CN1547455A - 在缝合线上形成倒刺的方法及实施该方法的装置 - Google Patents

在缝合线上形成倒刺的方法及实施该方法的装置 Download PDF

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CN1547455A
CN1547455A CNA028167783A CN02816778A CN1547455A CN 1547455 A CN1547455 A CN 1547455A CN A028167783 A CNA028167783 A CN A028167783A CN 02816778 A CN02816778 A CN 02816778A CN 1547455 A CN1547455 A CN 1547455A
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佩里·A·杰诺瓦
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罗伯特·C·威廉姆斯三世
瓦伦·朱伊特
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马修·A·梅加罗
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Abstract

本发明公开了一种通过在切割缝合线时改变刀片的几何形态和/或刀片的运动制造加有倒刺的缝合线的方法。所述方法也可以用一种切割装置在手术缝合线的外部造成多个倒刺来完成。使用切割装置通过该方法造成的倒刺可以是相同的构型也可以是随机的构型。

Description

在缝合线上形成倒刺的方法及实施该方法的装置
技术领域
本发明涉及通过改变刀片的几何形态和/或在切割缝合线丝时移动刀片在缝合线丝上加倒刺的方法，其中所述方法也可以用于在缝合线的外部切割出多个轴向间隔的倒刺，以及进行所述方法的装置。
技术背景
在现有技术中，众所周知手术和创伤的创口典型地通过附着于线的一端的缝合针把线送进组织内封闭。封闭创口和把组织固定在一起支持愈合和再生长。典型地用于此术的线公知为缝合线。
加倒刺的缝合线是一种单向的缝合线，它让针拉的缝合线沿一个方向穿过组织，但是不让沿相反的方向穿过。加倒刺的缝合线一般地是一种细长体，具有尖的前端并且在细长体的外表面上有多个轴向并且圆周地间隔开的倒刺。
在用带倒刺的缝合线封闭创口时，缝合线在创口的每个对侧穿过组织。形成缝合线对，其中缝合线尾端一般以对准方式位于创口的对侧。在插入每个缝合线时，推针以在横向远离创口的点伸出组织，然后拉针以把缝合线拉出至所希望的位置，再把缝合线从针上剪开(注意使用带倒刺的缝合线的方法公开于2001年6月29日提交的在审美国专利申请，系列号为09/896,455，题为“缝合方法(Suture Method)”，并且转让给Quill Medical，Inc.，该公开引入本文作为参照)。使用带倒刺的缝合线的优点是能够在组织中施加张力，结果缝合线在创口中滑动较少。缝合线对的数量根据创口的大小和保持创口封闭需要的力量而加以选择。尽管用非常尖的倒刺和相对瘦小的端头较容易把组织锚固，但是有槽端的倒刺可以得到更好的组织固定结果。
在一些组织修复的情况下，在缝合线外部的随机构型的倒刺可能较好。用尽可能多的倒刺角可能得到优良的创口固定作用。然而在另一些情况下，创口或者需要的组织修复较小，优选小的缝合线。小的缝合线要求缝合线外部上的倒刺数量较少。
已提出了各种切割倒刺的方法(例如见美国专利5,931,855号)，但是由于尚不清楚的原因，这些方法还没有商业性地开发。
综上所述，需要一种困难最少并且以可靠的和相对经济的方式在缝合线产外部切割倒刺的方法，从而让这样缝合线有广泛的商业化。这样的方法应当还能够改变倒刺的尺寸、其位置和深度，使之有变体并且有利于其应用。所述方法应当能够切割多个取决于需要的倒刺数而定位的倒刺。还需要有能够使用上述方法的装置，所述的装置可以提供多个或随机或相同构型的轴向间隔开的倒刺，同时构型主要取决于正修复的组织的类型等等。
