CN115956965B - Fibrous ring stitching instrument - Google Patents

Fibrous ring stitching instrument Download PDF

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Publication number
CN115956965B
CN115956965B CN202310020781.XA CN202310020781A CN115956965B CN 115956965 B CN115956965 B CN 115956965B CN 202310020781 A CN202310020781 A CN 202310020781A CN 115956965 B CN115956965 B CN 115956965B
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China
Prior art keywords
suture
anchoring
push rod
puncture outfit
anchoring structure
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CN202310020781.XA
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CN115956965A (en
Inventor
张强
吴文坚
梁裕
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Ruinjin Hospital Affiliated to Shanghai Jiaotong University School of Medicine Co Ltd
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Ruinjin Hospital Affiliated to Shanghai Jiaotong University School of Medicine Co Ltd
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Publication of CN115956965A publication Critical patent/CN115956965A/en
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    • YGENERAL 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
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02ATECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Abstract

The present invention provides an annular stapler, comprising: the puncture outfit comprises a puncture outfit sleeve and a single suture which is arranged in the puncture outfit sleeve and can slide along the puncture outfit sleeve, wherein two free ends of the suture are positioned at one end of the puncture outfit sleeve, which is far away from the spike, and the two free ends are mutually wound to form a three-star knot; two anchoring structures are slidably arranged on the suture at a certain distance, each anchoring structure is provided with a push rod which can be separated from the anchoring structure, the push rods extend along the length direction in the puncture outfit sleeve, and the push rods can push the anchoring structures to drive the suture to move out of the puncture outfit sleeve spike. The invention has the beneficial effects that: the problem of soft tissue suturing in a deep narrow space is solved; the suturing device solves the problems that the suturing technology of the existing suturing device based on two different sutures is difficult to grasp the depth of the puncture angle and the thread end is difficult to smoothly and conveniently and safely lead out from the deep tissue.

