CN116269559A - Medical lock-cutting integrated device - Google Patents

Abstract

The application provides a medical lock is cut integrated device, including base member, locking nail component, locking wire component and tangent line component. The base member includes a first base, a support, and a mating member; the distal end of the support piece is fixedly connected with the first basal body; the matching piece is arranged on the supporting piece. The locking pin component comprises a locking pin main body and a pressing line piece movably connected with the locking pin main body, and the locking pin main body is detachably arranged in the first base body. The locking wire component comprises a push rod, the far end of the push rod is detachably connected with the locking pin main body, and the push rod and the locking pin main body are provided with self-locking structures matched with each other; the push rod moves forward to drive the line pressing piece to move relative to the locking nail main body so as to lock the medical line; the self-locking structure is used for preventing the push rod from moving reversely under the action of the medical line. The tangent line component is connected with the support part in a sliding way and is used for being matched with the matching part to cut off the medical line extending out of the self-locking nail main body. The medical locking and cutting integrated device integrates a thread locking function and a thread cutting function, and ensures that a medical thread is always locked in thread cutting operation.

Description

Medical lock-cutting integrated device

Technical Field

The application relates to the field of medical equipment, in particular to a medical lock-cutting integrated device.

Background

The procedure of knotting and securing medical lines (including but not limited to sutures, repair lines for artificial chordae, repair lines for edge-to-edge repair of valves, etc.) and cutting off excess medical lines is often required in surgery.

Traditional surgery is performed under open direct vision, typically by manually tying knots to fix the knot, and then removing excess medical wire. With the advancement of technology, various minimally invasive and interventional procedures, such as endoscopic procedures, transcatheter interventions, etc., are becoming increasingly popular, which require only a small operating window to be cut through the patient's body, thereby extending the endoscope or interventional catheter, etc., into the patient's body to a predetermined site for treatment. In such procedures, it is often necessary for the operator to remotely manipulate the medical wire outside the patient's body through the smaller manipulation window to knot and resect the excess medical wire from the patient's body. The existing thread locking device and the thread cutting device are usually two independent instruments, the thread locking device is generally used for being inserted into a body, the thread locking device is operated to fix the medical thread by locking nails in the thread locking device, then the thread locking device is withdrawn, and the thread cutting device is operated to be inserted into the body to cut off redundant medical threads. On one hand, the thread locking device and the thread cutting device are respectively put into and out of the patient body, so that the operation is complex, and the whole operation time is long; on the other hand, in the tangential operation process after the locking of the medical wire, the medical wire is often required to be pulled towards the proximal end, so that the locking force of the locking nail on the medical wire can be reduced, and even the medical wire is loosened from the locking nail and falls off from the locking nail, thereby causing risks to a human body.

Disclosure of Invention

An object of the application is to provide a medical lock is cut integrated device, can integrate locking wire function and tangent line function, and guarantee that the tangent line operation in-process, medical line is in by locking state always.

The application provides a medical lock cuts integrated device, include: base member, staple member, lock wire member and tangent member. The base member includes first base member, support piece and cooperation piece, the distal end of support piece with first base member fixed connection, the cooperation piece is located on the support piece. The locking pin component comprises a locking pin main body and a pressing line piece movably connected with the locking pin main body, and the locking pin main body is detachably arranged in the first base body. The lockwire member includes a push rod; the distal end of the push rod is detachably connected with the locking nail main body, and the push rod and the locking nail main body are provided with self-locking structures which are matched with each other; the push rod moves forward to drive the pressing wire piece to move relative to the locking nail main body so as to lock a medical wire between the pressing wire piece and the locking nail main body; the self-locking structure is used for preventing the push rod from moving reversely under the action of the medical wire. A cutting member is slidably connected to the support for mating with the mating member to sever the medical line extending from the staple body.

According to the medical locking and cutting integrated device, the locking nail component, the locking wire component and the cutting wire component are mutually connected through the base component, so that the locking wire function and the cutting wire function are integrated into a whole, the locking wire operation and the cutting wire operation can be completed by one-time intervention of an instrument, the times of the intervention of the instrument in a surgical body can be reduced, the surgical operation process is simplified, and the surgical time is saved; in the tangential operation process, the distal end of the push rod in the locking wire component and the self-locking structure on the locking pin main body of the locking pin component can keep the locking pin component to lock the medical wire, so that the medical wire is always in a locked state, the medical wire is prevented from loosening from the locking pin component, the locking pin component is prevented from falling off, and the risk of the falling off of the locking pin component to a human body is avoided.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings that are required to be used in the embodiments will be briefly described below. It is obvious that the drawings in the following description are only some implementations provided by way of example of the present application, and that other drawings may be obtained from these drawings by those of ordinary skill in the art without the inventive effort.

