CN112656459A - Adjustable heart defect plugging device - Google Patents

Adjustable heart defect plugging device Download PDF

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Publication number
CN112656459A
CN112656459A CN202011492902.3A CN202011492902A CN112656459A CN 112656459 A CN112656459 A CN 112656459A CN 202011492902 A CN202011492902 A CN 202011492902A CN 112656459 A CN112656459 A CN 112656459A
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Prior art keywords
hole
adjusting
driving
handle
driving ring
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CN202011492902.3A
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CN112656459B (en
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彭博
杨研
陈祖君
王强
刘锦阳
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Fuwai Hospital of CAMS and PUMC
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Fuwai Hospital of CAMS and PUMC
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Abstract

The invention relates to the field of cardiovascular medical treatment, and particularly discloses an adjustable heart defect occluder which comprises a first umbrella disk, a second umbrella disk and a waist part positioned between the first umbrella disk and the second umbrella disk, wherein the first umbrella disk is provided with a first through hole, the second umbrella disk is provided with a second through hole, and the waist part is provided with a communicating pore passage used for communicating the first through hole with the second through hole; the first through hole, the second through hole or the communicating pore passage are provided with adjusting devices for adjusting the flow of the first through hole, the second through hole or the communicating pore passage. During treatment, the occluder can be positioned at the heart defect of a patient and the flow is adjusted to the maximum value through the adjusting device, so that the communicating structure formed by the first through hole, the second through hole and the communicating pore channel can play a role in transmitting pressure; then the flow can be gradually reduced through the adjusting device according to the rehabilitation condition of the patient so as to adapt to the rehabilitation of the patient until the flow in the communication structure reaches the minimum value finally, and therefore the defect is completely blocked.

Description

Adjustable heart defect plugging device
Technical Field
The invention relates to the field of cardiovascular medical treatment, in particular to an adjustable heart defect plugging device.
Background
Cardiac defects include Atrial Septal Defects (ASD) and Ventricular Septal Defects (VSD), which means that the atrial septum/ventricular septum is abnormal in the process of generation and absorption and is not normally closed, so that a through hole is remained between the left atrium and the right atrium/the left ventricle, and generally an occlusion operation is required for treatment. The main apparatus used in the occlusion operation is an occluder which can be implanted in an interventional way; the traditional occluder is generally in a double-disc thin waist-shaped structure (comprising a head umbrella disc, a tail umbrella disc and a waist part positioned between the head umbrella disc and the tail umbrella disc), and intracardiac shunt is prevented by the clamping action of a left umbrella disc and a right umbrella disc on the residual edge tissues of the atrial septum.
For normal people, the blood pressure in the left heart is higher than that in the right heart; the heart of a patient with heart defect is not normally closed due to the interval between the left ventricle and the right ventricle or the left atrium and the right atrium, so that the load of the heart is increased, the pulmonary circulation blood volume is increased, and finally pulmonary hypertension, arrhythmia and heart failure can be caused; if a common occluder is used for occluding the defective part of the heart, high pressure of the left pulmonary artery can be caused, namely, the partial defective patient can not tolerate the high pressure when the heart is completely closed.
In order to solve the technical problem, chinese patent CN202776633U proposes a cardiac occluder, which includes a head disc, a tail disc, and a waist portion located between the head disc and the tail disc, the occluder is disposed in a support frame, an axial through hole penetrating the tail disc and the head disc is provided on the cardiac occluder, the cardiac occluder can transmit the pressure between the left atrium and the right atrium through the axial through hole, properly increase the volume of the left ventricle, improve the left cardiac function of the patient after implantation of the cardiac occluder, prevent left cardiac insufficiency of the patient, and simultaneously relieve the right cardiac pressure load of the patient when the pulmonary artery pressure cannot be completely reduced to a normal value through the axial through hole.
However, after the patient is implanted with the cardiac defect occluder with the above structure, the cardiopulmonary function of the patient cannot be effectively improved all the time due to the existence of the communicating duct (i.e. the axial through hole in CN 202776633U), which is not favorable for the rehabilitation of the patient.
Therefore, how to effectively improve the cardiopulmonary function of a patient under the condition of arranging the communicating pore channel is an international problem to be solved urgently in the field of cardiovascular medical treatment at present.
Disclosure of Invention
In view of the above, the present invention provides an adjustable heart defect occluder, which is beneficial to effectively improve the cardiopulmonary function of a patient under the condition of providing a communicating duct.
In order to achieve the purpose, the invention provides an adjustable heart defect occluder which comprises a first umbrella disc, a second umbrella disc and a waist part positioned between the first umbrella disc and the second umbrella disc, wherein the first umbrella disc is provided with a first through hole, the second umbrella disc is provided with a second through hole, and the waist part is provided with a communicating pore passage used for communicating the first through hole with the second through hole; and the first through hole, the second through hole or the communicating pore passage are provided with adjusting devices for adjusting the flow of the first through hole, the second through hole or the communicating pore passage.
As a further improvement of the technical scheme of the invention, the adjusting device comprises a main shell, the main shell is connected with the first umbrella disc and covers the first through hole, the main shell is provided with a through hole I and is connected with an adjusting sheet and a driving mechanism, the through hole I is communicated with the first through hole, and the adjusting sheet is movably connected with the main shell and is driven by the driving mechanism to open or close the through hole I.
As a further improvement of the technical scheme of the invention, the driving mechanism comprises a driving ring, a through hole II is arranged in the driving ring, the axis of the through hole II is overlapped with the axis of the through hole I, and a plurality of adjusting sheets are uniformly distributed between the driving ring and the through hole I along the circumference; the driving ring is provided with a plurality of guide grooves which are uniformly distributed on the circumference, and the arc is arc-shaped and is bent along the circumferential direction in the same direction; the number of the adjusting sheets is the same as that of the guide grooves, the middle part of each adjusting sheet is hinged in the corresponding guide groove, the outer end of each adjusting sheet is hinged in the main shell, the inner end of each adjusting sheet extends inwards at the same time, the inner ends of the adjusting sheets surround a through hole III together, and the axis of the through hole III is superposed with that of the through hole I; the driving ring drives the adjusting sheet to rotate while rotating directionally, and the through hole III is gradually reduced and closed.
As a further improvement of the technical solution of the present invention, the driving ring is connected with a driving handle for driving the driving ring to rotate, and the main housing is provided with a limiting member for limiting the rotation of the driving handle.
As a further improvement of the technical scheme of the present invention, the limiting member includes a plurality of teeth connected in sequence, the teeth protrude toward the driving ring and are provided with an ascending inclined surface and a descending inclined surface, the descending inclined surface of each tooth cooperates with the ascending inclined surface of the next tooth to form a limiting groove, and the driving handle protrudes from one side of the driving ring and is clamped into the limiting groove to be limited.
As a further improvement of the technical scheme of the invention, the driving handle comprises an outer handle and an inner handle which is coaxially arranged with the outer handle, one end of the outer handle is fixed on the side surface of the driving ring, the outer handle is of a hollow structure, the inner handle extends from the other end of the outer handle and can axially slide along the outer handle, and the bottom of the inner handle is connected with the bottom of an inner cavity of the outer handle through a return spring I.
As a further improvement of the technical scheme of the invention, the main shell is provided with a fixed rod, and the fixed rod is connected with the outer handle through a return spring II.
As a further improvement of the technical scheme of the invention, the main shell is disc-shaped, the through hole I is formed in a bottom plate of the main shell, and the limiting piece is arranged on a side plate of the main shell.
As a further improvement of the technical scheme of the invention, a sealing ring is arranged between the driving ring and the bottom plate of the main shell. .
As a further improvement of the technical scheme of the invention, the axis of the communicating pore passage is parallel to or coincided with the axes of the first umbrella disk and the second umbrella disk.
Compared with the prior art, the invention has the following beneficial technical effects:
the adjustable heart defect occluder provided by the invention has the advantages that the flow of blood flowing through the first through hole, the second through hole or the communicating pore passage is adjustable by additionally arranging the adjusting device; when a patient with particularly high pulmonary artery pressure (or a patient close to the Eimen syndrome) is treated, the occluder can be positioned at the defect position and the flow is adjusted to the maximum value through the adjusting device, so that the communicating structure formed by the first through hole, the second through hole and the communicating pore channel plays a role in transmitting pressure; then the flow can be gradually reduced through the adjusting device according to the rehabilitation condition of the patient so as to adapt to the rehabilitation of the patient until the flow in the communication structure finally reaches the minimum value (generally zero), thereby realizing the complete occlusion of the defect without replacing the occluder in the process.
The adjustable heart defect occluder provided by the invention can gradually occlude the heart defect of a patient, which is the creative contribution of the occluder, while most of the existing occluders can only achieve one-time complete occlusion, while the heart occluder shown in patent CN202776633U can only achieve one-time incomplete occlusion.
Therefore, the implementation of the invention is beneficial to effectively improving the cardiopulmonary function of a patient under the condition of arranging the communicating pore channel, and meanwhile, the invention is also beneficial to improving the operation efficiency and reducing the treatment cost, so that the invention meets the social requirement, has strong practicability and is beneficial to promoting the further development of the cardiovascular medical technology.
Drawings
FIG. 1 is a perspective view of the present invention;
FIG. 2 is a top view of the adjustment device of the present invention;
FIG. 3 is a top view of the main housing of the present invention;
FIG. 4 is a top view of the drive ring of the present invention;
fig. 5 is a perspective view of a tab of the present invention.
Detailed Description
In order to make the technical solutions of the present invention better understood, the following detailed description of the present invention is provided with reference to the accompanying drawings and specific embodiments; of course, the drawings are simplified schematic drawings, and the scale of the drawings does not limit the patented products.
Examples
As shown in fig. 1 to 5: the embodiment provides an adjustable heart defect occluder, which comprises a first umbrella disk 11, a second umbrella disk 12 and a waist part 13 positioned between the first umbrella disk 11 and the second umbrella disk 12, wherein the first umbrella disk 11 is provided with a first through hole 21, the second umbrella disk 12 is provided with a second through hole 22, and the waist part 13 is provided with a communicating pore passage 23 for communicating the first through hole 21 with the second through hole 22; the first through hole 21, the second through hole 22 or the communication pore canal 23 is provided with an adjusting device 3 for adjusting the flow rate.
The structure of the first disk 11, the second disk 12 and the waist 13 and the principle of the combination thereof can be the same as the prior art; when in use, the first umbrella disk 11 can be positioned at the right heart of a human body, and the second umbrella disk 12 is positioned at the left heart of the human body; the positions of the first through hole 21, the second through hole 22 and the communicating pore canal 23 can be determined according to specific situations, preferably, the communicating pore canal 23 is an axial pore canal, and the axis of the communicating pore canal 23 is parallel to the axes of the first umbrella disk 11 and the second umbrella disk 12 (in fig. 1, the axis is parallel to the axes) or overlapped (in this case, the communicating pore canal 23 is arranged in the centers of the first umbrella disk 11 and the second umbrella disk 12); the communicating pore canal 23 can be provided with an elastic film, or the elastic film forms the communicating pore canal 23, a relatively sealed pore canal is formed by the elastic film, and the elastic film can adapt to the compression deformation of the first umbrella disk 11, the second umbrella disk 12 and the waist part 13, and is suitable for interventional operation.
The adjusting device 3 can be disposed at the first through hole 21, the second through hole 22 or the communicating pore 23 as required, and in fact, the blood flow at the first through hole 21, the second through hole 22 or the communicating pore 23 is the same, no matter where the adjusting device is disposed, the purpose of adjusting the flow can be achieved.
The adjusting device 3 may be, for example, an existing miniature electric control valve, and in this case, the external control may be performed in a wireless manner, but of course, the adjusting device 3 may be other devices suitable for adjusting the flow rate as long as the purpose of adjusting the flow rate can be achieved.
The flow of blood flowing through the first through hole 21, the second through hole 22 or the communicating pore canal 23 is adjustable by adding the adjusting device 3; when a patient with particularly high pulmonary artery pressure (or a patient close to the eisenmenger syndrome) is treated, the occluder can be positioned at the defect and the flow can be regulated to the maximum value through the regulating device 3, so that the communication structure formed by the first through hole 21, the second through hole 22 and the communication pore passage 23 plays a role in transmitting pressure; then the flow can be gradually reduced through the adjusting device 3 according to the rehabilitation condition of the patient so as to adapt to the rehabilitation of the patient until the flow in the communication structure finally reaches the minimum value (generally zero), thereby realizing the complete occlusion of the defect without replacing the occluder in the process; that is to say, the adjustable cardiac defect occluder provided in this embodiment can gradually occlude the cardiac defect of the patient, which is the creative contribution of this occluder, while most of the existing occluders can only achieve one-time complete occlusion, while the cardiac occluder shown in patent CN202776633U can only achieve one-time incomplete occlusion.
In this embodiment, the adjusting device 3 includes a main housing 301, the main housing 301 is connected to the first umbrella disk 11 and covers the first through hole 21, the main housing 301 is provided with a through hole i 302 and is connected to an adjusting sheet 303 and a driving mechanism, the through hole i 302 is communicated with the first through hole 21, and the adjusting sheet 303 is movably connected to the main housing 301 and is driven by the driving mechanism to open or close the through hole i 302. At this time, the adjusting device 3 is disposed at the first through hole 21 and can close the first through hole 21, and of course, may be disposed at the second through hole 22 as needed; the main shell 301 and the adjusting sheet 303 can be made of medical stainless steel or other hard materials suitable for medical use; the main shell 301 can be a disc structure, one end of the main shell is open, the other end of the main shell is a circular bottom plate, the bottom plate is a circular side plate, the through hole I302 is formed in the bottom plate of the main shell 301, the through hole I302 is a circular hole, and the circle center of the through hole I302 and the circle center of the bottom plate are on the same straight line; the adjusting sheet 303 can be moved through the driving mechanism, so that the through hole I302 has different flow sections, and the blood flow of the first through hole 21 is adjusted; the aperture of the through-hole i 302 may be the same as the aperture of the first through-hole 21.
In this embodiment, the driving mechanism includes a driving ring 304, a through hole ii 305 is provided in the driving ring 304, an axis of the through hole ii 305 coincides with an axis of the through hole i 302, and a plurality of the adjusting blades 303 are uniformly distributed between the driving ring 304 and the through hole i 302 along a circumference; a plurality of guide grooves 306 uniformly distributed on the circumference are arranged on the driving ring 304, and the arc is arc-shaped and is bent along the circumferential direction in the same direction; the number of the adjusting sheets 303 is the same as that of the guide grooves 306, the middle part of each adjusting sheet 303 is hinged and mounted in the corresponding guide groove 306, the outer end of each adjusting sheet 303 is hinged and mounted on the main shell 301, the inner end of each adjusting sheet 303 extends inwards at the same time, the inner ends of the adjusting sheets 303 enclose a through hole III 307, and the axis of the through hole III 307 is coincident with the axis of the through hole I302; the driving ring 304 rotates directionally and simultaneously drives the adjusting sheet 303 to rotate, so that the through hole III 307 is gradually reduced and closed. The drive ring 304 is of a circular ring structure; the through hole II 305 is a round hole; the through hole III 307 is formed by enclosing the adjusting sheets 303 and is of a structure close to a round hole; the adjusting sheet 303 is of a bent C-shaped structure, and the section of the adjusting sheet is gradually increased from the outer end to the inner end (the end close to the circle center of the through hole III 307); the number of the adjusting pieces 303 can be 5-10, specifically can be determined according to the needs, and is shown in fig. 5 as 6 pieces; the adjusting sheets 303 are not completely positioned on the same plane, so that interference generated during rotation is avoided; the outer end of the adjusting sheet 303 is provided with a first hinged column 308 which is matched and connected with a connecting hole on the bottom plate of the main shell 301 to form a single-degree-of-freedom rotating connection structure, and the axis of the first hinged column 308 is also used as a rotating shaft of the adjusting sheet 303; the middle of the adjusting tab 303 is provided with a second hinge column 309 to be connected with the guide groove 306 in a matching manner, when the driving ring 304 rotates in a fixed direction (the driving ring 304 rotates in a clockwise direction as shown in fig. 2), the second hinge column 309 slides along the guide groove 306 under the driving of the guide groove 306, so that the adjusting tab 303 rotates integrally, and the through hole iii 307 is gradually reduced, and finally the closed state is achieved. To improve the sealing of the adjustment device 3, a sealing ring 319 (e.g. an "O" ring) may be provided between the drive ring 304 and the bottom plate of the main housing 301.
In this embodiment, the driving ring 304 is connected to a driving handle 310 for driving the driving ring 304 to rotate, and the main housing 301 is provided with a limiting member 311 for limiting the rotation of the driving handle 310. When the device is used specifically, the driving handle 310 can be directly controlled manually, so that the device is safer and more reliable to use and has lower cost; or in interventional procedures, rotation of the drive shaft 310 may be controlled by a guidewire; the stop 311 allows the drive handle 310 to be positioned in a position that prevents the drive handle 310 from moving improperly.
In this embodiment, the retaining member 311 includes a plurality of teeth 312 connected in sequence, the teeth 312 protrude toward the driving ring 304 and are provided with an ascending inclined surface 312a and a descending inclined surface 312b, the descending inclined surface 312b of each tooth 312 cooperates with the ascending inclined surface 312a of the next tooth 312 to form a retaining groove 313, and the driving handle 310 protrudes from one side of the driving ring 304 and is clamped into the retaining groove 313 to be retained. The limiting member 311 is disposed on a side plate of the main housing 301, and may be integrally formed with the side plate; the number of the convex teeth 312 can be 3-6, and is 4 as shown in fig. 2, and a fourth gear limit for the driving handle 310 is formed at this time; the protruding tooth 312 may have a triangular shape or a circular arc shape, and the driving handle 310 may slide along the surface of the protruding tooth 312, and is limited when sliding into the limiting groove 313, and at this time, an additional driving force is required to overcome the limitation.
In this embodiment, the driving handle 310 includes an outer handle 314 and an inner handle 315 coaxially disposed with the outer handle 314, one end of the outer handle 314 is fixed to the side surface of the driving ring 304, the outer handle 314 is a hollow structure, the inner handle 315 extends from the other end of the outer handle 314 and can slide axially along the outer handle 314, and the bottom of the inner handle 315 is connected with the bottom of the inner cavity of the outer handle 314 through a return spring i 316. The driving handle 310 is a telescopic structure with adjustable overall length, when the driving handle 310 is stressed to slide along the ascending inclined surface 312a of the convex tooth 312, the return spring I316 is compressed, the inner handle 315 gradually extends into the outer handle 314 to shorten the length of the driving handle 310, so that the driving handle can continuously slide along the ascending inclined surface 312a, and when the driving handle slides to the descending inclined surface 312b, the return spring I316 is released, the inner handle 315 is reset, so that the driving handle can be clamped in the limit groove 313; preferably, the main housing 301 may be provided with a fixing rod 317, the fixing rod 317 is provided on a side plate of the main housing 301 and faces the driving ring 304, the fixing rod 317 and the outer handle 314 may be connected through a return spring ii 318, and the return spring ii 318 generates a pulling force on the driving handle 310, which may hinder the directional rotation of the driving ring 304, thereby improving the positioning effect of the driving handle 310 when being limited.
Finally, the principle and embodiments of the present invention are explained by using specific examples, and the above descriptions of the examples are only used to help understand the core idea of the present invention, and the present invention can be modified and modified without departing from the principle of the present invention, and the modified and modified examples also fall into the protection scope of the present invention.

Claims (10)

1. An adjustable heart defect occluder comprises a first umbrella disc, a second umbrella disc and a waist part positioned between the first umbrella disc and the second umbrella disc, wherein the first umbrella disc is provided with a first through hole, the second umbrella disc is provided with a second through hole, and the waist part is provided with a communicating pore passage used for communicating the first through hole with the second through hole; the method is characterized in that: and the first through hole, the second through hole or the communicating pore passage are provided with adjusting devices for adjusting the flow of the first through hole, the second through hole or the communicating pore passage.
2. The adjustable cardiac defect occluder of claim 1, wherein: adjusting device includes the main casing body, the main casing body is connected in first umbrella dish and is covered first through-hole, set up through-hole I on the main casing body and be connected with adjustment sheet and actuating mechanism, through-hole I is linked together with first through-hole, adjustment sheet swing joint is in the main casing body and opens or close through-hole I under actuating mechanism's drive.
3. The adjustable heart defect occluder of claim 2, wherein: the driving mechanism comprises a driving ring, a through hole II is formed in the driving ring, the axis of the through hole II is overlapped with the axis of the through hole I, and a plurality of adjusting blades are uniformly distributed between the driving ring and the through hole I along the circumference; the driving ring is provided with a plurality of guide grooves which are uniformly distributed on the circumference, and the arc is arc-shaped and is bent along the circumferential direction in the same direction; the number of the adjusting sheets is the same as that of the guide grooves, the middle part of each adjusting sheet is hinged in the corresponding guide groove, the outer end of each adjusting sheet is hinged in the main shell, the inner end of each adjusting sheet extends inwards at the same time, the inner ends of the adjusting sheets surround a through hole III together, and the axis of the through hole III is superposed with that of the through hole I; the driving ring drives the adjusting sheet to rotate while rotating directionally, and the through hole III is gradually reduced and closed.
4. The adjustable cardiac defect occluder of claim 3, wherein: the driving ring is connected with a driving handle for driving the driving ring to rotate, and the main shell is provided with a limiting part for limiting the rotation of the driving handle.
5. The adjustable cardiac defect occluder of claim 4, wherein: the limiting part comprises a plurality of convex teeth which are connected in sequence, the convex teeth are convex to the driving ring and provided with ascending inclined surfaces and descending inclined surfaces, the descending inclined surfaces of each convex tooth are matched with the ascending inclined surfaces of the next convex tooth to form limiting grooves, and the driving handle protrudes from one side of the driving ring and is clamped into the limiting grooves to be limited.
6. The adjustable cardiac defect occluder of claim 5, wherein: the driving handle comprises an outer handle and an inner handle which is coaxial with the outer handle, one end of the outer handle is fixed on the side face of the driving ring, the outer handle is of a hollow structure, the inner handle extends into the driving ring from the other end of the outer handle and can axially slide along the outer handle, and the bottom of the inner handle is connected with the bottom of an inner cavity of the outer handle through a reset spring I.
7. The adjustable cardiac defect occluder of claim 6, wherein: the main shell is provided with a fixed rod, and the fixed rod is connected with the outer handle through a return spring II.
8. The adjustable cardiac defect occluder of claim 7, wherein: the main casing body is discoid, through-hole I is established on the bottom plate of the main casing body, the locating part is established on the curb plate of the main casing body.
9. The adjustable cardiac defect occluder of claim 8, wherein: and a sealing ring is arranged between the driving ring and the bottom plate of the main shell.
10. The adjustable heart defect occluder of any one of claims 1 to 9, wherein: the axial line of the communicating pore canal is parallel to or coincident with the axial lines of the first umbrella disk and the second umbrella disk.
CN202011492902.3A 2020-12-16 2020-12-16 Adjustable heart defect plugging device Active CN112656459B (en)

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CN105997294A (en) * 2016-05-03 2016-10-12 李泽福 Repair system and repair method applied in craniocerebral operation
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CN109646063A (en) * 2019-02-27 2019-04-19 武汉唯柯医疗科技有限公司 The atrium part flow arrangement and tighten driving device that high stable type can be adjusted adaptively
CN109832910A (en) * 2019-04-09 2019-06-04 易新集团有限公司 A kind of Combined adjustable cup lid
CN211324862U (en) * 2019-12-10 2020-08-25 新乡市中心医院(新乡中原医院管理中心) Anus closing device for enteroscopy

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Publication number Priority date Publication date Assignee Title
US20150148731A1 (en) * 2009-09-04 2015-05-28 Edward I. McNamara Methods and devices for intra-atrial shunts having adjustable sizes
CN203827500U (en) * 2014-04-08 2014-09-10 微太科技股份有限公司 Sound box resonance control device
CN204738978U (en) * 2015-07-10 2015-11-04 特灵空调系统(中国)有限公司 Gas product smoke exhaust fan's wind pore structure
CN105997294A (en) * 2016-05-03 2016-10-12 李泽福 Repair system and repair method applied in craniocerebral operation
CN105889540A (en) * 2016-06-03 2016-08-24 中国石油天然气股份有限公司 Air regulating valve for fireflooding well control
CN207941633U (en) * 2018-01-26 2018-10-09 北京东方鸣泉喷泉设备有限责任公司 A kind of throttle valve and fountain apparatus for fountain
CN108577944A (en) * 2018-04-10 2018-09-28 中国人民解放军陆军军医大学第二附属医院 Multichannel single hole hysteroscope puncture outfit
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CN109646063A (en) * 2019-02-27 2019-04-19 武汉唯柯医疗科技有限公司 The atrium part flow arrangement and tighten driving device that high stable type can be adjusted adaptively
CN109832910A (en) * 2019-04-09 2019-06-04 易新集团有限公司 A kind of Combined adjustable cup lid
CN211324862U (en) * 2019-12-10 2020-08-25 新乡市中心医院(新乡中原医院管理中心) Anus closing device for enteroscopy

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