发明概述
因此本发明的主要目标是提供在缝合线中切割倒刺的实用方法。
因此本发明的另一个目标是提供在缝合线的外部切割各种尺寸预分端头的倒刺的方法。
因此本发明的又一个目标是提供在缝合线的外部切割多个轴向间隔开的倒刺的方法。
因此本发明的又一个目标是提供圆周地绕缝合线外部切割多个轴向间隔开的倒刺的方法。
因此本发明的又一个目标是提供在缝合线的外部以相同或者随机的构型切割多个轴向间隔开的倒刺的方法。
因此本发明的再一个目标是提供用于实施该方法的示例性装置。
为了达到所述的目标，提供了一种切割方法，所述的方法取决于使用刀片的几何形态和/或在切入缝合线时刀片的运动制造各种尺寸的缝合线倒刺。通过改变刀片的几何形态和/或刀片运动的程度或轨迹，可以把倒刺做成为各种外科应用设计的各种尺寸。例如：为了连接脂肪和相对软的组织希望较大的倒刺，而较小的倒刺更加适合于胶原蛋白密集的组织。同样，使用同一个缝合线上大倒刺和小倒刺的结合会保证最大的锚固特性，其中倒刺的尺寸是为每个组织层定制的。
切割方法可以用本文公开的切割装置实现。所公开的装置可以在沿缝合线的长度上以交错排列的位置制造六套倒刺，从而三套倒刺与另三套倒刺对置。在横截面上看缝合线，取决于切割方法倒刺套相互120度或者180度地定位。纵向地每个倒刺切割要在最接近的一端处开始。
与在不扭转的状态下切割倒刺的方法比较，使用扭转的构型可以：简化制造设备；制造较粗的缝合线；减少制造周期时间至少三成；并且易于达到较小的直径并且产生螺旋形的倒刺而不是120度或180度的倒刺。
通过改变、稍加修改，和/或用和不用扭转缝合线的方法的结合，可以获得具有随机构型的倒刺。有一些组织修复的例子，对于以尽可能多的倒刺角以提供优良的创口固定特性去锚固组织，随机构型可能较理想。本发明的这些目标和其它目标和特性会从以下详细说明的进一步公开中变得明了。
附图说明
从而通过本发明会实现其目标和优点，其说明会结合附图进行，附图中
图1A-F示出刀片的切割运动，带有一个运动自由度和两个刀片几何形态自由度。
图2A-C示出刀片的切割运动，带有二个切片运动自由度和一个刀片几何形态自由度。
图3A-C示出刀片的切割运动，带有三个切片运动自由度和一个固化的平面几何形态。
图4A-C示出刀片的曲折(往返和向下振动)的切割运动，带有三个切片运动自由度和一个固化的平面切片几何形态。
图5A-C示出铰接的刀片的切割运动，带有三个刀片运动自由度。
图6是组装的切割装置的顶视图。
图7是切割床的透视图。
图8示出切割装置的留置结的末端、侧面和截面图。
图9示出切割装置的刀片组件的顶视图和侧视图和刀片组件的一个示例刀片的顶视图。
图10示出刀片组件的模板块的顶视图和侧视图。
图11示出切割装置使用的切割模板的顶视图和侧视图。
图12示出切割装置使用的捣棒的顶视图和侧视图。
图13示出把缝合线固定到留置结和放置在间隔棒上。
图14示出切割床夹具使用的各种固定件的安置。
图15示出刀片组件的安置和相对于切割模板的下向运动，切割装置的其余部分从图中取走以图示清晰。
图16示出刀片组件的安置和相对于切割模板的上向运动。
图17是正视图，示出在用120度旋转的切割方法切割之前和之后把倒刺固定在切割床夹具中。
图18是正视图，示出在使用扭转的切割方法切割前把缝合线固定在切割床中。
图19示出在扭转的切割方法之前和之后的各种缝合线状态。
图20示出在使用120度旋转的切割方法的带倒刺的缝合线的侧视图、顶视图和细节图。
图21A-C示出带有旋转往复刀片组件的线性指数机构的透视图。
图22示出带有旋转往复刀片组件的旋转指数机构的透视图。
具体实施方式
下面参照附图详细地说明，其中对各个视图中的相同零件标以相同的标号。
本发明的目的是提供制造带倒刺的缝合线的有效方式。在此方面公开了几个不同类型的方法，所述方法针对刀片在缝合线上的切割动作以产生倒刺。如下面将说明地，设想所述的切割运动考虑刀片的运动和刀片的几何形态。
基本上，用刀片切割缝合线考虑到缝合线6的三个维数x-y-z。每个维数都是重要的并且可以通过刀片的切割运动和/或刀片的几何形态应对。取决于刀片几何形态，刀片的运动可能在其它的维数中有影响。
