CN116687481A

CN116687481A - Suture box of suture device, suture device and suture method

Info

Publication number: CN116687481A
Application number: CN202310987623.1A
Authority: CN
Inventors: 吴波; 胡建成; 张宇翔; 徐胜军
Original assignee: Hangzhou Rejoin Mastin Medical Device Co ltd
Current assignee: Hangzhou Rejoin Mastin Medical Device Co ltd
Priority date: 2023-02-14
Filing date: 2023-08-08
Publication date: 2023-09-05
Anticipated expiration: 2043-08-08
Also published as: CN116269563A; CN116687481B

Abstract

The invention provides a suture instrument wire box, a suture instrument and a suture method. The stapler cartridge includes a chin assembly; a tissue penetrator having a first end proximal to tissue and a second end distal from tissue, slidable within the stapler wire cartridge, the tissue penetrator first end including at least one notch; at least one suture is loaded on the tissue penetrator, the suture including at least one string loop; a suture retaining area in which at least one string loop is loaded and which extends in a direction toward the second end of the tissue penetrator to the suture end; and a securing device. When the tissue penetrator is retracted after being activated, the end suture at the loop is slowly tensioned until the loop is pulled into the tissue penetrator notch. The invention can keep the tension of the tail suture stable, is not influenced by the deformation of the tissue penetrator, and realizes the reliable hanging of the rope ring.

Description

Suture box of suture device, suture device and suture method

Technical Field

The invention relates to the technical field of medical instruments, in particular to a suture box of a suture instrument, a suture instrument and a suture method.

Background

Meniscal tear injuries are common in both young and elderly patients, and the movement of the tear member within the joint in an abnormal manner can result in pain and loss of joint function. Existing treatments are typically made with two incisions of about 3mm in the skin at the knee joint, with an articulation lens of about 5mm in diameter inserted into the joint through one of the incisions, and various surgical instruments passed through the other incision into the joint to examine internal structures and perform the surgical procedure. Although the tear can be arthroscopic, it is difficult for the instrument to pass through the narrow compartment of the knee to reach the designated suture area for suturing, so surgical procedures using suture-fixed tearing have high demands on instrument size and stability of the threading suture.

In chinese patent No. CN104939875B an automatic reload suture passer device and method is described, comprising a replaceable jaw case and a suture passer device. Wherein the jaw case includes a jaw housing and a tissue penetrator that is slidable distally and proximally within the jaw housing. The clamping jaw shell is also internally provided with a suture, and the suture comprises a first rope loop area and a second rope loop area. The tissue penetrator also has a releasable retainer thereon that abuts the tissue penetrator and releasably secures the first end region of the suture. The releasable retainer is capable of tensioning the suture between the first end region and the second loop region as the tissue penetrator is withdrawn proximally, the tensioning of the suture loading the second loop region into the suture engagement region of the tissue penetrator as the suture engagement region on the tissue penetrator is withdrawn past the second loop region.

Disclosure of Invention

In the prior art, as the tissue penetrator needs to turn when moving distally, the tissue penetrator can deform because of overcoming resistance, so that a gap between the tissue penetrator and a releasable retainer becomes larger, the clamping force of a suture at the tail end area of a second rope loop is influenced, the suture slips off, the tensioning of the suture is influenced, and the second rope loop area is influenced to be loaded into a suture joint area of the tissue penetrator; meanwhile, when the jaw shell with the radian design and the straight design is closed, access cannot be performed in a knee joint narrow compartment, so that the jaw box is designed to be of a telescopic structure, when the jaw is stretched out to start to be sewn, the straight jaw design can cause a meniscus on the access side to block a chute, an access port needs to be pressed downwards, and the operation steps and access difficulty of an operation process are increased; in addition, after the suture in the clamping jaw box is excited, the condition of the rope ring at the opening of the upper jaw can not be seen under an arthroscope during excitation because the opening of the upper jaw faces away from the incision and is shielded by the radian of femur, and visual information can not be provided for doctors.

