CN116869593B - Dura mater closer - Google Patents
Dura mater closer Download PDFInfo
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- CN116869593B CN116869593B CN202311141543.0A CN202311141543A CN116869593B CN 116869593 B CN116869593 B CN 116869593B CN 202311141543 A CN202311141543 A CN 202311141543A CN 116869593 B CN116869593 B CN 116869593B
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- Prior art keywords
- disc
- head
- unidirectional
- dura mater
- hook
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- 210000001951 dura mater Anatomy 0.000 title claims abstract description 73
- 230000000149 penetrating effect Effects 0.000 claims abstract description 39
- 238000001514 detection method Methods 0.000 claims abstract description 24
- 239000010410 layer Substances 0.000 claims description 42
- 238000000034 method Methods 0.000 claims description 15
- 238000004891 communication Methods 0.000 claims description 11
- 230000035515 penetration Effects 0.000 claims description 8
- 239000011241 protective layer Substances 0.000 claims description 8
- 230000001360 synchronised effect Effects 0.000 claims description 4
- 238000005491 wire drawing Methods 0.000 claims 3
- 244000208734 Pisonia aculeata Species 0.000 abstract description 13
- 230000000694 effects Effects 0.000 description 7
- 230000000007 visual effect Effects 0.000 description 3
- 241000446313 Lamella Species 0.000 description 2
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 210000004556 brain Anatomy 0.000 description 2
- 210000005013 brain tissue Anatomy 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 239000012528 membrane Substances 0.000 description 2
- 238000005381 potential energy Methods 0.000 description 2
- 239000000523 sample Substances 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 1
- 239000000227 bioadhesive Substances 0.000 description 1
- 238000007428 craniotomy Methods 0.000 description 1
- 238000001125 extrusion Methods 0.000 description 1
- 230000000670 limiting effect Effects 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 239000002861 polymer material Substances 0.000 description 1
- 238000006748 scratching Methods 0.000 description 1
- 230000002393 scratching effect Effects 0.000 description 1
- 238000007789 sealing Methods 0.000 description 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00349—Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1121—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis adapted for performing tissue or graft eversion
Abstract
The invention discloses a dura mater closer, which belongs to the field of medical appliances and comprises: the pulling-back assembly is used for pulling the dura mater flap back to a closed state and comprises a centralizing disc and a plurality of unidirectional hooks, wherein the unidirectional hooks are hinged to the centralizing disc in an annular array; the device comprises an execution head for accommodating a pullback assembly, a disc accommodating cavity and a guide sliding rail, wherein the interior of the execution head is provided with the disc accommodating cavity and the guide sliding rail, the guide sliding rail penetrates through the outer wall of the execution head at the proximal end and forms a detection outlet, a one-way hook is in sliding connection with the guide sliding rail, the disc accommodating cavity is coaxial with the execution head, a centralized disc is in sliding sleeve connection with the disc accommodating cavity and can do reciprocating motion in the axial direction of the execution head, and the one-way hook can extend outwards or retract inwards along the guide sliding rail through the detection outlet; the driving assembly for controlling the position and the posture of the centralized disc comprises a reset piece and a traction wire, wherein the two ends of the reset piece are respectively connected with the disc placing cavity and the centralized disc, the traction wire is arranged on the execution head in a penetrating mode, one end of the traction wire is connected with the centralized disc, and the other end of the traction wire is arranged on the far end of the execution head in a penetrating mode.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a dura mater closer.
Background
Clinical transnasal or transoral deep surgery generally requires cutting a cross-shaped opening from the dura mater of a patient, penetrating a surgical instrument into the brain of the patient through the opening, and re-closing the opened dura mater at the end of the surgery, and the operation space is limited because the dura mater is deeper and the operation path is narrow, and the current way of closing the dura mater is mainly needle-line stitching or bio-adhesive, but the following problems exist in the way:
1. the method is mainly suitable for the dura mater suture scene in external craniotomy, and is difficult to carry out closure treatment on the dura mater from inside through mouth or nose;
2. the operation is difficult, the control accuracy requirement on the surgical instrument is high, and the operation space is narrow, so that the surgical instrument is difficult to be matched with an endoscope to carry out dural closure, and the injury of a patient is easy to be caused.
It is therefore desirable to design an instrument, in particular a dura mater closer, that is capable of hooking and pulling back four lobes of dura mater at the cross-shaped opening such that the dura mater closes.
