CN109259853A - Stoma instrument - Google Patents
Stoma instrument Download PDFInfo
- Publication number
- CN109259853A CN109259853A CN201710587815.8A CN201710587815A CN109259853A CN 109259853 A CN109259853 A CN 109259853A CN 201710587815 A CN201710587815 A CN 201710587815A CN 109259853 A CN109259853 A CN 109259853A
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- China
- Prior art keywords
- catheter body
- grippers
- instrument according
- distal end
- tube wall
- Prior art date
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- 230000009471 action Effects 0.000 description 10
- 238000010586 diagram Methods 0.000 description 10
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- 210000003157 atrial septum Anatomy 0.000 description 7
- 206010019280 Heart failures Diseases 0.000 description 6
- 206010007559 Cardiac failure congestive Diseases 0.000 description 5
- 208000003037 Diastolic Heart Failure Diseases 0.000 description 5
- 239000000463 material Substances 0.000 description 5
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- 239000010931 gold Substances 0.000 description 2
- 229910052737 gold Inorganic materials 0.000 description 2
- 210000002837 heart atrium Anatomy 0.000 description 2
- 229910001000 nickel titanium Inorganic materials 0.000 description 2
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- 210000005239 tubule Anatomy 0.000 description 2
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- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 description 1
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00273—Anchoring means for temporary attachment of a device to tissue
- A61B2018/00291—Anchoring means for temporary attachment of a device to tissue using suction
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00351—Heart
Abstract
Stoma instrument disclosed by the invention includes grabbing device, cutter device and control handle, grabbing device includes catheter body, crawl section and negative pressure device, negative pressure device is connected with catheter body, negative pressure is provided for catheter body, crawl section is set to the interior of catheter body, and crawl section includes the limited part that is fixedly installed on the intracorporal grippers of conduit and can move axially in catheter body, and limited part is sheathed on grippers, when limited part is proximally moved towards distal end in catheter body, grippers are collapsed.Compared with the prior art, operation of the present invention is easy, and high reliablity, opening rule, the tissue after cutting are not fallen out in human body.
Description
Technical field
The present invention relates to a kind of medical instrument more particularly to a kind of stoma instruments.
Background technique
The normal contraction of heart and diastole are the guarantees that organism is able to normal activity, when cardiac structure or function generation are different
When often resulting in ventricular filling or impaired Ejection function, a complex set of clinical syndrome, referred to as heart failure can be generated.As each
The severe stage of kind heart disease development, heart failure are just becoming the most important cardiovascular disorder in the whole world.
Heart failure can be divided into diastolic heart failure and systolic heart failure.Diastolic heart failure refers in ventricle
In the normal situation of contractile function, ventricle slackness and compliance reduction increase the reduction of ventricular filling amount and filling pressure, thus
Generate pulmonary circulation and congestion of systemic circulation syndrome.Diastolic heart failure will lead to the pressure rise in atrium sinistrum and pulmonary vein,
Interfere the proper flow of oxygenated blood fluid.Now, the method for treating diastolic heart failure patient is seldom, and clinical data shows
An aperture is opened on the atrial septum of diastolic heart failure patient, is formed left to right shunt, is advantageously reduced heart failure patient
Atrium sinistrum pressure, improve the symptom of patients with heart failure.
A kind of method for treating heart failure is to be expanded first after secundum tissues are punctured with the method for balloon expandable at present
Opening organizes often to occur to spring back after withdrawing to larger size, but sacculus that opening is caused to reduce.Another method then uses knife
The mode of piece rotary-cut cuts off secundum tissues, but the opening tissue that the method is formed involves and irregularly, and shape is more difficult to control,
Operation time is long.
Based on this, it is necessary to design a kind of easy to operate, the atrial septum stoma of high reliablity, opening rule and stable appearance
Instrument.
Summary of the invention
The technical problem to be solved in the present invention is that in view of the drawbacks of the prior art, providing a kind of easy to operate, reliability
High, opening rule and stable appearance atrial septum stoma instrument.
The technical solution adopted by the present invention to solve the technical problems is: a kind of stoma instrument, including grabbing device, cutting
Device and control handle for controlling the grabbing device and cutter device, which is characterized in that the grabbing device packet
Catheter body, crawl section and negative pressure device are included, the negative pressure device is connected with the catheter body, provides for the catheter body negative
Pressure, the crawl section be set to the catheter body in, the crawl section include be fixedly installed on the intracorporal grippers of the conduit with
And the limited part that can be moved axially in the catheter body, the limited part part are sheathed on the grippers, and can be opposite
It is axially moved in the grippers.
The grippers proximal end is provided at least one fixing piece in one of the embodiments,.
The outer wall of the limited part offers at least one slot in one week along its length in one of the embodiments,.
The limited part is connected to the grippers in one of the embodiments, and the grippers are distally from the limit
Product distal end end face is stretched out, and the fixing piece is stretched out from the slot.
