CN109843187B - 缝线穿引器和抓取器器械和方法 - Google Patents
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Abstract
本发明公开了一种组合的缝线穿引器和抓取器器械(10、110)，所述器械具有针(16、116)，所述针可以将缝线(30)递送到修复部位，然后使用可形变线臂(24、26、124、126)捕获缝线(30)并将其拖拽到针(16、116)的中空内部中，因此不需要两个单独的器械。
Description
相关申请的交叉引用
本申请要求2016年10月31日提交的美国临时申请第62/414,886号的权益，所述申请的公开内容以全文引用的方式并入本文中。
技术领域
本公开涉及用于缝合组织的器械，并且更具体地涉及在患者体内传递或取回缝线的装置和相关方法。
背景技术
缝线在患者体内广泛使用，以将两层或更多层软组织固定在一起，或将软组织固定到骨骼。在开放式手术程序期间，大切口提供了对组织的准备好的进入，外科医生不难将缝线传递到手术部位，然后取回或抽出缝线以在组织的任一侧上提供两个自由端。此后缝线的两端被打结，或用于另外缝合组织。
然而，通过一个或多个套管内的狭窄通道提供对组织的接近的闭合程序的数量不断增加。在一些内窥镜程序和关节镜程序中，使用细长针通过第一套管递送缝线，并使缝线穿过组织的一侧。之后，必须使用窄抓取器型镊子或具有内部线圈的细长中空缝线取回器通过第二套管取回缝线。线圈可伸长到取回器的尖端外，以捕获缝线的自由端。虽然抓取器可抓取缝线的中间部分，但缝线取回器的线圈只能在缝线的自由端周围通过。因此，通常需要两种或更多种器械来进行内窥镜缝合或关节镜缝合。当缝线长度不足以容易地被缝线抓取器捕获时，会产生其它复杂问题。
发明内容
本文公开了具有针的组合缝线穿引器和抓取器器械，其可以将缝线递送到修复部位，然后使用可形变的线状臂来捕获缝线并将其拖拽到针的中空内部中，从而不需要两个单独的器械。另外，与缝线抓取器相比，使用柱塞式致动器，器械的滑动致动器允许线臂和捕获的缝线被进一步缩回到针中。有利的是，这允许在修复程序期间使用更长的缝线长度，从而使缝线捕获更容易。
在各实例中，本公开的缝线穿引器和抓取器器械包括中空细长轴，所述中空细长轴具有近端、远端以及在其间延伸的纵向轴线。轴的近端固定地联接到手柄，并且轴的远端限定用于穿透组织的尖端。所述器械还包括设置于所述手柄和所述轴内的组件，所述组件可独立于所述手柄和所述轴轴向地移动。组件的远端联接到第一线状构件和第二线状构件。第一线状构件和第二线状构件中的至少一个终止于钩状元件以抓取缝线。所述手柄还包括致动器，所述致动器用于使所述组件将所述线状构件从所述缩回位置移动到延伸位置，在缩回位置，所述线状构件在所述尖端的近侧，在所述延伸位置，所述线状构件在所述尖端的远侧。在各实例中，第一线状构件和第二线状构件的长度被选择为基本上相同。
在器械的另外的实例中，轴的远端向上弯曲，使得轴面中的远端开口面向侧向，并且尖端纵向突出。轴的远端开口还限定从开口向近侧延伸的纵向槽，所述槽具有为允许缝线通过而选择的长度和宽度。当第一线状构件和第二线状构件处于延伸位置时，第一线状构件和第二线状构件被线性地对准于尖端和槽之间。第一线状构件和第二线状构件可围绕在第一线状构件与第二线状构件之间延伸的纵向轴线既在顺时针方向又在逆时针方向上旋转。第一线状构件和第二线状构件也可围绕在第一线状构件与第二线状构件之间延伸的纵向轴线旋转一个或多个完整回转或部分回转。
在另外的例子中，从手柄的近端延伸到轴的远端的器械的长度约13英寸到约14英寸之间。从手柄延伸的轴的长度约为8英寸。第一线状构件和第二线状构件中的一个终止于钩状元件，且第一线状构件和第二线状构件中的另一个终止于半钩。第一线状构件和第二线状构件由具有圆形横截面的材料制成。在各实例中，致动器可为拇指滑动件。
一种操作本公开的缝线的方法的实例包括：1)如上所述将手术器械的针刺入并通过软组织延伸；2)在缝线的任一侧上向远侧延伸第一线状构件和第二线状构件；3)在第一线状构件与第二线状构件之间抓取缝线；以及4)将线状构件向远侧缩回到至少部分地在针的所述远端内的位置，使得缝线的至少一部分保持在针内部。
