CN113729817A

CN113729817A - Endoscope knot-pushing thread-cutting device

Info

Publication number: CN113729817A
Application number: CN202111127096.4A
Authority: CN
Inventors: 时强; 周平红; 林新林; 姚礼庆
Original assignee: Zhongshan Hospital Fudan University
Current assignee: Zhongshan Hospital Fudan University
Priority date: 2021-09-26
Filing date: 2021-09-26
Publication date: 2021-12-03

Abstract

The invention discloses an endoscope knot pushing and thread cutting device which comprises an operation part, a propelling part and a front end part which are sequentially connected; the operating part comprises a push-pull rod and an operating part base, and the push-pull rod is arranged on the operating part base and can slide on the operating part base; the propelling part comprises a guide pipe and a traction steel wire, and the traction steel wire is arranged in the guide pipe; the front end part comprises a front end part base, a threading hole and a blade, the middle position of the blade is connected with the front end part base, so that the blade can rotate around the middle position of the blade, and the threading hole is formed in the front end part base; the push-pull rod is connected with one end of the traction steel wire, one end of the guide pipe is connected with the far end of the operation part base, the other end of the guide pipe is connected with the front end part base, and the other end of the traction steel wire is connected with the other end of the blade. The device is simple to operate and easy to master, and can realize the tightening and closing of the suture line; the step of exchanging the thread cutter by the advanced knot pusher is eliminated, so that the operation time is shortened.

Description

Endoscope knot-pushing thread-cutting device

Technical Field

The invention relates to an endoscope knot pushing and thread cutting device, and belongs to the technical field of medical products.

Background

As shown in fig. 1, the current knot pusher is mainly divided into three parts: a knot pusher holding part a, a knot pusher pushing part b and a knot pusher front end part c; closing an internal wound of a body by using a suture in minimally invasive surgery, wherein one end of the suture remained at two ends outside the body penetrates through a thread hole at the front end part c of a knot pusher, and after the other end of the suture and one end of the thread hole penetrating through the front end part c of the knot pusher are wound and knotted between the knot pusher and a human body, an operation assistant fixes the two ends of the suture; the operator holds the holding part a of the knot pusher to push the knot pusher towards the direction of the human body; the knot pusher propelling part b transmits a pushing force and the front end part c of the knot pusher together with the knotted knots to push the human body to the wound, and the two ends of the suture line are pulled to tighten the knotted knots; the knotting, knot pushing and tightening actions are repeated for a plurality of times, so that the suture is tightened and fixed to achieve the effect of tightening the wound.

The knot pusher has no thread cutting function, and thread cutting needs to use endoscopic surgical scissors, as shown in fig. 2, the endoscopic surgical scissors are mainly divided into three parts: a scissors operating part d, a scissors pushing part e and a scissors blade f. In the minimally invasive surgery, a suture is used for closing an internal wound, after the suture is closed and tied and fixed, an operator holds the scissors operating part d to advance into a human body, the scissors advancing part e transmits a pushing force and the scissors blades f to enter the body and reach a suture part needing to be cut, the operator operates the scissors operating part d to open the two blades of the scissors blades f, the suture part needing to be cut is placed between the two blades of the scissors blades f, and the operator operates the scissors operating part d to close the two blades of the scissors blades f and simultaneously cut the suture part needing to be cut.

The knot pusher and the scissors complete the functions of knotting and trimming by using suture lines to close wounds. Most of the knot pushing device and the scissors used in the minimally invasive surgery are made of metal materials, so that the instrument can be pushed in a straight direction during the operation, and in addition, the knot pushing device and the scissors can be reused after being sterilized.

With the development of the digestive endoscopy treatment technology, the digestive endoscopy treatment operation application is developed from the surface of the digestive tract inner cavity to the wall of the digestive tract tube, even breaks through the wall of the digestive tract tube to the body cavity, thereby promoting the development of treatment instruments and the practical exploration of more operation methods; the key of the digestive endoscope treatment breakthrough is the wound closing treatment for breaking through the wall of the digestive tract tube.

The digestive tract of the human body is distributed in a tortuous manner in the body cavity, the digestive endoscope can conform to the bending state of the digestive tract when entering the digestive tract of the human body, and the knot pusher and the scissors in the minimally invasive surgery can not be used under the condition, so that instruments which are compatible with the digestive endoscope and have the knot pushing function and the thread cutting function need to be developed.

Disclosure of Invention

The technical problem to be solved by the invention is as follows: how to tie and cut off suture lines in the closing operation of the digestive tract wound surface of a human body.

