CN112869800A

CN112869800A - Conveyor, wire passing device, tunnel type wire passing system and operation method thereof

Info

Publication number: CN112869800A
Application number: CN202110283051.XA
Authority: CN
Inventors: 秦丹; 李泳龙; 葛亮
Original assignee: Shanghai Jingwei Fusheng Medical Technology Co ltd
Current assignee: Shanghai Jingwei Fusheng Medical Technology Co ltd
Priority date: 2021-03-16
Filing date: 2021-03-16
Publication date: 2021-06-01

Abstract

The invention provides a conveyor, a wire passing device, a tunnel type wire passing system and an operation method thereof, wherein the conveyor comprises: the conveying device comprises a conveying rod, a conveying head and at least two wire hubs; each of the hubs is for winding one suture; the delivery rod is provided with a suture cavity arranged along the axial direction of the delivery rod, and the suture cavity is used for accommodating the part extending out from the distal end of the suture coiled on the hub; the delivery head is arranged at the distal end of the delivery rod and is used for accommodating a coil wound by a part of the suture in the suture cavity extending to the distal end; the conveying rod is movably arranged in the positioner in a penetrating mode, and the conveying head is used for extending out of the far end of the positioner so that the positioner can be connected with the coil contained on the conveying head. With the configuration, after the tunnel type threading presetting of one thread is finished, the conveyor can be continuously utilized to carry out the tunnel type threading presetting of the next thread without replacing the conveyor.

Description

Conveyor, wire passing device, tunnel type wire passing system and operation method thereof

Technical Field

The invention relates to the technical field of medical instruments, in particular to a conveyor, a thread passing device, a tunnel type thread passing system and an operation method thereof.

Background

In addition to suturing the soft tissue itself, the repair of a torn soft tissue at the rotator cuff, knee, ankle, etc., generally requires pressing the soft tissue against the bone (tying the soft tissue to the bone) with a suture to promote healing. Presently, a revision surgery is usually performed with a suture anchor, which anchors a metal anchor in the bone and then binds soft tissue with a suture attached to the anchor, thereby pressing the soft tissue against the bone. However, due to the bulkiness of the anchor compared to the suture, it is not friendly to patients with smaller bone size or osteoporosis. If the selection of the anchor nail is improper or the position is deviated in the operation, the risk that the anchor nail falls off and the pulling force is insufficient and the like exists, secondary damage is easily caused to the affected part of the patient, the operation cost of the scheme is high, the difficulty is high, and the difficulty in repair is extremely high if the operation is carelessly damaged.

A safer surgical solution is to forego anchors, tunnel the bone, and thread sutures through the bone tunnel to complete the suture attachment of the soft tissue. However, no proper surgical tool exists at present, and only open surgery or suture passing under arthroscopic guidance through an epidural puncture needle can be selected, so that the surgical operation is extremely difficult.

Disclosure of Invention

The invention aims to provide a conveyor, a wire passing device, a tunnel type wire passing system and an operation method thereof, which are used for solving the problems of fixing a suture by an anchor in the prior art.

To solve the above technical problem, the present invention provides a conveyor for use with a positioner of a tunnel threading system, the conveyor comprising: the conveying device comprises a conveying rod, a conveying head and at least two wire hubs;

each of the hubs is for winding one suture;

the delivery rod is provided with a suture cavity arranged along the axial direction of the delivery rod, and the suture cavity is used for accommodating the part extending out from the distal end of the suture coiled on the hub;

the delivery head is arranged at the distal end of the delivery rod and is used for accommodating a coil wound by a part of the suture in the suture cavity extending to the distal end;

the conveying rod is movably arranged in the positioner in a penetrating mode, and the conveying head is used for extending out of the far end of the positioner so that the positioner can be connected with the coil contained on the conveying head.

Optionally, at least two of the hubs are juxtaposed in an axial direction.

Optionally, the conveyor comprises a suture partition disposed between two axially adjacent hubs for blocking sutures on different hubs.

Optionally, the suture partition has a first suture passing hole for passing a suture therethrough to interconnect sutures on axially adjacent hubs.

Optionally, at least two of the hubs are nested inside and outside about an axis.

Optionally, the thread passing hole is used for passing a thread, so that the thread on the adjacent inner and outer thread hubs are connected with each other.

Optionally, the conveyor further comprises a limiting part, and the limiting part is fixedly connected with the conveying rod; the limiting part is used for abutting against a part corresponding to the positioner so as to limit the displacement of the conveying rod relative to the positioner towards the far end.

Optionally, the delivery device comprises a housing fixedly connected to the proximal end of the delivery rod, the interior cavity of the housing communicating with the suture lumen, and the hub rotatably disposed in the housing.

Optionally, the conveyor comprises an indicating part, and the thread hub is driven by the suture to rotate, so that one end of the indicating part connected with the thread hub is driven to displace relative to the shell to form indication.

Optionally, the indicating part comprises a torsion spring and an indicating mark, one end of the torsion spring is connected with the wire hub, and the other end of the torsion spring is connected with the shell; the indicating mark and the torsion spring are connected with one end of the wire hub; the housing has a viewing area for viewing the indicator.

Optionally, the housing has a rotation limiting portion, the wire hub has a shift lever, and the wire hub is connected with one end of the torsion spring in an abutting manner through the shift lever; the wire hub rotates around the axis of the wire hub along a first direction to push one end of the torsion spring to generate displacement relative to the shell; the rotation limiting portion is used for abutting against the shifting lever or the torsion spring so as to limit the wire hub to continue to rotate along the first direction after rotating for a preset angle along the first direction.

Optionally, the delivery head has a first slot for catching the coil and a second slot for allowing the connection portion of the positioner to pass through.

In order to solve the above technical problem, the present invention further provides a wire passing device, including: a conveyor as described above and at least two sutures;

one suture is wound on each wire hub of the conveyor; the suture lines coiled on the adjacent wire hubs are sequentially connected end to end;

a part of one suture is also accommodated in the suture cavity of the conveyor, and the distal end of the suture is wound into a coil and accommodated on the conveying head of the conveyor.

Optionally, the thread passing device further comprises a suture connecting section connected between the adjacent sutures; the tensile strength of the suture connecting section is lower than that of the suture.

In order to solve the above technical problem, the present invention further provides a tunnel type threading system, including: the thread passing device and the positioner;

the positioner includes: a first positioning rod, a second positioning rod, a guide wire and a driving part; the first positioning rod is provided with a first channel which is axially communicated along the first positioning rod; the second positioning rod is connected with the first positioning rod, and the far end of the second positioning rod exceeds the far end of the first positioning rod; the second positioning rod is provided with a second channel which penetrates through the second positioning rod along the axial direction of the second positioning rod, and the extension direction of the far end of the second channel is intersected with the extension direction of the far end of the first channel; the guide wire can movably penetrate through the second channel along the axial direction of the second positioning rod, and the far end of the guide wire is provided with a connecting part; the driving part is connected with the guide wire and is used for driving the guide wire to move along the axial direction of the second positioning rod;

the conveying rod of the conveyor is used for penetrating into the first channel of the positioner, and the connecting part of the positioner is used for being connected with the coil accommodated on the conveying head of the conveyor.

In order to solve the above technical problem, the present invention further provides an operating method of a tunnel type threading system, which utilizes the above tunnel type threading system, and the operating method of the tunnel type threading system includes:

opening a second tunnel on a preset object;

inserting the far end of a second positioning rod of the positioner into the second tunnel, so that the far end extension direction of the second channel is coincident with the axial direction of the second tunnel;

opening a first tunnel on the predetermined object along the extending direction of a first channel of the positioner, so that the first tunnel is intersected with the second tunnel;

penetrating a conveying rod of the conveyor into the first channel, and enabling a distal end of the conveying rod to extend into the first tunnel, so that a conveying head of the conveyor is intersected with the second tunnel;

the connecting part is driven by the driving part to move towards the near end and is connected with a coil accommodated on the conveying head;

pulling proximally to withdraw the conveyor leaving the coil in the second tunnel;

pulling the positioner proximally, pulling the coil out of the second tunnel;

continuing to pull the loop proximally out of the previous suture of the second tunnel until the distal end of a subsequent suture coupled to the previous suture extends beyond the delivery head;

and separating the previous suture from the next suture, and accommodating a coil at the far end of the next suture on the delivery head for repeating the next tunnel type threading on the predetermined object.

Optionally, after pulling the loop of the previous suture out of the second tunnel, the method of operating the tunneled threading system further comprises:

driving the connecting part to move towards the far end by using a driving part;

and releasing the coil from the connecting part to separate the coil from the positioner.

In summary, in the conveyor, the thread passing device, the tunnel thread passing system and the operating method thereof provided by the present invention, the conveyor includes: the conveying device comprises a conveying rod, a conveying head and at least two wire hubs; each of the hubs is for winding one suture; the delivery rod is provided with a suture cavity arranged along the axial direction of the delivery rod, and the suture cavity is used for accommodating the part extending out from the distal end of the suture coiled on the hub; the delivery head is arranged at the distal end of the delivery rod and is used for accommodating a coil wound by a part of the suture in the suture cavity extending to the distal end; the conveying rod is movably arranged in the positioner in a penetrating mode, and the conveying head is used for extending out of the far end of the positioner so that the positioner can be connected with the coil contained on the conveying head.

The conveyor can be used for presetting at least two sutures, and after the tunnel type line passing presetting of one suture is completed, the conveyor can be continuously used for the tunnel type line passing presetting of the next suture without replacing the conveyor, thereby being beneficial to improving the continuity of the operation and reducing the total cost of using the conveyor in one operation.

Drawings

It will be appreciated by those skilled in the art that the drawings are provided for a better understanding of the invention and do not constitute any limitation to the scope of the invention. Wherein:

fig. 1 is a schematic view of a tunnel threading system according to a first embodiment of the invention;

fig. 2 is an axial cross-sectional view of a tunnel type threading system according to a first embodiment of the invention;

fig. 3 is a partial schematic view of a tunnel threading system according to a first embodiment of the invention;

FIG. 4 is an axial cross-sectional view of a retainer in accordance with a first embodiment of the present invention;

FIG. 5 is a schematic view of a positioning rod sleeve according to a first embodiment of the present invention;

FIG. 6 is a schematic view of a hook according to a first embodiment of the present invention;

FIG. 7 is a schematic view of a conveyor according to a first embodiment of the invention;

FIG. 8 is an enlarged partial view of the distal end of the carrier shown in FIG. 7;

fig. 9 is a schematic view of a usage scenario of the tunneling wire passing system according to the first embodiment of the present invention;

FIG. 10 is a schematic view of a locking portion of the first embodiment of the present invention;

FIG. 11 is a schematic view of a delivery head according to another preferred example of the first embodiment of the present invention;

FIG. 12 is a schematic view of a longitudinal positioning rod of a second embodiment of the present invention;

FIG. 13 is a schematic view of a first knob according to a second embodiment of the present invention;

FIG. 14 is a schematic view of a second knob and rack of a second embodiment of the present invention;

FIG. 15 is an exploded view of a conveyor according to a third embodiment of the invention;

FIG. 16 is a schematic view of an outer hub set according to a third embodiment of the present invention;

FIG. 17 is a schematic view of an indicating portion of a third embodiment of the present invention;

FIG. 18 is a schematic view of a torsion spring according to a third embodiment of the present invention;

FIG. 19 is a schematic view of a conveyor according to a fourth embodiment of the invention;

FIG. 20 is an enlarged partial view of the conveyor shown in FIG. 19;

FIG. 21 is a partial schematic view of a conveyor according to a fifth embodiment of the invention;

FIG. 22 is an overall schematic view of a suture receiving portion according to example five of the present invention;

FIG. 23 is a schematic view of the internal structure of a suture receiving portion according to example five of the present invention;

FIG. 24 is a schematic view of a two-leaf hook according to a sixth embodiment of the present invention;

FIG. 25 is a schematic view of a two-leaf hook and suture anchor connection according to a sixth embodiment of the present invention;

FIG. 26 is a schematic view of the attachment of two barbs to a titanium plate with a tab according to a sixth embodiment of the present invention;

FIG. 27 is a schematic representation of a two-leaf hook suture of example six of the present invention;

FIG. 28 is a schematic view of a flat screw hook according to a sixth embodiment of the present invention;

FIG. 29 is a schematic view of a flat hook and interface screw connection according to a sixth embodiment of the present invention;

fig. 30 is a schematic view of a hook according to the sixth embodiment of the present invention.

