CN115715695A

CN115715695A - Endarterectomy stripper

Info

Publication number: CN115715695A
Application number: CN202211562011.XA
Authority: CN
Inventors: 乔刚; 张志东; 邹刚强; 翟水亭; 崔明哲; 李晓健
Original assignee: Individual
Current assignee: Individual
Priority date: 2022-12-07
Filing date: 2022-12-07
Publication date: 2023-02-28

Abstract

The invention relates to the field of medical instruments, in particular to an endarterectomy stripper. Including solid fixed ring, gu the fixed ring lower extreme is fixed with curved first stationary knife, gu the fixed ring lower extreme all is provided with curved cutting assembly, cutting assembly's head end and first stationary knife contact, cutting assembly includes a plurality of curved movable knives, gu the fixed ring lower extreme between the adjacent two movable knives all is fixed with the second stationary knife, the second stationary knife is crisscross and sliding contact rather than the movable knife of one side, and first stationary knife is crisscross and sliding contact with the movable knife of cutting assembly head end, and two movable knives of two cutting assembly tail ends are crisscross and sliding contact. In the moving process of the movable knife, the movable knife can cut off the branch blockage connected with the main blockage, the main blockage and the branch blockage can be conveniently removed after the endarterium is stripped, and the removal efficiency of the branch blockage and the main blockage can be improved.

Description

Endarterectomy stripper

Technical Field

The invention relates to the field of medical instruments, in particular to an endarterectomy stripper.

Background

The main causes of stenotic and occlusive arterial lesions are atheromatous plaques, organized thrombi, emboli and the like formed in the lumen of the artery, and the blockages are fused with the intima of the artery into a whole and are hard in texture. The plug, if calcified, is hard as stone. They are not only present in the main vessel but also enter its branch vessels, forming an integral obstruction, causing ischemia in the corresponding arterial supply area.

The existing solutions have three:

firstly, the bypass grafting operation, which is a common bypass operation in clinic, faces the problems that the bypass grafting operation can not be anastomosed on the occluded blood vessel, the diameter of a far-end target blood vessel can not be too thin, and the problem of the restenosis of the transplanted blood vessel is solved.

The second is the intracavity technology, which is the rotational grinding and stent technology for the occlusive lesions, and has high cost and poor long-term curative effect.

Third, endarterectomy, which removes the blockages in these trunks and branches intact. This is often clinically difficult because these blockages adhere tightly to the adventitia and the branching vessels are sometimes far and small, difficult to reach instruments. If the blockage in the branch blood vessel can not be cut off, the blockage in the artery main trunk can not be completely taken out, and the problem of main artery stenosis occlusion can not be solved.

Currently, most treatments are performed by endarterectomy. The existing surgical instruments are nerve dissectors and annular dissectors. The prior annular dissector consists of a fixed rod and a dissecting ring at the tail end of the fixed rod, however, the dissecting ring with a smooth surface can not separate branch obstruction in a branch vessel from main obstruction in a main artery. This is why the loop dissector cannot be pushed further when it reaches these branch vessels during dissection. Because the inner diameters of the main artery blood vessel and the branch blood vessel are greatly changed and the blood flow direction is also changed, atherosclerosis or calcification of the blood vessel is easier to occur at the branch opening, and the problem of bifurcation occlusion is solved, so that most arterial occlusive lesions are solved.

The prior art is to use nerve dissectors or loop dissectors to pull off these branch vessel occlusions hard. The problems currently faced: firstly, sometimes the occlusion is tough and difficult to break, the main occlusion is broken by pulling forcibly, so that the occlusion cannot be relieved, or the adventitia is damaged by rough pulling because of tight adhesion, so that postoperative bleeding or hematoma is caused; secondly, the floating intima after being torn off sometimes forms a flap, and turns over to the far end under the impact of blood flow, so that the stenosis of the far end blood vessel is aggravated, and even the occlusion is caused, and the operation failure is caused.

The removal of the branch vessel occlusion at the slight bifurcation and severing it, the stroke is allowed to continue distally until the occlusion within the main vessel is completely removed, which may be critical to solving this problem.