The invention solves the technical problems that the traditional suture box of the suture instrument is not stable enough when loading the second rope ring, the instrument is difficult to access and the observation in the operation is inconvenient.

In order to solve the above technical problems, the present invention provides a suture instrument cartridge, including: a tissue penetrator having a first end proximal to tissue and a second end distal to tissue, the tissue penetrator first end including at least one notch; a chin assembly within which the tissue penetrator is slidable; at least one suture, said suture being loaded on said tissue penetrator, said suture comprising at least one string loop, said string loop being attachable to said tissue penetrator aperture; at least one suture retaining area, at least one of the string loops extending in the suture retaining area and toward the second end of the tissue penetrator to a suture end; and at least one fixation device, the suture end being connected to the fixation device.

The suture instrument wire box provided by the invention has at least the following beneficial effects:

firstly, when the tissue penetrator is retracted, the tail end suture of the rope ring loaded in the suture holding area along the second end direction of the tissue penetrator can be tensioned, the suture tensioning force is stable in the process and is not influenced by the deformation of the tissue penetrator until the rope ring is pulled into a notch of the tissue penetrator from the suture holding area, so that reliable hanging of the rope ring is realized.

Secondly, the suture is loaded on the tissue penetrator, so that operation steps in the operation can be reduced, and the suture can be threaded for multiple times through one access.

According to certain embodiments, the fixation device is provided on the tissue penetrator, enabling reduced structural complexity; the fixing device comprises at least one fixing hole, the tail end of the suture is inserted into or penetrates through the fixing hole, and the size of the tail end of the suture is larger than that of the fixing hole, so that the fixing of the fixing hole to the tail end of the suture is conveniently realized, and the tail end of the suture is prevented from slipping.

According to certain specific embodiments, the shape of the suture tail end is cake-shaped or cylindrical, and the fixing hole is a circular through hole or a circular blind hole, so that the suture tail end is convenient to process.

According to certain embodiments, the jaw assembly comprises a jaw, a slide rail, the jaw being coupled to the slide rail, the tissue penetrator being slidable within the slide rail; the chin also comprises a suture separation pin, one end of the suture separation pin is fixed on the chin, a chin channel is formed between the other end of the suture separation pin and the chin, the suture comprises a first rope loop and a second rope loop, the first rope loop passes through the suture separation pin, the second rope loop is loaded in the suture holding area and extends to the tail end of the suture in the second end direction of the tissue penetrator, and the suture can be conveniently managed when the tissue penetrator is excited or when the tissue penetrator is retracted; the jaw component is provided with an angle beta bent towards one side of the tissue penetrator, and the angle beta is smaller than 179 degrees, so that the angle beta can enable the approach to be more fit with the knee joint structure, the step of stretching the jaw in the prior art is omitted, and the instrument structure is simpler and more reliable.

Further, the angle β may be 165, 170, 175 degrees, where 175 degrees is optimal, conforming to human tissue structure.

According to certain embodiments, the stapler cartridge further comprises a magazine within which the suture is received adjacent the second end of the tissue penetrator, which acts to prevent the suture from becoming entangled as the suture is pulled upon and after the tissue penetrator is activated.

The invention also provides a suture device comprising the suture device wire box provided by the invention.

According to certain embodiments, the stapler further comprises a suture threading device, wherein the suture threading device sequentially comprises a palate assembly from a tissue approaching end to a tissue distancing end, the palate assembly comprises a palate, and the upper surface of the palate is of a straight design; the driving assembly is connected with the upper jaw assembly; and the handle assembly is connected with the driving assembly.

Further, the upper jaw assembly comprises an upper jaw, a sliding chute and a long connecting rod, wherein the upper jaw comprises an openable upper jaw window, the sliding chute and the lower jaw assembly form a sliding area, and the long connecting rod can slide in the sliding area; the driving assembly comprises a sliding rod and a steering block, the sliding rod is arranged in the lower jaw assembly of the suture instrument wire box, and the steering block is connected with one end of the long connecting rod of the upper jaw assembly, which is far away from tissues, and is used for pushing the long connecting rod to close or open the upper jaw; the handle assembly comprises a handle and a slide bar fixing piece, wherein the slide bar fixing piece is connected with one end, far away from tissues, of the slide bar of the driving assembly and is used for pushing the tissue penetrator.

