CN114271906A

CN114271906A - Actuating assembly, actuating device, pericardial puller device and operating method

Info

Publication number: CN114271906A
Application number: CN202111485376.2A
Authority: CN
Inventors: 王云兵; 邵南; 吴智明; 余越盛; 訾振军
Original assignee: Deke Medtech (hangzhou) Inc
Current assignee: Deke Medtech (hangzhou) Inc
Priority date: 2021-12-07
Filing date: 2021-12-07
Publication date: 2022-04-05

Abstract

The application discloses an action assembly, an action device, a pericardial retractor device and an operation method, wherein the action assembly comprises a fixed tube, an operation sleeve and a constraint structure, and the fixed tube is provided with a relative far end and a relative near end; the operating sleeve is connected with the proximal end of the fixed tube, an operating channel is formed in the side wall of the operating sleeve, and the operating channel is used for receiving and guiding the pericardial retractor; a restraining structure is disposed at a predetermined location of the operative channel for maintaining the pericardial puller in a current position. Compared with the prior art, the moving track of the pericardium puller is adjusted by the operation channel on the operation sleeve, so that the pericardium can be stably operated, and the damage to peripheral tissues such as the myocardium is avoided.

Description

Actuating assembly, actuating device, pericardial puller device and operating method

Technical Field

The application relates to the technical field of medical equipment, in particular to an action assembly, an action device, a pericardium puller device and an operation method.

Background

The heart comprises a ventricle, a heart muscle and a heart sac, wherein the ventricle is enclosed by the heart muscle, the heart sac is wrapped outside the heart muscle, and the heart muscle sequentially comprises a fiber layer, a wall layer and an internal organ layer from outside to inside, wherein the internal organ layer is also called as epicardium, a heart sac is arranged between the epicardium layer and the wall layer, and the heart sac usually contains 20-25ml of physiological fluid.

The current epicardial stem cell injection technology comprises open chest to perform direct-view operation, and the direct-view operation has the defects of large wound and slow recovery, so that the stem cell injection by entering the pericardium through minimally invasive operation becomes a preferred treatment means.

The medical apparatus adopted by the minimally invasive surgery is a pericardium puncture outfit, after the pericardium is cut by a tissue engagement needle on the pericardium puncture outfit, the medical apparatus enters the pericardium cavity along the pericardium puncture outfit, so that medical staff can carry out the medical surgery of injecting stem cells in the pericardium cavity.

Of course, the medical operation after the pericardium is incised by the pericardium puncture outfit is not limited to the injection of stem cells, and also includes medical operations such as puncture drainage, myocardial excision, ablation, biological patch placement, left atrial appendage ligation, and cardiac pacemaker placement.

The inventor finds that the pericardium puncture device in the prior art is unreliable in pulling the pericardium during the use process.

Disclosure of Invention

In order to solve the technical problem, the present application discloses an action assembly based on a pericardial retractor, including:

a fixed tube having opposite distal and proximal ends;

the operating sleeve is connected with the proximal end of the fixed tube, an operating channel is formed in the side wall of the operating sleeve, and the operating channel is used for receiving and guiding the pericardial retractor;

a constraint structure arranged at a preset position of the operation channel and used for keeping the pericardium puller at the current position.

The moving track of the pericardium puller is adjusted by the operation channel on the operation sleeve, so that the pericardium can be stably operated, and the damage to peripheral tissues such as myocardium is avoided.

Several alternatives are provided below, but not as an additional limitation to the above general solution, but merely as a further addition or preference, each alternative being combinable individually for the above general solution or among several alternatives without technical or logical contradictions.

Optionally, both ends of the operation channel are provided with an inlet and an outlet which are positioned at the proximal end of the operation sleeve;

the operation channel comprises:

the extension direction of the first section at least has a direction vector along the axial direction of the operating sleeve, and the proximal end of the first section is communicated with the inlet;

the extending direction of the second section at least has a direction vector along the circumferential direction of the operating sleeve, and the second section is provided with a first end and a second end which are opposite to each other, and the first end of the second section is communicated with the far end of the first section;

and the extending direction of the third section at least has a direction vector along the axial direction of the operating sleeve, the far end of the third section is communicated with the second end of the second section, and the near end of the third section is communicated with the outlet.

The operation of the pericardium is stably realized by the pericardium lifting device, and the damage to peripheral tissues such as the myocardium is avoided.

Optionally, along the circumferential direction of the operating sleeve, the second section includes a first unit area and a second unit area, the first unit area is communicated with the first section, and the second unit area is communicated with the third section;

the first unit area and the second unit area are in transition connection through a first step.

The first unit area is a preparation position before the pericardium puller rotates, and at the moment, an operator can loosen the pericardium puller and adjust the hand posture.

Optionally, the joint of the second section and the third section is communicated through a butt joint;

a portion of the structure of the second section passes over the interface and is provided with a second step that maintains the position of the pericardial puller.

The pericardial puller can be kept at the current position through the second step, and the pericardial puller can be operated at the moment.

Optionally, the third section is axially bent along the operating sleeve to form a third unit area and a fourth unit area, and a third step is disposed at the bent portion.

The third step can also hold the pericardial puller in the current position, at which time the pericardial puller can be operated.

Optionally, the constraining structure is formed by the operating channel side walls.

The processing difficulty of the constraint structure is reduced, and the structural strength between the constraint structure and the operation sleeve is increased.

Optionally, the actuating assembly further includes a force application member acting between the operating sheath and the pericardial lifter, and the force application member provides a force to the pericardial lifter, which is in the axial direction of the operating sheath and separated from the operating sheath.

Under the action of the force application part, the pericardium lifting device is abutted with the side wall on the far end side of the operation channel.

Optionally, the outer side wall of the fixed pipe is provided with a spiral part;

the pipe wall of the far end of the fixed pipe is provided with a plurality of grooves with the far ends open, and the grooves are sequentially arranged at intervals along the circumferential direction of the pipe body.

The spiral part can increase the friction force between the fixing tube and the skin and muscle so as to anchor the fixing tube in the skin and muscle, and the groove can play a role in accommodating the pericardium.

The present application further provides an action device, comprising:

the motion assembly described herein;

the expansion sheath is movably arranged in the fixed tube in a penetrating mode, the far end of the expansion sheath is exposed out of the far end of the fixed tube, and the near end of the expansion sheath is provided with a limiting part which is abutted against the near end of the operation sleeve.

The expansion sheath can close the distal opening of the fixing tube, and the fixing tube is inserted into skin and muscle along with the distal end of the expansion sheath so as to realize that the fixing tube establishes a channel at the thoracic cavity.

The present application also provides a pericardial lifter device, comprising:

a pericardial puller as described herein;

an actuating assembly to receive and guide the pericardial lifter.

