CN116898505A

CN116898505A - Interventional structure and closing device with same

Info

Publication number: CN116898505A
Application number: CN202310855769.0A
Authority: CN
Inventors: 蔡奕; 刘文奇; 华育然; 黄河清
Original assignee: Jianyuan Medical Technology Wuxi Co ltd
Current assignee: Jianyuan Medical Technology Wuxi Co ltd
Priority date: 2023-07-12
Filing date: 2023-07-12
Publication date: 2023-10-20

Abstract

The invention relates to the technical field of vascular staplers, in particular to an interventional structure and a closing device with the same. An interventional structure, comprising: a cylindrical body having a distal end and a proximal end, the distal end being provided with a blade; and the conveying structure is arranged on the cylindrical body and provided with a bearing part for placing the medicament, and is suitable for moving along the axial direction when the cylindrical body is stressed so as to convey the medicament to a preset position. A closure device comprising said interventional structure, further comprising: an outer tube which is sleeved outside the cylindrical body and is provided with a suture opening and a medicament delivery port; the shell is arranged at the proximal end of the intervention structure, and a first actuator and a second actuator which are connected with the cylindrical body are arranged on the shell. The invention provides an intervention structure with reliable hemostatic effect and capable of improving surgical efficiency and a closing device with the intervention structure.

Description

Interventional structure and closing device with same

Technical Field

The invention relates to the technical field of vascular staplers, in particular to an intervention structure and a closing device with the intervention structure.

Background

Although in the field of existing post-interventional vascular closure, percutaneous minimally invasive procedures have been developed to replace conventional open sutures or manual compression hemostasis. Common minimally invasive approaches include both embolic and suture suturing techniques, where the suture is first placed in a vessel or tissue and sutured, and then trimmed to a suitable length so that it is not exposed to the body and causes infection to the patient. Conventional suture trimmers can replace surgical scissors or scalpels, penetrate into the interventional surgical site, trim the suture and reduce the surgical time. However, after the suture is trimmed, the knot is locked, so that the user is not allowed to continuously push the knot or change the knot position, and when the blood vessel is closed, a doctor or the user needs to continuously manually press the bleeding site when bleeding or bleeding occurs, thereby reducing the blood vessel closing efficiency and prolonging the operation time. And limited by the size of the surgical tools, it is difficult for a physician to deliver certain agents for treatment to a predetermined location of a patient after vascular closure for subsequent or adjuvant treatment after vascular closure, thereby affecting the efficiency of the surgery.

Disclosure of Invention

Therefore, the technical problem to be solved by the invention is to overcome the defect that the closing device in the prior art cannot convey certain medicaments to a preset position and affects the operation efficiency, so as to provide an intervention structure which is convenient to use and can improve the operation efficiency and a closing device with the intervention structure.

In order to solve the above technical problems, the present invention provides an interventional structure, including:

a cylindrical body having a distal end and a proximal end, the distal end being provided with a blade;

and the conveying structure is arranged on the cylindrical body and is suitable for moving along the axial direction when the cylindrical body is stressed so as to convey the medicament to a preset position.

Optionally, the agent is at least one of an adhesive, an antimicrobial agent, a clotting agent, a therapeutic agent, or a tissue gel.

Optionally, a limit portion is provided at the proximal end of the cylindrical body, the limit portion cooperating with a second actuator to limit rotation of the cylindrical body.

Optionally, the limiting part is a protruding block in clamping fit with the groove of the second actuator, the protruding block is provided with a plane matched with the groove wall of the groove and a cavity allowing the rod body of the first actuator to penetrate, and the cavity is communicated with the inner cavity of the cylindrical body.

Optionally, the blade is semicircular or wavy.

Optionally, the blade comprises two oppositely disposed semi-circles separated by a slot.

Optionally, the delivery structure is provided integrally with or separately from the cylindrical body.

Optionally, the conveying structure is separately arranged from the cylindrical body, is arranged at the proximal end of the cylindrical body and is positioned in the accommodating space of the housing, and the conveying structure comprises a bearing part for placing the medicament and a main body part connected with the bearing part, and the main body part is suitable for moving in the accommodating space along the axial direction when being acted by external force so as to push out the medicament on the bearing part.