在此方面，图1A说明刀片8的连贯的切割运动，带有一个运动自由度和两个跨在缝合线6上的刀片几何形态的自由度。运动自由度的一个是在三维“x-y-z”布局中的一个方向的运动。对于图1A，方向(2)跟随缝合线6切口中的横向“x”轴，在完成切割之前刀片8沿方向(2)运动。刀片8的刀刃10有一个用(12)标出的角，在其刀片的几何形态中介于刀片8的侧端14、16之间，还有一个角(图中未示)在其几何形态中介于刀片8的顶板和底板之间。这样的几何形态仅通过刀片8在x方向的运动就会引起沿y和z维(也就是沿倒刺的长度和深度)的作用。
如图1B所示，这些角使之能够在以方向(2)的运动过程中沿y和z的方向切割进缝合线。这种切入运动示出结果方向(18)。图1C示出用沿方向(2)远离缝合线6的连续运动完成的缝合线6的切割。
与图1A相似，图1D说明带有一个运动自由度和两个跨缝合线的刀片几何形态的自由度的刀片8的切割运动。在图1D中，刀片8是空心的研磨光的刀片，其中刀刃10在其侧面14、16的端部之间在其刀片几何形态中有一个角，并且在其刀片8的顶板和底板之间在其刀片的几何形态中具有一个凹陷或者说弯曲进去的面。这样的几何形态可以仅通过沿x方向运动刀片8造成沿y和z维(也就是沿倒刺的长度和深度)的作用。
如图1E和1F所示，这种刀片几何形态使得在刀片8沿方向(2)的运动过程中能够沿y和z方向切割进缝合线6。把图1E与图1F比较说明刀片8沿方向(2)的运动怎样增加倒刺的长度和深度。
现在转向图2A-2C，说明了带有两个运动自由度和一个刀片几何形态自由度的刀片的连贯切割运动。两个运动自由度是沿x和y两个方向的运动。对于图2，在缝合线6的切口中方向(2)跟随横向“x”而方向(22)跟随“y”轴。在这方面同时沿两个方向(2)和(22)的刀片8运动可用于完成一个切割。刀片8的刀刃19有90°或以下的角，标出为(24)，这是在刀片8的侧面14、16的端部之间的刀片的几何形态中的一个角度。
如图2B所示，沿方向(22)和沿横向(22)的前向运动允许较图1中产生的要长的进入缝合线6中的切口，因为图1中刀片的几何形态和沿x轴的刀片运动决定倒刺的长度，而在图2中同时沿“y”和“x”轴的刀片运动决定倒刺的长度。这个较长的切割动作是沿“y”方向的。图2C示出缝合线6切割完成，同时有沿方向(2)远离缝合线6的连续运动。
图3A示出了带有三个运动自由度并且刀刃10有90°或以下的另一种刀片的连贯的切割。三个运动自由度是沿三维x-y-z布局的三个方向中运动。对于图3A，方向(2)跟随横向的“x”轴、方向(22)跟随前向的“y”轴而方向(32)跟随下向的“z”轴。在所有三个方向(2)、(22)和(32)的刀片8运动用于完成在缝合线6上切割倒刺。
横向(2)、前向(22)和下向方向(32)的运动的结合使之能够改变切口的长度和深度以产生倒刺。沿方向(32)进一步切割可能是较深的倒刺和/或沿方向(22)进一步切割可能是较长的倒刺。通过同时沿横向(2)、前向(22)和下向(32)运动刀片8形成一种轨迹，所述的轨迹可改变以产生有不同质量的倒刺，所述的质量譬如是纵横比。图3C示出完成的缝合线6切割，同时有沿方向(2)、(22)和(32)远离缝合线6的连续运动。
切割倒刺的另一种方法示于图4A-C，其中示出了带有三个运动自由度的刀片运动和固化的平面几何形态的后向和前向或者曲折(结合沿z和/或y轴的运动的“x”轴上的振动)的刀片运动以锯式的切割运动切割倒刺。运动的三个自由度是在三维x-y-z布局中三个方向的运动。在图4A中，方向(2)跟随横的“x”轴、方向(22)跟随前向的“y”轴、方向(32)跟随下向的“z”轴，而方向42跟随横向的“x”轴，只是与方向(2)相反。图4A示出可以用于完成沿方向(22)和(32)的刀片8的切割的运动，同时有在方向(2)和(42)之间的运动的交替。刀片8的刀刃10可是在刀片8的侧面14、16的端头之间的直线。
沿横向(2)和(42)的交替运动、稳定的沿前向(22)的运动和稳定的沿下向(32)的运动的结合使得能够改变切口的深度。合成的曲折的切割运动在图4B中示出为交变的方向(44)。图4C示出完成的缝合线6的切口。