In the drawings:

1-a locator; 11-transverse positioning rod; 110-a transverse channel; 111-a butting face; 112-an engagement portion; 12-longitudinal positioning rod; 120-longitudinal channels; 121-a curved section; 122-straight section; 13-a guide wire; 131-a hook part; 132-a connecting rod; 133-two-leaf hook; 1331-an extension; 1332-an adaptation; 134-flat screw hook; 135-circle hook; 14-a drive section; 141-a push button; 142-a first knob; 15-positioning rod sleeve; 150-rod sleeve passage; 151-longitudinal positioning rod accommodating channel; 152-a positioning recess; 153-longitudinal channel extension channels; 16-a handle; 161-positioning protrusions; 162-a shaft receiving ring; 17-a locking portion; 171-a wheel; 1710-the runner body; 1711-a shaft section; 1712-limit table; 172-a pusher; 181-a second knob; 182-a rack;

2-a conveyor; 21-a conveying rod; 210-a suture cavity; 22-a delivery head; 221-a first groove; 222-a second slot; 223-guiding slope surface; 23-a suture receiving portion; 231-a wire hub; 2311-a deflector rod; 2312-an outer hub; 2313-inner hub; 2314-ratchet; 2315-outer hub group; 2316-inner hub set; 2317-baffle; 232-a housing; 2320-Window; 233-suture partition; 234 — a first wire passing hole; 235-a second wire through hole; 236-observation area; 237-hub shaft; 238-suture preset holes; 2370-circumferential indentations; 2371-rotation limiter; 24-a limiting part; 250-a card slot hole; 251-a locator card; 252-branch; 26-an indication part; 261-torsion spring; 262-an indicator; 27-a cannula; 270-a pushrod channel; 271-notch; 28-a push rod; 281-an expansion section; 29-a pullback drive;

31-a coil; 32-suture; 33-suture connecting section; 34-suture anchor; 341-a pull wire; 35-a titanium plate with a tab; 351-a titanium plate body; 352-a pull wire; 36-interface screw;

4-a predetermined object; 41-longitudinal tunnel; 42-transverse tunnels.

Detailed Description

To further clarify the objects, advantages and features of the present invention, a more particular description of the invention will be rendered by reference to specific embodiments thereof which are illustrated in the appended drawings. It is to be noted that the drawings are in greatly simplified form and are not to scale, but are merely intended to facilitate and clarify the explanation of the embodiments of the present invention. Further, the structures illustrated in the drawings are often part of actual structures. In particular, the drawings may have different emphasis points and may sometimes be scaled differently.

As used in this application, the singular forms "a", "an" and "the" include plural referents, the term "or" is generally employed in a sense including "and/or," the terms "a" and "an" are generally employed in a sense including "at least one," the terms "at least two" are generally employed in a sense including "two or more," and the terms "first", "second" and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicit to the number of technical features indicated. Thus, features defined as "first", "second", "third" may explicitly or implicitly include one or at least two of such features, the term "proximal" generally being the end near the operator, the term "distal" generally being the end near the patient, i.e. near the lesion, the terms "end" and "proximal" and "distal" generally referring to the corresponding two parts, which include not only the end points, the terms "mounted", "connected" and "connected" being to be understood in a broad sense, e.g. as being fixedly connected, as well as detachably connected, or as an integral part; can be mechanically or electrically connected; either directly or indirectly through intervening media, either internally or in any other relationship. Furthermore, as used in the present invention, the disposition of an element with another element generally only means that there is a connection, coupling, fit or driving relationship between the two elements, and the connection, coupling, fit or driving relationship between the two elements may be direct or indirect through intermediate elements, and cannot be understood as indicating or implying any spatial positional relationship between the two elements, i.e., an element may be in any orientation inside, outside, above, below or to one side of another element, unless the content clearly indicates otherwise. The specific meanings of the above terms in the present invention can be understood by those skilled in the art according to specific situations.

The tunnel threading system provided by the embodiment is mainly used for opening a bone tunnel on a bone and threading a suture or an implant (such as an interface screw, a strap titanium plate and the like) through the bone tunnel. Of course, the application scenario of the tunnel threading system is not limited to threading a bone tunnel, and the tunnel threading may be performed on other objects.

The following description will be made by taking the opening of a bone tunnel in a bone as an example with reference to the accompanying drawings. For convenience of description, a transverse positioning rod, a longitudinal positioning rod, a transverse tunnel, and a longitudinal tunnel are described below as examples of the first positioning rod, the second positioning rod, the first tunnel, and the second tunnel, respectively. The person skilled in the art can also, according to the above idea, swap the transverse direction and the longitudinal direction, and the invention is not limited to this.

[ EXAMPLES one ]

Referring to fig. 1 to 11, in which, fig. 1 is a schematic view of a tunnel threading system according to a first embodiment of the invention; fig. 2 is an axial cross-sectional view of a tunnel type threading system according to a first embodiment of the invention; fig. 3 is a partial schematic view of a tunnel threading system according to a first embodiment of the invention; FIG. 4 is an axial cross-sectional view of a retainer in accordance with a first embodiment of the present invention; FIG. 5 is a schematic view of a positioning rod sleeve according to a first embodiment of the present invention; FIG. 6 is a schematic view of a hook according to a first embodiment of the present invention; FIG. 7 is a schematic view of a conveyor according to a first embodiment of the invention; FIG. 8 is an enlarged partial view of the distal end of the carrier shown in FIG. 7; fig. 9 is a schematic view of a usage scenario of the tunneling wire passing system according to the first embodiment of the present invention; FIG. 10 is a schematic view of a locking portion of the first embodiment of the present invention; fig. 11 is a schematic view of a delivery head according to another preferred example of the first embodiment of the present invention.

As shown in fig. 1 to 3, a tunnel threading system according to an embodiment of the present invention includes a positioner 1 and a conveyor 2. The conveyor 2 is removable with respect to the positioner 1.

Referring to fig. 4 in conjunction with fig. 2 and 3, the positioner 1 includes: a transverse positioning rod 11, a longitudinal positioning rod 12 and a connecting piece; the transverse positioning rod 11 is provided with a transverse channel 110 which is penetrated along the axial direction of the transverse positioning rod; the longitudinal positioning rod 12 is connected with the transverse positioning rod 11, and the far end of the longitudinal positioning rod 12 exceeds the far end of the transverse positioning rod 11; the longitudinal positioning rod 12 is provided with a longitudinal channel 120 which axially penetrates along the longitudinal positioning rod, and the distal extension direction of the longitudinal channel 120 is crossed with the distal extension direction of the transverse channel 110; the connecting piece is movably arranged through the longitudinal channel 120 along the axial direction of the longitudinal positioning rod 12, and the connecting piece is used for connecting a suture or an implant. Further, the positioner 1 further comprises a driving portion 14, wherein the driving portion 14 is connected to a proximal end of the connecting member, and is configured to drive the connecting member to move along the axial direction of the longitudinal positioning rod 120. In one example, the connector is a guidewire 13 having a connector at its distal end for connection to a suture or implant. Optionally, the attachment portion comprises a mechanical abutment for mechanically hooking the suture or implant, or an adhesive for adhesively attaching the suture or implant. Preferably, the mechanical abutment is a hook 131, which can hook a suture or an implant.

It should be noted that the axial directions of the transverse positioning rod 11 and the longitudinal positioning rod 12 are not limited to a straight direction, and if the transverse positioning rod 11 or the longitudinal positioning rod 12 itself is curved, it should be understood that the respective axes are also curved, and the axial directions are curved directions. Therefore, the transverse channels 110 and the longitudinal channels 120 are not limited to be linear. Further, the distal extension direction of the transverse channel 110 and the longitudinal channel 120 refers to the extension direction of the axis of the transverse channel 110 and the longitudinal channel 120 at the distal end, and if the transverse channel 110 and the longitudinal channel 120 extend linearly at the distal end, the distal extension direction is the linear extension of the axis; if the transverse channel 110 and the longitudinal channel 120 are curved at their distal ends, their distal ends extend tangentially to the distal end of their axes, i.e., at the distal end point of their axes. Here, "the distal extension direction of the longitudinal channel 120 intersects the distal extension direction of the transverse channel 110" means that the distal extension direction of the longitudinal channel 120 and the distal extension direction of the transverse channel 110 share a common point, including a geometric intersection, and also includes a case on the same straight line, but does not include a case of being parallel or non-planar.

Referring to fig. 7 and 8, the conveyor 2 includes: a transfer rod 21 and a transfer head 22; the delivery head 22 is arranged at the distal end of the delivery rod 21 and is used for accommodating a coil 31 or an implant wound by a suture 32; the delivery rod 21 is configured to movably penetrate through the transverse channel 110 of the positioner 1, and the delivery head 22 is configured to extend from the distal end of the transverse positioning rod 11, so that the hook 131 of the positioner 1 can hook the coil 31 or the implant accommodated on the delivery head 22. In one example, the delivery rod 21 has a suture cavity 210 disposed axially along the delivery rod, the suture cavity 210 being configured to receive a portion of the suture 32; preferably, the delivery head 22 has a first slot 221 and a second slot 222, the first slot 221 is used for accommodating and clamping the coil 31, and the second slot 222 is used for allowing the connecting part (such as the hook part 131) to pass through. The present invention is not limited to the shape of delivery head 22, and preferably, the distal end of delivery head 22 is rounded and blunted to prevent scratching of the bone tunnel. The loop 31 is formed by bending the distal end of the suture 32, which can be wound around the delivery head 22. The suture lumen 210 is disposed along the axial direction of the delivery rod 21, and in some embodiments, the suture lumen 210 may be a tubular lumen extending through the delivery rod 21. Of course, in other embodiments, suture cavity 210 may be a radially open slot formed in delivery rod 21. The present invention is not limited to the particular arrangement of the suture cavity 210.