In order to solve the technical problem, the technical scheme of the invention is to provide an endoscope knot pushing and thread cutting device which is characterized by comprising an operation part, a propelling part and a front end part which are sequentially connected;

the operating part comprises a push-pull rod and an operating part base, and the push-pull rod is arranged on the operating part base and can slide on the operating part base;

the propelling part comprises a guide pipe and a traction steel wire, and the traction steel wire is arranged in the guide pipe;

the front end part comprises a front end part base, a threading hole and a blade, the middle position of the blade is connected with the front end part base, so that the blade can rotate around the middle position of the blade, the threading hole is arranged on the front end part base, and the motion track of one end of the blade is crossed with a suture line in the threading hole;

the push-pull rod is connected with one end of the traction steel wire, one end of the guide pipe is connected with the far end of the operation part base, the other end of the guide pipe is connected with the front end part base, and the other end of the traction steel wire is connected with the other end of the blade;

threading holes are formed in the front side and the rear side of the blade on the front end base; a threading hole on the front end base is arranged at the far end of the front end base.

Preferably, the push-pull rod is sleeved on the operation part base, an axis is arranged between two ends of the push-pull rod, and the axis penetrates through the operation part base; the axle center is connected with one end of the traction steel wire.

Preferably, the push-pull rod is provided with a fixing structure for supporting the push-pull rod and the operating part base to be relatively fixed.

Preferably, the operating part base is provided with an inner cavity, the shaft center is arranged in the inner cavity of the operating part base, and one end of the traction steel wire enters the inner cavity of the operating part base from the far end of the operating part base and is connected with the shaft center.

Preferably, the front end part further comprises a cutting groove and a rivet, the middle position of the blade is connected with the front end part base through the rivet, and the cutting groove is formed in the front end part base and located on the motion track of one end of the blade; when the push-pull rod moves towards the proximal direction of the base of the operating part, the blade rotates around the middle position of the blade until one end of the blade is arranged in the cutting groove.

Preferably, there is a height difference between the slot face and the slot base of the slot.

Preferably, one end of the blade is arranged in the front end base, and the other end of the blade penetrates through the outer wall of the front end base and is arranged outside the front end base.

Preferably, the operating part further comprises a fixing ring, and the fixing ring is fixed at the near end of the operating part base; two ends of the push-pull rod are provided with annular structures for fingers to pass through.

Preferably, the material of the propelling part is flexible material which ensures that the endoscope knot-pushing thread-cutting device can pass through the instrument channel of the digestive endoscope.

The endoscope knot pushing and thread cutting device provides instrument selection for assisting suture line knotting and integrating multiple functions of quantification and thread cutting for wound closure treatment of the wall of the digestive tract.

Compared with the prior art, the invention has the following advantages:

a. can realize the tightening and closing of the suture

The use of sutures to close wounds in minimally invasive surgery is an efficient and reliable way of closing wounds, and the device of the invention may facilitate the use of sutures to close wounds in a digestive endoscope.

b. Simple operation and easy mastering

The mode of knotting the suture line is generally mastered in minimally invasive surgery and other surgery, and the use mode of the invention is the same as that of a knot used in surgery, so the invention can be mastered easily after learning.

c. Simplifying the operation steps

The invention realizes the knot pushing and thread trimming functions on one device, only needs to be arranged in the digestive endoscope for one time, and avoids the step of exchanging thread trimmers by an advanced knot pusher, thereby shortening the operation time. The suture line is cut quantitatively, and the residual suture line is ensured to meet the length requirement of the standard.

Drawings

FIG. 1 is a schematic view of a knot pusher used in minimally invasive surgery;

FIG. 2 is a schematic view of endoscopic surgical scissors;

FIG. 3 is a schematic view of an endoscopic knot pushing and thread trimming device;

FIG. 4 is an enlarged partial schematic view of FIG. 3;

FIG. 5 is a cross-sectional view of an endoscopic knot and thread trimming device;

FIG. 6 is a cross-sectional view A-A of FIG. 5;

fig. 7 is a schematic working diagram of an endoscope knot-pushing thread-cutting device.

Detailed Description

In order to make the invention more comprehensible, preferred embodiments are described in detail below with reference to the accompanying drawings.