Fig. 1 is a schematic perspective assembly view of a medical lock-cutting integrated device according to an embodiment of the present disclosure;

FIG. 2 is an axial cross-sectional view of the medical lock-cut integrated device of FIG. 1;

FIG. 3 is an exploded perspective view of the medical latch and switch integrated device of FIG. 1;

FIG. 4 is a perspective assembly view of the medical lock-cut integrated device of FIG. 1 from a perspective with the sleeve removed;

FIG. 5 is a perspective assembly schematic view of the medical lock cutting integrated device of FIG. 1 from another perspective with the sleeve removed;

FIG. 6 is a perspective assembly schematic view of a base member removal sleeve in a medical lock-cut integrated device;

FIG. 7 is an axial cross-sectional schematic view of a base member removal sleeve in a medical lock-cut integrated device;

FIG. 8 is a perspective view of the support and mating member in the base member assembled together;

fig. 9, 10 and 11 are perspective views of a first substrate in the substrate member from different perspectives;

FIG. 12 is a perspective assembly schematic view of a staple component of the medical latch integrated device;

FIG. 13 is a perspective assembly schematic view of another view of the staple component of the medical latch integrated device;

FIG. 14 is an exploded perspective view of the staple member;

FIG. 15 is a schematic view of the staple member with the cover plate removed;

FIG. 16 is a schematic cross-sectional view of the staple body in the staple member in an axial direction;

FIG. 17 is a perspective view of a tangential component in the medical lock-cutting integrated device;

FIGS. 18 and 19 are schematic views illustrating a process of locking a medical wire by the medical locking and cutting integrated device;

FIG. 20 is a schematic view of a medical lock-cut integrated device cut line;

FIG. 21 is a schematic view of the staple member separated from the first substrate;

fig. 22 is a perspective view of the staple member after securing the medical wire and releasing the first substrate.

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. It will be apparent that the described embodiments are only some, but not all, of the embodiments of the present application. All other embodiments, which can be made by one of ordinary skill in the art without undue burden from the present disclosure, are within the scope of the present disclosure.

Furthermore, the following description of the embodiments refers to the accompanying drawings, which illustrate specific embodiments that can be used to practice the present application. Directional terms, such as "upper", "lower", "front", "rear", "left", "right", "inner", "outer", "side", etc., in the present invention are merely referring to directions of the attached drawings, and thus, directional terms are used for better, more clear description and understanding of the present application, rather than indicating or implying that the apparatus or element being referred to must have a specific orientation, be constructed and operated in a specific orientation, and thus, should not be construed as limiting the present invention.

Orientation definition: for clarity of description, the end proximal to the operator and the end distal to the operator will be referred to as the "proximal end" in the surgical procedure; "axial" refers to a direction parallel to the line connecting the distal center and the proximal center of the medical device; "radial" refers to a direction perpendicular or substantially perpendicular to the axial direction. "circumferential" refers to a direction about the axial direction. The foregoing definitions are provided for convenience of description and are not to be construed as limiting the present application.

Referring to fig. 1, an embodiment of the present application provides a medical locking and cutting integrated device 100 for locking a medical wire 200 and cutting off redundant medical wires 200.

Referring to fig. 2, 3, 4 and 5, the medical lock and cutting integrated device 100 includes a base member 10, a locking pin member 20, a locking wire member 30 and a cutting wire member 50. The locking pin member 20 is detachably provided on the base member 10. The locking wire member 30 is detachably connected with the locking pin member 20 for driving the locking pin member 20 to lock the medical wire 200. The wire cutting member 50 is slidably coupled to the base member 10 for cutting off excess medical wire 200 extending from the staple member 20.

Referring to fig. 2 to 5, 6, 7 and 8, the base member 10 includes a first base 11, a supporting member 13 and a mating member 15. The distal end of the support 11 is fixedly connected to the first base 11. The mating member 15 is provided on the support member 11.

Referring to fig. 2 to 5 and fig. 12 to 14, the locking pin member 20 includes a locking pin body 21 and a pressing member 23 movably connected to the locking pin body 21. The latch main body 21 is detachably provided in the first base 11.

Referring to fig. 2 to 5, the locking wire member 30 includes a push rod 31, and a distal end of the push rod 31 is detachably connected to the locking pin main body 21, and the push rod and the locking pin main body have a self-locking structure 210. The push rod 31 is moved forward to drive the wire pressing member 23 to move relative to the staple body 21 to lock the medical wire 200 between the wire pressing member 23 and the staple body 21. The self-locking structure 210 is used to prevent the push rod 31 from moving in the opposite direction under the medical line 200. Wherein, forward refers to the movement from the proximal end to the distal end, and forward movement refers to the movement from the proximal end to the distal end; reversing refers to distal to proximal movement and reversing movement refers to distal to proximal movement. In the subsequent cutting process, the medical wire 200 needs to be pulled towards the proximal end, the pressing wire piece 23 has a trend of reverse movement under the driving of the medical wire 200, if the self-locking structure 210 is not arranged, the push rod 31 may be driven by the pressing wire piece 23 to move in the reverse direction, so that the locking force of the locking nail component 20 on the medical wire 200 is triggered to be reduced, and even the medical wire is loosened from the locking nail component, so that the locking nail component is caused to fall off; it is because the self-locking structure 210 is provided, after the push rod 31 moves forward to drive the wire pressing member 23 to move relative to the locking nail main body 21 to lock the medical wire 200 between the wire pressing member 23 and the locking nail main body 21, the pulling of the medical wire 200 in the cutting process is insufficient to overcome the self-locking effect of the self-locking structure 210, and the push rod 31 keeps the position of locking the medical wire 200 and does not move reversely under the action of the medical wire 200. In this embodiment, the self-locking structure 210 includes an external thread 311 (as shown in fig. 2 and 3) disposed at a distal end of the push rod 31 and a threaded hole 211 (as shown in fig. 2) disposed at a proximal end of the locking pin body 21 and adapted to the external thread, that is, the push rod 31 and the locking pin body 21 realize self-locking through the threaded self-locking structure 210; the unlocking between the push rod 31 and the locking nail main body 21 can be realized by rotating the push rod 31, and the self-locking is established between the internal thread and the external thread when the push rod 31 is stopped, so that the operation is simple and convenient. It is understood that the self-locking structure 210 is not limited to threaded connection, and the push rod 31 and the locking pin main body 21 may be self-locked by other manners, such as a clamping manner, etc.