The stitching instrument provided by the invention has at least the following beneficial effects:

the movable upper jaw window can conveniently observe the conditions of the tissue penetrator and the rope ring during excitation, so that a doctor can operate more confidently.

The upper surface of the upper jaw is of a straight design, and the head size of the stitching instrument can be reduced by combining the angle design of the lower jaw, so that the stitching instrument is convenient to access, and the operation steps of the instrument are reduced.

According to certain embodiments, the stapler cartridge includes a support, the handle assembly includes a guide bar, one end of the guide bar adjacent to the tissue is connected to the support, movement of the stapler cartridge can be limited, and the detachable structural design facilitates replacement of the stapler cartridge, saving surgical time.

The invention also provides a suturing method which uses the suturing device wire box provided by the invention or the suturing device provided by the invention.

According to some embodiments, the suturing method comprises the steps of:

loading the suture on a tissue penetrator, the first string loop passing through the suture spacer pin, hanging in the tissue penetrator aperture, the second string loop being located in the suture retaining area formed by the chin and the tissue penetrator, the second string loop extending in a second direction of the tissue penetrator to the suture end, the suture end being connected to the securing means, the suture being received in the magazine proximate the second end of the tissue penetrator;

the tissue penetrator is excited for the first time, and the tissue penetrator notch brings up the first rope ring and moves along the tissue penetrator channel towards the first end direction to penetrate tissue;

the tissue penetrator is retracted, the retraction stroke is larger than the advancing stroke when the tissue penetrator is excited for the first time, the tail end suture of the second rope loop along the second end direction of the tissue penetrator is tensioned, and the tensioned tail end suture pulls the second rope loop into the tissue penetrator notch from the suture retaining area;

exciting the tissue penetrator for the second time, wherein the tissue penetrator notch brings up the second rope ring and moves along the tissue penetrator channel towards the first end direction, the suture tail end is separated from the fixing device, the tissue penetrator penetrates through tissue, and the suture in the suture storage box is correspondingly taken out;

the tissue penetrator is retracted and the stapler cartridge is withdrawn from the tissue, and the suture within the stapler cartridge is disengaged from the stapler cartridge by the suture separation pin and the chin channel between the chin.

According to some embodiments, the suturing method comprises the steps of:

squeezing the handle to close the palate, and allowing the stapler to enter the tissue;

squeezing the handle to cause the stapler to engage tissue;

activating the tissue penetrator a first time, the tissue penetrator notch carrying the first string ring and passing through the upper jaw window page, the first string ring being gripped by the upper jaw window page;

releasing the handle, the tissue penetrator retracting;

activating the tissue penetrator a second time, the tissue penetrator notch carrying the second string ring and passing through the upper jaw window page, the second string ring being gripped by the upper jaw window page;

releasing the handle, the tissue penetrator retracting;

the suture instrument withdraws from the tissue, and knots and cuts the thread;

pulling the support of the stapler cartridge to disengage the stapler cartridge from the suture passing device.

The sewing method provided by the invention has at least the following beneficial effects:

Again, the condition of tissue penetrator and string loop when being stimulated is conveniently observed, which makes the doctor more confident in the operation.

Finally, operation steps in the operation are reduced, and the operation time is saved.