The present application also provides a method of operating a pericardial retractor, comprising:

s100, pushing the action assembly until the far end of the fixed pipe approaches to a target area;

s200, under the guidance of the operation channel, pushing the pericardium puller in the inner cavity of the operation sleeve until the far end of the pericardium puller penetrates out of the far end of the fixing tube;

s300, operating the pericardial puller to enable the distal end of the pericardial puller to act on the target area, wherein when the pericardial puller is operated, the relative position of the pericardial puller and the action assembly is limited through the constraint structure.

The operating sleeve can guide the movement of the pericardium puller so as to stably realize each step action of the pericardium puller.

Optionally, the operation method of the pericardial lifter device further includes:

s400, operating the pericardial retractor to enable the far end of the pericardial retractor to release a target area;

s500, recovering the pericardium lifting device and the action assembly.

Optionally, the pericardial retractor comprises a first tube and a second tube movably sleeved, and a tube wall at a distal end of each tube is provided with at least one anchoring thorn;

in step S300, the operating the pericardial lifter includes:

s310, rotating the first pipe fitting to enable the anchor thorn at the far end of the first pipe fitting to be in place;

s320, pushing the second pipe fitting along the axial direction of the first pipe fitting to enable the anchoring thorn at the far end of the second pipe fitting to be close to a target area;

s330, rotating the second pipe fitting to enable the anchor stabs at the far end of the second pipe fitting to be in place, wherein the anchor stabs in place on the pipe fittings are mutually matched to form a clamping posture;

and S340, synchronously pulling the two pipes to a desired amplitude.

The anchoring of each pipe fitting realizes the clamping of the target area, so that the two pipe fittings realize the stable traction of the target area.

Optionally, the constraint structure is arranged on the inner wall of the operation channel;

in step S310, the constraint structure constrains the guide when the first tubular member is rotated to a position where the distal anchor is in place;

in step S340, the constraint structure constrains the guide while simultaneously pulling the two pipes to a desired amplitude.

The actuating assembly, the actuating device, the pericardium puller device and the operating method in the actuating assembly, the pericardium puller are guided through the operating channel on the operating sleeve, so that the pericardium can be stably operated.

Drawings

Fig. 1 is a schematic structural diagram of a pericardial access system according to an embodiment of the present disclosure;

fig. 2 is a schematic structural diagram of a pericardial access system according to an embodiment of the present disclosure;

FIG. 3 is a schematic structural view of the center bag lifter of FIG. 1;

FIG. 4 is a schematic view of the construction of the pipes of FIG. 3;

FIG. 5 is a schematic view of a portion of the inner tube of FIG. 4;

FIG. 6 is a partial structural view of the tube of FIG. 4;

FIG. 7 is a schematic view of the two pipes of FIG. 3 in an initial state;

FIG. 8 is a schematic view of the two pipes of FIG. 3 in an operating state;

FIG. 9 is a cross-sectional view of the center package puller of FIG. 3;

FIG. 10 is a schematic view of the center bag lifter of FIG. 3 without the rotating handle;

FIG. 11 is an exploded view of the center bag lifter of FIG. 3;

FIG. 12 is a schematic structural diagram of the actuating assembly of FIG. 1;

FIG. 13 is a partial schematic view of the actuator assembly of FIG. 12;

FIG. 14 is a partial schematic view of the actuator assembly of FIG. 13;

FIG. 15 is a schematic structural diagram of an actuator according to an embodiment of the present disclosure;

FIG. 16 is an exploded view of the actuator of FIG. 15;

FIG. 17 is a schematic structural view of the pericardial puncture device of FIG. 1;

FIG. 18 is a schematic view of the guide tube and piercing member of FIG. 17;

FIG. 19 is a schematic view of the guide tube and piercing member of FIG. 18 in an exploded configuration;

FIG. 20 is a cross-sectional view of the guide tube of FIG. 18;

fig. 21 is a system block diagram of an operating method of a pericardial puller device according to an embodiment of the present disclosure.

The reference numerals in the figures are illustrated as follows:

100. a pericardial access system; 101. a distal end; 102. a proximal end;

10. a pericardial puller; 11. a pipe fitting; 111. an outer tube; 112. an inner tube; 113. a window; 12. anchoring and stabbing; 1211. a first anchor thorn; 1212. a second anchor thorn; 121. a receiving cavity; 122. a housing area; 123. a guide slope; 124. cutting edges; 125. an open site; 126. an accumulation zone; 13. a drive handle; 131. a support body; 1311. a helical groove; 1312. mounting grooves; 1313. a partition plate; 132. a screw drive mechanism; 1321. a transmission member; 1322. rotating the handle; 1323. a limiting groove; 1324. a pin shaft; 1325. mounting holes; 134. a sleeve; 1341. a first portion; 1342. a second portion; 1343. flanging; 135. an elastic member; 136. a diameter reducing portion; 137. an operating handle; 138. a rear end plug; 139. a front end plug; 14. a guide member;

20. a pericardial puncture device; 21. a piercing member; 211. a drive section; 212. a piercing section; 213. a sharp portion; 22. a drive structure; 221. a limiting member; 222. a notch; 223. a strip-shaped hole; 23. a guide tube; 231. a channel; 232. a joint;

30. an actuating device; 31. an action component; 32. a fixed tube; 321. a spiral portion; 322. a groove; 33. an operating sleeve; 331. a flange; 34. an operation channel; 341. an inlet; 342. an outlet; 343. a first stage; 344. a second stage; 3441. a first unit region; 3442. a second unit region; 345. a third stage; 3451. a third unit region; 3452. a fourth unit region; 3453. a butt joint port; 35. a constraint structure; 351. a first step; 352. a second step; 353. a third step; 36. expanding the sheath; 361. a limiting part.

Detailed Description

The technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only a part of the embodiments of the present application, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application.

It will be understood that when an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. When a component is referred to as being "disposed on" another component, it can be directly on the other component or intervening components may also be present.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs. The terminology used in the description of the present application herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the application. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.

In this application, the terms "first", "second", etc. are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implying any particular order or number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include one or more of that feature. In the description of the present application, "plurality" means at least two, e.g., two, three, etc., unless specifically limited otherwise.

As shown in fig. 1, fig. 2, and fig. 12 to fig. 14, the present application provides an actuating assembly 31 based on a pericardial lifter 10, in this embodiment, the actuating assembly 31 includes:

a fixed tube 32 having opposite distal and proximal ends;

an operation sleeve 33 connected with the proximal end of the fixed tube 32, wherein an operation channel 34 is arranged on the side wall of the operation sleeve 33, and the operation channel 34 is used for receiving and guiding the pericardial retractor 10;

and a constraint structure 35 arranged at a predetermined position of the operation channel 34 for keeping the pericardial lifter 10 at the current position.