Referring to fig. 2 to 5, 17 and 20, the tangential member 50 is slidably connected to the support 13. The cutting member 50 is adapted to cooperate with the counterpart 15 to cut off the medical wire 200 extending from the locking staple body 21.

Taking the medical wire 200 as an artificial tendon repair wire as an example, after the cutting is completed, the locking pin main body 21 is easily pulled out from the first base body 11 under the pulling of the heart beat, in the process, the pulling direction of the heart beat to the medical wire 200 is towards the distal end, and the acting force of the medical wire 200 to the wire pressing member 23 is towards the distal end, so that the locking pin member 20 can press the medical wire 200 more tightly.

Specifically, referring to fig. 9, 10 and 11, referring to fig. 3 to 6, the first base 11 includes a first mounting portion 111 and a second mounting portion 113 fixedly connected to each other. The first mounting portion 111 is located at the proximal end of the first base 11. The first mounting portion 111 is provided with a through groove 1111 penetrating in the axial direction for accommodating the support 13. The proximal end of the first mounting portion 111 has a step 1113 for engagement with the tangential member 50. In the present embodiment, the step 1113 is formed by removing a part of the material in the radial direction at the proximal end of the first mounting portion 111. The second mounting portion 113 is provided with a receiving groove 1131 penetrating in the axial direction for receiving the lock pin body 21.

Referring to fig. 3 to 6, 7 and 9, the supporting member 13 extends in the axial direction. The proximal end of the support member 13 is fixedly attached within the through slot 1111. The supporting member 13 is provided with a penetrating channel 131 penetrating along the axial direction and communicating with the accommodating groove 1131, so as to penetrate the push rod 31. The through passage 131 communicates with the threaded hole 211 (shown in fig. 2). The push rod 31 is movably arranged in the penetrating channel 131. The through passage 131 provides a limiting and guiding function for the push rod 31.

Referring to fig. 1 to 6, the base member 10 further includes a second base 16 and a sleeve 17. The second base 16 is fixed to the proximal end of the support 13. The mating element 15 is located between the tangential member 50 and the second body 16. The sleeve 17 is sleeved outside the first base 11, the tangential member 50, the matching piece 15 and the second base 16. The two ends of the sleeve 17 are fixedly connected with the first base 11 and the second base 16 respectively. The second base 16 supports the sleeve 17 together with the first base 11. The sleeve 17 is provided with a wire passing hole 171 for guiding out the medical wire 200 extending from the staple body 21. The sleeve 17 is substantially cylindrical, and the arrangement of the sleeve 17 improves the uniformity and smoothness of the appearance of the medical lock-cutting integrated device 100, thereby improving the smoothness of the running of the medical lock-cutting integrated device 100 in a blood vessel. In the present embodiment, referring to fig. 9 to 11, the outer contour of the second mounting portion 113 of the first base 11 is circular, and has a larger diameter for fitting the distal end face of the sleeve 17; the outer contour of the distal end of the first mounting portion 111 is generally circular but slightly reduced in diameter to mate with the inner wall of the sleeve 17. It will be appreciated that the shape of the sleeve 17 is not limited.

The base member 10 further comprises a positioning element 18, the mating element 15 being provided with a first positioning hole 151 and the sleeve 17 being provided with a second positioning hole 173 extending through a side wall of the sleeve 17. The positioning piece 18 is inserted into the first positioning hole 151 and the second positioning hole 173 to fix the matching piece 15 and the sleeve 17 together, so as to facilitate the assembly of the base member 10. In the present embodiment, the number of the first positioning holes 151 on the mating member 15 is two, the number of the second positioning holes 173 is two, the number of the positioning members 18 is two, and the two first positioning holes 151 are symmetrically arranged along the same diameter of the mating member 15 with respect to the axis. It will be appreciated that the number of positioning members 18 of the present application is not limited.

The latch main body 21 is clearance fit in the receiving groove 1131. The gap between the inner wall of the receiving groove 1131 and the outer wall of the locking pin body 21 is preferably in the range of [0.03,0.15] mm, more preferably [0.06,0.10] mm, so that the locking pin body 21 can be easily fitted into the receiving groove 1131 and removed from the receiving groove 1131.

Referring to fig. 12, 13 and 14, and referring to fig. 1 to 5, the latch main body 21 includes a first mounting portion 214 and a second mounting portion 215. The first mounting portion 214 is located at the proximal end of the staple body 21. In the present embodiment, the first mounting portion 214 has a substantially truncated cone shape so that the lock pin body 21 is more easily separated from the first base 11. A threaded hole 211 (shown in fig. 13) is provided at the proximal end of the first mounting portion 214, to enable detachable connection of the first mounting portion 214 to the push rod 31. The first mounting portion 214 is reduced in size in various directions, including radial and axial directions, as compared to the second mounting portion 215.

The second mounting portion 215 of the latch main body 21 is clearance fit with the inner wall of the receiving groove 1131 (as shown in fig. 2). The first base 11 and the second mounting portion 215 are further provided with a rotation stopping structure which is mutually matched, the rotation stopping structure is used for preventing the locking nail main body 21 from rotating relative to the first base 11, and when the medical locking and cutting integrated device 100 performs a locking line operation, the locking nail main body 21 does not rotate, and the push rod 31 rotates and axially moves relative to the locking nail main body 21.