Drawings

FIG. 1 is a schematic view of a stapler provided by the present invention;

FIG. 2 is a schematic diagram of the components of the wire box;

FIG. 3 is a schematic view of the components of the suture passer;

FIG. 4 is a schematic illustration of an initial wrap of suture;

FIG. 5 is a cross-sectional view of a partial wire box;

fig. 6A is a top view of a partial wire cassette, and fig. 6B is a bottom view of the partial wire cassette;

FIG. 7 is a schematic illustration of an initial state of suture excitation in a cartridge;

FIG. 8 is a schematic view of movement in a first direction at a first excitation;

FIG. 9 is a schematic illustration after a first firing in place;

FIG. 10 is a schematic diagram of rollback to an initial state after a first excitation;

fig. 11 is a schematic diagram of the second rope loop loading upon further retraction;

FIG. 12 is a schematic view of movement in the direction of the first end upon a second excitation;

FIG. 13 is a schematic illustration after a second excitation in place;

FIG. 14 is a schematic illustration of rollback to bottom after a second excitation;

FIG. 15 is a schematic view of the suture spacer pin attached to the chin;

FIG. 16 is a schematic view of the various components of the upper jaw assembly;

FIG. 17 is a diagram illustrating the rotation of the upper jaw;

FIG. 18 is a diagram of the rotation of the upper jaw window page;

FIG. 19 is a schematic view of the tooth-like structure of the upper jaw window leaf gripping the rope loop;

FIG. 20 is a schematic view of the cartridge assembled to the suture passer;

FIG. 21 is a schematic view of the instrument after reaching the meniscus from the incision;

FIG. 22 is a schematic illustration of the instrument engaging a meniscus;

FIG. 23 is a schematic view of the first and second rope loops being clamped by the upper jaw window page;

FIG. 24 is a schematic illustration of a first shot during surgery;

FIG. 25 is a schematic illustration of a second shot during surgery;

FIG. 26 is a schematic view of an intraoperative instrument withdrawal incision;

FIG. 27 is a schematic illustration after an intraoperative suturing;

FIG. 28 is a schematic view of a post-operative detachable stapler cartridge.

Icon: 1-a wire box; 2-suture passers;

11-a tissue penetrator; 12-stitching; 13-suture spacer pin; 14-a stiffener; 15-a chin assembly; 16-a wire storage box; 17-a bracket;

150-mandible; 151-cover plate; 152-sliding rails;

161-wire storage hole;

111-tissue penetrator notch; 112-fixing holes;

121-a first rope loop; 122-a second rope loop;

1501—tissue penetrator channel; 1502-upper suture channel; 1503-lower layer suture channel; 1504-mandible gap; 1505-mandibular passage;

20-upper jaw assembly; 21-a drive assembly; 22-a handle assembly;

200-a window rotating shaft; 201-upper jaw; 202-upper jaw window page; 203-a torsion spring; 204-connecting pins; 205-short link; 206-long connecting rod; 207-chute;

216-slide bar; 217-turning block;

220 handles; 221-side handle; 222-front handle; 223-rear handle; 224-a stopper; 225-coil springs; 228—a guide bar; 229-a slide bar mount;

2021-dentiform structure.

Detailed Description

In order to make the above objects, features and advantages of the present invention more comprehensible, embodiments accompanied with figures are described in detail below.

Unless otherwise indicated, the starting materials used in the examples were commercial industrial products and were commercially available.

All numbers expressing feature sizes, amounts, and physical properties used in the specification and claims are to be understood as being modified by the term "about" unless otherwise indicated. Accordingly, unless indicated to the contrary, the numerical parameters set forth in the specification and attached claims are approximations that can be varied by one of ordinary skill in the art to obtain the desired properties according to the teachings of the present invention. The recitation of numerical ranges by endpoints includes all numbers subsumed within that range, e.g., angle β is less than 179 degrees, including 150, 151, 153.5, 156.86, 165, 170, 175, 179 degrees, etc.