Disclosure of Invention

The invention aims to solve the technical problem that in the endarterectomy dissection working process, branch blockages and a main blockage can be separated, and the main blockage and the branch blockages can be conveniently cleaned.

In order to achieve the purpose, the invention provides the technical scheme that:

endarterectomy stripper, including solid fixed ring, gu be provided with the annular cavity in the fixed ring, its characterized in that, gu the fixed ring lower extreme is fixed with curved first stationary knife, gu the position that fixed ring lower extreme is located first stationary knife both sides all is provided with curved cutting assembly, cutting assembly's head end and first stationary knife contact, cutting assembly's tail end links up mutually, cutting assembly includes a plurality of curved movable knives, gu the fixed ring lower extreme between two adjacent movable knives all is fixed with the second stationary knife, the movable knife is crisscross and sliding contact rather than the second stationary knife of one side, the movable knife and the crisscross and sliding contact of first stationary knife of cutting assembly head end, two movable knives of two cutting assembly tail ends are crisscross and sliding contact, movable knife and solid fixed ring sliding connection, gu be provided with actuating mechanism on the fixed ring, actuating mechanism allows the arcuate motion of drive movable knife on solid fixed ring in order to be close to or keep away from first stationary knife.

Specifically, the spout that corresponds with the activity sword is seted up to solid fixed ring lower extreme, and the spout is the arc and concentric with solid fixed ring, activity sword run through the spout and with solid fixed ring sliding connection, gu sliding connection has the spliced pole that corresponds with the activity sword in the ring cavity of fixed ring, spliced pole and activity sword fixed connection.

The driving mechanism comprises a first pull rope, the first pull rope is located in an annular cavity of a fixing ring, the two adjacent connecting columns of the same cutting assembly are fixedly connected through the first pull rope, the connecting column connected with the movable knife at the tail end of the cutting assembly is connected with the inner wall of the annular cavity of the fixing ring through a spring, the upper end of the fixing ring is fixed with a fixing pipe corresponding to the first fixing knife, the inner cavity of the fixing pipe is communicated with the annular cavity of the fixing ring, the two sides of the upper end of the fixing pipe are respectively fixed with a first ring, the upper end of the fixing pipe is provided with a second ring in a sliding mode, the second ring allows movement along the axial direction of the fixing pipe, a second pull rope is arranged in the fixing pipe, one end of the second pull rope is fixedly connected with the connecting columns of the movable knives at the head ends of the two cutting assemblies, and the other end of the second pull rope is fixedly connected with the second ring.

Specifically, the first fixed knife and the second fixed knife have the same structure, and the first fixed knife, the second fixed knife and the movable knife are all arc-shaped.

Specifically, the structure of first stationary knife and second stationary knife is the same, and the whole volume of first stationary knife, second stationary knife and activity sword is the arc, and the volume of first stationary knife and second stationary knife is greater than the volume of activity sword, and the taper groove has all been seted up at the both ends of first stationary knife and second stationary knife, and the taper groove corresponds rather than the activity sword tip of one side.

Specifically, the included angle between the fixed tube and the fixed ring is 90 degrees.

Specifically, the fixed pipe and the fixed ring form an included angle of 135 degrees.

In particular, the second finger ring allows movement in the axial direction of the stationary tube.

Compared with the prior art, the invention has the beneficial effects that:

1. according to the invention, the movable knife matched with the first fixed knife and the second fixed knife is arranged, so that the movable knife can move relative to the first fixed knife and the second fixed knife in the process of peeling the intima of the artery, the movable knife can cut off the branch blockage connected with the main blockage in the process of moving the movable knife, the main blockage and the branch blockage can be conveniently removed after peeling the intima of the artery, and the removal efficiency of the branch blockage and the main blockage can be improved.

2. Through set up the awl groove that corresponds with the activity sword on first stationary knife and second stationary knife, after branch's plug entered into the awl inslot, the activity sword can improve the shearing effect to branch's plug for the in-process that first stationary knife and second stationary knife moved, prevents to appear because branch's plug glues the circumstances that smooth and inconvenient quilt dissection takes place.