Description

Fibrous ring stitching instrument
Technical Field
The invention belongs to the technical field of medical appliances, and particularly relates to a fibrous ring stitching instrument.
Background
The protrusion of the intervertebral disc is one of clinical common diseases, and the number of patients tends to rise year by year; the most common cause of the disease is that the nucleus pulposus, the annulus fibrosus, the cartilaginous plates and the like of each part of the intervertebral disc are subjected to different degrees of degenerative changes, and the annulus fibrosus of the intervertebral disc is broken and the nucleus pulposus protrudes under the action of external force factors, so that a series of clinical symptoms such as lumbago or lower limb radiation pain are generated; in the minimally invasive surgery of spinal surgery, a medical staff usually cuts and establishes a minimally invasive surgery channel (the diameter is 28mm, the depth is 50 mm) on the skin of a human body to reach a diseased intervertebral disc, then the medical staff cuts a tiny incision (about 5-10 mm) on the annulus fibrosus of the intervertebral disc, and then the medical staff sequentially passes through the minimally invasive channel and the annulus fibrosus through special minimally invasive surgery instruments to perform further surgery operations such as nuclectomy and the like, the residual annulus fibrosus after nuclectomy is conventionally not effectively sutured and closed by proper surgery machinery, and accordingly the postoperative intervertebral disc protrusion is recrudesced again.
In recent years, a plurality of special fibrous ring staplers for minimally invasive surgery are commercially available, but the staplers have more or less respective defects, and are inconvenient or safe in clinical application. Such as the commercially available suture device (CN 217244575U), the principle is that two separate sutures are fixed on two sides of the annulotomy through an anchoring structure, and the two separate sutures are knotted through a knotting technique, so as to close the annulotomy. The problem is that such deep tissue tying techniques based on two different sutures are very difficult, it is difficult to tighten the knot, and the knot is prone to slackening, or to forcefully tighten the knot, resulting in suture breakage or slippage of the anchoring structure. Or another suture device (CN 113827292 a), the principle is that two ends of the same suture thread are respectively passed through two sides of the annular incision by a puncture thread passing device, and the knots are tied by using a conventional knotting technique, so that the knotting technique based on two different suture threads is avoided, but the problem is that the puncture thread passing technique has complicated operation, especially the puncture angle depth is difficult to grasp, namely, the puncture angle is required to be respectively inclined from two sides of the incision to the central position of the incision, in a narrow space, the proper inclination angle is difficult to be set, and meanwhile, the thread ends are difficult to be smoothly, safely and simply led out from deep tissues after the puncture due to the problem of operation vision.
Disclosure of Invention
The invention aims to provide a fibrous ring stitching instrument, which is characterized in that a traditional fibrous ring stitching instrument is improved, a single suture is arranged in a puncture instrument sleeve, two anchoring structures are slidably arranged on the suture at a certain distance, a push rod which can be separated from the anchoring structures is arranged on each anchoring structure, the push rod can push the anchoring structures out of the puncture instrument sleeve, and the free ends of the two sutures are mutually wound to form a samsung knot; in the use process, the puncture device sleeve is used for respectively puncturing two sides of the annular incision at any angle, namely, the puncture angle is not required to be pursued deliberately, the push rod pushes, turns and separates the anchoring structures, the anchoring structures are separated and then are pulled away, the two anchoring structures are arranged on two sides of the annular incision, the conventional knot pusher is used for pushing down the samsung knots preset on the two free ends, the suture can be used for closing the incision of the annular incision after the suture is in the adjusted position, and the suture is knotted on one thread, so that the operation is simple and firm, the risk that nucleus pulposus tissues are reextracted from the annular incision can be reduced, and the probability of recurrence of protrusion of intervertebral discs is reduced; by adopting the scheme, the problem of soft tissue suturing in a deep narrow space, namely the problem of difficult deep tissue suturing technology and difficult knotting technology, can be solved; the problems that the traditional suturing device is difficult to grasp the depth of the puncture angle and difficult to lead out the thread head smoothly from the deep tissue conveniently and safely are overcome.
In order to solve the technical problems, the invention provides the following technical scheme:
a fibrous ring stapler, comprising: the puncture outfit comprises a puncture outfit sleeve and a single suture which is arranged in the puncture outfit sleeve and can slide along the puncture outfit sleeve, wherein two free ends of the suture are positioned at one end of the puncture outfit sleeve, which is far away from the spike, and the two free ends are mutually wound to form a three-star knot; the suture line is characterized in that two anchoring structures are slidably arranged on the suture line at a certain distance, a push rod which can be separated from each anchoring structure is arranged on each anchoring structure, the push rod extends along the inner length direction of the puncture outfit sleeve, and the push rod can push the anchoring structures to drive the suture line to move outwards from the puncture outfit sleeve.
As a preferred embodiment of the annular stapler, the anchoring structure is of absorbable material.
As a preferable scheme of the annular suture device, two wire passing holes are arranged in front of each anchoring structure, and the anchoring structures can be slidably mounted on the sutures after the sutures sequentially pass through the two wire passing holes.
As a preferred embodiment of the annular stapler, barbs are provided on each of the anchoring structures, which barbs prevent withdrawal of the anchoring structures after anchoring.
As a preferred embodiment of the annular stapler, each of the anchoring structures is an asymmetric structure, and each of the anchoring structures automatically turns laterally after the suture is pulled.
As a preferable scheme of the fiber ring stitching instrument, a planet structure is arranged at the top end of each push rod, and each anchoring structure is provided with a push rod fixing groove; the planet structure can rivet the push rod fixing groove, and when the push rod is longitudinally connected with the anchoring structure, the push rod fixing groove cannot be separated from the planet structure; when the push rod is perpendicular to the anchoring structure, the planet structure can be separated from the push rod fixing groove.
The beneficial effects of the invention are as follows:
in the present invention, the fibrous ring stapler includes: the puncture device comprises a puncture device sleeve and a single suture which is arranged in the puncture device sleeve and can slide along the puncture device sleeve, wherein two free ends of the suture are positioned at one end of the puncture device sleeve far away from a spike, and the two free ends are mutually wound to form a samsung knot; through improving the traditional fiber ring stitching instrument, a single suture line is arranged in a puncture outfit sleeve, two anchoring structures are slidably arranged on the suture line at a certain distance, a push rod which can be separated from the anchoring structures is arranged on each anchoring structure, the push rod can push the anchoring structures out of the puncture outfit sleeve, and the free ends of the two suture lines are mutually wound to form a three-star knot; in the use process, the puncture device sleeve can be used for respectively puncturing two sides of the annular incision at any angle (namely, the puncture angle is not required to be pursued intentionally), the push rod is used for pushing, steering and separating the anchoring structures, the two anchoring structures can be respectively arranged on two sides of the annular incision after separation and are separated and separated, the conventional knot pusher is used for downwards pushing the three-star knots preset on the two free ends, the incision of the annular incision can be closed after the suture is in the adjusted position, the knotting method realized on one single suture is simple and firm to operate, and the risk that nucleus pulposus tissues are separated from the annular incision again after the annular incision is closed can be reduced, so that the probability of recurrence of intervertebral disc protrusion is reduced; by adopting the scheme, the problem of soft tissue suturing in a deep narrow space, namely the problem of difficult deep tissue suturing technology and difficult knotting technology, can be solved; the problems that the traditional suturing device is difficult to grasp the depth of the puncture angle and difficult to lead out the thread head smoothly from the deep tissue conveniently and safely are overcome.
Drawings
For a clearer description of the technical solutions of the embodiments of the present invention, the drawings that are needed in the description of the embodiments will be briefly described below, it will be apparent that the drawings in the following description are only some embodiments of the present invention, and it is possible for a person skilled in the art to obtain other drawings according to these drawings without inventive effort, all falling within the scope of protection of the present invention, wherein:
FIG. 1 is a schematic view of the structure of the annular stapler of the present invention;
FIG. 2 is a cross-sectional view of the annular stapler shown in FIG. 1;
FIG. 3 is a schematic view of the pusher bar of the ring binder shown in FIG. 2;
FIG. 4 is a schematic illustration of the anchoring structure of the annular stapler shown in FIG. 2;
FIG. 5 is a schematic illustration of the combination of the push rod and anchor structure of the annular stapler shown in FIG. 1;
FIG. 6 is a schematic illustration of the push rod and anchor structure of the ring stapler of FIG. 2 shown in a disengaged configuration;
fig. 7 is a schematic view of the structure in the stitched state of the present invention.
Detailed Description
The following description of the technical solutions in the embodiments of the present invention will be clear and complete, and it is obvious that the described embodiments are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
Thus, the following detailed description of the embodiments of the invention, as presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. It should be noted that, under the condition of no conflict, the features of the embodiments of the present invention may be combined with each other, and the combined embodiments still fall within the protection scope of the present invention.
In the description of the present invention, it should also be noted that, unless explicitly specified and limited otherwise, the terms "disposed," "mounted," "connected," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; can be directly connected or indirectly connected through an intermediate medium, and can be communication between two elements. The specific meaning of the above terms in the present invention will be understood in specific cases by those of ordinary skill in the art.
The protrusion of the intervertebral disc is one of clinical common diseases, and the number of patients tends to rise year by year; the most common cause of the disease is that the nucleus pulposus, the annulus fibrosus, the cartilaginous plates and the like of each part of the intervertebral disc are subjected to different degrees of degenerative changes, and the annulus fibrosus of the intervertebral disc is broken and the nucleus pulposus protrudes under the action of external force factors, so that a series of clinical symptoms such as lumbago or lower limb radiation pain are generated; in the minimally invasive surgery of spinal surgery, a medical staff usually cuts and establishes a minimally invasive surgery channel (the diameter is 28mm, the depth is 50 mm) on the skin of a human body to reach a diseased intervertebral disc, then the medical staff cuts a tiny incision (about 5-10 mm) on the annulus fibrosus of the intervertebral disc, and then the medical staff sequentially passes through the minimally invasive channel and the annulus fibrosus through special minimally invasive surgery instruments to perform further surgery operations such as nuclectomy and the like, the residual annulus fibrosus after nuclectomy is conventionally not effectively sutured and closed by proper surgery machinery, and accordingly the postoperative intervertebral disc protrusion is recrudesced again.
In recent years, there are some special annular staplers for minimally invasive surgery on the market, but these staplers have more or less respective drawbacks, and are inconvenient or safe in clinical application, such as a commercially available stapler (CN 217244575U), the principle is that two separate sutures are fixed on two sides of an annular incision by an anchoring structure, and the two separate sutures are knotted by a knotting technique, so as to close the annular incision. The problem is that such deep tissue tying techniques based on two different sutures are very difficult, it is difficult to tighten the knot, and the knot is prone to slackening, or to forcefully tighten the knot, resulting in suture breakage or slippage of the anchoring structure. Or another suture device (CN 113827292 a), the principle is that two ends of the same suture thread are respectively passed through two sides of the annular incision by a puncture thread passing device, and the knots are tied by using a conventional knotting technique, so that the knotting technique based on two different suture threads is avoided, but the problem is that the puncture thread passing technique has complicated operation, especially the puncture angle depth is difficult to grasp, namely, the puncture angle is required to be respectively inclined from two sides of the incision to the central position of the incision, in a narrow space, the proper inclination angle is difficult to be set, and meanwhile, the thread ends are difficult to be smoothly, safely and simply led out from deep tissues after the puncture due to the problem of operation vision.