The feeding rod 21 of the conveyor 2 is adapted to penetrate the transverse channel 110 of the positioner 1, and the connecting portion of the positioner 1 is adapted to be connected to the coil 31 received on the feeding head 22 of the conveyor 2. Referring to fig. 9, with such a configuration, after the predetermined object 4 (such as humerus) is pre-formed with the longitudinal tunnel 41, the distal end of the longitudinal positioning rod 12 can be inserted into the longitudinal tunnel 41, and then the transverse tunnel 42 can be formed on the predetermined object 4 along the direction of the transverse channel 110; because the distal extension direction of the longitudinal channel 120 of the positioner 1 intersects with the distal extension direction of the transverse channel 110, the transverse tunnel 42 necessarily intersects with the longitudinal tunnel 41, so that the accuracy which cannot be realized by percutaneous positioning is realized, and the problem that the transverse tunnel 42 cannot be hooked due to the fact that the transverse tunnel 42 does not intersect with the longitudinal tunnel 41 is solved. Furthermore, the connecting part can be used for connecting the coil 31 extending along the transverse tunnel 42 and leading the suture 32 out of the longitudinal tunnel 41, so that the suture 32 can pass through the tunnel of the predetermined object 4, the fixation of the suture 32 is reliable, and the risk caused by anchor falling and the like is avoided; the locator 1 is simple to use, low in cost and high in safety. In addition, since the transverse tunnel 42 is arranged later than the longitudinal tunnel 41, the transverse tunnel 42 can be used for discharging the scraps generated when the longitudinal tunnel 41 is arranged, so that the smoothness in the tunnel can be ensured, and the scraps can be prevented from blocking the hooking of the sewing line 32.

Referring to fig. 6, optionally, the guide wire 13 is flexible, and the connecting portion is rounded. In the following description, the hook 131 is taken as an example of the connecting portion, the hook 131 can be directly used for hooking the coil 31 of the suture 32, and the suture 32 is generally flexible, so that the edge of the hook 131 needs to be arranged in a smooth manner to avoid cutting the suture 32. The guide wire 13 is flexible and can bend along with the bending of the longitudinal channel 120, which is beneficial to reducing the overall radial size of the distal end of the positioner 1, improving the trafficability and reducing the wound. In addition, the flexible guide wire 13 can be conveniently pulled, the tension and compression stress of the guide wire 13 can be larger than 450MPa, and the guide wire 13 can be made of medical metal such as 30Cr13, 40Cr13, 12Cr18Ni9, 12Cr18Ni10 or 12Cr17Ni 7. Further, since the hook 131 needs to move smoothly in the longitudinal tunnel 41, the hardness of the hook 131 is preferably not less than 45HRC, for example, the hook can be formed by bending a stainless steel wire with a thickness of 0.1 to 2mm (preferably 0.5 to 0.6mm), and then performing heat treatment to harden the hook. Of course, the hook part 131 with hardness not less than 45HRC can also be used for hooking hard guide wires or implants, such as nitinol wires or titanium plate with loops. Preferably, the hook 131 is made of the same material as the guide wire 13, but the guide wire 13 is not heat-treated to maintain its original toughness. It should be noted that fig. 6 shows a side view of the hook 131, in practice, the hook 131 has a spatial height along a direction perpendicular to the paper surface, that is, the hook 131 is substantially in a spring-like shape, and the coil 31 can be easily inserted into the middle of the hook 131. It should be understood that the above description of the guide wire 13 and the hook 131 is only a preferred example and not a limitation to the guide wire 13 and the hook 131, and those skilled in the art can adopt other configurations of the guide wire 13 and the hook 131 according to the prior art, and the invention is not limited thereto.

Further, the transverse positioning rod 11 is movably connected to the longitudinal positioning rod 12 along its own axial direction, so that after the longitudinal positioning rod 12 is inserted into the longitudinal tunnel 41, the transverse positioning rod 11 can abut against the predetermined object 4 by its own axial movement. Referring to fig. 5 in conjunction with fig. 3 and 4, in an exemplary embodiment, the positioner 1 further includes a positioning rod sleeve 15, the positioning rod sleeve 15 has a rod sleeve passage 150 passing through along its axial direction, an inner contour shape of the rod sleeve passage 150 is adapted to an outer contour shape of the transverse positioning rod 11, and the transverse positioning rod 11 is movably inserted through the rod sleeve passage 150 along the axial direction of the positioning rod sleeve 15; the longitudinal positioning rod 12 is fixedly connected with the positioning rod sleeve 15. The arrangement of the positioning rod sleeve 15 limits the radial degree of freedom of the transverse positioning rod 11, and can avoid uncontrolled deflection of the transverse positioning rod 11.

Optionally, the longitudinal positioning rod 12 comprises a curved segment 121 and a straight segment 122 connected to the proximal end of the curved segment 121; the straight section 122 is parallel to the axial direction of the transverse positioning rod 11. For ease of use, the entire positioner 1 should extend in a straight line to avoid interference with other parts of the patient's body. Thereby, the straight section 122 of the longitudinal positioning rod 12 is arranged parallel to the axial direction of the transverse positioning rod 11. Preferably, the positioning rod sleeve 15 further has a longitudinal positioning rod receiving channel 151 axially disposed along the longitudinal positioning rod sleeve, an inner contour shape of the longitudinal positioning rod receiving channel 151 is adapted to an outer contour shape of the longitudinal positioning rod 12, and the longitudinal positioning rod receiving channel 151 is configured to receive a proximal end of the longitudinal positioning rod 12. The straight section 122 may be inserted into the longitudinal rod receiving channel 151, and after adjusting and confirming that the distal extension direction of the longitudinal channel 120 intersects the distal extension direction of the transverse channel 110, the straight section 122 and the longitudinal rod receiving channel 151 are fixed (e.g., welded or pressed). This step can, of course, be carried out during the production of the fixture 1, or at the point of use of the fixture 1, which is not a limitation of the present invention. It should be noted that the shape of the curved segment 121 can be adapted according to different predetermined objects 4, and preferably, the distal end of the curved segment 121 has a small linear segment to facilitate the insertion into the longitudinal tunnel 41 of the predetermined object 4, and also to facilitate the reduction of the opening diameter of the longitudinal tunnel 41.

Optionally, for convenience of use, the shaft portion of the retainer 1 has a certain length, and for convenience of assembly, the straight section 122 of the longitudinal positioning rod 12 should not be too long, and based on this, the positioning rod sleeve 15 is further provided with a section of longitudinal channel extension channel 153, and the longitudinal channel extension channel 153 is coaxially arranged with the longitudinal positioning rod receiving channel 151 and is located at the proximal end of the longitudinal positioning rod receiving channel 151. After the straight section 122 is inserted into the longitudinal positioning rod receiving channel 151, the proximal extending direction of the longitudinal channel 120 inside the straight section coincides with the axial direction of the longitudinal channel extending channel 153, and the guide wire 13 can extend proximally from the longitudinal channel extending channel 153.

Preferably, the included angle formed between the distal extension direction of the longitudinal channel 120 and the distal extension direction of the transverse channel 110 is in the range of 10 ° to 180 °. The included angle range is suitable for more application scenes.

Referring to fig. 1 and 2, preferably, the positioner 1 further includes a handle 16, and the handle 16 wraps the proximal end of the transverse positioning rod 11 and extends linearly. The handle 16 may be fixedly connected to the positioning rod sleeve 15. In one example, the handle 16 comprises two parts that are detachable from each other, and the two parts are connected by a snap fit that locates with each other. Preferably, the handle 16 has a positioning protrusion 161, and the positioning rod sleeve 15 has a positioning recess 152, and after the positioning protrusion 161 is inserted into the positioning recess 152, the handle 16 can be fixedly connected with the positioning rod sleeve 15. Further, the distal end of the handle 16 is configured to conform to the peripheral contour of the detent lever sleeve 15, and is configured such that the detent lever sleeve 15 can be stably fixed in the handle 16. Of course, in other embodiments, the handle 16 may be integrated with the positioning rod sleeve 15, or the outer contour of the positioning rod sleeve 15 may be configured as the handle 16, but the invention is not limited thereto.

With continued reference to fig. 1 and 2, in an alternative embodiment, the driving portion 14 may include a push button 141, and the handle 16 has a push button slot for sliding the push button 141, the push button slot extends along the axial direction of the transverse positioning rod 11, and the push button 141 can be limited by the push button slot to move only along the axial direction of the positioning rod 11 after being fitted into the push button slot, so as to avoid radial side-to-side shaking. The push button 141 can be fixedly connected to the proximal end of the guide wire 13, and the operator can push the push button 141 to drive the guide wire 13 to move back and forth along the longitudinal channel 120.

In an alternative embodiment, the positioner 1 further comprises a locking portion 17, the locking portion 17 being configured to drive the transverse positioning rod 11 to move distally so that the transverse positioning rod 11 and the longitudinal positioning rod 12 jointly clamp onto the predetermined object 4. Referring to fig. 9, it can be understood that, after the longitudinal positioning rod 12 is inserted into the longitudinal tunnel 41 of the predetermined object 4, the transverse positioning rod 11 is moved toward the distal end with respect to the longitudinal positioning rod 12, and after the distal end of the transverse positioning rod 11 abuts against the predetermined object 4, the transverse positioning rod 11 can clamp the predetermined object 4 together with the longitudinal positioning rod 12. Thus, the operator can disengage the retainer 1 from both hands, and does not need to hold it all the time.

Referring to fig. 10, in an exemplary embodiment, the locking part 17 includes: a rotating wheel 171 and a propelling member 172, wherein the rotating wheel 171 has an internal thread, the propelling member 172 has an external thread matched with the internal thread, and the rotating wheel 171 is in threaded connection with the propelling member 172 through the internal thread and the external thread; the pushing member 172 is fixedly connected to the lateral positioning rod 11, and the rotating wheel 171 is rotatably connected to the positioning rod sleeve 15 and is limited to axial displacement relative to the positioning rod sleeve 15. Since the longitudinal positioning rod 12 and the positioning rod sleeve 15 are fixed in position after being assembled, the transverse positioning rod 11 can be driven to move forward and backward along the axial direction of the transverse positioning rod when the rotating wheel 171 rotates.

With such a configuration, before the transverse tunnel 42 is opened on the predetermined object along the direction of the transverse channel, the locking part 17 can be used to fix the positioner 1 on the predetermined object 4, so that both hands of an operator can be separated from the positioner 1, and the operator does not need to hold the positioner all the time, on one hand, the transverse positioning rod 11 can be stably abutted against the predetermined object 4, so that the extending direction of the transverse channel 110 can be accurately intersected with the longitudinal tunnel 41, which is beneficial for further opening the transverse tunnel 42 along the transverse channel 110 by using a tool such as a bone drill, and accurate positioning can be realized; on the other hand, the operator can conveniently operate tools such as a bone drill to open the transverse tunnel 42 after both hands are separated from the positioner 1.

Optionally, the wheel 171 is rotatably disposed at the proximal end of the handle 16 and is constrained against axial displacement relative to the handle 16. Since the relative positional relationship between the handle 16 and the positioning rod sleeve 15 is fixed after assembly, the handle 16 limits the axial position of the rotating wheel 171 relative to the longitudinal positioning rod 12. In the exemplary embodiment shown in fig. 10, the wheel 171 includes a wheel body 1710, a shaft segment 1711 and a limit stop 1712, the shaft segment 1711 is axially disposed at the distal end of the wheel body 1710, and the limit stop 1712 is disposed at the distal end of the shaft segment 1711, wherein the outer diameter of the shaft segment 1711 is smaller than the radial outer dimension of the limit stop 1712 and the radial outer dimension of the wheel body 1710; the handle 16 has a rotating shaft receiving ring 162 at a proximal end thereof, the inner diameter of the rotating shaft receiving ring 162 is adapted to the outer diameter of the rotating shaft segment 1711, the rotating shaft segment 1711 is rotatably inserted into the rotating shaft receiving ring 162, and two end faces of the rotating shaft receiving ring 162 abut against the rotating wheel body 1710 and the limiting table 1712, so that the handle 16 can limit the axial position of the rotating wheel 171 without limiting the circumferential rotation thereof. Of course, the above-mentioned exemplary embodiment is only a preferred example of the wheel 171, and is not a limitation on the wheel 171, and those skilled in the art can make variations according to the above-mentioned idea.

