CN112842476B

CN112842476B - Aorta blood vessel puncher capable of stably punching

Info

Publication number: CN112842476B
Application number: CN202011623596.2A
Authority: CN
Inventors: 王永生; 吴延庆; 韩婉青
Original assignee: First Affiliated Hospital of Henan University of Science and Technology
Current assignee: First Affiliated Hospital of Henan University of Science and Technology
Priority date: 2020-12-31
Filing date: 2020-12-31
Publication date: 2022-03-22
Anticipated expiration: 2040-12-31
Also published as: CN112842476A

Abstract

The utility model provides an aorta blood vessel hole puncher that can stably punch, includes anvil tube, sleeve pipe, core bar, top subassembly and cutter unit spare, and the top subassembly includes top body and stripper plate, and the top body comprises sharp head portion and the hidden sword portion of an organic whole connection, and cutter unit spare includes circular blade disc and cutter. The blood vessel puncher disclosed by the invention can be used for clamping a blood vessel wall by using the ejector and the anvil tube before punching, and the operation cutter extends out of the end face of the ejector to cut the blood vessel wall.

Description

Aorta blood vessel puncher capable of stably punching

Technical Field

The invention relates to the technical field of medical auxiliary instruments, in particular to an aorta blood vessel puncher capable of stably punching holes.

Background

Coronary artery bypass surgery, one of the main treatment methods of coronary heart disease, is to take the blood vessel or blood vessel substitute of the patient himself, connect the distal end of the stenotic coronary artery with the aorta, let the blood bypass the stenotic part, reach the ischemic site, improve the myocardial blood supply and cardiac function. In coronary artery bypass surgery, it is often necessary to make a circular opening in the ascending aortic vessel wall for anastomosis of the bypass vessel. The traditional method is that a cardiac surgeon uses a scalpel to cut a round hole on a blood vessel wall, but the manually cut round hole is extremely irregular, and blood vessel wall tissue fragments are easy to remain in the operation process, and the remaining tissue will inevitably cause thrombus and threaten the postoperative survival of a patient. With the development of cardiac surgical techniques, this knife-piercing method is abandoned because of the overwhelming primitive and operational risks.

In order to solve the above technical problems, many blood vessel punches have been proposed in the prior art, such as a blood vessel punch disclosed in patent publication No. CN107374703A, an aorta punch disclosed in patent publication No. CN107951515A, and a blood vessel punch assembly and punch disclosed in patent publication No. CN108514441A, which can be used to punch holes at required positions instead of cutting holes with a scalpel, but still have some disadvantages, which are mainly shown in that: the utility model discloses a blood vessel fast operation method, including the hole puncher, the hole puncher is difficult for the stable operation on the target blood vessel, wherein unstable operation includes the problem of relative slip between hole puncher and the blood vessel at least, and two, the operation degree of difficulty is big, is difficult to guarantee to the perpendicular cutting of vascular wall, increases the risk of adverse reactions such as the anastomotic stoma in later stage hemorrhage. Based on this, the applicant has designed an aortic vessel perforator that can stabilize the perforation.

Disclosure of Invention

The present invention is directed to solving the above-mentioned problems and providing an aortic blood vessel perforator capable of stably perforating.

In order to solve the technical problems, the invention adopts the technical scheme that: an aorta blood vessel puncher capable of stably punching comprises an anvil tube, a sleeve, a core bar, a top assembly and a cutter assembly;

the anvil base pipe is a pipe body provided with a central channel, the sleeve is arranged in the central channel of the anvil base pipe in a penetrating mode, the head end of the sleeve is connected with the ejector assembly, and the tail end of the sleeve extends out of the anvil base pipe;

the plug assembly comprises a plug body and an extrusion plate, the plug body consists of a sharp head part and a knife hiding part which are integrally connected, the knife hiding part is provided with a hidden cavity for hiding the cutter assembly, the head end of a sleeve extends into the hidden cavity and is fixedly connected with the knife hiding part, the extrusion plate is fixedly sleeved on the sleeve, the extrusion plate is arranged in parallel and level with the end surface of the knife hiding part, an annular gap is formed between the extrusion plate and the inner wall of the hidden cavity, and a vascular wall clamping position is formed between the extrusion plate and the end surface of the anvil tube;

the cutter assembly comprises a circular cutter disc and a cutter, the cutter disc is movably sleeved on the sleeve positioned in the hidden cavity, the cutter is of a circular structure, one end of the cutter is fixed on the circular cutter disc, and the other end of the cutter is provided with a cutting edge;

the core bar penetrates through the interior of the sleeve, a plurality of through holes are formed in the side wall of the head end of the sleeve along the circumferential direction of the sleeve, and the head end of the core bar is connected with a cutter disc of the cutter assembly through a connecting sheet penetrating through the through holes.