另一种切割倒刺的方法示于图5A-5C中，其中刀片8绕轴9的链接，结合以上在图1-4中说明的任何一种切割运动，可以用于改变倒刺的深度。在图5A中，方向(2)跟随横向的“x”轴(进入图纸平面)、方向(22)跟随前向的“y”轴、而方向(32)跟随下向的“z”轴。图5B示出可以用于完成沿方向(2)和(22)的刀片8的切割的刀片运动，与图2B所示相似。以方向(22)和沿横向(2)的前向运动产生基于两个自由度的切片运动的倒刺。在图5C中，也允许刀片8绕轴9铰接，提供一个附加的自由度，所述附加的自由度可以用于赋予z轴上沿方向(32)的附加倒刺深度。该刀片8的铰接运动可用于结合以上所述的任何刀片的几何形态和/或刀片的运动。刀片9的铰接还可以用于提升倒刺并且使之远离缝合线的表面，从而导致槽或者更显著的倒刺。
图1-5示出的刀片运动可以切割由聚乙醇酸交酯、polydioxinone、聚丙烯或者其它可吸收的，或者其它不可吸收的，Gore-Tex，双组分材料制造的缝合线丝，或者用其它适用于此目的的材料制造的缝合线。
尽管在以上的示例中仅示出单个刀片，但可以想像可以使用多个刀片。它们可以在能够实施上述运动的级联的或者旋转的机构或者在任何其它类型的机械装置中。还有，尽管缝合线示出为处于不扭转的状态，然而也可以把它以扭转的状态切割，如后文所述。
用于实施以上说明的方法的机械装置的示例，参见图6-19和21-22。然而应当理解，这些装置不应当视为排它性的，并且可以设想其它的装置用于这样的实施。
现在更为具体地参阅图6，图中示出切割装置50，所述的切割装置50让操作人员能够用以上所述的方法在缝合线6的外部切割多个倒刺。所述的切割装置50包含固位旋钮52、54用于在切割过程中把缝合线6留置在夹具63上。固位旋钮52、54包括旋钮支架61、62。切割床夹具螺丝58、60用于打开和闭合切割床夹具63，在切割过程中缝合线6置于所述的夹具63上。
切割模板64引导刀片组件66的切割运动，所述的刀片组件66含有多个跨越缝合线6的刀片。设有两个附加的切割模板用于运行切割装置，但是可以偏调以提供刀片相对于缝合线6的不同的轴向位置。切割模板有与切割模板64相同的构型并且以相似的方式在几个不同的视角上安装。还有，尽管所述的模板特别适用于实践切割倒刺的方式之一，这样的模板可以方便地修改以允许其它的实施方式，包括以上说明的方式，正如本领域内普通技术人员会理解的。
切割床夹具63辅助对准切割模板。在切割床夹具63的块68的顶部有两个突起。所述的突起是对齐销钉70、72，它们用于固定切割模板和捣棒101。
对于本领域内普通技术人员会明白，切割床63的构型可以改变。如果转动(例如120度或者180度)缝合线以实行绕其圆周切割倒刺，切割床夹具可以构型得如图6所示。如果在切割前扭转缝合线，如下面所说明，切割床夹具63优选地具有梯形的侧面的构型，如图7所示。由于缝合线的材料是稍微顺性的，这个设计提供优良地夹卡到具有平行侧面的夹具上。请注意图7所示的夹具还可以用于转动的缝合线，因为有空间容纳切割的倒刺。在此方面，在图7中块68、74向外从其内侧的顶部向表面74渐细，同时从末端断面上看去时块示出梯形的形状。从块68的斜削突出的是梯形或者平台的缝合线卡78，所述的缝合线卡78用于在闭合切割床夹具63过程中固定缝合线6。缝合线卡78是始于表面76并且稍低于顶部80终止的楔形。
除了固定缝合线6以外，把固位旋钮52、54转动于各种切割方法之间，并且进行数字的刻度用于精确的运动。如图8中所示，固位旋钮52是实心的细长体。固位旋钮52含有一个具有与三角形突起86为一体的握持84的圆柱82。三角形的突起82座落在切割床56上或者间隔棒100上，如图13所示。锚固螺  90把缝合线6固定在固位旋钮上。三角形的突起包括数字标记用于引导操作人员在切割方法的不同阶段中定位固位旋钮；然而三角形的突起可以用其它的变量刻度。在三角形突起的一个侧面上印有数字“1”，另一个侧面印有数字“2”，第三个侧面上印有数字“3”。固位旋钮54具有与固位旋钮52相同的特性。
为了同时切割多个带倒刺的缝合线，使用多刀片组件。如图9中所示，刀片组件66由多个固定在固位块92中的多个刀片组成。在图8中，示出了13个刀片，尽管显而易见，所用切片的数目可以改变。刀片组件66中使用的每个刀片的刀刃10伸过模板块94，在图10中通过所希望的倒刺深度的量示出。
