closer assembly of the first embodiment, the first channel 21 is near the outlet thereof, and the second channel 22 is near the outlet thereof, which are provided with curved sections, so that the outlet of the second channel 22 can be aligned with the lead structure when the head of the rod 20 is bent. That is, at this time, the center line of the outlet of the second passage 22 is aligned with the center line of the lead structure. The structure can ensure that the puncture needle 10 can not be pricked to other places in the forward pushing process after coming out of the second channel 22, can accurately enter the lead structure of the first channel 21, and can not damage other tissues.
As shown in fig. 2 and 6, in the defect closer assembly of the first embodiment, the lead structure is a buckle 40. The buckle 40 is provided with a groove, and the inner wall of the groove is provided with a barb 41. In this embodiment, the barbs 41 extend one revolution in the circumferential direction of the groove, and the barbs 41 can be considered as inwardly protruding formation of the inner wall of the groove. The longitudinal section of the barb 41 is triangular. The head of the puncture needle 10 has a pointed tip (in this embodiment, the longitudinal section of the head of the puncture needle 10 is also triangular, i.e., the head of the puncture needle 10 is triangular cone-shaped), and the head of the puncture needle 10 protrudes from the rest of the puncture needle 10 in its radial direction. When the head of the puncture needle 10 just stretches into the groove, the triangular conical surface of the head of the puncture needle 10 contacts and slides with the inclined surface of the barb 41, and after the head of the puncture needle 10 stretches completely, the bottom surface of the barb 41 clamps the bottom surface of the head of the puncture needle 10, so that the head of the puncture needle 10 is hooked, and the puncture needle 10 can drive the buckle 40 to move together.
The lead structure is provided as the buckle 40 with the barb 41, the head of the puncture needle 10 is hooked by the barb 41, the structure is simple, and the connection between the lead structure and the puncture needle 10 can be more reliable. The barb 41 is arranged in a circle, so that the connection reliability is further ensured, and the falling-off between the buckle 40 and the head of the puncture needle 10 is effectively prevented. Likewise, the head of the puncture needle 10 protrudes from the rest of the puncture needle 10 in the radial direction thereof, also in order to be able to mate the bottom surface of the protruding portion of the head of the puncture needle 10 with the barb 41, thereby further securing the connection reliability. In addition, the head of the puncture needle 10 is in a triangular cone shape, and the longitudinal section of the barb 41 is in a triangular shape, so that the triangular cone surface of the puncture needle 10 can slide in contact with the inclined surface of the barb 41, and the puncture needle plays a role in guiding, so that the head of the puncture needle 10 can more easily extend into the U-shaped groove of the buckle 40.
The specific form of the lead structure is not limited to this, and in other embodiments not shown in the drawings, the lead structure may be other structures that can be connected to the head of the puncture needle. In this embodiment, the buckle 40 is integrally cylindrical, a groove is formed in the center of the buckle, the barbs 41 are arranged to form a circle along the circumferential side wall of the groove, and of course, the structure of the buckle 40, the number and shape of the barbs 41 are not limited thereto, and in other embodiments not shown in the drawings, the buckle may be integrally U-shaped, barbs are arranged on the inner sides of the buckle, and the barbs are symmetrically arranged. The barbs can be strip-shaped barbs which are obliquely arranged, and the number of the barbs can be only one or more than three, so long as the head of the puncture needle can be hooked. In addition, the head of the puncture needle 10 is not limited to the triangular pyramid shape, and in other embodiments not shown in the drawings, the shape of the head of the puncture needle may be entirely similar to the combined shape of a triangular pyramid and a cylinder, as long as the head of the puncture needle can be made to protrude from the rest of the puncture needle in the radial direction thereof.
As shown in fig. 2, 4 and 6, in the defect closer assembly of the first embodiment, the head and the lead structure of the puncture needle 10 each have a metal portion, and the metal portion is provided with a bubble structure 70 therein, and the bubble structure 70 enables the metal portion to be clearly developed under ultrasound, so that positioning under ultrasound guidance can be performed without using radiation. Specifically, in the manufacturing process, microbubbles are mixed in the metal, so that a bubble structure 70 is formed in the formed metal part, thus the echo of the head of the puncture needle 10 and the lead structure under ultrasound can be enhanced, and the puncture needle can be positioned away from important tissues by showing a highlight bright spot on an ultrasound image.
