Sleeve hole suturing device
Technical Field
The invention belongs to the field of medical instruments, and is used for suturing and closing sleeve holes in laparoscopic surgery.
Background
The laparoscope technology is widely applied to various surgical operations, is popular among doctors and patients, has delicate operation, small wound, small abdominal wall incision and quick recovery of post-operation physiology and psychology, and is the development trend of minimally invasive surgery.
In laparoscopic surgery, 3-5 small incisions of 0.5-1.2 cm are often needed to be made on the abdomen of a patient, a cannula is arranged, and the surgical operation is carried out through a cannula hole; one of the sleeves is used to place a laparoscope, typically located in the umbilicus; after the operation is completed, the incision of the umbilical sleeve hole cannot be automatically retracted due to no abdominal muscle covering, and the suture is necessary. The curved needle is generally used for direct suturing clinically, but for the suture with small diameter and deep position of the sleeve hole from the base part, certain technical difficulty is caused in operation, and particularly for patients with obesity, the suture is difficult to be sutured to the bottom of the sleeve hole. Therefore, some patients may develop postoperative hernia of the cannula hole clinically. The designed cannula hole suturing device is inserted into a cannula hole by utilizing the appearance similar to that of a cannula when the operation is finished, the lower section of the suturing device is unfolded with the bracket part by pulling the operating rod, and the plane of the upper end of the bracket can be tightly attached to and firmly grasp the peritoneum beside the hole; rotating a knob at the top end of the suturing device to screw out a round needle in the middle of the suturing device, wherein the round needle penetrates through abdominal wall tissues beside the hole and penetrates through a glue film of the bracket through peritoneum; at the moment, the top knob is rotated reversely, so that the round needle returns back into the suturing device body along the way, and the suture thread brought out by the needle point is firmly clamped and hung on the adhesive film of the bracket; when the bracket is folded, the suturing device is taken out from the sleeve hole, and the sutures passing through the abdominal wall base part at the two sides are also pulled out together; and (4) tightening the suture and stably knotting to complete the sewing of the sleeve hole from the deep base.
Disclosure of Invention
The sleeve hole suturing device consists of three parts:
first, the housing part: "lower round, middle square, upper gate" (see attached figure 1 in the description)
Lower circle part: the lower end is a hemisphere with the diameter of 1.2cm, which is convenient for being placed in the abdominal wall casing hole.
The middle part: the side length of the square columnar body is 1.2cm, the volume occupying the sleeve hole is increased, the square columnar body is enabled to be tightly attached to the wall of the sleeve hole, meanwhile, the space in the middle of the suturing device is increased, and the support frame and the rotary suturing device are favorably arranged.
The upper organ part: 1. wing rods on both sides of the top end: when the wing rods on the two sides face upwards, the support frames on the two sides are contracted in the shell through the linkage rods, so that the support frames can be conveniently inserted into the sleeve holes; when the wing rods at the two sides are pulled downwards, the support frames at the two sides can be unfolded outwards to form a plane frame with 90 degrees, the plane frame is attached with a glue film, and the two sides of the frame are provided with the glue films with inward sawteeth. The suturing device is lifted upwards, and the two sides of the suturing device are tightly attached to the peritoneum beside the sleeve hole like a drag hook.
2. A top knob: the knob is arranged at the top of the screw rod, and when the knob rotates leftwards, the screw rod can drive the gears at the two sides to rotate, so that the circular needle fixed on the gear is screwed out of the shell, penetrates through abdominal wall tissues and pierces through a glue film at the horizontal part of the support frame; when rotated to the right, the double-sided circular needle may be rotated back into the housing.