As shown in fig. 1, 2, 3, 4, 5, 6 and 7, an embodiment of the present invention provides an annular stapler including: the puncture outfit comprises a puncture outfit sleeve 10 and a single suture line 20 which is arranged in the puncture outfit sleeve 10 and can slide along the puncture outfit sleeve, wherein two free ends of the suture line 20 are positioned at one end of the puncture outfit sleeve 10 far away from a spike, and the two free ends are mutually wound to form a three-star knot 30;
wherein, two anchoring structures 40 are slidably arranged on the suture 20 at a certain distance, a push rod 50 which can be separated from each anchoring structure 40 is arranged on each anchoring structure 40, the push rod 50 extends along the length direction of the anchoring structure, and the push rod 50 can push the anchoring structure 40 to drive the suture 20 to move out of the puncture outfit sleeve 10.
In the present invention, the above-mentioned scheme is adopted, so that, during the use, the puncture device sleeve 10 is respectively punctured at two sides of the annular incision at any angle (without deliberately pursuing the puncture angle), after the push rod 50 pushes the anchoring structure 40, the push rod 50 is held by one hand, the suture 20 is pulled by one hand, the asymmetric design of the anchoring structure 40 and the rotatable design between the anchoring structure 40 and the push rod 50 thereof can easily change the anchoring structure 40 from the longitudinal direction to the transverse direction, and when the anchoring structure 40 and the push rod 50 thereof are turned at an angle of 90 °, the push rod 50 can be separated from the anchoring structure 40, after the push rod 50 is separated, the two anchoring structures 40 are respectively arranged at two sides of the annular incision, the three-star knots preset at two free ends are pushed downwards by using a conventional knot pusher, and the suture 20 can close the annular incision in combination with a subsequent series of conventional half knots. The knotting method realized on a single suture line is convenient to operate and firm in knotting, and after the annular incision is closed, the risk of secondary extraction of nucleus pulposus tissues from the annular incision can be reduced, so that the probability of recurrence of the protrusion of the intervertebral disc is reduced; by adopting the scheme, the problem of soft tissue suturing in a deep narrow space, namely difficult suturing and knotting technology of the deep tissue, can be solved; the problems that the traditional suturing device is difficult to grasp the depth of the puncture angle and difficult to lead out the thread head smoothly from the deep tissue conveniently and safely are overcome.
In order to make the anchoring structures 40 slidable on the sutures 20, two through-holes 41 are provided in front of each anchoring structure 40, and after the sutures 20 sequentially pass through the two through-holes 41, the sutures 20 can slide in the two through-holes 41, so that the anchoring structures 40 are slidably mounted on the sutures 20.
In order to prevent the anchoring structures 40 from being withdrawn after anchoring is completed, a barb 42 is provided on each anchoring structure 40, and the barbs 42 can form good resistance, so that the anchoring structures 40 can be prevented from being withdrawn after anchoring, and the contact area of the anchoring structures 40 during suturing is increased, thereby increasing the stability of suturing.
In order to further increase the stability of the suture, each anchoring structure 40 is configured as an asymmetric structure, and after the push rod 50 is held by one hand and the suture 20 is pulled by the other hand, each anchoring structure 40 automatically turns transversely, so as to further increase the contact area between the anchoring structure 40 and the intervertebral disc tissue, thereby further increasing the stability of the suture and reducing the withdrawal risk.
In order to make the push rods 50 and the anchoring structures 40 separable, a star structure 51 is arranged at the top end of each push rod 50, the anchoring structures 40 are provided with push rod fixing grooves 43 at positions corresponding to the push rods 50, the star structures 51 can rivet the push rod fixing grooves 43, and when the push rods 50 are longitudinally connected with the anchoring structures 40, the push rod fixing grooves 43 cannot be separated from the star structures 51; when the push rod 50 is perpendicular to the anchoring structure 40, the star structure 51 can be disengaged from the push rod fixing groove 43.
In the invention, the working principle and the operation principle of the fiber ring stitching instrument are as follows:
working principle: by means of a single suture thread 20 with two anchoring structures 40 arranged in the puncture outfit sleeve 10, the puncture outfit sleeve 10 punctures two sides of the annular incision at any angle (without deliberately pursuing the puncturing angle), the two anchoring structures 40 are arranged on two sides of the annular incision, the anchoring structures 40 are slidably arranged on the suture thread 20, thus the preset three-star knot on the suture thread 20 can be easily pushed to the annular incision and fastened by pulling two free ends of the suture thread, and finally the knot is locked by a series of conventional half knots, so that the annular incision is completely closed; moreover, to prevent withdrawal of the anchoring structure 40, barbs 42 are provided on the anchoring structure 40 and the anchoring structure 40 itself is provided in an asymmetric design so that the anchoring structure 40 automatically turns laterally after tightening the suture 20, further preventing withdrawal of the anchoring structure 40.
Principle of operation: inserting the puncture outfit sheath 10 into the depth of the intervertebral disc at one side of the annulotomy, pushing the anchoring structure 40 out of the puncture outfit sheath 10 into the intervertebral disc by using one push rod 50, pushing one push rod 50 by one hand, pulling the tail of the suture 20 by one hand, so that the anchoring structure 40 is changed from the longitudinal direction to the transverse direction in the intervertebral disc, and at the moment, the one push rod 50 can be smoothly separated from the push rod fixing groove 43; thus, one of the anchoring structures 40 is positioned, the other anchoring structure 40 is pushed to the spike of the puncture outfit sheath 10 by the other push rod 50, and the other anchoring structure 40 is implanted in the same manner;
the suture 20 passes through the annulus fibrosus from outside the body into the disc, passes through the two wire holes 41 of the anchoring structure 40, and then passes out of the disc to outside the body; crossing the annular incision, penetrating the annulus again from outside the body into the intervertebral disc, penetrating through the two wire through holes 41 of the anchoring structure 40, and then exiting from the intervertebral disc to outside the body; finally, the conventional knot pusher is used for locking the three star knots and the subsequent half knots, and the operation is convenient and quick.
The invention is described in detail above with reference to the accompanying drawings, but the invention is not limited to the described embodiments. It will be apparent to those skilled in the art that various changes, modifications, substitutions and alterations can be made to these embodiments without departing from the principles and spirit of the invention, and yet fall within the scope of the invention.