In the present embodiment, the rotation stopping structure between the first base 11 and the second mounting portion 215 is at least a pair of mutually matched planes. Specific: the first substrate 11 has two opposite planes on the inner wall of the accommodating groove 1131. The second mounting portion 215 of the staple body 21 includes a first outer surface 2151 (shown in fig. 13), a second outer surface 2152 (shown in fig. 13), a third outer surface 2153 (shown in fig. 12), and a fourth outer surface 2154 (shown in fig. 12) that are interconnected. The first outer surface 2151 is disposed opposite the third outer surface 2153, and the second outer surface 2152 is disposed opposite the fourth outer surface 2154. The first outer surface 2151 and the third surface 2153 are circular arc surfaces, and the second outer surface 2152 and the fourth outer surface 2154 are flat surfaces. The second outer surface 2152 is in non-rotational engagement with a flat surface within the receptacle 1131 of the first base 11, and the fourth outer surface 2154 is in non-rotational engagement with another flat surface within the receptacle 1131 of the first base 11. In other words, the rotation stopping structure between the first base 11 and the second mounting portion 215 is two pairs of mutually matched planes. It is understood that the present application does not limit the first outer surface 2151 and the third surface 2153 to be circular arc surfaces, and does not limit the second outer surface 2152 and the fourth outer surface 2154 to be flat surfaces, and the second mounting portion 215 may be in rotation-preventing fit with the inner wall of the first base 11. It is understood that the rotation stop feature 216 may also include, but is not limited to, axially extending and mating protrusions and recesses.

The staple body 21 has a receiving cavity 217 for receiving the wire 23. The receiving cavity 217 extends from the first mounting portion 215 to the second mounting portion 215. The receiving cavity 217 penetrates the second mounting portion 215 away from the distal end of the first mounting portion 214, i.e. the distal end opening of the staple body 21, to facilitate assembly and disassembly between the wire pressing member 23 and the staple body 21. The inner wall of the receiving cavity 217 is provided with a wire pressing groove 2171. The crimp slot 2171 has a bottom wall 2173. As push rod 31 moves forward, wire pressing member 23 is driven gradually toward bottom wall 2173 until the gap between wire pressing member 23 and bottom wall 2173 is smaller than the diameter of medical wire 200, to lock medical wire 200 between wire pressing member 23 and bottom wall 2173.

The staple body 21 further comprises a guide 218 provided on a side wall of the receiving cavity 217. The wire 23 is movably connected to the guide 218 and is movable along the guide 218. The guide portion 218 is used to guide the movement of the wire 23 relative to the staple body 21. The guide 218 is gradually closer to the bottom wall 2173 from its proximal end to its distal end. The guide portion 218 includes a first guide portion 2181 and a second guide portion 2183. The first guide portion 2181 is located at a proximal end of the guide portion 218, the first guide portion 2181 is disposed obliquely with respect to an axial direction of the staple body 21, and the second guide portion 2183 extends in the axial direction of the staple body 21.

The staple body 21 further includes a wire outlet hole 219 in communication with the receiving cavity 217. The wire outlet hole 219 extends from the first surface 2151 of the second mounting portion 215 to the first mounting portion 214, the wire outlet hole 219 being for guiding the medical wire 200 out of the receiving cavity 217. The wire outlet 219 is disposed obliquely with respect to the axial direction. The ratio range between the length of the wire outlet 219 and the length of the staple body 21 is preferably [1/3,1/2], and the ratio range between the width of the wire outlet 219 and the maximum width of the staple body 21 is preferably [1/3,1], so that the wire outlet 219 is arranged to reduce the weight of the staple body 21 to the maximum extent, reduce the volume of the staple body 21, and reduce the influence on human tissues after the release of the staple member 20 which locks the medical wire 200.

The pressing member 23 is movably accommodated in the accommodating chamber 217 and movably connected with the guide portion 218. In this embodiment, the wire 23 includes a wire pressing portion 231 and a connecting portion 233 that are fixedly connected. The pressing portion 231 may be pressed onto the bottom wall 2173 of the pressing groove 2171. The outside diameter of the pressing line part 231 is larger than the outside diameter of the connecting part 233. The connection portion 233 is rotatable within the guide portion 231, and the pressing portion 231 is disposed coaxially with the connection portion 233. Referring to fig. 15 and 16, let the axial direction of the staple main body 21 be the first direction, the extending direction of the central axis of the wire pressing member 23 be the second direction, the directions perpendicular to the first direction and the second direction be the third direction, the width of the wire pressing portion 231 in the second direction be W1, the width of the wire pressing groove 217 in the second direction be W2, the diameter of the wire pressing portion 231 be D1, the height of the distal end of the guiding portion 218 along the third direction be H2, the maximum distance between the distal end of the guiding portion 218 and the bottom wall 2173 of the distal end of the wire pressing groove 2171 be H1, the diameter of the medical wire 200 be D2, and the following steps:

w2> W1, and

0≤H1-H2/2-D1/2≤D2。

the pressing member 23 further includes a limiting portion 235 fixed to the connecting portion 233, for preventing the connecting portion 233 from being separated from the guiding portion 18. In this embodiment, the guiding portion 18 is a guiding groove penetrating through the locking pin main body 21, the connecting portion 233 passes through the guiding groove, the limiting portion 235 is located outside the locking pin main body 21, and the diameter of the limiting portion 235 is larger than the opening height of the guiding groove. In the present embodiment, the guide portion 18 is disposed on the second surface 2152 and the fourth surface 2154. In other embodiments, the guide portion 18 may be a guide rail provided on an inner wall of the accommodating cavity 217, the connecting portion 233 may be accommodated in the accommodating cavity 217 and may roll along the guide rail, and the limiting portion 235 may be omitted.