Suture box of suture instrument

As shown in fig. 2, the wire box 1 comprises a tissue penetrator 11 and a suture separation pin 13, a suture 12 is pre-wound on the tissue penetrator 11 and the suture separation pin 13, and a reinforcement 14 is arranged on the tissue penetrator 11 to strengthen the tail of the tissue penetrator 11 and prevent deformation of the tail when pushing force is not transmitted to the first end of the tissue penetrator 11 during excitation. The chin assembly 15 includes a chin 150, a cover plate 151, and a slide rail 152, wherein the chin 150 is connected to the slide rail 152, and the cover plate 151 is disposed on the chin 150. The first end of tissue penetrator 11 is the side near spacer pin 13 which is also near tissue, and the second end of tissue penetrator 11 is the side away from spacer pin 13 which is also far from tissue. Tissue penetrator 11 is mounted within jaw assembly 15 and is capable of sliding between a first end and a second end within a space defined by sled 152, and jaw 150 and cover plate 151. The bracket 17 is welded on the sliding rail 152, the bracket 17 is used for fixing the wire storage box 16, a plurality of wire storage holes 161 are formed in the wire storage box 16, redundant annular sutures below the tissue penetrator 11 can be folded and placed into the wire storage holes 161 to realize wire storage, and the sutures are prevented from being wound when the sutures are pulled out during and after excitation. Those skilled in the art will appreciate that other means of attachment or integral formation of the bracket 17 to the rail 152 are possible.

Fig. 4 is a schematic view of an initial winding pattern of the suture. The first end of the tissue penetrator 11 is provided with a tissue penetrator notch 111 for threading a suture, the tissue penetrator 11 is also provided with a fixing hole 112, and the aperture of the fixing hole 112 is 0.3-1 mm, so that the tissue penetrator can adapt to the size of a common suture. The wound suture 12 is a complete piece and has a length of about 765mm. As shown in fig. 5, 6A and 6B, tissue penetrator channel 1501 is formed in jaw 150, upper suture channel 1502 is formed between tissue penetrator 11 and cover plate 151, and lower suture channel 1503 is formed between tissue penetrator 11 and jaw 150. The suture 12 is divided into an upper side and a lower side by the tissue penetrator 11, the tail end of the first rope ring 121 passes through the tissue penetrator notch 111 and is arranged above the tissue penetrator 11, the second rope ring 122 extends to the tail end of the suture in the second end direction of the tissue penetrator, and the tail end of the suture passes through the fixing hole 112 and is arranged below the tissue penetrator 11 after hardening treatment, so that the tail end of the suture is fixed. The first string ring 121 is wound around the suture separation pin 13, and the winding can be prevented from being knotted. Second string loop 122 is positioned in the suture retaining area formed by chin indentation 1504 and tissue penetrator 11, which is closer to the second end of tissue penetrator 11 than tissue penetrator indentation 111 when the stapler cartridge is assembled. Those skilled in the art will appreciate that the suture 12 may be an entire suture or several sutures to achieve the same technical result, and is not exhaustive.

The size of the suture end can be larger than that of the fixing hole, and the suture end with the larger size is inserted into the fixing hole with the smaller size, so that the suture end is fixed; in addition, when the size of the suture end is smaller than or equal to the size of the fixing hole, the suture end can be fixed in the fixing hole by using an adhesive, heating or the like.

Wherein, the fixing hole 112 on the tissue penetrator 11 can be a through hole or a non-through hole, and when the fixing hole is a through hole, the processing is convenient, and at the moment, the suture end can be inserted into but not pass through the fixing hole 112 or inserted into and pass through the fixing hole 112; in the case of a non-through hole, the suture ends are merely inserted into but not through the fixation holes 112.

The shape of the fixing hole 112 may be circular, which is convenient for processing. Those skilled in the art will appreciate that other shapes of the securing apertures 112 are possible to achieve the same technical result, and are not exhaustive.

When the fixing hole 112 is a through hole and the suture end is inserted into and through the fixing hole 112, the suture end may be treated to have a size larger than that of the fixing hole 112, and the fixing hole 112 having a smaller size may restrict the movement of the suture end having a larger size to prevent the suture end from slipping. The manner of processing the suture ends includes, but is not limited to, heat hardening, compression molding, and the like. The processed suture end can be cake-shaped, cylindrical, spherical and the like, and is convenient to process. Those skilled in the art will appreciate that other shapes of suture ends are possible to achieve the same technical result, and are not exhaustive.