Optionally, at least two expansion agent containing cavities are further arranged between the main body part and the bearing part of the conveying structure, and the cavity walls of the containing cavities are made of flexible materials and are suitable for being penetrated under the action of external force, so that at least two expansion agents are mixed to generate gas to push the medicament to reach a preset position.

Alternatively, the at least two expanding agents are hydrogen peroxide and manganese dioxide, or sodium azide and potassium nitrate.

Optionally, the device further comprises a puncture structure arranged on the limiting part, wherein the puncture structure is suitable for moving towards the accommodating cavity under the action of external force so as to puncture the cavity wall of the accommodating cavity.

Optionally, the puncture structure is a plurality of puncture needles annularly arranged on the circumference of the limiting part, and a through hole allowing the puncture needles to penetrate is arranged on the main body part of the conveying structure.

Optionally, the delivery structure is disposed separately from the cylindrical body, and is disposed at a proximal end of the cylindrical body, in an accommodation space of the housing, and the medicament is disposed in the accommodation space between the delivery structure and the housing, and is disposed near a distal end.

Optionally, the conveying structure is arranged at the distal end of the cylindrical body and is a sheet structure integrally or separately formed with the cylindrical body.

Optionally, the sheet structure is arc-shaped.

There is also provided a closure device comprising the interventional structure, further comprising:

an outer tube which is sleeved outside the cylindrical body and is provided with a suture opening and a medicament delivery port;

the shell is arranged at the proximal end of the intervention structure, and a first actuator and a second actuator which are connected with the cylindrical body are arranged on the shell.

Optionally, the second actuator has two clamping ends, between which a recess is formed allowing insertion of the proximal end of the cylindrical body.

Optionally, at least two groups of blades are arranged on the outer wall of the cylindrical body.

Optionally, the included angle of rotation between each set of blades is 90 degrees.

The technical scheme of the invention has the following advantages:

1. according to the intervention structure provided by the invention, when certain appointed medicaments are required to be conveyed to the preset position of a patient, the cylindrical body is driven to move by external force, so that the conveying structure is driven to move, the medicaments are conveyed to the preset position, the subsequent operation is convenient, and the operation efficiency is improved.

2. According to the intervention structure provided by the invention, after hemostasis is performed by the suture, or when the suture is failed or poor in suturing of the blood vessel, the cylindrical body is driven to move by external force, so that the conveying structure is driven to move, the adhesive is conveyed to the preset position, the suture is bonded, the blood vessel intervention wound is blocked, the blood vessel sealing efficiency and the hemostasis effect are improved, and the operation is convenient.

3. According to the intervention structure provided by the invention, the proximal limit part of the cylindrical body is arranged, so that the cylindrical body cannot rotate when being stressed, but moves along the axis, the cutting direction of the distal cutting edge of the intervention structure and the suture material is fixed, the cutting edge is ensured to contact with the suture material when moving to the distal end for cutting, the position without the cutting edge is not contacted with the suture material, the cutting cannot be performed or the cutting is difficult, and the cutting efficiency is improved.

4. According to the intervention structure provided by the invention, the conveying structure is arranged at the proximal end of the cylindrical body, and the conveying structure is driven to move by pushing the cylindrical body, so that the medicament on the bearing part is pushed out under the action of pressure; when the medicament can not be completely pushed out, the puncture needle punctures the cavity wall of the accommodating cavity, so that the two expanding agents are mixed to generate gas after contacting, the medicament is further pushed out until reaching a preset position, the residue of the medicament in the shell is reduced, and the problem of residual dead angles is solved.

5. The intervention structure provided by the invention has the advantages that the conveying structure is of a sheet structure integrally formed with the cylindrical body, the structure is simple, and the cost is low.

6. According to the intervention structure provided by the invention, the suture is not just opposite to the suture when the suture is cut, and the intervention structure has forward movement and tangential movement, so that the wavy blade can be more effective when the suture is cut, the repeated cutting times are reduced, and the cutting failure can be effectively prevented.

7. According to the closing device provided by the invention, the rotation included angle between each group of blades is 90 degrees, so that the medicament can rotate along with the blades after passing through the mixing blades with the included angle, and medicaments with different components can be uniformly mixed once after passing through one group of blades, so that a better mixing effect is realized, and the bonding effect is further improved.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are needed in the description of the embodiments or the prior art will be briefly described, and it is obvious that the drawings in the description below are some embodiments of the present invention, and other drawings can be obtained according to the drawings without inventive effort for a person skilled in the art.

