CN113907817A - Puncture stitching instrument capable of pre-arranging suture - Google Patents
Puncture stitching instrument capable of pre-arranging suture Download PDFInfo
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- CN113907817A CN113907817A CN202111344053.1A CN202111344053A CN113907817A CN 113907817 A CN113907817 A CN 113907817A CN 202111344053 A CN202111344053 A CN 202111344053A CN 113907817 A CN113907817 A CN 113907817A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0491—Sewing machines for surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0493—Protective devices for suturing, i.e. for protecting the patient's organs or the operator
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3468—Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Abstract
The invention relates to a puncture stitching instrument capable of pre-arranging a suture, and relates to the technical field of medical instruments. The puncture stitching instrument capable of pre-arranging the suture comprises a puncture cannula device and a puncture device; the puncture cannula device comprises a shell cover, a connecting base, a cannula upper shell, a cannula lower shell, a sealing pad upper pressing sheet, a sealing pad lower pressing sheet, a rubber ring, a choke valve, a cannula, an air injection valve and a buckle; the puncture device comprises a handle, a puncture shell cover, a separation blade, a side wing locking block, a spring, a stop block, a puncture tube, a push-pull rod, a guide connecting block, a side wing, a puncture cone, a push-wire rod, a long pressure spring, a retainer ring, a fixed shaft, a puncture shell and a connecting pin; the puncture suturing device can realize puncture of abdominal cavity under an endoscope, meanwhile, a channel is established for laparoscopic surgery, a mode of pre-knotting suture lines is provided, and the suture lines on two sides of an incision can be pulled out of a sleeve to be pre-knotted without influencing operation in the operation.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a puncture stitching instrument capable of pre-arranging a suture.
Background
The laparoscopic surgery has the advantages of small wound, small physiological interference to patients, good beautifying effect, light pain, quick recovery and the like, gradually replaces the traditional surgery, and is widely applied to general surgery, gynecology and cardiothoracic surgery. The celioscope operation needs to open a hole on the abdomen of a patient, the operation is carried out under the view of the celioscope, fascia suture is needed after the operation, and the fascia suture is difficult to suture due to the characteristics of small incision, deep inner wall and the like. The existing solution is manual suture and fascia suture device suture, the manual suture is suitable for a patient with a thin body, and for an obese patient, abdominal wall tissues are thick and cannot meet the requirement of accurate and effective suture of a puncture incision, so that a series of complications such as bleeding, infection, puncture hernia, injury and the like are caused. The fascia stitching instrument can stitch fascia of an obese patient, but the puncture instrument needs to be pulled out first and then the fascia stitching instrument is operated, so that the operation is complex, the operation time is long, and the risk of infection of the patient is increased.
In order to solve the above technical problems, CN 108158635 a discloses a laparoscopic puncture suture instrument, which arranges sutures on both sides of an incision in advance, and after the operation is finished, tightens and ties the sutures to complete the suture. However, in view of the apparatus, the tapered portion of the laparoscopic puncture suture instrument is divided into two parts, which are easily displaced during puncture to affect the puncture performance, and the both sides of the puncture cannula are grooved to damage tissues during puncture.
Disclosure of Invention
To solve the above technical problems in the prior art, it is an object of the present invention to provide a puncture suturing device in which a suture can be previously arranged.
The puncture stitching instrument capable of pre-arranging the suture comprises a puncture cannula device and a puncture device matched with the puncture cannula device; the method is characterized in that:
the puncture cannula device comprises a shell cover, a connecting base, a cannula upper shell, a cannula lower shell, a sealing gasket upper pressing sheet, a sealing gasket lower pressing sheet, a rubber ring, a choke valve, a cannula, an air injection valve and a buckle; the upper end of the sleeve is arranged at the lower end in the sleeve lower shell, the lower end pipe body of the sleeve extends out of the lower end of the sleeve lower shell, the choke valve is connected with the upper end of the sleeve, and the sleeve lower shell is fixedly clamped with the sleeve upper shell through the buckle; the gas injection valve penetrates through the lower casing of the casing and is connected with the inside of the upper end of the casing, the gas injection valve is provided with a gas injection valve switch, the connecting base is arranged on the upper casing of the casing, the connecting base is connected with the casing cover, and the upper pressing piece of the sealing gasket, the rubber ring and the lower pressing piece of the sealing gasket are sequentially arranged in an inner space defined by the casing cover and the connecting base from top to bottom;
the puncture device comprises a handle, a puncture outer shell cover, a separation blade, a side wing locking block, a spring, a stop block, a puncture pipe, a push-pull rod, a guide connecting block, a side wing, a puncture cone, a push-wire rod, a long pressure spring, a retaining ring, a fixed shaft, a puncture outer shell and a connecting pin, wherein the puncture pipe is arranged at the lower end of the puncture outer shell and is fixed through the retaining ring, the side wing locking block is arranged in the puncture outer shell, the push-wire rod is arranged in the puncture pipe, and the push-pull rod is arranged in the push-wire rod.
