CN110584735B - Tissue ligation device for laparoscopic surgery - Google Patents

Tissue ligation device for laparoscopic surgery Download PDF

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Publication number
CN110584735B
CN110584735B CN201910788780.3A CN201910788780A CN110584735B CN 110584735 B CN110584735 B CN 110584735B CN 201910788780 A CN201910788780 A CN 201910788780A CN 110584735 B CN110584735 B CN 110584735B
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China
Prior art keywords
rack
tooth
ligation
laparoscopic surgery
tissue
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CN201910788780.3A
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Chinese (zh)
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CN110584735A (en
Inventor
朱剑锋
方草
华菲
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Zhejiang Jingjia Medical Technology Co ltd
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Zhejiang Jingjia Medical Technology Co ltd
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Priority to CN201910788780.3A priority Critical patent/CN110584735B/en
Publication of CN110584735A publication Critical patent/CN110584735A/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12009Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
    • A61B17/12013Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot for use in minimally invasive surgery, e.g. endoscopic surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/32056Surgical snare instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3468Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3478Endoscopic needles, e.g. for infusion

Abstract

The invention belongs to the technical field of medical instruments, and particularly relates to a tissue ligation device for laparoscopic surgery, which comprises: the ligation strip comprises a rack, wherein the surface of the rack is provided with a plurality of first anti-skidding teeth distributed along the length direction of the rack; the first end of the rack is connected with a tooth cavity, and second anti-skid teeth for meshing and limiting with the first anti-skid teeth are arranged in the tooth cavity; the second end of the rack is inserted into the tooth cavity and is movably matched with the tooth cavity; when the second end of the rack moves to a target position, the corresponding first anti-slip teeth on the rack are meshed with the second anti-slip teeth in the tooth cavity for limiting so as to perform ligation on lesion tissues; a draw-in rod having a guide hole; the furling rod is used for abutting against the tooth cavity so that the second end of the rack penetrates through the guide hole and guides the movement of the rack through the guide hole. The invention can quickly and effectively perform ligation, tightening and blocking on the intestinal canal in the using process of laparoscopic surgery, in particular to laparoscopic rectal cancer radical surgery, and facilitates the intestinal canal flushing to ensure the principle of no tumor.