The locking pin member 20 further includes an end cap 25, and the end cap 25 is fixedly disposed on the distal end of the second mounting portion 215 to close the distal end of the locking pin body 21. The end cap 25 also serves to limit the movement of the wire 23 on the guide 218, preventing the wire 23 from being disengaged from the staple body 21. The lock pin main body 21 and the end cover 25 are arranged in a split mode, and assembling and disassembling of the line pressing piece 23 are facilitated. The end cap 25 is provided with an access hole 251, the access hole 251 being used to pass the medical wire 200 into the receiving cavity 217. Assuming that the axial length of the staple body 21 is L1, the axial length of the first base 11 is L, the axial length of the distal end of the support 13 inserted into the first base 11 is L2, and the axial length of the end cap 25 along the staple body 21 is L3, the following condition l=l1+l2+l3 is satisfied.

Since the locking pin member 20 (including the locking pin body 21, the wire pressing member 23 and the end cap 25) is finally implanted in the human body, the material of the locking pin member 20 includes but is not limited to biocompatible materials such as stainless steel, pure titanium, nickel titanium, cobalt chromium alloy, etc., preferably pure titanium, stainless steel.

Referring to fig. 2 to 7, referring to fig. 18 to 20, the push rod 31 of the locking wire member 30 is movably disposed in the through channel 131. When the push rod 31 rotates so that the push rod 31 moves in the axial distal direction (i.e., forward direction) synchronously, the pressing wire 23 is pushed to move from the proximal end to the distal end along the guide portion 218 (i.e., forward direction), the medical wire 200 is gradually pressed in the pressing wire portion 231 and the pressing wire groove 2171 of the pressing wire 23, then the wire cutting member 50 moves in the axial proximal direction, the redundant medical wire 200 is cut off on the matching piece 15, and in the wire cutting process, the distal end of the push rod 31 continuously pushes the pressing wire 23 due to the self-locking effect of the external thread on the push rod 31 and the threaded hole 211 of the locking pin main body 21, so that the pressing wire 23 is prevented from moving proximally, the pressing wire portion 231 of the pressing wire 23 and the bottom wall 2173 of the pressing wire groove 2171 always keep the minimum gap to press the medical wire 200, and even if the medical wire 200 is pulled proximally or otherwise forced in the operation, the medical wire 200 can be prevented from loosening, and the locking reliability is ensured.

The wire locking member 30 further includes a wire locking core 33 fixedly attached to the proximal end of the push rod 31. The lock wire inner core 33 is used for driving the push rod 31 to rotate and axially move. The locking wire core 33 is a flexible body with torsion-resistant supporting force, preferably a flexible body such as a laser cutting tube, a spring, a stainless steel wire, a multilayer solid core shaft, and the like, and in this embodiment, the locking wire core 33 is a stainless steel wire. The push rod 31 is rotated and moved by driving the lock wire core 33 to rotate. The lock wire inner core 33 is rotated in a preset direction, the lock wire inner core 33 drives the push rod 31 to move forward towards the distal end, and the push rod 31 can drive the wire pressing piece 23 to move relative to the lock pin main body 21. After the thread cutting is completed, the thread locking inner core 33 is rotated in the opposite direction, the thread locking inner core 33 drives the push rod 31 to move in the opposite direction towards the proximal end, and the distal end of the push rod 31 is separated from the locking pin main body 21.

Referring again to fig. 2-5, in conjunction with fig. 17 and 20, the tangential member 50 includes a seat 51, an insert 53, and a driver 55. The tool holder 51 is used for carrying the blade 53, and the driving member 55 is used for driving the blade 53 to move.

The tool holder 51 is located between the first base body 11 and the mating element 15. The tool holder 51 is slidably sleeved on the support member 13 so as to be capable of moving along the support member 13. The holder 51 is provided with a mounting groove 511 for mounting the insert 53. The tool holder 51 further includes a third mounting portion 512 and a fourth mounting portion 514. The fourth mounting portion 514 is axially protruding on the distal end surface of the third mounting portion 512. The proximal end of the third mounting portion 512 is provided with a through hole 5120 for passing the supporting member 13. The third mounting portion 512 is in a rotationally fixed connection with the support 13. Preferably, referring to fig. 17 and 8, the supporting member 13 includes two oppositely disposed flat surfaces 135 and two oppositely disposed curved surfaces 137, the profile of the through hole 5120 is adapted to the profile of the supporting member 13, and the tool holder 51 is prevented from rotating relative to the supporting member 13 by the cooperation of the flat surfaces.

The fourth mounting portion 514 is provided to cover the step 1113 and is slidable in the axial direction of the first base 11. The step 1113 is used for providing support for the tool holder 51, and also provides guidance for axial movement of the tool holder 51, which is beneficial for improving stability of movement of the tool holder 51. In addition, the step 1113 and the fourth mounting portion 514 are complementary and adapted in shape, and share a radial space and an axial space, so that the radial dimension and the axial length of the whole distal end of the medical locking and cutting integrated device 100 are reduced, which is beneficial to reducing the volume of the medical locking and cutting integrated device 100 and reducing the weight of the medical locking and cutting integrated device 100.