As shown in fig. 5, the chin assembly 15 of the wire box 1 is provided with an angle β bent toward one side of the tissue penetrator 11, the angle β may be 150-179 degrees, preferably 165, 170, 175 degrees, wherein 170 degrees are optimal, the angle β enables the approach to be more fit with the knee joint structure, the step of telescoping the chin in the prior art is omitted, and the instrument structure is simpler and more reliable.

Suture device

As shown in fig. 1, the suture device of the invention consists of a thread box 1 and a suture threading device 2, which can be combined in a detachable and replaceable way, and in the same operation, the suture threading device 2 can be matched with a plurality of thread boxes 1 according to suture requirements.

As shown in fig. 3, suture passer 2 includes, in order from a proximal tissue end to a distal tissue end, a jaw assembly 20, a drive assembly 21, and a handle assembly 22. The driving assembly comprises a sliding rod 216 and a steering block 217, wherein the sliding rod 216 is arranged in the sliding rail 152 in the wire box 1, and the steering block 217 is connected with one end of the long connecting rod 206 in the upper jaw assembly 20, which is far away from tissues; the handle assembly 22 comprises a handle 220, a side handle 221, a front handle 222, a rear handle 223, a limiter 224, a coil spring 225, a guide rod 228 and a slide rod fixing member 229, wherein the slide rod fixing member 229 is connected with one end of the slide rod 216 far away from tissue, and one end of the guide rod 228 near the tissue can hook the bracket 17 to limit the movement of the wire box 1.

As shown in fig. 16-18, the upper jaw assembly 20 includes a window vane rotation shaft 200, an upper jaw 201, an upper jaw window vane 202, a torsion spring 203, a connecting pin 204, a short link 205, a long link 206, and a chute 207. The slide slot 207 in combination with the slide rail 152 in the chin assembly 15 forms a sliding region within which the long link 206 can slide. The upper jaw 201 is connected with a short connecting rod 205 through a connecting pin 204, the short connecting rod 205 is connected with a long connecting rod 206, the upper jaw 201 is connected with a chute 207 through the connecting pin 204, and the upper jaw 201 can rotate around the connecting pin 204 under the driving of the long connecting rod 206; the upper surface of the upper jaw 201 is of a flat design, which reduces the size of the stapler head, and when the upper jaw 201 is tilted up, the overall size together with the lower jaw 150 is about 5.9mm; the torsion spring 203 is installed on the window vane rotating shaft 200, one end of the torsion spring is abutted against the upper jaw window vane 202, the other end of the torsion spring is abutted against the upper jaw 201, and the upper jaw window vane 202 can be opened after being stressed and can be reset to be closed under the action of the torsion spring 203. Those skilled in the art will appreciate that other springs or structures, etc., may be used to achieve the same technical result, and are not exhaustive. Openable upper jaw window 202 allows for convenient observation of tissue penetrator 11 and string loop condition upon excitation; the edge of the upper jaw window 202 is designed with a tooth-like structure 2021 to facilitate gripping of the rope loop, as shown in fig. 19.

Squeezing the front handle 222 will drive the steering block 217 to move toward the first end of the tissue penetrator 11, and the steering block 217 will drive the long link 206 and the short link 205 to rotate the upper jaw 201; squeezing the front handle 222 drives the limiter 224 to rotate, and the limiter 224 is foolproof: the rear handle 223 cannot be pushed without squeezing the front handle 222, preventing false excitation of the tissue penetrator 11; upon release of the front handle 222, the upper jaw 201 and stop 224 will automatically return.

After squeezing the front handle 222, the stopper 224 rotates. By pushing on rear handle 223, rear handle 223 will push slide bar fastener 229 and slide bar 216, causing slide bar 216 to move toward the first end of tissue penetrator 11. After firing is completed, rear handle 223 and slide bar mount 229 (slide bar 216) will return under the pull of coil spring 225.