Disclosure of Invention
In order to overcome the problems in the background art, the invention adopts the following technical scheme:
an dural sealer, comprising: the retraction assembly is used for retracting the dura mater flap to a closed state and comprises a centralized disc and a plurality of unidirectional hooks, wherein the unidirectional hooks are hinged to the centralized disc in an annular array; the device comprises an execution head for accommodating a pullback assembly, a disc accommodating cavity and a guide sliding rail are arranged in the execution head, the guide sliding rail penetrates out of the outer wall of the execution head at the proximal end and forms a detection outlet, the unidirectional hook is in sliding connection with the guide sliding rail, the disc accommodating cavity is coaxial with the execution head, the disc accommodating cavity is sleeved with the disc accommodating cavity in a sliding manner and can do reciprocating motion in the axial direction of the execution head, and when the disc accommodating cavity moves from the distal end to the proximal end of the disc accommodating cavity, the unidirectional hook extends to the outside of the execution head along the guide sliding rail through the detection outlet; the driving assembly is used for controlling the position of the centralized disc in the disc placing cavity and comprises a reset piece and a traction wire, wherein the two ends of the reset piece are respectively connected with the disc placing cavity and the centralized disc, the traction wire is arranged on the execution head in a penetrating mode, one end of the traction wire is connected with the centralized disc, and the other end of the traction wire is arranged on the far end of the execution head in a penetrating mode.
Further, the communication groove of the communication dish chamber inwards wears to be equipped with on the outer wall of the execution head, the direction slide rail sets up on the lateral wall of communication groove, the direction slide rail is whole to be the J shape of inversion, vertical accomodating is close to the inside of distal end at the direction slide rail under the unidirectional hook initial state, the quantity of visit mouth with the quantity of unidirectional hook is the same.
Further, an elastic protection layer is arranged on the outer side wall of the execution head and corresponds to the position of the one-way hook, the elastic protection layer is embedded in the communication groove, the elastic protection layer is connected with the one-way hook, and when the one-way hook extends out of the execution head along the guide sliding rail, the elastic protection layer stretches and enables the one-way hook to bend downwards; in the process of pulling back the dura mater by the unidirectional hooks, the elastic protective layer is arranged between the unidirectional hooks and the dura mater.
Further, the executing head comprises a moving state, the unidirectional hook is contained in the executing head in the moving state, the elastic protection layer is embedded in the communicating groove, and the diameter difference from the proximal end to the distal end of the executing head is not more than 1mm; the actuating head further comprises a working state, when the proximal end of the actuating head passes through the opened dura mater, the actuating head is switched from a moving state to the working state, the unidirectional hooks extend out of the outer side of the actuating head in the working state, the unidirectional hooks leaving the detection port bend towards the distal end of the actuating head under the deformation constraint of the elastic protective layer, and at the moment, the unidirectional hooks can be pressed by the unidirectional hooks to close the dura mater valve by pulling the actuating head.
Further, the unidirectional hook comprises a plurality of sections of connecting parts which are connected in a hinged manner, the connecting parts can rotate to the outer side of the execution head through the hinging parts in an initial state, and the connecting parts are provided with sliding protrusions and are in sliding connection with the guide sliding rails through the sliding protrusions; each section the connecting portion all with the elastic protection layer links to each other for the elastic protection layer can laminate in the outside of unidirectional hook all the time in unidirectional hook stretching process, makes unidirectional hook more be close to L shape at the orbit of stretching out and expanding the process, thereby reduces the motion area that unidirectional hook formed on the face of the vector in stretching process by a wide margin, and then reduces unidirectional hook and the contact of patient's internal tissue, plays apparent protection effect.
Further, the bottom end of the execution head is connected with a detection rod; the device comprises an execution head, a detection rod, a wire passing hole, a pulling wire sleeve, a unidirectional hook and a unidirectional hook, wherein the execution head and the detection rod are internally provided with the wire passing hole in an axial direction, one end of the wire passing hole is penetrated out of the bottom end of the detection rod, the other end of the wire passing hole is penetrated out of the inner wall of the tray cavity, the pulling wire is sleeved in the wire passing hole, the number of the wire passing holes is the same as that of the pulling wire, and the number of the wire passing holes is the same as that of the unidirectional hooks.
Further, a placement cavity is arranged from the proximal end of the execution head to the distal end of the probing rod in a penetrating manner and is used for placing endoscope and other observation auxiliary instruments, and the observation auxiliary instruments are used for providing the visual field of the area near the dura mater valve to be closed of a patient for an operator, so that the operator can more accurately control the action and the space pose of the unidirectional hook, and the efficiency of pulling back the dura mater valve and closing the dura mater valve after the operation is finished is greatly improved.
Further, the centralized disc is integrally formed, the unidirectional hooks are hinged to the centralized disc, and the traction lines and the reset pieces are respectively and uniformly distributed at the bottom end and the top end of the centralized disc, so that the movement of each unidirectional hook is synchronous.
Further, the bottom of the penetrating rod is provided with a line concentration structure, the far end of each traction line is connected to the line concentration structure, and the line concentration structure is connected with the penetrating rod and can reciprocate along the axial direction of the penetrating rod.
Further, the centralized disc is composed of a plurality of disc blocks, each disc block is hinged with one unidirectional hook, and each disc block is independently connected with at least one reset piece and at least one traction wire, so that each unidirectional hook can independently move.