In the present embodiment, the entirety of the head portion of the puncture needle 10 and the entirety of the lead structure are made of a metal material, that is, the entirety of the head portion of the puncture needle 10 and the entirety of the lead structure form a metal portion. Of course, the form of the metal portion is not limited to this, and in other embodiments, the metal portion may be a metal structure such as a metal block or a metal sheet provided on the head portion of the puncture needle or the lead structure.
As shown in fig. 1, 3 and 4, in the defect closer assembly of the first embodiment, the shaft 20 includes a shaft body 23 and a bending lever 24 rotatably provided on the shaft body 23. The bending bar 24 forms the head of the bar body 20. The outlet of the second passage 22 is located on a side wall of the body of rod 23. In this embodiment, the bending rod 24 is connected to the rod body 23 through a rotation shaft, and the bending rod 24 can pivot in the setting plane of the rod body 23. The length of the bending bar 24 is 1 to 10cm, preferably 2cm. The angle between the body 23 of the closer rod and the bending rod 24 is 10-160 degrees, preferably 60 degrees. The closer also comprises a rotation control part arranged at the tail of the rod body 23, through which the bending rod 24 can be controlled to rotate (the specific implementation manner is that a plurality of prior art devices are provided, for example, a rotary shaft is controlled to rotate in a manner of matching a knob, a wire and a rotary shaft). The first channel 21 includes a main channel section provided in the rod body 23 and an auxiliary channel section provided in the bending rod 24, and the diameter of one end of the auxiliary channel section near the rod body 23 is smaller than the diameter of one end of the main channel section near the bending rod 24. When the bending rod 24 rotates, the secondary channel section rotates along with the bending rod 24, but the port of the secondary channel section close to the rod body 23 is always kept corresponding to the port of the primary channel section close to the bending rod 24, so that the secondary channel section and the primary channel section can be always communicated.
It should be noted that, the rotational connection manner between the bending rod 24 and the rod body 23 is not limited to the connection via a rotation shaft, and in other embodiments not shown in the drawings, the bending rod and the rod body may be connected via other connection structures (see fifth embodiment); the bending lever 24 is not limited to pivoting in the plane of the lever body 23, and in other embodiments, the bending lever may be rotated in any direction relative to the lever body. In addition, the specific form of the rod 20 is not limited thereto, and in other embodiments not shown in the drawings, the rod may be an integral flexible rod, the head of which can be bent.
The main difference between the defect sealer assembly of the second embodiment (not shown) and the first embodiment is that the lead structure is a cloth material filled at the outlet of the first channel, and the head of the puncture needle has barbs. After the head of the puncture needle is inserted into the cloth, the barb hooks the cloth so that the puncture needle can drive the cloth to move together. In addition, other structures and working principles of the second embodiment are basically the same as those of the first embodiment, and will not be described herein.
The main difference between the defect closer assembly of the third embodiment (not shown) and the first embodiment is that the lead structure is a first magnet and the head of the puncture needle has a second magnet. When the head of the puncture needle is close to the first magnet, the first magnet and the second magnet are connected in an attractive manner, so that the puncture needle can drive the first magnet to move together. In addition, other structures and operation principles of the third embodiment are substantially the same as those of the first embodiment, and will not be described herein.
The defect closer assembly (not shown) of the fourth embodiment is mainly different from that of the first embodiment in that the defect closer assembly further includes a third magnet and a metal portion capable of being attracted by the third magnet, one of the third magnet and the metal portion forms a lead structure, and the other of the third magnet and the metal portion is disposed at the head of the puncture needle. When the head of the puncture needle is close to the lead structure, the third magnet adsorbs the metal part, so that the puncture needle can drive the lead structure to move together. In addition, other structures and operation principles of the fourth embodiment are substantially the same as those of the first embodiment, and will not be described herein.
The main difference between the defect sealer assembly of the fifth embodiment (not shown) and the first embodiment is that the shaft further includes a connection structure connected between the shaft body and the bending shaft. The connecting structure is rotatably connected with the rod body main body and the bending rod. The connecting structure comprises one or more sections of connecting rods. When the connecting rod is multistage, rotatable connection between each two adjacent sections connecting rods. The above-mentioned connection structure can function like a joint, thereby making the rotation range of the bending rod larger. In addition, other structures and operation principles of the fifth embodiment are substantially the same as those of the first embodiment, and will not be described herein.
