CN110547834B - Tendon guiding forceps - Google Patents
Tendon guiding forceps Download PDFInfo
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- CN110547834B CN110547834B CN201910827273.6A CN201910827273A CN110547834B CN 110547834 B CN110547834 B CN 110547834B CN 201910827273 A CN201910827273 A CN 201910827273A CN 110547834 B CN110547834 B CN 110547834B
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- 210000002435 tendon Anatomy 0.000 title claims abstract description 226
- 230000007246 mechanism Effects 0.000 claims abstract description 70
- 238000000034 method Methods 0.000 claims description 23
- 238000004804 winding Methods 0.000 claims description 13
- 230000000149 penetrating effect Effects 0.000 claims description 7
- 230000007704 transition Effects 0.000 claims description 7
- 238000009987 spinning Methods 0.000 claims description 5
- 230000008602 contraction Effects 0.000 claims description 4
- 238000003825 pressing Methods 0.000 claims description 3
- 230000008569 process Effects 0.000 description 20
- 230000006378 damage Effects 0.000 description 13
- 230000003872 anastomosis Effects 0.000 description 8
- 206010061213 Iatrogenic injury Diseases 0.000 description 7
- 230000008439 repair process Effects 0.000 description 7
- 230000009471 action Effects 0.000 description 6
- 208000027418 Wounds and injury Diseases 0.000 description 5
- 230000000694 effects Effects 0.000 description 5
- 208000014674 injury Diseases 0.000 description 5
- 238000010276 construction Methods 0.000 description 4
- 239000012528 membrane Substances 0.000 description 4
- 210000003205 muscle Anatomy 0.000 description 4
- 206010043248 Tendon rupture Diseases 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 230000008859 change Effects 0.000 description 2
- 230000002439 hemostatic effect Effects 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 239000000523 sample Substances 0.000 description 2
- 238000004901 spalling Methods 0.000 description 2
- 239000000725 suspension Substances 0.000 description 2
- RYGMFSIKBFXOCR-UHFFFAOYSA-N Copper Chemical compound [Cu] RYGMFSIKBFXOCR-UHFFFAOYSA-N 0.000 description 1
- 230000004308 accommodation Effects 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 229910052802 copper Inorganic materials 0.000 description 1
- 239000010949 copper Substances 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 230000000642 iatrogenic effect Effects 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 239000012535 impurity Substances 0.000 description 1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
- A61B2017/0225—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery flexible, e.g. fabrics, meshes, or membranes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2946—Locking means
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Ophthalmology & Optometry (AREA)
- Surgical Instruments (AREA)
Abstract
The invention discloses tendon guiding pliers, which comprise a biting part for accommodating and fixing tendon breaking ends, a traction part, an operating part and a lasso mechanism, wherein the first end of the traction part is connected to the biting part and is used for pulling the biting part to move along the axial direction, the operating part is connected to the second end of the traction part and is used for controlling the biting part to receive the tendon breaking ends and fix the tendon breaking ends; the operation part is connected with and controls the second binding clip to rotate relative to the first binding clip so as to realize the occlusion opening and closing control of the occlusion part, and the operation part is connected with and controls the lasso mechanism to tighten or loosen the tendon breaking end.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to tendon guide forceps for dragging retracted tendons or guiding tendons to pass through a sheath tube and a tissue internal channel.
Background
Proximal retraction often occurs when a tendon breaks when damaged, and how to pull the retracted tendon through a tendon sheath or channel to reach the tendon anastomosis and keep the broken end and peritendinous membrane intact is one of the key techniques for tendon repair.
Currently, hemostatic forceps or tendon probes are often used for tendon traction during surgery. For hemostatic forceps, the disadvantages are: the distance of penetrating into the tendon sheath is small, and the forced pushing can lead to the tearing of the sheath tube; the tendon sheath is difficult to effectively open when penetrating the distal tendon sheath, and the action of guiding the tendon is not achieved; and cannot bend and change direction along with the tendon sheath channel. When the probe is applied, an auxiliary incision is made at the broken end position of the tendon for suture; tendon broken ends are often blocked at tendon sheath openings in the traction process, so that the suture is easily pulled off to cause operation failure, and side injuries such as tendon broken ends splitting, peritenosynovial spalling and the like are easily caused.
In the prior art, a novel tendon forceps also exist, such as a tendon forceps disclosed in CN 2549912Y, which comprises a spinning cone-shaped forceps head consisting of an upper jaw and a lower jaw, wherein cone-shaped teeth for occluding tendon broken ends when the jaws are closed are distributed in the forceps head. Obviously, the broken end of the tendon is fixed and pulled by the tapered teeth, so that the broken end is possibly aggravated to split when the tapered teeth act on the tendon, and the iatrogenic injury such as the peritendinous membrane stripping is caused; the forceps head which is completely closed during closing can also aggravate tendon breaking and splitting and cause iatrogenic injuries such as peritendinous membrane stripping when clamping tendons, and the tendon breaking end is difficult to be completely contained in the jaw, so that smooth traction of the tendons can not be well realized.
Disclosure of Invention
The invention provides tendon guiding forceps, which are used for solving the problems that the existing tendon forceps are easy to aggravate the splitting of tendon ends and cause iatrogenic injuries such as peritendinous membrane stripping and the like; the tendon can not be completely taken into the broken end of the tendon, so that the technical problem of incapability of successfully pulling the tendon is solved.
The invention provides tendon guiding pliers, which comprise a biting part for accommodating and fixing a tendon breaking end, a traction part, an operation part and a lasso mechanism, wherein the first end of the traction part is connected to the biting part and is used for pulling the biting part to move along the axial direction, the operation part is connected to the second end of the traction part and is used for controlling the biting part to receive the tendon breaking end and fix the tendon breaking end; the operation part is connected with and controls the second binding clip to rotate relative to the first binding clip so as to realize the occlusion opening and closing control of the occlusion part, and the operation part is connected with and controls the lasso mechanism to tighten or loosen the tendon breaking end.
Further, the lasso mechanism comprises a plurality of elastic connecting pieces which are arranged in the accommodating cavity along the circumferential direction of the engagement part, a grommet which is fixedly connected with each elastic connecting piece and a pull rope which controls the grommet to shrink or expand, the fixed end of the grommet is fixed on one of the elastic connecting pieces through a slipknot, and the pull rope passes through the slipknot and is connected with the adjusting end of the grommet.