Optionally, the thread leads of the wheel 171 and the impeller 172 are self-locking, i.e., the ratio of the thread lead to the diameter of the impeller 172 is within a predetermined range. With such a configuration, the rotating wheel 171 can push the transverse positioning rod 11 to move forward and backward, and the rotating wheel 171 cannot be driven to rotate by the forward and backward movement of the transverse positioning rod 11, so as to form self-locking. In practice, the thread lead may be set according to the operator's usage of the twist-type instrument. In one example, the wheel 171 may be configured to rotate 1.5 turns but not more than 2 turns to complete the pushing out of the lateral positioning rod 11, so that the lateral positioning rod 11 abuts against the predetermined object 4. Preferably, the pusher 172 is fixed to the proximal end of the transverse positioning rod 11, and the pusher 172 has a passage extending axially therethrough which is in communication with the transverse passage 110 to facilitate passage of the delivery rod 21 or drill bit or the like.

Optionally, the distal end of the lateral positioning rod 11 has an abutting surface 111, and the abutting surface 111 is adapted to the shape of the predetermined object 4 and is used for abutting against the surface of the predetermined object 4. Further, the distal end of the lateral positioning rod 11 is further provided with an engaging portion 112, and the engaging portion 112 is used for being inserted into the surface of the predetermined object 4 to engage with the predetermined object 4. The engaging portion 112 can be a sharp corner disposed at the edge of the abutting surface 111. In use, after the abutting surface 111 is attached to the surface of the predetermined object 4, the rotating wheel 171 can be slightly rotated so that the engaging portion 112 slightly bites into the bone, and the configuration can increase the stability of the connection between the positioner 1 and the predetermined object 4, and ensure that the subsequent opening process of the transverse tunnel 42 is not affected by the vibration of the external power, thereby realizing accurate positioning.

Referring to fig. 7 and 8, the conveyor 2 preferably further comprises a suture receiving portion 23, wherein the suture receiving portion 23 is connected to the proximal end of the conveying rod 21 for receiving a proximal portion of the suture 32, such as for coiling the suture 32. In the example shown in fig. 7 and 8, the suture receiving portion 23 includes a hub 231 and a housing 232, the housing 232 is fixedly connected to the proximal end of the delivery rod 21, the inner cavity of the housing 232 is communicated with the suture cavity 210, and the hub 231 is rotatably disposed in the housing 232. The suture 32 extends from the suture lumen 210 into the interior cavity of the housing 232 and is coiled around the hub 231. In some embodiments, the suture 32 can be pulled distally, the hub 231 can rotate about its axis, whereupon the suture 32 coiled thereon extends distally. In other embodiments, the hub 231 can rotate about its axis by an angle, and is therefore constrained from further rotation by the housing 232, whereupon the suture 32 coiled thereon slides relative to the hub 231 as it is further pulled distally.

Referring to fig. 11, in an alternative embodiment, the delivery head 22 includes a fork-shaped clip, the distal end of which includes a locator 251 and at least two branches 252, at least two of the branches 252 are connected by the locator 251 to form a closed slot 250, and the slot 250 is used for retrieving the loop 31 of the suture 32 or for receiving an implant. Further, the delivery head 22 includes two of the furcation clips, which are oppositely disposed. The slot openings 250 of the two prongs can be positioned flush with some of the implant (e.g., a titanium strap tab) to provide gripping of the implant, which in use can be fed through the transverse channel 110 into the transverse tunnel 42. Further, the space between the two prongs is accessible for the hook 131 to facilitate the hooking of the implant or suture 32.

Optionally, the handle 16, the wheel 171, the driving portion 14 and other components are made of medical plastic, preferably polyvinyl chloride PVC, acrylonitrile butadiene styrene ABS, polyethylene PE, polypropylene PP, polycarbonate PC or the like. The transverse positioning rod 11, the longitudinal positioning rod 12, the positioning rod sleeve 15 and other parts are made of medical metal and can be independently selected from 12Cr13, 20Cr13, 05Cr17NiCu4Nb, 32Cr13Mo, 40Cr13, Y10Cr17, 06Cr19Ni10 and the like. Of course, the above materials are only examples and are not limiting on the materials of the components, and those skilled in the art can select other suitable materials according to the prior art.

Preferably, the conveyor 2 further comprises a limiting part 24, and the limiting part 24 is fixedly connected with the conveying rod 21; the limiting part 24 is used for abutting against a corresponding part of the positioner 1 so as to limit the distal displacement of the conveying rod 21 relative to the transverse channel 110; when the position-limiting part 24 abuts against a corresponding part of the positioner 1, the delivery head 22 is located at the intersection of the distal extending direction of the longitudinal channel 120 and the distal extending direction of the transverse channel 110. In the exemplary embodiment shown in fig. 7, the connection between the housing 232 and the feeding rod 21 can be configured as the limiting portion 24, and the proximal end of the handle 16 of the positioner 1 or the rotating wheel 171 can be used as the corresponding portion against the housing 232. As shown in fig. 1 and 2, when the conveying rod 21 of the conveyor 2 is inserted into the transverse channel 110 and moves towards the distal end until the limiting portion 24 abuts against the rotating wheel 171, the conveyor 2 cannot be pushed further towards the distal end. Of course, in other embodiments, the position-limiting portion 24 and the corresponding portion of the locator 1 may be independently configured, for example, a corresponding stop, a retaining ring, etc. may be provided, and those skilled in the art may configure the position-limiting portion according to the actual implementation, which is not limited by the invention.

Optionally, the conveyor 2 provided in this embodiment is a disposable consumable, inside which a suture 32 is predisposed. Circular, flat, or flat (i.e., two ends rounded with a center flat) sutures 32 may be preplaced depending on the type of suture desired for the tendon repair procedure. The material of the suture 32 may be: natural fibers, synthetic fibers or metal wires, etc. Natural fibers such as silk and the like; synthetic fibers such as ultra high molecular weight polyethylene, polyamide 6/6, polypropylene, polyethylene terephthalate, polyamide 6, and the like. 3-0-5 round suture lines and 0.1-5 mm flat wires can be preset. The positioner 1 can be repeatedly used for a plurality of times, and an operator can discard the conveyor 2 after finishing the tunnel type threading presetting of one suture 32 and continuously select a new conveyor 2 for presetting other sutures.

The following describes an operation method of the tunnel threading system based on the above tunnel threading system with the humerus as the predetermined object 4. The operation method of the tunnel type threading system comprises the following steps:

step S1: a longitudinal tunnel 41 is arranged on the humerus; because of the small muscle group at the position of the longitudinal tunnel 41, the operator can quickly and accurately determine the approach of the longitudinal tunnel 41 by trial and error, and prepare the longitudinal tunnel 41 by using a circuit breaker or a bone drill.

Step S2: inserting the distal end of the longitudinal positioning rod 12 of the positioner 1 into the longitudinal tunnel 41 so that the distal extension direction of the longitudinal channel 120 coincides with the axial direction of the longitudinal tunnel 41; further optionally, after the step S2, the method may further include the step S21: the locking part 17 is used for driving the transverse positioning rod 11 to move towards the far end, so that the transverse positioning rod 11 and the longitudinal positioning rod 12 are clamped on the humerus together, and the positioner 1 is locked with the humerus. For example, the rotating wheel 171 can be rotated to push the distal end of the transverse positioning rod 11 against the greater tuberosity of the humerus, and then the rotating wheel 171 is slightly rotated to slightly bite the engaging portion 112 into the humerus, so that the longitudinal positioning rod 12, the transverse positioning rod 11 and the humerus are mutually tightly pressed and locked.

Step S3: a transverse tunnel 42 is opened on the humerus along the extending direction of the transverse channel 110 of the positioner 1, so that the transverse tunnel 42 and the longitudinal tunnel 41 are intersected; in one example, this step may be performed by a bone drill. Specifically, the bone drill is passed out from the distal end of the transverse passage 110, the transverse tunnel 42 is prepared along the extending direction of the transverse passage 110, and due to the fact that the bone drill is provided with the spiral groove, bone fragments (including bone fragments generated when the longitudinal tunnel 41 is drilled) can be discharged while the bone drill rotates, and therefore the smoothness in the bone tunnel can be guaranteed. The depth of penetration of the bone drill should not be less than that which would intersect the transverse tunnel 42 with the longitudinal tunnel 41. Preferably, in practice, the bone drill can be prevented from being drilled too deeply by arranging the limiting block on the bone drill. After the transverse tunnel 42 is prepared, the bone drill is removed.

Step S4: passing the conveyor bar 21 of the conveyor 2 through the transverse channel 110 with the distal end of the conveyor bar 21 extending into the transverse tunnel 42, with the conveyor 2 at the intersection of the longitudinal tunnel 41 and the transverse tunnel 42; before or after this step S4, the push button 141 of the driving part 14 may be pushed toward the distal end to extend the connecting part. After the conveying rod 21 of the conveyor 2 moves to a position (e.g., the limiting portion 24 abuts against the positioner 1) toward the far end, the coil 31 on the conveying head 22 should be able to be connected to the connecting portion, e.g., sleeved in the hook portion 131.

Step S5: the driving part 14 is used for driving the connecting part to move towards the proximal end and is connected with the coil 31 or the implant accommodated on the delivery head 22; optionally, after this step, the conveyor 2 may be pulled back slightly proximally, if a stretch is felt, it cannot be pulled back easily, indicating that the wire was successfully connected.

Step S6: pulling proximally to withdraw the conveyor 2 leaving the coil 31 or the implant in the longitudinal tunnel 41; in this step, the carrier 2 may be pulled slightly harder until the inner suture 32 or implant is completely detached from the carrier 2.

Step S7: pulling the positioner 1 proximally, pulling the coil 31 or a portion of an implant (e.g., a pull wire of an implant, etc.) out of the longitudinal tunnel 41; alternatively, before this step S7, the runner 171 may be rotated reversely to unlock the positioner 1 from the humerus.

Step S8: pushing the push button 141 distally to extend the connecting portion, and releasing the coil 31 or the implant from the connecting portion, so as to separate the coil 31 or the implant from the positioner 1. This completes the placement of a suture or implant in the bone tunnel.

[ example two ]

The positioner, the conveyor, the tunnel type threading system and the operation method thereof in the second embodiment of the invention are basically the same as those in the first embodiment, and the same parts are not described again, and only different points are described below.

Referring to fig. 12 to 14, fig. 12 is a schematic view of a longitudinal positioning rod according to a second embodiment of the present invention; FIG. 13 is a schematic view of a first knob according to a second embodiment of the present invention; fig. 14 is a schematic view of a second knob and rack of a second embodiment of the present invention.