Drawings

FIG. 1 is a schematic view of the present invention.

Fig. 2 is a schematic view of a matching structure of the first fixed knife, the second fixed knife and the movable knife.

Fig. 3 is a bottom view of the first stationary knife, the second stationary knife, and the moveable knife mating structure.

Fig. 4 is a schematic view of the internal structure of the fixing ring.

Fig. 5 is a schematic view of the connection of the second cord to the first cord.

FIG. 6 is a schematic view of the connection of the second pull cord to the second finger ring.

Fig. 7 is a schematic structural diagram of a first fixed cutter and a second fixed cutter provided with conical grooves.

FIG. 8 is a schematic view of the fitting of the fixing tube with the fixing ring.

Part names in the drawings are as follows:

1. a fixing ring; 2. a first stationary knife; 2.1, a second fixed knife; 3. a movable knife; 4. a chute; 5. connecting columns; 6. a first pull cord; 7. a spring; 8. a second finger ring; 9. a fixed tube; 10. a second draw cord; 11. a conical groove; 12. a first finger ring.

Detailed Description

Example one

As shown in fig. 1-6, the endarterectomy dissector comprises a fixation ring 1. An annular cavity is arranged in the fixing ring 1, and an arc-shaped first fixing knife 2 is fixed at the lower end of the fixing ring 1. The lower end of the fixing ring 1 is positioned on two sides of the first fixing knife 2 and is provided with an arc-shaped cutting assembly. In this embodiment, the number of the cutting assemblies is two. The head end of the cutting assembly is in contact with the first stationary knife 2. The tail ends of the two cutting assemblies are connected.

The cutting assembly comprises a plurality of arcuate moving knives 3. In this embodiment, each cutting assembly comprises two movable knives 3. The lower end of the fixed ring 1 is positioned between two adjacent movable knives 3 and is fixed with a second fixed knife 2.1. The movable knife 3 is staggered and in sliding contact with the second fixed knife 2.1 on one side. The movable knife 3 at the head end of the cutting component is staggered with the first fixed knife 2 and is in sliding contact with the first fixed knife. The two movable knives 3 at the tail ends of the two cutting assemblies are staggered and in sliding contact. The movable knife 3 is connected with the fixed ring 1 in a sliding way. The stationary ring 1 is provided with a driving mechanism which allows the movable blade 3 to be driven in an arc-shaped movement on the stationary ring 1 to approach or depart from the first stationary blade 2.

The first fixed knife 2 and the second fixed knife 2.1 are identical in structure, and the first fixed knife 2, the second fixed knife 2.1 and the movable knife 3 are all arc-shaped. The cutting edge direction of first stationary knife 2, the fixed sword 2.1 of second, activity sword 3 should be towards the lower extreme of solid fixed ring 1 and to the axis direction slope of solid fixed ring 1, prevents that the cutting edge of first stationary knife 2, the fixed sword 2.1 of second, activity sword 3 from causing the injury to the artery inner wall.

The lower end of the fixing ring 1 is provided with a sliding chute 4 corresponding to the movable knife 3, and the sliding chute 4 is arc-shaped and concentric with the fixing ring 1. The movable knife 3 penetrates through the sliding groove 4 and is connected with the fixed ring 1 in a sliding mode. A connecting column 5 corresponding to the movable knife 3 is connected in the annular cavity of the fixed ring 1 in a sliding way. The connecting column 5 is fixedly connected with the movable knife 3.

The driving mechanism comprises a first pull rope 6, and the first pull rope 6 is positioned in an annular cavity of the fixing ring 1. Two adjacent connecting columns 5 of the same cutting assembly are fixedly connected through a first pull rope 6, and the connecting column 5 connected with the movable knife 3 at the tail end of the cutting assembly is connected with the inner wall of the annular cavity of the fixing ring 1 through a spring 7.