The limited part proximal end is connected with the control handle in one of the embodiments,.
The grippers distal end is provided with multiple in its natural state proximally to distal end phase in one of the embodiments,
The clamping jaw mutually separated, the distance between clamping jaw described in any two are not more than the interior electrical path length of the catheter body.
Anchor unit is provided on the clamping jaw in one of the embodiments,.
Casing is provided in the catheter body in one of the embodiments, described sleeve pipe is sheathed in the catheter body
Wall, described sleeve pipe outer wall fit with the catheter body inner wall, and described sleeve pipe distal end is no more than the catheter body distal end end
Portion.
The fixing piece includes parallel-segment interconnected and bending section, the parallel-segment in one of the embodiments,
Outer wall is bonded with the fixation of described sleeve pipe inner wall.
The first tube wall chamber and the second tube wall chamber are provided on the tube wall of the catheter body in one of the embodiments,
The first tube wall chamber is symmetrical relative to the horizontal axis of the catheter body with the second tube wall chamber.
The distal openings of the first tube wall chamber are opened compared to the distal end of the second tube wall chamber in one of the embodiments,
Mouth is closer to the catheter body distal end.
The cutter device includes the cutting part and use for being set to the catheter body distal end in one of the embodiments,
In the high frequency electric source powered to the cutting part.
The cutting part is set to the catheter body distal end and partially surrounds in the conduit in one of the embodiments,
On outer wall at body distal openings.
The cutting part includes control silk and traction fiber in one of the embodiments, the control silk first end with
And the traction fiber first end is connected with the control handle, the control silk second end is connected with the traction fiber second end
And around circlewise.
The control silk first end passes through the first tube wall chamber and the control handle phase in one of the embodiments,
Even, the traction fiber first end passes through the second tube wall chamber and is connected with the control handle, under control handle effect,
The control silk can be moved axially with the traction fiber.
Stoma instrument provided by the invention include grabbing device, cutter device and for control the grabbing device, with
And the control handle of cutter device, the negative pressure device are connected with the catheter body, provide negative pressure, crawl section for the catheter body
It is described including the limited part that is fixedly installed on the intracorporal grippers of the conduit and can be moved axially in the catheter body
Limited part is sheathed on the grippers, and the grippers are collapsed.Compared with the prior art, it is arranged on grabbing device of the present invention
Have negative pressure device, the group wait cut off is woven under the action of negative pressure device be inhaled into catheter body after, pass through control proximal control handle
It is mobile towards distal end to control limited part, under the constraint of limited part, grippers firmly grasp the intracorporal tissue of suction lead, then
Cutter device is tightened by control handle and is powered, and cutting can be completed under the action of controlling handle, it is easy to operate.It has cut
Cheng Hou is still within rounding state and can clamp the tissue under cutting since grippers are under the action of limited part
And withdrawn from together with conduit to external, during dropping back stoma instrument, the tissue under cutting is not fallen out in internal
Risk is generated, while stoma instrument cuts the opening stable appearance to be formed by cutting, will not generate retraction.
Detailed description of the invention
Present invention will be further explained below with reference to the attached drawings and examples, in attached drawing:
Fig. 1 is the structural schematic diagram for the stoma instrument that the embodiment of the present invention 1 provides；
Fig. 2 is the partial structural diagram of the stoma instrument in Fig. 1；
Fig. 3 is the structural schematic diagram of the catheter body of the stoma instrument in Fig. 2；
Fig. 4 is the structural schematic diagram of the cutting part of stoma instrument in Fig. 1；
Fig. 5 is the structural schematic diagram of the crawl section of stoma instrument in Fig. 1；
Fig. 6 is the structural schematic diagram of the grippers of crawl section and fixing piece in Fig. 1；
Fig. 7 is structural schematic diagram of the crawl section of Fig. 5 in the case where grippers are bound state；
Fig. 8 is the partial structural diagram for the stoma instrument that the embodiment of the present invention 2 provides；
Fig. 9 is the partial structural diagram for the stoma instrument that the embodiment of the present invention 3 provides；
Figure 10 is the partial structural diagram for the stoma instrument that the embodiment of the present invention 4 provides.
Specific embodiment
For a clearer understanding of the technical characteristics, objects and effects of the present invention, now control attached drawing is described in detail
A specific embodiment of the invention.
In order to clearly describe structure of the invention, the noun of locality is used as using " distal end ", " proximal end ", which is
Interventional medical device field common terminology, wherein " distal end " indicates that one end in surgical procedure far from operator, " proximal end " indicate
One end of proximal operator is leaned in surgical procedure.The axial direction refers to and is parallel to medical instrument distal center and proximal hub line
Direction；The radial direction refers to perpendicular to above-mentioned axially direction.