在另外的实例中，本公开的方法可包括围绕在第一线状构件与第二线状构件之间延伸的轴线旋转第一线状构件和第二线状构件，其中旋转第一线状构件和第二线状构件包括沿顺时针或逆时针方向旋转第一线状构件和第二线状构件和/或围绕在第一线状构件与第二线状构件之间延伸的纵向轴线将第一线状构件和第二线状构件旋转一个或多个完整回转或部分回转。将手术器械的针刺入软组织包括用针的尖端刺入组织。在缝线的任一侧上将第一线状构件和第二线状构件向远侧延伸包括将滑动地安装到手柄的致动器从第一位置移动到第二位置，在第一位置，致动器更靠近手柄的近端，在第二位置，致动器更靠近手柄的远端。在第一线状构件与第二线状构件之间抓取缝线包括用钩状元件抓取缝线。使线状构件向远侧缩回包括将滑动地安装到手柄的致动器从第二位置移动到第一位置，在第二位置，致动器更靠近手柄的远端，在第一位置，致动器更靠近手柄的近端。
本发明的另一个实施例包括缝线穿引器和抓取器器械。所述器械可包括：中空细长轴，所述中空细长轴具有近端、远端以及纵向轴线，所述纵向轴线在近端与远端之间延伸，轴的近端联接到手柄，并且轴的远端限定被构造成穿透组织的尖端；以及组件，所述组件部分地设置于手柄内且部分地设置于中空细长轴内，所述组件可独立于手柄和中空细长轴轴向地和旋转地移动。所述组件可以包括：致动器，所述致动器在靠近所述手柄处可接近；连接器，所述连接器联接到所述致动器；联接到所述连接器的第一线状构件和第二线状构件，所述第一线状构件和第二线状构件中的至少一个终止于钩状元件，所述钩状元件能够接合缝线。所述致动器的移动能够将所述第一线状构件和第二线状构件从缩回位置移动到延伸位置，且能够相对于所述中空细长轴旋转所述第一线状构件和第二线状构件中的至少一个，在缩回位置，所述线状构件在所述远端的所述尖端的近侧，在延伸位置，所述线状构件在所述远端的所述尖端的远侧。
本发明的又一个实施例是一种操作缝线的方法。所述方法可以包括：将手术器械刺入并延伸到软组织中，所述手术器械包括：至少中空细长轴，所述中空细长轴具有近端、远端以及在近端与远端之间延伸的纵向轴线，轴的近端联接到手柄，并且轴的远端限定被构造成穿透组织的尖端；以及组件，所述组件部分地设置在所述手柄内并且部分地设置在所述中空细长轴内，所述组件能够独立于所述手柄和所述中空细长轴轴向地且旋转地移动。所述组件可以包括：致动器，所述致动器在靠近所述手柄处可接近；连接器，所述连接器联接到所述致动器；联接到所述连接器的第一线状构件和第二线状构件，所述第一线状构件和第二线状构件中的至少一个终止于钩状元件，所述钩状元件能够接合缝线。所述方法还可包括：围绕在第一线状构件和第二线状构件之间延伸的轴线相对于中空细长轴旋转第一线状构件和第二线状构件中的一者或两者；在缝线的任一侧上移动第一线状构件和第二线状构件；在第一线状构件与第二线状构件之间抓取缝线；以及将所述线状构件向近侧缩回到至少部分地在所述中空细长轴的所述远端内的位置，使得所述缝线的至少一部分保持在所述中空细长轴内部。
本发明的又一个实施例是一种操作缝线的方法。所述方法可以包括将手术器械刺穿并延伸到软组织中。所述手术器械包括：至少中空细长轴，所述中空细长轴具有近端、远端、以及在近端与远端之间延伸的纵向轴线，轴的近端联接到手柄，并且轴的远端限定被构造成穿透组织的尖端；以及组件，所述组件部分地设置在所述手柄内并且部分地设置在所述中空细长轴内，所述组件能够独立于所述手柄和所述中空细长轴轴向地且旋转地移动。所述组件可以包括：致动器，所述致动器在靠近所述手柄处可接近；连接器，所述连接器联接到所述致动器；联接到所述连接器的第一线状构件和第二线状构件，所述第一线状构件和第二线状构件中的至少一个终止于钩状元件，所述钩状元件能够接合缝线。所述方法还可以包括：通过相对于手柄旋转组件，在缝线的任一侧上延伸第一线状构件和第二线状构件；通过相对于手柄向近侧移动致动器在第一线状构件与第二线状构件之间抓取缝线；以及将所述线状构件向近侧缩回到至少部分地在所述中空细长轴的远端内的位置，使得通过相对于所述手柄向近侧移动所述致动器，所述缝线的至少一部分保持在所述中空细长轴内部。
本公开的其它适用领域将从下文提供的详细描述变得显而易见。应理解，详细描述和具体实例虽然指示本公开的优选实例，但旨在仅用于说明的目的而无意限制本公开的范围。
附图说明
并入本说明书中且形成本说明书的一部分的附图说明本公开的实例，且连同书面描述一起用于解释本公开的原理、特性和特征。在附图中：
图1是本公开的示范性缝线穿引器和抓取器器械的图示；