The blade 53 is fixedly received in the mounting groove 511. After assembly, a gap 530 (shown in FIG. 2) is provided between the blade 53 and the support 13 for the medical wire 200 (shown in FIGS. 1, 4 and 5) of the self-locking staple body 21 to pass through and under the blade 53. The blade 53 has a cutting edge 531. Referring to fig. 4, the mating member 15 further has a tangential surface 153 opposite to the cutting edge 531, and the cutting edge 531 cooperates with the tangential surface 153 to cut off the medical wire 200 extending from the wire outlet 219 of the self-locking pin body 21. The tangential surface 153 is used to provide abutment for the medical wire 200 during the cutting process of the cutting member 50 to facilitate cutting of the medical wire 200 by the cutting edge 531. In the present embodiment, the tangential plane 153 is a plane. It will be appreciated that the tangential surface 153 may also be a curved surface.

The driving member 55 is fixedly connected with the tool holder 51 to drive the tool holder 51 to move along the supporting member 13 toward the mating member 15, so that the blade 53 cooperates with the mating member 15 to cut off the medical wire 200 extending from the wire outlet 219 of the self-locking nail body 21. The driving piece 55 comprises a connecting rod 551, a guiding piece 553 and a tangential inner core 555. The connecting rod 551 is fixedly connected between the guide 553 and the third mounting portion 512 of the tool holder 51. The tangential inner core 555 is fixedly connected with the guide piece 553 and is used for driving the connecting rod 551, the guide piece 553 and the tool apron 51 to axially move.

More specifically, the proximal end of the third mounting portion 512 of the tool holder 51 is provided with a connection hole 5121. The connecting rod 551 is fixedly connected with the connecting hole 5121, so that the connecting rod 551 is fixedly connected with the tool apron 51. The matching element 15 is also provided with a guide hole 155, and the connecting rod 551 passes through the guide hole 155 (as shown in fig. 8). In the present embodiment, the guide hole 155 is a substantially half-waist-shaped hole, and the guide hole 155 penetrates the peripheral wall of the mating member 15. The inner wall of the guide hole 155 guides the movement of the connection rod 551 with respect to the supporter 13. The connecting rod 551 is a rigid body having a certain length, preferably a rigid body such as a stainless steel tube or a stainless steel rod, and in this embodiment, a stainless steel rod is used. In this embodiment, the number of the connecting rods 551 is two, the supporting member 13 is located between the two connecting rods 551, the two connecting rods 551 are symmetrically arranged about the central axis of the supporting member 13, and the stability of the movement of the tool apron 51 relative to the supporting member 13 is improved. It is understood that the present application does not limit the number of the connection bars 551.

The guide piece 553 is slidably sleeved on the support piece 13, and the guide piece 553 is fixedly connected with the proximal end of the connecting rod 551. The guide 553 is used to guide the movement of the tool holder 51. The guide 553 is located between the mating piece 15 and the second base 16. Referring to fig. 2, the portion of the support 13 between the first base 11 and the mating member 15 serves as a guide for axial movement of the tool holder 51, and the portion of the support 13 between the mating member 15 and the second base 16 serves as a guide for axial movement of the guide 553. The guide 553 is also provided with a through hole 5531 which is matched with the shape of the support 13, so as to ensure the rotation stopping and guiding functions. The outer shape of the guide 553 includes, but is not limited to, a circular shape, an oval shape, and the like.

The tangential inner core 555 is fixedly connected with the proximal end of the guide 553. The mating piece 15 is located between the tool holder 51 and the guide piece 553. The tangential inner core 555 is a flexible body with torsion-resistant supporting force, preferably a flexible body such as a laser cutting tube, a spring, a stainless steel wire, a multilayer solid core shaft and the like, and the stainless steel wire is selected in the embodiment. The tangential inner core 555 applies an axial driving force to the guide member 553, and the guide member 553 drives the connecting rod 551 to move axially so as to drive the tool holder 51 and the blade 53 to move.

According to the lock-cutting integrated device 100 provided by the embodiment of the application, the lock pin member 20, the lock wire member 30 and the thread cutting member 50 are mutually connected through the base member 10, so that the lock wire function and the thread cutting function are integrated, the lock wire operation and the thread cutting operation can be completed by one-time intervention of an instrument, the frequency of the intervention of the instrument in a surgical body can be reduced, the surgical operation process is simplified, and the surgical time is saved; in the tangential operation process, the self-locking structure 210 on the distal end of the push rod 31 in the locking wire member 30 and the locking pin main body 21 of the locking pin member 20 can keep the locking pin member 20 to lock the medical wire 200, so that the medical wire 200 is ensured to be in a locked state all the time, the medical wire 200 is prevented from loosening from the locking pin member 20, the locking pin member 20 is prevented from falling off, and the risk of the falling off of the locking pin member 20 to a human body is avoided.

The mitral valve is a unidirectional "valve" between the Left Atrium (LA) and the Left Ventricle (LV), which ensures that blood flows from the left atrium to the left ventricle. A normal healthy mitral valve has multiple chordae tendineae. The valve leaflet of the mitral valve is divided into an anterior leaflet and a posterior leaflet, and when the left ventricle is in a diastole state, the two are in an open state, and blood flows from the left atrium to the left ventricle; when the left ventricle is in a contracted state, chordae tendineae are stretched, so that the valve leaflet cannot be flushed to the atrial side by blood flow, and the front leaf and the rear leaf are well closed, thereby ensuring that blood flows from the left ventricle to the aorta through the Aortic Valve (AV). If the mitral valve is ruptured, the mitral valve will not return to a fully closed state as in the normal state when the left ventricle is in a contracted state, but the insufficiency phenomenon occurs, and the impulse of blood flow will further cause the valve leaflet to drop into the left atrium, resulting in regurgitation of blood.