Description

Tissue ligation device for laparoscopic surgery
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a tissue ligation device for laparoscopic surgery.
Background
In laparoscopic surgery, there is still a lack of ideal instruments for ligation and blocking tissues such as diseased stomach and intestine. Yarn strands are commonly used for knotting, and in practice the following problems arise: (1) the tightening degree after ligation cannot be judged, and subsequent operation is inconvenient; (2) due to the limited material of the yarn strips, the yarn strips are not easy to tighten after knotting and can not be effectively blocked; (3) the thread breakage may be caused by the abrasion of the yarn thread and the knot pusher in the binding process, and the operation process is influenced. Especially in laparoscopic rectal cancer radical surgery, the problems that exist are far from completely solved, such as the tumor-free operation principle. In order to prevent recurrence of anastomotic stoma after rectal cancer anus protection, a common consensus is established in the last 90 s at home and abroad on the tumor-free principle, and the tumor-free operation principle in the operating guideline for laparoscopic colorectal cancer (2018 version) has positioned rectal irrigation as 2A-grade evidence and B-grade recommendation (recommended or to be carried out), but the technical problem of how to effectively perform ligature and block the tumor distal rectum before flushing the rectal cancer exists.
The current approach is to use a vascular clamp ("pug") to occlude the bowel, then to irrigate the bowel lumen transanally in order to flush out the cancer cells that may be present, and then to detach the bowel below the occlusion. However, this blocking technique has several problems in practical clinical practice: (1) part of patients have enlarged rectal mesentery or large tumor, the operation space in narrow pelvis is very limited, and the vascular clamp cannot be placed below the tumor; (2) due to the fact that the size and the type of the vascular clamp are limited, the vascular clamp which is not suitable is selected, so that poor occlusal force can be displaced or fall off; in the prior art, a oval forceps is adopted to directly close and block an intestinal canal, but when the oval forceps are placed, a hole needs to be built in the lower abdomen, an incision protective sleeve is placed in the hole, and pneumoperitoneum is built, so that the process is very complicated.
Because there is no specific instrument in the market at present, if the closing and flushing of the intestinal canal at the distal end of the tumor is abandoned, the tumor-free principle cannot be guaranteed, and the brought consequences are very serious. Firstly, the rectum cannot be flushed, and the tumor-free and sterile degree is greatly reduced; secondly, the intestinal canal is cut off under the condition that the intestinal canal at the far end of the tumor is not blocked, and free cancer cells are cast off and infected or cast off cells are planted to cause relapse, thereby bringing serious influence to the life quality and life of patients;
recently, clinical experts also use nylon bands to block the intestinal canal at the far end of the tumor in the anorectal protection of the laparoscopic cancer to flush the rectum, and good effects are achieved. The structure of the nylon bandage comprises a lock head and a sawtooth belt, wherein a through hole matched with the sawtooth belt is arranged in the lock head, and after the sawtooth belt penetrates through the through hole, sawteeth on the sawtooth belt form backstop with the through hole, so that intestinal tracts below tumors can be effectively blocked. However, conventional nylon ties also have limitations in practical clinical practice: (1) the nylon cable tie is used for performing encircling loop tying on the intestinal canal, two hands are required to respectively operate the needle holding forceps or the separating forceps, one end clamps the lock head of the cable tie, the other end clamps the tail part of the sawtooth cable tie and penetrates through the lock head, and due to the fact that the lock head of the nylon cable tie is very small, the step of penetrating through the lock head needs to be repeatedly tried, and the process of an operation is delayed. (2) The completion still need tighten up the ribbon and carry out blocking of intestines pipe around the ligation back, because two-handed operation, the needle holder or the pulling point of holding the needle pincers or separating forceps pulling tighten up the sawtooth belt and withholding the power point of tapered end are not on a straight line, can not firmly tighten up the nylon ribbon in narrow and small operating space, can not effectively block the intestines pipe.
Disclosure of Invention
Based on the above-mentioned shortcomings of the prior art, the present invention provides a tissue ligation device for laparoscopic surgery.
In order to achieve the purpose, the invention adopts the following technical scheme:
a tissue ligator for laparoscopic surgery comprising:
the ligation strip comprises a rack, wherein the surface of the rack is provided with a plurality of first anti-skidding teeth distributed along the length direction of the rack; the first end of the rack is connected with a tooth cavity, and second anti-skid teeth for meshing and limiting with the first anti-skid teeth are arranged in the tooth cavity; the second end of the rack is inserted into the tooth cavity and is movably matched with the tooth cavity; when the second end of the rack moves to a target position, the corresponding first anti-slip teeth on the rack are meshed with the second anti-slip teeth in the tooth cavity for limiting so as to perform ligation on lesion tissues;
a draw-in rod having a guide hole; the furling rod is used for abutting against the tooth cavity so that the second end of the rack penetrates through the guide hole and guides the movement of the rack through the guide hole.
Preferably, the first anti-slip teeth and the second anti-slip teeth are helical tooth structures, and the helical tooth structures of the first anti-slip teeth are matched with the helical tooth structures of the second anti-slip teeth. The first anti-slip tooth and the second anti-slip tooth are firmly meshed.
Preferably, the first anti-slip teeth are distributed at equal intervals. Meet the size requirements of various lesion tissues.
Preferably, the second end of the rack is of a necking structure, so that the second end of the rack can rapidly enter the tooth cavity to form the pre-ligation.
Preferably, the area of the surface of the rack adjacent to the second end of the rack is of a plane structure, and the other surface of the rack is of a plane structure, so that the second end of the rack can rapidly enter the tooth cavity to form pre-ligation.
