CN110368155B

CN110368155B - Broken end blood vessel anastomosis supporting device

Info

Publication number: CN110368155B
Application number: CN201910811772.6A
Authority: CN
Inventors: 代洪娜; 张宾
Original assignee: First Affiliated Hospital of Henan University of Science and Technology
Current assignee: First Affiliated Hospital of Henan University of Science and Technology
Priority date: 2019-08-30
Filing date: 2019-08-30
Publication date: 2021-03-09
Anticipated expiration: 2039-08-30
Also published as: CN110368155A

Abstract

The invention relates to a broken end blood vessel anastomosis supporting device, which effectively solves the problems of high alignment and suture difficulty during blood vessel suture; the technical scheme includes that the device comprises an inner supporting portion and an outer supporting portion, wherein the inner supporting portion comprises a hollow L-shaped rod, one end of the L-shaped rod is hinged with a plurality of first connecting rods which are uniformly distributed on the circumference, the outer end of each first connecting rod is hinged with a second connecting rod, the outer end of each second connecting rod is hinged with a third connecting rod, the outer ends of the third connecting rods are hinged on the same disc, a piston rod is arranged between the disc and the L-shaped rod, one end of the piston rod is fixed on the disc, the other end of the piston rod extends into a cavity of the L-shaped rod and is attached to the inner wall of the cavity, the other end of the cavity of the L-shaped rod is connected with a hose, a one-way valve capable of pumping air from the cavity to the outside is arranged on the; the invention effectively reduces the operation difficulty during the blood vessel suture and reduces the probability of thrombosis.

Description

Broken end blood vessel anastomosis supporting device

Technical Field

The invention relates to the field of vascular anastomosis, in particular to a broken end vascular anastomosis supporting device.

Background

The blood vessel end-to-end anastomosis operation is a common means for reconstructing a broken blood vessel passage, the accurate and flat alignment of the broken end is required when the blood vessel end-to-end anastomosis is performed, the narrowing and torsional dislocation are not generated after the blood vessel is sutured, and otherwise the probability of thrombosis is greatly increased; at present, a mode of suturing blood vessels by using sutures after hemostasis by using vascular clamps is adopted for vascular anastomosis, the blood vessels are in a flat state during alignment and suturing, so that the alignment difficulty is high, the blood vessels are easy to twist and dislocate, the blood vessels are narrowed or twisted after suturing, and needle insertion and needle withdrawal need to be very careful during suturing to prevent the blood vessels from penetrating into the intima of the opposite side blood vessels, so that the blood vessels need to be slightly lifted by using forceps, and the operation difficulty is high; in order to solve the problem, some internal supporting devices, such as shape memory alloy stents, are delivered into a blood vessel, then the blood vessel is expanded and then sutured, the stent is kept in the blood vessel after suturing, local thrombosis is easily caused by the stent, anticoagulant drugs need to be taken for a long time, the stent belongs to foreign matters, and the organism has rejection reaction, so that the stent can be implanted only when the blood vessel is narrowed by more than 70 percent even when the blood vessel is embolized, and the implantation of the stent in the blood vessel anastomosis operation obviously has great disadvantages.

Disclosure of Invention

Aiming at the situation, in order to overcome the defects of the prior art, the invention provides a broken end blood vessel anastomosis supporting device, which effectively solves the problems of high alignment and suture difficulty during blood vessel suture.