FIG. 20 is a schematic view of the cartridge assembled to a suture passer. The upper surface of the upper jaw 201 is of a flat design, enabling a reduction in stapler head size. The overall size of the closed upper jaw 201 and the closed lower jaw 150 is about 3.27mm by squeezing the front handle 222, and the entrance is possible under the condition of small entrance opening, and the entrance is closer to the knee joint structure by matching with the beta angle design on the lower jaw assembly 15, so that the step of telescoping the lower jaw in the prior art is omitted, and the instrument structure is simpler and more reliable.

Stitching method

Embodiments of the present invention provide a suturing method employing the aforementioned suture instrument cartridge or the aforementioned suture instrument, and in particular, FIGS. 7-14 are schematic illustrations of two firing procedures of a tissue penetrator.

Fig. 7 is a schematic view of an initial state of suture excitation in a suture magazine. At this point, the end suture of second string loop 122 in the direction of the second end of the tissue penetrator is not bent.

Fig. 8 is a schematic view of the movement of the tissue penetrator toward a first end upon a first excitation. At this point, the first end of tissue penetrator 11 is deflected along the path of the tissue penetrator with suture 12 initially passing over and under the notch 111 of the tissue penetrator.

Fig. 9 is a schematic view after the first firing in place. At this time, tissue penetrator 11 is pushed to the bottom in the direction of the first end, the first string ring is clamped by the upper jaw window, and after lower suture 12 of tissue penetrator 11 is pulled out, outside suture partitioning pin 13.

Fig. 10 is a schematic view of the tissue penetrator retracted to an initial state after a first firing. After the first firing is completed, tissue penetrator 11 is retracted and when retracted to the initial position, the end suture of second string 122 in the direction of the second end of the tissue penetrator returns to the initial position in an unbent state.

Fig. 11 is a schematic view of the loading of the second string loop as the tissue penetrator is further retracted. When tissue penetrator 11 is retracted from the initial position toward the second end, the end suture of second loop 122 in the direction of the second end of the tissue penetrator is slowly tensioned due to the fixation of suture end by fixation hole 112, and a certain pulling force is required to pull suture 12 out of fixation hole 112, so that the tensioning force is stable. When tissue penetrator aperture 111 and the chin aperture are slowly coincident to some extent, the tensioned end suture will pull second string loop 122 from the suture retaining area into tissue penetrator aperture 111.

FIG. 12 is a schematic view of movement of the tissue penetrator toward a first end upon a second excitation. At this point, the tissue penetrator notch 111 is threaded through the second string loop 122 and the suture ends break loose from the securing holes 112.

Fig. 13 is a schematic view after a second excitation in place. At this point tissue penetrator 11 is pushed down in the direction of the first end and the upper jaw window page grips both the first and second string loops.

Fig. 14 is a schematic representation of the retraction of the tissue penetrator to the bottom after a second firing. After the second firing, tissue penetrator 11 is retracted to its bottom, with suture 12 still partially below tissue penetrator 11 and inside suture spacer pin 13. During withdrawal of the instrument from the knee, the portion of the suture gradually disengages the instrument until it abuts the suture spacer pin 13. Suture spacer pin 13 is secured at one end to chin 150 and forms a chin channel 1505 (see fig. 15) between the other end and chin 150. When the portion of suture abuts suture spacer pin 13, suture spacer pin 13 flexes and deforms, guiding the portion of suture through chin channel 1505 and out of the instrument.

As shown in fig. 21-27, wherein fig. 21-23 are schematic views of the instrument access condition and fig. 24-27 are schematic views of two activations and suturing. The second rope ring is stable in loading, the instrument is convenient to access, and the operation is convenient to observe. FIGS. 21-27 schematically illustrate some of the components of an intraoperative stapler to illustrate how the stapler provided by the present invention works.

Squeezing the front handle, the upper jaw 201 closes and enters the incision. The instrument reaches the meniscus from the incision (fig. 21). The instrument engages the meniscus (fig. 22). The condition of the tissue penetrator and the threaded suture is observed arthroscopically over the upper jaw 201 upon two activations, after which the first and second loops 121, 122 are clamped by the upper jaw window page 202 (fig. 23); the first and second activations are shown in fig. 24 and 25, respectively, after the two activations, the instrument is withdrawn from the incision (fig. 26), knotted and cut, then sutured (fig. 27), and the stent 17 is pulled to separate the thread cassette from the suture threading device 2.