The aorta blood vessel puncher can be further optimized as a puncher capable of stably punching holes: the tail end of the anvil tube is provided with an adjusting sleeve, a first button is arranged in the adjusting sleeve and fixedly connected with the sleeve, a first spring is arranged on the sleeve between the anvil tube and the first button, a central through hole is formed in the first button, and the tail end of the core rod penetrates through the central through hole and extends out of the first button.

The aorta blood vessel puncher can be further optimized as a puncher capable of stably punching holes: the tail end terminal surface of first button is seted up flutedly, and the notch department of recess is provided with the fender ring, the tail end of core bar passes central through-hole and keeps off the ring and stretch out first button setting, and fixed cover is equipped with the retaining ring on the body of rod that the core bar is located the recess, and the core bar is located and is provided with the second spring on the body of rod between retaining ring and the fender ring, the lateral wall of core bar is provided with spacing hole, and the central through-hole lateral wall of first button corresponds spacing hole and is provided with the mounting groove, is provided with the gag lever post in the mounting groove, and the tail end of gag lever post passes through the third spring and is connected with the mounting groove, and the head end of gag lever post can stretch out the mounting groove and implant the spacing downthehole of core bar, and the gag lever post can be along its axial displacement under the effect of the control unit.

The aorta blood vessel puncher can be further optimized as a puncher capable of stably punching holes: the control unit includes control lever, control handle and fourth spring, and the tail end terminal surface of first button has seted up the control channel who communicates to the mounting groove, and the control lever is worn to establish in the control channel, and the tail end of control lever stretches out control channel and connects the control handle, and the fourth spring housing is established on the body of rod that the control lever is located between first button and the control handle, and the head end of control lever is provided with the inclined plane, the gag lever post is provided with the control flume towards one side of control channel, and the control lever is carrying out axial displacement's in-process, can make gag lever post axial displacement through the inclined plane of its head end and the cooperation of control flume.

The aorta blood vessel puncher can be further optimized as a puncher capable of stably punching holes: the ratio of the diameter of the central channel of the anvil tube to the diameter of the anvil tube is 1: 5-1: 3.

advantageous effects

The blood vessel puncher disclosed by the invention can be used for clamping a blood vessel wall by using the ejector and the anvil tube before punching, and the operation cutter extends out of the end face of the ejector to cut the blood vessel wall.

Drawings

FIG. 1 is a schematic view of the connection of a plug assembly to a casing and a mandrel in a hole punch according to the present invention;

FIG. 2 is a schematic view of the connection (from an exploded perspective) of the punch assembly to the casing and the mandrel of the present invention;

FIG. 3 is a schematic view of the cutter assembly of the hole punch of the present invention in connection with a sleeve and a mandrel;

FIG. 4 is a schematic view of the connection between the pressing plate and the casing of the hole punch according to the present invention;

FIG. 5 is a schematic view of the connection of the plug assembly (with the cutting blade in an extended position) to the sleeve and the mandrel of the hole punch of the present invention;

FIG. 6 is a schematic view of the construction of the hole punch (initial state) of the present invention;

FIG. 7 is a schematic diagram of the structure of the perforator (in a state of clamping the vessel wall);

FIG. 8 is a schematic view of the construction of the hole punch (in the punching state) of the present invention;

FIG. 9 is an enlarged view of a portion of FIG. 6 at A;

FIG. 10 is an enlarged view of a portion of FIG. 7 at A;

FIG. 11 is an enlarged view of a portion of FIG. 8 at A;

the labels in the figure are: 1. anvil tube, 2, sleeve, 3, top head component, 4, cutter component, 3-1, extrusion plate, 3-2, sharp head, 3-3, knife hiding part, 3-4, hidden cavity, 4-1, cutter head, 4-2, cutter, 5, core bar, 6, adjusting sleeve, 7, first button, 8, first spring, 9, baffle ring, 10, retainer ring, 11, second spring, 12, spacing hole, 13, mounting groove, 14, spacing rod, 15, third spring, 16, control rod, 17, control handle, 18, fourth spring, 19, control channel, 20, control groove, 21, vascular wall.