The invention provides an endoscope knot pushing and thread cutting device, which is used for knotting and cutting off suture threads in the closing operation of a digestive tract wound surface under a digestive endoscope, and is mainly divided into 3 parts as shown in figures 3-6: an operation unit 101, a pusher 102, and a tip 103. The operation unit 101 mainly includes the following components: a fixed ring 101a, a push-pull rod 101b, and an operation portion base 101 c; the axis between the two ends of the push-pull rod 101b passes through the operating part base 101c and supports the relative fixation of the push-pull rod 101b and the operating part base 101 c; the push-pull rod 101b is provided on the operation portion base 101c and is slidable on the operation portion base 101 c; the propelling part 102 mainly comprises the following parts: a guide tube 102a, a pull wire 102 b; the traction wire 102b is arranged in the guide tube 102 a; the front end 103 is mainly composed of: a front end base 103a, a threading hole 103b, a blade 103c, a cutting groove 103d, and a rivet 103 e; the middle position of the blade 103c is arranged in the cavity of the front end base 103a through a rivet 103e in a perforation way, so that the blade 103c can rotate around the middle position of the blade 103 c; the operation part base 101c is connected with one end of the conduit 102a in a sticking way; the front end base 103a is adhered to one end of the guide tube 102 a; the push-pull rod 101b is sleeved on the operating part base 101c, an axis is arranged between two ends of the push-pull rod 101b, and the axis penetrates through the operating part base 101 c; the axle center is connected with one end of the traction steel wire 102b in a buckling way; the handle end of the blade 103c is connected with one end of the traction steel wire 102b in a buckling way; the traction wire 102b passes through the lumen of the catheter 102a, the lumen of the operation portion base 101c, and the lumen of the distal end portion base 103 a. The threading hole 103b is provided in the distal end base 103a, and the movement locus of one end of the blade 103c intersects with the suture thread in the threading hole 103 b. The push-pull rod 101b is provided with a fixing structure for fixing the push-pull rod 101b and the operation portion base 101c relative to each other.

The operation portion base 101c has an inner cavity therein, the shaft center is provided in the inner cavity of the operation portion base 101c, and one end of the traction wire 102b enters the inner cavity of the operation portion base 101c from the distal end of the operation portion base 101c and is connected to the shaft center. Threading holes 103b are provided in the front and rear sides of the blade 103c in the front end base 103 a. A threading hole 103b in the front end base 103a is provided at the distal end of the front end base 103 a. The cutting groove 103d is arranged on the front end base 103a and is positioned on the motion track of one end of the blade 103 c; when the push-pull rod 101b is moved toward the proximal end of the operating portion base 101c, the blade 103c rotates about its neutral position until one end of the blade 103c is disposed in the slot 103 d. There is a difference in height between the slit surface and the slit bottom of the slit 103 d. One end of the blade 103c is disposed inside the tip end base 103a, and the other end of the blade 103c passes through the outer wall of the tip end base 103a and is disposed outside the tip end base 103 a. A fixing ring 101a fixed to the proximal end of the operation portion base 101 c; both ends of the push-pull rod 101b are provided with ring structures for fingers to pass through.

The digestive endoscope enters the human body through a digestive natural cavity, the digestive tract bends and roundly bypasses in the human body trunk and penetrates through the whole human body trunk, so that the inserting part of the digestive endoscope inserted into the human body is of a soft structure, the endoscope has certain flexibility and malleability so as to be attached to conform to the bending trend of the digestive tract of the human body, and the digestive endoscope can be driven to move forwards and backwards in the digestive tract; the diagnosis and treatment instrument matched with the digestive endoscope is put into the body from the instrument channel on the digestive endoscope, and similarly, the part of the digestive endoscope diagnosis and treatment instrument put into the digestive endoscope needs to be of a soft structure, so that the moving flexibility and the moving flexibility are kept. Therefore, the pushing part 102 of the present invention is made of flexible material to ensure the passability of the instrument channel of the present invention inserted into the digestive endoscope.

The front half part of the front end part 103 is provided with a threading hole 103b, one end of a suture line is allowed to pass through the threading hole 103b, and an operator can push the suture line into the human body under the guidance of the suture line and keep the knot of the suture line at the top position of the front end part 103 to finally reach an internal wound;

the rear portion of the front end portion 103 is provided with a threading hole 103b, a blade 103c and a slit 103 d. Both ends of the suture thread are passed through the threading holes 103b of the rear half of the front end portion 103 to fix the movable range of the suture thread held by the blade 103c (between the blade 103c and the slit 103 d); the length of the front half part of the front end part 103 can be used as a fixed quantity to ensure that the cut residual suture line meets the length requirement of the standard; the front end portion 103 is provided with a notch 103d, and a height difference exists between a notch surface and a notch bottom, which provides a space and a fulcrum required for cutting when cutting the suture thread; the blade 103c is perpendicular to the suture line, has a long blade edge, and has a wide cutting range for cutting the suture line.

As shown in fig. 7, the process of using the present invention is as follows:

an operator holds the operating part 101 of the present invention with one hand, places the thumb in the fixing ring 101a, places the index finger and the middle finger in the rings at both ends of the push-pull rod 101B, and pushes or pulls the push-pull rod 101B upward to control the opening and closing of the blade 103c at the front end part 103 (the arrow at the position B in the figure is the moving direction of the push-pull rod 101B);

closing an internal wound of a human body by using a suture in a digestive endoscope, wherein one end of the suture remained at two ends outside the human body passes through a threading hole 103b at the front half part of the front end part 103 of the invention, the other end of the suture and one end which passes through the threading hole 103b are wound and knotted between the front end part 103 of the invention and the human body, and an assistant fixes the two ends of the suture; the operator holds the operation part 101 of the present invention and advances it toward the human body; the pushing part 102 of the invention transmits pushing force and the front end part 103 together with the tied knot are pushed to the wound in the body, and an operator pulls the two ends of the suture line to tighten the tied knot; the knotting, knot pushing and tightening actions are repeated for a plurality of times, so that the suture line is tightened and fixed to achieve the effect of tightening the wound.