Preferably, the insertion end of the tooth cavity is provided with a slope structure for guiding the insertion of the rack, so that the resistance of the rack in the process of forming pre-sheathing binding can be reduced.
Preferably, the slope structure is provided with guide arc surfaces distributed along the insertion direction of the rack, so that the moving resistance of the rack is reduced.
Preferably, the gathering rod further has a guide slope extending in the extending direction of the guide hole.
Preferably, the furling rod is of a round rod structure, and the guide hole of the furling rod is positioned at one end of the furling rod. The furling rod is designed into a round rod structure, the puncture needle for the laparoscope can enter the body and be firmly attached to a sealing ring in the puncture needle, and the reduction of the air pressure in the body caused by air leakage in the operation process is prevented.
Preferably, the ligation strips and the furling rod are integrally formed by medical high polymer materials and are sterilized by ethylene oxide or irradiation. Is disposable.
Compared with the prior art, the invention has the beneficial effects that:
1. the problems that the operation process is influenced because the knotting is not easy to tighten and the knotting cannot be effectively blocked due to the fact that the existing yarn is cumbersome to knot are solved;
2. compare the nylon ribbon, the design of drawing in the pole in can tighten up the rack fast, firmly, and it is clear and definite to block the effect.
3. After the intestinal canal is quickly, accurately and firmly tightened and blocked, the rectum can be flushed, and the tumor-free and sterile degree is greatly improved.
4. The product of the invention has reasonable size and small design, meets the requirements of surgical instruments for laparoscopes, and can be placed into the body through the puncture needle. The product of the invention is made of medical polymer material, and has better biocompatibility and high flexibility. Ethylene oxide sterilization or irradiation sterilization can be adopted to achieve the sterility assurance level.
Drawings
FIG. 1 is a schematic structural view of a tissue ligator for laparoscopic surgery according to a first embodiment of the present invention;
FIG. 2 is a schematic structural view of a ligation strip of the tissue ligator for laparoscopic surgery according to a first embodiment of the present invention;
FIG. 3 is a schematic structural view of the tooth space of the ligation strip of the tissue ligation device for laparoscopic surgery according to the first embodiment of the present invention;
FIG. 4 is a schematic structural view of a furling rod of the tissue ligation device for laparoscopic surgery according to a first embodiment of the present invention;
FIG. 5 is a view showing a state in which a ligation bar of the tissue ligator for laparoscopic surgery according to the first embodiment of the present invention is in a pre-ligation state;
FIG. 6 is a view showing a state of use of the tissue ligator for laparoscopic surgery according to the first embodiment of the present invention;
FIG. 7 is a drawing showing a tightened state of the tissue ligator for laparoscopic surgery according to the first embodiment of the present invention.
Detailed Description
In order to more clearly illustrate the embodiments of the present invention, the following description will explain the embodiments of the present invention with reference to the accompanying drawings. It is obvious that the drawings in the following description are only some examples of the invention, and that for a person skilled in the art, other drawings and embodiments can be derived from them without inventive effort.
The first embodiment is as follows:
as shown in fig. 1 to 7, the tissue ligator for laparoscopic surgery of the present embodiment includes two components, i.e., a ligation strip 1 and a gathering rod 2.
As shown in fig. 2 and 3, the ligation strip 1 of the present embodiment includes a rack 10, the upper surface of the rack 10 has a first anti-slip tooth array 100, and the first anti-slip tooth array 100 includes a plurality of first anti-slip teeth 101 arranged at equal intervals along the length direction thereof, so as to meet the size requirements of various lesion tissues. The right end of the rack 10 is connected with a tooth cavity 11, and the tooth cavity 11 is a cavity structure with two open ends and comprises an inserting end (namely the left end of the tooth cavity) and an extending end (namely the right end of the tooth cavity); the tooth chamber 11 has at least one second anti-slip tooth 110 therein, which is engaged with and retained by the first anti-slip tooth 101. The left end of the rack 10 is used for being inserted into the tooth cavity 11 from the insertion end (namely the left end) of the tooth cavity and is movably matched with the tooth cavity 11, namely the rack 10 is used for pre-sheathing and ligating the lesion tissues, and the rack 10 can continuously extend along the direction of the extending end of the tooth cavity 11 to realize the tightening of the pre-sheathing and ligating; when the left end of the rack 10 moves to a target position, the corresponding first anti-slip teeth 101 on the rack 10 are meshed with the second anti-slip teeth 110 in the tooth cavity 11 for limiting, so that the focal tissues are bound.
As shown in fig. 3, the first anti-slip tooth 101 and the second anti-slip tooth 110 are both helical tooth structures, and the helical tooth structures of the first anti-slip tooth 101 and the second anti-slip tooth 110 are matched, i.e. in opposite directions, so that after the rack 10 is inserted into the tooth cavity 11, the first anti-slip tooth 101 and the second anti-slip tooth 110 on the rack can be engaged and limited, and the first anti-slip tooth 101 and the second anti-slip tooth 110 are firmly engaged; in addition, after the rack 10 is inserted into the tooth chamber 11, the rack can only move along the direction of the extending end of the tooth chamber 11 and cannot retract. Moreover, the left end of the rack 10 of this embodiment is designed to be the necking structure a, the area on the upper surface of the rack near the second end of the rack is a planar structure, and the lower surface of the rack is a planar structure, i.e. both surfaces of the left end of the rack do not have the first anti-slip teeth, and the width of the rack is gradually reduced to the tail end, so that the rack can rapidly enter the tooth cavity to form pre-ligation.
As shown in fig. 3, the insertion end of the tooth chamber 11 of the present embodiment has a slope structure 3 for inserting and guiding the rack 10, so that the resistance of the rack when forming the pre-ligation can be reduced. Wherein, the slope structure 3 has a guiding cambered surface 30 distributed along the insertion direction of the rack, so as to further reduce the resistance of the movement of the rack 10.