Two, movable support frame part
The middle shell of the seaming device is internally provided with a support frame (please refer to attached figure 1 in the specification), a wing rod at the top end of the seaming device is pulled downwards, the support frame extends out of the shell and is supported to form a triangle, and the horizontal part of the support frame is right-angled with the shell. The surface of the horizontal part frame is attached with a glue film, and the two sides of the frame are provided with the glue films with inward sawteeth, so that the glue films are easy to attach and cling to the peritoneum. When the circular needle penetrates the adhesive film and retreats, the elastic force of the adhesive film can firmly clamp the suture line penetrated by the needle. The triangle formed by the support frame also has the function of isolation and protection, so as to prevent the round needle from hurting other tissues in the abdominal cavity. When the wing rod is pulled upwards, the supporting frame can be recovered into the shell of the seaming device, and when the seaming device is pulled out, the threads clamped on the adhesive film at the two sides are also taken out of the body.
Thirdly, rotating the circular needle part
The middle part of the suturing device is provided with a pair of circular suturing needles, the tail parts of the needles are symmetrically fixed on a pair of gears respectively (refer to the attached figures 2 and 3 of the specification), and the circular suturing needles are designed to rotate 120 degrees to be screwed out of the shell part to pierce the horizontal rubber membrane part of the support frame. Namely: when the knob at the top of the suturing device is rotated leftwards, the screw can drive the gears at the two sides to rotate, so that the circular needle is screwed out, penetrates through abdominal wall tissues and pierces through a glue film at the horizontal part of the support frame; when rotated to the right, the double-sided circular needle can be rotated back into the stapler housing. The other characteristics of the rotary circular needle are as follows: the needle tip section is designed with a notch which faces the needle tip direction. When the thread is hung at the notch of the needle point, the thread moves along with the needle when the needle is inserted, and the thread is separated from the needle when the needle is withdrawn. Two small barbs are arranged at the head end of the thread, and the thread moves along with the needle when the needle is inserted; the thread is separated from the needle when the needle is withdrawn, and the agnail of the thread can hook the glue film.
The invention has the beneficial effects that: compared with the prior art, the invention comprises a sewing needle, a shell and a movable support frame; operating wing rods to drive the supporting frame to open towards the two sides of the shell; the sawtooth on the surface of the support frame bites the part to be sutured; and the part to be sutured is closed to the shell; firstly, rotating a screw rod in the forward direction, driving a sewing needle to be screwed out of a shell by the screw rod, penetrating abdominal wall tissues to be sewn and puncturing an adhesive film; then the screw rod is rotated reversely, the sewing needle is driven to leave the adhesive film and return to the shell; the barb line is hung on the adhesive film and is taken out of the body along with the adhesive film; finally, the barbed lines which penetrate through the parts to be sewn on the left side and the right side are connected and sewn after the barbed lines are connected; the whole sewing process is rapid and convenient, and the barb thread penetrates out from the bottom of the part to be sewn, so that the problems of difficult sewing and incomplete sewing in the conventional sewing process are solved.
Drawings
FIG. 1 is an overall block diagram of the present invention;
FIG. 2 is a schematic view of the present invention with the needle not inserted into the cradle;
FIG. 3 is a schematic view of the present invention with the needle not penetrating the moveable support;
FIG. 4 is a view of the needle and screw fitting configuration of the present invention;
FIG. 5 is an enlarged view of the tip structure of the needle of the present invention;
FIG. 6 is a view of the barb line of the present invention;
FIG. 7 is a structural diagram of the driving portion structure of the present invention when the driving portion drives the supporting portion to open;
FIG. 8 is a structural diagram of the driving portion structure of the present invention when the driving support portion is folded;
FIG. 9 is a top view of the support bracket of the present invention;
FIG. 10 is a side view of the support bracket of the present invention;
FIG. 11 is a schematic view of the shell of the present invention with the barbed wire being carried out of the sleeve hole;
FIG. 12 is a schematic view of a barbed suture of the present invention;
fig. 13 is a schematic view of a sleeve hole of the present invention after suturing.
The main element symbols are as follows:
1. a screw; 2. a housing; 3. wing rods; 4. a knob portion; 6. a gear; 7. sewing a needle; 8. a portion to be sutured; 9. a barbed line; 51. a support portion; 52. a driving lever; 53. an outer stay bar; 54. saw teeth; 55. a glue film; 56. a linkage rod; 61. a limiting block; 71. a needle tip; 72. a needle body; 73. and (4) a groove.