Detailed Description

The technical solution in the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention.

As shown in the figure: an aorta blood vessel puncher capable of stably punching comprises an anvil tube 1, a sleeve 2, a core bar 5, a plug assembly 3 and a cutter assembly 4.

Anvil pipe 1 is for being equipped with the body of a central channel, and sleeve pipe 2 wears to establish in anvil pipe 1's central channel, and sleeve pipe 2's head end is connected with top subassembly 3, and sleeve pipe 2's tail end stretches out anvil pipe 1 and sets up. The sleeve 2 can slide along the axial direction of the anvil tube 1, and further drives the plug assembly 3 to perform axial displacement.

Wherein the ratio of the diameter of the central channel of the anvil tube 1 to the diameter of the anvil tube 1 is 1: 5-1: and 3, the end surface of the anvil tube 1 has a certain area, so that the clamping effect is ensured.

The top head component 3 comprises a top head body and an extrusion plate 3-1, the top head body is composed of a pointed head part 3-2 and a hidden cutter part 3-3 which are integrally connected, the pointed head part 3-2 is of a cone structure, the hidden cutter part 3-3 is of a cylindrical structure, the hidden cutter part 3-3 is coaxially arranged at the cone bottom of the pointed head part 3-2, the hidden cutter part 3-3 is provided with a hidden cavity 3-4 for hiding the cutter component 4, the hidden cavity 3-4 is a cylindrical cavity dug along the end surface of the hidden cutter part 3-3, the head end of the sleeve 2 extends into the hidden cavity 3-4 and is fixedly connected with the hidden cutter part 3-3 (fixed at the bottom of the hidden cavity 3-4), the extrusion plate 3-1 is fixedly sleeved on the sleeve 2, and the extrusion plate 3-1 is flush with the end surface of the hidden cutter part 3-3, and an annular gap is formed between the extrusion plate 3-1 and the inner wall of the hidden cavity 3-4, and a vessel wall clamping position is formed between the extrusion plate 3-1 and the end surface of the anvil tube 1.

The cutter assembly 4 comprises a circular cutter head 4-1 and a cutter 4-2, the cutter head 4-1 is movably sleeved on the sleeve 2 positioned in the hidden cavity 3-4, the cutter 4-2 is of a circular structure, one end of the cutter 4-2 is fixed on the circular cutter head 4-1, and the other end of the cutter 4-2 is provided with a blade. The core rod 5 penetrates through the sleeve 2, a plurality of through holes are formed in the side wall of the head end of the sleeve 2 along the circumferential direction of the sleeve, and the head end of the core rod 5 is connected with a cutter head 4-1 of the cutter assembly 4 through a connecting sheet 4-3 penetrating through the through holes.

The structure of the plug assembly 3 is one of the main innovation points of the invention, the distance between the extrusion plate 3-1 and the end face of the anvil tube 1 (namely the vessel wall clamping position) can be adjusted through the relative displacement between the sleeve 2 and the anvil tube 1, when the plug assembly 3 passes through a small opening cut in advance on the vessel wall, the maximum distance between the extrusion plate 3-1 and the end face of the anvil tube 1 is kept away, and after the plug assembly 3 completely passes through the vessel wall, the distance between the extrusion plate 3-1 and the end face of the anvil tube 1 is reduced through the axial displacement of the sleeve 2, and finally the clamping of the vessel wall is realized. In the above process, the cutter assembly 4 needs to be hidden, and the specific principle is as follows: the core rod 5 can axially displace in the sleeve 2, and further drives the cutter head 4-1 to axially displace, so that the cutter 4-2 extends out of the annular gap. It should be noted that in order to ensure that the cutting blade 4-2 can move a sufficient distance, the through hole in the sleeve 2 needs to have a sufficient distance in the axial direction so that the connecting piece 4-3 can move in the axial direction of the sleeve 2.

In order to control the anvil tube 1 conveniently, the tail end of the anvil tube 1 is provided with an adjusting sleeve 6, a first button 7 is arranged in the adjusting sleeve 6, the first button 7 is fixedly connected with the sleeve 2, a first spring 8 is arranged on the sleeve 2 between the anvil tube 1 and the first button 7, a central through hole is formed in the first button 7, and the tail end of the core rod 5 penetrates through the central through hole and extends out of the first button 7.