Both ends of the suture thread are passed through the thread passing hole 103b of the rear half portion of the front end portion 103 of the present invention to fix the both end threads of the suture thread and to keep the movable range of the blade 103C of the present invention (between the blade 103C and the slit 103d), and the operator operates the push-pull rod 101b of the operation portion 101 of the present invention to pull the push-pull rod 101b of the present invention in the direction of the fixing ring 101a of the present invention to pull the blade 103C of the present invention to rotate in the direction of the slit groove 103d of the present invention, and the edge portion of the blade 103C of the present invention is pressed against the fixed suture thread to cut the suture thread (the arrow at the position C in the figure is the movable direction of the blade 103C).

Claims

1. An endoscope knot pushing and thread cutting device is characterized by comprising an operation part (101), a propelling part (102) and a front end part (103) which are connected in sequence;

the operating part (101) comprises a push-pull rod (101b) and an operating part base (101c), and the push-pull rod (101b) is arranged on the operating part base (101c) and can slide on the operating part base (101 c);

the propelling part (102) comprises a guide pipe (102a) and a traction steel wire (102b), wherein the traction steel wire (102b) is arranged in the guide pipe (102 a);

the front end part (103) comprises a front end part base (103a), a threading hole (103b) and a blade (103c), the middle position of the blade (103c) is connected with the front end part base (103a), so that the blade (103c) can rotate around the middle position of the blade (103c), the threading hole (103b) is arranged on the front end part base (103a), and the movement track of one end of the blade (103c) is crossed with a suture line in the threading hole (103 b);

the push-pull rod (101b) is connected with one end of a traction steel wire (102b), one end of a guide pipe (102a) is connected with the far end of an operation part base (101c), the other end of the guide pipe (102a) is connected with a front end part base (103a), and the other end of the traction steel wire (102b) is connected with the other end of a blade (103 c);

threading holes (103b) are formed in the front end part base (103a) and positioned on the front side and the rear side of the blade (103 c); a threading hole (103b) in the front end base (103a) is provided at the distal end of the front end base (103 a).

2. The endoscope knot-pushing and thread-cutting device as claimed in claim 1, wherein the push-pull rod (101b) is sleeved on the operation part base (101c), an axis is arranged between two ends of the push-pull rod (101b), and the axis passes through the operation part base (101 c); the axial center is connected with one end of a traction steel wire (102 b).

3. An endoscope knot-pushing thread-cutting device according to claim 1 or 2, characterized in that the push-pull rod (101b) is provided with a fixing structure for supporting the push-pull rod (101b) and the operation part base (101c) to be fixed relatively.

4. An endoscope knot-pushing thread-cutting device according to claim 1 or 2, characterized in that the operating part base (101c) is provided with an inner cavity, the axial center is arranged in the inner cavity of the operating part base (101c), and one end of the traction wire (102b) enters the inner cavity of the operating part base (101c) from the far end of the operating part base (101c) and is connected with the axial center.

5. An endoscope knot-pushing thread trimming device according to claim 1, wherein the front end portion (103) further comprises a cutting groove (103d) and a rivet (103e), the middle position of the blade (103c) is connected with the front end portion base (103a) through the rivet (103e), the cutting groove (103d) is arranged on the front end portion base (103a) and is positioned on the motion track of one end of the blade (103 c); when the push-pull rod (101b) moves towards the proximal direction of the operating portion base (101c), the blade (103c) rotates around its own middle position until one end of the blade (103c) is disposed in the slot (103 d).

6. An endoscope knot-pushing thread-cutting device according to claim 5, characterized in that there is a height difference between the cutting surface and the cutting bottom of the cutting groove (103 d).

7. An endoscope knot-pushing thread-cutting device according to claim 1, characterized in that one end of the blade (103c) is arranged in the front end base (103a), and the other end of the blade (103c) passes through the outer wall of the front end base (103a) and is arranged outside the front end base (103 a).

8. An endoscope knot-pushing thread-cutting device according to claim 1, characterized in that the operating part (101) further comprises a fixing ring (101a), the fixing ring (101a) is fixed at the proximal end of the operating part base (101 c); two ends of the push-pull rod (101b) are provided with annular structures for fingers to pass through.