Although the present invention is disclosed above, the present invention is not limited thereto. Various changes and modifications may be made by one skilled in the art without departing from the spirit and scope of the invention, and the scope of the invention should be assessed accordingly to that of the appended claims.

Claims

1. A stapler cartridge, comprising:

a tissue penetrator having a first end proximal to tissue and a second end distal to tissue, the tissue penetrator first end including at least one notch;

a chin assembly within which the tissue penetrator is slidable;

at least one suture, said suture being loaded on said tissue penetrator, said suture comprising at least one string loop, said string loop being attachable to said tissue penetrator aperture;

at least one suture retaining area, at least one of the string loops extending in the suture retaining area and toward the second end of the tissue penetrator to a suture end; and

at least one fixation device, the suture end being connected to the fixation device.

2. The stapler cartridge of claim 1, wherein the fixation device is disposed on the tissue penetrator, the fixation device including at least one fixation hole through which the suture end is inserted or passed, the suture end having a size greater than a size of the fixation hole.

3. The stapler cartridge of claim 2, wherein the suture end is pie-shaped or cylindrical in shape and the securing hole is a circular through hole or a circular blind hole.

4. The stapler cartridge of claim 1, wherein the chin assembly comprises a chin, a slide rail, the chin being coupled to the slide rail, the tissue penetrator being slidable within the slide rail; the chin further comprises a suture spacer pin having one end secured to the chin and the other end forming a chin channel with the chin, the suture comprising a first loop of string passing through the suture spacer pin and a second loop of string loaded in the suture retaining area and extending in a second direction of the tissue penetrator to the suture end; the mandible assembly has an angle beta bent to one side of the tissue penetrator, the angle beta being less than 179 degrees.

5. The stapler cartridge of claim 4, further comprising a cartridge within which the suture proximate the second end of the tissue penetrator is received.

6. A stapler comprising the stapler cartridge of any one of claims 1-5.

7. The stapler of claim 6, further comprising a suture threading device comprising, in order from a proximal tissue end to a distal tissue end, a palate assembly comprising a palate, an upper surface of the palate being of a flat design; the driving assembly is connected with the upper jaw assembly; and the handle assembly is connected with the driving assembly.

8. The stapler of claim 7, wherein the upper jaw assembly comprises an upper jaw including an openable upper jaw window, a chute forming a sliding region with the lower jaw assembly, a long link slidable in the sliding region; the driving assembly comprises a sliding rod and a steering block, the sliding rod is arranged in the jaw assembly of the suture instrument wire box, and the steering block is connected with one end of the long connecting rod of the jaw assembly, which is far away from tissues; the handle assembly comprises a handle and a slide bar fixing piece, and the slide bar fixing piece is connected with one end, far away from tissues, of the slide bar of the driving assembly.

9. The stapler of claim 7, wherein the stapler cartridge comprises a frame, and wherein the handle assembly comprises a guide bar coupled to the frame at an end of the guide bar adjacent the tissue.

10. A suturing method, characterized in that a suture cartridge according to any one of claims 1-5 or a suture device according to any one of claims 6-9 is used.

11. A suturing method, characterized in that it uses the stapler cartridge according to claim 5, comprising the steps of:

loading the suture on the tissue penetrator, the first loop of string passing through the suture spacer pin, hanging in the tissue penetrator aperture, the second loop of string being located in the suture retaining area formed by the chin and the tissue penetrator, the second loop of string extending in a second direction of the tissue penetrator to the suture end, the suture end being connected to the securing means, the suture being received in the magazine proximate the second end of the tissue penetrator;

12. A suturing method, characterized in that it uses the suturing device according to claim 9, comprising the steps of:

squeezing the handle to cause the stapler to engage tissue;

releasing the handle, the tissue penetrator retracting;

the suture instrument withdraws from the tissue, and knots and cuts the thread;