图9的固位块92由两个矩形的块组成，所述的矩形块通过夹卡的动作滞留刀片组件66。刀片组件66共形地安装在固位块的剖开截面上，而刀片8以所希望的角度插入，在此例是所述的角度是148度。刀片被固定在固位块92中，同时模板块94附着于其上。模板块94在切割模板的限制下起到引导刀片组件的作用。
如图11所示，切割模板64为刀片组件66提供一个切割通道97。切割通道97示出为平行四边形的周边。请注意，例如，可以把切割通道97做成有矩形周边的形状，以适于图1的切割方法所述的运动，或者是其它的形状，以允许如图2-5中所述的其它刀片运动的角度。设有附加的切割模板，并且类似地制做，旨在偏调沿轴向的刀片切割。所述的切割模板64得以鉴定，从而向使用者指示在什么切割阶段要用哪个模板。在切割模板64的对侧是一个沟槽99，尺寸做得要容纳没有由刀片组件66切割的缝合线6的其它部分。
如图12A所示，设有一个捣棒101以保证缝合线6均匀地处在平台78上。在捣棒101上设有孔隙102、104以接合对齐销钉70、72。设有沟槽105以在标定过程中把缝合线6固定在位。沟槽105深度等于缝合线6在夹具顶80以上的缝合线6的厚度。
为了操作切割装置50，首先把缝合线6固定到固位旋钮52、54之一上的锚固螺丝90上，如图13所示。固位旋钮52放置在间隔棒100的边缘上，同时把缝合线6拉过其上，以第二固位旋钮54定位在对置的边缘上。一旦把缝合线通过锚定螺丝90固定在第二固位旋钮上后，不应当过度地绷紧它。在定尺寸后，把缝合线6放置在切割床56上并且通过切割床夹具63固定在位。固位旋钮52、54被指示在第一位置，显然在具有间隔开120度的带有倒刺的缝合线上进行第二和第三切割时，分别地把固位旋钮52、54转动到第二和第三位置。
如图14所示，把捣棒101放置在切割床56上，把缝合线6定位在夹具63中，紧固夹具63。然后取走所述的捣棒。接着把切割模板64放置在切割床56上。
在缝合线6的切割方法中，把刀片组件66放置在切割床56上。在从切割模件的顶部上沿图15中所示的通道97滑至底部的同时向下压刀片组件。设定刀片的深度以产生所希望的倒刺深度。当刀片组件停止在切割模件64的底部之后，取走刀片组件。
为了产生沿与第一切割的倒刺相反方向的倒刺，然后可以把刀片组件66转动180度并且放置在切割床56上，如图16所示。刀片组件的左边和顶部沿通道97与切割模件的右边和底部接触。在刀片组件从底部向顶部滑动时下向压该刀片组件。当刀片组件66停止在切割模件64的顶部之后，取走刀片组件和模件。
作为工序过程，可以把缝合线6旋转，例如120度、180度等等，并且重复如图15-16所示的切割工序。应当把缝合线牢固地固定在切割床夹具63的开口中，并且前次切割的倒刺不应当突出在顶面80以上，以及重复所述的工序。对于在绕圆周的三套倒刺，把缝合线转动三次，对于两套转动二次，依此类推。
图17A-F示出，在切割具有间隔开120度的倒刺的缝合线之前和之后把倒刺固定在夹具63之中。图17A示出夹具开放，缝合线6没有切割，同时没有使用槽口120、122。图17B示出夹具闭合同时刀片组件66正要切割缝合线6。图17C示出在第一套倒刺切割并且放置在槽口122中之后夹具打开。图17D示出在刀片组件66接合缝合线6以切割第二套倒刺之前夹具闭合。图17E示出夹具打开，同时示出两套倒刺并放置在槽口120、122中。图17F示出在刀片组件66接合缝合线元件6以进行切割之前夹具闭合。在切割后，取出缝合线6并且检验。对于领域内普通技术人员很清楚可以设附加的或者更少的槽口用于在后续的切割步骤过程中保护倒刺。
在切割倒刺的扭转方法中，如前所述地设置缝合线6并且沿其轴线扭转。所需要的扭转数量取决于倒刺的数量、缝合线的材料和缝合线的直径。例如，已发现零号尺寸、PDS-2材料要求2-1/2”的倒刺将要求扭转它三十九次以得到可接受的结果。当然，过多的扭转可能引起缝合线材料超过限度，导致不希望的结果，包括损伤缝合线材料。