Further, the second binding clip is articulated to be connected on first binding clip and/or traction portion, and the base member of second binding clip passes through the pin joint and extends towards first binding clip direction and constitutes the control end, and traction portion includes inside hollow connecting rod and is in the connecting rod and runs through the pull rod at connecting rod both ends along the axial of connecting rod, and the one end of pull rod is articulated with the control end of second binding clip, and the other end and the operating portion of pull rod are connected.
Further, an elastic connecting piece fixedly connected with the slipknot end of the grommet is arranged on the inner wall surface of the first clamp head, a wire pulling channel for a pull rope to pass through is reserved between the control end of the second clamp head and the inner wall surface of the first clamp head, and a guide ring for the pull rope to pass through to limit the arrangement position of the pull rope and the pulling loosening movement direction is arranged on the inner wall surface of the first clamp head and/or the inner wall surface of the connecting rod.
Further, the operating portion includes a gripping mechanism and a ratchet mechanism; the holding mechanism comprises a holding base fixedly connected with the connecting rod, a first holding piece and a second holding piece which are connected to the holding base, an elastic mechanism arranged between the first holding piece and the second holding piece, and a closing buckle which is respectively arranged on the first holding piece and the second holding piece and is correspondingly arranged; the ratchet mechanism is arranged on the holding base and comprises a ratchet wheel penetrating through the holding base and used for winding the pull rope to control the pull rope to axially stretch out and draw back, a rotating handle which is arranged outside the holding base and connected with the outer extending end of the ratchet wheel and used for controlling the ratchet wheel to rotate to pull the pull rope, and a pawl which is arranged in the holding base and used for preventing the ratchet wheel from reversely rotating, wherein the ratchet wheel is provided with gear teeth which are matched with the pawl to prevent the ratchet wheel from reversely rotating, a winding groove which is used for winding the pull rope, and an elastic piece which is used for elastically propping against the ratchet wheel to force the gear teeth to be clamped on the pawl; the rotating handle is axially pressed to enable the gear teeth to be separated from the pawl and release the ratchet wheel, so that the pull rope is pulled by the resilience force action of the elastic connecting piece to expand the cable loop and drive the pull rope to move towards the direction of the occlusion part; by loosening the rotating handle, the ratchet returns to the initial position under the action of the resilience force of the elastic piece, and the gear teeth are clamped on the pawl again so as to limit the ratchet to rotate reversely.
Further, the engagement end of the first clamp head and the engagement end of the second clamp head are respectively provided with a semicircular notch, and the semicircular notches of the first clamp head and the semicircular notches of the second clamp head are distributed up and down symmetrically, so that a circular opening is formed when the second clamp head is engaged on the first clamp head.
Further, a first conical tooth used for being inserted on the outer wall surface of the broken end of the tendon under the occlusion force of the second clamp head is arranged on one side, close to the circular opening, of the inner wall surface of the first clamp head so as to assist in fixing the broken end of the tendon; and/or the side, close to the circular opening, of the inner wall surface of the second clamp head is provided with second conical teeth which are used for being meshed on the outer wall surface of the broken end of the tendon along with the movement of the second clamp head so as to assist in fixing the broken end of the tendon.
Further, detachable conical parts are meshed on the circular openings, the outer surfaces of the conical parts are respectively in smooth transition with the outer surfaces of the first binding clip and the outer surfaces of the second binding clip, the outer surfaces of the first binding clip and the second binding clip are arc-shaped outer surfaces, and the conical parts, the first binding clip and the second binding clip are combined to form the spinning cone shape.
Further, the taper portion includes: the conical head is conical and is in smooth transition with the first clamp head and the second clamp head respectively, the conical head is used for accommodating an engagement end of the first clamp head, an engagement end of the second clamp head, annular engagement grooves of the first conical teeth and the second conical teeth, and a positioning plate which is used for simultaneously abutting and contacting with the first conical teeth and the second conical tooth tops to fix the positions of the conical heads, and the annular engagement grooves are positioned between the conical heads and the positioning plate.
Further, the traction part adopts a flexible structural member or a flexible structural member; the traction part is internally provided with a working channel for accommodating the passage of the endoscope soft mirror or the hose clamp, one end of the working channel is communicated to the accommodating cavity of the occlusion part, and the other end of the working channel is communicated to the outside of the traction part through a channel connecting port.
The invention has the following beneficial effects:
The tendon guiding forceps of the invention designs the occluding part into a structure mode that two half structures are occluded relatively, one side is a first forceps head fixed on the traction part, and the other side is a second forceps head which is opened and closed in a rotating way relative to the first forceps head; the method changes the prior mode of rigidly clamping, occluding and fixing the tendon by adopting the closed forceps heads, and a circular opening is formed in the occluding end of the occluding part, when the second forceps head is occluded with the first forceps head relatively, the circular opening is utilized to carry out occluding contact with the broken end of the tendon to form the annular hoop fixing of the broken end of the tendon, thereby avoiding iatrogenic injuries such as splitting of the broken end of the tendon, stripping of peritenons of the tendon and the like; the tendon is not damaged in the biting process, so that the inclusion length of the broken tendon end can be adjusted at any time, stable fixation of the broken tendon end is facilitated, and secondary damage to the tendon in the traction process is avoided. The lasso mechanism is arranged in the accommodating cavity of the occluding part, the muscle broken ends which are accommodated in the accommodating cavity and penetrate through the lasso mechanism are tightened and fixed, the lasso contraction and tightening mode is adopted to form the constraint and fixation of the muscle broken ends, the tendon is in flexible contact, and the tendon is also an elastic body after being fixed, so that the injury to the tendon is small, and the tendon can be naturally restored after being loosened. The lasso mechanism is adopted to firstly fix the broken ends of the tendons which are accommodated in the accommodating cavity, then the biting part is controlled to bite to fix the broken ends of the tendons, the two parts are fixed at a certain distance, the fixing effect is better, and the lasso mechanism after tightening in the traction process can swing along with the self-adaptive broken ends of the tendons so as to buffer acting force on the broken ends of the tendons, and further reduce damage to the broken ends of the tendons. The whole occlusion process and the traction process are used for stably fixing the broken ends of the tendons, and the damage to the tendons is small, so that unnecessary iatrogenic damage caused by the action of excessive external force on the broken ends of the tendons is avoided.