The two side wings are arranged, the upper ends of the side wings are fixed on the upper part of the puncture cone through pin shafts, and the two sides of the puncture cone are provided with notch parts for accommodating the side wings; the guide connecting block is arranged at the lower end of the puncture tube, the upper part of the puncture cone is matched with the guide connecting block, and the puncture cone and the guide connecting block are fixedly connected with the lower end of the puncture tube by the connecting pin.
The side wing comprises a side wing transmission part and a silica gel block, an arc chute is arranged on the side wing transmission part, and the side wing transmission part is installed with the puncture cone through a groove shaft arranged on the arc chute; the push-pull rod, the side wings and the puncture cone form a push-pull unfolding mechanism, the guide connecting blocks comprise first connecting blocks and second connecting blocks, the first connecting blocks and the second connecting blocks are buckled with the clamping blocks through Z-shaped clamping grooves, guide oblique blocks are formed at the upper ends of the first connecting blocks and the second connecting blocks, the guide oblique blocks enable the crossed push pin structures of the push-wire rod to be located in the puncture tube in an initial state, the crossed push pin structures are opened at an angle when pushed forwards and are inserted into the silica gel blocks of the side wings, and fascia puncture positions of the crossed push pin structures are located on two sides of a wound.
The push-pull rod comprises a push-pull rod body, a push-pull rod connecting end is arranged at the upper end of the push-pull rod body, a first shaft hole and a second shaft hole are sequentially formed in the push-pull rod connecting end from top to bottom, a first avoidance ring body and a second avoidance ring body are sequentially arranged at the lower end of the push-pull rod from top to bottom, a push plate is arranged at the lower end of the second avoidance ring body, and protruding columns matched with the side wings are arranged on two sides of the push plate.
The wire pushing rod comprises a wire pushing rod body, a wire pushing rod connecting section is arranged at the upper end of the wire pushing rod body, a plane and an arc surface are arranged on the outer surface of the wire pushing rod connecting section along the length direction of the wire pushing rod connecting section, a connecting groove is arranged at the upper end of the wire pushing rod connecting section, a central hole for accommodating the wire pushing rod is formed in the wire pushing rod body and the wire pushing rod connecting section, and the crossed push pin structure is arranged at the lower end of the wire pushing rod body; the cross push pin structure penetrates through the first avoidance ring body, and the connecting pin penetrates through the second avoidance ring body to fixedly connect the puncture cone and the guide connecting block with the lower end of the puncture tube; the long pressure spring is sleeved on the crossed push pin structure and is positioned between the lower end of the push rod body and the first avoidance ring body.
A handle rod body is arranged below the handle, a long groove for avoiding the fixed shaft is formed in the outer surface of the handle rod body, an upper handle bulge, a lower handle bulge and a lower flange are sequentially arranged on the handle rod body from top to bottom, and the handle rod body extends into the bottom of the puncture shell cover, the blocking piece, the side wing locking block and the puncture shell and can be matched with a connecting groove in the upper end of the wire pushing rod through the lower flange; the connecting end of the push-pull rod is arranged in the middle of the flank locking block, and the fixed shaft penetrates through the flank locking block and a second shaft hole in the connecting end to connect the upper end of the push-pull rod with the middle of the flank locking block; the stoppers are disposed at both ends of the fixed shaft, and the springs are disposed between the stoppers and the inner walls of the wing locking blocks.
The stop pin is arranged in the first shaft hole and limits the stop piece through the stop pin.
When the handle is lifted up and the lower bulge of the handle contacts the wing locking block, the handle lifts the wing locking block together, and the wing is unfolded.