Embodiment 1
Also referring to Fig. 1 and Fig. 2, stoma instrument 100 provided in this embodiment includes cutter device 20, grabbing device
10 and control handle 30.Cutter device 20 includes cutting part 21 and the high frequency electric source 22 for powering to cutting part 21, crawl
Device 10 includes catheter body 11, crawl section 12 and negative pressure source 13.Cutting part 21 is set to 11 distal end of catheter body and partially surrounds
On the outer wall at 11 distal openings of catheter body, for cutting by the intraluminal human body of 100 suction lead body 11 of stoma instrument
Secundum tissues.Negative pressure source 13 is connected to catheter body 11, is adsorbed for forming negative pressure in the catheter body 11 to stoma instrument 100
The lumen distal of catheter body 11 is arranged in human body secundum tissues, crawl section 12, close to 11 distal openings of catheter body, for pressing from both sides
It holds by the intraluminal human body secundum tissues of 100 suction lead body of stoma instrument 11.It is close that control handle 30 is set to catheter body 11
It holds and is connected with 11 proximal end of catheter body, control handle 30 is for driving each component of stoma instrument 100 to move.
Further, also referring to Fig. 1 and Fig. 2, catheter body 11 includes two parts, and the part of 11 proximal end of catheter body is arranged
There are more reinforcing ribs 110, to form multiple not connected tubule chambers 115, to increase the hardness of 11 proximal end of catheter body, improves
The warping resistance performance of catheter body 11.The part of 11 distal end of catheter body is hollow, forms unique main tube cavity 111.It, can in the present embodiment
Catheter body 11 to be molded as one to the structure of multi-cavity by molding equipment, the material of catheter body 11 can be nylon, polytetrafluoroethyl-ne
Alkene, Pebax etc..Reinforcing rib 110 is the flake of uniform thickness, is distributed along 11 axisymmetrical of conduit, and quantity can be 2~6, preferably
2~4.In actual use, it after needing to puncture due to catheter body 11 in intervener's body, to avoid puncturing node expansion, protects simultaneously
11 internal diameter meet demand of catheter body is demonstrate,proved, therefore 11 wall thickness of catheter body need to be reduced, after 11 wall thickness of catheter body reduces, catheter body
11 can become more soft, and reinforcing rib 110 is arranged here can effectively increase the intensity and buckle resistance energy of catheter body 11.
It is understood that in other embodiments, when 11 material hardness of catheter body is higher, can also be not provided with reinforcing
Muscle 110, i.e. catheter body 11 are integrated design, as long as can guarantee that 11 wall thickness of catheter body is lesser while has catheter body 11
Certain anti-performance bending.
In other embodiments, its warping resistance can also be enhanced by way of being embedded titanium-nickel wire in catheter body 11
Can, or support tube is arranged in the proximal part of catheter body 11, it can also increase the hardness of proximal part, reach good warping resistance
The purpose of performance.
Referring to Figure 2 together and Fig. 3, in the present embodiment, first is also symmetrically arranged on the tube wall of catheter body 11
Tube wall chamber 112 and the second tube wall chamber 113.Wherein the first tube wall chamber 112 proximally passes through the tube wall of catheter body 11 to distal end, i.e.,
Wherein the proximal end of 11 tube wall of catheter body is arranged in the proximal openings of the first tube wall chamber 112.Second tube wall chamber 113, which is set to, leads
11 tube wall of tube body is additionally provided with the proximal openings being connected to the second tube wall chamber 113 on proximal part, 11 tube wall of catheter body, makes
The second tube wall chamber 113 is obtained to be interlinked to the outside with catheter body 11.A coaxial lumen 116 is additionally provided in catheter body 11, outside lumen 116
Side is connected with reinforcing rib 115.The tubule chamber 115 and lumen 116 of 111 proximal end of main tube cavity are connected.
It is understood that in other embodiments, the first tube wall chamber 112 can also be not through the pipe of entire catheter body 11
Wall, the distal openings of the first tube wall chamber 112 are close to the distal end of tube wall, and the proximal end of the first tube wall chamber 112 is close to conduit
The proximal end of body 11.
In the present embodiment, the first tube wall chamber 112 and the second tube wall chamber 113 are symmetrical arranged, and this setup can make
Cutting part 21 more smoothly moves, and being also possible to prevent the cutting part 21 during mobile to distal end of cutting part 21 can not entangle
The human body secundum tissues adsorbed by conduit mouth.
It is understood that in other embodiments, the first tube wall chamber 112 and the second tube wall chamber 113 can not also be right
Claim setting, as long as guaranteeing to cut to the intracorporal human body secundum tissues of conduit are adsorbed in cutting part 21.
In the present embodiment, the distal openings of the first tube wall chamber 112 are more leaned on compared to the distal openings of the second tube wall chamber 113
It is bordering on 11 distal face of catheter body, it is therefore intended that so that cutting part 21 is tilted and be sheathed on 11 distal end of catheter body.It will not be moved through
Cheng Zhong causes scraping collision to tissue.