In this embodiment and the following embodiments, the "distal end 101" refers to the end close to the lesion, i.e., the end far from the operator, and the "proximal end 102" refers to the opposite, unless otherwise specified.

The fixing tube 32 can be anchored to tissue (for example, extrathoracic skin and muscle), the fixing tube 32 fixes the whole actuating unit 31, the pericardial retractor 10 passes through the operating sheath 33 and the fixing tube 32 to reach the pericardial position, when the pericardial retractor 10 performs the actions of puncturing the pericardium and lifting the pericardium, the moving track of the pericardial retractor 10 is adjusted through the operating channel 34 on the operating sheath 33, so that the operation on the pericardium can be stably realized, and the damage to the surrounding tissue such as the myocardium can be avoided.

The constraint structure 35 can realize that the position between the pericardial stretcher 10 and the operation sleeve 33 is relatively fixed, and an operator can also adjust the hand posture, so that the hand operation difficulty of the operator is reduced, and meanwhile, the pericardial stretcher 10 and the operation sleeve 33 can be prevented from being fixed by the extra hand required by the operator.

The fixed tube 32 and the operating sleeve 33 have an axis in space, and the axis of the fixed tube 32 and the axis of the operating sleeve 33 are arranged substantially in parallel. In the present embodiment, the axis of the fixed tube 32 coincides with the axis of the operating sleeve 33.

The operating sleeve 33 is substantially cylindrical, one axial end of the operating sleeve 33 is a closed end, the other axial end of the operating sleeve 33 is an open end, the open end of the operating sleeve 33 is used for the pericardial retractor 10 to enter, the closed end of the operating sleeve 33 is connected with the proximal end of the fixed tube 32, and the joint of the operating sleeve 33 and the fixed tube 32 is communicated.

The constraint structure 35 is primarily intended to define the relative position between the pericardial lifter 10 and the actuating sheath, and thus the shape and specific configuration of the constraint structure 35 are not critical. The constraint structure 35 may be an additional component or a part of the operating sheath 33, such as a bolt or a slot, and the general principle is that at least sufficient mechanical strength is required to ensure the firmness of the fixation between the pericardial lifter 10 and the operating sheath.

In order to reduce the difficulty of machining the constraint structure 35 and to increase the structural strength between the constraint structure 35 and the operating sleeve 33, reference is made to one embodiment in which the constraint structure 35 is formed by a side wall of the operating channel 34.

In the specific configuration of the operation channel 34, referring to one embodiment, as shown in fig. 12 to 14, both ends of the operation channel 34 are provided with an inlet 341 and an outlet 342 at the proximal end of the operation sleeve 33;

the operation passage 34 includes:

a first section 343 extending in at least a direction vector along the axial direction of the operating sleeve 33, the proximal end of the first section 343 communicating with the inlet 341;

a second section 344 extending at least along the circumferential direction of the operating sleeve 33 and having a first end and a second end opposite to each other, the first end of the second section 344 communicating with the distal end of the first section 343;

the third segment 345 extends at least along the axial direction of the operating sleeve 33, and the distal end of the third segment 345 is connected to the second end of the second segment 344, and the proximal end is connected to the outlet 342.

In the specific arrangement of the operating channel 34, the first section 343 extends in the axial direction of the operating sleeve 33, the second section 344 extends in the circumferential direction of the operating sleeve 33, and the third section 345 extends in the axial direction of the operating sleeve 33.

The first section 343 of the working channel 34 can define the length of the anchor spur 12 on the tube 11 extending out of the fixation tube 32, the second section 344 of the working channel 34 can define the number of turns of pericardium wrapped around the tube 11, and the third cell region 3451 of the third section 345 of the working channel 34 can define the distance that the pericardium is pulled by the pericardial puller 10.

In the present embodiment, as shown in fig. 13, in the circumferential direction of the operating sleeve 33, the second section 344 includes a first unit area 3441 and a second unit area 3442, the first unit area 3441 communicates with the first section 343, and the second unit area 3442 communicates with the third section 345;

the first unit area 3441 is connected to the second unit area 3442 via a first step 351.

The pericardial lifter 10 enters the first unit area 3441 from the first section 343, and the first unit area 3441 is a preparation position before the pericardial lifter 10 rotates, and at this time, the operator can release the pericardial lifter 10 and adjust the hand posture. In the present embodiment, the constraining structure 35 includes a first step 351.

In the present embodiment, as shown in fig. 14, the junction of the second section 344 and the third section 345 communicates through a pair of interfaces 3453;

a portion of the structure of the second section 344 passes over the interface 3453 and is provided with a second step 352 that maintains the position of the pericardial lifter 10.

When the pericardial puller 10 is rotated to the second end of the second section 344, the second step 352 prevents the inner tube 112 from rotating axially relative to the operating sheath 33 by holding the guide 14 of the pericardial puller 10 in the current position, and at this time, the distal end of the pericardial puller 10 is located outside the fixed tube 32, and the pericardial puller 10 can pull the pericardium. In this embodiment, the constraining structure 35 includes a second step 352.

In the present embodiment, as shown in fig. 14, the third segment 345 is formed by turning the third section 3451 and the fourth section 3452 along the axial direction of the operating sleeve 33, and a third step 353 is disposed at the turning point.

The third step 353 can also hold the pericardial retractor 10 in the current position, and the third step 353 can limit the pericardial lifting range, and in this embodiment, the restraint structure 35 includes the third step 353.

In this embodiment, the actuating assembly 31 further includes a force applying member acting between the operating sheath 33 and the pericardial lifter 10, and the force applying member provides a force to the pericardial lifter 10 along the axial direction of the operating sheath 33 and separated from the operating sheath 33.

When no external force is applied between the pericardial lifter 10 and the actuating member 31 by the force application member, the pericardial lifter 10 abuts against the side wall on the distal end side of the operation channel 34.

The force application member may be part of the operating sheath 33 or the pericardial lifter 10, but may be a separate member. The force application component is mainly used for driving the pericardial lifter 10 to move axially along the operating sleeve 33, and a cylinder or an elastic component 135 can be selected in the prior art for realizing the basic function. In this embodiment, the force application member is an elastic member 135.

In the present embodiment, as shown in fig. 12, the outer side wall of the fixed tube 32 is provided with a spiral portion 321.

The spiral portion 321 can increase the frictional force between the fixing tube 32 and the human tissue to enable the fixing tube 32 to be fixed to the human tissue. The screw portion 321 is an external thread that extends spirally in the axial direction of the fixed pipe 32.