The following describes a process of using the medical lock-cutting integrated device 100 according to the present embodiment in a chordae tendineae prosthesis, taking a chordae tendineae prosthesis of a mitral valve as an example, that is, a medical thread as a prosthetic chordae tendineae prosthesis.

The first step: one or more medical wires 200 are first implanted into the anterior or posterior leaflet of the mitral valve.

And a second step of: penetrating the medical wire 200 on the leaflet into the anchoring device's anchors outside the patient's body and delivering the anchors into the left ventricle and anchoring the anchors to the anterior papillary muscle or posterior papillary muscle or ventricular wall;

and a third step of: the medical wire 200 on the valve leaflet is all penetrated into the locking pin member 20 of the medical locking and cutting integrated device 100 outside the patient's body, and the medical wire 200 is penetrated out through the wire outlet hole 219 on the locking pin body 21 and the wire through hole 171 on the sleeve 17, as shown in fig. 1.

Fourth step: along the guide of the medical wire 200, the distal end of the medical locking and cutting integrated device 100 is pushed into the left atrium of the heart through the femoral vein and the atrial septum, and the anterior papillary muscle or the posterior papillary muscle of the left ventricle is moved closer together, while the medical wire 200 is pulled until the distal end of the medical locking and cutting integrated device 100 reaches a predetermined position in the left ventricle.

Fifth step: the tightness of the medical lines 200 is adjusted separately while the state in which mitral regurgitation is minimized is determined by ultrasound, and when this state is reached, the adjustment is stopped and the tightness state of each medical line 200 is maintained. Referring to fig. 18, the wire pressing member 23 is located at the proximal end of the staple body 21. The wire locking member 30 is rotated and the push rod 31 is driven axially distally against the wire pressing member 23 to continue to press the medical wire 200 into the wire pressing groove 2171 (shown in fig. 14) of the staple body 21. When the wire pressing member 23 moves to be limited by the end cap 25, the medical wire 200 is pressed against the staple body 21 by the wire pressing member 23, as shown in fig. 19.

Sixth step: after compression of the medical wire 200, an axial pulling force is applied to the wire cutting core 555, and the wire cutting member 50 is moved distally and proximally under the guide of the support member 13, cutting the excess medical wire 200 off the wire cutting surface 153 of the mating member 15, as shown in fig. 20. Specifically, during the cutting process, the cutting edge 531 of the blade 53 abuts against the tangential surface 153, and the tangential surface 153 provides abutment for the medical wire 200, and provides an impetus for the cutting edge 531 of the blade 53, so that the medical wire 200 is easily cut; meanwhile, because the cutting edge 531 of the blade 53 and the tangent plane 153 are in a mutually abutting relationship, a mutually staggered relationship similar to that of scissors is not generated, so that the abnormal condition of the extruded wire does not exist between the blade 53 and the tangent plane 153, the whole medical locking and cutting integrated device 100 is ensured to be successfully withdrawn, and the risk of pulling organ tissues due to the extruded wire is avoided. During the cutting process of the cutting member 50, the wire pressing member 23 is still kept at a position where the medical wire 200 is locked due to the self-locking structure 210, without loosening.

After the thread cutting is completed, the thread locking member 30 (the push rod 31 and the thread locking core 33) is rotated to drive the thread locking member 30 to move proximally in the axial direction, the distal end of the push rod 31 is separated from the locking pin main body 21 of the locking pin member 20, and the locking pin member 20 is easily released from the first base 11 under the action of heart beat due to the truncated cone-shaped structure of the proximal end of the locking pin main body 21, as shown in fig. 21.

Seventh step: the base member 10, the locking wire member 30, the wire cutting member 50, and the excess medical wire 200 of the medical lock-cutting integrated device 100 are withdrawn from the patient, and the locking pin member 20 remains in the patient, at which time the locking pin member 20 secures the medical wire 200 (as shown in fig. 22) to the anterior papillary muscle or the posterior papillary muscle or the ventricular wall, and the chordae tendineae are completed.

It can be appreciated that the medical thread 200 may also be a suture thread, a repair thread for performing edge-to-edge repair on a valve, etc., and the medical locking and cutting integrated device 100 provided in the present application may also be applied to a tissue suturing operation, a valve edge-to-edge repair operation, etc., to lock and cut the medical thread 200.

The foregoing is a partial embodiment of the present application and it should be noted that, for a person skilled in the art, several improvements and modifications can be made without departing from the principle of the present application, and these improvements and modifications are also considered as the protection scope of the present application.

Claims (17)

1. A medical locking and cutting integrated device, comprising:

the base body component comprises a first base body, a supporting piece and a matching piece, wherein the distal end of the supporting piece is fixedly connected with the first base body, and the matching piece is arranged on the supporting piece;

the locking pin component comprises a locking pin main body and a pressing line piece movably connected with the locking pin main body, and the locking pin main body is detachably arranged in the first base body;

a lockwire member including a push rod; the distal end of the push rod is detachably connected with the locking nail main body, and the distal end of the push rod and the locking nail main body are provided with self-locking structures which are matched with each other; the push rod moves forward to drive the pressing wire piece to move relative to the locking nail main body so as to lock a medical wire between the pressing wire piece and the locking nail main body; the self-locking structure is used for preventing the push rod from moving reversely under the action of the medical line; and

and a cutting member slidably coupled to the support member, the cutting member being adapted to cooperate with the mating member to cut the medical wire extending from the staple body.