Further, the bottom of the penetrating rod is provided with a plurality of wire collecting structures, the far end of each traction wire is respectively connected with one wire collecting structure, and the wire collecting structures are connected with the penetrating rod and can do reciprocating motion along the axial direction of the penetrating rod.
The invention has the beneficial effects that:
1. through setting up one-way hook, provide the guide slide rail of removal track for one-way hook, constraint one-way hook stretches out the elastic protection layer of form behind the execution head, make the proximal end under the mobile state reach and pass the membrane lamella of dura mater opening part along the operation route through nose or mouth for this dura mater closer, then make one-way hook stretch out along the axial tangent plane of execution head in the execution head through pulling line collection structure, thereby realize the extension of a plurality of one-way hooks in narrow and small space, pull the lever of penetrating to distal end and make the dura mater lamella closure, then resume the mobile state with the execution head and follow former route and take out, this process easy and simple to handle and required extension space is minimum, can effectively be used for the dura mater closure, therefore possess apparent technological effect and practical value.
2. The elastic protection layer can buffer slight extrusion when the unidirectional hook stretches to contact the outer side face of brain tissue of a patient, and prevents the unidirectional hook from damaging the dura mater when the unidirectional hook pulls back the dura mater valve, so that the elastic protection layer has a good protection effect, and the elastic protection layer is embedded in the outer side of the execution head in a moving state, so that a sealing effect is provided for the execution head in the moving state to a certain extent.
3. The device has small volume and small occupied space, and can be matched with an endoscope to finish dural closure in a deep and thin channel.
4. The operation is simple, only the dura mater is required to be pulled back to the original position, and the dura mater can gradually heal later.
Drawings
Fig. 1 is a schematic overall structure of the execution head in the moving state in embodiment 1;
fig. 2 is a schematic overall structure of the execution head in the working state in embodiment 1;
fig. 3 is a schematic sectional view of a partial structure in the case where the execution head is in a moving state in embodiment 1;
fig. 4 is a schematic sectional view showing a partial structure of the actuator head in the working state in embodiment 1;
FIG. 5 is a schematic view showing the overall structure of a focus disc hinged unidirectional hook in example 1;
FIG. 6 is a schematic view showing a partial structure of the distal end of the probe in example 1;
FIG. 7 is a schematic sectional view showing a partial structure of the distal end of the penetrating shaft in embodiment 1;
FIG. 8 is a schematic view showing the overall structure of a focus disc hinged unidirectional hook in example 2;
FIG. 9 is a schematic view showing a partial structure of the distal end of the penetration rod in example 2;
in the figure, 1, a pull-back assembly; 11. a hub; 111. a tray block; 12. a one-way hook; 121. a connection part; 122. a sliding protrusion; 2. a execution head; 21. a tray cavity; 22. a guide rail; 221. a detection port; 23. a communication groove; 24. an elastic protective layer; 25. a penetration rod; 26. a wire through hole; 27. a line concentration sliding sleeve; 28. a line concentration slide block; 3. a drive assembly; 31. a reset member; 32. a pulling wire; 4. the cavity is placed.
Detailed Description
The following detailed description of the embodiments of the present invention will be made more apparent to those skilled in the art from the following detailed description, in which the invention is embodied in several, but not all, embodiments of the invention. The invention may be embodied or applied in other specific forms and features of the following examples and examples may be combined with each other without conflict, all other examples being contemplated by those of ordinary skill in the art without undue burden from the present disclosure, based on the examples of the invention.
Example 1
The dura mater closer defines that one end of the dura mater closer, which is close to a patient in use, is a proximal end, and one end of the dura mater closer, which is far away from the patient, is a distal end, and as shown in fig. 1-7, the dura mater closer comprises a pull-back assembly 1, an execution head 2 and a driving assembly 3, wherein the pull-back assembly 1 is sleeved in the execution head 2, the driving assembly 3 is connected with the pull-back assembly 1, the pull-back assembly 1 is used for pulling back a dura mater flap to a closed state, and the dura mater closer comprises a centralizing disc 11 and a plurality of unidirectional hooks 12, and the unidirectional hooks 12 are hinged to the centralizing disc 11 in an annular array; the actuating head 2 is used for accommodating the pullback assembly 1, a disc placing cavity 21 and a guide slide rail 22 are arranged in the actuating head 2, the guide slide rail 22 penetrates through the outer wall of the actuating head 2 at the proximal end and forms a detection opening 221, the unidirectional hook 12 is in sliding connection with the guide slide rail 22, the disc placing cavity 21 is coaxial with the actuating head 2, the centralizing disc 11 is in sliding sleeve connection with the disc placing cavity 21 and can do reciprocating motion in the axial direction of the actuating head 2, and when the centralizing disc 11 moves from the distal end of the disc placing cavity 21 to the proximal end, the unidirectional hook 12 extends to the outside of the actuating head 2 along the guide slide rail 22 through the detection opening 221; the driving component 3 is used for controlling the position of the centering disc 11 in the disc placing cavity 21, and comprises a reset piece 31 and a traction wire 32, wherein two ends of the reset piece 31 are respectively connected with the disc placing cavity 21 and the centering disc 11, the traction wire 32 penetrates through the execution head 2, one end of the traction wire 32 is connected with the centering disc 11, the other end of the traction wire 32 penetrates out of the distal end of the execution head 2, the reset piece 31 is an elastic wire made of high polymer materials or an elastic metal sheet capable of being bent, an operator pulls the traction wire 32 to enable the centering disc 11 to slide in the disc placing cavity 21, at the moment, the unidirectional hooks 12 change the movement direction through the guide sliding rails 22 and pop out of the execution head 2 or retract into the execution head 2, and the number of the unidirectional hooks 12 is not less than four.