Claims (3)

1. A fibrous ring stapler, comprising: the puncture outfit comprises a puncture outfit sleeve and a single suture which is arranged in the puncture outfit sleeve and can slide along the puncture outfit sleeve, wherein two free ends of the suture are positioned at one end of the puncture outfit sleeve, which is far away from the spike, and the two free ends are mutually wound to form a three-star knot;
two anchoring structures are slidably arranged on the suture at a certain distance, two wire passing holes are formed in front of each anchoring structure, the suture sequentially passes through the two wire passing holes, the anchoring structures are slidably arranged on the suture, each anchoring structure is an asymmetric structure, each anchoring structure can automatically and transversely turn after the suture is pulled, a push rod which can be separated from each anchoring structure is arranged on each anchoring structure, the push rod extends along the length direction in the puncture outfit sleeve, and the push rod can push the anchoring structure to drive the suture to move outwards in a sharp-puncturing manner of the puncture outfit sleeve;
a planet structure is arranged at the top end of each push rod, and each anchoring structure is provided with a push rod fixing groove;
the planet structure can rivet the push rod fixing groove, and when the push rod is longitudinally connected with the anchoring structure, the push rod fixing groove cannot be separated from the planet structure; when the push rod is perpendicular to the anchoring structure, the planet structure can be separated from the push rod fixing groove.
2. The annular stapler of claim 1, wherein the anchoring structure is an absorbable material.
3. The annuloplasty stapler of claim 1, wherein barbs are provided on each of said anchoring structures, said barbs preventing withdrawal of said anchoring structures after anchoring.
CN202310020781.XA 2023-01-06 2023-01-06 Fibrous ring stitching instrument Active CN115956965B (en)