图2是图1的针的远端的细节；
图3A-3B是处于延伸位置的图1的器械的线状臂的详细视图；
图4是包括致动器的图1的器械的示范性手柄的横截面；
图5A-5C示出了使用图1的器械通过组织取回缝线的方法；
图6图示了包括可旋转臂的缝线穿引器和抓取器器械的替代实施例；
图7A-7B更详细地描绘了器械处于致动器旋转状态的图6中所示的器械的部分；
图8是图6的器械的内部组件的一部分的正视图；
图9是说明器械的一种操作状态的图6的器械的透视图；
图10是说明器械的另一操作状态的图6的器械的透视图；和
图11是说明器械的又一操作状态的图6的器械的透视图。
具体实施方式
以下对于优选实例的描述在本质上仅是示例性的，并且绝不旨在限制本公开、其应用或用途。
为了以清晰扼要的方式说明实例，附图可不一定按比例绘制，且某些特征可以某种示意性形式示出。相对于一个实例描述和/或说明的特征可以相同方式或以类似方式在一个或多个其它实例中和/或与其它实例的特征组合或代替其它实例的特征被使用。
Comprise(包括)、include(包含)和/或各自的复数形式是开放式的并包括所列零件，并且可包括未列出的额外零件。和/或是开放式的，且包括所列零件中的一个或多个以及所列零件的组合。
现在转到图1，图示了示范性的缝线穿引器和抓取器器械10。在图1中，器械10大体上包括手柄12和细长套管针16，手柄包括抓握部分14，细长套管针终止于远端18。基于要执行的修复程序的类型，选择从手柄12的近端46到针16的远端18的器械10的总长度L。例如，对于需要比膝部或肩部手术更长的器械的髋部手术，器械10的总长度L可以约13英寸到约14英寸，包括从手柄12的远端44延伸的大约8.0英寸的针16。针16可以由不锈钢皮下导管构成，但是本公开涵盖其它合适的材料。针16以远端开口20终止，远端开口与针16的内部连通，这在下文进一步描述。在所示的实例中，手柄12以同轴构造形成，基本上与针16的纵向轴线LA同轴。在未示出的替代实例中，手柄12可以形成为枪柄式或其它合适的构型。手柄12的抓握部分14被构造成由使用者抓握和操作。
仍参考图1，用于操作缝线的一对可缩回的可形变线状臂24、26在延伸位置从针16的远端开口20突出，这在下文进一步描述。线状臂24、26可由不锈钢钢琴丝或具有圆柱形横截面的其它合适材料形成。线状臂24、26可由相同材料或具有不同拉伸强度和/或柔性度的不同材料制成。在延伸位置，线状臂24、26自然地弹出分开，但当它们缩回到针16中时，它们被强制在一起。类似地，当线状臂24、26从针16的远端开口20延伸时，它们恢复分开的偏置状态。因此，线状臂24、26相对于针16的远侧/近侧运动产生线状臂24、26的打开/关闭运动，这可用于缝合操作，这在下文进一步描述。
如图2中所示，针16的远端18可以呈弧形或向上弯曲，使得远端开口20面向侧向，而用于穿透组织的尖锐的尖端22相对于针16的纵向轴线LA纵向突出。针16还包括纵向缝线槽28，纵向缝线槽在其远端处以远端开口20终止。槽28的长度和宽度被选择为适应一个或多个缝线的通过，其具有切成圆角的边缘，以避免损坏缝线。如图2中所图示，当线状臂24、26(图1、图3A、图3B和图5A-5C)处于缩回位置时，缝线30的一部分可由器械10承载，使得缝线腿部32、34从槽28延伸。该构型特别适用于使用尖端22使缝线30通过组织，这在下文更详细地描述。
现在转到图3A，线状臂24、26中的每一个端终止于共同的连接构件38。连接构件38可以是弯曲的，以适应针16的远端18处的曲率。连接构件38固定到杆42或固定到设置在手柄12内的其它元件，这在下文进一步描述。在未示出的其它实例中，线状臂24、26可由单个U形线形成，所述单个U形线的中心部分固定到杆42。线状臂24、26中的一个的长度可以与线状臂24、26中的另一个的长度相同或比所述长度更长/更短。基本上相等长度的线状臂24、26可以避免缝线仅被一个臂24、26捕获。另外，如果线状臂24、26两者的长度基本上相等，则使用者在缩回行程开始时知道缝线是否伸手可及。线状臂24、26中的至少一个(在存在时优选更强的/更刚性的臂)终止于满钩(full hook)36以帮助抓取缝线。线状臂24、26中的另一个可终止于部分钩(partial hook)37(图3A)、另一满钩36(图5A-5C)中，或可为直面的。如图3B中所示，当线状臂24、26处于延伸位置时，它们被基本上线性对准于尖端22和针16的缝线槽28之间，使得钩36、37朝向彼此弯曲。