In a more preferred embodiment, as shown in fig. 1-7, the driving assembly 3 is specifically connected to the hub 11 in the following manner: the two ends of the reset piece 31 are respectively connected with the bottom of the inner part of the tray cavity 21 and the bottom of the centralizing tray 11, the proximal end of the wire passing hole 26 is arranged at a position close to the top end of the tray cavity 21, so that the traction wire 32 hangs down from the top of the tray cavity 21 and is connected with the top end of the centralizing tray 11, the reset piece 31 is a tension rope or a miniature tension spring with elasticity, the reset piece 31 is in an untensioned diastole state in the moving state of the executing head 2, when an operator pulls the distal end of the traction wire 32, the centralizing tray 11 is close to the proximal end of the executing head 2 along the axial direction of the tray cavity 21, the reset piece 31 is tensioned at the moment, and the unidirectional hook 12 extends out of the executing head 2; after the operator releases the pulling wire 32, the reset element 31 releases potential energy and resumes the length in the relaxed state, the centralizing disk 11 is restored to the position close to the distal end in the disk placing cavity 21, and the unidirectional hook 12 returns to the communicating groove 23 through the detecting opening 221 under the sliding connection of the sliding protrusion 122 and the guiding sliding rail 22.
In another more preferred embodiment, two ends of the reset element 31 are respectively connected with the top of the cavity inside the disc placing cavity 21 and the top of the centralizing disc 11, the proximal end of the wire passing hole 26 is arranged at a position close to the top of the disc placing cavity 21, so that the traction wire 32 hangs down from the top of the disc placing cavity 21 and is connected with the top of the centralizing disc 11, in this case, the reset element 31 is a micro spring or a micro air spring, in the moving state of the executing head 2, the reset element 31 is in an uncompressed stretching state, when an operator pulls the distal end of the traction wire 32, the centralizing disc 11 is close to the proximal end of the executing head 2 along the axial direction of the disc placing cavity 21, at this time, the reset element 31 is compressed, and the unidirectional hook 12 extends out of the executing head 2; after the operator releases the pulling wire 32, the restoring member 31 releases potential energy and returns to the extended state, the concentration disc 11 returns to the position when approaching the distal end in the disc placement cavity 21, and the unidirectional hooks 12 return to the communication groove 23 through the detection ports 221 under the sliding connection of the sliding protrusions 122 and the guide sliding rails 22.
In a more preferred embodiment, as shown in fig. 1-7, a communicating groove 23 communicating with the tray cavity 21 is formed in the outer wall of the executing head 2 in a penetrating manner, the communicating groove 23 is formed by flattening the outer contour of the communicating groove, and then is formed by forming rounded corner rectangles or right-angle rectangles on the same side, the guiding slide rail 22 is arranged on the side wall of the communicating groove 23, the guiding slide rail 22 is formed by forming an inverted J-shape on the whole, the unidirectional hooks 12 are vertically accommodated in the inner part, close to the far end, of the guiding slide rail 22 in the initial state, and the number of the protruding openings 221 is the same as that of the unidirectional hooks 12. The inverted J-shaped guide slide rail 22 comprises a 1/4 circular upper section and an I-shaped lower section, when the execution head 2 is in a moving state, the sliding protrusions 122 of the connecting parts 121 on the unidirectional hooks 12 vertically slide in the I-shaped lower sections of the guide slide rail 22 at the two sides of the communication groove 23 in a straight line shape, when the execution head 2 is switched from the moving state to the working state, the connecting parts 121 are separated from the detection port 221 one by one from the 1/4 circular upper section, the part of the unidirectional hooks 12 separated from the execution head 2 is bent towards the far end under the limiting action of the elastic protective layer 24, the hinging rotation angle of the adjacent connecting parts 121 is not more than 5 degrees, and the largest rotation angle between the two connecting parts 121 at the two ends of the unidirectional hooks 12 is not more than 10 degrees, so that the falling distance of the far end of the unidirectional hooks 12 along the axial direction of the execution head 2 in the abduction process after the execution head 2 is detected can be greatly reduced, the unidirectional hooks 12 are sufficiently close to the dura mater of a patient when being stretched, the space required for the unidirectional hooks 12 to stretch in the brain of the patient is reduced, and the risk of injury of the patient is reduced when the patient is closed in the patient is performed in the deep operation; in other embodiments, guide rail 22 may also be C-shaped or sloped I-shaped.