Referring to Figure 4 together, cutting part 21 includes control silk 211 and traction fiber 212.Control 211 first end 2112 of silk
It is connected across the first tube wall chamber 112 with the control handle 30,212 first end 2122 of traction fiber passes through described second
Tube wall chamber 113 is connected with the control handle 30；Under the action of control handle 30, the control silk 211 is led with described
Drawing silk 212 can move axially.Control silk 211 is bent into the first semi-ring 2111 close to the part of second end 2113, controls silk
211 second ends 2113 are bent into the state parallel with first end 2112 and towards 11 proximal ends of catheter body.The cloth of traction fiber 212
Set mode with control silk 211 it is similar, 212 first end 2122 of traction fiber penetrate the second tube wall chamber 113 of catheter body 11 and with control
Handle 30 is connected, and under the driving of control handle 30, traction fiber 212 can move axially in the second tube wall chamber 113.Traction
Silk 212 is bent into the second semi-ring 2121 close to the part of second end, and 212 second end 2123 of traction fiber is bent into and first end 2122
Parallel state.First semi-ring 2111 and the second semi-ring 2121 are combined into the cut ring 210 of cutting part 21, while passing through heat
The mode of draw pyrocondensation, by 211 second end 2113 of control silk and 212 first end 2122 of traction fiber, 212 second end 2123 of traction fiber
It is bonded, is prevented in cutting process, cut ring 210 side by side by way of heat-shrink tube pyrocondensation with control 211 first end 2112 of silk
Generate separation.The cut ring 210 of cutting part 21 is constituted by the way of traction fiber 212 and control 211 phase of silk splicing, it is therefore intended that
The intensity that cut ring 210 can effectively be increased prevents cut ring 210 from occurring during cutting human body secundum tissues disconnected
It splits.
It is understood that in other embodiments, 212 second end 2123 of traction fiber and control 211 first end 2112 of silk
Parallel fitting, the fitting parallel with 212 first end 2122 of traction fiber of control 211 second end 2113 of silk, laminating type can be weldering
It connects, gluing etc..
It will also be appreciated that in other embodiments, cut ring 210 can also pass through one one metal wire of bending or gold
Belonging to item makes its distal end have cyclic structure, while the both ends of wire are connected with control handle 30 respectively.
Please continue to refer to Fig. 4, in the present embodiment, the global shape of cut ring 210 be substantially in it is heart-shaped, have concave side 2101 with
And the convex side 2102 opposite with concave side 2101.Cut ring 210 is with the purpose of convex side 2102 and concave side 2101 herein,
Make cut ring 210 during being received to the first tube wall chamber 112, entire cut ring 210, which is more easier to be bound, to be in line
Shape, and concave side 2101 does not scrape 11 outer wall of catheter body, to guarantee that cutting process is more smooth.
In the present embodiment, a metallic sheath 213 is also set up in the convex side 2102 of cut ring 210, makes 212 first end of traction fiber
2122 connect stronger with control 211 second end 2113 of silk, and cut ring can be prevented by adding metallic sheath 213 in convex side 2102
210 212 first ends 2122 of traction fiber when deformation occurs are separated with control 211 second end 2113 of silk.Metallic sheath 213 is stainless steel
Matter, or have other metal materials of certain rigidity and electric conductivity, shape is circular or elliptical ring, is led being sheathed on
Draw silk 212 with behind designated position on control silk 211, compresses and fix by way of mechanical pressurization, welding or bonding.
In the present embodiment, traction fiber 212 and the first end for controlling silk 211 are to have conducting function through micronization processes
Wire, can be for titanium-nickel wire, stainless steel wire etc..The effect for illustrating its refinement by taking traction fiber 212 as an example below, due to traction
212 first ends 2122 of silk need to connect side by side with control 211 second end 2113 of silk, and the diameter after connecting side by side can become larger, because
After this refines 212 first end 2122 of traction fiber, 212 first end 2122 of traction fiber can be made more easily to take in the second tube wall chamber
In 113.
Further, the minimum diameter of the cut ring 210 of cutting part 21 is greater than the outer diameter of 11 distal openings of catheter body, cutting
Ring 210 has two states of relaxation and tightening under the traction action of traction fiber 212, leads when control handle 30 proximally pulls
When drawing silk 212,212 first end 2122 of traction fiber continues to move into the second tube wall chamber 113, to make circular cut ring 210
Deformation, forms state as shown in Figure 2, i.e., entire cut ring 210 fits in 11 outer wall of catheter body, is in tightening state.Due to
The distal openings of one tube wall chamber 112 are closer to 11 distal end of catheter body compared to the distal openings of the second tube wall chamber 113
Face, therefore under Fig. 2 state, traction fiber 212 tenses entire cut ring 210 towards proximal end, and cut ring 210 is in heeling condition, energy
It is enough to be tightly attached at 11 outer wall of catheter body.When controlling handle 30 to when distally pushing traction fiber 212, traction fiber 212 is managed from second
It is stretched out in wall chamber 113 to distal end, cut ring 210 is made to be gradually recovered into circle, until cut ring 210 and 11 distal end of catheter body
Flush.Cut ring 210 is in relaxed state at this time.The purpose that the state of cut ring 210 changes is existed by control handle 30
In when cut ring 210 is in tightening state, cut ring 210 is tightly attached at 11 outer wall of catheter body, will not influence catheter body 11
It reclines and sucks secundum tissues.
Similar with traction fiber 212, in the present embodiment, control silk 211 equally can under the traction action of control handle 30
It is moved axially in the first tube wall chamber 112, since the tapping of the first tube wall chamber 112 is located at 11 end of catheter body or close to leading
11 end of tube body, therefore the horizontal component almost all for controlling 211 first end 2112 of silk is contained in the first tube wall chamber 112.When need
When the tissue for wanting cutting part 21 to adsorb catheter body 11 is cut, control silk is pulled towards proximal end by control handle 30
211, to make the entire cut ring 210 under relaxed state gradually deform and be contained in the first tube wall chamber 112, first
Under the action of 112 opening inner wall of tube wall chamber, cut ring 210, which is gradually squeezed, fetters the shape that is in line, and is gradually contained in first
In tube wall chamber 112, thus cut ring 210 gradually squeezed constraint be in line shape when, to being adsorbed on 11 opening of catheter body
Tissue is cut.Please refer to fig. 5, crawl section 12 includes grippers 121, limited part 123, fixing piece 122, connection
Part 124 and tube body 125.Grippers 121 are located at 12 distal end of crawl section, are coaxially disposed with catheter body 11, the distal end of grippers 121
It shrinks back in the distal end end face of catheter body 11 in face.Limited part 123 is coaxially set in grippers 121, for fettering grippers 121
The folding of distal end.Connector 124 is connected to the proximal end of limited part 123, and connector 124 passes through proximal end and control hand after lumen 116
Handle 30 is connected, for controlling the movement of limited part 123 in the axial direction.Tube body 125 is set to 11 inner wall of catheter body, for solid
Determine grippers 121.
Referring to Figure 6 together, 121 proximal end of grippers is connected with multiple fixing pieces 122, is distally equipped with multiple clamping jaws 1211,
Multiple fixing pieces 122 are connect with multiple clamping jaws 1211 by shaft 1212.Multiple clamping jaws 1211 are in its natural state proximally extremely
Distal end is separated from each other, and under the constraint of external force, multiple clamping jaws 1211 can mutually be gathered.Between any two of them clamping jaw 1211
Linear distance be less than the catheter body 11 interior electrical path length, to guarantee that multiple clamping jaws 1211 can accommodate in its natural state
In in catheter body 11.Wherein the quantity of fixing piece 122 is 2~5, preferably 2~3.
Fixing piece 122 is 3 in the present embodiment, and 3 fixing pieces 122 are evenly distributed on grippers 121 along the circumference of axis
On, it is to be understood that in other embodiments, fixing piece 122 can also be with uneven distribution.
In the present embodiment, each fixing piece 122 is set to the proximal end of crawl section 12, along the circumferential direction extends outwardly, including
Bending section 1221 and parallel-segment 1222.Wherein, parallel-segment 1222 is sheet, and parallel-segment 1222 is equal with the axis of catheter body 11
Row, for being connected with tube body 125 and the entire grippers 121 of fixation, parallel parallel-segment 1222 can maximum area with pipe
125 inner wall of body is in contact, and is easy to fixed.Parallel-segment 1222 can be fixed by modes such as laser spot welding, riveting and machinery positionings
In the inner wall of tube body 125.In the present embodiment, parallel-segment 1222 is fixed on to the inner wall of tube body 125 by way of laser spot welding.
Since in the present invention, 11 inner wall of catheter body is fixed on by fixing piece 122 in crawl section 12, when stoma instrument 100 moves in human body
When dynamic, the distal end of grippers 121 will not be extend out to outside catheter body 11 because catheter body 11 is bent, and avoid causing tissue
It scratches, hurt, puncture.
It is understood that in other embodiments, fixing piece 122 also can be set in the other positions of crawl section 12,
The shape of fixing piece 122 may be other shapes, such as column, sheet, barb-like etc., it is only necessary to guarantee 122 energy of fixing piece
It is bonded with tube body 125.
In the present embodiment, the quantity of the clamping jaw 1211 of grippers 121 is 4, and 4 clamping jaws 1211 are proximally to distally gradually
Separation.Clamping jaw 1211 includes clamping part 1213 and the interconnecting piece 1214 for connecting clamping part 1213 and shaft 1212, each clamping jaw
1211 clamping part 1213 is parallel to each other, and interconnecting piece 1214 is proximally to being distally gradually disengaged.Preferably, in the present embodiment, folder
Multiple anchor units 1215 are provided on the clamping part 1213 of pawl 1211, anchor unit 1215 can be fin, sawtooth etc., this reality
It applies in example, anchor unit 1215 is sawtooth.Sawtooth is set to the inside opposite with 121 horizontal axis of grippers of clamping part 1213,
Can symmetrical or distribution straggly, the quantity of sawtooth is 1~10, preferably 4~8, can evenly distributed or unequal spacing
Arrangement.When multiple sawtooth are arranged together, global shape can with triangular wave, square wave, sine wave or random waveform, or more than
The combination of two or more waveforms.Sawtooth is arranged on clamping part 1213 can guarantee when clamping to tissue, saw
Tooth can make to clamp stronger with tissue phase hook.