In the second embodiment, the specific structure of the positioner 1 is different from that of the first embodiment. Specifically, as shown in fig. 12, in the positioner 1, at least a part of the longitudinal positioning rod 12 is made of a shape memory material. The shape memory material may be, for example, a memory metal, which can transform its strength according to a change in temperature. The longitudinal positioning rod 12 can be prefabricated into various angles and various shapes in real time according to requirements so as to be attached to the structure of the predetermined object 4 in a personalized manner. In some embodiments, the proximal end of the longitudinal positioning rod 12 is fixedly connected to the longitudinal positioning rod receiving channel 151 of the positioning rod sleeve 15, while in other embodiments, the longitudinal positioning rod 12 is also detachable with respect to the positioning rod sleeve 15, in use, when the longitudinal positioning rod 12 is assembled into the longitudinal positioning rod receiving channel 151 of the positioning rod sleeve 15, the longitudinal positioning rod receiving channel 151 may be in interference fit with the longitudinal positioning rod 12 or be reliably and fixedly connected by other connecting structures, and after the longitudinal positioning rod 12 is inserted into the longitudinal positioning rod receiving channel 151, the longitudinal positioning rod and the longitudinal positioning rod may be relatively tightly fitted to facilitate the locking of the locator 1 by the subsequent locking portion 17.

Preferably, the material of the curved section 121 of the longitudinal positioning rod 12 is a shape memory material, and the straight section 122 can be made of a shape memory material, and preferably can also be made of a common non-shape memory material.

Optionally, the longitudinal positioning rod 12 is configured to soften in an environment of a first preset temperature, and further configured to bend to fit the shape of the predetermined object 4, and configured to harden at a second preset temperature. The first predetermined temperature and the second predetermined temperature can be selected according to the use environment, in one example, the first predetermined temperature can be 60 ℃ for example, and the second predetermined temperature can be 40 ℃ for example, the shape memory material can soften and deform at a temperature above 60 ℃ and solidify to restore the original strength and hardness when cooled to a temperature below 40 ℃. In one example, the operator may first put the portion of the shape memory material of the longitudinal positioning rod 12 in hot water to soften, and then bend the longitudinal positioning rod 12 according to the shape of the predetermined object 4, particularly according to the shape of the prefabricated longitudinal tunnel 41, until the longitudinal positioning rod 12 is naturally cooled and solidified or immersed in cold water to solidify and set. Of course, cold water and hot water are only one example of providing the preset temperature, and those skilled in the art can also provide the preset temperature meeting the requirement by using a hot air gun or an incubator.

In the second embodiment, the structure of the driving portion 14 is different from that of the first embodiment. Specifically, referring to fig. 13, the driving portion 14 includes a first knob 142, the proximal end of the guide wire 13 is fixedly connected to the first knob 142 through a connecting rod 132, and the guide wire 13 is configured to move forward and backward along its own axial direction by rotation of the first knob 142.

Referring to fig. 14, preferably, the positioner 1 further includes a second knob 181 and a rack 182, the second knob 181 has teeth on its outer periphery, the rack 182 is fixedly connected to the transverse positioning rod 11, and the rack 182 is configured to engage with the teeth; the rotation of the second knob 181 is converted into the movement of the transverse positioning rod 11 along its own axis by the engagement of the rack 182 and the teeth.

In an alternative embodiment, the first knob 142 includes two oppositely disposed sub-portions, which are clamped on both sides of the second knob 181 along the axial direction of the second knob 181, and the first knob 142 and the second knob 181 can rotate independently from each other. Optionally, a limiting structure can be designed to ensure that the first knob and the second knob move independently, namely, the first knob is limited to rotate along with the second knob, and the second knob is limited to rotate along with the first knob. For convenience of description, the rotation direction of the second knob 181 when the lateral positioning lever 11 is driven to move distally is referred to as the forward direction (clockwise direction in fig. 14) when the second knob 181 is rotated in one direction. The second knob 181 is rotated in the advancing direction to drive the transverse positioning rod 11 to move distally, at this time, the first knob 142 is not moved, and the guide wire 13 does not extend distally. Further, when the locking portion 17 locks the movement of the lateral positioning rod 11, the second knob 181 is locked together and cannot rotate, and at this time, the first knob 142 is rotated in the advancing direction (clockwise direction in fig. 14), so that the guide wire 13 is driven by the connecting rod 132 to extend to the distal end.

Based on the locator 1 provided in the second embodiment, in the operating method of the tunnel threading system, before step S2, the operating method further includes:

step S20: softening at least part of the longitudinal positioning rod 12 in an environment with a first preset temperature, and then bending the longitudinal positioning rod 12 to be matched with the shape of the preset object 4; and then the at least part of the longitudinal positioning rod 12 is hardened at a second preset temperature.

In step S21, the transverse positioning rod 11 may be moved distally by turning the second knob 181. In addition, in steps S4 to S8, it can be understood that the driving of the advancing and retreating of the guide wire 13 is realized by rotating the first knob 142.

[ EXAMPLE III ]

The positioner, the conveyor, the tunnel type threading system and the operation method thereof in the third embodiment of the invention are basically the same as those in the first embodiment, and the same parts are not described again, and only different points are described below.

Referring to fig. 15 to 18, fig. 15 is an exploded schematic view of a conveyor according to a third embodiment of the present invention; FIG. 16 is a schematic view of an outer hub set according to a third embodiment of the present invention; FIG. 17 is a schematic view of an indicating portion of a third embodiment of the present invention; fig. 18 is a schematic view of a torsion spring according to a third embodiment of the present invention.

In the third embodiment, the specific structure of the conveyor 2 is different from that of the first embodiment. Specifically, as shown in fig. 15, the conveyor 2 includes: a delivery rod 21, a delivery head 22 and at least two wire hubs 231; each of the hubs 231 is used for winding one suture 32; the delivery rod 21 is provided with a suture cavity 210 arranged along the axial direction of the delivery rod, and the suture cavity 210 is used for accommodating the part of the suture 32 coiled on the hub 231 and extending out towards the far end; the delivery head 22 is arranged at the distal end of the delivery rod 21 and is used for accommodating the coiled coil 31 of the part of the suture 32 in the suture cavity 210 extending towards the distal end; the conveying rod 21 is movably arranged in the positioner 1 in a penetrating manner, and the conveying head 22 is used for extending out of the distal end of the positioner 1 so that the positioner 1 can hook the coil 31 accommodated on the conveying head 22.

Because a plurality of sutures are often needed in one operation, the conveyor 2 can be preset with at least two sutures 32, and after the tunnel-type line-passing presetting of one suture 32 is completed, the conveyor 2 can be continuously utilized to perform the tunnel-type line-passing presetting of the next suture 32 without replacing the conveyor 2, thereby being beneficial to improving the continuity of the operation and reducing the total cost of using the conveyor 2 in one operation.

Based on the conveyor 2, the embodiment also provides a thread passing device, which comprises the conveyor 2 and at least two threads 32, wherein one thread 32 is wound on each thread hub 231 of the conveyor 2; the suture lines 32 coiled on the adjacent wire hubs 231 are connected end to end in sequence; a portion of one of the sutures 32 is also received in the suture cavity 210 of the conveyor 2, and the distal end of the suture 32 is received in a coil 31 on the delivery head 22 of the conveyor 2. In practice, at least two identical or different sutures 32 are attached end to end, with the head of each suture 32 forming a loop 31. It will be appreciated that the coil 31 may be pre-formed prior to shipment of the suture 32, or may be wound by an operator during surgery. The thread guide integrates a suture 32 for delivering the suture 32 into a transverse tunnel 42 of the intended object 4. It should be noted that the suture 32 is coiled around the hub 231, and the connection relationship between the end (i.e., the proximal end) of the suture 32 and the hub 231 is not limited. In a preferred embodiment, the suture 32 is simply coiled around the hub 231 and does not form a secure connection with the hub 231. So configured, the suture 32 can slide relative to the hub 231, and the suture 32 can be withdrawn distally when the hub 231 is secured.

As shown in fig. 16, optionally, the thread passing device further comprises a suture connecting section 33, and the suture connecting section 33 is connected between the adjacent sutures 32; the tensile strength of the suture connecting section 33 is lower than that of the suture 32. Preferably, the suture connecting section 33 is a point-break connecting section, which may be made of the same material as the suture 32, and a part of the material is mechanically removed at the suture connecting section 33, so that the suture connecting section 33 forms the point-break connecting section, which is convenient for an operator to directly tear off during an operation. Each suture 32 may be set to 1 meter long, for example, depending on the amount of normal surgical use. Of course, in other embodiments, the suture connecting section 33 may be made of a different material than the suture 32 to achieve a lower tensile strength.

Referring to fig. 16, in one embodiment, at least two of the hubs 231 are arranged side by side along an axial direction. At least two sutures 32 are wound in sequence end to end on different hubs 231, all sutures 32 preferably being wound in the same order. To avoid interference and knotting between different sutures 32 during the operation, at least two of the hubs 231 are arranged side by side along an axial direction, so as to distinguish the sutures 32.

Preferably, the conveyor 2 comprises a suture partition 233, wherein the suture partition 233 is arranged between two axially adjacent hubs 231 for blocking the sutures 32 on different hubs 231. The suture interruptions 233 may be, for example, ridges having an outer diameter greater than the outer diameter of the hub 231 to interrupt the coiled sutures 32 on different hubs 231.

Further, the suture partition 233 has a first thread passing hole 234, and the first thread passing hole 234 is used for passing the suture 23 therethrough, so that the suture 32 on the axially adjacent hubs 231 are connected to each other. The first thread passing hole 234 is preferably diagonally perforated through the suture partition 233 to reduce resistance to withdrawal of the suture 32 from the hub 231. It is understood that the first threading hole 234 may be the suture connecting section 33, or one of the two sutures 32 blocked by the suture blocking 233, and the suture connecting section 33 is disposed at one side of the first threading hole 234.

With continued reference to fig. 15, in another embodiment, at least two of the wire hubs 231 are nested inside out about an axis. In the above-described manner in which the hubs 231 are arranged in parallel in the axial direction, if the number of stitches 32 is large, the plurality of hubs 231 are arranged in parallel to be excessively wide, and therefore, the number of stitches 32 that can be integrated in the manner in which the hubs are arranged in parallel in the axial direction is limited. To this end, at least two of the hubs 231 may be configured in an in-out nested arrangement about an axis. The hub 231 of each layer may be coiled with at least one suture 32. Preferably, the two solutions described above can be used in combination, i.e. both nested inside and outside the hub 231 about the axis, and juxtaposed along said axis. In an alternative example, two wire hubs 231 are juxtaposed in an axial direction to form an outer hub group 2315; the other two wire hubs 231 are arranged side by side along the axial direction to form an inner wire hub group 2316; the outer hub set 2315 is sleeved outside the inner hub set 2316 around the axis, and the outer hub set 2315 and the inner hub set 2316 can rotate independently. Optionally, the inner hub assembly 2316 may prevent the outer hub assembly 2315 from backing out by cooperating with a stop 2317.

Preferably, the two wire hubs 231 of the outer set 2315 are fixedly connected to each other, and the two wire hubs 231 of the inner set 2316 are also fixedly connected to each other. So configured, the conveyor 2 can accommodate four sutures 32. It is understood that the number and arrangement of the hubs 231 can be set differently by those skilled in the art according to the above idea, for example, two layers of hubs, three parallel hubs in each layer, etc. are adopted to meet the actual requirement.