In this embodiment, as shown in fig. 12, the tube wall at the distal end of the fixing tube 32 has a plurality of grooves 322 with a distal end open, and the plurality of grooves 322 are sequentially arranged at intervals in the circumferential direction of the tube body.

The groove 322 is arranged to receive the pericardium.

As shown in fig. 15 to 16, the present application further provides an actuating device 30, which includes the actuating assembly 31 according to the above technical solution and an expanding sheath 36 movably disposed in the fixed tube 32, wherein a distal end of the expanding sheath 36 is exposed at a distal end of the fixed tube 32, and a proximal end thereof has a limit portion 361 abutting against a proximal end of the operating sheath 33.

The dilating sheath 36 is capable of closing the distal opening of the fixation tube 32, and the fixation tube 32 is inserted into the body tissue along with the distal end of the dilating sheath 36 to enable the fixation tube 32 to establish a passage at the thoracic cavity. Wherein the proximal end of the dilating sheath 36 is radially dilated to form the stop 361.

In this embodiment, the distal end of the dilating sheath 36 is arcuately tapered.

In this embodiment, the proximal end of the operating sleeve 33 is folded outwardly to form a flange 331. The flange 331 can increase the effect of the deformation resistance of the operating sleeve 33.

As shown in fig. 1 to 2, an embodiment of the present application further provides a pericardial puller device, including the actuating assembly 31 of each of the above embodiments and a pericardial puller 10 coupled to the pericardial puller device, where the pericardial puller 10 has a guide 14 coupled to an operation channel 34, and the first step 351, the second step 352, and the third step 353 are respectively capable of holding the guide 14 at a predetermined position.

The pericardial retractor 10 is used to lift the pericardium to achieve pericardial puncture.

There is no strict limitation on the shape and configuration of the guide 14. For example: to accommodate the operating channel 34, the guide 14 is a slider corresponding to the operating channel 34.

As shown in fig. 1 to 6, the pericardial retractor 10 includes two tubes 11 movably sleeved, each tube 11 having a distal end and a proximal end, and at least one anchoring spike 12 provided on the wall of the distal end of each tube 11; when the two pipes 11 move relatively, the anchoring thorns 12 of the pipes 11 are mutually matched to clamp the pericardium.

When the far ends of the two pipe fittings 11 move relative to the pericardium, the pericardium enters between the two anchoring thorns 12 adjacent to each other along the circumferential direction of the pipe fittings 11, when the two pipe fittings 11 move relative to each other, the pericardium is clamped through the anchoring thorns 12 of the pipe fittings 11, and when the far ends of the two pipe fittings 11 move away from the pericardium, the pericardium is stably pulled, so that the damage to peripheral tissues such as the myocardium is avoided.

The two pipes 11 move relatively: the movement of any one of the pipe members 11 can be realized only, and the movement of the two pipe members 11 can also be realized together. In this embodiment, the two pipe members 11 are engaged in a manner of rotation and sliding along the axial direction of the pipe members. The position between the anchors 12 of the two tubes 11 can be changed in multiple directions to increase the versatility of the pericardial lifter 10.

The two pipe members 11 are respectively an outer pipe 111 and an inner pipe 112 inserted into the outer pipe 111, and the outer side wall of the inner pipe 112 is attached to or in clearance fit with the inner side wall of the outer pipe 111, wherein the anchoring on the inner pipe 112 is a first anchoring 1211, and the anchoring on the outer pipe 111 is a second anchoring 1212. The interior of inner tube 112 provides space for more lines and provides a structural basis for complex procedures, particularly procedures that require multiple surgical instruments (e.g., puncture knives, puncture needles, endoscopes, etc.) to enter inner tube 112 for operation. The anchoring spike 12 is arranged at the wall of the tube 11 and also prevents the anchoring spike 12 from interfering with the passage of surgical instruments through the inner tube 112.

The shape and the specific structure of the anchor thorn 12 are not strictly limited, and certain mechanical properties can be met, particularly the mechanical property requirement of the anchor thorn 12 on the lifting operation of the pericardium is met. In order to reduce the difficulty of the process of the anchoring spike 12 and the pipe 11 and to increase the structural strength between the anchoring spike 12 and the pipe 11, reference is made to an embodiment in which the anchoring spike 12 and the pipe 11 are integrally disposed.

In this embodiment, the anchoring spike 12 is located on the same circumference as the tubular member 11.

The anchor 12 can not be suddenly changed in the radial direction of the pipe fitting 11, so that the pipe fitting 11 can provide a smooth outer wall, the situation that the anchor 12 needs extra working space in the relative movement process is avoided, and the implementation of the intervention process is facilitated. In the flattened state of the tube 11, the tube 11 and the anchoring thorn 12 are in the same plane, ignoring the thickness of the tube 11 and the anchoring thorn 12.

In the present embodiment, the number of the anchor stabs 12 is plural for any one of the pipes 11; along the circumference of the pipe fitting, a receiving cavity 121 which is open at the far end and is used for the pericardium to enter is formed between two adjacent anchoring thorns 12. The collecting cavity 121 realizes the collection of the pericardium in a preset area, and facilitates the clamping of the anchoring thorn 12 to the preset area. The increase in the number of the anchors 12 can improve the effect of pulling the pericardium and ensure the stability of the operation.

The anchoring points of the tubes 11 acting on the pericardium are arranged around the circumference of the tubes 11, and the central area surrounded by the anchoring points is opposite to the cavity part of the inner tube 112, so that the pericardium can be punctured by a puncturing knife or a puncturing needle or other tools.

Functionally, the containing cavity 121 can stir, even hook, and lift the pericardium, and on the change of the specific shape of the containing cavity 121, the containing cavity has various options, even can be in a hook shape, and can be understood from the function. In this embodiment, a receiving area 122 for receiving at least a portion of the pericardium is disposed in the receiving cavity 121, and a side wall of the opening 125 of the receiving cavity 121 is obliquely disposed to form a guide slope 123 to allow the pericardium to enter the receiving area 122 in the receiving cavity 121.

The guide inclined plane 123 plays a role of guiding while avoiding, and cooperatively realizes the movement of the pericardium in the accommodating cavity 121; meanwhile, the guide slope 123 reserves a space for the pericardium to enter the open part of the receiving cavity 121 and the receiving area 122. The guide ramps 123 are disposed obliquely to the axis of the pipe elements. The housing area 122 extends in the axial direction of the pipe, and the length of the housing area 122 in the axial direction of the pipe is larger than the length in the circumferential direction of the pipe. The receiving area 122 can retain the pericardium entering the receiving cavity 121 within the receiving cavity 121 and achieve a certain gathering or stacking to facilitate the clamping of each anchor 12.