Detailed Description
Referring to fig. 1, fig. 2, fig. 3, fig. 11, fig. 12 and fig. 13, a cannula hole closer includes a needle 7, a housing 2 and a movable support portion; the sewing needle 7 is used for driving the barb line 9 to move; the sewing needle 7 is connected with the gear 6, and the gear 6 is meshed with the screw rod; the screw 1 rotates to drive the sewing needle 7 to rotate around the wheel center of the gear 6; the shell 2 is sleeved outside the screw rod; the movable support frame comprises a support part provided with a through hole, and the through hole is covered with the adhesive film 55; and a driving part for driving the supporting part 51 to open or close to both sides of the housing 2; the shell 2 is provided with a wing rod 3, and the wing rod 3 is connected with the driving part; the wing rod 3 is operated to control the driving part to drive the supporting part to open towards the two sides of the shell 2, and the supporting frame hooks the part to be sutured 8; and then the screw rod 1 is rotated to drive the sewing needle 7 to rotate to sequentially pierce the part 8 to be sewn and the adhesive film 55, meanwhile, the barbed wire 9 sequentially penetrates through the part 8 to be sewn and the adhesive film 55 along with the sewing needle 7, the screw rod 1 is rotated reversely to drive the sewing needle 7 to leave the adhesive film 55, and the barbed wire 9 is hung on the adhesive film 55 and moves together along with the adhesive film 55.
When the laparoscopic surgery is to be finished, the sleeve hole of the umbilical region needs to be finally sutured and closed, and the suturing device disclosed by the invention is applied to the link that: pulling out the original umbilical sleeve, and placing the sleeve suturing device with the same diameter into the sleeve hole; trial adjustment is carried out to a certain depth, the wing rod 3 at the top end of the seaming device is pulled, and the supporting part 51 extends out of the seaming device shell and is supported; the suturing device is pulled upwards to make the horizontal part of the supporting part 51 tightly attached to the peritoneum in the abdominal cavity; the knob at the top end of the suturing device is rotated leftwards, the circular suturing needles 7 at the two sides are screwed out, penetrate through abdominal wall tissues and penetrate through the glue film at the horizontal part of the supporting part 51; when rotating to the right, the double-sided circular sewing needle 7 can rotate back into the suturing device shell; pulling the wing rod 3 upwards, and the supporting parts 51 at the two sides can be recovered into the seaming device shell; pulling out the seaming device, and taking out the sutures clamped on the adhesive film at two sides out of the body; and (5) tightening the stitches at the two ends, and ligating to complete the sewing of the base part of the sleeve hole.
Referring to fig. 2, 3, 7 and 8, the driving part includes an active rod 52 and an outer stay 53; one end of the support frame is hinged with the shell 2, and the other end is hinged with the active rod 52; the other end of the active rod 52 is connected with the shell 2 in a sliding way; the outer stay 53 is connected with the wing rod 3 through the link rod 56, the wing rod 3 is operated to control the outer stay 53 to push the driving rod 52 to two sides, so that the sliding end of the driving rod 52 slides towards the direction close to the support frame, meanwhile, the hinged end of the driving rod 52 moves towards the direction far away from the shell 2, so that the support frame opens towards two sides of the shell 2, otherwise, the wing rod 3 is operated to control the outer stay 53 to close each other, the sliding end of the driving rod 52 slides towards the direction far away from the support frame under the action of gravity, and meanwhile, the hinged end of the driving rod 52 moves towards the direction close to the shell 2, so that the support frame closes towards the shell 2.