The main difference between the defect closure assembly of the sixth embodiment and the first embodiment is that the defect closure assembly of the first embodiment is used for closure repair of an foramen ovale, and the defect closure assembly of the sixth embodiment is combined with an existing occluder to achieve closure repair of a large atrial septal defect. Specifically, for large atrial septal defects, the periphery of the atrial septal defect needs to have enough edges to be plugged by the existing plugging device, and if the edges of the atrial septal defect part are insufficient, the plugging device can fall off due to insufficient supporting force of the part. Thus, such a patient may first implant two symmetrical non-absorbable sutures in a sufficient portion of the defect edge through the defect closure assembly of this embodiment, tying the two sutures taut. Although the two sides of the atrial septal tissue cannot be connected together through two sutures because the defect is large, the sutures are transversely arranged in the defect to divide the defect into two defects with smaller sizes, one defect has enough edge and supporting force around with the help of the sutures, the conventional common occluder can be implanted, and the umbrella disc of the common occluder can cover the other part of the atrial septal defect separated by the sutures because the diameter of the umbrella disc of the common occluder is 14mm larger than that of the waist, and the two instruments are jointly used, so that the patient incapable of being plugged by intervention can be subjected to minimally invasive treatment.
The application also provides an intervention method of the defect closer assembly, and an embodiment of the intervention method according to the application comprises the following steps in sequence:
puncturing the femoral vein, delivering the catheter and the guide wire into the body, introducing into the defect hole 50 of the organ, withdrawing the catheter, and retaining the guide wire;
a third passage 25 for threading a guidewire into the interior of the shaft 20 of the obturator, the obturator being fed into the body along the guidewire and inserted into the organ defect hole 50, withdrawing the guidewire;
bending the bending rod 24 of the rod body 20 to one side of the organ defect hole 50, and passing the puncture needle 10 through the second channel 22, penetrating the tissue around the organ defect hole 50, and connecting with the lead structure inside the bending rod 24;
withdrawing the puncture needle 10, the puncture needle 10 driving the lead structure to move together so that the absorbable suture 30 connected with the lead structure passes through the tissues around the organ defect hole 50 along the withdrawing path of the puncture needle 10, straightening the head of the rod body 20, feeding the guide wire again along the third channel 25, keeping the guide wire in the body, withdrawing the closer, and penetrating the suture 30 on one side of the organ defect hole 50;
inserting a new suture 30 into the closure or using a new closure, inserting the suture 30 into the organ defect hole 50 along the retained guide wire, repeating the above steps, and threading the suture 30 into the tissue on the other side of the organ defect hole 50;
suture 30 located on both sides of organ defect hole 50 is tied off by knotter 60, thereby closing organ defect hole 50.
In particular, as shown in fig. 7, the head of the knotter 60 has a hook 61, and in the specific operation, the free ends of the suture lines 30 located at both sides of the organ defect hole 50 extending outside the body are tied together, and then the tied knot is pushed into the body to be tied by the hook 61 of the knotter 60. Of course, the specific form of the knotter 60 is not limited thereto, and in other embodiments not shown in the drawings, the knotter may also have a string cutting function.
The above description is only of the preferred embodiments of the present application and is not intended to limit the present application, but various modifications and variations can be made to the present application by those skilled in the art. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present application should be included in the protection scope of the present application.
Claims (10)
1. A defect closure assembly comprising a closure and a puncture needle (10), the closure comprising:
the rod body (20), a first channel (21) and a second channel (22) are arranged in the rod body (20), the head of the rod body (20) can be bent, the inlet of the first channel (21) and the inlet of the second channel (22) are both positioned at the tail part of the rod body (20), the outlet of the first channel (21) is positioned at the inner side of the bent head of the rod body (20), and the outlet of the second channel (22) is positioned below the outlet of the first channel (21);
a lead structure movably arranged at an outlet of the first channel (21);
a suture (30) which is an absorbable suture or a non-absorbable suture, wherein the suture (30) penetrates into the first channel (21) from the inlet of the first channel (21) and is connected with the lead structure, when the closer is inserted into the organ defect hole (50), the head of the rod body (20) is bent, the puncture needle (10) sequentially penetrates through the second channel (22) and the tissue around the organ defect hole (50) and is connected with the lead structure, and when the puncture needle (10) is withdrawn, the puncture needle (10) drives the lead structure to move together so that the suture (30) penetrates through the tissue around the organ defect hole (50) along the path along which the puncture needle (10) is withdrawn;
the positions of the first channel (21) close to the outlet and the positions of the second channel (22) close to the outlet are respectively provided with a bending section, so that the outlet of the second channel (22) can be aligned with the lead structure when the head of the rod body (20) is bent.
2. The defect closer assembly according to claim 1, wherein the lead structure is a buckle (40), the buckle (40) is provided with a groove, a barb (41) is arranged on the inner wall of the groove, and when the head of the puncture needle (10) stretches into the groove, the barb (41) hooks the head of the puncture needle (10) so that the puncture needle (10) can drive the buckle (40) to move together.
3. The defect closure assembly according to claim 2, wherein the longitudinal section of the barb (41) is triangular, the head of the needle (10) having a pointed tip, the head of the needle (10) protruding in its radial direction from the rest of the needle (10).
4. A defect closure assembly according to any of claims 1-3, wherein the head of the needle (10) and the lead structure each have a metal portion with a bubble structure (70) disposed therein, the bubble structure (70) enabling the metal portion to be clearly developed under ultrasound so that positioning can be conducted under ultrasound guidance without the use of radiation.
5. The defect closure assembly of claim 1 wherein said lead structure is a cloth material filled at the outlet of said first channel, the head of said piercing needle having barbs which hook the cloth material when the head of said piercing needle is inserted into the cloth material to enable said piercing needle to move said cloth material together.
6. The defect closer assembly according to claim 1, wherein the lead structure is a first magnet, the head of the piercing needle has a second magnet, and the first magnet is in attractive connection with the second magnet when the head of the piercing needle is close to the first magnet, so that the piercing needle can drive the first magnet to move together; or alternatively, the process may be performed,
the defect closer assembly further comprises a third magnet and a metal part which can be adsorbed by the third magnet, one of the third magnet and the metal part forms the lead structure, the other of the third magnet and the metal part is arranged at the head part of the puncture needle, and when the head part of the puncture needle is close to the lead structure, the third magnet adsorbs the metal part, so that the puncture needle can drive the lead structure to move together.
7. The defect closure assembly according to claim 1, wherein the shaft (20) comprises a shaft body (23) and a bending rod (24) rotatably provided on the shaft body (23), the bending rod (24) forming a head of the shaft (20), the outlet of the second channel (22) being located on a side wall of the shaft body (23).
8. The defect closure assembly of claim 7, wherein the first channel (21) comprises a main channel section and a secondary channel section, the main channel section is disposed in the shaft body (23), the secondary channel section is disposed in the bending bar (24), the diameter of the end of the secondary channel section adjacent to the shaft body (23) is smaller than the diameter of the end of the main channel section adjacent to the bending bar (24), the secondary channel section rotates along with the bending bar (24) during rotation of the bending bar (24), and the secondary channel section is always communicated with the main channel section.
9. The defect closure assembly of claim 8 wherein said stem further comprises a connecting structure connected between said stem body and said bending rod, said connecting structure being rotatably connected to both said stem body and said bending rod, said connecting structure comprising at least one segment of connecting rod, wherein when said connecting rod is multi-segment, each adjacent two segments of said connecting rod are rotatably connected.
10. The defect closure assembly of claim 1, wherein the shaft (20) further has a third channel (25) therein, an inlet of the third channel (25) being located at a trailing portion of the shaft (20), an outlet of the third channel (25) being located at a leading portion of the shaft (20), the third channel (25) being configured to pass through a guidewire to enable the closure to be delivered into the body along the guidewire and inserted into the organ defect hole (50).
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811058435.6A CN109044427B (en) | 2018-09-11 | 2018-09-11 | Defect closure assembly and method of intervention |
| PCT/CN2018/112649 WO2020052016A1 (en) | 2018-09-11 | 2018-10-30 | Defect closure device assembly and intervention method therefor |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811058435.6A CN109044427B (en) | 2018-09-11 | 2018-09-11 | Defect closure assembly and method of intervention |
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| Publication Number | Publication Date |
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| CN109044427A CN109044427A (en) | 2018-12-21 |
| CN109044427B true CN109044427B (en) | 2023-10-20 |
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| CN201811058435.6A Active CN109044427B (en) | 2018-09-11 | 2018-09-11 | Defect closure assembly and method of intervention |
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| Country | Link |
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| CN (1) | CN109044427B (en) |
| WO (1) | WO2020052016A1 (en) |
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| CN114343746B (en) * | 2022-01-07 | 2024-03-15 | 上海傲流医疗科技有限公司 | Foramen ovale closing clamp |
| CN117224179B (en) * | 2023-09-05 | 2024-02-23 | 南京思脉德医疗科技有限公司 | Stitch adjusting mechanism for suturing and suturing device for patent foramen ovale |
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| CN109044427A (en) | 2018-12-21 |
| WO2020052016A1 (en) | 2020-03-19 |
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