1-7, the outer side wall of the execution head 2 is provided with an elastic protection layer 24 corresponding to the position of the unidirectional hook 12, the elastic protection layer 24 is embedded in the communication groove 23, the elastic protection layer 24 is connected with the unidirectional hook 12, and when the unidirectional hook 12 extends out of the execution head 2 along the guide sliding rail 22, the elastic protection layer 24 stretches and causes the unidirectional hook 12 to bend downwards; during the retraction of the unidirectional hooks 12 back into the dura mater, the elastic protective layer 24 is placed between the unidirectional hooks 12 and the dura mater. The bottom end of the elastic protection layer 24 is fixed at the bottom end of the communicating groove 23, the outer contour of the elastic protection layer 24 is the same as the outer contour of the communicating groove 23, when the unidirectional hook 12 is completely contained in the executing head 2, the elastic protection layer 24 connected with the unidirectional hook 12 is also restrained by the resetting piece 31, at the moment, the elastic protection layer 24 is embedded in the communicating groove 23, so that the outer side wall of the executing head 2 is relatively smooth, and further, the surface of the executing head 2 does not have bulges or warping angles capable of scratching tissues in the patient when the executing head 2 is stretched into the patient or pulled out from the patient; each of the connection portions 121 constituting the unidirectional hooks 12 is connected to the elastic protection layer 24, respectively, and when the respective connection portions 121 are rotated relatively and the unidirectional hooks 12 are bent, the elastic protection layer 24 is bent from the inside of the communication groove 23 to the outside toward the distal end of the actuator head 2, and when the unidirectional hooks 12 come close to and contact the tilted dura mater, the elastic protection layer 24 can buffer the pressing of the unidirectional hooks 12 against the dura mater, thereby protecting the dura mater.
1-7, the actuating head 2 comprises a moving state, in which the unidirectional hooks 12 are accommodated in the actuating head 2, and the elastic protection layer 24 is embedded in the communicating groove 23, and the diameter difference between the proximal end and the distal end of the actuating head 2 is not more than 1mm; the actuator head 2 further comprises an operating state in which the actuator head 2 is switched from a moving state to an operating state after the proximal end of the actuator head 2 passes over the opened dura mater, the unidirectional hooks 12 extend out of the actuator head 2 in the operating state, the unidirectional hooks 12 leaving the detection openings 221 bend towards the distal end of the actuator head 2 under the deformation constraint of the elastic protection layer 24, and when the elastic protection layer 24 on the unidirectional hooks 12 contacts the membrane flap of the dura mater of the patient after the unidirectional hooks 12 are extended, the unidirectional hooks 12 can be pushed by pulling the actuator head 2 to close the dura mater flap.
1-7, the unidirectional hook 12 comprises a plurality of joints of connecting parts 121 which are connected in a hinged manner, wherein the connecting parts 121 can rotate to the outer side of the execution head 2 through the joints in the initial state, and the connecting parts 121 are provided with sliding protrusions 122 and are in sliding connection with the guide sliding rails 22 through the sliding protrusions 122; each section of connecting part 121 is connected with the elastic protection layer 24, so that the elastic protection layer 24 can be always attached to the outer side of the unidirectional hook 12 in the stretching process of the unidirectional hook 12, and the track of the unidirectional hook 12 in the stretching and unfolding process is more approximate to an L shape; when the unidirectional hook 12 extends, from the outer side of the execution head 2, the observer can find that the extending track of the unidirectional hook 12 is nearly parallel to the radial direction of the execution head 2, so that the movement space required by the unidirectional hook 12 when extending in the patient takes a flat strip shape, the contact with brain tissues of the patient and the influence possibly caused by the contact can be reduced to the greatest extent, the movement area formed on the sagittal plane in the extending process of the unidirectional hook 12 is reduced to the greatest extent, and a remarkable protection effect is achieved.
In a more preferred embodiment, as shown in fig. 1 to 7, a probe rod 25 is connected to the bottom end of the execution head 2; the execution head 2 and the penetrating rod 25 are internally provided with the wire through holes 26 in the axial direction, one end of each wire through hole 26 penetrates out of the bottom end of the penetrating rod 25, the other end of each wire through hole 26 penetrates out of the inner wall of the disc accommodating cavity 21, the pulling wires 32 are sleeved in the wire through holes 26, the number of the wire through holes 26 is the same as that of the pulling wires 32, the number of the wire through holes 26 is the same as that of the unidirectional hooks 12, the number of the wire through holes 26 is preferably 4, and at the moment, the number of the unidirectional hooks 12, the elastic protection layer 24 and the pulling wires 32 is 4, and the connection points of each pulling wire 32 on the surface of the concentrated disc 11 are distributed in a circumferential array, so that stress of the concentrated disc 11 is balanced; alternatively, two pull wires 32 are disposed in each of the via holes 26 to avoid affecting the operation of the unidirectional hooks 12 when one of them breaks.