When the handle is lifted to the bottom, the lower flange is connected with the corresponding connecting groove to realize the locking connection with the wire pushing rod, the handle is rotated to drive the blocking piece to rotate together, then the blocking piece is ejected out, and the side wing is locked by the locking of the puncture shell.
When the handle rotates back, the stop block rebounds to unlock under the action of the spring, the handle is pushed down, when the upper protrusion of the handle touches the side wing locking block, the side wing locking block can slide downwards along with the handle, the side wing is closed, and the handle and the wire pushing rod are unlocked.
Compared with the prior art, the puncture stitching instrument capable of pre-arranging the suture has the following beneficial effects:
the puncture suturing device capable of pre-arranging the suture can realize the puncture of the abdominal cavity under an endoscope, meanwhile, a way of pre-knotting the suture is provided for establishing a passage for other minimally invasive instruments to enter the body for laparoscopic surgery, and the suture at two sides of the incision can be pulled out of the sleeve to be pre-knotted without influencing the operation in the surgery.
Drawings
FIG. 1 is a schematic view showing an assembled structure of a puncture suturing device in which a suture can be previously arranged according to example 1.
FIG. 2 is a schematic view showing the structure of a puncture cannula in the puncture suturing device of example 1.
FIG. 3 is an exploded view of the puncture cannula in the puncture suturing device of example 1.
FIG. 4 is a schematic view showing the structure of a puncture cone in the puncture suturing device of example 1.
FIG. 5 is an exploded view of the puncture cone in the puncture suturing device of example 1.
Fig. 6 is a sectional structure view of a push pin crossing ramp expanding mechanism in the puncture cone of embodiment 1.
Fig. 7 is a schematic sectional view showing a connection structure of a puncture tube and a puncture cone head in the puncture cone of example 1.
Fig. 8 is a schematic structural view of a push rod in the puncture cone of embodiment 1.
Fig. 9 is a schematic structural view of the push-pull rod in the puncture cone of example 1.
FIG. 10 is a connection view of the handle with the wing locking block and the push rod in the puncture awl of embodiment 1.
Fig. 11 is a schematic view showing the structure of a spring button push-pull lock mechanism in the puncture cone of embodiment 1.
Fig. 12 is a schematic structural view of a push-pull and push-wire mechanism in the puncture cone of embodiment 1.
Fig. 13 is a schematic view of the state in which the flanks are closed in the puncture cone of example 1.
FIG. 14 is a schematic view of the puncture cone of example 1 with the wings open.
FIG. 15 is a schematic view showing the use of the puncture suturing device of example 1 in which a suture can be previously arranged.
Detailed Description
The suture passer of the present invention, which is capable of pre-deploying sutures, will be further described with reference to specific embodiments thereof to assist those skilled in the art in providing a more complete, accurate and thorough understanding of the present invention.
Example 1
As shown in FIG. 1, the puncture stapler capable of pre-arranging a suture of the present embodiment includes a puncture cannula device 200 and a puncture device 100.
As shown in fig. 2 to 3, the puncture cannula device 200 includes a housing cover 29, a connection base 30, a cannula upper housing 18, a cannula lower housing 19, a gasket upper pressing piece 20, a gasket 21, a gasket lower pressing piece 23, a rubber ring 22, a choke valve 25, a cannula 24, an air injection valve 27 and a buckle 28. The upper end of the sleeve 24 is arranged at the lower end of the interior of the lower sleeve shell 19, the lower end of the sleeve 24 extends out of the lower end of the lower sleeve shell 19, the choke valve 25 is connected with the upper end of the sleeve 24, and the lower sleeve shell 19 is clamped and fixed with the upper sleeve shell 18 through the buckle 28. The air injection valve 27 penetrates through the lower casing 19 of the casing and is connected with the inner part of the upper end of the casing 24, and an air injection valve switch 26 is arranged on the air injection valve 27. The connecting base 30 is arranged on the casing upper shell 18, the connecting base 30 is connected with the casing cover 29, and the sealing gasket upper pressing sheet 20, the sealing gasket 21, the rubber ring 22 and the sealing gasket lower pressing sheet 23 are sequentially arranged in the inner space defined by the casing cover 29 and the connecting base 30 from top to bottom. The puncture cannula device 200 is used as a surgical channel for surgical operation, the air inlet pipe can be connected with the air injection valve on the puncture cannula, the air injection valve is opened, when no instrument exists in the puncture cannula, the sealing system still keeps an inflation state, and in the process, the puncture device 100 can be used for performing surgical operation by matching with other endoscope instruments through the puncture cannula if needed.