As shown in fig. 4, the gathering rod 2 of the present embodiment is a round rod structure, and one end thereof has a guide hole 20. The furling rod 2 is used for abutting against the extending end of the tooth chamber 11, so that the left end of the rack 10 penetrates through the guide hole 20, the movement of the necking structure A of the rack 10 is guided through the guide hole 20, and the pulling movement of the rack 10 is also guided. The furling rod 2 is designed to be a round rod structure, and can enter the body through the puncture needle for the laparoscope and be firmly attached to a sealing ring in the puncture needle, so that the reduction of the air pressure in the body caused by air leakage in the operation process is prevented. In addition, the furling rod 2 is also provided with a guide slope 21 distributed along the extension direction of the guide hole 20, the inclination of the guide slope 21 is preferably 10-60 degrees, and the movement stability of the rack 10 is further improved.
The ligation strip 1 and the furling rod 2 of the embodiment are integrally formed by medical high polymer materials, sterilized by ethylene oxide or irradiation and disposable.
The key design of the embodiment is a tooth cavity and a furling rod; after the rack finishes the positioning and the ligation of the intestinal canal at the far end of the tumor and passes through the tooth cavity, the rack needs to be pulled to tighten the rack so as to finish the blocking of the intestinal canal, and the gathering rod well solves the problem of how to tighten the intestinal canal quickly; when the operation is started, the rack is placed into the body through the puncture needle for the laparoscope, the two ends of the rack are respectively clamped by using the operating forceps and wound around the intestinal canal at the far end of the tumor for one circle, and the positioning, the ligation and the penetration are completed. The furling rod enters the body through the puncture needle for the laparoscope, so that the rack which passes through the tooth cavity passes through the guide hole of the furling rod, the rack is clamped by using the operating forceps, and the furling rod is propped against the tooth cavity by the other end of the furling rod. Because force is exerted on one point, namely the tooth cavity, the rack can be quickly and firmly tightened no matter the rack is pulled at any angle, and the blockage of the intestinal canal can be completed. The rectum is flushed before the intestinal canal is cut off without being influenced by flushing pressure, the rack can not be loosened after the intestinal canal is cut off, and pelvic infection or exfoliated cell planting caused by intestinal fluid overflow is effectively prevented.
The tissue ligation device for laparoscopic surgery of the embodiment is specifically applied to laparoscopic rectal cancer radical surgery, firstly, a ligation strip is placed into a body through a puncture needle for the laparoscopic surgery, two ends of a rack are respectively clamped by using operating forceps and wound around a tumor distal intestinal canal for one circle, and the left end of the rack passes through a tooth cavity through a guide arc surface of a slope structure to complete pre-ligation. As shown in fig. 5, the furling rod enters the body through the puncture needle for the laparoscope, and the left end of the rack which forms the pre-ligation passes through the guide hole through the guide slope. As shown in figures 6 and 7, at the moment, one end of the collecting rod is used for propping against the tooth cavity, the other end of the collecting rod can be used for clamping the left end of the rack by using the operating forceps 6, the rack is quickly tensioned, the anti-skidding helical teeth in the tooth cavity and the rack which are in opposite directions are firmly occluded and can only advance and not retreat, the tightening and blocking effects can be formed, the rectum is flushed at the moment, the blocking effect is not influenced by flushing pressure, and the aseptic and non-tumor principle can be guaranteed. The rack can not be loosened after the enteron tube is separated in the laparoscopy. The furling rod can be withdrawn out of the body after the blocking is finished, and the ligation strip can be taken out along with the specimen after the operation is finished.
The two parts of the ligation device are made of medical polymer materials, and the materials with good flexibility are selected; meanwhile, the two parts of the embodiment have simple and clear structural design, simple injection molding process and low manufacturing cost; the two parts are convenient for final cleaning, can greatly reduce particle pollution, and can be sterilized by ethylene oxide or irradiation to achieve the sterility assurance level; the two parts are disposable and cannot cause cross infection, and particularly, the rack part is designed to be self-locking, only advances and does not retreat, so that secondary use is avoided.
Example two:
the tissue ligation device for laparoscopic surgery of the present embodiment is different from the first embodiment in that:
at least one of the design of the slope structure of the insertion end of the tooth cavity and the design of the guide slope of the furling rod in the first embodiment is omitted, and the structure of the ligation device is simplified so as to meet the requirements of different application occasions.
Other structures can refer to the first embodiment.
Example three:
the tissue ligation device for laparoscopic surgery of the present embodiment is different from the first embodiment in that:
the tissue ligation device for laparoscopic surgery of the embodiment can also be used for open surgery, the structure of the furling rod is not limited to a round rod structure, and the cross section of the furling rod can also be in a structure of triangle, quadrangle, ellipse and the like so as to meet the requirements of different users.
Other structures can refer to the first embodiment.
Example four:
the tissue ligation device for laparoscopic surgery of the present embodiment is different from the first embodiment in that:
the first anti-skid teeth can be distributed at unequal intervals, the first anti-skid teeth at the part close to the right end of the rack are distributed sparsely, and the first anti-skid teeth at the part far away from the right end of the rack are distributed densely. Simplify the structure of antiskid tooth.
Other structures can refer to the first embodiment.
The foregoing has outlined rather broadly the preferred embodiments and principles of the present invention and it will be appreciated that those skilled in the art may devise variations of the present invention that are within the spirit and scope of the appended claims.

Claims (9)

1. A tissue ligation device for laparoscopic surgery, comprising:
the ligation strip comprises a rack, wherein the surface of the rack is provided with a plurality of first anti-skidding teeth distributed along the length direction of the rack; the first end of the rack is connected with a tooth cavity, and second anti-skid teeth for meshing and limiting with the first anti-skid teeth are arranged in the tooth cavity; the second end of the rack is inserted into the tooth cavity and is movably matched with the tooth cavity; when the second end of the rack moves to a target position, the corresponding first anti-slip teeth on the rack are meshed with the second anti-slip teeth in the tooth cavity for limiting so as to perform ligation on lesion tissues;
a draw-in rod having a guide hole; the furling rod is used for abutting against the tooth cavity so as to enable the second end of the rack to penetrate through the guide hole and guide the movement of the rack through the guide hole;
the furling rod is further provided with guide slopes distributed along the extension direction of the guide hole, and the slope of each guide slope is 10-60 degrees.
2. The tissue ligation device for laparoscopic surgery according to claim 1, wherein said first and second anti-slip teeth are both of a skewed tooth configuration, the skewed tooth configuration of the first anti-slip tooth mating with the skewed tooth configuration of the second anti-slip tooth.
3. The tissue ligator for laparoscopic surgery as set forth in claim 1 or 2, wherein said first anti-slip teeth are equally spaced.
4. The tissue ligator for laparoscopic surgery of claim 1, wherein said second end of said rack is of a necked down configuration.
5. The tissue ligator for laparoscopic surgery as set forth in claim 1 or 4, wherein a region of the surface of said rack adjacent to the second end of the rack is a planar structure and the other surface of the rack is a planar structure.
6. The tissue ligator for laparoscopic surgery as set forth in claim 1, wherein said insertion end of said tooth chamber has a slope structure for guiding the insertion of said rack.
7. The tissue ligator for laparoscopic surgery as set forth in claim 6, wherein said ramp structure has a guide curved surface distributed along the direction of insertion of the rack.
8. The tissue ligator for laparoscopic surgery as set forth in claim 1, wherein said furling rod is a round rod structure, and the guide hole thereof is formed at one end of the furling rod.
9. The tissue ligation device for laparoscopic surgery according to claim 1, wherein the ligation strip and the furling rod are integrally formed by medical polymer material and sterilized by ethylene oxide sterilization or irradiation.
CN201910788780.3A 2019-08-26 2019-08-26 Tissue ligation device for laparoscopic surgery Active CN110584735B (en)

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CN110584735B true CN110584735B (en) 2021-08-20

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Citations (5)

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CN207912747U (en) * 2017-03-31 2018-09-28 上海长海医院 A kind of medical band with fixed locking head
CN207928353U (en) * 2017-09-07 2018-10-02 宁波泽世医疗科技有限公司 Novel binding strap

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Publication number Priority date Publication date Assignee Title
US8512362B2 (en) * 2007-11-05 2013-08-20 Usgi Medical Inc. Endoscopic ligation
CN105832370B (en) * 2016-01-07 2018-02-06 王劲 Disposal tube type internal organ tie up drawing device
CN208640851U (en) * 2017-09-11 2019-03-26 李东林 Cervical cerclage lasso

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH10324364A (en) * 1997-05-27 1998-12-08 Morito Co Ltd Binding tool
CN204744284U (en) * 2015-06-23 2015-11-11 柳立军 Medical exempt from to sew up exempt from to knot pocket area
CN105054986A (en) * 2015-08-17 2015-11-18 何定甫 Umbilical cord pulling binding band
CN207912747U (en) * 2017-03-31 2018-09-28 上海长海医院 A kind of medical band with fixed locking head
CN207928353U (en) * 2017-09-07 2018-10-02 宁波泽世医疗科技有限公司 Novel binding strap

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