然而把扭转的缝合线6固定在切割床56上却稍有不同。在此方面，图18A和B示出在切割前和切割过程中把缝合线6固定在卡子76中。图18A示出在把缝合线6卡住前把它放置在夹具中，而图18B示出卡定后的缝合线。轻轻卡住的缝合线形成椭圆的形状并且准备好被切割。缝合线6的切割方法会与前面所述的相同，然而需要转动缝合线。
图19A-D示出使用扭转方法切割缝合线6的各种情况。图19A中示出未改变的缝合线6，用一个想像的线150示出它的纵轴。图19B示出缝合线6沿方向(152)扭转准备进行切割。图19C示出以扭转的状态切割的倒刺，带有沿其一侧切割的倒刺。在切割了缝合线6之后并且允许它恢复到其未扭转的状态，倒刺是处于如图19D中所示的那些，在此图中倒刺绕缝合线的圆周螺旋。
扭转的方法对比不扭转的方法在倒刺的安置上的区别可以从比较图19D和图20最易看出。在图20中，示出在不扭转的状态下缝合线6切割同时间隔的倒刺位于缝合线6的圆周上120°。在图19D中，缝合线6以扭转的状态切割，以及在去扭转时，倒刺的图案沿缝合线6的长度取螺旋的构型。
请注意当缝合线6不论是以扭转还是不扭转的状态下切割时通过省略一些切割运动，可以在缝合线的外表面上以随机的构型形成倒刺。还有，缝合线可以既用扭转的状态也可以用不扭转的状态切割以制造其它类型的随机构型的倒刺。
根据本发明，切割倒刺的变通的实施方案示于图21-22。图21A-C示出沿切割床夹具63在方向(22)上进给缝合线6，同时往复的刀片组件250沿缝合线6的轴线切割倒刺的线性指数机构。可以沿切割床夹具63在扭转的状态中进给缝合线6，以形成螺旋切割倒刺，如图21A和B，在不扭转的状态，或随着其进给绕其轴线按增量(例如120度，180度等)转动，如图21C中所示。
往复的刀片组件250包括经臂225与线性往复的螺线管220连接的刀片8，所述的螺线管220沿方向(2)和(42)相应于x轴，以及相应于旋转的螺线管230往复运动，该旋转的螺线管230可以绕其轴线转动，如图21A和B所示。切割床夹具63与往复的刀片组件250和指数机构同步，从而在切割过程中闭合夹具以把缝合线6固定在位，并且开放让缝合线6通过指数器向下一个切割位置进给。
可以调节线性螺线管220和旋转螺线管230以控制往复的刀片组件250的线性行程和臂225的刀片角度从而使之能够改变沿y和z轴切割的倒刺的深度。另外，旋转螺线管230的旋转让倒刺能够沿缝合线6的轴线以相反的方向切割倒刺，如图21B所示。刀片角度和行程可以调节以在所希望的长度切断缝合线6。
图22示出进给缝合线6的旋转指数机构。在图22中，示出缝合线6绕旋转滚筒210进给，同时往复的刀片组件250沿缝合线6的轴线切割倒刺。缝合线6经缝合线供应卷轴300馈给在滚筒210上并且馈给到切割槽沟215中。加了倒刺的缝合线从滚筒210上绕开到收线卷轴210上。卷轴300和310可以供应和收取不扭转状态的缝合线，或者变通地，不论哪个卷筒或者同时两个卷筒都可以以这样的方式对扭转和不扭转的缝合线6转动，以能够得到如上所述的螺旋切割的倒刺。
虽然已经与认为是最实用和优选的实施方案相关联说明了本发明，应当理解本发明不限于所公开的实施方案，相反地，是要覆盖包括在所附权利要求书的精神和范围内的各种修改和等同的安排。

Claims (37)

1.一种在具有纵轴的缝合线上切割倒刺的方法，所述方法包含下列步骤：
提供缝合线；
提供切割刀片；
通过刀片的运动在所述缝合线上产生倒刺，所述刀片的运动考虑到刀片在三维中沿缝合线的x-y-z轴由刀片的几何形态结合刀片的运动所引起的在缝合线上的切割动作；以及
提供用于移动刀片产生所述的切割动作以创造倒刺的装置。
2.如权利要求1所述的方法，其中刀片的几何形态沿两个轴线引起对缝合线的切割动作，同时刀片的运动引起沿其余轴的切割动作。
3.如权利要求2所述的方法，其中y轴是缝合线的纵轴，而x轴垂直于纵轴并且z轴相对x轴成90°。
4.如权利要求3所述的方法，其中刀片的几何形态引起沿y轴和z轴的切割动作，同时刀片的运动引起沿x轴的切割动作。
5.如权利要求4所述的方法，其包括提供多个刀片的进一步步骤，所述多个刀片的每个都在缝合线上产生相应的倒刺。