As shown in fig. 4 to 7, the puncturing device 100 includes a handle 1, a puncturing housing cover 2, a blocking piece 3, a wing locking block 4, a spring 5, a stop 6, a puncturing tube 7, a push-pull rod 8, a guide connecting block 9, a wing 10, a puncturing cone 11, a push-wire rod 12, a long compression spring 13, a retainer ring 14, a fixed shaft 15, a puncturing housing 16 and a connecting pin 17. The puncture tube 7 is provided at the lower end of the puncture housing 16 and is fixed by a retainer ring 14. The wing locking block 4 is arranged in a puncture shell 16, the push-wire rod 12 is arranged in the puncture tube 7, and the push-pull rod 8 is arranged in the push-wire rod 12. The lower end of the handle 1 penetrates through the puncture housing cover 2 and the flank locking block 4 to be connected with the wire pushing rod 12, and the upper end of the wire pushing rod 8 is connected with the flank locking block 4 through the fixing shaft 15. The number of the side wings 10 is two, the upper ends of the side wings 10 are fixed on the upper part of the puncture cone 11 through pin shafts, and the two sides of the puncture cone 11 are provided with notch parts for accommodating the side wings 10. The guide connecting block 9 is arranged at the lower end of the puncture tube 7, the upper part of the puncture cone 11 is matched with the guide connecting block 9, and the connecting pin 17 fixedly connects the puncture cone 11 and the guide connecting block 9 with the lower end of the puncture tube 7.
As shown in fig. 8-9, the push-pull rod 8 includes a push-pull rod body 801, the upper end of the push-pull rod body 801 is provided with a push-pull rod connecting end 802, the push-pull rod connecting end 802 is sequentially provided with a first shaft hole 808 and a second shaft hole 803 from top to bottom, the lower end of the push-pull rod 8 is sequentially provided with a first avoiding ring body 804 and a second avoiding ring body 805 from top to bottom, the lower end of the second avoiding ring body 805 is provided with a push plate 806, and two sides of the push plate 806 are provided with convex columns 807. The normal direction of the plane where the first avoidance ring body 804 is located is perpendicular to the normal direction of the plane where the second avoidance ring body 805 is located. The wire pushing rod 12 comprises a wire pushing rod body 1205, a wire pushing rod connecting section is arranged at the upper end of the wire pushing rod body 1205, a plane 1201 and an arc surface 1202 are arranged on the outer surface of the wire pushing rod connecting section along the length direction of the wire pushing rod connecting section, a connecting groove 1203 is arranged at the upper end of the wire pushing rod connecting section, a central hole 1204 for accommodating the wire pushing rod 8 is arranged in the wire pushing rod body 1205 and the wire pushing rod connecting section, and a crossed push pin structure 1206 is arranged on the wire pushing rod body 1205. The cross push pin structure 1206 penetrates through the first avoidance ring body 804, and the connecting pin 17 penetrates through the second avoidance ring body 805 to fixedly connect the puncture cone 11 and the guide connecting block 9 with the lower end of the puncture tube 7. With reference to fig. 4 to 5, the long compression spring 13 is sleeved on the crossing push pin structure 1206, and the long compression spring 13 is located between the lower end of the push rod body 1205 and the first avoidance ring body 804.
The flank 10 includes flank transmission portion and silica gel piece, be provided with the circular arc spout in the flank transmission portion, flank transmission portion is through setting up grooved shaft on the circular arc spout with puncture cone 11 installs. The push-pull rod 8, the side wings 10 and the puncture cone 11 form a push-pull unfolding mechanism, the push-pull rod 8 is pushed or pulled back downwards, the convex columns 807 on the push plate 806 enable the silica gel blocks (the opened parts) to be opened or closed, the suture line is locked, and the side wing transmission part ensures the realization of movement. In the puncture cone of the present embodiment, the side wings are combined with the puncture, and the shape of the side wings is changed in accordance with the curvature of the puncture cone, so that the blade portion of the puncture cone is retained without affecting the puncture performance. As shown in fig. 6, the guide connection block comprises a first connection block and a second connection block, the first connection block and the second connection block are buckled with each other through a Z-shaped clamping groove, and a guide sloping block 91 is formed at the upper end of the first connection block and the second connection block, the guide sloping block 91 enables the cross push pin structure 1206 to be located in the puncture tube in an initial state, and the cross push pin structure 1206 can be inserted into the silica gel block of the side wing 10 at an opening angle when being pushed forward, and can not be clamped (the cross angle of the cross push pin structure enables the push pin to pierce the fascia at a position 8-15mm away from the wound edge).