In the present embodiment, the housing area 122 and the opening portion 125 of the housing chamber 121 are in staggered communication in the circumferential direction of the pipe. The accommodating area 122 and the open part which are communicated in a staggered mode in the circumferential direction can prevent the pericardium entering the accommodating area 122 from automatically separating out of the accommodating cavity 121, and the constraint capacity of the accommodating cavity 121 on the pericardium is improved.

The ultimate purpose of the anchoring spike 12 is to achieve a lifting of the pericardium and thus to interact with the pericardium, at the specific site of action, and with reference to one embodiment, the distal end of the anchoring spike 12 is provided with a cutting edge 124 capable of puncturing the pericardium.

The cutting edge 124 is used to achieve the puncture of the pericardium by the anchoring spike 12 for lifting. For example, the cutting edge 124 punctures a portion of the pericardium to achieve stable lifting. The cutting edge 124 serves to enhance the interaction between the anchor spike 12 and the pericardium and is not limited to puncturing or puncturing the pericardium.

In this embodiment, the cutting edge 124 is marked on the anchoring spike 12 of the outer tube 111, however, in practical products, it is preferred that the cutting edge 124 is provided on the inner tube 112, i.e. the inner tube 112 is used for piercing the fiber and wall layers, and the outer tube 111 is used for clamping the fiber and wall layers in cooperation with the inner tube 112.

In the present embodiment, as shown in fig. 4 to 6, the anchor 12 is disposed obliquely with respect to the axis of the pipe member 11; the extending trend of the anchor stabs 12 of the two pipe fittings 11 is in a reverse direction.

The anchoring thorn 12 can guide the pericardium to enter the containing cavity 121, and the anchoring thorn 12 can generate acting force far away from the cardiac muscle to the pericardium acted by the anchoring thorn, so that the pericardium is gathered, and the anchoring thorn 12 is convenient to realize the next operation. The extending direction vectors of the anchor stabs 12 of the two pipe fittings 11 in the circumferential direction of the pipe body are arranged in opposite directions. For example, the anchoring barbs 12 on one of the pipes 11 extend counterclockwise in the circumferential direction of the pipe body, and the anchoring barbs 12 on the other pipe 11 extend clockwise in the circumferential direction of the pipe body.

When the anchoring thorn 12 is arranged obliquely relative to the axis of the pipe 11, the anchoring thorn 12 can generate acting force far away from cardiac muscle to the pericardium acted by the anchoring thorn, so that the pericardium is gathered, and each anchoring thorn 12 is convenient to realize the next operation.

The inner tube 112 is rotated to make the pericardium enter the receiving cavity 121 of the inner tube 112, the pericardium is gathered in the receiving cavity 121 of the inner tube 112, and the pericardium is wound at the distal end of the inner tube 112; the outer tube 111 is then rotated relative to the inner tube 112, and the second anchor 1212 on the outer tube 111 engages the first anchor 1211 on the inner tube 112 to achieve the pericardial clamping.

Preferably, the cutting edge 124 is arranged on the inner tube 112, i.e. the first anchoring barbs 1211 on the inner tube 112 are adapted to pierce the fibre layers and the wall layers, and the second anchoring barbs 1212 on the outer tube 111 are adapted to engage the first anchoring barbs 1211 on the inner tube 112 to grip the fibre layers and the wall layers.

In the present embodiment, as shown in fig. 5 and 6, the distal ends of the two tubes 11 have a viewing window 113 for observation by the endoscope.

When the pericardium is wound around the distal end of the inner tube 112, the pericardium covers the viewing window 113, and the endoscope can observe the pericardium through the viewing window 113, so as to determine whether the pericardium is clamped. When each anchor 12 clamps the pericardium, at least part of the structures of the windows 113 on the two pipes 11 are overlapped.

In order to increase the field of view of the endoscope, in the present embodiment, the number of viewing windows 113 in each tube 11 is plural along the circumferential direction of the tube 11. The state between each anchor 12 and the pericardium is observed through the window 113.

In this embodiment, the two tubes 11 have an initial state in which the distal end of the inner tube 112 is exposed outside the outer tube 111, and in the initial state, the first anchoring protrusion 1211 of the inner tube 112 is located below the second anchoring protrusion 1212 of the outer tube 111. As shown in fig. 7 to 8, the two tubes 11 have an operating state in which the outer tube 111 is axially pushed to make the second anchor stabs 1212 of the outer tube 111 and the first anchor stabs 1211 of the inner tube 112 cooperate with each other, in the operating state, the first anchor stabs 1211 of the inner tube 112 are located inside the second anchor stabs 1212 of the outer tube 111, and a clamping gap is formed between the first anchor stabs 1211 of the inner tube 112 and the second anchor stabs 1212 of the outer tube 111, and the existence of the clamping gap prevents the two tubes 11 from cutting off the pericardium therebetween in the operating state.

When the two pipes 11 contact the pericardium in the initial state, the pericardium can enter the receiving cavity 121 of the inner pipe 112 conveniently. Meanwhile, when the two pipes 11 contact the pericardium in the initial state, the pericardium is prevented from being clamped between the second anchoring burr 1212 of the outer pipe 111 and the first anchoring burr 1211 of the inner pipe 112 that does not penetrate the fiber layer and the wall layer.

In this embodiment, in the working state, an aggregation region 126 is formed between the second anchoring barb 1212 of the outer tube 111 and the first anchoring barb 1211 of the inner tube 112, and the aggregation region 126 is gradually reduced from the proximal end to the distal end. Wherein the distal end of the gathering region 126 may be open or closed. The gathering area 126 is arranged to realize the firmness of the pericardium clamped by the anchoring thorn 12 on the pipe fitting 11.

In this embodiment, the distal end limit of the second anchoring barb 1212 of the outer tube 111 does not pass beyond the distal end of the first anchoring barb 1211 of the inner tube 112, and the anchoring barb 12 on each tube 11 remains unchanged in the radial position of the tube 11. The inner tube 112 does not affect tissue beyond the distal side in the path of movement of the anchor 12 on the outer tube 111.

The moving path of the second anchor prong 1212 on the outer tube 111 never goes beyond the distal end of the first anchor prong 1211 of the inner tube 112, i.e., the moving path of the second anchor prong 1212 on the outer tube 111 does not affect the tissue outside the distal end of the inner tube 112. When the two pipes 11 are in the switching state, the inner tube 112 remains stationary, and the distal end of the outer tube 111 advances axially and rotates synchronously.

In this embodiment, as shown in fig. 1 to 3 and 9, the pericardial lifter 10 further includes a driving handle 13, and the driving handle 13 includes:

a support 131 connected to the inner tube 112;

and a screw driving mechanism 132 connected to the outer tube 111 and driving the outer tube 111.