The traction process of the whole tendon guide forceps is as follows: the operation part controls the traction part and the occlusal part at the front end of the traction part to move to the focus position, the occlusal part stretches into the tendon sheath through the tendon broken end anastomosis position and continues to stretch into the tendon broken end retraction position, the occlusal part is opened, the tendon broken end is accommodated in the accommodating cavity of the occlusal part and penetrates through the lasso mechanism, the tendon broken end penetrates through the lasso mechanism to a certain length, the operation part controls the lasso mechanism to tighten and tie the tendon broken end, then the second forceps head is operated to be meshed on the first forceps head, the tendon is positioned in the circular opening, and the tendon guiding forceps is operated to retract to the tendon broken end anastomosis position, and then subsequent tendon connection repair is carried out. The tendon connection repair process can be performed in a tightened state of the lasso mechanism, and the lasso mechanism can be used as an auxiliary fixing device for tendon connection repair.
In addition to the objects, features and advantages described above, the present invention has other objects, features and advantages. The present invention will be described in further detail with reference to the drawings.
Drawings
The accompanying drawings, which are included to provide a further understanding of the application and are incorporated in and constitute a part of this specification, illustrate embodiments of the application and together with the description serve to explain the application. In the drawings:
fig. 1 is a schematic view of a tendon guide forceps according to a preferred embodiment of the present invention;
FIG. 2 is a schematic view of the structure of the bite portion in an initial closed state according to the preferred embodiment of the present invention;
FIG. 3 is a schematic view of the structure of the bite portion of the removal taper portion to be received in the tendon stump according to the preferred embodiment of the present invention;
FIG. 4 is a schematic view of the ratchet mechanism of the preferred embodiment of the present invention;
FIG. 5 is a schematic view of the pawl and gear teeth co-operation of the preferred embodiment of the present invention;
FIG. 6 is a schematic view of the tendon stump of the preferred embodiment of the present invention incorporated into a lasso mechanism in a released state;
FIG. 7 is a schematic view of the lasso mechanism in a tightened state in accordance with a preferred embodiment of the present invention;
FIG. 8 is a schematic structural view of a traction portion with an internal working channel according to a preferred embodiment of the present invention;
FIG. 9 is a schematic view showing the construction of a tendon guide forceps according to a preferred embodiment of the present invention in operation;
fig. 10 is a second schematic view of the construction of the tendon guide forceps according to the preferred embodiment of the present invention in operation.
Legend description:
1. A bite portion; 101. a first binding clip; 1011. a first cone-shaped tooth; 102. a second binding clip; 1021. a second conical tooth; 103. a circular opening; 2. a traction section; 201. a connecting rod; 202. a pull rod; 203. a guide ring; 204. a working channel; 205. a channel connection port; 3. an operation unit; 301. a holding mechanism; 3011. a holding base; 3012. a first grip; 3013. a second grip; 3014. an elastic mechanism; 3015. closing and buckling; 302. a ratchet mechanism; 3021. a ratchet wheel; 3022. a rotating handle; 3023. a pawl; 3024. gear teeth; 3025. a winding groove; 3026. an elastic member; 4. a lasso mechanism; 401. an elastic connection member; 402. a grommet; 403. a pull rope; 5. a tapered portion; 501. a conical head; 502. an annular engagement groove; 503. a positioning plate; 6. tendon is broken.
Detailed Description
Embodiments of the invention are described in detail below with reference to the attached drawing figures, but the invention can be practiced in a number of different ways, as defined and covered below.
Fig. 1 is a schematic view of a tendon guide forceps according to a preferred embodiment of the present invention; FIG. 2 is a schematic view of the structure of the bite portion in an initial closed state according to the preferred embodiment of the present invention; FIG. 3 is a schematic view of the structure of the bite portion of the removal taper portion to be received in the tendon stump according to the preferred embodiment of the present invention; FIG. 4 is a schematic view of the ratchet mechanism of the preferred embodiment of the present invention; FIG. 5 is a schematic view of the pawl and gear teeth co-operation of the preferred embodiment of the present invention; FIG. 6 is a schematic view of the tendon stump of the preferred embodiment of the present invention incorporated into a lasso mechanism in a released state; FIG. 7 is a schematic view of the lasso mechanism in a tightened state in accordance with a preferred embodiment of the present invention; FIG. 8 is a schematic structural view of a traction portion with an internal working channel according to a preferred embodiment of the present invention; FIG. 9 is a schematic view showing the construction of a tendon guide forceps according to a preferred embodiment of the present invention in operation; fig. 10 is a second schematic view of the construction of the tendon guide forceps according to the preferred embodiment of the present invention in operation.
As shown in fig. 1,2 and 3, the tendon guide forceps of this embodiment includes a biting portion 1 for accommodating and fixing a tendon breaking end 6, a traction portion 2 having a first end connected to the biting portion 1 and for drawing the biting portion 1 to move in an axial direction, and an operation portion 3 connected to a second end of the traction portion 2 for controlling the biting portion 1 to receive the tendon breaking end 6 and fixing the tendon breaking end 6, the biting portion 1 includes a first binding clip 101 fixedly connected to the traction portion 2 and a second binding clip 102 rotatably connected to the first binding clip 101 and/or the traction portion 2, the first binding clip 101 and the second binding clip 102 enclose to form an accommodating cavity for receiving the tendon breaking end 6, the biting end of the biting portion 1 is provided as a circular opening 103 for the annular hoop breaking end 6 when the first binding clip 101 and the second binding clip 102 are meshed, and a lashing mechanism 4 for fixing the tendon breaking end 6 by tightening when receiving the tendon breaking end 6 is provided in the accommodating cavity; the operation part 3 is connected with and controls the second clamp head 102 to rotate relative to the first clamp head 101 so as to realize the occlusion opening and closing control of the occlusion part 1, and the operation part 3 is connected with and controls the lasso mechanism 4 to tighten or loosen the tendon broken end 6. The tendon guiding forceps of the invention is characterized in that a biting part 1 is designed into a structure mode that two half structures are oppositely meshed, one side is a first forceps head 101 fixed on a traction part 2, and the other side is a second forceps head 102 which is pivoted and opened relative to the first forceps head 101; the way of rigidly clamping, occluding and fixing the tendon by adopting the closed forceps head in the past is changed, a circular opening 103 is formed on the occluding end of the occluding part 1, when the second forceps head 102 is occluded with the first forceps head 101 relatively, the circular opening 103 is utilized to carry out occluding contact with the tendon breaking end 6, so that the annular hoop of the tendon breaking end 6 is fixed, and thus, iatrogenic injuries such as splitting, periteno-teno spalling and the like of the tendon breaking end 6 are avoided; the tendon is not damaged in the biting process, so that the inclusion length of the tendon broken end 6 can be adjusted at any time, stable fixation of the tendon broken end 6 is facilitated, and secondary damage to the tendon in the traction process is avoided. The lasso mechanism 4 is arranged in the accommodating cavity of the occluding part 1, the muscle broken ends which are accommodated in the accommodating cavity and pass through the lasso mechanism 4 are tightened and fixed, the lasso contraction and tightening mode is adopted to form the constraint and fixation of the muscle broken ends, the tendon is in flexible contact, and the tendon is also an elastic body after being fixed, so that the injury to the tendon is small, and the tendon can be naturally restored after being loosened. The lasso mechanism 4 is adopted to firstly fix the tendon broken end 6 which is accommodated in the accommodating cavity, then the biting part 1 is controlled to bite to fix the tendon broken end 6 in a second weight, the double fixing intervals are a certain distance, the fixing effect is better, and the lasso mechanism 4 after being tightened in the traction process can swing along with the tendon broken end 6 in a self-adaptive manner so as to buffer acting force on the tendon broken end 6 and further reduce damage to the tendon broken end 6. The whole occlusion process and the traction process are used for stably fixing the tendon broken end 6, and the injury to the tendon is small, so that unnecessary iatrogenic injury caused by the action of excessive external force on the tendon broken end 6 is avoided. Optionally, the combined parts of the first binding clip 101 and the second binding clip 102 are arc edges and arc angles, so as to damage the peripheral matrix in the process of occlusion opening and closing.
As shown in fig. 9 and 10, the whole tendon guide forceps has the following traction processes: the operation part 3 controls the traction part 2 and the occlusal part 1 at the front end thereof to move to the focus position, the occlusal part 1 stretches into the tendon sheath through the tendon breaking end anastomosis position and continues to stretch into the tendon breaking end 6 retraction position, the occlusal part 1 is opened, the tendon breaking end 6 is taken into the accommodating cavity of the occlusal part 1 and passes through the lasso mechanism 4, the tendon breaking end 6 passes through the lasso mechanism 4 to a certain length, the operation part 3 controls the lasso mechanism 4 to tighten and bind the tendon breaking end 6, then the second clamp head 102 is operated to be meshed on the first clamp head 101, the tendon is positioned in the circular opening 103, the tendon guiding clamp is operated to retract to the tendon breaking end anastomosis position, and then the subsequent tendon connection repair is carried out. The tendon connection repair process can be performed in a state that the lasso mechanism 4 is tightened, and the lasso mechanism 4 can be used as an auxiliary fixing device for tendon connection repair.
As shown in fig. 2, 3, 6 and 7, in the present embodiment, the lasso mechanism 4 includes a plurality of elastic connection members 401 arranged in the accommodating chamber along the circumferential direction of the nip portion 1, a grommet 402 fixedly connected to each of the elastic connection members 401, and a pulling rope 403 controlling contraction or expansion of the grommet 402, the fixed end of the grommet 402 is fixed to one of the elastic connection members 401 by a slip knot, and the pulling rope 403 passes through the slip knot and is connected to the adjustment end of the grommet 402. The pull rope 403 and the grommet 402 are a rope, a slipknot is tied at one of the elastic connection members 401 through one end of the rope, and then the rope is sequentially fixed on each elastic connection member 401 in the accommodating cavity, finally the rope passes through the slipknot and extends to the operation part 3, the rope is pulled and controlled to be tightened through the operation part 3, and the release is realized by utilizing the resilience force of the elastic connection member 401. Optionally, the lasso mechanism 4 includes a grommet 402, a hanging ring fixed on the inner wall surface of the first binding clip 101, a hook fixed on the inner wall surface of the second binding clip 102, and a pull rope 403 of the grommet 402 connected to the hook or the hook, where the grommet 402 adopts an elastic ring, one side of the elastic ring sequentially passes through the hanging ring, the other side sequentially passes through the grommet 402, when the tendon broken end 6 passes through the grommet 402 to a predetermined length, the grommet 402 is pulled by the pull rope 403 to disengage from the hook and shrink toward the hanging ring direction and bind the tendon broken end 6, so as to fix the tendon broken end 6; when the tendon end 6 needs to be released, the tendon end 6 is released by continuing to pull the grommet 402 to form a loop gap relative to the hanging ring position, so as to release the tendon end 6, or by cutting the grommet 402; when re-applied, the grommet 402 needs to be reloaded. Optionally, at least two lifting hooks are arranged, one lifting ring is arranged or two lifting rings are arranged next to each other; the position of tightening the tendon breaker 6 is controlled by the suspension length of the suspension ring. Alternatively, the direction of the pulling force of the pulling rope 403 is achieved by means of a guide ring 203 arranged on the inner wall surface of the second binding clip 102.
As shown in fig. 1,2 and 3, in this embodiment, the second clamp head 102 is hinged to the first clamp head 101 and/or the traction portion 2, the base body of the second clamp head 102 extends towards the first clamp head 101 through a hinge point to form a control end, the traction portion 2 includes a connecting rod 201 hollow inside and a pull rod 202 located in the connecting rod 201 and penetrating through two ends of the connecting rod 201 along the axial direction of the connecting rod 201, one end of the pull rod 202 is hinged to the control end of the second clamp head 102, and the other end of the pull rod 202 is connected to the operation portion 3. Alternatively, the second binding clip 102 may be hinged to the traction portion 2 and the pull rod 202 by an L-shaped hinge link, respectively, to achieve rotational control of the second binding clip 102 relative to the first binding clip 101. Alternatively, the second binding clip 102 may be hinged to the first binding clip 101 and the pull rod 202 by an L-shaped hinge link, respectively, to achieve rotational control of the second binding clip 102 relative to the first binding clip 101. Optionally, the second binding clip 102 is hinged on the first binding clip 101 and the traction portion 2 through a four-bar mechanism, and is hinged and supported on the four-bar mechanism through a pull rod 202, so as to realize the closing and opening movement of the second binding clip 102 relative to the first binding clip 101, and through different hinging combination modes and the change of the positions of hinge points, the closing and opening of translation can be realized, the closing and opening of rotation can be realized, and the closing and opening of translation and rotation can be realized.
As shown in fig. 2, 3, 6 and 7, in the present embodiment, an elastic connecting member 401 to which a slip end of a grommet 402 is fixedly connected is disposed on an inner wall surface of a first binding clip 101, a stay wire channel for passing a stay wire 403 is left between a control end of a second binding clip 102 and the inner wall surface of the first binding clip 101, and a guiding ring 203 for passing the stay wire 403 to limit a layout position and a loosening movement direction of the stay wire 403 is disposed on the inner wall surface of the first binding clip 101 and/or an inner wall surface of a connecting rod 201. Through the reasonable avoiding design of the second clamp head 102 and the pull rope 403 in structure, the mutual interference between the movement process of the second clamp head 102 and the movement process of the pull rope 403 is avoided, so that the control is smoother. By sequentially arranging a plurality of guide rings 203 on the movement track of the pull rope 403 to limit the force application direction and the movement direction of the pull rope 403, the lasso mechanism 4 is ensured to be stably implemented in the control process, the movement interference is reduced, the space utilization rate is improved, and the force application direction is ensured to reduce the control difficulty.
As shown in fig. 1, 4 and 5, in the present embodiment, the operating portion 3 includes a grip mechanism 301 and a ratchet mechanism 302. The holding mechanism 301 comprises a holding base 3011 fixedly connected with the connecting rod 201, a first holding member 3012 and a second holding member 3013 connected to the holding base 3011, an elastic mechanism 3014 arranged between the first holding member 3012 and the second holding member 3013, and a closing buckle 3015 respectively arranged on the first holding member 3012 and the second holding member 3013. The holding mechanism 301 is improved on the basis of the traditional scissor type grip structure, and the pull rod 202 is pushed and pulled to move along the axial direction through the scissor type cross movement, so that the occlusion opening and closing of the occlusion part 1 are controlled; the engagement fastener 3015 is arranged to control and lock the engagement force between the first clamp head 101 and the second clamp head 102; the elastic mechanism 3014 is used for realizing whether the first holding piece 3012 and the second holding piece 3013 rebound to the initial positions after the buckles 3015 are closed, so that the operation process is simplified. Ratchet mechanism 302 is provided on grip base 3011. The ratchet mechanism 302 comprises a ratchet 3021 penetrating through the holding base 3011 and used for winding the pull rope 403 to control the pull rope 403 to axially stretch out and draw back, a rotating handle 3022 which is arranged outside the holding base 3011 and connected with the overhanging end of the ratchet 3021 and used for controlling the ratchet 3021 to rotate so as to pull the pull rope 403, a pawl 3023 which is arranged in the holding base 3011 and used for preventing the ratchet 3021 from rotating reversely, gear teeth 3024 which are used for being matched with the pawl 3023 to prevent the ratchet 3021 from rotating reversely, a winding groove 3025 used for winding the pull rope 403, and an elastic piece 3026 which is used for elastically pushing against the ratchet 3021 to force the gear teeth 3024 to be clamped on the pawl 3023; by axially pressing the rotating handle 3022, the gear teeth 3024 are separated from the pawl 3023 and the ratchet wheel 3021 is released, so that the pull rope 403 is acted by the resilience force of the elastic connecting piece 401 to pull the grommet 402 to expand and drive the pull rope 403 to move towards the occlusal portion 1; by releasing the rotation handle 3022, the ratchet 3021 is returned to the initial position by the resilient force of the resilient member 3026, and the gear teeth 3024 are re-engaged with the pawl 3023 to restrict the ratchet 3021 from rotating reversely. Optionally, the ratchet mechanism 302 includes a ratchet 3021 penetrating the holding base 3011 for winding the pull rope 403 to control the pull rope 403 to axially stretch, a handle 3022 located outside the holding base 3011 and connected to an overhanging end of the ratchet 3021 for controlling the rotation of the ratchet 3021 to pull the pull rope 403, and a pawl 3023 located outside the holding base 3011 for preventing the ratchet 3021 from rotating reversely, wherein the ratchet 3021 is provided with gear teeth 3024 located outside the holding base 3011 for cooperating with the pawl 3023 to prevent the ratchet 3021 from rotating reversely, and a winding groove 3025 for winding the pull rope 403; the pawl 3023 is provided with a spring piece for driving the pawl 3023 to rotate towards the gear teeth 3024; by stripping the pawl 3023, the pawl 3023 is separated from the gear teeth 3024 and the ratchet wheel 3021 is released, so that the pull rope 403 is acted by the resilience force of the elastic connecting piece 401 to pull the grommet 402 to expand and drive the pull rope 403 to move towards the occlusal part 1; by releasing the pawl 3023, the pawl 3023 returns to the original position by the resilient force of the spring, and the pawl 3023 is again engaged with the gear teeth 3024 to limit the reverse rotation of the ratchet 3021, as shown in fig. 1. Optionally, a force handle is further provided on the pawl 3023 for applying force to peel the pawl 3023 off the wheel tooth 3024.
As shown in fig. 1,2 and 3, in this embodiment, the engaging end of the first clamp head 101 and the engaging end of the second clamp head 102 are provided with semicircular notches, and the semicircular notches of the first clamp head 101 and the semicircular notches of the second clamp head 102 are vertically and symmetrically arranged, so that the second clamp head 102 forms a circular opening 103 when being engaged on the first clamp head 101. The position for occluding the tendon stump 6 is not completely closed, and only the annular hoop is constrained, so that the tendon stump 6 is prevented from being rigidly pressed and damaged. Optionally, the edge of the circular opening 103 for forming adopts a circular arc edge, and the corner parts of the semicircular notch are also designed to be in circular arc transition so as to form circular arc smooth surface contact with the tendon broken end 6, so that an acute angle is avoided at the contact part. Optionally, the semicircular notch of the first clamp head 101 and the semicircular notch of the second clamp head 102 may also adopt a minor arc notch, so as to increase the arc length of the minor arc notch, and a minor arc notch with a larger arc length is used to bite and contact the tendon, further reduce the probability of contacting the tendon with the corner portion, and because the tendon has a certain elasticity, although the pressing force on the tendon is increased, the tendon is not completely closed, so that the tendon is not damaged, and the bite fixing effect is due to the semicircular notch.
As shown in fig. 2 and 3, in the present embodiment, a first conical tooth 1011 for being inserted into the outer wall surface of the tendon end 6 under the engagement force of the second clip 102 is provided on one side of the inner wall surface of the first clip 101 near the circular opening 103 to assist in fixing the tendon end 6; and/or the side of the inner wall surface of the second clamp head 102 near the circular opening 103 is provided with a second cone-shaped tooth 1021 for being meshed on the outer wall surface of the tendon rupture end 6 along with the movement of the second clamp head 102 so as to assist in fixing the tendon rupture end 6. The first conical teeth 1011 and/or the second conical teeth 1021 act on the surface of the tendon stump 6 to serve as auxiliary fixing effect, and the circular opening 103 is used for fixing the closed hoop of the tendon stump 6, so that the tendon acted by the first conical teeth 1011 and/or the second conical teeth 1021 and the tendon of the hoop of the circular opening 103 are positioned at different axial positions, and the tightening and binding effect of the lasso mechanism 4 on the tendon stump 6 is combined, so that the tendon stump 6 is not easy to be separated from the accommodating cavity in the occlusion part 1 when being subjected to the comprehensive action of traction force and retraction force of the tendon, and the stability in the traction process is ensured. Optionally, the tips of the first cone-shaped teeth 1011 and/or the second cone-shaped teeth 1021 may also be rounded to avoid scratching or splitting the tendon surface by the sharp angle.
As shown in fig. 2 and 3, in this embodiment, a detachable conical portion 5 is snapped on the circular opening 103, the outer surface of the conical portion 5 is in smooth transition with the outer surface of the first binding clip 101 and the outer surface of the second binding clip 102, the outer surfaces of the first binding clip 101 and the second binding clip 102 are both circular arc-shaped outer surfaces, and the conical portion 5, the first binding clip 101 and the second binding clip 102 are combined to form a spinning cone shape. The circular opening 103 and the inner cavity of the occluding part 1 are protected through the conical part 5, so that impurities are prevented from entering the inner cavity of the occluding part 1, the circular opening 103 is protected, and the circular opening 103 is prevented from being damaged or polluted before use.
As shown in fig. 2 and 3, in the present embodiment, the taper portion 5 includes: the conical head 501 is in a cone shape and is in smooth transition with the first clamp head 101 and the second clamp head 102 respectively, an annular meshing groove 502 for accommodating the meshing end of the first clamp head 101, the meshing end of the second clamp head 102, the first conical tooth 1011 and the second conical tooth 1021, and a positioning plate 503 for simultaneously propping against the first conical tooth 1011 and the second conical tooth 1021 to fix the position of the conical head 501, wherein the annular meshing groove 502 is positioned between the conical head 501 and the positioning plate 503. So that the conical portion 5 can be engaged and stably fixed at the position of the circular opening 103, avoiding displacement during use, and protecting the circular opening 103, the first conical teeth 1011 and the second conical teeth 1021. Optionally, the conical portion 5 contains a metal marker, so as to facilitate locating and searching the position of the conical portion 5, and avoid leaving the conical portion 5 at the focus position. Optionally, a hanging ring or a bump is provided at the front end of the conical portion 5 to facilitate the removal of the conical portion 5, so as to facilitate the removal of the conical portion 5. As shown in fig. 10, when the occlusal portion 1 moves to the retracted position of the tendon stump 6, the tendon stump 6 is pulled by taking out the taper portion 5 through the opening in the tendon sheath wall and then operating the tendon guide forceps to receive and fix the tendon stump 6.
As shown in fig. 8, in this embodiment, the traction portion 2 is a flexible structural member or a ductile structural member. So that the traction part 2 can swing adaptively in the process of entering the focus position or being taken out from the focus position, thereby avoiding mechanical damage to the periphery. The traction part 2 is internally provided with a working channel 204 for accommodating the passage of an endoscope soft mirror or a hose clamp, one end of the working channel 204 is communicated to the accommodating cavity of the occlusion part 1, and the other end of the working channel 204 is communicated to the outside of the traction part 2 through a channel connecting port 205. The working channel 204 is not limited to accommodating endoscope soft scope or hose clamp, but may accommodate other auxiliary instruments that may access the elongated tube. So as to facilitate corresponding auxiliary observation, minimally invasive surgical operations and other auxiliary operations.
In practice, a tendon guide forceps is provided, which comprises a forceps head (occlusion part 1), a connecting part (traction part 2) and a holding part (operation part 3).
The forceps head (occlusion part 1) comprises a first forceps head 101, a second forceps head 102 and a conical part 5, and the main body of the forceps head (occlusion part 1) is in a partial spinning conical shape, so that tendon guide forceps can conveniently enter tendon sheaths. The inside of the clamp head (the occluding part 1) is in a cavity shape, and the front part of the clamp head (the occluding part 1) is provided with a circular opening 103 for accommodating tendons therein, so that the situation that tendon ends are clamped on the upper jaw and the lower jaw and are rigidly pressed by the upper jaw and the lower jaw with great force as mentioned in the background art is avoided; the second clamp 102 is hinged to the first clamp 101 and the pull rod 202 respectively, and can be opened and closed at a certain angle relative to the first clamp 101. The lasso mechanism 4 comprises a natural state, a first working state and a second working state, and is folded in an inner accommodating cavity of the clamp head part (the occluding part 1) along with the closing of the first clamp head 101 and the second clamp head 102 in the natural state; the first working state is opened along with the second forceps head 102, and can receive the tendon broken end 6 (see fig. 3 and 6); in the second working state, the rotating ratchet 3021 tightens and binds the lasso mechanism 4 on the tendon stump 6 (see fig. 7), and pulls the tendon stump 6 to the tendon stump anastomosis as the tendon guide forceps withdraw from the tendon sheath; the first binding clip 101 and the second binding clip 102 may respectively include a plurality of conical teeth (first conical teeth 1011 and second conical teeth 1021), and the number of the conical teeth is preferably four, and the conical teeth are symmetrically distributed in the first binding clip 101 and the second binding clip 102, and the two first conical teeth 1011 in the first binding clip 101 and the two second conical teeth 1021 in the second binding clip 102 (see fig. 2). The conical part 5 comprises a conical front part (conical head 501) and a rear part (annular engagement groove 502 and positioning plate 503) provided with annular engagement grooves, when the first clamp head 101 and the second clamp head 102 are closed, the conical front part (conical head 501) is in smooth engagement with the outer surfaces of the first clamp head 101 and the second clamp head 102, the entering resistance of the clamp head (engagement part 1) is further reduced, and the rear part (annular engagement groove 502 and positioning plate 503) is engaged with the conical teeth (first conical teeth 1011 and second conical teeth 1021) in the clamp head (engagement part 1) to fix the conical part 5.
The connection portion (traction portion 2) includes a connection rod 201 and a tie rod 202. The connecting rod 201 is made of a flexible structure or flexible material, such as a universal flexible shaft or a soft copper rod. The connecting rod 201 can be freely bent as required, and has certain rigidity so as to overcome the resistance of the forceps head (the occlusal portion 1) when the tendon guide forceps enter the tendon sheath. The connecting rod 201 may include one or more hollow working channels 204 and channel connection ports 205 (see fig. 8), and the working channels 204 may accommodate endoscopic soft mirrors, soft forceps, etc. instruments therethrough, and may also be used as channels for irrigation, smoking, and aspiration. The pull rod 202 is hinged to the second binding clip 102 and the holding member (the first holding member 3012 or the second holding member 3013) to control the opening and closing of the second binding clip 102.
The holding part (the operation part 3) comprises a first holding piece 3012 and a second holding piece 3013 which are mutually hinged, a closing buckle 3015 and an elastic piece (an elastic mechanism 3014), wherein the closing buckle 3015 is used for positioning the opening and closing angles of the first holding piece 3012 and the second holding piece 3013 and the corresponding second clamp head 102;
The ratchet part (ratchet mechanism 302) comprises a ratchet 3021 and a pawl 3023 (see fig. 4 and 5), the ratchet 3021 is connected with the distal end of a pull rope 403 of the lasso mechanism 4, and the pull rope 403 is controlled to be in different tightening states by rotating the ratchet 3021; the pawl 3023 limits and positions the unidirectional movement of the ratchet 3021.
Intraoperative manipulation: the tendon stump 6 is retracted and exposed to the operative field (injury or intraoperative auxiliary incision) (see fig. 10), tendon guide forceps are put into the tendon sheath to the tendon stump 6 position in the closed state of the forceps head (occlusion part 1), the jaws are opened (second forceps head 102), the taper part 5 is removed (see fig. 3, the taper part 5 is removed from the tendon retraction incision), the tendon stump 6 is taken into the grommet 402 of the lasso mechanism 4, the ratchet 3021 is rotated to tighten the grommet 402, the grasping part (operation part 3) is grasped to close the forceps head (occlusion part 1), and the tendon guide forceps are withdrawn from the tendon sheath and pulled to the tendon stump anastomosis.
Intraoperative manipulation: the tendon cutting end 6 is retracted and not exposed to the operative field (see fig. 9), the taper portion 5 of the tendon guide forceps is removed, the tendon guide forceps enters the tendon sheath to the tendon cutting end 6 position in the closed state of the forceps head (the biting portion 1), the jaw (the second forceps head 102) is opened, the tendon cutting end 6 is accommodated in the accommodation cavity of the forceps head (the biting portion 1), the forceps head (the biting portion 1) is closed by the holding and holding portion (the operation portion 3), the first taper tooth 1011 of the first forceps head 101 and the second taper tooth 1021 of the second forceps head 102 are meshed with the tendon cutting end 6, the tendon guide forceps is withdrawn from the tendon sheath, and the tendon cutting end 6 is pulled to the tendon cutting end anastomosis. For tendons at different positions, the occlusion force is controlled through the closing buckle 3015, so that unnecessary iatrogenic injury caused by excessive pressure applied to the tendon broken end 6 is avoided.
The above description is only of the preferred embodiments of the present invention and is not intended to limit the present invention, but various modifications and variations can be made to the present invention by those skilled in the art. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (10)
1. A tendon guiding forceps comprises a biting part (1) for accommodating and fixing a tendon breaking end (6), a traction part (2) with a first end connected to the biting part (1) and used for traction of the biting part (1) along the axial movement, and an operation part (3) connected to a second end of the traction part (2) and used for controlling the biting part (1) to be accommodated in the tendon breaking end (6) and fixing the tendon breaking end (6),
The occlusion part (1) comprises a first clamp head (101) fixedly connected with the traction part (2) and a second clamp head (102) rotatably connected with the first clamp head (101) and/or the traction part (2), the first clamp head (101) and the second clamp head (102) are enclosed to form a containing cavity for containing the tendon breaking end (6),
It is characterized in that the method comprises the steps of,
The occlusion end of the occlusion part (1) is provided with a circular opening (103) for annular hoops of the tendon breaking end (6) when the first clamp head (101) and the second clamp head (102) are occluded,
The holding cavity is internally provided with a lasso mechanism (4) for fixing the tendon broken end (6) by tightening when the tendon broken end (6) is accommodated;
The operation part (3) is connected with and controls the second clamp head (102) to rotate relative to the first clamp head (101) so as to realize the occlusion opening and closing control of the occlusion part (1), and the operation part (3) is connected with and controls the lasso mechanism (4) to tighten or loosen the tendon broken end (6).
2. Tendon guide clamp as claimed in claim 1, characterized in that,
The lasso mechanism (4) comprises a plurality of elastic connecting pieces (401) which are arranged in the accommodating cavity along the circumferential direction of the occluding part (1), a grommet (402) which is fixedly connected with each elastic connecting piece (401) and a pull rope (403) which controls the contraction or expansion of the grommet (402),
The fixed end of the cable loop (402) is fixed on one elastic connecting piece (401) through a slipknot, and the pull rope (403) passes through the slipknot and is connected with the adjusting end of the cable loop (402).
3. Tendon guide clamp as claimed in claim 2, characterized in that,
The second clamp head (102) is hinged on the first clamp head (101) and/or the traction part (2), the basal body of the second clamp head (102) passes through the hinge point and extends towards the direction of the first clamp head (101) to form a control end,
The traction part (2) comprises a connecting rod (201) with a hollow inside and a pull rod (202) which is positioned in the connecting rod (201) and penetrates through two ends of the connecting rod (201) along the axial direction of the connecting rod (201), one end of the pull rod (202) is hinged with the control end of the second clamp head (102), and the other end of the pull rod (202) is connected with the operation part (3).
4. A tendon guide clamp as claimed in claim 3 in which,
The elastic connecting piece (401) fixedly connected with the slipknot end of the grommet (402) is arranged on the inner wall surface of the first clamp head (101), a stay wire channel for the stay wire (403) to pass through is reserved between the control end of the second clamp head (102) and the inner wall surface of the first clamp head (101),
The inner wall surface of the first clamp head (101) and/or the inner wall surface of the connecting rod (201) are provided with guide rings (203) used for the pull ropes (403) to pass through so as to limit the arrangement positions and the pulling movement directions of the pull ropes (403).
5. Tendon guide clamp as claimed in claim 4, characterized in that,
The operation part (3) comprises a holding mechanism (301) and a ratchet mechanism (302);
the holding mechanism (301) comprises a holding base (3011) fixedly connected with the connecting rod (201), a first holding piece (3012) and a second holding piece (3013) which are connected to the holding base (3011), an elastic mechanism (3014) which is arranged between the first holding piece (3012) and the second holding piece (3013), and a closing buckle (3015) which is respectively arranged on the first holding piece (3012) and the second holding piece (3013) and is correspondingly arranged;
The ratchet mechanism (302) is arranged on the holding base (3011), the ratchet mechanism (302) comprises a ratchet wheel (3021) penetrating through the holding base (3011) and used for winding the pull rope (403) to control the pull rope (403) to axially stretch out and draw back, a rotating handle (3022) which is arranged outside the holding base (3011) and connected with the overhanging end of the ratchet wheel (3021) and used for controlling the rotation of the ratchet wheel (3021) to pull the pull rope (403), and a pawl (3023) which is arranged in the holding base (3011) and used for preventing the ratchet wheel (3021) from reversely rotating, and the ratchet wheel (3021) is provided with gear teeth (3024) which are used for being matched with the pawl (3023) to prevent the ratchet wheel (3021) from reversely rotating, a winding groove (3025) which is used for winding the pull rope (403) and an elastic piece (3026) which is used for elastically pushing against the ratchet wheel (3021) to force the gear teeth (3024) to be clamped on the pawl (3023);
by axially pressing the rotary handle (3022) to disengage the gear teeth (3024) from the pawl (3023) and release the ratchet wheel (3021), the pull rope (403) is pulled by the resilience force of the elastic connecting piece (401) to expand the cable ring (402) and drive the pull rope (403) to move towards the engaging portion (1);
By releasing the rotating handle (3022), the ratchet wheel (3021) is returned to the initial position under the resilience of the elastic member (3026), and the gear teeth (3024) are re-clamped on the pawl (3023) to limit the reverse rotation of the ratchet wheel (3021).
6. Tendon guide clamp according to any one of claims 1 to 5, characterized in that,
The engagement end of the first clamp head (101) and the engagement end of the second clamp head (102) are respectively provided with a semicircular notch, and the semicircular notches of the first clamp head (101) and the semicircular notches of the second clamp head (102) are distributed up and down symmetrically, so that the second clamp head (102) is engaged on the first clamp head (101) to form the circular opening (103).
7. Tendon guide clamp as claimed in claim 6, characterized in that,
A first conical tooth (1011) which is used for being inserted on the outer wall surface of the tendon breaking end (6) under the occlusion force of the second clamp head (102) so as to assist in fixing the tendon breaking end (6) is arranged on one side of the inner wall surface of the first clamp head (101) close to the circular opening (103); and/or
And a second conical tooth (1021) which is used for being meshed on the outer wall surface of the tendon breaking end (6) along with the movement of the second clamp head (102) so as to assist in fixing the tendon breaking end (6) is arranged on one side, close to the circular opening (103), of the inner wall surface of the second clamp head (102).
8. Tendon guide clamp as claimed in claim 7, characterized in that,
A detachable conical part (5) is meshed on the circular opening (103), the outer surface of the conical part (5) is in smooth transition with the outer surface of the first clamp head (101) and the outer surface of the second clamp head (102) respectively,
The outer surfaces of the first clamp head (101) and the second clamp head (102) are arc-shaped outer surfaces,
The conical part (5), the first clamp head (101) and the second clamp head (102) are combined to form a spinning cone shape with a smooth outer surface.
9. Tendon guide clamp as claimed in claim 8, characterized in that,
The taper (5) comprises:
a conical head (501) which is cone-shaped and is in smooth transition with the first clamp head (101) and the second clamp head (102) respectively,
An annular engagement groove (502) for receiving the engagement end of the first jaw (101), the engagement end of the second jaw (102), the first tapered tooth (1011) and the second tapered tooth (1021), and
A positioning plate (503) for simultaneously abutting against the first conical teeth (1011) and the second conical teeth (1021) to fix the position of the conical head (501),
The annular engagement groove (502) is located between the conical head (501) and the locating plate (503).
10. Tendon guide clamp according to any one of claims 1 to 5, characterized in that,
The traction part (2) adopts a flexible structural member or a flexible structural member;
the flexible endoscope comprises a traction part (2), wherein a working channel (204) for accommodating the passage of a flexible endoscope or a flexible pipe clamp is arranged in the traction part (2), one end of the working channel (204) is communicated to an accommodating cavity of the occlusion part (1), and the other end of the working channel (204) is communicated to the outside of the traction part (2) through a channel connecting port (205).
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| CN201910827273.6A CN110547834B (en) | 2019-09-03 | 2019-09-03 | Tendon guiding forceps |
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| CN113040840B (en) * | 2021-02-23 | 2022-06-21 | 长沙众智医疗器械有限责任公司 | Nerve guiding device |
| CN114145793B (en) * | 2021-12-07 | 2024-03-22 | 江西省人民医院 | Flexible traction type self-adaptive angle adjustment surgical retractor |
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