As shown in fig. 10-11, a handle bar body 105 is disposed below the handle 1, and a long groove 104 is disposed on an outer surface of the handle bar body 105 to avoid the fixed shaft 15. The handle rod body 105 is sequentially provided with a handle upper bulge 101, a handle lower bulge 102 and a lower flange 103 from top to bottom. The handle rod body 105 extends into the bottom of the puncture housing cover 2, the baffle 3, the side wing locking block 4 and the puncture housing 16 and is matched with the connecting groove 1203 at the upper end of the wire pushing rod 12 through the lower flange 103.
The push-pull rod connecting end 802 is disposed in the middle of the wing locking block 4, and the fixed shaft 15 passes through the wing locking block 4 and the second shaft hole 803 of the connecting end 802 to connect the upper end of the push-pull rod 8 with the middle of the wing locking block 4. Stoppers 6 are provided at both ends of the fixed shaft 15, and springs 5 are provided between the stoppers 6 and the inner walls of the wing locking blocks 4. The wing locking block 4 not only serves to connect the push-pull rod 8, but it also connects the stop 6 and provides a passage for the handle 1, making the push-pull rod 8 more stable in movement. The puncture housing cover 2 and the puncture housing 3 cooperate to form a closed housing structure. The puncture shell cover 2, the puncture shell 16, the stop 6, the fixed shaft 15, the spring 5 and the flank locking block 4 form a push-pull locking mechanism. When the handle is lifted, the handle lower protrusion 102 contacts the wing locking block, the handle lifts the wing locking block 4 together, and the wing is unfolded, as shown in fig. 14; after the needle is lifted to the bottom, the lower flange 103 corresponds to the connecting groove 1203, when the handle rotates, the blocking piece 3 is driven to rotate together, then the stop block 6 is ejected out and locked by the puncture shell 16 to lock the side wings; when the handle rotates back, the stop block 6 rebounds under the action of the spring 5 to be unlocked, the handle is pushed down, when the upper protrusion 101 of the handle touches the lateral wing locking block 4, the lateral wing locking block 4 can slide down along with the handle 1, the lateral wing is closed, as shown in fig. 13, and the handle and the wire pushing rod are unlocked.
With reference to fig. 8-12, the wing 10 is unfolded by pulling, the triggering mode is realized by pulling the handle 1, the push-pull rod 8 connects the wing locking block 4 located in the puncture housing 16 with the wing 10 located in the puncture cone 11, the first shaft hole 808 is connected with the stop pin 301 to limit the stop blade 3 through the stop pin 301, the second shaft hole 803 is connected with the wing locking block 4 through the fixed shaft 15, the first ring body 804 avoids the crossing push pin structure 1206, the second ring body 805 avoids the connecting pin 17 to connect, and the convex column 807 is matched with the wing 10.