The technical scheme for solving the problem is that the broken end blood vessel anastomosis supporting device comprises two groups of supporting devices, wherein each group of supporting device comprises an inner supporting part and an outer supporting part, the inner supporting part comprises a hollow L-shaped rod, one end of the L-shaped rod is hinged with a plurality of first connecting rods which are uniformly distributed on the circumference, the outer end of each first connecting rod is hinged with a second connecting rod, the outer end of each second connecting rod is hinged with a third connecting rod, the outer ends of the third connecting rods are hinged on the same disc, the three connecting rods form a hinged chain, and a plurality of groups of hinged chains form a cage-shaped structure which can be unfolded and folded; a piston rod is installed at the axis of the cage-shaped structure, one end of the piston rod is fixed on the disc, the other end of the piston rod extends into the cavity of the L-shaped rod and is attached to the inner wall of the cavity, the other end of the cavity of the L-shaped rod is connected with a hose, a one-way valve capable of pumping air from the cavity to the outside is installed on the hose, a first branch pipe and a second branch pipe are installed on the hose, a pressure valve is installed on the first branch pipe, and a switch valve is installed on the second branch pipe; the outer supporting part comprises two arc-shaped pressing plates, two ends of each arc-shaped pressing plate are respectively provided with a first through hole, when the two arc-shaped pressing plates are buckled, the first through holes on the two arc-shaped pressing plates are coaxially opposite, and the outer wall of each arc-shaped pressing plate is provided with an axial second through hole; the two ends of the opposite pulling strips can penetrate into the first through hole or the second through hole so as to tension the two arc-shaped pressing plates or the two groups of supporting devices.

The invention adopts the internal and external support mode, so that the suturing of the blood vessel under the expanded normal state effectively reduces the operation difficulty during the suturing of the blood vessel, ensures the accuracy and the flatness of the involution of the blood vessel, can completely take out the internal support part after the suturing, has no implant in the blood vessel and reduces the probability of thrombosis.

Drawings

Fig. 1 is a front sectional view of the inner support portion when it is collapsed.

Fig. 2 is a left side sectional view at a plurality of second links.

Fig. 3 is a front sectional view at the time of suturing.

Fig. 4 is a left side view when suturing.

Fig. 5 is a top view of the suture.

Fig. 6 is an enlarged view of a portion a in fig. 1.

Detailed Description

The following description of the embodiments of the present invention will be made in detail with reference to the accompanying drawings.

As shown in fig. 1 to 6, the invention comprises two groups of supporting devices, each group of supporting device comprises an inner supporting part and an outer supporting part, the inner supporting part comprises a hollow L-shaped rod 1, one end of the L-shaped rod 1 is hinged with a plurality of first connecting rods 2 which are uniformly distributed on the circumference, the outer end of each first connecting rod 2 is hinged with a second connecting rod 3, the outer end of each second connecting rod 3 is hinged with a third connecting rod 4, the outer ends of the third connecting rods 4 are hinged on the same disc 5, the three connecting rods form a hinged chain, and a plurality of groups of hinged chains form a cage-shaped structure which can be opened and closed; a piston rod 6 is installed at the axis of the cage-shaped structure, one end of the piston rod 6 is fixed on the disc 5, the other end of the piston rod 6 extends into the cavity of the L-shaped rod 1 and is attached to the inner wall of the cavity, the other end of the cavity of the L-shaped rod 1 is connected with a hose 7, a one-way valve 8 capable of pumping air from the cavity to the outside is installed on the hose 7, a first branch pipe 9 and a second branch pipe 10 are installed on the hose 7, a pressure valve 11 is installed on the first branch pipe 9, and a switch valve 12 is installed on the second branch pipe 10; the outer supporting part comprises two arc-shaped pressing plates 13, two ends of each arc-shaped pressing plate 13 are respectively provided with a first through hole 14, when the two arc-shaped pressing plates 13 are buckled, the first through holes 14 on the two arc-shaped pressing plates 13 are coaxially opposite, and the outer wall of each arc-shaped pressing plate 13 is provided with an axial second through hole 15; and a plurality of pairs of pulling strips 16 are also included, and both ends of the pair of pulling strips 16 can penetrate into the first through holes 14 or the second through holes 15 so as to tighten the two arc-shaped pressing plates 13 or the two groups of supporting devices.

The plurality of second connecting rods 3 of the inner supporting part are sleeved with an elastic rubber sleeve 17, the inner side of each arc-shaped pressing plate 13 is attached with a rubber pad 18, the rubber sleeve 17 and the rubber pads 18 can protect the intravascular outer membrane from being damaged, and the elasticity of the rubber sleeve 17 can enable the plurality of groups of hinge chains to be automatically folded when the cavity of the L-shaped rod 1 is decompressed.