FIG. 1 is an exploded view of a closure device according to a first embodiment of the present invention;

FIG. 2 is a schematic cross-sectional view of a closure device according to a first embodiment of the present invention;

FIG. 3 is a schematic view of a cylindrical body of an intermediate structure according to a first embodiment of the present invention;

FIG. 4 is a schematic view illustrating the installation of the cylindrical body and the second brake in the first embodiment of the present invention;

FIG. 5 is a schematic illustration showing the medicament in the push-out state in the insertion structure according to the first embodiment of the present invention;

FIG. 6 is a schematic illustration of the medicament in the non-pushed-out state in the first embodiment of the present invention;

FIG. 7 is a schematic illustration of the swelling agent in the intervening structure when not mixed in accordance with the first embodiment of the present invention;

FIG. 8 is a schematic illustration of the swelling agent in the intervening structure during mixing in accordance with the first embodiment of the present invention;

FIG. 9 is a schematic illustration of the swelling agent in the intervening structure after mixing in accordance with the first embodiment of the present invention;

FIG. 10 is a schematic view of a first configuration of a distal blade of an intermediate structure according to a first embodiment of the present invention;

FIG. 11 is a schematic view of a second configuration of the distal blade of the intermediate structure in the first embodiment of the present invention;

FIG. 12 is a schematic view of a third configuration of a distal blade with intervening structures in accordance with the first embodiment of the present invention;

FIG. 13 is a schematic illustration of the medicament in the insertion structure in an un-pushed state according to a second embodiment of the present invention;

fig. 14 is a schematic view showing a medicament in an insertion structure in a pushed-out state according to a second embodiment of the present invention.

Reference numerals illustrate:

1. a cylindrical body; 2. a conveying structure; 3. a blade; 4. capping; 5. a limit part; 6. a first actuator; 7. the rod body, 8 and the cavity; 9. a blade; 10. a second actuator; 11. a receiving chamber; 12. a piercing structure; 13. an outer tube; 14. a housing; 15. a suture opening; 16. a delivery port; 17. a cover body; 18. a first housing; 19. a second housing; 20. and a clamping end.

Detailed Description

The following description of the embodiments of the present invention will be made apparent and fully in view of the accompanying drawings, in which some, but not all embodiments of the invention are shown. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.

In addition, the technical features of the different embodiments of the present invention described below may be combined with each other as long as they do not collide with each other.

Example 1

In one embodiment of the intervention structure shown in fig. 1 to 12, the end of the intervention structure far away from the operator in use is a distal end, the end near the operator is a proximal end, the medicament is at least one of an adhesive, an antibacterial agent, a coagulant, a therapeutic agent or a tissue adhesive, and the intervention structure of this embodiment is exemplified by the adhesive, but of course, the intervention structure of this embodiment can also be used for conveying other medicaments, including a cylindrical body 1 and a conveying structure 2 disposed on the cylindrical body 1, in this embodiment, the conveying structure 2 and the cylindrical body 1 are separately disposed and disposed at the proximal end of the cylindrical body 1.

The cylindrical body 1 has a distal end provided with a blade 3, a proximal end and an inner cavity. Since only part of the outer edge of the distal end needs to be sharpened to cut the suture, as shown in fig. 10, the sharpening side can be distinguished from the non-sharpening side through the middle square groove at the distal end, the sharpening side is used for cutting suture materials, and the sharpening side is usually arranged below, or the sharpening sides are arranged above or above and below according to actual requirements, namely, two semicircles are oppositely arranged, the shape of the blade can be a semicircle as shown in fig. 11 or a wave as shown in fig. 12, and the wave-shaped blade is distributed along the circumferential direction of the cylindrical body 1 and has different orientations, so that the cutting of the suture can be more effective compared with other shapes.