图4图示了本公开的示范性手柄12的横截面。在图4中，手柄12包括可滑动地安装到手柄12的侧壁48的致动器50(例如，拇指滑动件)。在图4的实例中，致动器50具有线性底座和有角度的侧面以便在两个方向上的任一个由使用者的拇指轻松操作。然而，本公开涵盖致动器50的其它合适构型。致动器50安装到手柄12以便在基本上平行于针16的纵向轴线LA的方向上滑动。具体讲，致动器50可从第一位置移动到第二位置，在第一位置，致动器50最靠近手柄12的近端46，在第二位置，致动器50最靠近手柄12的远端44。致动器50还可选择性地定位在第一位置与第二位置之间的位置，这在下文更详细地描述。
仍然参考图4，致动器50通过横向构件40与手柄12的内部连通。横向构件40可以延伸穿过手柄12的侧壁48中的槽47，致动器50沿着手柄滑动。横向构件40又连接到图3A的细长杆42。在各种实施例中，杆42可以是固体或由不锈钢或其它合适材料形成的中空管。杆42从手柄12的内部中的横向构件40延伸到针16的内部，以便与线状臂24、26(图1、图3A、图3B和图5A-5C)连通。因此，致动器50相对于手柄12的移动导致线状臂24、26相对于针16移动。具体讲，致动器50向远侧的移动使杆42向远侧移动，从而导致线状臂24、26从针16伸出。以类似的方式，致动器50向近侧的移动使杆42反向运动。
在未示出的替代实例中，杆42的位置相对于手柄12固定，而针16以机械方式接合到致动器50且可相对于杆42轴向移动。在此实例中，针16可由使用者致动以向近侧或远侧滑动线状臂24、26，产生线状臂24、26的延伸位置和缩回位置。
在未示出的附加实例中，手柄12可以包括与杆42机械连通的锁定机构，该锁定机构抑制杆42和致动器50相对于针16的运动。锁定机构可以是一个或多个机械止动件，其在一个或多个选定位置(例如，缩回位置、延伸位置和两者之间的中间位置)处相对于针16固定杆42的位置。在其它实例中，抑制杆42相对于针16的运动的锁定机构可从器械10中省略，并且杆42可自由地轴向滑动到范围内的任何位置，包括延伸位置和缩回位置。
在图5A-5C中进一步图示了在手术程序期间使用时器械10的线状臂24、26的延伸位置、中间位置和缩回位置。在图5A中，示出了针16的远端18刺穿并且延伸通过软组织52。示出了线状臂24、26处于延伸位置，在手术缝线30的任一侧上通过。在缝线取回期间，如图5B中所示，线状臂24、26至少部分地在针16的远端18内被向近侧拖拽。如上文所讨论的，通过使用满钩36，对开口20的边缘的凸轮效应迫使线状臂24、26朝彼此运动，以环绕缝线30。
此时，使用者可选择在线状臂24、26处于中间位置时从组织52撤出器械10，以实现缝线30与线状臂24、26之间的相对移动。当希望接近缝线30的一端同时将缝线30的剩余部分留在组织52的远侧上时，这是尤其有用的。替代性地，当针16正刺穿组织52时，线状臂24、26可进一步被拖拽到缩回位置(相对于针16的更近侧的移动)。因此抑制缝线30与器械10之间的相对移动，并且器械10随后可从组织52抽出，如图5C中所示。
如上文参照图2所讨论的，针16的远端18中的缝线槽28使得缝线30的腿部32、34能够容易地跟随针16的尖端22，同时总体上仍呈现针16的低外形。此外，虽然设置在槽28内，但是缝线30避免了接触损伤，如果针16的远端开口20周围有尖锐边缘或由于磨损组织或其它器械，则可能会发生所述接触损伤。当缝线30停留在槽28中，针16的远端18的组织穿透能力也保持不受缝线妨碍。
在图6-11中示出了缝线穿引器和抓取器器械110的替代实例。器械110大体上包括手柄112以及终止于远端118的细长套管轴116(也称为针)，手柄包括抓握部分114。基于要执行的修复程序的类型选择从手柄112的近端146到中空细长轴116的远端118的器械110的总长度。例如，对于需要比膝部或肩部手术更长的器械的髋部手术，器械110的总长度可以约为13英寸到约14英寸，包括从手柄112的远端144延伸的大约8.0英寸的中空细长轴116。中空细长轴116可以由不锈钢皮下导管构成，但是本公开涵盖其它合适的材料。中空细长轴116以远端开口120(图7A)终止，远端开口与中空细长轴116的内部连通，这在下文进一步描述。在所示的实例中，手柄112以同轴构造形成，基本上与中空细长轴116的纵向轴线同轴。在未示出的替代实例中，手柄112可以形成为枪柄式或其它合适的构型。手柄12的抓握部分114被构造成由使用者抓握和操作。