With continued reference to fig. 16, preferably, the outer hub 231 has a second thread passing hole 235, and the second thread passing hole 235 is used for passing the suture 32 therethrough, so as to connect the sutures 32 on the inner and outer adjacent hubs 231 to each other. In an exemplary embodiment, a second thread passing hole 235 may be formed in one of the hubs 231 in the outer hub group, and the thread 32 is sequentially wound around each of the hubs 231 in the outer hub group, and then inwardly passes through the outer hub group from the second thread passing hole 235, and then is continuously wound around the hubs 231 in the inner hub group. So configured, the wound suture 32 on each hub 231 of the inner and outer hub sets may be continuous, facilitating sequential withdrawal for use intraoperatively. It should be noted that the hub 231 located at the outer side herein does not only refer to the hub 231 located at the outermost one of the hub groups, but should be understood to have other hubs inside. That is, the outer wire hub 231 is understood here to be the wire hub of the non-innermost wire hub group. For example, when the conveyor 2 is provided with three sets of hubs, it is also possible for the set of hubs of the intermediate layer to be located outside with respect to the set of hubs of the innermost layer, and therefore it is also possible to provide the second threading holes 235 so that the stitches 32 can pass through continuously. Preferably, the second thread passing hole 235 is provided at an end of the most peripheral one of the hubs 231 in each of the sets of hubs to prevent the thread 32 from being entangled.

Referring to fig. 17, optionally, the conveyor 2 includes an indicating portion 26, and the thread hub 231 is driven by the suture 32 to rotate, so as to displace the end of the indicating portion 26 connected with the thread hub 231 relative to the housing 232, thereby forming an indication. The inventors found that the operator cannot see what happens inside the bone tunnel due to the blind zones within the bone tunnel (i.e., the longitudinal tunnel 41 and the transverse tunnel 42 opened on the predetermined object 4) which are part of this type of surgery. The operator can only judge the intervention condition of the instrument completely by hand feeling and experience, and the operation risk is large. In response to this problem, the indication portion 26 is configured to provide an indication outside the bone canal by the conveyor 2 to indicate to the operator whether the suture 32 is successfully hooked by the hook portion 131.

Referring to fig. 17 and 18, preferably, the indicating part 26 includes a torsion spring 261 and an indicating mark 262, one end of the torsion spring 261 is connected with the wire hub 231, and the other end is connected with the housing 232; the indicator 262 and the torsion spring 261 are coupled to one end of the wire hub 231; the housing 232 has a viewing area 236 for viewing the indicator 262.

In one example, the housing 232 forms the hub axle 237, and the first end 2611 of the torsion spring 261 is embedded in the hub axle 237 and constrained by the hub axle 237 from rotating about the hub axle 237. The hub axle 237 has a circumferential notch 2370 at the second end 2612 of the torsion spring 261, and the second end 2612 of the torsion spring 261 can move within the circumferential notch 2370. When not subjected to an external force, the second end 2612 of the torsion spring 261 abuts against one side edge (the upper edge in fig. 18) of the circumferential notch 2370 under the action of the self-elastic force. A hub 231 is rotatably disposed about a hub axle 237, a raised lever 2311 is formed on the hub 231, and the hub 231 is abuttingly coupled to a second end 2612 of the torsion spring 261 via the lever 2311. When the suture 32 is successfully caught by the hook 131, the suture 32 is pulled distally by the hook 131, thereby driving the hub 231 to rotate in a first direction. The hub 231 rotates around its axis in a first direction (counterclockwise in fig. 18), which pushes the second end 2612 of the torsion spring 261 to displace relative to the housing 232; it should be noted that the first direction here may be one of a clockwise direction and a counterclockwise direction, and is not limited to the counterclockwise direction in the above-mentioned exemplary embodiment. Further, the indicator 262 is coupled to the second end 2612 of the torsion spring 261, and when the second end 2612 of the torsion spring 261 is pushed, the indicator 262 follows the displacement relative to the housing 232, and the operator can observe the displacement of the indicator 262 through the observation region 236. In an alternative embodiment, the housing 232 is substantially cylindrical, the observation area 236 is opened on a bottom surface of the cylindrical shape, such as being hollowed out or covered by a transparent material, or the bottom surface of the cylindrical shape of the housing 232 or the entire housing is made of a transparent material, and a position on the housing 232 near the observation area 236 may be marked with an "OK" indicator, such that when the indicator 262 moves into the observation area 236, the suture 32 is successfully hooked.

It will be appreciated that the above-described indicator 26 can already be adapted to a conveyor 2 accommodating only the single suture 32, as it can be provided in combination with the conveyor 2 provided in the first embodiment. In response to the conveyor 2 accommodating at least two sutures 32, it is preferable that the housing 232 has a rotation limiting portion 2371, and the rotation limiting portion 2371 is configured to abut against the shift lever 2311 or the torsion spring 261 to limit the rotation of the thread hub 231 in the first direction after rotating in the first direction by a predetermined angle. With continued reference to fig. 18, the rotation limiting portion 2371 is a side edge of the circumferential notch 2370 of the hub axle 237, and the side edge is away from the second end 2612 of the torsion spring 261 and against which the external force is not applied. In the exemplary embodiment shown in fig. 18, when the shift lever 2311 pushes the second end 2612 of the torsion spring 261 to rotate around the axis of the hub axle 237 in the first direction (i.e., counterclockwise direction) and abuts against the rotation limit portion 2371, the rotation limit portion 2371 limits the second end 2612 of the torsion spring 261 and the shift lever 2311 from rotating continuously in the first direction, so that the hub 231 cannot rotate continuously in the first direction. At this point, as suture 32 continues to be pulled distally, suture 32 will slide relative to hub 231, with indicator 262 remaining in viewing area 236, displaying an "OK" cue. When one suture 32 is completely drawn out and separated from the next suture 32, the suture 32 generates no torque in the first direction to the hub 231, the hub 231 is restored to the initial position shown in fig. 18 under the driving of the elastic force of the torsion spring 261, the indication mark 262 moves out of the observation area 236, the indication mark of "OK" is not displayed any more, and the next hook is waited. It should be understood that, in the above-mentioned exemplary embodiment, a portion of the hub axle 237 is used as the rotation limiting portion 2371, in other embodiments, the rotation limiting portion 2371 may also be a component separately disposed on the housing 232, and the rotation limiting portion 2371 may also limit the rotation of the hub 231 by abutting against the shift lever 2311, which is not limited in this respect.

Based on the above-mentioned conveyor 2 and the thread passing device, in the method for operating the tunnel thread passing system of the present embodiment, after step S9, the method further includes:

step S91: continuing to pull the loop proximally out of the previous suture of the longitudinal tunnel 41 in step S7 until the distal end of the next suture attached to the previous suture is beyond the delivery head 22;

step S92: the previous and subsequent sutures are separated and the distal loop of the subsequent suture is received on the delivery head 22 for the next repeated tunnel-through on the predetermined object 4.

Similarly, the distal end of the subsequent suture 32 is wound into the coil 31, either by pre-shaping the suture 32 at the time of shipment or by in situ winding by the operator at step S92.

[ EXAMPLE IV ]

The positioner, the conveyor, the tunnel type threading system and the operation method thereof in the fourth embodiment of the present invention are basically the same as those in the first embodiment, and the description of the same parts is omitted, and only different points will be described below.

Referring to fig. 19 and 20, fig. 19 is a schematic view of a conveyor according to a fourth embodiment of the present invention; fig. 20 is an enlarged view of a portion of the conveyor shown in fig. 19.

In the fourth embodiment, the specific structure of the conveyor 2 is different from that of the first embodiment. Specifically, as shown in fig. 19 and 20, the conveyor 2 includes: cannula 27, pushrod 28, and delivery head 22; the sleeve 27 is provided with a push rod channel 270 which is axially penetrated along the sleeve and a notch 271 which is opened along the radial direction, and the notch 271 is communicated with the push rod channel 270; a part of the push rod 28 is movably arranged through the push rod channel 270 along the axial direction of the sleeve 27; the delivery head 22 is connected to the distal end of the push rod 28; the notch 271 is used for the passage of the coiled coil 31 of the suture 32, the push rod 28 is used for moving from the push rod channel 270 to the side of the distal end from the proximal end side of the notch 271, and the delivery head 22 is used for taking the coil 31 extending into the push rod channel 270 through the notch 271 in the process of moving the push rod 28 to the distal end and extending from the distal end of the sleeve 27; the sleeve 27 is movably arranged in the positioner 1 in a penetrating manner, and the delivery head 22 is used for extending out from the distal end of the positioner 1 so that the positioner 1 can hook the coil 31 accommodated on the delivery head 22.

So configured, after placing the loop 31 of suture 32 into the push rod channel 270 through the notch 271, the push rod 28 can be conveniently moved distally to pick up the loop 31, so that no additional tools are needed for installing the loop 31 on the delivery head 22, and the loop 31 can be conveniently installed on the delivery head 22, thereby also facilitating the continuous pre-placement of multiple sutures 32.

Optionally, the delivery head 22 is switched between a first state and a second state, and when the delivery head 22 is inserted into the push rod channel 270, the delivery head is limited by the sleeve 27 to be in the first state; after the delivery head 22 extends from the distal end of the sleeve 27, it is transformed to the second state by expanding along the radial direction of the sleeve 27, so as to tension the coil 31. In an alternative embodiment, the material of the delivery head 22 is a shape memory material. The shape memory material is a reversibly deformable material such that delivery head 22 is constrained within pushrod passageway 270 by sleeve 27 to automatically contract, in a first state, to fit the inner diameter of pushrod passageway 270, and to automatically expand to a second state when delivery head 22 extends out of sleeve 27.

In another alternative embodiment, the delivery head 22 has elasticity along the radial direction of the sleeve 27, and when the delivery head 22 is inserted into the push rod channel 270, the delivery head is limited by the sleeve 27 to store elastic potential energy, and is in a first state; after the delivery head 22 extends from the distal end of the sleeve 27, it releases the elastic potential energy to expand along the radial direction of the sleeve 27 to the second state, so as to tension the coil 31.

Preferably, as shown in fig. 11, the delivery head 22 has a guide slope 223, and the guide slope 223 gradually inclines inward toward the axial direction of the push rod 28 in the distal direction toward the proximal direction. Guide ramps 223 are configured to facilitate sleeve 27 applying an inward retraction force to delivery head 22 to facilitate retraction of delivery head 22 from the second configuration to the first configuration when push rod 28 is retracted proximally into sleeve 27.

With continued reference to fig. 19, optionally, the delivery device 2 includes a pull-back drive 29, the pull-back drive 29 is connected to the push rod 28, the pull-back drive 29 is configured to store potential energy during the proximal movement of the push rod 28 when pulled by an external force (the pull-back drive 29 is extended), and release the potential energy to drive the push rod 28 to move distally when the push rod 28 is not subjected to the external force until the delivery head 22 moves to the distal end of the cannula 27, and the delivery head 22 protrudes from the distal side of the push rod channel 270. The retraction drive 29 is configured to automatically retract the push rod 28 to the distal end of the push rod channel 270 when no external force is applied, facilitating continuous distal advancement of the suture 32, and facilitating one-handed operation (without having to control the conveyor 2 with one hand) during suture hooking. In some embodiments, the retraction actuator 29 comprises a resilient member having one end connected to the push rod 28 and the other end connected to the sleeve 27. Of course, in other embodiments, the pull-back driving portion 29 may also include a magnetic member or the like, and store and release potential energy by using magnetic force.