As shown in fig. 3, the proximal end of the cylindrical body 1 is further provided with a cap 4 and a limiting portion 5, the limiting portion 5 is disposed on the cap 4 and is a pair of protruding blocks disposed at intervals, a cavity 8 allowing the rod body 7 of the first actuator 6 to penetrate is formed between the two protruding blocks, and the cavity 8 is disposed through the inner cavity of the cylindrical body 1, so that the rod body 7 of the first actuator 6 extends into the inner cavity of the cylindrical body 1; the two lugs are far away from each other and are arranged on a pair of surfaces which are plane surfaces so as to form a limiting surface. Meanwhile, at least two groups of blades 9 are arranged on the outer wall of the cylindrical body 1, a rotation included angle is formed between each group of blades 9, and preferably, the rotation included angle between each group of blades 9 is 90 degrees. After the adhesive passes through the blades 9 with included angles, the adhesive rotates along with the blades, and the adhesive with different components is uniformly mixed once after passing through one group of blades 9, for example, the adhesive is mixed into four layers in a left-right layering way. In a preferred embodiment, 7 sets of blades 9 are provided, so that the two components of the adhesive are mixed 2-7=128 times when passing through all 7 sets of blades 9, and the two components of the adhesive are arranged at intervals of 128 layers, so that a better mixing effect is achieved. More blade sets can be arranged at the far end of the tubular intervention structure to realize more uniform mixed layering. And finally, when the suture trimming device is pushed out, the evenly mixed adhesive can realize better bonding effect.

The conveying structure 2 has a carrying portion for placing an adhesive and a main body portion connected to the carrying portion, and the conveying structure 2 is adapted to move in an axial direction when the cylindrical body 1 is subjected to a force to convey the adhesive to a predetermined position. In particular, as shown in fig. 1, 2, 5 and 6, the delivery structure 2 is located in a receiving space of the housing 14, i.e. the distal end of the housing 14 has a receiving space, in which the body portion is adapted to move axially when acted upon by an external force of the second actuator 10 to push out the adhesive on the carrier portion.

Since the distal pushing distance of the conveying structure 2 is limited by the size of the accommodating space of the housing 14 when the second actuator 10 is used for distal pushing, a part of adhesive remains at the corners, and thus, in this embodiment, at least two accommodating chambers 11 for expanding agents are further provided between the main body and the bearing parts of the conveying structure 2, as shown in fig. 7 to 9, the walls of the accommodating chambers 11 are made of flexible materials, such as elastic rubber diaphragms, which are suitable for being penetrated under the action of external force, so that at least two expanding agents are mixed to generate gas to push the adhesive to reach the predetermined position. The at least two expanding agents are hydrogen peroxide and manganese dioxide, or sodium azide and potassium nitrate. The hydrogen peroxide and manganese dioxide are mixed and contacted to generate oxygen, and the sodium azide and potassium nitrate are mixed and contacted to generate nitrogen, and the oxygen or the nitrogen pushes the adhesive to move towards the distal end so as to remove residues. Of course, a single-component or more than three-component expanding agent can be used, and the number of the accommodating cavities is matched with that of the accommodating cavities.

Specifically, the limiting part 5 is provided with a puncture structure 12, the puncture structure 12 is a plurality of puncture needles annularly arranged on the circumference of the cap 4 connected with the limiting part 5, the puncture needles can be fixed in a jogged inserting mode, and the number of puncture needles can be one or more according to actual needs. The main body of the conveying structure 2 is provided with a through hole which allows the puncture needle to penetrate, and the length of the puncture needle is longer than the length of the through hole and the axial length of one containing cavity 11 so as to ensure that the two expanding agents can be normally mixed and contacted. The piercing structure 12 is moved towards the receiving chamber 11 by the second actuator 10 to pierce the chamber wall of the receiving chamber 11.

As an alternative embodiment, the delivery structure 2 is disposed separately from the cylindrical body 1 and at the proximal end of the cylindrical body 1, in the receiving space of the housing 14, and the medicament is disposed in the receiving space between the delivery structure 2 and the housing 14 and near the distal end. That is, the forward medicine is directly pushed out by the pushing force of the conveying structure 2 without providing an additional carrier portion.

One embodiment of the closure device shown in fig. 1 and 2 comprises the interventional structure described in example 1, an outer tube 13 arranged around the tubular body 1 and a housing 14 arranged at the proximal end of the interventional structure.

The distal end of the outer tube 13 has a suture opening 15 and a delivery port 16 of adhesive, specifically, the suture opening 15 is provided on the peripheral wall of the outer tube 13 and the delivery port 16 is provided on the radial end face of the outer tube 13. The proximal end of the outer tube 13 is provided with a cover 17, the cover 17 being adapted to be fixedly connected to the distal end of the housing 14 by means of a fitting, together forming a receiving space for the delivery structure 2.