During operation, the puncture cone 100 and the puncture sleeve 200 are assembled, the handle 1 is pulled out and then rotated, the handle 1 is connected with the wire pushing rod 12 and locked under the action of a mechanism, the handle 1 is pushed out for a certain distance, a suture needle in the wire pushing rod 12 is exposed out of the sleeve 24, a medical suture line with a corresponding specification is arranged on a crossed needle pushing structure 1206 in the wire pushing rod 12 according to requirements, the handle 1 is pulled out again, the wire pushing rod 12 returns to an initial position under the action of the mechanism, the handle 1 resets, and the preassembling of the medical suture line is completed. The palm center is arranged at the position of a handle 1 of the puncture stitching instrument, two fingers respectively hold a lower casing 19 of the sleeve to carry out rotary slow puncture, the sleeve is vertical to the abdominal wall (the force cannot be too large) during puncture, and the puncture is stopped when the sleeve reaches a specified position; the puncture cone 100 has a wing-like front end of the puncture cone 1, which is rotated left and right during puncturing to separate the tissue and reduce the damage to the tissue. The handle 1 is lifted upwards and rotated, the side wings 10 are unfolded and locked under the action of the mechanism, the sleeve 24 is lifted upwards, the side wings 10 abut against the fascia, the handle 1 is pushed downwards to push out the suture, the suture penetrates through the fascia and enters the silica gel blocks of the side wings 10, the suture is slowly drawn out after a certain distance, whether the suture is clamped on the silica gel blocks is observed, then the handle 1 is completely withdrawn, the handle 1 is pulled to the bottom, the rotary handle 1 is pushed downwards again to return to the initial position, the side wing 10 is closed under the action of the mechanism, then the whole puncture cannula 200 is pushed into the abdominal cavity, and forms an inclined angle of 45 degrees with the abdominal wall when puncturing (attention can not be paid to excessive force, and the puncture needle can not damage the viscera when observing), after the puncture cannula 200 is penetrated, the puncture awl 100 is pulled out of the puncture sleeve 200, the puncture sleeve 200 is used as an operation channel for operation, the puncture sleeve 200 is withdrawn after the operation is finished, the suture knot is pulled out of the abdominal cavity, and the suture knot is cut and knotted again to finish fascia closure.
As shown in FIG. 15, the operation of the puncture stapler of the present embodiment, in which a suture can be previously arranged, is as follows:
1-correctly inserting the puncture awl into the puncture cannula;
2, pulling out the handle to lock, pushing out for a certain distance, and installing the suture with the corresponding specification on the suture pushing needle, wherein two ends of the suture are respectively installed on the suture pushing needles at two sides;
3, pulling the wire pushing rod back into the sleeve through the handle, and then resetting the handle;
4-using standard surgery, cutting a skin incision sufficient to introduce a puncture stapler;
5, the puncture suture device is arranged in the palm center, two fingers respectively hold the handle of the puncture sleeve to perform rotary slow puncture, the sleeve is vertical to the abdominal wall (the force cannot be too large) during puncture, and the puncture suture device stops when the puncture suture reaches a specified position;
6, lifting the handle upwards, rotating and locking, unfolding and locking the side wings, lifting the sleeve upwards, and propping the side wings against the fascia;
7-the handle is pushed downwards to push out the suture, the suture passes through the fascia, enters the silica gel block of the side wing, exceeds a certain distance, then is slowly pulled back (whether the suture is clamped in the silica gel block is observed), the handle is retracted to the bottom, the rotary handle is pushed downwards again to return to the initial position, and meanwhile, the side wing is closed;
8, pushing the whole sleeve into the abdominal cavity, wherein the angle of inclination of 45 degrees is formed between the sleeve and the abdominal wall when in puncture (the force cannot be too large, and the puncture needle cannot damage viscera when being observed), and pulling the puncture cone out of the sleeve after the sleeve is penetrated;
9-after the sleeve enters the abdominal cavity, pulling out the puncture awl, taking out the suture, pre-knotting two ends of the suture, and firmly knotting to pull the suture knot back to the abdominal cavity;
the 10-puncture cannula is used as an operation channel for operation, the air inlet pipe can be connected with an air injection valve on the puncture cannula, and the air injection valve is opened. When no instrument is arranged in the puncture cannula, the sealing system still keeps an inflated state, and other matched endoscopic instruments can enter a human body through the puncture cannula in the process;
11-after the operation is finished, the puncture cannula is slightly pulled out, the suture knot is pulled out of the abdominal cavity, the suture is cut and knotted again according to the doctor's technique, and the fascia tissue suture is finished.
It is obvious to those skilled in the art that the specific embodiments are only exemplary descriptions of the present invention, and it is obvious that the specific implementation of the present invention is not limited by the above-mentioned manner, and various insubstantial modifications made by the method concept and technical scheme of the present invention are within the protection scope of the present invention.