2. The medical lock-cutting integrated device of claim 1, wherein the tangential member comprises a blade holder, a blade, and a driver; the tool apron is sleeved on the supporting piece in a sliding way between the first base body and the matching piece; the blade is fixedly arranged on the blade holder; the driving piece is fixedly connected with the tool apron, so that the tool apron is driven to move along the supporting piece towards the matching piece, and the blade and the matching piece are matched to cut off the medical wire extending from the locking nail main body.

3. The medical lock-cutting integrated device according to claim 2, wherein the tool holder is provided with a mounting groove, the blade is fixedly accommodated in the mounting groove, a gap is formed between the blade and the supporting member, the blade is provided with a cutting edge, the matching member is provided with a tangential surface opposite to the cutting edge, and the cutting edge is matched with the tangential surface for cutting off a medical line extending from the lock pin main body.

4. The medical lock-cut integrated device of claim 2, wherein the first base comprises a first mounting portion and a second mounting portion fixedly connected; the first mounting part is positioned at the proximal end of the first base body, and the proximal end of the first mounting part is provided with a step; the tool apron comprises a third installation part and a fourth installation part, the fourth installation part is axially arranged on the far end surface of the third installation part in a protruding mode, and the fourth installation part is arranged on the step in a covering mode and can axially slide along the first base body.

5. The medical lock-cutting integrated device according to claim 4, wherein the tool holder is provided with a mounting groove, and the mounting groove extends from the proximal end surface of the third mounting part to the fourth mounting part; the blade is fixedly accommodated in the mounting groove, and a gap is reserved between the blade and the supporting piece.

6. The medical lock-cutting integrated device according to claim 4, wherein the second mounting portion is provided with a receiving groove penetrating along the axial direction, and the lock pin main body is in clearance fit in the receiving groove; the first mounting part is provided with a through groove penetrating along the axial direction, and the proximal end of the supporting piece is fixedly connected in the through groove; the support piece is internally provided with a penetrating channel which penetrates through the support piece along the axial direction and is communicated with the accommodating groove, and the push rod movably penetrates through the penetrating channel.

7. The medical lock-cutting integrated device according to claim 2, wherein the driving member comprises a connecting rod, a guiding member and a tangent inner core, the connecting rod is fixedly connected with the proximal end of the tool apron, a guiding hole is arranged on the matching member, and the connecting rod passes through the guiding hole; the guide piece is sleeved on the support piece in a sliding way, the guide piece is fixedly connected with the proximal end of the connecting rod, and the tangent inner core is fixedly connected with the proximal end of the guide piece; the mating element is located between the tool holder and the guide element.

8. The medical lock-cut integrated device of claim 2, wherein the base member further comprises a second base and a sleeve, the second base being secured to the proximal end of the support, the mating element being located between the tool holder and the second base; the sleeve is sleeved outside the first base body, the tool apron, the matching piece and the second base body, and two ends of the sleeve are respectively and fixedly connected with the first base body and the second base body; the sleeve is provided with a wire passing hole for guiding out the medical wire extending out of the locking nail main body.

9. The medical lock-cut integrated device of claim 1, wherein the locking wire member further comprises a locking wire inner core, the locking wire inner core being a flexible body, the locking wire inner core being fixedly connected to the proximal end of the push rod.

10. The medical lock-cutting integrated device of claim 1, wherein the self-locking structure comprises an external thread provided at a distal end of the push rod and a threaded hole provided at a proximal end of the locking pin body and adapted to the external thread;

the support piece is internally provided with a penetrating channel penetrating through the support piece along the axial direction, the penetrating channel is communicated with the threaded hole, and the push rod movably penetrates through the penetrating channel.

11. The medical lock-cutting integrated device according to any one of claims 1 to 10, wherein the lock pin body has a receiving cavity, and the wire pressing member is movably received in the receiving cavity; the locking pin main body comprises a first mounting part and a second mounting part, and the first mounting part is positioned at the proximal end of the locking pin main body; the first mounting portion is reduced in size in each direction as compared to the second mounting portion.

12. The medical lock-cut integrated device of claim 11, wherein the first base is in clearance fit with the second mounting portion of the locking pin body, and the first base and the second mounting portion are provided with mutually-adapted rotation-stopping structures.

13. The medical lock and cut integrated device of claim 11, wherein the lock pin body further comprises a wire outlet hole in communication with the receiving cavity, the wire outlet hole extending from the second mounting portion to the first mounting portion, the wire outlet hole for guiding the medical wire out of the receiving cavity.

14. The medical lock-cut integrated device according to claim 13, wherein a ratio between a length of the wire-outlet hole and a length of the lock pin main body ranges from [1/3,1/2]; the ratio between the width of the wire outlet hole and the maximum width of the locking pin main body is in the range of [1/3,1].

15. The medical lock-cut integrated device according to claim 11, wherein the inner wall of the receiving cavity is provided with a wire-pressing groove, the wire-pressing groove having a bottom wall; when the push rod moves forward, the pressing line piece is driven to gradually approach the bottom wall until a gap between the pressing line piece and the bottom wall is smaller than the diameter of the medical line, so that the medical line between the pressing line piece and the bottom wall is locked.

16. The medical lock and cutting integrated device according to claim 15, wherein the lock pin main body further comprises a guide portion provided on a side wall of the accommodating chamber, the wire pressing member is movably connected with and moves along the guide portion, and the guide portion gradually approaches the bottom wall from a proximal end thereof to a distal end thereof.

17. The medical lock and cut integrated device according to claim 11, wherein the locking pin member further comprises an end cap, the end cap being fixedly capped at a distal end of the locking pin body, the end cap being provided with a wire-in hole for penetrating the medical wire into the receiving cavity.

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