The housing 14 includes a first shell 18 and a second shell 19 that are detachably connected in a radial direction, and the housing 14 is formed of two parts, facilitating assembly with other parts. The housing 14 is provided with a first actuator 6 and a second actuator 10 connected to the cylindrical body 1. Wherein, the part of the first actuator 6 extending into the shell 14 is connected with a rod body 7, the rod body 7 is inserted into the inner cavity of the cylindrical body 1, and the other part is exposed outside the shell 14, thereby being convenient for operation. The portion of the second actuator 10 extending into the housing 14 has two clamping ends 20, the two clamping ends 20 are spaced apart to form a groove therebetween for allowing the proximal end of the cylindrical body 1 to be inserted, the inner walls of the groove are flat, and the flat of the projection is disposed in abutment with the flat of the groove to limit the rotation of the cylindrical body 1.

When the adhesive is multi-component, the adhesive can be stored at intervals when not in use. When in use, the second actuator 10 is shifted to move the conveying structure 2 towards the distal end, and simultaneously the puncture needle on the cap 4 sequentially penetrates through the main body part of the conveying structure 2 and the adjacent containing cavity 11 of one expanding agent, so that the two containing cavities 11 are communicated, the two expanding agents are in mixed contact, a certain amount of gas is generated, the gas and the main body part of the conveying structure 2 jointly act to push the adhesive out of the containing space of the shell 14, then the adhesive enters between the outer tube 13 and the outer wall of the cylindrical body 1, the adhesive is further mixed along with the rotation of the blade 9, and finally the uniformly mixed adhesive is output from the conveying port 16 of the outer tube 13 and reaches a preset position.

Example 2

Another embodiment of the intervention structure as shown in fig. 13 and 14 comprises a cylindrical body 1 and a delivery structure 2 provided on said cylindrical body 1, the delivery structure 2 having a carrier part for placing a medicament and a main body part connected to said carrier part, said delivery structure 2 being adapted to move axially when said cylindrical body 1 is subjected to a force for delivering the medicament to a predetermined position. Specifically, the medicament is an adhesive, the conveying structure 2 is arranged at the distal end of the cylindrical body 1, and is of a sheet-shaped structure integrally formed with the cylindrical body 1, the bearing part is an arc plate arranged at the distal end of the sheet-shaped structure, and a track suitable for sliding of the conveying structure 2 is arranged on the inner wall of the distal end of the outer tube 13. In the non-use state, the arc-shaped plate is accommodated in the outer tube 13, and in the use state, the second actuator 10 is pulled to apply a force to the cylindrical body 1 for moving towards the distal end, and the arc-shaped plate extends out of the distal end of the outer tube 13, so that the adhesive is conveyed to a preset hemostasis position, such as a suture knot position or the vicinity of a vascular intervention operation opening, and the adhesive is adhered to the vascular opening to complete vascular closure.

As shown in fig. 3, the proximal end of the cylindrical body 1 is further provided with a cap 4 and a limiting portion 5, the limiting portion 5 is disposed on the cap 4 and is a pair of protruding blocks disposed at intervals, a cavity 8 allowing the rod body 7 of the first actuator 6 to penetrate is formed between the two protruding blocks, and the cavity 8 is disposed through the inner cavity of the cylindrical body 1, so that the rod body 7 of the first actuator 6 extends into the inner cavity of the cylindrical body 1; the two lugs are far away from each other and are arranged on a pair of surfaces which are plane surfaces so as to form a limiting surface.

Alternatively, the sheet-like structure may also be provided separately from the cylindrical body 1 and connected to the cylindrical body 1 by a plug-in structure or a connection.

Alternatively, the distal end of the sheet-like structure integrally formed with the cylindrical body 1 may be provided with no bearing portion, and the forward medicine may be directly pushed out by the pushing force of the sheet-like structure.

Another embodiment of the closure device comprises the interventional structure described in example 2, an outer tube 13 arranged around the cylindrical body 1 and a housing 14 arranged at the proximal end of the interventional structure.

The distal end of the outer tube 13 has a suture opening 15 and a delivery port 16 of adhesive, specifically, the suture opening 15 is provided on the peripheral wall of the outer tube 13 and the delivery port 16 is provided on the radial end face of the outer tube 13.