In this embodiment, the media passage may be a passage within the stationary tube 32.

The supporting body 131 is mainly used to support and fixedly mount the components such as the inner tube 112, the screw driving mechanism 132, etc., so the shape and specific configuration of the supporting body 131 are not limited strictly, for example, a frame structure or a solid body component can be adopted, and the general principle is that at least enough mechanical strength is provided and the above components are firmly connected. The support 131 itself may be an integral structure or a detachable separate structure, and may be connected by bolts, pins, or the like for easy detachment.

The screw driving mechanism 132 drives the outer tube 111 to rotate and axially move the outer tube 111, and various transmission modes in the prior art can be adopted according to the installation positions and the movement forms of the screw driving mechanism 132 and the outer tube 111, and the movement direction and speed are changed to adapt to the working characteristics of the outer tube 111. The screw drive 132 ensures at least the necessary mechanical strength and a good, precise fit to ensure the outer tube 111 trajectory, speed and response time.

When the actuating assembly 31 is engaged with the pericardial retractor 10, the distal ends of the two tubes 11 are inserted into the fixing tube 32, the anchoring barbs 12 on the two tubes 11 can be exposed out of the distal end of the fixing tube 32, and the two tubes 11 can also be hidden in the distal end of the fixing tube 32. Drive handle 13 is partially configured to be disposed within operating sleeve 33 and to guide drive handle 13 through operating sleeve 33. The guide 14 is located outside the support 131.

In the present embodiment, the driving handle 13 has an axial direction spatially parallel to or substantially parallel to the axial direction of each pipe. The drive handle 13 is arranged cylindrically or substantially cylindrically, and each tube 11 passes through the geometric center of the drive handle 13.

In a specific arrangement of the screw driving mechanism 132, referring to one embodiment, as shown in fig. 9 to 11, the screw driving mechanism 132 includes:

a transmission member 1321 slidably and rotatably installed at the supporting body 131, the transmission member 1321 being connected with the outer tube 111;

a rotating handle 1322 rotatably installed at an outer circumference of the transmission member 1321 and driving the transmission member 1321;

the pin 1324, the rotating handle 1322, drives the transmission member 1321 through the pin 1324.

The screw drive mechanism 132 further includes a pin 1324, and the rotating handle 1322 drives the transmission member 1321 via the pin 1324.

The pin 1324 can simplify the structure of the screw driving mechanism 132 to reduce the difficulty of assembling the screw driving mechanism 132.

The rotating handle 1322 drives the pin 1324 to rotate along the spiral groove 1311 and move axially along the limiting groove 1323. Helical groove 1311 allows pin 1324 to move axially along drive handle 13 while rotating axially about drive handle 13 to enable synchronized rotation of outer tube 111 and axial movement of tube 11. The limit groove 1323 can limit the movement stroke of the transmission member 1321 in the axial direction of the driving handle 13 and the rotation angle in the circumferential direction.

In the present embodiment, as shown in fig. 9 to 11, the transmission component 1321 is disposed in the supporting body 131, and the supporting body 131 is provided with a spiral groove 1311 disposed axially around the driving handle;

the rotating handle 1322 is rotatably installed on the outer periphery of the supporting body 131, and the rotating handle 1322 has a limit groove 1323 extending axially along the driving handle;

one end of the pin 1324 is connected to the transmission member 1321, and the other end passes through the spiral groove 1311 and is disposed in the limiting groove 1323.

Wherein, along the axial direction of the driving handle, the pin 1324 is abutted with two opposite side walls of the spiral groove 1311; the pin 1324 abuts against two opposite side walls of the limiting groove 1323 along the circumferential direction of the driving handle 13. In this embodiment, the outside of the rotating handle 1322 has an anti-slip thread.

The supporting body 131 has a mounting groove 1312 matching with the transmission member 1321, the transmission member 1321 has a mounting hole 1325, the proximal end of the outer tube 111 extends into the mounting hole 1325 and is fixed in the mounting hole 1325 by gluing or the like, and the proximal end of the inner tube 112 passes through the mounting hole 1325 and is fixedly connected with the supporting body 131. The transmission member 1321 is substantially cylindrical, and the transmission member 1321 is substantially attached to the inner wall of the mounting groove 1312.

In this embodiment, drive handle 13 has a reduced diameter portion 136, and rotating knob 1322 is tubular in configuration and fits over reduced diameter portion 136 with its outer surface flush with the outer surface of drive handle 13.

The reduced diameter portion 136 is an annular recess formed in the drive handle 13 in the circumferential direction thereof, and both sides of the annular recess abut against both ends of the rotating knob 1322. To facilitate assembly of the rotating handle 1322 to the reduced diameter portion 136, referring to one embodiment, as shown in fig. 9-11, the drive handle 13 further includes an operating handle 137, the operating handle 137 being mounted to the support body 131 to form one of the side walls of the annular recess and defining the reduced diameter portion 136 with the support body 131. In order to save material of the lever 137, in another embodiment, the lever 137 is hollow.

The operating handle 137 is mounted on the supporting body 131, and referring to one embodiment, the driving handle 13 further includes a rear end plug 138, and the rear end plug 138 is screwed with the supporting body 131 and cooperates with the supporting body 131 to fix the operating handle 137.

Specifically, the operation lever 137 is substantially cylindrical, the operation lever 137 is fitted around a partial structure of the support body 131, and one axial end of the operation lever 137 abuts against the support body 131 and the other axial end abuts against the rear end plug 138.

In order to prevent the operation handle 137 from rotating relative to the support body 131, one of the operation handle 137 and the support body 131 is provided with a rib, and the other is provided with a rotation stopping groove matched with the rib.

In this embodiment, as shown in fig. 9 to 11, the driving handle 13 further includes a sleeve 134 movably connected to the supporting body 131, the sleeve 134 is sleeved outside the outer tube 111 and has a first state of wrapping the anchor 12 and a second state of exposing the anchor 12.

The sleeve 134 wraps the anchor 12 when the pericardial puller 10 is not in use, and has an effect of protecting the anchor 12. The cannula 134 exposes the anchor spike 12 in the use state of the pericardial retractor 10, so as to avoid the cannula interfering with the anchor spike 12 and facilitate the pericardial clamping by the anchor spike 12. In the initial state of the two pipe elements 11, the sleeve 134 covers the anchoring thorn 12, and the effect of protecting the anchoring thorn 12 is achieved. In the working state of the two tubes 11, the sleeve 134 exposes the anchoring thorn 12, so as to prevent the sleeve 134 from interfering with the anchoring thorn 12, and facilitate the first anchoring thorn 1211 of the inner tube 112 and the second anchoring thorn 1212 of the outer tube 111 to clamp the pericardium.