在图7A中更详细地示出具有可旋转线状臂124、126的器械110的远端。在这种类型的实施方式中，线状臂124、126可通过扭曲、通过并排固定到彼此或另一部件或通过任何其它有效机构来一起接合在其远端的近侧，以建立联接，例如如图8中所示的连接构件138。通过在管状的中空细长轴116内旋转连接构件138，线状臂124、126中的一者或两者可以围绕在线状臂124、126之间延伸的纵向轴线既在顺时针方向又在逆时针方向上旋转。在所示实施例中连接构件138的旋转通过连接到致动器150的杆142(图8)的旋转来实现，致动器设置在手柄112内且可相对于手柄旋转，如由图7B中的动作箭头所指示的。线状臂124、126中的一者或两者可以旋转一个或多个完整回转或部分回转，部分回转可以约为45度。在需要改变线状臂124、126的定向以在不旋转整个器械110的情况下增加抓取区域时，使用器械110是有利的。在所示实施例中，手柄112的致动器150适于围绕手柄112旋转地(周向地)以及轴向地移动，以用于旋转连接构件138，如将结合图9-11进一步描述的。在其它实施例中，用于旋转线状臂124、126的致动器可以是与平移致动器分开的部件。
线状臂124、126可由相同材料或具有不同拉伸强度和/或柔性度的不同材料制成。在延伸位置，线状臂124、126自然地弹出分开，但当线状臂124、126缩回到中空细长轴116中时，它们被强制在一起。类似地，当线状臂124、126从中空细长轴116的远端开口120伸出时，它们恢复了分开的偏置状态。因此，线状臂124、126相对于中空细长轴116的远侧/近侧运动产生线状臂124、126的打开/关闭运动，这可用于缝合操作。
中空细长轴116的远端118可以呈弧形或是弯曲的，使得远端开口120(图7A)面向侧向，而用于穿透组织的尖锐的尖端122(图6-7A)相对于中空细长轴116的纵向轴线纵向地突出。中空细长轴的一些实施例还可以包括纵向缝线槽，纵向缝线槽在远端处以远端开口终止，类似于上述的槽28。这种槽的长度和宽度被选择为适应一个或多个缝线通过，槽具有切成圆角的边缘，以避免损坏缝线。
如图8中所示，线状臂124、126中的每一个端接于共同的连接构件138。连接构件138可呈弧形以适应中空细长轴116的远端118处的曲率。所示的连接构件138固定到杆142。在未示出的其它实例中，线状臂可由单个U形线形成，所述单个U形线的中心部分固定到杆或其它构件。线状臂中的一个的长度可以与线状臂中的另一个的长度相同或比所述长度更长/更短。如图所示，基本上相等长度的线状臂124、126可以避免缝线仅被一个线状臂124、126捕获。另外，如果线状臂124、126两者的长度基本上相等，则使用者在缩回行程开始时知道缝线是否伸手可及。线状臂124、126中的至少一个可以终止于满钩136以帮助抓取缝线。线状臂中的另一个可终止于部分钩，如上文结合图3A所描述，或以任何其它有效构型构造。
如图7B和图9-11中所示，手柄112与致动器150(例如，拇指滑动件)相互作用，致动器可滑动地且可旋转地安装于手柄112。致动器150安装到手柄112以便在基本上平行于中空细长轴116的纵向轴线的方向上滑动。具体讲，致动器150可从第一位置移动到第二位置，在第一位置，致动器150最靠近手柄112的近端146(图9)，在第二位置，致动器150最靠近手柄112的远端144(图10)。致动器150还可选择性地定位在第一位置与第二位置之间的位置。如图11中所示，致动器150可相对于手柄112旋转以旋转线状臂124、126中的一者或两者，以使得能够以其它角度以相对于中空细长轴116的其它距离抓取缝线。
所示的致动器150通过横向构件140(图6、图7B和图9-11)联接到杆142。横向构件140可以延伸穿过手柄112的侧壁148中的槽147，致动器150沿着手柄滑动。横向构件140又连接到图8的细长杆142。在各种实施例中，杆142可以是固体或由不锈钢或其它合适材料形成的中空管。杆142从手柄112的内部中的横向构件140延伸到中空细长轴116的内部，以便与线状臂124、126连通。因此，致动器150相对于手柄112的移动导致线状臂124、126相对于中空细长轴116移动。具体讲，致动器150向远侧的移动使杆142向远侧移动，从而导致线状臂124、126从中空细长轴116伸出。以类似的方式，致动器150向近侧的移动使杆142反向运动。