6.如权利要求1所述的方法，其中刀片的几何形态沿一个轴线引起对缝合线的切割动作，同时刀片的运动引起沿其余两个轴的切割动作。
7.如权利要求6所述的方法，其中y轴是缝合线的纵轴，而x轴垂直于纵轴并且z轴相对x轴成90°
8.如权利要求7所述的方法，其中刀片的几何形态引起沿z轴线的切割动作，同时刀片的运动引起沿x和y轴的切割动作。
9.如权利要求8所述的方法，其包括提供多个刀片的进一步步骤，所述多个刀片的每个都在缝合线上产生相应的倒刺。
10.如权利要求1所述的方法，其中y轴是缝合线的纵轴，而x轴垂直于纵轴并且z轴相对x轴成90°。
11.如权利要求10所述的方法，其中刀片的运动引起沿x-y-z轴对缝合线的切割动作。
12.如权利要求11所述的方法，其包括提供多个刀片的进一步步骤，所述多个刀片的每个都在缝合线上产生相应的倒刺。
13.如权利要求1所述的方法，其包括在割动之前沿其纵轴扭转所述缝合线的进一步步骤。
14.如权利要求13所述的方法，其包括在切割之后使所述缝合线去扭转的进一步步骤。
15.如权利要求1所述的方法，其包括在切割之前或之后绕其纵轴旋转所述缝合线的进一步步骤。
16.如权利要求1所述的方法，其包括铰接所述切割刀片的进一步步骤。
17.如权利要求1所述的方法，其包括在切割之前或之后沿其纵轴进给所述缝合线的进一步步骤。
18.一种装置，用于按照权利要求5所述的方法在缝合线上切割倒刺，所述装置包含：
切割床，在切割过程中把缝合线保持于其上的位置；
刀片组件，包含多个具有几何形态的切割刀片；以及
装置，用于以预定的方式沿缝合线的x轴在多个位置上移动所述刀片组件，同时刀片的运动和刀片的几何形态在所述缝合线上造成多个倒刺。
19.一种装置，用于按照权利要求9所述的方法在缝合线上切割倒刺，所述装置包含：
切割床，在切割过程中把缝合线保持于其上的位置；
刀片组件，包含多个具有几何形态的切割刀片；以及
装置，用于以预定的方式沿缝合线的x轴和y轴在多个位置上移动所述刀片组件，同时刀片的运动和刀片的几何形态在所述缝合线上造成多个倒刺。
20.一种装置，用于按照权利要求12所述的方法在缝合线上切割倒刺，所述装置包含：
切割床，在切割过程中把缝合线保持于其上的位置；
刀片组件，包含多个切割刀片；以及
装置，用于以预定的方式沿缝合线的x轴、y轴和z轴在多个位置上移动所述刀片组件，同时刀片的运动在所述缝合线上造成多个倒刺。
21.一种装置，用于按照权利要求13所述的方法在缝合线上切割倒刺，所述装置包含：
切割床，在切割过程中把缝合线保持于其上的位置，所述缝合线具有x-y-z轴，其中y轴是缝合线的纵轴，而x轴垂直于纵轴并且z轴相对x轴成90°；
装置，用于引起刀片组件以预定的方式接触缝合线；和
刀片组件，包含多个具有几何形态的切割刀片；以及
装置，用于以预定的方式沿缝合线的x轴在多个位置上移动所述至少一个切割刀片，同时刀片的运动和刀片的几何形态在所述缝合线上造成多个倒刺。
22.一种装置，用于在具有纵轴的缝合线上切割倒刺，所述的装置包含：
切割床，在切割过程中把缝合线保持于其上的位置；
至少一个刀片；
装置，用于以预定的方式跨越缝合线移动所述至少一个刀片，同时所述至少一个刀片的运动或者几何形态在所述缝合线上造成至少一个倒刺。
23.如权利要求22所述的装置，其进一步包含用于在切割之前沿其纵轴扭转缝合线的装置。
24.如权利要求22所述的装置，其进一步包含用于在切割之前或之后绕其纵轴转动缝合线的装置。
25.如权利要求22所述的装置，其进一步包含用于在切割之前或之后沿其纵轴进给缝合线的装置。
26.如权利要求22所述的装置，其中所述至少一个刀片是铰接的刀片。
27.如权利要求22所述的装置，其中所述至少一个刀片是往复的刀片。
28.如权利要求22所述的装置，其中所述至少一个刀片是旋转的刀片。
29.如权利要求22所述的装置，其中所述至少一个刀片是空心的磨光的刀片。
30.如权利要求22所述的装置，其中所述的用于移动所述至少一个刀片的装置包含切割模板。
31.如权利要求22所述的装置，其中所述的用于移动所述至少一个刀片的装置包含螺线管。
32.如权利要求31所述的装置，其中所述螺线管是线性螺线管。