In this embodiment, the driving handle 13 further includes a front end plug 139 and an elastic member 135, the front end plug 139 is mounted on the supporting body 131 and surrounds a movable slot with the supporting body 131, the proximal end of the sleeve 134 enters the movable slot through the front end plug 139 and has a flange matched with the front end plug 139, and the elastic member 135 is pressed between the transmission member 1321 and the sleeve 134 to drive the sleeve 134 to maintain the first state.

The distal end of the support 131 is open and a front plug 139 is secured (e.g., by threaded engagement) to the open end of the support 131 to define a movable channel. The movable groove is separated from the installation groove 1312 by a partition 1313, and one end of the elastic member 135 abuts against the partition 1313 and the other end abuts against the sleeve 134. Front plug 139 has a through hole through which sleeve 134 passes. When the sleeve 134 is in the first state, the outward flange 1343 is attached to one side of the movable slot of the front end plug 139.

Sleeve 134 includes a first portion 1341 at the distal end and a second portion 1342 at the proximal end, wherein first portion 1341 substantially abuts outer tube 111, and second portion 1342 has a certain installation gap with outer tube 111 for accommodating elastic member 135, and second portion 1342 can slide along the through hole of front end plug 139. In this embodiment, the elastic member 135 is a spring.

Of course, in other embodiments, the driving handle 13 further includes a partition 1313, the partition 1313 presses against the inner wall of the movable slot, and the elastic member 135 presses between the partition 1313 and the sleeve 134 to separate the elastic member 135 from the transmission member 1321.

Based on the pericardial lifter device in each of the above embodiments, as shown in fig. 21, the present application also provides an operation method of the pericardial lifter device, which may be performed in vivo on the pericardium or in vitro, for example, on a simulation subject, and the pericardium is taken as an example for convenience of description below.

The operation method of the embodiment includes:

s100, pushing the action assembly 31 until the far end of the fixed tube 32 is close to the target area.

S200, the guide 14 of the pericardial puller 10 enters the first section 343 from the inlet 341, the pericardial puller 10 in the inner cavity of the operating sheath 33 is pushed, the guide 14 moves along the first section 343, and when the guide reaches the distal end of the first section 343, the anchoring thorn 12 is exposed outside the distal end of the fixing tube 32 and contacts or at least is adjacent to the target area.

S300, operating the pericardial lifter 10 to enable the distal end of the pericardial lifter 10 to act on the target area, wherein when the pericardial lifter 10 is operated, the relative position of the actuating assembly 31 and the pericardial lifter is limited by the constraint structure 35.

In step S300, the operation of the pericardial lifter 10 includes:

s310, the guide member 14 of the pericardial retractor 10 enters the second section 344 from the first section 343, and then the guide member 14 of the pericardial retractor 10 moves along the second section 344, the inner tube 112 is rotated to position the first anchoring spur 1211, and the first anchoring spur 1211 will act on the target area during the rotation to achieve the pre-anchoring effect. In this step, the constraint structure 35 constrains the guide 14 of the pericardial lifter 10 as the guide 14 moves along the second section 344 to the second section.

S320, pushing the outer tube 111 along the axial direction of the inner tube 112 to enable the second anchor 1212 at the distal end of the outer tube 111 to approach the target area; in order to avoid interference with the pre-anchoring of the first anchor 1211, the second anchor 1212 is always situated on the proximal side of the first anchor 1211 before this step, in which the second anchor 1212 is moved distally, i.e. gradually closer to the first anchor 1211, preferably without the second anchor 1212 ever passing over the first anchor 1211 during the entire process.

S330, the outer tube 111 is rotated to make the second anchor 1212 at the distal end of the outer tube 111 be in a position, that is, to cooperate with the first anchor 1211 to form a clamping posture. When the outer tube 111 is rotated, the direction opposite to the direction of the inner tube 112 in step S310 is rotated, so as to form a clamping posture, and at this time, the first anchor 1211 and the second anchor 1212, which are mutually matched, are preferably not staggered, so as to avoid the formation of shear, and compared with the previous pre-anchoring, the slippage between each anchor 12 and the target area can be further avoided in the clamping posture.

When the step S320 and the step S330 are performed simultaneously, when the guide 14 of the pericardium puller 10 enters the second end of the second segment 344, the rotating handle 1322 rotates in the forward direction and drives the pin 1324 to rotate along the spiral groove 1311, the pin 1324 drives the outer tube 111 to rotate through the transmission component 1321, and the outer tube 111 is also pushed in the axial direction while rotating in the forward direction due to the guiding of the spiral groove 1311 until the second anchor 1212 and the first anchor 1211 cooperate to clamp the pericardium.

S340, keeping the clamping posture, the guide 14 of the pericardial puller 10 enters the third section 345 from the second end of the second section 344, and then the guide 14 of the pericardial puller 10 moves along the third unit area 3451 of the third section 345, and pulls the two pipe fittings 11 to a desired amplitude synchronously. The target region can be pulled when the two tubes 11 are pulled up, and the following operation is performed by taking puncture as an example, and a puncture biopsy can be performed on the pulled pericardium portion by using the puncture. In this step, constraining structure 35 constrains guide 14 as guide 14 moves along third segment 345 to the proximal end of third unit region 3451.

Subsequently, the operating method of the pericardial lifter device may further include:

s400, the direction of rotating the outer tube 111 is opposite, so that the second anchor stabs 1212 and the first anchor stabs 1211 release the target area. The outer tube 111 is rotated in the opposite direction to the rotation of the outer tube 111 in step S330.

In step S400, after the guide 14 of the pericardial retractor 10 enters the proximal end of the third unit area 3451, the rotating handle 1322 rotates reversely and drives the pin 1324 to rotate along the spiral groove 1311, and the pin 1324 drives the outer tube 111 to rotate reversely through the transmission member 1321 and also retracts axially at the same time until the distal end of the pericardial retractor 10 releases the target area.

S500, synchronously or alternately recovering the pericardial lifter 10 and the action assembly 30. In this step, the guide 14 of the pericardial puller 10 enters the fourth unit area 3452 of the third section 345 from the third unit area 3451 of the third section 345, then the guide 14 of the pericardial puller 10 moves along the fourth unit area 3452 of the third section 345, and finally the guide 14 of the pericardial puller 10 exits the operating sleeve 33 from the outlet 342, and the recycling of the pericardial puller 10 relative to the operating assembly 30 is completed.