When pressing first button 7, first button 7 linkage sleeve pipe 2 carries out axial displacement, and sleeve pipe 2 drives top subassembly 3 and removes, and top subassembly 3 separates with anvil pipe 1, when loosening first button 7, owing to lost the exogenic action, under the effect of first spring 8, first button 7 resumes initial position.

In order to control the core rod 5 conveniently, a groove is formed in the end face of the tail end of the first button 7, a baffle ring 9 is arranged at the notch of the groove, the tail end of the core rod 5 penetrates through the central through hole and the baffle ring 9 to extend out of the first button 7, a retainer ring 10 is fixedly sleeved on the rod body of the core rod 5 located in the groove, a second spring 11 is arranged on the rod body of the core rod 5 located between the retainer ring 10 and the baffle ring 9, a limiting hole 12 is formed in the side wall of the core rod 5, a mounting groove 13 is formed in the side wall of the central through hole of the first button 7 corresponding to the limiting hole 12, a limiting rod 14 is arranged in the mounting groove 13, the tail end of the limiting rod 14 is connected with the mounting groove 13 through a third spring 15, the head end of the limiting rod 14 can extend out of the mounting groove 13 and is implanted into the limiting hole 12 of the core rod 5, and the limiting rod 14 can move axially under the action of the control unit.

When the tail end of the core rod 5 is pressed, the core rod 5 is driven to move axially until the limiting hole 12 of the core rod 5 moves to the position of the limiting rod 14, the limiting rod 14 is rapidly inserted into the limiting hole 12 of the core rod 5 under the action of the third spring 15, and at the moment, the core rod 5 cannot move (mainly cannot move back) any more due to the mutual matching of the limiting rod 14 and the limiting hole 12. When the stopper rod 14 is pulled out of the stopper hole 12, the core bar 5 is restored to the original position by the second spring 11 because the restriction is lost.

In order to control the limiting rod 14 conveniently, the control unit comprises a control rod 16, a control handle 17 and a fourth spring 18, a control channel 19 communicated to the mounting groove 13 is formed in the end face of the tail end of the first button 7, the control rod 16 penetrates through the control channel 19, the tail end of the control rod 16 extends out of the control channel 19 and is connected with the control handle 17, the fourth spring 18 is sleeved on a rod body of the control rod 16 between the first button 7 and the control handle 17, an inclined surface is arranged at the head end of the control rod 16, a control groove 20 is formed in one side, facing the control channel 19, of the limiting rod 14, and the limiting rod 14 can move axially in the process of axial movement of the control rod 16 through the matching of the inclined surface at the head end of the control rod and the control groove 20.

When the limiting rod 14 is inserted into the limiting hole 12, the head end of the control rod 16 is located on one side of the control groove 20, at the moment, the control handle 17 is pressed, the control handle 17 drives the control rod 16 to axially displace towards the control groove 20 (extend into the control groove 20), the control groove 20 is extruded under the action of the slope surface of the head end of the control handle 17, the limiting rod 14 is enabled to move upwards, the limiting rod 14 is finally enabled to be pulled out of the limiting hole 12, and after the control handle 17 is loosened, the control handle 17 is restored to the initial position under the action of the fourth spring 18.

The use method of the aortic blood vessel puncher disclosed by the invention comprises the following steps: at first, the point portion that utilizes the top body punctures a osculum on the vascular wall, then under the state of pressing first button, it is inboard to pass the osculum with the top subassembly and arrange the vascular wall in, at this moment, loosen first button, the top subassembly retraction will take the vascular wall clamp that punches to press from both sides between the terminal surface of stripper plate and anvil tube (also be the vascular wall centre gripping position promptly), at this moment, press down the control handle, make the gag lever post extract spacing hole, and then the core bar retracts back, drive cutter subassembly axis and remove, at this in-process, cutter subassembly's cutter stretches out and will press from both sides tight vascular wall cutting from the annular gap, accomplish the operation of punching, at this moment, it can carry out follow-up operation to shift out the blood vessel with the top subassembly.

The foregoing description of specific embodiments of the present invention has been presented. It is to be understood that the present invention is not limited to the specific embodiments described above, and that various changes and modifications may be made by one skilled in the art within the scope of the appended claims without departing from the spirit of the invention.

Claims

1. An aortic vessel perforator capable of stable perforation, characterized in that: comprises an anvil tube (1), a sleeve (2), a core bar (5), a top head component (3) and a cutter component (4);

the anvil tube (1) is a tube body provided with a central channel, the sleeve (2) is arranged in the central channel of the anvil tube (1) in a penetrating mode, the head end of the sleeve (2) is connected with the ejector component (3), and the tail end of the sleeve (2) extends out of the anvil tube (1);

the plug assembly (3) comprises a plug body and an extrusion plate (3-1), the plug body is composed of a sharp head part (3-2) and a cutter hiding part (3-3) which are integrally connected, the cutter hiding part (3-3) is provided with a hidden cavity (3-4) for hiding the cutter assembly (4), the head end of a sleeve (2) extends into the hidden cavity (3-4) and is fixedly connected with the cutter hiding part (3-3), the extrusion plate (3-1) is fixedly sleeved on the sleeve (2), the extrusion plate (3-1) and the end face of the cutter hiding part (3-3) are arranged in parallel and level, an annular gap is formed between the extrusion plate (3-1) and the inner wall of the hidden cavity (3-4), and a vascular wall clamping position is formed between the extrusion plate (3-1) and the end face of the anvil tube (1);

the cutter assembly (4) comprises a circular cutter disc (4-1) and a cutter (4-2), the cutter disc (4-1) is movably sleeved on the sleeve (2) positioned in the hidden cavity (3-4), the cutter (4-2) is of a circular structure, one end of the cutter (4-2) is fixed on the circular cutter disc (4-1), and the other end of the cutter (4-2) is provided with a cutting edge;

the core rod (5) penetrates through the sleeve (2), a plurality of through holes are formed in the side wall of the head end of the sleeve (2) along the circumferential direction of the sleeve, the head end of the core rod (5) is connected with a cutter head (4-1) of the cutter assembly (4) through a connecting piece (4-3) penetrating through the through holes, and the through holes in the sleeve (2) need to have enough distance in the axial direction to enable the connecting piece (4-3) to move in the axial direction of the sleeve (2);

an adjusting sleeve (6) is arranged at the tail end of the anvil tube (1), a first button (7) is arranged in the adjusting sleeve (6), the first button (7) is fixedly connected with the sleeve (2), a first spring (8) is arranged on the sleeve (2) between the anvil tube (1) and the first button (7), a central through hole is formed in the first button (7), and the tail end of the core rod (5) penetrates through the central through hole and extends out of the first button (7);

the tail end face of the first button (7) is provided with a groove, a baffle ring (9) is arranged at the notch of the groove, the tail end of the core rod (5) penetrates through the central through hole and the baffle ring (9) to extend out of the first button (7), a retainer ring (10) is fixedly sleeved on the rod body of the core rod (5) positioned in the groove, a second spring (11) is arranged on the rod body of the core rod (5) positioned between the retainer ring (10) and the baffle ring (9), the side wall of the core rod (5) is provided with a limiting hole (12), the side wall of the central through hole of the first button (7) is provided with a mounting groove (13) corresponding to the limiting hole (12), a limiting rod (14) is arranged in the mounting groove (13), the tail end of the limiting rod (14) is connected with the mounting groove (13) through a third spring (15), and the head end of the limiting rod (14) can extend out of the mounting groove (13) and is implanted into the limiting hole (12) of the core rod (5), the limiting rod (14) can move along the axial direction thereof under the action of the control unit.

2. The stably-fenestratable aortic blood punch of claim 1, wherein: the control unit comprises a control rod (16), a control handle (17) and a fourth spring (18), a control channel (19) communicated to the mounting groove (13) is formed in the end face of the tail end of the first button (7), the control rod (16) penetrates through the control channel (19), the tail end of the control rod (16) extends out of the control channel (19) and is connected with the control handle (17), the fourth spring (18) is sleeved on a rod body of the control rod (16) between the first button (7) and the control handle (17), an inclined surface is arranged at the head end of the control rod (16), a control groove (20) is formed in one side, facing the control channel (19), of the limiting rod (14), and the limiting rod (14) can axially move through the cooperation of the inclined surface at the head end of the control rod (16) and the control groove (20) in the process of axial movement of the control rod (16).

3. The stably-fenestratable aortic blood punch of claim 1, wherein: the ratio of the diameter of the central channel of the anvil tube (1) to the diameter of the anvil tube (1) is 1: 5-1: 3.