The upper end of the fixing ring 1 is fixed with a fixing tube 9 corresponding to the first fixing knife 2, the inner cavity of the fixing tube 9 is communicated with the annular cavity of the fixing ring 1, the two sides of the upper end of the fixing tube 9 are both fixed with first finger rings 12, and the upper end of the fixing tube 9 is provided with a second finger ring 8. A second pull rope 10 is arranged in the fixed pipe 9, one end of the second pull rope 10 is fixedly connected with a connecting column 5 connected with the movable knife 3 at the head end of the two cutting assemblies, and the other end of the second pull rope 10 is fixedly connected with a second ring 8.

Through the arrangement of the movable knife 3 matched with the first fixed knife 2 and the second fixed knife 2.1, the movable knife 3 can move relative to the first fixed knife 2 and the second fixed knife 2.1 in the process of peeling the endarterium. In the process of the movement of the movable knife 3, the movable knife 3 can cut off the branch blockage connected with the main blockage, the main blockage and the branch blockage can be conveniently removed after the endarterium is stripped, and the removal efficiency of the branch blockage and the main blockage can be improved.

When the stripper is used, a doctor inserts a forefinger and a middle finger into the two first finger rings 12 respectively, inserts a thumb into the second finger ring 8, moves the stripper and enables the fixing ring 1 to enter a blood vessel of a patient and a circumferential seam of a blockage, when the fixing ring 1 moves to a joint of a branch blockage and a main blockage, the thumb is lifted upwards, the thumb pulls the second finger ring 8 to move upwards, the second finger ring 8 pulls the second pull rope 10 to move upwards, and the second pull rope 10 pulls the connecting column and the first pull rope 6 to move. The second pull rope 10 pulls the connecting column 5 to be close to the fixed pipe 9 in the annular cavity of the fixed ring 1, the spring 7 is stretched to store force, the movable knife 3 is close to the first fixed knife 2 in the process that the connecting column 5 moves towards the direction of the fixed pipe 9, and the movable knife 3 is matched with the first fixed knife 2 and the second fixed knife 2.1 in the moving process, so that the joint of the branch blockage and the main blockage can be cut off. After the thumb is released, the second finger ring 8 descends under the elastic action of the spring 7, so that the movable knife 3 can move to the initial position.

In use, the physician inserts the index finger and the middle finger into the two first finger rings 12 and the thumb into the second finger ring 8, respectively. The doctor can push the fixing tube 9 to make the fixing ring 1 move along the length direction of the artery, and the joint of the branch blockage and the main blockage can be cut off.

Example two

As shown in fig. 7, in this embodiment, the first fixed knife 2 and the second fixed knife 2.1 have the same structure, the whole volume of the first fixed knife 2, the second fixed knife 2.1 and the movable knife 3 is arc-shaped, the volume of the first fixed knife 2 and the second fixed knife 2.1 is larger than the volume of the movable knife 3, both ends of the first fixed knife 2 and the second fixed knife 2.1 are provided with conical grooves 11, and the conical grooves 11 correspond to the end of the movable knife 3 on one side thereof. The other structures in this embodiment are the same as those in the first embodiment.

Through set up the taper groove 11 that corresponds with activity sword 3 on first stationary knife 2 and second stationary knife 2.1, after branch's jam entered into taper groove 11, activity sword 3 can improve the shearing effect to branch's jam for the in-process that first stationary knife 2 and second stationary knife 2.1 carried out the motion, prevents to appear because branch's jam glutinous smooth and inconvenient circumstances by the dissection from taking place.

EXAMPLE III

As shown in fig. 1 and 2, the angle between the fixing tube 9 and the fixing ring 1 is 90 degrees. The intima of the artery in the vertical direction can be conveniently stripped through the fixing tube 9. The other structures in this embodiment are the same as those in the first embodiment.

Example four

As shown in fig. 8, the angle between the fixing tube 9 and the fixing ring 1 is 135 degrees. The fixed tube 9 can be used for conveniently stripping the intima of the artery in the oblique direction. The other structures in this embodiment are the same as those in the first embodiment.

EXAMPLE five

The second finger ring 8 is provided with a sliding tube which is arranged in the fixed tube 9 in a sliding manner. The second finger ring 8 allows movement in the axial direction of the fixed tube 9. The other structures in this embodiment are the same as those in the first embodiment.