Referring to fig. 19, in an alternative example, the pull-back driving portion 29 includes an elastic member, which is a spring, and the spring is sleeved outside the push rod 28; the proximal end of the push rod 28 has an enlarged section 281, and one end of the spring is connected to the enlarged section 281 in an abutting manner, and the other end is connected to the proximal end of the sleeve 27 in an abutting manner. When the push rod 28 is not subjected to external force, the delivery head 22 of the push rod 28 is located at the far end of the push rod channel 270 under the elastic force of the spring. Preferably, a limiting member, such as a snap, is disposed between the pushing rod 28 and the sleeve 27 to limit the pushing rod 28 from coming out of the proximal end of the sleeve 27 for convenient use.

Optionally, the conveyor 2 comprises a suture receiving portion 23, the suture receiving portion 23 being configured to receive at least two sutures 32; the suture receiving portion 23 has at least two suture preset holes 238, each suture preset hole 238 is used for allowing one suture 32 to pass through; at least two of the suture preset holes 238 are used to align with the notches 271 in sequence. The specific structure of the suture receiving portion 23 is not particularly limited in this embodiment, and for example, the inner and outer nested hubs, or the axially parallel hubs, etc. as in the third embodiment can be used. The at least two suture preset holes 238 are preferably evenly distributed circumferentially around the suture receiving portion 23. In the exemplary embodiment shown in fig. 20, the suture receiving portion 23 has six suture arranging holes 238, and at the same time, six sutures 32 are arranged in the suture receiving portion 23, and the distal end of each suture 32 respectively passes through six different suture arranging holes 238, and the coil 31 is hardened and bent by glue or other means to an angle corresponding to the slot 271, so that the coil 31 can be conveniently passed through the slot 271 to enter the push rod channel 270. After one suture 32 is pushed out of the sleeve 27 by the push rod 28, the next suture preformed hole 238 can be aligned with the notch 271 by rotating the suture receiving portion 23 to push the next suture 32. The rotary suture receiving portion 23 may be rotated manually or may be rotated automatically by a mechanical structure or the like, and is not limited herein.

Preferably, in the present embodiment, the delivery head 22 may select a scheme of a relative arrangement of two fork-shaped clips as in the first embodiment, so as to pick up the coil 31, specifically referring to fig. 11 and the first embodiment.

Based on the above conveyor 2, the present embodiment further provides a thread passing device, which includes: the conveyor 2 as described above and at least two stitches 32; the coils 31 wound by at least two sutures 32 are used for sequentially extending into the push rod channel 270 through the notches 271, so that the delivery head 22 can sequentially pick up the sutures and push the sutures out of the distal end of the sleeve 27 along with the delivery head 22. Further, the tunnel type threading system provided by the embodiment includes: with the thread guide and the positioner 1, after the delivery head 22 of the delivery device 2 is used for sleeving the coil 31 and pushing out the distal end of the sleeve 27, the sleeve 27 is used for penetrating into the transverse passage 110 of the positioner 1, and the connecting part of the positioner 1 is used for connecting with the coil 31 accommodated on the delivery head 22 of the delivery device 2.

Further, in the operating method of the tunneling wire-passing system, before step S4, the operating method of the tunneling wire-passing system further includes:

step SA: the wound coil 31 of suture 32 is threaded into the pusher channel 270 through the slot 271 of the carrier 2, pushing the pusher 28 distally, causing the delivery head 22 to capture the coil 31 and extend distally from the cannula 27.

Further, after step S5, the method for operating a tunneling wire passing system further includes:

step SB 1: moving the cannula 27 proximally, withdrawing the transverse channel 110;

step SB 2: the wound loop 31 of the subsequent suture 32 is threaded into the push rod channel 270 through the slot 271 of the conveyor 2, and the push rod 28 is pushed distally, so that the delivery head 22 can pick up the loop 31 of the subsequent suture 32 and extend from the distal end of the sleeve 27 for repeating the next tunneling over the predetermined object 4. Optionally, before or after "the coil 31 of the following suture 32 is wound through the slot 271 of the conveyor 2 into the push rod channel 270", the method further includes step SB 3: the push rod 28 is moved proximally to the proximal side of the delivery head 22 at the notch 271.

The conveyor 2 and the thread passing device provided by the embodiment can realize automatic back-chamber suture thread replacement 32, are beneficial to providing the continuity of the operation, and simplify the step of mounting the coil 31 of the suture thread 32 on the conveying head 22.

[ EXAMPLE V ]

The positioner, the conveyor, the tunnel type threading system and the operation method thereof in the fifth embodiment of the present invention are basically the same as those in the first embodiment, and the description of the same parts is omitted, and only different points are described below.

Referring to fig. 21 to 23, fig. 21 is a partial schematic view of a conveyor according to a fifth embodiment of the invention; FIG. 22 is an overall schematic view of a suture receiving portion according to example five of the present invention; FIG. 23 is a schematic view of the internal structure of a suture receiving portion according to example five of the present invention.

In the fifth embodiment, the specific structure of the conveyor 2 is different from that of the first embodiment. Specifically, as shown in fig. 21 and 22, the conveyor 2 includes: a delivery rod 21, a delivery head 22, and a suture receiving portion 23; the suture accommodating part 23 is connected with the conveying rod 21 and is used for accommodating at least two sutures 32; the suture receiving portion 23 has at least two suture preset holes 238, each suture preset hole 238 is used for allowing one suture 32 to pass through; at least two of the suture preset holes 238 are used to align with the suture cavity 210, respectively, for different sutures 32 to pass through the suture cavity 210.

Unlike the first embodiment, the suture receiving portion 23 of the present embodiment is configured to receive at least two sutures 32, and different sutures 32 received therein may be used alternatively. The suture receiving portion 23 has at least two suture preset holes 238 thereon for respectively aligning with the suture cavities 210. For the specific structure of the suture receiving portion 23, reference may be made to the above embodiments, which may be used in combination with the embodiments, and the detailed description thereof is omitted here. In particular, the suture receiving portion 23 of the present embodiment can selectively align the desired suture preset hole 238 with the suture cavity 210, so that the operator can select different sutures 32 to be inserted into different suture preset holes 238 according to the need, thereby better adapting to the needs of the operation. In practice, the operator may actively poke the suture receiving portion 23 to align the selected suture preset hole 238 with the suture cavity 210, and then withdraw the suture 32 therein, so as to receive the loop 31 of the suture 32 on the delivery head 22 for being hooked by the hook portion 131 of the positioner 1.

Referring to fig. 23, in one example, the suture receiving portion 23 includes an outer hub 2312 and an inner hub 2313, the outer hub 2312 is rotatably disposed outside the inner hub 2313 about an axis of the inner hub 2313, and the outer hub 2312 has only one rotational degree of freedom relative to the inner hub 2313; the suture 32 is adapted to be coiled around the outer hub 2312, and the outer hub 2312 is configured to rotate in one direction relative to the inner hub 2313 to align the different suture deployment apertures 238 with the suture lumens 210, respectively.

Referring to fig. 21, the housing 232 is adapted to have a window 2320, and an operator can insert the window 2320 into the housing 232 to rotate the outer hub 2312, and can observe the specific configuration of the suture 32 wound around the outer hub 2312 through the window 2320 to select the suture 32.

Optionally, the inner wall of the outer hub 2312 and the outer wall of the inner hub 2313 are provided with matching ratchets 2314, and the ratchets 2314 are used for limiting the outer hub 2312 to have only one-way rotation freedom relative to the inner hub 2313. In the example shown in fig. 23, the ratchet 2314 is configured to restrict the rotation of the outer hub 2312 relative to the inner hub 2313 in only a clockwise direction in the drawing, but not a counterclockwise direction. So configured, the operator can dial the outer hub 2312 to rotate clockwise to select a different suture 32.

Further, the suture 32 is coiled around the outer hub 2312 in a direction opposite to the unidirectional rotation of the outer hub 2312 relative to the inner hub 2313. For example, in the example shown in fig. 23, the outer hub 2312 is rotated in a clockwise direction relative to the inner hub 2313, and the suture 32 is wound around the outer hub 2312 in a counterclockwise direction, such that the suture 32 is not pulled distally to synchronously rotate the outer hub 2312 relative to the inner hub 2313. It is to be understood that the arrangement direction of the ratchet 2314 is only an example and is not limited to the arrangement direction of the ratchet 2314, and those skilled in the art can reverse the arrangement of the ratchet 2314 as needed to reverse the unidirectional rotation direction of the outer hub 2312 relative to the inner hub 2313, and the description thereof will not be provided herein.

In some embodiments, the inner hub 2313 may be fixedly disposed on the housing 232. The inner hub 2313 is fixedly secured to the housing 232 to provide an alternative to the suture 32, but does not indicate whether the suture 32 was successfully grasped by the hook 131.

Preferably, in other embodiments, the inner hub 2313 is rotatably disposed about its axis within the housing 232. Further, the conveyor 2 comprises an indicating part 26, the outer hub 2312 is driven by the suture 32 to rotate, the inner hub 2313 is driven to rotate in the same direction, and one end of the indicating part 26 connected with the inner hub 2313 is driven to displace relative to the shell 232, so that indication is formed.

Optionally, the indicating portion 26 includes a torsion spring 261 and an indicating mark 262, a first end 2611 of the torsion spring 261 is connected with the housing 232, and a second end 2612 of the torsion spring 261 is connected with the inner hub 2313; the indicator 262 and the torsion spring 261 are coupled to the end (i.e., the second end 2612) of the inner hub 2313 coupled thereto; the housing 232 has a viewing area 236 for viewing the indicator 262.

Further, the housing 232 has a rotation limiting portion 2371, the inner hub 2313 has a shift lever 2311, and the inner hub 2313 is connected with the second end 2612 of the torsion spring 261 in an abutting mode through the shift lever 2311; the inner hub 2313 rotates about its axis in a first direction, pushing the second end 2612 of the torsion spring 261 to displace relative to the housing 232; the rotation limiting portion 2371 is configured to abut against the shift lever 2311 or the torsion spring 261 to limit the rotation of the inner hub 2313 in the first direction after rotating in the first direction by a predetermined angle. Here, the arrangement of the torsion spring 261, the shift lever 2311, the rotation limiting portion 2371 and the indication mark 262 is similar to that of the embodiment, and thus, the description thereof is omitted.

As configured above, in use, an operator can select a desired suture 32 by dialing the outer hub 2312 clockwise. At this time, the inner hub 2313 is not rotated due to the presence of the ratchet teeth 2314 between the outer hub 2312 and the inner hub 2313, and the inner hub 2313 is restrained by the housing 232. Further, when the coil 31 of the suture 32 is hooked by the hook 131, the suture 32 will drive the outer hub 2312 to rotate counterclockwise due to the opposite winding direction to the one-way rotation direction of the outer hub 2312, at this time, the outer hub 2312 drives the inner hub 2313 to rotate counterclockwise together through the ratchet 2314, and the shift lever 2311 provided on the inner hub 2313 drives the second end 2612 of the torsion spring 261 to move, so that the indication mark 262 moves to indicate. In an alternative embodiment, the observation area 236 is open on the circumference of the cylindrical housing 232, and the indicator 262 may include, for example, a red section and a green section disposed circumferentially around the housing 232, wherein in an initial state, the red section of the indicator 262 is aligned with the observation area 236, and when the suture 32 is successfully drawn, the green section of the indicator 262 is brought into alignment with the observation area 236, indicating that the thread drawing is successful. Further, after one suture 32 is completely withdrawn, the indicator 262 can be reset to the initial state by the elastic force of the torsion spring 261, so that the red section is aligned with the viewing area 236 for the next indication.