In this embodiment, the outer stay 53 is a pair of mutually hinged struts, the struts are provided with strip-shaped through holes, the housing 2 is provided with limiting posts, and the limiting posts are clamped in the strip-shaped through holes; operating the wing rod 3 to drive the link rod 56 to press the hinged part of the support rod, and enabling the limiting column to slide relatively along the strip-shaped hole; the included angle between the two support rods gradually approaches 180 degrees, and the outer support rods 53 open towards the two sides to push the driving rod 52; operating the wing rod 3 to drive the link rod 56 to pull up the hinged position of the support rod, and enabling the limiting column to relatively slide along the strip-shaped hole; the included angle between the two supporting rods is gradually close to 0 degree, and the outer supporting rod 53 is folded towards the middle; the sliding end of the active lever 52 slides away from the support frame under the action of gravity, and the support frame is folded towards the housing 2 so as to be folded.
Referring to fig. 3, 9 and 10, after the lower end of the housing 2 is inserted into the sleeve hole, the wing rod 3 is rotated downward, and the support frame is unfolded towards the two sides of the housing 2 and forms a right angle with the housing 2; so that the support frame can be tightly attached to the side wall of the sleeve hole; preferably, the surface of the supporting frame is provided with saw teeth 54 which can grasp the abdominal wall firmly and pull the part 8 to be sutured to close towards the shell 2; wherein, the surface of the supporting frame is provided with a film 55, the needle 7 is returned after puncturing the film 55, and the barbed wire 9 which is punctured with the needle is hung on the film 55.
Referring to fig. 4, 5 and 6, a knob portion 4 is disposed at the end of the screw rod 1 extending out of the housing 2, and the screw rod 1 and the control housing 2 are driven to rotate relatively by rotating the knob portion 4; specifically, the inner diameter of an outlet at the upper end of the shell 2 is equal to that of the screw rod 1, and an internal thread matched with the screw rod 1 is arranged; the inner diameter of the middle end of the shell 2 is larger than that of the screw rod 1, so that the sewing needle 7 and the gear 6 are accommodated in the shell 2; the knob part 4 is rotated in the positive direction, the screw 1 drives the gear 6 to rotate, and the sewing needle 7 rotates from the sleeve to the outside along with the gear 6; the knob part 4 is rotated reversely, the screw 1 drives the gear 6 to rotate, and the sewing needle 7 follows the gear 6 to rotate from the outside of the sleeve to the inside of the sleeve.
In the present embodiment, the needle 7 includes a needle tip 71 and a needle body 72; the needle body 72 gradually sharpens the sewing needle 7 along the needle point 71 direction; the end of the needle point 71 is provided with a groove 73, and the opening of the groove 73 faces to the sharp direction of the needle point 71; the barbed wire 9 is clamped in the groove 73, when the needle point 71 pierces the film 55, the barbed wire 9 and the groove 73 are mutually abutted and clamped in the groove 73 and move together with the sewing needle 7; when the needle tip 71 is removed from the film 55, the barbed wire 9 slides out of the groove 73, and the barbed wire 9 hooks with the film 55 and remains on the film 55.
In this embodiment, the tail of the needle body 72 is provided with a limit block 61, and the limit block 61 is connected with the gear 6; in the process that the sewing needle 7 rotates along with the gear 6, the limiting block 61 and the inner wall of the shell 2 are mutually abutted, and the range value of the rotation angle of the sewing needle 7 is controlled; after the sewing needle 7 pierces the film 55, the limiting block 61 is abutted against the inner wall of the shell 2 to limit the sewing needle 7 to continuously rotate to stab other tissues in the human body; preferably, the rotation angle of the needle 7 is 120 degrees.
The invention has the advantages that:
1. the suture needle can drive the barbed thread to pass through the part to be sutured only by rotating the screw rod;
2. after the sewing needle pierces the part to be sewn, the barb line can directly return along the original path to hang the barb line on the adhesive film, and the barb line is taken out of the body along with the adhesive film;
3. the whole sewing process is fast and convenient to operate, and the barbed thread penetrates out from the bottom to be sewn, so that the problems of difficult sewing and incomplete sewing in the conventional sewing process are solved.
The above disclosure is only for a few specific embodiments of the present invention, but the present invention is not limited thereto, and any variations that can be made by those skilled in the art are intended to fall within the scope of the present invention.