Claims (10)
1. A puncture suturing device capable of pre-arranging a suture comprises a puncture cannula device and a puncture device matched with the puncture cannula device; the method is characterized in that:
the puncture cannula device comprises a shell cover, a connecting base, a cannula upper shell, a cannula lower shell, a sealing gasket upper pressing sheet, a sealing gasket lower pressing sheet, a rubber ring, a choke valve, a cannula, an air injection valve and a buckle; the upper end of the sleeve is arranged at the lower end in the sleeve lower shell, the lower end pipe body of the sleeve extends out of the lower end of the sleeve lower shell, the choke valve is connected with the upper end of the sleeve, and the sleeve lower shell is fixedly clamped with the sleeve upper shell through the buckle; the gas injection valve penetrates through the lower casing of the casing and is connected with the inside of the upper end of the casing, the gas injection valve is provided with a gas injection valve switch, the connecting base is arranged on the upper casing of the casing, the connecting base is connected with the casing cover, and the upper pressing piece of the sealing gasket, the rubber ring and the lower pressing piece of the sealing gasket are sequentially arranged in an inner space defined by the casing cover and the connecting base from top to bottom;
the puncture device comprises a handle, a puncture outer shell cover, a separation blade, a side wing locking block, a spring, a stop block, a puncture pipe, a push-pull rod, a guide connecting block, a side wing, a puncture cone, a push-wire rod, a long pressure spring, a retaining ring, a fixed shaft, a puncture outer shell and a connecting pin, wherein the puncture pipe is arranged at the lower end of the puncture outer shell and is fixed through the retaining ring, the side wing locking block is arranged in the puncture outer shell, the push-wire rod is arranged in the puncture pipe, and the push-pull rod is arranged in the push-wire rod.
2. The puncture stapler of claim 1, wherein: the number of the side wings is two, the upper ends of the side wings are fixed on the upper part of the puncture cone through pin shafts, and the two sides of the puncture cone are provided with notch parts for accommodating the side wings; the guide connecting block is arranged at the lower end of the puncture tube, the upper part of the puncture cone is matched with the guide connecting block, and the puncture cone and the guide connecting block are fixedly connected with the lower end of the puncture tube by the connecting pin.
3. The puncture stapler of claim 2, wherein: the side wing comprises a side wing transmission part and a silica gel block, an arc chute is arranged on the side wing transmission part, and the side wing transmission part is installed with the puncture cone through a groove shaft arranged on the arc chute; the guide inclined block enables the crossed push pin structure of the wire push rod to be located in the puncture tube in an initial state, the crossed push pin structure is opened in an angle when the wire push rod is pushed forwards and is inserted into the silica gel block of the side wing, and therefore fascia puncture positions of the crossed push pin structure are located on two sides of a wound.
4. The puncture stapler of claim 3, wherein: the push-pull rod comprises a push-pull rod body, a push-pull rod connecting end is arranged at the upper end of the push-pull rod body, a first shaft hole and a second shaft hole are sequentially formed in the push-pull rod connecting end from top to bottom, a first avoidance ring body and a second avoidance ring body are sequentially arranged at the lower end of the push-pull rod from top to bottom, a push plate is arranged at the lower end of the second avoidance ring body, and protruding columns matched with the side wings are arranged on two sides of the push plate.
5. The puncture stapler of claim 4, wherein: the wire pushing rod comprises a wire pushing rod body, a wire pushing rod connecting section is arranged at the upper end of the wire pushing rod body, a plane and an arc surface are arranged on the outer surface of the wire pushing rod connecting section along the length direction of the wire pushing rod connecting section, a connecting groove is arranged at the upper end of the wire pushing rod connecting section, a central hole for accommodating the wire pushing rod is formed in the wire pushing rod body and the wire pushing rod connecting section, and the crossed push pin structure is arranged at the lower end of the wire pushing rod body; the cross push pin structure penetrates through the first avoidance ring body, and the connecting pin penetrates through the second avoidance ring body to fixedly connect the puncture cone and the guide connecting block with the lower end of the puncture tube; the long pressure spring is sleeved on the crossed push pin structure and is positioned between the lower end of the push rod body and the first avoidance ring body.
6. The puncture stapler of claim 5, wherein: a handle rod body is arranged below the handle, a long groove for avoiding the fixed shaft is formed in the outer surface of the handle rod body, an upper handle bulge, a lower handle bulge and a lower flange are sequentially arranged on the handle rod body from top to bottom, and the handle rod body extends into the bottom of the puncture shell cover, the blocking piece, the side wing locking block and the puncture shell and can be matched with a connecting groove in the upper end of the wire pushing rod through the lower flange; the connecting end of the push-pull rod is arranged in the middle of the flank locking block, and the fixed shaft penetrates through the flank locking block and a second shaft hole in the connecting end to connect the upper end of the push-pull rod with the middle of the flank locking block; the stop blocks are arranged at two ends of the fixed shaft, and the springs are arranged between the stop blocks and the inner walls of the side wing locking blocks.