在未示出的替代实例中，杆的位置相对于手柄固定，而中空细长轴以机械方式接合到致动器并且可相对于杆轴向移动。在此实例中，中空细长轴可由使用者致动以向近侧或远侧滑动线状臂，产生线状臂的延伸位置和缩回位置。
在未示出的附加实例中，手柄112可以包括与杆142机械连通的锁定机构，该锁定机构抑制杆142和致动器150相对于中空细长轴116的运动。锁定机构可以是一个或多个机械止动件，其在一个或多个选定位置(例如，缩回位置、延伸位置和两者之间的中间位置)处相对于中空伸长轴116固定杆142的位置。在其它实例中，可以从器械110省略抑制杆142相对于中空细长轴116运动的锁定机构，并且杆142可以自由轴向滑动到范围内的任何位置，包括延伸位置和缩回位置。
用器械110进行的手术操作基本上与上文结合器械10描述并在图5A-5C中图示的操作类似，不同之处是器械110还能够相对于中空细长轴116旋转线状臂124、126中的一者或两者以帮助对齐器械110，从而在线状臂124、126内捕获缝线。
尽管本公开的具体特征在一些附图中示出在其它附图中没有示出，但这仅出于方便起见，因为每个特征可以与根据本公开的任何或所有其它特征组合。其它实例将会被本领域技术人员想到，并且在所附权利要求书内。
Claims (15)
1.一种缝线穿引器和抓取器器械，包括：
中空细长轴，所述中空细长轴具有近端、远端以及在所述近端与所述远端之间延伸的纵向轴线，所述轴的所述近端联接到手柄，并且所述轴的所述远端限定被构造成穿透组织的尖端，所述手柄包括纵向槽，所述纵向槽具有设置在所述纵向槽的远端处的垂直部分；和
组件，所述组件部分地设置在所述手柄内并且部分地设置在所述中空细长轴内，所述组件可独立于所述手柄和所述中空细长轴轴向地移动，所述组件包括：
致动器，所述致动器在靠近所述手柄处可被接近，并且设置在所述手柄的所述纵向槽之内；
连接器，所述连接器联接到所述致动器；以及
联接到所述连接器的第一线状构件和第二线状构件，所述第一线状构件和第二线状构件中的至少一个能够接合缝线；
其中，所述致动器在所述纵向槽之内的移动能够将所述第一线状构件和第二线状构件从缩回位置移动到延伸位置，且所述致动器在所述垂直部分之内的移动能够相对于所述中空细长轴旋转所述第一线状构件和第二线状构件中的至少一个，在缩回位置，所述线状构件在所述远端的所述尖端的近侧，在延伸位置，所述线状构件在所述远端的所述尖端的远侧；以及
其中，所述中空细长轴的远端开口包括从所述开口向近侧延伸的纵向缝线槽。
2.根据权利要求1所述的器械，其中所述中空细长轴的所述远端远离所述纵向轴线弯曲，使得所述中空细长轴中的远端开口至少部分地面向侧向，并且所述尖端纵向突出。
3.根据权利要求1所述的器械，所述纵向缝线槽具有为允许缝线通过而选择的长度和宽度。
4.根据权利要求1所述的器械，其中当所述第一线状构件和第二线状构件处于所述延伸位置时，所述第一线状构件和第二线状构件被线性地对准于所述尖端和所述纵向缝线槽之间。
5.根据权利要求1所述的器械，其中所述连接器包括杆，所述杆联接在所述致动器与所述第一线状构件和第二线状构件之间。
6.根据权利要求5所述的器械，其中所述连接器包括连接构件，所述连接构件联接在所述杆与所述第一线状构件和第二线状构件之间。
7.根据权利要求1所述的器械，其中所述器械从所述手柄的近端延伸到所述尖端的长度为13英寸到14英寸之间。
8.根据权利要求1所述的器械，其中从所述手柄延伸的所述中空细长轴的长度为约8英寸。
9.根据权利要求1所述的器械，其中所述第一线状构件和第二线状构件中的至少一个终止于能够接合缝线的钩状元件。
10.根据权利要求9所述的器械，其中所述第一线状构件和第二线状构件中的一个终止于所述钩状元件，并且所述第一线状构件和第二线状构件中的另一个终止于半钩。
11.根据权利要求1所述的器械，其中所述第一线状构件和第二线状构件由具有圆形横截面的材料构成。
12.根据权利要求1所述的器械，其中所述第一线状构件和第二线状构件的长度被选择成基本上相同。
13.根据权利要求1所述的器械，其中所述致动器是拇指滑动件。
14.根据权利要求1所述的器械，其中所述致动器的移动还能够使所述第一线状构件和所述第二线状构件移动到所述缩回位置和所述延伸位置之间的中间位置。
15.根据权利要求1所述的器械，其中所述连接器至少部分地延伸穿过所述手柄中的纵向槽，所述致动器沿着所述手柄滑动。
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201662414886P | 2016-10-31 | 2016-10-31 | |
| US62/414,886 | 2016-10-31 | ||
| PCT/US2017/058460 WO2018081374A1 (en) | 2016-10-31 | 2017-10-26 | Suture passer and grasper instrument and method |
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| CN109843187A CN109843187A (zh) | 2019-06-04 |
| CN109843187B true CN109843187B (zh) | 2022-12-06 |
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| CN201780062645.XA Active CN109843187B (zh) | 2016-10-31 | 2017-10-26 | 缝线穿引器和抓取器器械和方法 |
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| US (1) | US10682133B2 (zh) |
| EP (1) | EP3531931A1 (zh) |
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| US11278274B2 (en) | 2018-05-04 | 2022-03-22 | Arch Day Design, Llc | Suture passing device |
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| US10646217B2 (en) | 2018-05-04 | 2020-05-12 | Arch Day Design, Llc | Suture passing device |
| EP3801293A1 (en) * | 2018-05-29 | 2021-04-14 | Smith & Nephew, Inc. | Suture passer with locking actuator |
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| US11246586B2 (en) | 2019-08-20 | 2022-02-15 | Arch Day Design, Llc | Instrument to manipulate and pass suture |
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| US11154295B1 (en) * | 2020-05-14 | 2021-10-26 | Composite Surgical, LLC | Steerable suture retriever |
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| WO2018081374A1 (en) | 2018-05-03 |
| US20180116652A1 (en) | 2018-05-03 |
| EP3531931A1 (en) | 2019-09-04 |
| CN109843187A (zh) | 2019-06-04 |
| US10682133B2 (en) | 2020-06-16 |
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