1-7, a placement cavity 4 is arranged from the proximal end of the execution head 2 to the distal end of the detection rod 25 in a penetrating manner and is used for placing an endoscope and other observation auxiliary instruments, and the observation auxiliary instruments are used for providing the visual field of the area near the dura mater valve to be closed of a patient for an operator, so that the operator can more accurately control the action and the space pose of the unidirectional hook 12, and the efficiency of pulling back the dura mater valve and closing the dura mater valve after the operation is finished is greatly improved.
Another more preferred embodiment is that no placement cavity 4 is provided in the actuation head 2 and the penetration rod 25, thereby significantly reducing the diameters of the actuation head 2 and the penetration rod 25.
More preferred embodiment is, as shown in fig. 1-7, the centralized disc 11 is integrally formed, the unidirectional hooks 12 are all hinged on the centralized disc 11, and the traction wire 32 and the reset piece 31 are respectively and uniformly distributed at the bottom end and the top end of the centralized disc 11, so that the motion of each unidirectional hook 12 is synchronous, and through the arrangement, an operator can control the synchronous opening and closing of each unidirectional hook 12 by one hand only by pulling the centralized wire collecting structure for connecting the traction wire 32, thereby greatly reducing the operation difficulty. The bottom end of the penetrating rod 25 is provided with a line concentration structure, the distal end of each pulling line 32 is connected to the line concentration structure, the line concentration structure is connected with the penetrating rod 25 and can reciprocate along the axial direction of the penetrating rod 25, and the line concentration structure in the embodiment is a line concentration sliding sleeve 27 which is integrally and slidably sleeved on the penetrating rod 25 and is partially inserted into the penetrating rod 25 to be connected with the pulling line 32.
Example 2
The dura mater closer defines that one end of the dura mater closer, which is close to a patient in use, is a proximal end, and one end of the dura mater closer, which is far away from the patient, is a distal end, and as shown in fig. 1-9, the dura mater closer comprises a pull-back assembly 1, an execution head 2 and a driving assembly 3, wherein the pull-back assembly 1 is sleeved in the execution head 2, the driving assembly 3 is connected with the pull-back assembly 1, the pull-back assembly 1 is used for pulling back a dura mater flap to a closed state, and the dura mater closer comprises a centralizing disc 11 and a plurality of unidirectional hooks 12, and the unidirectional hooks 12 are hinged to the centralizing disc 11 in an annular array; the actuating head 2 is used for accommodating the pullback assembly 1, a disc placing cavity 21 and a guide slide rail 22 are arranged in the actuating head 2, the guide slide rail 22 penetrates through the outer wall of the actuating head 2 at the proximal end and forms a detection opening 221, the unidirectional hook 12 is in sliding connection with the guide slide rail 22, the disc placing cavity 21 is coaxial with the actuating head 2, the centralizing disc 11 is in sliding sleeve connection with the disc placing cavity 21 and can do reciprocating motion in the axial direction of the actuating head 2, and when the centralizing disc 11 moves from the distal end of the disc placing cavity 21 to the proximal end, the unidirectional hook 12 extends to the outside of the actuating head 2 along the guide slide rail 22 through the detection opening 221; the driving component 3 is used for controlling the position of the centralized disc 11 in the disc placing cavity 21, and comprises a reset piece 31 and a traction wire 32, wherein two ends of the reset piece 31 are respectively connected with the disc placing cavity 21 and the centralized disc 11, the traction wire 32 is arranged on the execution head 2 in a penetrating mode, one end of the traction wire 32 is connected with the centralized disc 11, and the other end of the traction wire 32 is arranged on the far end of the execution head 2 in a penetrating mode.
This embodiment differs from embodiment 1 in that, as shown in fig. 1 to 9: the centering disc 11 is composed of a plurality of disc blocks 111, each disc block 111 is hinged with one unidirectional hook 12, and each disc block 111 is independently connected with at least one reset piece 31 and at least one traction wire 32, so that each unidirectional hook 12 can independently move. The bottom end of the penetrating rod 25 is provided with a plurality of line concentration structures, in this embodiment, the line concentration structures are specifically line concentration sliding blocks 28 which are mutually independent and are connected to the outer wall of the penetrating rod 25 in a sliding manner along the axial direction of the penetrating rod 25, the moving tracks of the adjacent line concentration sliding blocks 28 are mutually parallel, the far end of each pulling line 32 is respectively connected with one line concentration sliding block 28, and the line concentration sliding blocks 28 are connected with the penetrating rod 25 and can do reciprocating motion along the axial direction of the penetrating rod 25. This embodiment has the advantage that independent control of the unidirectional hooks 12 can be achieved by controlling each hub slide 28 separately, and that the space required for operation can be further reduced in cooperation with viewing aids such as endoscopes.