It is apparent that the above examples are given by way of illustration only and are not limiting of the embodiments. Other variations or modifications of the above teachings will be apparent to those of ordinary skill in the art. It is not necessary here nor is it exhaustive of all embodiments. While still being apparent from variations or modifications that may be made by those skilled in the art are within the scope of the invention.

Claims

1. An interventional structure comprising:

a cylindrical body (1) having a distal end and a proximal end, said distal end being provided with a blade (3);

and the conveying structure (2) is arranged on the cylindrical body (1), and the conveying structure (2) is suitable for moving along the axial direction when the cylindrical body (1) is stressed so as to convey the medicament to a preset position.

2. The interventional structure of claim 1, wherein said agent is at least one of an adhesive, an antimicrobial agent, a clotting agent, a therapeutic agent, or a tissue glue.

3. The intervention structure according to claim 2, wherein the proximal end of the cylindrical body (1) is provided with a stop (5), the stop (5) cooperating with a second actuator (10) to limit the rotation of the cylindrical body (1).

4. An intervention structure according to claim 3, wherein the limit part (5) is a projection which is in clamping fit with a groove of the second actuator (10), the projection is provided with a plane which is matched with a groove wall of the groove and a cavity (8) which allows a rod body (7) of the first actuator (6) to penetrate, and the cavity (8) is arranged in a penetrating way with an inner cavity of the cylindrical body (1).

5. The intervention structure according to claim 1, wherein said blade (3) is semicircular or wavy.

6. The intervention structure according to claim 5, wherein said blade (3) comprises two opposite semi-circles separated by a notch.

7. The intervention structure according to any of the claims 1-6, wherein the delivery structure (2) is provided integrally or separately with the cylindrical body (1).

8. The intervention structure according to claim 7, wherein the delivery structure (2) is arranged separate from the cylindrical body (1) and at the proximal end of the cylindrical body (1) in a receiving space of a housing (14), the delivery structure (2) comprising a carrier part for placing a medicament and a body part connected to the carrier part, the body part being adapted to move axially in the receiving space when subjected to an external force, in order to push out the medicament on the carrier part.

9. The intervention structure according to claim 8, wherein at least two containing cavities (11) of expansion agents are further arranged between the main body part and the bearing part of the delivery structure (2), the cavity walls of the containing cavities (11) are made of flexible materials and are suitable for being penetrated under the action of external force, so that the at least two expansion agents are mixed to generate gas to push the medicament to reach a preset position.

10. The interventional structure of claim 9, wherein the at least two expanding agents are hydrogen peroxide and manganese dioxide, or sodium azide and potassium nitrate.

11. The intervention structure according to claim 9 or 10, further comprising a piercing structure (12) provided on the limiting part (5), the piercing structure (12) being adapted to move towards the receiving cavity (11) under the effect of an external force to pierce the cavity wall of the receiving cavity (11).

12. The intervention structure according to claim 11, wherein the puncture structure (12) is a plurality of puncture needles annularly arranged on the circumference of the limiting part (5), and a through hole allowing the puncture needles to penetrate is arranged on the main body part of the conveying structure (2).

13. The intervention structure according to claim 7, wherein the delivery structure (2) is arranged separate from the cylindrical body (1) and at the proximal end of the cylindrical body (1), in the receiving space of the housing (14), the medicament being arranged in the receiving space between the delivery structure (2) and the housing (14) and near the distal end.

14. The intervention structure according to claim 7, wherein the delivery structure (2) is provided at the distal end of the cylindrical body (1) and is a sheet-like structure formed integrally or separately with the cylindrical body (1).

15. The interventional structure of claim 14, wherein the sheet structure is arcuate.

16. A closure device comprising the interventional structure of any one of claims 1-15, further comprising:

an outer tube (13) sleeved outside the cylindrical body (1) and provided with a suture opening (15) and a medicament delivery port (16);

and the shell (14) is arranged at the proximal end of the intervention structure, and a first actuator (6) and a second actuator (10) which are connected with the cylindrical body (1) are arranged on the shell (14).

17. The closure device according to claim 16, wherein the second actuator (10) has two gripping ends (20), between which two gripping ends (20) a recess is formed allowing the insertion of the proximal end of the cylindrical body (1).

18. A closure device according to claim 16 or 17, wherein at least two sets of blades (9) are provided on the outer wall of the cylindrical body (1).

19. A closure device according to claim 18, wherein the angle of rotation between each set of blades (9) is 90 degrees.