33.如权利要求31所述的装置，其中所述螺线管是旋转螺线管。
34.如权利要求22所述的装置，其中所述切割床是旋转滚筒。
35.一种在缝合线上切割倒刺的方法，所述方法包含下列步骤：
提供具有纵轴线的缝合线；
沿其纵轴扭转所述缝合线；以及
在其扭转的状态下在所述缝合线上切割倒刺。
36.如权利要求34所述的方法，其包括在其扭转的状态下在所述缝合线上切割多个倒刺的进一步步骤。
37.如权利要求34所述的方法，其包括在切割之前或之后沿其纵轴进给所述缝合线的进一步步骤。
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CN101172050B (zh) * 2006-11-02 2013-08-21 柯惠Lp公司 长期生物可吸收的带刺缝线
CN103315785A (zh) * 2007-09-17 2013-09-25 柯惠Lp公司 在缝合线上形成倒刺的方法
CN103315785B (zh) * 2007-09-17 2016-06-22 柯惠Lp公司 在缝合线上形成倒刺的方法
CN101874747A (zh) * 2009-04-29 2010-11-03 Tyco医疗健康集团 在缝合线上形成倒刺的系统和方法
CN101874747B (zh) * 2009-04-29 2014-09-17 柯惠Lp公司 在缝合线上形成倒刺的系统和方法
CN105212976A (zh) * 2010-05-04 2016-01-06 伊西康有限责任公司 具有激光切割固位刺的自固位系统
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CN103068324A (zh) * 2010-05-04 2013-04-24 伊西康有限责任公司 具有激光切割固位刺的自固位系统
CN103025251A (zh) * 2010-07-08 2013-04-03 埃萨特欧洲股份公司 缝合线
CN103025251B (zh) * 2010-07-08 2015-10-14 埃萨特欧洲股份公司 缝合线
CN107811665B (zh) * 2012-02-23 2020-09-04 高级缝合有限公司 改进的缝合线
CN107811665A (zh) * 2012-02-23 2018-03-20 西北大学 改进的缝合线
US10881394B2 (en) 2012-02-23 2021-01-05 Northwestern University Mesh suture
CN103961147A (zh) * 2013-01-25 2014-08-06 柯惠Lp公司 水凝胶填充的有倒刺的缝线
CN103144131B (zh) * 2013-03-20 2015-01-21 东华大学 自锁紧式缝合线制备装置及其制备方法
CN103144131A (zh) * 2013-03-20 2013-06-12 东华大学 自锁紧式缝合线制备装置及其制备方法
CN105745371A (zh) * 2013-11-07 2016-07-06 金春东 手术用线的突起形成装置及其方法
CN105745371B (zh) * 2013-11-07 2018-02-23 金春东 手术用线的突起形成装置及其方法
CN107049388A (zh) * 2016-11-25 2017-08-18 温州科技职业学院 一种外科手术线切线装置
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CN106725674A (zh) * 2016-12-14 2017-05-31 天津昕黎科技有限公司 一种医疗装置复合倒刺加工用的装置及加工方法
CN108326936A (zh) * 2018-01-22 2018-07-27 周福义 一种医用线割线装置
WO2023000210A1 (zh) * 2021-07-21 2023-01-26 台北科技大学 具改良性质的外科手术缝线

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