In another more preferred embodiment, only one unidirectional hook 12 capable of protruding out is arranged in the execution head 2, the relative position relationship between the unidirectional hook 12 and the dura mater flap is changed by rotating the execution head 2 and the detection rod 25 during operation, the volume of the unidirectional hook 12 and the tensile force which the unidirectional hook 12 can bear during traction can be increased to a greater extent, and further, better technical effect can be achieved during dura mater traction.
In a more preferred embodiment, as shown in fig. 1-9, a communicating groove 23 communicating with the tray cavity 21 is penetrated inwards on the outer wall of the executing head 2, the guiding slide rail 22 is arranged on the side wall of the communicating groove 23, the guiding slide rail 22 is in an inverted J shape as a whole, the unidirectional hooks 12 are vertically accommodated in the inner part of the guiding slide rail 22 near the far end in the initial state, and the number of the protruding openings 221 is the same as that of the unidirectional hooks 12.
1-9, the outer side wall of the executing head 2 is provided with an elastic protection layer 24 corresponding to the position of the unidirectional hook 12, the elastic protection layer 24 is embedded in the communication groove 23, the elastic protection layer 24 is connected with the unidirectional hook 12, and when the unidirectional hook 12 extends out of the executing head 2 along the guiding sliding rail 22, the elastic protection layer 24 stretches and causes the unidirectional hook 12 to bend downwards; during the retraction of the unidirectional hooks 12 back into the dura mater, the elastic protective layer 24 is placed between the unidirectional hooks 12 and the dura mater.
1-9, the actuating head 2 comprises a moving state, in which the unidirectional hooks 12 are accommodated in the actuating head 2, and the elastic protection layer 24 is embedded in the communicating groove 23, and the diameter difference between the proximal end and the distal end of the actuating head 2 is not more than 1mm; the actuator head 2 further includes an operating state in which the actuator head 2 is switched from the moving state to the operating state after the proximal end of the actuator head 2 passes over the opened dura mater, the unidirectional hooks 12 extending outside the actuator head 2 in the operating state, the unidirectional hooks 12 exiting the detection port 221 being bent toward the distal end of the actuator head 2 under the deformation constraint of the elastic protection layer 24, when the actuator head 2 is pulled so that the unidirectional hooks 12 press the dura mater flap and close.
1-9, the unidirectional hook 12 comprises a plurality of joints of connecting parts 121 which are connected in a hinged manner, wherein the connecting parts 121 can rotate to the outer side of the execution head 2 through the joints in the initial state, and the connecting parts 121 are provided with sliding protrusions 122 and are in sliding connection with the guide sliding rails 22 through the sliding protrusions 122; each connecting portion 121 is connected with the elastic protection layer 24, so that the elastic protection layer 24 can be always attached to the outer side of the unidirectional hook 12 in the stretching process of the unidirectional hook 12, the track of the unidirectional hook 12 in the stretching and unfolding process is more approximate to an L shape, the movement area of the unidirectional hook 12 formed on the sagittal plane in the stretching process is greatly reduced, the contact between the unidirectional hook 12 and tissues in a patient is further reduced, and a remarkable protection effect is achieved.
In a more preferred embodiment, as shown in fig. 1-9, the bottom end of the execution head 2 is connected with a penetration rod 25; the execution head 2 and the penetrating rod 25 are internally provided with wire through holes 26 along the axial direction, one end of each wire through hole 26 penetrates out of the bottom end of the penetrating rod 25, the other end of each wire through hole 26 penetrates out of the inner wall of the disc cavity 21, the pulling wires 32 are sleeved in the wire through holes 26, the number of the wire through holes 26 is the same as that of the pulling wires 32, and the number of the wire through holes 26 is the same as that of the unidirectional hooks 12.
1-9, a placement cavity 4 is arranged from the proximal end of the execution head 2 to the distal end of the detection rod 25 and is used for placing an endoscope and other observation auxiliary instruments, and the observation auxiliary instruments are used for providing the visual field of the area near the dura mater valve to be closed of a patient for an operator, so that the operator can more accurately control the action and the space pose of the unidirectional hook 12, and the efficiency of pulling back the dura mater valve and closing the dura mater valve after the operation is finished is greatly improved.
Another more preferred embodiment is that no placement cavity 4 is provided in the actuation head 2 and the penetration rod 25, thereby significantly reducing the diameters of the actuation head 2 and the penetration rod 25.
Claims (8)
1. A dural sealer, comprising:
the retraction assembly is used for retracting the dura mater flap to a closed state and comprises a centralized disc and a plurality of unidirectional hooks, wherein the unidirectional hooks are hinged to the centralized disc in an annular array;
the device comprises a carrying head, a disc placing cavity and a guide sliding rail, wherein the inside of the carrying head is provided with a disc placing cavity and the guide sliding rail, the guide sliding rail penetrates out of the outer wall of the carrying head at the proximal end and forms a detection outlet, the unidirectional hook is in sliding connection with the guide sliding rail, the disc placing cavity is coaxial with the carrying head, the disc placing cavity is sleeved with the disc placing cavity in a sliding manner and can do reciprocating motion in the axial direction of the carrying head, and when the disc placing cavity moves from the distal end to the proximal end of the disc placing cavity, the unidirectional hook extends to the outside of the carrying head along the guide sliding rail through the detection outlet;
a communicating groove communicated with the disc accommodating cavity is internally penetrated on the outer wall of the execution head, and the guide sliding rail is arranged on the side wall of the communicating groove;
the elastic protection layer is embedded in the communication groove, the elastic protection layer is connected with the unidirectional hook, when the unidirectional hook extends out of the execution head along the guide sliding rail, the unidirectional hook extends out of the execution head along an axial tangential plane of the execution head, and the elastic protection layer stretches and enables the unidirectional hook to bend downwards; in the process of pulling back the dura mater by the unidirectional hooks, the elastic protective layer is arranged between the unidirectional hooks and the dura mater.
2. The dura mater closer according to claim 1, wherein the unidirectional hook comprises a plurality of joints connected in a hinged manner, the joints being rotatable to the outside of the actuator head through the joints in an initial state, the joints being provided with a sliding protrusion and being slidably connected with the guide rail through the sliding protrusion; each section of connecting part is connected with the elastic protection layer, so that the elastic protection layer can be always attached to the outer side of the unidirectional hook in the stretching process of the unidirectional hook.
3. The dura mater closer according to claim 1, wherein the actuating head is further provided with a driving component for controlling the position of the central disc in the disc placing cavity, the driving component comprises a reset piece and a traction wire, two ends of the reset piece are respectively connected with the disc placing cavity and the central disc, the traction wire is arranged on the actuating head in a penetrating way, one end of the traction wire is connected with the central disc, and the other end of the traction wire is arranged on the distal end of the actuating head in a penetrating way; the centralized disc is integrally formed, the unidirectional hooks are hinged to the centralized disc, and the traction lines and the reset pieces are respectively and uniformly distributed at the bottom end and the top end of the centralized disc, so that the movement of each single hook is synchronous.
4. The dura mater closer according to claim 1, wherein the actuating head is further provided with a driving component for controlling the position of the central disc in the disc placing cavity, the driving component comprises a reset piece and a traction wire, two ends of the reset piece are respectively connected with the disc placing cavity and the central disc, the traction wire is arranged on the actuating head in a penetrating way, one end of the traction wire is connected with the central disc, and the other end of the traction wire is arranged on the distal end of the actuating head in a penetrating way; the centralized disc consists of a plurality of disc blocks, each disc block is hinged with one unidirectional hook, and each disc block is independently connected with at least one reset piece and at least one traction wire, so that each unidirectional hook can independently move.
5. A dural sealer according to claim 3 wherein the bottom end of the actuator head is connected to a penetration rod; the wire drawing device comprises an execution head, a wire drawing rod and a wire drawing sleeve.
6. The dural closer of claim 5 wherein the bottom end of the access shaft has a hub structure to which the distal end of each of the pull wires is connected, the hub structure being connected to the access shaft and being capable of reciprocating in the axial direction of the access shaft.
7. The dura mater closer of claim 5, wherein a plurality of wire collecting structures are arranged at the bottom end of the penetrating rod, one wire collecting structure is connected to the distal end of each traction wire, and the wire collecting structure is connected to the penetrating rod and can reciprocate along the axial direction of the penetrating rod.
8. The dura mater closer according to claim 1, wherein the actuator head comprises a moving state in which the one-way hook is accommodated inside the actuator head, and the elastic protection layer is engaged in the communicating groove, and a difference in diameter from the proximal end to the distal end of the actuator head is not more than 1mm; the actuating head further comprises a working state, when the proximal end of the actuating head passes through the opened dura mater, the actuating head is switched from a moving state to the working state, the unidirectional hooks extend out of the outer side of the actuating head in the working state, the unidirectional hooks leaving the detection port bend towards the distal end of the actuating head under the deformation constraint of the elastic protective layer, and at the moment, the unidirectional hooks can be pressed by the unidirectional hooks to close the dura mater valve by pulling the actuating head.
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| CN202311141543.0A CN116869593B (en) | 2023-09-06 | 2023-09-06 | Dura mater closer |
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| CN202311141543.0A CN116869593B (en) | 2023-09-06 | 2023-09-06 | Dura mater closer |
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| CN116869593A (en) | 2023-10-13 |
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