It is understood that in other embodiments, anchor unit 1215 also can be set in the every of each clamping jaw 1211
A 1213 inside of clamping part, in this way setting can make its clamping stronger.
It is understood that in other embodiments, the anchor unit 1215 on clamping part 1213 also can be omitted should not.
It will also be appreciated that in other embodiments, clamping jaw 1211 can also be replaced using other structures, for example,
In grippers 121, crawl net, a clamping plate etc. are distally set.
In conjunction with Fig. 5 and Fig. 7, in the present embodiment, limited part 123 is whole in a tubular form, and tube wall one week of limited part 123 is along length
Direction offers multiple slots 1231, and the quantity of slot 1231 is identical as the quantity of fixing piece 122.Limited part 123, which is sheathed on, grabs
Pickup 121, single fixing piece 122 are stretched out from the single slot 1231 of limited part 123, and grippers 121 are remote from limited part 123
End opening stretches out.As shown in fig. 7, when limited part 123 is in first position, the bending section 1221 and slot of fixing piece 122
1231 proximal end inner wall offsets, and multiple clamping jaws 1211, which are bound, to be closed up.Limited part 123 is moved to the near end until limited part 123 moves
It moving to the second position, the bending section 1221 and the distal end inner wall of the slot 1231 on limited part 123 of fixing piece 122 offset, with
Limited part 123 is moved to the second position from first position, and limited part 123 fades away to 1213 constraint of clamping part effect, multiple
Clamping jaw 1211 is gradually stretched out from limited part 123, and clamping jaw 1211 is separated from each other, so that grippers 121, which are in, can accommodate human body
The state of tissue.Limited part 123 tightens required axis by multiple clamping jaws 1211 from the distance that first position is moved to the second position
It is determined to length, length range is 3~8mm, preferably 4~6mm, the present embodiment 5mm.
It is understood that in other embodiments, limited part 123 can also be not provided with slot 1231, can limit
The sliding slot to match with fixing piece 122, or the buckle etc. to fasten with fixing piece 122 are opened up on part 123, it is only necessary to guarantee limit
During product 123 moves axially, it can offset or fasten with fixing piece 122 in extreme position, to make to limit
123 distal end of part can generate constraint to grippers 121, or the grippers 121 of constraint are discharged.
Tube body 125 is set to 11 inner wall of catheter body, 125 distal end of tube body and 11 distal end flush of catheter body or summary
Shrink in 11 distal end of catheter body.For fixing grippers 121,125 outer wall of tube body can lead to tube body 125 with 11 inner wall of catheter body
The mode for crossing bonding is fixed, and the fixing piece 122 of grippers 121 can be fixed in tube body 125 by way of welding or being bonded
Wall, to guarantee that grippers 121 will not generate axial movement, prevent 121 distal end of grippers from catheter body 11 in the course of surgery
Expose and scratch tissue in distal end.
It is understood that in other embodiments, tube body 125 can also be not provided with, height can be arranged in fixing piece 122
Molecular material is directly fixedly connected by modes such as hot melt or gluings with 11 inner wall of catheter body.
Further, in the present embodiment, the gold such as Nitinol, stainless steel and cochrome are can be selected in the material of tube body 125
Belong to material, can be by the processing of mechanical wire cutting, by becket cold moudling, or the 3D printing for passing through selective laser sintering
Technology obtains.The body shape of tube body 125 can be round, oval or combined abnormity.
Connector 124 is fixedly connected with 123 proximal end of limited part, and 124 distal end of connector is connected with control handle 30, passes through control
Handle 30 processed controls connector 124 and is axially moved, and is axially moved to control limited part 123.
It is understood that in other embodiments, connector 124 also can be omitted, 123 proximal end of limited part can be direct
It is connected with control handle 30.
In the embodiment of the present invention, grabbing device 10 and cutter device 20 respectively further comprise negative pressure device 13 and high frequency electric source
22.Negative pressure device 13 connect by the first connecting tube 301 with control handle 30, high frequency electric source 22 pass through the second connecting tube 302 and
Handle 30 is controlled to connect.For tissue to be adsorbed in catheter body 11, high frequency electric source 22 is used for cutting negative pressure device 13
Ring 210 leads to high-frequency current, and is formed into a loop with the indifferent plate electrode (not shown) of patient body-surface, so that excision is by catheter body
11 tissues being sucked.22 working frequency of high frequency electric source be 300kHz~5MHz, it is preferred that frequency range be 400kHz~
1000kHz, the output power of high frequency electric source 22 are 0~300w, it is preferred that power bracket is 50~100w.
Course of work when carrying out atrial septum stoma to Fistulation apparatus tool 100 below is further described.
When carrying out atrial septum stoma using the stoma instrument 100 of the present embodiment, 11 percutaneous puncture of catheter body enters human body, arrives
Up to heart, 11 distal end end face of catheter body is butted on secundum tissues, drives negative pressure device 13, under the action of negative pressure part human body group
It knits and is inhaled into catheter body 11.Further operating control handle 30 makes connector 124 drive limited part 123 mobile to distal face,
Clamping jaw 1211 is gradually clamped along the radial direction of catheter body 11.Sawtooth on clamping jaw 1211 can reversely catch on secundum tissues,
Clamp grippers 121 tissue securely.Further operating control handle 30 moves cut ring 210 to human body atrial septum
Dynamic, i.e., entire cut ring 210 is moved to 11 distal end of cut ring 210 and catheter body from the tightening state for fitting in 11 outer wall of catheter body
The relaxed state of end flush.Control silk 211 is proximally further pulled by controlling handle 30, to make in relaxation shape
Entire cut ring 210 under state is gradually deformed and is contained in the first tube wall chamber 112, in 112 opening inner wall of the first tube wall chamber
Under the action of, cut ring 210, which is gradually squeezed, fetters the shape that is in line, and is gradually contained in the first tube wall chamber 112, in cut ring
210 constantly enter the first tube wall chamber 112 when, the human body secundum tissues for being inhaled into catheter body 11 will also be entangled by cut ring 210,
During cut ring 210 is constantly tightened, high frequency electric source 22 can deliver height to cut ring 210 under the control of clinician
Frequency electric current, and be formed into a loop with the indifferent plate electrode (not shown) of patient body-surface, thus the human body that excision is sucked by catheter body 11
Secundum tissues.Tissue after excision is still clamped by clamping jaw 1211, simultaneously because the position-limiting action of limited part 123, folder
It is very secured to hold 1213 trapping human of portion tissue, the human body group cut will not be made because of movement, the vibration etc. of stoma instrument 100
It knits and falls, to improve the safety of operation.
Embodiment 2
Referring to Fig. 8, the stoma instrument that embodiment 2 provides is roughly the same with the stoma instrument 100 in embodiment 1, it is different
Place is the grippers of the present embodiment for crawl net 121a.The crawl net proximal end 121a is connected with fixing piece 122a, works as limited part
It, can be by crawl net 121a constraint when 123a is moved to distal end.Crawl net 121a is cut using NiTi pipe according to particular texture, is led to
Cross thermal finalization expand to be formed it is netted.Orderly or unordered grid distribution is arranged in crawl on the net, and mesh shape can be round, oval
Shape, diamond shape and other irregular shapes.Crawl net 121a as grippers, fall by the tissue after capable of effectivelying prevent cutting
It falls, crawl net 121a is easy to process, can simplify the processing program of stoma instrument
Embodiment 3
Referring to Fig. 9, the stoma instrument that the present embodiment 3 provides is roughly the same with the stoma instrument 100 in embodiment 1, no
It is turned back in cut ring 210b in this present embodiment by the front end control silk 211b with place and forms cyclic structure, the control silk after fold-back
The first end 2112b of the second end 2113b and control silk 211b of 211b pass through the side such as soldering, laser spot welding or heat-shrink tube pyrocondensation
Formula is fixed.Controlling further includes a U-shaped structure 2123b in the ring structure of the bending of silk 211b, the root U-shaped structure 2123b set
If traction fiber 212b, and be fixedly clamped by lock ring ring 230b.This embodiment is advantageous in that traction fiber 212b can be effectively prevent
Sliding due to using lock ring ring 230b to step up to fix, cut ring 210b can be reduced and be drawn as straight line and in cutting process
The root U-shaped structure 2123b stress, effectively prevent it to be broken here in state procedure.
Embodiment 4
Referring to Fig. 10, the stoma instrument that embodiment 4 provides is roughly the same with the stoma instrument 100 in embodiment 1, it is different
First tube wall chamber 112c of the place on catheter body 11c in this present embodiment concaves towards catheter body main tube cavity 111c, the second tube wall chamber
113c is in semi-convex half concavity state relative to catheter body 11c.Advantage of this embodiment is that can expand the first tube wall chamber 112c with
And second the diameter of tube wall chamber 113c enable not increase catheter body while cutter device (not shown) more convenient mobile
The integral thickness of 11c can adsorb more human body atrial septum group so as to guarantee that the space in catheter body 111c is larger
It knits.Since people's body vessel is thinner, the maximum outside diameter of catheter body 11c has the upper limit, if therefore catheter body 11c tube wall mistake
Thickness, then can reduce the accommodation space of catheter body main tube cavity 111c, and then reduce adsorbable human body secundum tissues, this implementation
The first tube wall chamber 112c and the second tube wall chamber 113c, the suction to catheter body 11c is arranged in example catheter body 11c by the way of convex
Attached capacity impact is minimum.
Each technical characteristic of embodiment described above can be combined arbitrarily, for simplicity of description, not to above-mentioned reality
It applies all possible combination of each technical characteristic in example to be all described, as long as however, the combination of these technical characteristics is not deposited
In contradiction, all should be considered as described in this specification.
The embodiments described above only express several embodiments of the present invention, and the description thereof is more specific and detailed, but simultaneously
It cannot therefore be construed as limiting the scope of the patent.It should be pointed out that coming for those of ordinary skill in the art
It says, without departing from the inventive concept of the premise, various modifications and improvements can be made, these belong to protection of the invention
Range.Therefore, the scope of protection of the patent of the invention shall be subject to the appended claims.
Claims (15)
1. a kind of stoma instrument, including grabbing device, cutter device and for controlling the grabbing device and cutter device
Control handle, which is characterized in that the grabbing device includes catheter body, crawl section and negative pressure device, the negative pressure device
It is connected with the catheter body, provides negative pressure for the catheter body, the crawl section is set in the catheter body, the crawl section packet
Include the limited part that is fixedly installed on the intracorporal grippers of the conduit and can move axially in the catheter body, the limit
Product part is sheathed on the grippers, and can be axially moved relative to the grippers.
2. stoma instrument according to claim 1, which is characterized in that the grippers proximal end is provided at least one and fixes
Part.
3. stoma instrument according to claim 2, which is characterized in that open along its length outer wall one week of the limited part
Equipped at least one slot.
4. stoma instrument according to claim 3, which is characterized in that the limited part is sheathed on the grippers, described
Grippers distal end is stretched out from limited part distal end end face, and the fixing piece is stretched out from the slot.
5. stoma instrument according to claim 1, which is characterized in that the limited part proximal end and the control handle phase
Even.
6. stoma instrument according to claim 1, which is characterized in that the grippers distal end is provided with multiple in natural shape
Proximally to the clamping jaw being distally separated from each other under state, the distance between clamping jaw described in any two is interior no more than the catheter body
Electrical path length.
7. stoma instrument according to claim 6, which is characterized in that be provided with anchor unit on the clamping jaw.
8. stoma instrument according to claim 1, which is characterized in that be provided with casing, described sleeve pipe in the catheter body
It is sheathed on the catheter body inner wall, described sleeve pipe outer wall fits with the catheter body inner wall, and described sleeve pipe distal end does not surpass
Cross the catheter body distal end end.
9. stoma instrument according to claim 8, which is characterized in that the fixing piece include parallel-segment interconnected and
Bending section, the parallel-segment outer wall are bonded with the fixation of described sleeve pipe inner wall.
10. stoma instrument according to claim 1, which is characterized in that be provided with the first pipe on the tube wall of the catheter body
Wall chamber and the second tube wall chamber, the first tube wall chamber are symmetrical relative to the horizontal axis of the catheter body with the second tube wall chamber.
11. stoma instrument according to claim 10, which is characterized in that the distal openings of the first tube wall chamber compare institute
The distal openings for stating the second tube wall chamber are closer to the catheter body distal end.
12. stoma instrument according to claim 1, which is characterized in that the cutter device includes being set to the conduit
The cutting part of body distal end and high frequency electric source for powering to the cutting part.
13. stoma instrument according to claim 12, which is characterized in that the cutting part is set to the catheter body distal end
And it partially surrounds on the outer wall of the catheter body distal end opening.
14. stoma instrument according to claim 13, which is characterized in that the cutting part includes control silk and traction
Silk, the control silk first end and the traction fiber first end are connected with the control handle, the control silk second end
It is connected with the traction fiber second end and surround circlewise.
15. stoma instrument according to claim 14, which is characterized in that the control silk first end passes through first pipe
Wall chamber is connected with the control handle, and the traction fiber first end passes through the second tube wall chamber and is connected with the control handle,
Under control handle effect, the control silk can be moved axially with the traction fiber.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710587815.8A CN109259853A (en) | 2017-07-18 | 2017-07-18 | Stoma instrument |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710587815.8A CN109259853A (en) | 2017-07-18 | 2017-07-18 | Stoma instrument |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN109259853A true CN109259853A (en) | 2019-01-25 |
Family
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201710587815.8A Pending CN109259853A (en) | 2017-07-18 | 2017-07-18 | Stoma instrument |
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| CN114052897A (en) * | 2022-01-07 | 2022-02-18 | 深圳佰特微医疗科技有限公司 | Atrial shunt apparatus and ostomy apparatus |
| WO2023015966A1 (en) * | 2021-08-12 | 2023-02-16 | 深圳佰特微医疗科技有限公司 | Stoma instrument and stoma method |
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