7. The puncture stapler of claim 4, wherein: the stop pin is arranged in the first shaft hole and limits the stop piece through the stop pin.
8. The puncture stapler of claim 6, wherein: when the handle is lifted up and the lower bulge of the handle contacts the wing locking block, the handle lifts the wing locking block together, and the wing is unfolded.
9. The puncture stapler of claim 8, wherein: when the handle is lifted to the bottom, the lower flange is connected with the corresponding connecting groove to realize the locking connection with the wire pushing rod, the handle is rotated to drive the blocking piece to rotate together, then the stop block is ejected out and locked by the puncture shell to lock the side wing.
10. The puncture stapler of claim 9, wherein: when the handle circles round, the stop dog rebounds under the spring action for unlocking, the handle is pushed down, when the upper protrusion of the handle touches the side wing locking block, the side wing locking block can slide downwards along with the handle, the side wing is closed, and the handle and the wire pushing rod are unlocked.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111344053.1A CN113907817B (en) | 2021-11-15 | 2021-11-15 | Puncture stitching instrument capable of pre-arranging suture |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111344053.1A CN113907817B (en) | 2021-11-15 | 2021-11-15 | Puncture stitching instrument capable of pre-arranging suture |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN113907817A true CN113907817A (en) | 2022-01-11 |
| CN113907817B CN113907817B (en) | 2023-07-04 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202111344053.1A Active CN113907817B (en) | 2021-11-15 | 2021-11-15 | Puncture stitching instrument capable of pre-arranging suture |
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| Country | Link |
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| US20080015624A1 (en) * | 2005-10-31 | 2008-01-17 | Terumo Kabushiki Kaisha | Puncture device |
| CN201260840Y (en) * | 2008-04-28 | 2009-06-24 | 李欣 | Intramedullary infusion needle with pressure monitoring device |
| CN102341047A (en) * | 2009-03-11 | 2012-02-01 | 斯恩蒂斯有限公司 | Threadable knot soft tissue defect repair system |
| CN104887283A (en) * | 2015-06-10 | 2015-09-09 | 常州健瑞宝医疗器械有限公司 | Fascia stitching instrument |
| US20170245852A1 (en) * | 2014-11-21 | 2017-08-31 | Ki Seong KIM | Surgical suture for laparoscopic port site closure device |
| CN110368046A (en) * | 2013-12-09 | 2019-10-25 | 泰利福医疗公司 | Laparoscope fascia closed system |
| CN112569004A (en) * | 2019-09-27 | 2021-03-30 | 巴德阿克塞斯系统股份有限公司 | Intraosseous sterile barrier and packaging |
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2021
- 2021-11-15 CN CN202111344053.1A patent/CN113907817B/en active Active
Patent Citations (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20080015624A1 (en) * | 2005-10-31 | 2008-01-17 | Terumo Kabushiki Kaisha | Puncture device |
| CN201260840Y (en) * | 2008-04-28 | 2009-06-24 | 李欣 | Intramedullary infusion needle with pressure monitoring device |
| CN102341047A (en) * | 2009-03-11 | 2012-02-01 | 斯恩蒂斯有限公司 | Threadable knot soft tissue defect repair system |
| CN110368046A (en) * | 2013-12-09 | 2019-10-25 | 泰利福医疗公司 | Laparoscope fascia closed system |
| US20170245852A1 (en) * | 2014-11-21 | 2017-08-31 | Ki Seong KIM | Surgical suture for laparoscopic port site closure device |
| CN104887283A (en) * | 2015-06-10 | 2015-09-09 | 常州健瑞宝医疗器械有限公司 | Fascia stitching instrument |
| CN112569004A (en) * | 2019-09-27 | 2021-03-30 | 巴德阿克塞斯系统股份有限公司 | Intraosseous sterile barrier and packaging |
Also Published As
| Publication number | Publication date |
|---|---|
| CN113907817B (en) | 2023-07-04 |
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