It is understood that the conveyor 2 in this embodiment may push the selected suture 32 in a manner similar to the fourth embodiment using the sleeve 27 and the push rod 28, or may configure the suture cavity 210 to be open in the radial direction of the conveying rod 21, that is, the conveying rod 21 is not tubular, but has a groove shape, so as to facilitate the placement of the selected suture 32 into the suture cavity 210.

Based on the conveyor 2, the present embodiment provides a thread passing device, which includes the conveyor 2 as described above and at least two stitches 32; at least two sutures 32 are respectively coiled on the outer hub 2312 of the conveyor 2. Further, the tunnel type threading system provided by the embodiment includes: the thread guide and the locator 1 are described above.

step SC: a certain suture preset hole 238 of the suture containing part 23 is selected to be aligned with the suture cavity 210, and the suture 32 which is penetrated in the suture preset hole 238 aligned with the suture cavity 210 is wound into a coil 31 to be contained on the delivery head 22.

[ EXAMPLE six ]

The positioner, the conveyor, the tunnel type threading system and the operation method thereof in the sixth embodiment of the invention are basically the same as those in the first embodiment, and the same parts are not described again, and only different points are described below.

Please refer to fig. 24 to 30, wherein fig. 24 is a schematic view of a two-leaf hook according to a sixth embodiment of the present invention; FIG. 25 is a schematic view of a two-leaf hook and suture anchor connection according to a sixth embodiment of the present invention; FIG. 26 is a schematic view of the attachment of two barbs to a titanium plate with a tab according to a sixth embodiment of the present invention; FIG. 27 is a schematic representation of a two-leaf hook suture of example six of the present invention; FIG. 28 is a schematic view of a flat screw hook according to a sixth embodiment of the present invention; FIG. 29 is a schematic view of a flat hook and interface screw connection according to a sixth embodiment of the present invention; fig. 30 is a schematic view of a hook according to the sixth embodiment of the present invention.

In the sixth embodiment, the specific structure of the positioner 1 is different from the first embodiment. Specifically, the positioner 1 includes: a transverse positioning rod 11, a longitudinal positioning rod 12, a guide wire 13, a hook 131, and a driving unit 14; the hook 131 is detachably connected to the distal end of the guide wire 13. The structure and the arrangement principle of the transverse positioning rod 11, the longitudinal positioning rod 12 and the driving part 14 are similar to those of the first embodiment, and are not described in detail here. The guide wire 13 of the sixth embodiment is different from the first embodiment in that the distal end thereof does not have the integrally formed hook portion 131, and the hook portion 131 is independently disposed and detachable with respect to the guide wire 13.

So configured, the corresponding adapted hook 131 can be quickly removed and replaced for different implants or different types of sutures 32, facilitating intraoperative applications.

As shown in fig. 24, in an exemplary embodiment, the hook 131 includes two lobes 133, the two lobes 133 have two proximally extending extensions 1331, and the extensions 1331 gradually expand outward toward the proximal end; the extension 1331 is used to hook the suture 32 or pull wire of the implant. Preferably, the two extensions 1331 extend in a spiral shape to reduce the friction between the extensions 1331 and the bone tunnel.

Referring to fig. 25, an example of a suture anchor 34 as an implant is shown, showing an example of using two leaves 133 to hook the suture anchor 34. The suture anchor 34 is a conventional orthopedic implant that can be fed into the transverse tunnel 42 via the delivery head 22 of the transporter 2, and the two hooks 133 of the hook 131 pass through the two extensions 1331, so as to be able to hook the pull wire 341 of the suture anchor 34.

Referring to fig. 26, an example of a titanium strap plate 35 used as an implant is shown for hooking a threaded anchor 34 with two barbs 133. The tab titanium plate 35 has a titanium plate body 351 and a plurality of pulling wires 352 threaded through the titanium plate body, and the tab titanium plate 35 can be fed into the transverse tunnel 42 via the feed head 22 of the conveyor 2, such as a fork-shaped card shown in fig. 11, which can grip the titanium plate body 351 of the tab titanium plate 35, thereby feeding the tab titanium plate 35 into the transverse tunnel 42 and bringing the tab titanium plate 35 to the intersection of the transverse tunnel 42 and the longitudinal tunnel 41. Furthermore, the two extending portions 1331 of the two hooks 133 can hook the pull wire 352 of the titanium plate with loop 35.

Referring to fig. 27, it is understood that the two-leaf hook 133 may also directly hook the loop 31 formed by the suture 32.

With continued reference to fig. 24 and 25, the two leaflets 133 preferably also have distally extending adaptations 1332, such adaptations 1332 being for adapting attachment to an implant. Preferably, the fitting portion 1332 has a blunt taper that tapers distally. Referring to fig. 26, generally, the proximal end of the implant, such as the suture anchor 34 or the interface screw, often has a recessed structure for manipulation of the attachment member, such as a recessed hexagon socket, and the blunt tapered adapter portion 1332 may be inserted into the recessed structure of the implant to form a mating attachment with the implant. By blunt tapered is meant that the tip portion of the taper is at an obtuse angle to reduce accidental scoring of the bone tunnel.

Referring to fig. 28, in an exemplary embodiment, the hook 131 includes a flat spiral hook 134, the flat spiral hook 134 is spirally wound, and the winding direction is perpendicular to the axial direction of the hook 131; the flat hook 134 is used to hook the suture 32 or pull line of the implant. The winding direction of the flat spiral hook 134 is perpendicular to the axial direction of the hook 131, so that the flat spiral hook has an expanded end relative to the hook 131, thereby facilitating the hooking of various types of sutures or traction wires of implants. Preferably, the entire hook 131 is integrally formed to improve robustness.

Further, the guide wire 13 is rotatable about its own axis relative to the longitudinal channel 120. Thereby, the hook 131 can be brought to rotate relative to the longitudinal tunnel 41. Referring to fig. 29, the flat screw 134 may also be rotated to drill into some flexible implants, such as the absorbable interface screw 36. In some cases, penetration into an absorbable interface screw 36 or like implant may be accomplished by rotating the guidewire 13, causing rotation of a flat screw 134 attached to its distal end. Of course, the guide wire 13 may also be rotated to drive the two leaf hooks 133 to rotate, so as to improve the success rate of hooking the thread.

Referring to fig. 30, in another example, the hook portion 131 includes a hook 135, the hook 135 is spirally wound, and the winding direction is parallel to the axial direction of the hook portion 131; the loop 135 is used to hook the suture 32 or pull wire of the implant. The winding direction of the ring hook 135 is parallel to the axial direction of the hook part 131, so the radial outer dimension of the ring hook can be slightly smaller than that of the flat spiral hook 134, which is beneficial to operation in a narrow tunnel. The success rate of the thread hooking is high. Preferably, the entire hook 131 is integrally formed to improve robustness.

Preferably, the hook 131 is connected to the guide wire 13 by a screw thread. Optionally, the proximal end of the hook 131 is provided with a threaded connection portion 1333, and the hook 131 can be conveniently and quickly assembled or disassembled with the corresponding portion of the guide wire 13 through the threaded connection portion 1333, in practice, different hook 131 can be quickly replaced as required to adapt to different implants or sutures 32.

It should be noted that the above examples of the plurality of hook portions 131 are only exemplary of the hook portions 131 and not limiting the structure of the hook portions 131, and the hook portions 131 may also include other components, and those skilled in the art may reasonably modify the hook portions 131 according to actual conditions. Similarly, the positioner 1 provided in this embodiment may be used with the conveyor 2 provided in the above embodiments to form a tunnel threading system, and a description of this embodiment is not repeated here.

It should be noted that, several of the above embodiments may be combined with each other. The above description is only for the purpose of describing the preferred embodiments of the present invention, and is not intended to limit the scope of the present invention, and any variations and modifications made by those skilled in the art based on the above disclosure are within the scope of the appended claims.

Claims

1. A conveyor apparatus for use with a positioner of a tunnel threading system, comprising: the conveying device comprises a conveying rod, a conveying head and at least two wire hubs;

each of the hubs is for winding one suture;

2. Conveyor according to claim 1, characterized in that at least two of said hubs are juxtaposed in an axial direction.

3. A conveyor according to claim 2, characterized in that said conveyor comprises a suture partition provided between two axially adjacent hubs for blocking sutures on different hubs.

4. A conveyor according to claim 3 wherein said suture interruptions have first thread holes for passing sutures therethrough to interconnect sutures on axially adjacent hubs.

5. The conveyor of claim 1, wherein at least two of said wire hubs are nested one inside the other about an axis.

6. A conveyor according to claim 5, characterized in that the outer hubs have second thread holes for the passage of stitches for interconnecting the stitches on the adjacent hubs.

7. The conveyor according to claim 1, further comprising a limiting portion fixedly connected to said conveying rod; the limiting part is used for abutting against a part corresponding to the positioner so as to limit the displacement of the conveying rod relative to the positioner towards the far end.

8. The conveyor of claim 1, including a housing fixedly attached to the proximal end of the conveyor rod, the housing having an interior cavity in communication with the suture lumen, the hub rotatably disposed within the housing.

9. The conveyor of claim 8 including an indicator portion, said hub being driven by the suture to rotate and displace an end of said indicator portion connected to said hub relative to said housing to provide the indication.

10. The conveyor of claim 9, wherein the indicator portion comprises a torsion spring and an indicator mark, one end of the torsion spring being connected to the hub and the other end being connected to the housing; the indicating mark and the torsion spring are connected with one end of the wire hub; the housing has a viewing area for viewing the indicator.

11. A conveyor according to claim 9, wherein said housing has a rotation-limiting portion, said hub having a deflector rod, said hub being abuttingly connected to one end of said torsion spring by said deflector rod; the wire hub rotates around the axis of the wire hub along a first direction to push one end of the torsion spring to generate displacement relative to the shell; the rotation limiting portion is used for abutting against the shifting lever or the torsion spring so as to limit the wire hub to continue to rotate along the first direction after rotating for a preset angle along the first direction.

12. A conveyor according to claim 1, characterized in that said conveying head has a first slot for seizing said coil and a second slot for the passage of the connection portion of said locator.

13. A wire passing device, comprising: a conveyor according to any one of claims 1 to 12 and at least two stitches;

14. The thread passing device of claim 13, further comprising a suture connecting section connected between adjacent ones of the sutures; the tensile strength of the suture connecting section is lower than that of the suture.

15. A tunneling threading system, comprising: the thread passing device and the positioning device according to claim 13 or 14;

16. A method of operating a tunneling threading system, using the tunneling threading system of claim 15, the method comprising:

opening a second tunnel on a preset object;

pulling the positioner proximally, pulling the coil out of the second tunnel;

17. The method of operating a tunneling threading system according to claim 15, wherein after pulling the loop of the previous suture out of the second tunnel, the method of operating a tunneling threading system further comprises: