CN109199546B

CN109199546B - Puncture core assembly with sewing function and puncture device thereof

Info

Publication number: CN109199546B
Application number: CN201710531507.3A
Authority: CN
Inventors: 孙宝峰; 马猛
Original assignee: Jiangsu Fengh Medical Equipment Co Ltd
Current assignee: Jiangsu Fengh Medical Equipment Co Ltd
Priority date: 2017-07-03
Filing date: 2017-07-03
Publication date: 2020-11-10
Anticipated expiration: 2037-07-03
Also published as: CN109199546A

Abstract

The invention discloses a puncture core assembly, which comprises a puncture assembly and a suture assembly; the puncture assembly comprises a puncture end and a puncture core rod; the stapling assembly comprises a first element and a movable second element; the second element is provided with a first position and a second position, the puncture end drives the proximal end of the suture to be below the skin layer, the second element moves from the first position to the second position and supports the suture, and the first element drives the suture to penetrate out of the tissue on the opposite side of the puncture hole after penetrating through the tissue, so that the puncture hole is sutured by the suture. According to the puncture core assembly and the puncture outfit with the same, not only can the puncture function be realized, but also the puncture hole can be sutured, and the whole skin layer can be sutured, so that the suturing effect is good; can effectively avoid the puncture hole hernia caused by the puncture hole of the minimally invasive surgery, effectively reduce the pain of the patient and facilitate the postoperative rehabilitation of the patient.

Description

Puncture core assembly with sewing function and puncture device thereof

Technical Field

The invention relates to a surgical instrument, in particular to a puncture core assembly with a suturing function and a puncture outfit thereof, belonging to the field of medical equipment.

Background

In abdominal cavity examination, abdominal cavity operation and other minimally invasive or surgical operations, a puncture outfit is an indispensable surgical instrument. The puncture instrument may establish an access channel in the abdominal wall of the body for the entry of a stapler or other surgical instrument (e.g., endoscope, scissors, guide wire, catheter, filter, stent, etc.) into the abdominal cavity and provide a passage for the ingress and egress of gas to control the pneumoperitoneum required for the procedure to be performed for examination or surgical procedures.

In the minimally invasive laparoscopic medical operation, if the focus is found in a human body and needs to be operated or cut, pneumoperitoneum needs to be performed in the abdominal cavity of the human body in the operation process. The establishment of pneumoperitoneum is an important operation process of laparoscopic surgery, and under the condition of sufficient pneumoperitoneum, the distance between an abdominal cavity and an organ is expanded, the distance between the organ and the organ is also expanded, and a relatively wide visual field and an operation environment which is easy to operate are provided for an operator. After the pneumoperitoneum is completed, a doctor generally firstly cuts a small incision on the abdomen of a patient, then aligns the puncture end of the puncture outfit with the cut small incision to reciprocate and simultaneously moves the puncture outfit downwards, so that the puncture core assembly guides the puncture sleeve to pass through the cortex of the abdomen of the patient; then the puncture core component is pulled out, and the anastomat or other surgical instruments can enter and exit the abdominal cavity of the patient through the puncture cannula to carry out surgical operation. The existing puncture core assembly only plays a role of puncture, and the puncture cannula is discarded after being guided into a patient body from an incision of the abdomen of the human body.

And (4) removing the focus, taking out the puncture cannula assembly, and finishing the operation. The punctured wound is generally not sutured and is automatically healed only by the patient; because the puncture hole of the minimally invasive surgery is small and deep, particularly, the abdominal wall of an obese patient is thick, the visual field of the suture is small, the skin on the surface of the patient is only sutured after the surgery, and the peritoneum on the inner side of the abdominal wall is difficult to suture. Such patients are prone to serious complications such as hernia in the puncture hole after surgery, and require further treatment. When a puncture hole of a patient needs to be sutured, particularly a puncture hole of an obese patient, only a suturing device special for suturing the puncture hole can be used, but surgical instruments are additionally added, suturing cost is high, the surgical instruments are multiple, and operation is inconvenient. In addition, the suturing device specially used for suturing the puncture hole has a complex structure and is inconvenient to use.

The existing puncture outfit can only realize the puncture function and does not have the function of sewing a puncture hole, so improvement on the basis of the existing design is urgently needed to achieve a more ideal effect.

Disclosure of Invention

Aiming at the defects of the prior art, the invention aims to provide a puncture core assembly with a puncture function and capable of suturing a puncture hole and a puncture outfit with the same, and the invention is realized by the following technical scheme:

a puncture core assembly comprising a puncture assembly and a suture assembly; the puncture assembly comprises a puncture end and a puncture core rod; the stapling assembly comprises a first element and a movable second element; the second element has a first position and a second position; the puncture end drives the proximal end of the suture to be below the skin layer, the second element moves from the first position to the second position and supports the suture, the first element penetrates through the tissue and then moves in the direction opposite to the direction of penetrating the tissue so as to drive the suture to penetrate through the tissue on the opposite side of the puncture hole, and therefore the suture is utilized to suture the puncture hole.

Further, the suturing assembly further comprises a pressure plate, the first element is fixedly connected to the pressure plate, and the first element is perpendicular to the pressure plate.

Further, the pressure plate is provided with a central hole, and the inner diameter of the central hole is equal to or larger than the outer diameter of the puncture core rod so as to allow the puncture core rod to penetrate through the central hole.

Preferably, the first element comprises a pointed end and a guide slot.

Further, the first element is a suture needle, and the tip is a needle point; the guide groove of the suture needle is used for accommodating and guiding the suture.

Further, the second element is a blade movably connected to the piercing mandrel, the blade being movable between the first position, which is a closed position, and the second position, which is an open position.

Further, the blade includes a wireway and a flap for forming the wireway for receiving and securing the suture.

Further, when the blade is located at the second position, the horizontal distance between the groove bottom of the wire groove and the puncture core rod is larger than the horizontal distance between the first element and the puncture core rod.

Further, the plunger assembly further comprises a button for controlling the movement of the blade between the open position and the closed position.

Further, the suturing assembly further comprises an inner rod, the inner rod is located in the puncture core rod and can move in the puncture core rod, a guide portion is arranged at the proximal end of the inner rod, and the guide portion is matched with the second element and drives the second element to move.

A puncture instrument comprising the puncture core assembly according to any of the preceding claims, the puncture instrument comprising a puncture cannula assembly into which the puncture core assembly is extendable.

According to the puncture core assembly and the puncture outfit with the same, the puncture hole does not need to be enlarged, and additional surgical instruments do not need to be added, so that the puncture effect can be realized to establish a channel for an anastomat or other surgical instruments to enter a patient body; the suture line can sequentially penetrate subcutaneous tissues, dermis and epidermis layers at two sides of the puncture hole, so that the suture of the whole skin layer is realized; can effectively avoid puncture hole hernia caused by the puncture hole of the minimally invasive surgery.

Drawings

FIG. 1 is a schematic structural view of an initial state of a piercing core assembly according to an embodiment of the present invention;

FIG. 2 is a schematic view of the blades of the piercing core assembly in an open position in accordance with an embodiment of the present invention;

FIG. 3 is a schematic view of a suture needle engaging a suture according to an embodiment of the present invention

FIG. 4 is a schematic structural view in the process of removing a piercing core assembly according to an embodiment of the present invention;

FIG. 5 is a schematic structural view of an inner rod of the puncture core assembly according to an embodiment of the present invention;

FIG. 6 is a schematic structural view of the blades of the piercing core assembly according to an embodiment of the present invention;

FIG. 7 is a schematic view of a core assembly piercing suturing assembly according to an embodiment of the present invention;

FIG. 8 is a schematic structural view of a core assembly piercing suture needle according to an embodiment of the present invention;

FIGS. 9a-9b are schematic illustrations of tissue penetrating suturing of a suture thread after withdrawal of the plunger assembly in accordance with an embodiment of the present invention;

fig. 10 is a schematic structural view of a puncture instrument according to an embodiment of the present invention.

Detailed Description

Reference will now be made in detail to embodiments of the present invention, examples of which are illustrated in the accompanying drawings. In the description of the present invention, it is to be understood that the terms "center", "longitudinal", "lateral", "length", "width", "thickness", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", "clockwise", "counterclockwise", "axial", "radial", "circumferential", etc., indicate orientations or positional relationships based on the orientation or positional relationships shown in the drawings.

Furthermore, the terms "first", "second" and "first" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include at least one such feature. In the description of the present invention, "a plurality" means at least two, e.g., two, three, etc., unless specifically limited otherwise.

The embodiments described below with reference to the drawings are illustrative and intended to be illustrative of the invention and are not to be construed as limiting the invention.

The puncture core rod of the puncture core component of the existing puncture outfit is a hollow round tube, the puncture end is conical, and the rear end of the puncture end is connected with the front end of the puncture core rod. The puncture core assembly in the prior art only plays a role of puncture, cannot suture a puncture hole, and is discarded after the puncture cannula is guided to enter a patient body from an incision of the abdomen of the human body; if the puncture needs to be sutured, a special suturing instrument is needed to be used again.

The puncture core assembly 100 of the present embodiment includes a puncture assembly and a suture assembly. As shown in FIG. 1, the lancing assembly includes a lancing end 1, a lancing core rod 2 and a handle 3. As shown in FIG. 2, the suturing assembly includes a blade 4, a footplate 6, a suturing needle 7, and a suture 9. For convenience of description and simplicity of description, in the embodiment of the present invention, based on the orientation or positional relationship shown in fig. 1, one end of each member near the puncturing end 1 is referred to as a "proximal" end or a "lower" side, one end near the handle 3 is referred to as a "distal" end or an "upper" side, the axial direction of the puncturing core rod is referred to as a "height" direction, and the radial direction of the puncturing core rod is referred to as a "width" direction.

As shown in FIG. 1, the distal end of the piercing tip 1 is integrally formed with or connected to the proximal end of the piercing mandrel 2, the distal end of the piercing mandrel 2 is integrally formed with or connected to the handle 3, and the blade 4 is rotatably connected to the proximal end of the piercing mandrel 2. The piercing end 1 is substantially inverted conical, by substantially conical is meant that the piercing end 1 is conical or similar. The puncture core rod 2 has the same diameter from the proximal end to the distal end, and the maximum diameter of the puncture end 1 is approximately equal to the diameter of the puncture core rod 2. Preferably, the distal end of the piercing end 1 is connected to the proximal end of the piercing mandrel 2.

The puncture core rod 2 is provided with a groove 23, and the groove 23 is axially arranged on the puncture core rod 2 and is used for accommodating the blade 4; when the blade 4 is in the closed position, the blade 4 is located in the groove 23 and the outer surface of the blade 4 does not extend beyond the outer surface of the piercing mandrel 2. Referring to fig. 1-3, the distal end of the piercing mandrel 2 is attached to or integrally formed with the handle 3. The stapling assembly further comprises an inner rod 5, which is configured as shown in fig. 5. The inner rod 5 can be moved inside the piercing mandrel 2, i.e. the inner rod 5 can be moved up and down inside the piercing mandrel 2. Specifically, the piercing core rod 2 is a hollow circular tube, and the inner rod 5 is placed in the hollow circular tube. The puncture core rod 2 is also internally provided with a spring, the near end of the spring is abutted against the near end of the puncture core rod 2, and the far end of the spring is abutted against the near end of the inner rod 5. In one embodiment of the invention, the distal end of the piercing mandrel 2 and the distal end of the inner rod 5 are provided with corresponding stop structures which limit the stroke of the up-and-down movement of the inner rod 5 and thus the stroke of the up-and-down movement of the inner rod 5 in the piercing mandrel 2, so as to ensure that the blades 4 do not rotate any more after reaching the open position. The inner rod 5 is movable within a range of the piercing mandrel 2 to control movement of the blades 4 between the open and closed positions. The limiting structure is a common mode in the art, such as a protrusion arranged on the outer wall of the inner rod 5 and a protrusion arranged on the inner wall of the puncture core rod 2 abut against each other for limiting, and the details are not described herein.

With reference to fig. 5, the proximal end of the inner rod 5 is provided with a guide 52, the guide 52 being in the form of an inverted truncated cone, the generatrix of the guide 52 having a length equal to the trajectory of the guide surface 43, again ensuring that the blades 4 do not rotate any further after reaching the open position. The guide part 52 is further provided with a step 53 below, a small section of cylinder 54 is further arranged below the step 53, the far end of the spring is sleeved on the cylinder 54 and then abutted against the step 53, and the diameter of the step 53 is larger than that of the spring, so that the spring is positioned and assembled conveniently.

As shown in fig. 6, the blade 4 includes a rotation shaft 42 and a guide surface 43. The blade 4 is connected to the piercing core 2 through a rotating shaft 42, and the portion of the blade 4 other than the rotating shaft 42 is rotatable around the rotating shaft 42. When the blades 4 are positioned at the closed position, the outer surfaces of the blades do not exceed the outer surface of the puncture core rod 2, so that the puncture core rod assembly 100 can extend into the sleeve assembly during puncture; and smoothly enter and exit the puncture hole during suturing. During the rotation of the blade 4 around the rotating shaft 42, the guide surface 43 always moves along the outer peripheral surface of the guide part 52, the guide surface 43 is an arc surface, and preferably, the guide surface 43 is an arc surface; further, the guide surface 43 is a quarter circular arc surface. The blade 4 comprises two wings 44, a slot 41 is formed between the two wings 44, the slot 41 is an open slot and is approximately U-shaped, so that when the blade 4 is opened, the suture 9 enters the slot 41 from the opening without being attached.

As shown in FIG. 7, the suture needle assembly comprises a pressing plate 6 and a suture needle 7, wherein the suture needle 7 is connected to the pressing plate 6, the suture needle 7 is perpendicular to the pressing plate 6, the needle point 71 is downward, and the needle point is parallel to the puncture core bar 2. In the embodiment of the present invention, the suture needle 7 is disposed near the outer side of the pressing plate 6, preferably, the pressing plate 6 is a circular ring, and the ring width of the circular ring is 2-15 mm; the suture needle 7 is farthest away from the central axis of the puncture core rod 2 in a limited range, so that the suture space is largest on the premise of not expanding the puncture wound, and the risk that the puncture wound is torn by the suture thread 9 in the process of tensioning the suture thread 9 due to the fact that the suture position is too close to the puncture wound is effectively prevented. Preferably, the annular proximal end surface of the pressing plate 6 is uniformly provided with 4 suture needles 7, the pressing plate 6 is provided with a central hole 63, the inner diameter of the central hole 63 is slightly larger than the outer diameter of the puncture core rod 2 so as to allow the puncture core rod 2 to penetrate through, and the pressing plate 6 can move up and down along the outer periphery of the puncture core rod 2. The pressure plate 6 is formed integrally or by at least two annular blocks connected. The pressing plate 6 can also be rectangular, a central hole 63 is arranged at the center, and 4 suture needles 7 are respectively positioned at four vertexes of the rectangle. The number of the suture needles 7 and the number of the suture lines 9 can be changed according to requirements, so that the skin on two sides of the puncture hole can be punctured, and the suture lines can be driven to penetrate through the tissues on the opposite sides of the puncture hole, which is not illustrated herein. At least one positioning block 64 is arranged at the central hole of the pressing plate 6, and at least one positioning groove which is matched with the positioning block 64 one by one is arranged on the outer wall of the puncture core rod 2 so as to ensure that the pressing plate 6 does not rotate when the suture needle assembly moves downwards, namely, the suture needle 7 is always positioned on the same straight line with the thread groove 41.

In the initial state, the integrally formed pressure plate 6 is located at the distal end of the piercing mandrel 2. The pressing plate 6 comprises two annular blocks, the first annular block 61 and the second annular block 62 jointly form the pressing plate 6, the first annular block 61 and the second annular block 62 are symmetrically arranged, the centers of the first annular block 61 and the second annular block 62 are provided with semicircular notches, and a central hole 63 of the pressing plate 6 is jointly formed. When the pressing plate 6 is formed by connecting two annular blocks, the pressing plate 6 is separated from the puncture core rod 2 in an initial state, and when suturing is needed, the pressing plate 6 is installed on the puncture core rod 2; specifically, the puncture core bar 2 is placed into the semicircular notch of the first annular block 61, the suture needle assembly is adjusted to enable the suture needles 7 and the blades 4 to correspond one to one, the suture needles 7 and the wire grooves 41 are positioned on the same straight line, and then the puncture core bar 2 is placed into the semicircular notch of the second annular block 62 and connected with the first annular block 61.

As shown in FIG. 8, the suturing needle 7 includes a needle tip 71, and the needle tip 71 is a sharp tip to facilitate piercing of tissue to be sutured during suturing. The needle 7 further comprises a guide channel 72 for receiving and guiding the suture 9 through the tissue to be sutured. The width of the guide groove 72 is larger than the diameter of the suture thread 9, the groove bottom 721 of the guide groove 72 is close to the needle point 71, and the groove opening faces away from the needle point 71, so that the suture thread 9 can be hooked by the suture needle 7 after the suture needle 7 penetrates through the tissue of the patient, specifically, after the suture needle 7 penetrates through the tissue of the patient and the groove opening of the guide groove 72 of the suture needle 7 contacts the suture thread 9, the suture thread 9 enters the groove bottom 721 of the guide groove 72 from the groove opening of the guide groove 72, the suture needle 7 is moved upwards by holding the pressing plate 6, and the suture thread 9 is.

During operation, after pneumoperitoneum is finished, a doctor firstly cuts a small incision on the abdomen of a patient, and then moves the puncture outfit downwards while aligning the puncture end of the puncture outfit 300 to the small incision to rotate left and right in a reciprocating manner, so that the proximal end of the puncture cannula penetrates through the cortex of the abdomen of the patient; the puncture core assembly 100 is then withdrawn, and the stapler or other surgical instrument may be passed through the puncture cannula assembly and into and out of the patient's abdominal cavity for surgical procedures.

After removing the lesion and pulling out the puncture cannula assembly, the direction of the puncture core assembly 100 according to the embodiment of the present invention is adjusted to ensure that both ends of each suture 9 are located at opposite sides of the puncture, and as shown in fig. 9a, the puncture core assembly 100 is inserted into the patient from the puncture C with the blades 4 in the closed state, as shown in fig. 1. In the embodiment of the invention, two sutures 9 are arranged outside the puncture core rod 2, the proximal ends 92 of the two sutures 9 extend upwards along the outer wall of the puncture core rod 2 after intersecting at the tip of the puncture end 1, the proximal ends 92 of the two sutures 9 are perpendicular to each other at the tip of the puncture end 1, and two tail ends 91 of each suture 9 form a slipknot at the distal end of the puncture core rod 2; the proximal end 92 of the suture 9 is removably secured to the puncture tip 1 with the centerlines of the wireways 41 of the two leaflets 4 on opposite sides passing through the plane of the corresponding suture 9. The number of the suture lines 9 can be changed according to the requirement, and the requirement of suturing the puncture hole can be met, and the description is omitted here.

The blades 4 are uniformly distributed along the circumference of the puncture core rod 2, after the proximal end face of the puncture core rod 2 enters subcutaneous tissues of a patient, a slipknot of the suture line 9 at the distal end of the puncture core rod 2 is opened, the button 8 is pressed downwards, the inner rod 5 is forced to move downwards, so that the blades 4 rotate around the rotating shaft 42 of the blades, the suture lines 9 respectively fall into the wire grooves 41 of the corresponding blades 4 one by one, the guide part 52 of the inner rod 5 drives the blades 4 to move to an opening position through the guide surface 43, namely, the blades 4 are in an approximately mutually vertical state with the puncture core rod 2, as shown in fig. 2, the blades 4 are positioned under skin layers in abdominal cavities of the patient, and. For convenience of description, the groove bottom of the linear groove 41 of the blade 4 is defined as a point a, and as shown in fig. 2 and 6, the horizontal distance from the point a to the puncture core 2 is greater than the horizontal distance from the suture needle 7 to the puncture core 2. The point of intersection of the proximal face of footplate 6 with suture 9 is defined as point B, which is a dynamic point that slides down the suture assembly. After the pressing plate 6 at the distal end of the puncture core bar 2 is slid downwards, or the first annular block 61 and the second annular block 62 are mounted on the puncture core bar 2 to form the pressing plate 6 together, the pressing plate 6 is slid downwards to make the suture needle 7 pierce the pre-suture tissue on the opposite side of the puncture hole C of the patient, and the pressing plate 6 is continuously slid downwards until the suture needle 7 contacts A, B the suture thread 9 between two points, as shown in fig. 3, because the horizontal distance between the thread groove 41 and the puncture core bar 2 is greater than that between the suture needle 7 and the puncture core bar 2, the suture thread between the two points A, B enters the groove bottom 721 of the guide groove 72 from the notch of the guide groove 72, the pressing plate 6 is held to move the suture needle 7 upwards along the outer wall of the puncture core bar 2, and. When the key 8 is released, the spring is released and extended, the inner rod 5 is pushed upwards by the elastic tension of the spring, the side surface of the guide part 52 at the proximal end of the inner rod 5 acts on the guide surface 43 of the blade 4, and the blade 4 is guided to rotate around the rotating shaft 42 thereof to the closed position. The puncture core assembly 100 is moved upward until the puncture tip 1 is removed from the patient's body. The suture needle 7 can be detached from the patient body together with the puncture core assembly 100; alternatively, as shown in FIG. 4, the puncture core assembly 100 is detached from the patient, and the pressing plate 6 is moved upward to separate the suture needle 7 from the patient.

After the puncture core assembly 100 and the suture needle 7 are separated from the patient, as shown in fig. 9a, because the proximal ends 92 of the sutures 9 are positioned in the patient and both ends of the sutures 9 penetrate through the tissues of the abdomen of the patient and are exposed from the abdominal cortex of the patient, the two tails 91 of the sutures 9 on the opposite side of the puncture hole C are tensioned until the proximal ends 92 of the sutures 9 are attached to the skin layer of the abdominal cavity of the patient, as shown in fig. 9b, the tail of one suture 9 and any suture 9 on the opposite side of the puncture hole are knotted to the skin layer of the patient, and the rest two tails are knotted to the skin layer of the patient, and then the redundant sutures 9 are subtracted, so that the suture of the puncture hole C is completed; preferably, the two thread tails of each suture thread 9 are knotted to each other. Preferably, the suture 9 is a human body absorbable suture, and can be degraded and absorbed by a human body after the puncture hole is healed without removing the suture, so that the pain of a patient caused by the removal of the suture is avoided.

Based on the puncture core assembly 100 as described above, the present invention further provides a puncture device 300, referring to fig. 10, the puncture device 300 further comprises a puncture cannula assembly 200, during puncturing, the puncture core assembly 100 is inserted into the puncture cannula assembly 200, and the puncture cannula assembly 200 is guided into the abdominal cavity of the patient, so that other surgical instruments can enter the body of the patient for performing the surgical operation, after the surgical operation is finished, the puncture core assembly 100 of the present invention can also suture the puncture hole.

In conclusion, according to the puncture core assembly and the puncture outfit with the same, the puncture hole does not need to be enlarged, and additional surgical instruments do not need to be added, so that the puncture function can be realized to establish a channel for an anastomat or other surgical instruments to enter a patient body; the suture line can sequentially penetrate subcutaneous tissues, corium layers and epidermis layers on two sides of the puncture hole, the whole skin layer is sutured, and the suturing effect is good; can effectively avoid the puncture hole hernia caused by the puncture hole of the minimally invasive surgery, effectively reduce the pain of the patient and facilitate the postoperative rehabilitation of the patient.

In the description herein, references to the description of the term "one embodiment," "some embodiments," "an example," "a specific example," or "some examples," etc., mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above are not necessarily intended to refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, various embodiments or examples and features of different embodiments or examples described in this specification can be combined and combined by one skilled in the art without contradiction.

Although embodiments of the present invention have been shown and described above, it is understood that the above embodiments are exemplary and should not be construed as limiting the present invention, and that variations, modifications, substitutions and alterations can be made to the above embodiments by those of ordinary skill in the art within the scope of the present invention.

Claims

1. A puncture core assembly comprising a puncture assembly and a suture assembly; it is characterized in that the preparation method is characterized in that,

the puncture assembly comprises a puncture end and a puncture core rod; the stapling assembly comprises a first element and a movable second element; the second element has a first position and a second position; the puncture end drives the proximal end of the suture to be below the skin layer, the second element moves from the first position to the second position and supports the suture, the first element penetrates through the tissue to be sutured and then moves along the direction opposite to the direction of penetrating through the tissue so as to drive the suture to penetrate through the tissue on the opposite side of the puncture hole, and therefore the suture is utilized to suture the puncture hole; the stitching assembly further comprises a pressing plate, the first element is fixedly connected to the pressing plate and perpendicular to the pressing plate, the pressing plate is provided with a central hole, and the inner diameter of the central hole is equal to or larger than the outer diameter of the puncture core rod so as to allow the puncture core rod to penetrate through the central hole.

2. The puncture core assembly of claim 1, wherein the first element comprises a tip and a guide slot.

3. The puncture core assembly of claim 2, wherein the first element is a suture needle and the pointed end is a needle tip; the guide groove of the suture needle is used for accommodating and guiding the suture.

4. The puncture core assembly of claim 1, wherein the second element is a blade movably connected to the puncture core rod, the blade being movable between the first position, which is a closed position, and the second position, which is an open position.

5. The puncture core assembly of claim 4, wherein the blades comprise a slot for forming the slot and a tab for receiving and securing the suture.

6. The puncture core assembly of claim 5, wherein when the blade is in the second position, the slot bottom of the slot is a greater horizontal distance from the plunger than the first element.

7. The puncture core assembly of claim 4, further comprising a key for controlling movement of the vanes between the open position and the closed position.

8. The puncture core assembly of claim 1, wherein the suturing assembly further comprises an inner rod disposed and movable within the puncture core rod, the inner rod having a guide at a proximal end thereof, the guide cooperating with and driving the second member.

9. A puncture instrument comprising the puncture core assembly according to any one of claims 1 to 8, wherein said puncture instrument further comprises a puncture cannula assembly into which said puncture core assembly is extendable.