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CN104394778A (en) * 2012-03-09 2015-03-04 史密夫和内修有限公司 Suture-based knotless repair
CN109498085A (en) * 2018-12-27 2019-03-22 上海执中医疗技术有限公司 A kind of disposable Minimally Invasive Surgery stamp card opening closer and method of closing
CN109793557A (en) * 2017-11-17 2019-05-24 江苏风和医疗器材股份有限公司 A kind of puncture core assembly and the puncture outfit with it
CN209847262U (en) * 2019-02-18 2019-12-27 天津翔越医疗器械有限公司 Knotter for deep part of operation
CN113576567A (en) * 2021-07-26 2021-11-02 二零二零(北京)医疗科技有限公司 Puncture needle with thread and suture knot
CN216229083U (en) * 2021-04-09 2022-04-08 浙江斐凌工具有限公司 Convenient to use's star spanner

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US7232448B2 (en) * 2004-06-17 2007-06-19 Ethicon, Inc. - Usa Minimally invasive stitching device
CN106413574B (en) * 2014-06-20 2019-05-31 恩多工具治疗股份有限公司 For fixing the component of gastrointestinal tissue's folding
EP3738520B1 (en) * 2019-05-16 2024-01-24 Smith & Nephew, Inc. Tissue repair assembly

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR20120059776A (en) * 2010-12-01 2012-06-11 (주)티디엠 Suture device for disk surgical operation
CN104394778A (en) * 2012-03-09 2015-03-04 史密夫和内修有限公司 Suture-based knotless repair
CN109793557A (en) * 2017-11-17 2019-05-24 江苏风和医疗器材股份有限公司 A kind of puncture core assembly and the puncture outfit with it
CN109498085A (en) * 2018-12-27 2019-03-22 上海执中医疗技术有限公司 A kind of disposable Minimally Invasive Surgery stamp card opening closer and method of closing
CN209847262U (en) * 2019-02-18 2019-12-27 天津翔越医疗器械有限公司 Knotter for deep part of operation
CN216229083U (en) * 2021-04-09 2022-04-08 浙江斐凌工具有限公司 Convenient to use's star spanner
CN113576567A (en) * 2021-07-26 2021-11-02 二零二零(北京)医疗科技有限公司 Puncture needle with thread and suture knot

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