As shown in fig. 1 to 2 and 17, an embodiment of the present application further provides a pericardial access system 100, including the pericardial puller device of the above embodiments and a pericardial puncture device 20 coupled to the pericardial puller device, where the pericardial puncture device 20 includes a puncture element 21, the puncture element 21 is movably mounted in the innermost tube 11 (inner tube 112) and has a puncture state moving toward the distal end, and the puncture element 21 in the puncture state is used for puncturing the pericardium interacting with each anchoring puncture.

The puncturing action is performed by the puncturing member 21.

In one embodiment of the puncturing element 21, as shown in fig. 17 to 19, with reference to one embodiment, the puncturing element 21 comprises a driving section 211 extending from the distal end to the proximal end of the inner tube 112 and a puncturing section 212 disposed at the distal end of the driving section 211, wherein the driving section 211 is movably engaged with the inner tube 112 and is used for driving the puncturing section 212 into the puncturing state.

Different designs of the piercing member 21 can meet different treatment requirements. In this embodiment, the distal ends of piercing section 212 converge to form a sharp 213 for cutting the pericardium, as shown in fig. 16. The sharp part 213 can realize the puncture of the pericardium, and meanwhile, the puncture section 212 and the driving section 211 can be internally provided with communicated channels to arrange other pipelines, so that the subsequent operation can be conveniently carried out after the puncture.

The driving section 211 is movably arranged in the inner tube 112, a corresponding driving structure 22 can be arranged, the driving section 211 is driven by the driving structure 22, and after the pericardium is lifted and pulled by the pipe fitting 11, the pericardium can be stably punctured by the puncturing section 212, so that a further treatment process can be carried out.

The driving structure 22 mainly drives the driving section 211 to make a linear reciprocating motion along the axial direction of the pipe fitting, and in order to realize the basic function, a motor, a cylinder, a hydraulic cylinder or even a manual driving part can be selected in the prior art, and when the motion mode directly output by the driving structure 22 is inconsistent with the motion mode of the driving section 211, the motion mode can be rotated and transmitted by using a proper transmission part.

In the implementation manner of the driving structure 22, referring to fig. 17, in an embodiment, the driving structure 22 includes a limiting member 221, and the limiting member 221 is movably connected to the pericardial retractor 10 or the pericardial puncture device 20 and is fixedly connected to the driving section 211, so as to be able to control the depth of the pericardium puncture by the puncture piece 21.

The limiting member 221 is sleeved on the outer side of the pericardial retractor 10 and has a notch 222 avoiding the rotating handle 1322. The limiting member 221 is substantially cylindrical, one axial end of the limiting member 221 is a closed end, the other axial end of the limiting member 221 is an open end, the closed end is provided with a hole site, the outer side wall of the puncturing member 21 is fixed in the hole site, the outer side of the limiting member 221 is provided with a joint, and an external pipeline is communicated with the inside of the puncturing member 21 through the joint.

After the operating sheath 33 and the pericardial lifter 10 are used in a fourth stage, that is, after the guide 14 of the pericardial lifter 10 reaches the proximal end of the third unit area 3451, the limiting member 221 is sleeved outside the pericardial lifter 10 from the open side, and the limiting member 221 is pushed axially, so that the limiting member 221 drives the puncturing member 21 to move along the inside of the fixing tube 32 to puncture. In order to limit the penetration section 212 to the extreme position, the outer periphery of the open side abuts against the flange 331 on the operating sleeve 33, providing a safety shield.

Referring to one embodiment, as shown in fig. 17 to 20, the pericardial puncture device 20 further includes a guide tube 23 having a plurality of channels 231, and a plurality of connectors 232 mounted at a proximal end of the guide tube 23 and respectively communicated with the corresponding channels 231, wherein the puncture element 21 is movably inserted into one of the channels 231, and the other channels 231 can be inserted into other devices (such as an endoscope, etc.).

The front end plug 139 is provided with a through hole for the guide tube 23 to pass through, and the joint of each joint 232 and the guide tube 23 is provided with a limit boss matched with the front end plug 139. The extending path of one of the joints 232 is consistent with the axis of the guide pipe 23, the extending paths of the other joints 232 are arranged in an arc shape, and the side wall of the limiting member 221 is provided with a strip-shaped hole 223 matched with the joint 232 of which the extending path is in the arc shape.

The technical features of the above embodiments can be arbitrarily combined, and for the sake of brevity, all possible combinations of the technical features in the above embodiments are not described, but should be considered as the scope of the present specification as long as there is no contradiction between the combinations of the technical features. When technical features in different embodiments are represented in the same drawing, it can be seen that the drawing also discloses a combination of the embodiments concerned.

The above examples only express several embodiments of the present application, and the description thereof is more specific and detailed, but not construed as limiting the claims. It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the concept of the present application, which falls within the scope of protection of the present application.

Claims

1. Action subassembly based on pericardium lifting ware, its characterized in that includes:

a fixed tube having opposite distal and proximal ends;

2. The pericardial puller-based actuating assembly of claim 1, wherein the operating channel has an inlet and an outlet at both ends of the operating sheath at the proximal end;

the operation channel comprises:

3. The pericardial puller-based action assembly of claim 2, wherein, in a circumferential direction of the operating sheath, the second section includes a first cell area in communication with the first section and a second cell area in communication with the third section;

4. The pericardial puller-based action assembly of claim 3, wherein the junction of the second segment and the third segment communicates through a docking port;

5. The pericardial lifter-based actuating assembly of claim 3, wherein the third section is folded along the axial direction of the operating sleeve to form a third unit area and a fourth unit area, and a third step is arranged at the folding position.

6. The pericardial puller-based action assembly of claim 1, wherein the constraint structure is formed by the working channel sidewall.

7. The pericardial puller-based actuating assembly of claim 1, further comprising a force applying member acting between the operating sheath and the pericardial puller, the force applying member providing a force to the pericardial puller in an axial direction of the operating sheath and separate from the operating sheath.

8. The pericardial puller-based action assembly of claim 1, wherein an outer sidewall of the stationary tube is provided with a spiral;

9. An action device, comprising:

using the action assembly of any of claims 1-8;

10. A pericardial puller device, comprising:

using the action assembly of any of claims 1-8;

a pericardial puller having a guide that mates with the operating channel.

11. The method of operating the pericardial lifter device of claim 10, comprising:

12. The method of operating the pericardial puller device of claim 11, further comprising:

s500, recovering the pericardium lifting device and the action assembly.

13. The method of operating the pericardial puller device of claim 11, wherein the pericardial puller comprises a first tube and a second tube that are movably sleeved, and wherein the tube wall at the distal end of each tube has at least one anchoring barb;

in step S300, the operating the pericardial lifter includes:

and S340, synchronously pulling the two pipes to a desired amplitude.

14. The method of operating the pericardial puller device of claim 13, wherein the constraint structure is disposed on an inner wall of the operating channel;