The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents and improvements made within the spirit and principle of the present invention are intended to be included within the scope of the present invention.

Claims

1. The endarterectomy stripper comprises a fixing ring (1), wherein an annular cavity is formed in the fixing ring (1), and is characterized in that the lower end of the fixing ring (1) is fixed with a first arc-shaped fixed knife (2), the positions () of the lower end of the fixing ring (1) at the two sides of the first fixed knife (2) are respectively provided with an arc-shaped cutting assembly, the head end of the cutting assembly is in contact with the first fixed knife (2), and the tail end of the cutting assembly is connected with each other, the cutting assembly comprises a plurality of arc-shaped movable knives (3), the lower ends of the fixing ring (1) between every two adjacent movable knives (3) are respectively fixed with a second fixed knife (2.1), the movable knives (3) are in staggered and sliding contact with the second fixed knife (2.1) at one side of the cutting assembly, the movable knives (3) at the head ends of the cutting assemblies are in staggered and sliding contact with the first fixed knife (2), the two movable knives (3) at the tail ends of the two cutting assemblies are in staggered and sliding contact with each other, the fixing ring (3) are in sliding connection with the fixing ring (1), and a driving mechanism is arranged on the fixing ring (1) to allow the movable knives to move or be close to the first arc-shaped fixed knife (2).

2. The endarterectomy stripper according to claim 1, wherein the lower end of the fixing ring (1) is provided with a sliding groove (4) corresponding to the movable knife (3), the sliding groove (4) is arc-shaped and concentric with the fixing ring (1), the movable knife (3) penetrates through the sliding groove (4) and is in sliding connection with the fixing ring (1), the annular cavity of the fixing ring (1) is in sliding connection with a connecting column (5) corresponding to the movable knife (3), and the connecting column (5) is fixedly connected with the movable knife (3).

3. The endarterectomy stripper according to claim 2, wherein the driving mechanism comprises a first pull rope (6), the first pull rope (6) is positioned in an annular cavity of the fixing ring (1), two adjacent connecting columns (5) of the same cutting assembly are fixedly connected through the first pull rope (6), the connecting column (5) connected with the movable knife (3) at the tail end of the cutting assembly is connected with the inner wall of the annular cavity of the fixing ring (1) through a spring (7), the upper end of the fixing ring (1) is fixedly provided with a fixing tube (9) corresponding to the first fixing knife (2), the inner cavity of the fixing tube (9) is communicated with the annular cavity of the fixing ring (1), two sides of the upper end of the fixing tube (9) are respectively fixedly provided with a first finger ring (12), the upper end of the fixing tube (9) is provided with a second finger ring (8), a second pull rope (10) is arranged in the fixing tube (9), one end of the second pull rope (10) is fixedly connected with the connecting column (5) connected with the movable knives (3) at the head ends of the two cutting assemblies (10), and the other end of the second pull rope (10) is fixedly connected with the second finger ring (8).

4. The endarterectomy dissector according to claim 3, characterized in that the first fixed knife (2) and the second fixed knife (2.1) are identical in structure, and the first fixed knife (2), the second fixed knife (2.1) and the movable knife (3) are all arc-shaped.

5. The endarterectomy stripper as claimed in claim 3, wherein the first fixed knife (2) and the second fixed knife (2.1) have the same structure, the whole volume of the first fixed knife (2), the second fixed knife (2.1) and the movable knife (3) is arc-shaped, the volume of the first fixed knife (2) and the second fixed knife (2.1) is larger than that of the movable knife (3), both ends of the first fixed knife (2) and the second fixed knife (2.1) are provided with conical grooves (11), and the conical grooves (11) correspond to the end parts of the movable knife (3) on one side of the conical grooves.

6. The endarterectomy dissector according to claim 4 or 5, characterized in that the angle between the fixing tube (9) and the fixing ring (1) is 90 degrees.

7. The endarterectomy dissector according to claim 4 or 5, characterized in that the angle between the fixation tube (9) and the fixation ring (1) is 135 degrees.

8. The endarterectomy dissector according to claim 3, characterized in that the second finger ring (8) allows movement in the axial direction of the fixed tube (9).