The two end outer walls of the opposite pulling strip 16 are provided with conical bulges 19 connected end to end, and the conical bulges 19 at the two ends face in opposite directions, so that each end of the opposite pulling strip 16 can only pass through the first through hole 14 or the second through hole 15 in a one-way manner.

The outer end of the hose 7 is provided with a connector 20, and the connector 20 can be connected with an injection port of a medical injector.

The multi-group hinge chain can be replaced by a plurality of elastic rods, the piston rod 6 drives the disc 5 to move inwards after the negative pressure is pumped in the L-shaped rod 1, the middle parts of the elastic rods are arched outwards to be unfolded, and the diameter of the device can be further reduced by adopting the elastic rods.

When the device is used for anastomosis of the end of the blood vessel, the blood vessel is firstly clamped and closed at a position 2-3 cm away from the broken end of the blood vessel by using a blood vessel clamp, and then the adventitia of the blood vessel is stripped: clamping the outer membrane of the broken end of the blood vessel by using blood vessel forceps, pulling outwards and then cutting off the outer membrane so as to prevent the outer membrane from being brought into the lumen to cause thrombosis during suturing, then building the broken ends of the blood vessel at two sides orderly, flushing the lumens at the two broken ends by using 0.1% heparin normal saline, 0.5% procaine or 3.8% sodium citrate solution, and flushing out coagulated blood clots so as to prevent thrombosis after anastomosis; after trimming and flushing are finished, the inner supporting parts of the two groups of supporting devices are respectively inserted into blood vessels at two ends, one end of the L-shaped rod 1 connected with the hose 7 is left outside the blood vessel, then a medical injector is connected to a connector 20 at the outer end of the hose 7, an injector piston is pulled outwards, air in the cavity of the L-shaped rod 1 is pumped out, negative pressure is formed in the cavity of the L-shaped rod 1, the piston rod 6 moves towards the L-shaped rod 1, so that the disc 5 is driven to move inwards, a plurality of groups of hinged chains are unfolded, when the rubber sleeve 17 outside the second connecting rod 3 contacts the inner wall of the blood vessel, the resistance of continuous air pumping is increased, namely the negative pressure in the cavity of the L-shaped rod 1 is obviously increased, at the moment, the pressure difference between the inside and outside of the L-shaped rod 1 is greater than the opening threshold value of the pressure valve 11, the pressure valve 11 is opened, outside air enters the cavity of the L-, avoid the too big damage inner membrance of pressure to the blood vessel inner wall of second connecting rod 3, stop to bleed this moment and take off the syringe can.

After the two groups of inner supporting parts are all expanded, two arc-shaped pressing plates 13 of each group of outer supporting parts are buckled at the positions, corresponding to the multiple expanded second connecting rods 3, on the outer wall of the blood vessel, then opposite through holes 14 on the two arc-shaped pressing plates 13 of the same group are respectively provided with a pair of pulling strips 16 for tensioning, so that the two arc-shaped pressing plates 13 of the same group are buckled outside the blood vessel, and the inner supporting parts and the outer supporting parts are used for expanding, shaping and clamping the blood vessel; when the arc-shaped pressing plates 13 are buckled, the second through holes 15 on the arc-shaped pressing plates 13 of the two groups of outer supporting parts are aligned.

After two broken ends of the blood vessel are both expanded and clamped, one pair of brace 16 is penetrated and tensioned in the second through holes 15 opposite to the two groups of arc-shaped pressing plates 13, so that the two groups of supporting devices are closed, the broken ends of the blood vessel are closed, then the broken ends of the blood vessel after closing can be sewn, because the blood vessel is in an expanded and aligned state, the needle can be conveniently inserted and withdrawn during sewing, the blood vessel is not easy to twist and close, the smoothness of the closed surface is ensured to the maximum degree, and the possibility of later-stage thrombosis is reduced.

After the broken end of the blood vessel is sewn by about three quarters, the switch valve 12 on the second branch pipe 10 is opened, outside air enters the L-shaped rod 1, the negative pressure disappears, the inner support part is gradually folded into a rod shape under the action of the elastic force of the rubber sleeve 17, the folded inner support part is drawn out from the unsewn gap, then the gap is completely sewn, finally each pair of brace 16 is cut off from the middle, and the four arc-shaped pressing plates 13 are taken down.

After the suturing is finished, the far-end vascular clamp is loosened, if a little blood leaks from an anastomotic stoma, the bleeding can be stopped by lightly pressing the anastomotic stoma for a few minutes generally, if necessary, 1-2 needles can be sutured at the position with much blood leakage, and if no blood leakage exists, the near-end vascular clamp is opened immediately to recover the blood flow.

The invention adopts the internal and external support mode to suture the blood vessel in the expanded normal state, thereby facilitating the needle insertion and needle withdrawal, being not easy to damage the intima of the opposite side blood vessel, simultaneously being not easy to twist and dislocate the blood vessel, not manually closing the blood vessel during the suture, effectively reducing the operation difficulty during the blood vessel suture, ensuring the accuracy and the flatness of the blood vessel closing, and the internal support part can be completely taken out after the suture, no implant is arranged in the blood vessel, and reducing the probability of thrombosis.

Claims

1. The broken end blood vessel anastomosis supporting device is characterized by comprising two groups of supporting devices, wherein each group of supporting device comprises an inner supporting part and an outer supporting part, the inner supporting part comprises a hollow L-shaped rod (1), one end of the L-shaped rod (1) is hinged with a plurality of first connecting rods (2) which are uniformly distributed on the circumference, the outer end of each first connecting rod (2) is hinged with a second connecting rod (3), the outer end of each second connecting rod (3) is hinged with a third connecting rod (4), the outer ends of the third connecting rods (4) are hinged on the same disc (5), three connecting rods which are connected form a hinged chain, and a plurality of groups of hinged chains form a cage-shaped structure which can be unfolded and folded; a piston rod (6) is installed at the axis of the cage-shaped structure, one end of the piston rod (6) is fixed on the disc (5), the other end of the piston rod extends into the cavity of the L-shaped rod (1) and is attached to the inner wall of the cavity, the other end of the cavity of the L-shaped rod (1) is connected with a hose (7), a one-way valve (8) capable of pumping air from the cavity outwards is installed on the hose (7), a first branch pipe (9) and a second branch pipe (10) are installed on the hose (7), a pressure valve (11) is installed on the first branch pipe (9), and a switch valve (12) is installed on the second branch pipe (10); the outer supporting part comprises two arc-shaped pressing plates (13), two ends of each arc-shaped pressing plate (13) are respectively provided with a first through hole (14), when the two arc-shaped pressing plates (13) are buckled, the first through holes (14) on the two arc-shaped pressing plates (13) are coaxially opposite, and the outer wall of each arc-shaped pressing plate (13) is provided with an axial second through hole (15); the two ends of the opposite braces (16) can penetrate into the first through hole (14) or the second through hole (15) so as to tighten the two arc-shaped pressing plates (13) or the two groups of supporting devices.

2. A supporting device for anastomosis of severed vessels according to claim 1, wherein a plurality of second connecting rods (3) of said inner supporting portion are externally sleeved with an elastic rubber sleeve (17), and a rubber pad (18) is attached to the inner side of each arc-shaped pressing plate (13).

3. The broken end blood vessel anastomosis supporting device according to claim 1, wherein the two end outer walls of the opposite pulling strips (16) are provided with conical bulges (19) connected end to end, and the conical bulges (19) at the two ends face in opposite directions.

4. A broken end blood vessel anastomosis supporting device according to claim 1, wherein the outer end of the flexible tube (7) is provided with a connector (20), and the connector (20) can be connected with an injection port of a medical injector.

5. The broken end blood vessel anastomosis supporting device according to claim 1, wherein the plurality of groups of articulated chains can be replaced by a plurality of elastic rods, after negative pressure is pumped in the L-shaped rod (1), the piston rod (6) drives the disc (5) to move inwards, and the middle parts of the plurality of elastic rods are arched and spread outwards.