CN202128575U - Support conveying device during operation - Google Patents
Support conveying device during operation Download PDFInfo
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- CN202128575U CN202128575U CN201120165550U CN201120165550U CN202128575U CN 202128575 U CN202128575 U CN 202128575U CN 201120165550 U CN201120165550 U CN 201120165550U CN 201120165550 U CN201120165550 U CN 201120165550U CN 202128575 U CN202128575 U CN 202128575U
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Abstract
The utility model discloses a support conveying device during an operation comprising a coating, a suture and a pulling stitch, which are connected with the coating. The suture and the pulling stitch are sewed on the coating, and can be used to form a releasable connection with the coating. The support during the operation can be furled and be covered by the coating. An aorta can be cut on an end of a pathologic position of a blood vessel, and the support during the operation disposed on a conveying device can be implanted in the corresponding pathologic positions, including the pathologic positions of the branch blood vessels, quickly and conveniently. The suture can be released by dropping the pulling stitch out, and then the support during the operation with branches can be released and positioned on a blood vessel with branches like a main aortic arch, and thereafter the conveying device can be taken out and the cut can be stitched. The quantity of sewed openings during the operation can be reduced, the operation process can be simplified, the operation time can be reduced, the operational complications can be reduced, the survival rate of patients can be improved, the treatment effect can be improved, and the wounds of patients suffering from the diseases of main aortic arch or other diseases can be effectively reduced.
Description
Technical field
This utility model relates under the condition of hybridization operation the medical auxiliary apparatus field that the art medium-height trestle is transported to the corresponding lesion locations of aortic arch, and in particular, improving what relate to is a kind of art medium-height trestle conveyer device.
Background technology
1994, American scholar Dake was applied to the treatment of descending aorta interlayer and descending aorta tumor with the inner cavity insulation technology, had started the brand-new route of chest arotic disease treatment, and had been promoted the use of all over the world rapidly.Because the general percutaneous intervening mode delivery instrument that adopts of inner cavity insulation technology need not cut the patient thoracic cavity, its great advantage is that wound is little, and operating time is shorter, and success rate is higher, therefore enjoys various countries scholar's high praise and patient to like.The disease that present most chest aorta, ventral aorta, ilium portion blood vessel etc. are located all can obtain medical treatment through endovascular graft.
Aortic arch is one section bending and is with a plurality of ramose trunks; With and in the uniqueness of aspects such as anatomy, hemodynamics; With the design philosophy and the implementation method of present inner cavity insulation technology, also can't use conventional inner cavity insulation technology treatment aortic arch pathological changes.
So a lot of in recent years experts begin the inner cavity insulation technical application in traditional surgery, promptly under direct-view, support is discharged in lumen of vessels, the method for this integrated use traditional surgery and inner cavity insulation operation is called as hybridization hands art; This operation method combines both advantages, has both avoided the traditional surgery wound big, and the shortcoming that operating time is long has solved some difficult problems that simple dependence endovascular graft can't be implemented simultaneously again.
Yet this technology still needs a kind of overlay film frame, and the support of using in this support and the endovascular graft is similar; And need under the orthopaedic surgical operations surgical condition this support to be implanted to the aortic disease position, this thus support is commonly referred to the art medium-height trestle.The art medium-height trestle must just can be implanted to corresponding aortic disease position by means of conveyer device; Promptly utilize the reduced of conveyer device with the art medium-height trestle; After being transported to the corresponding lesion locations of aorta then the art medium-height trestle is discharged, at last conveyer device is withdrawn from.
But, because the complexity of aorta section anatomical structure does not still have suitable conveyer device can aortic arch art medium-height trestle be transported to the corresponding lesion locations of aortic arch portion easily and safely at present; And ramose art medium-height trestle is not with in the yet only suitable conveying of conveyer device of the prior art.
Therefore, prior art still haves much room for improvement and develops.
The utility model content
The purpose of this utility model is, a kind of art medium-height trestle conveyer device is provided, and can reduce the quantity of anastomotic stoma in the operation, simplifies operation process, shortens operating time, reduces postoperative complication, improves patient's survival rate, improves therapeutic effect.
The technical scheme of this utility model is following: a kind of art medium-height trestle conveyer device, wherein, be used for installing and discharging said art medium-height trestle, and comprise peplos, suture and backguy; Two side seams of said peplos are closed in suture and backguy, so that said art medium-height trestle is drawn in and is wrapped in the said peplos, it is being connected of releasable that suture forms the extraction backguy with said peplos.
Described art medium-height trestle conveyer device, wherein: said art medium-height trestle comprises a main body and more than one branch.
Described art medium-height trestle conveyer device, wherein: said peplos adopts a kind of material in polyester, the politef or derivatives thereof.
Described art medium-height trestle conveyer device, wherein: have main body peplos and more than one branch peplos; Main body peplos is used to wrap up said main body, and each branch's peplos is respectively applied in the said branch of parcel; Main body peplos is connected with a backguy respectively with each branch's peplos.
Described art medium-height trestle conveyer device, wherein: suture forms equally spaced stitch points along the edge of main body peplos or branch's peplos; Said stitch points is basic along said main body or said ramose axial distribution; The all stitch points on corresponding main body peplos or the branch's peplos are passed in said each root backguy successively one by one.
Described art medium-height trestle conveyer device, wherein: said art medium-height trestle is for having three ramose aortic arch art medium-height trestles; Said main body peplos is divided into four independent sectors; Four independent sectors of said main body peplos are with the boundary that branches into of aortic arch art medium-height trestle, and a shared backguy.
Described art medium-height trestle conveyer device, wherein: comprise handle, the fixed bar of flexibility and branch's sheath core of three flexibilities; The near-end of the near-end of said fixed bar and said branch sheath core all is fixed on the handle; Said fixed bar is used to install said aortic arch art medium-height trestle main body, and each of said three branch's sheath cores is respectively applied for the branch that said aortic arch art medium-height trestle is installed; The said branch that is installed on the said branch sheath core can be a spot wobble with the connecting portion of itself and said main body.
Described art medium-height trestle conveyer device, wherein: handle is provided with the wire casing and the separable plug of hollow; Backguy on corresponding main body peplos and the branch's peplos is all passed from wire casing, and the near-end of backguy is fastened on the plug.
Described art medium-height trestle conveyer device, wherein: at the far-end of said fixed bar or the far-end of said branch sheath core target seeker is set respectively, the far-end of said target seeker is streamlined outline.
Described art medium-height trestle conveyer device, wherein: the core at said fixed bar is provided with sheath in the main body, and sheath has inner chamber in the said main body, and the inner chamber of sheath is provided with slidably main body seal wire in main body; Said each branch's sheath core has inner chamber respectively, at the inner chamber of said each branch's sheath core slidably branch's seal wire is set respectively.
A kind of art medium-height trestle conveyer device that this utility model provided; Owing to adopted the technological means of disengageable suture and backguy; Only needing to extract backguy out is the corresponding suture of releasable, and then will be with ramose art medium-height trestle to discharge to be positioned at and be with in ramose blood vessel such as the aortic arch; Compared with techniques with treatment arotic disease in the prior art; Utilize the conveyer device of this utility model; Only need aorta be cut in the end of aortic arch portion lesion locations; Through conveyer device aortic arch art medium-height trestle is implanted to the corresponding lesion locations of aortic arch quickly and easily then, comprises the lesion locations of branch vessel, only needing to extract backguy out is the corresponding suture of releasable; And then will be with ramose art medium-height trestle to discharge to be positioned at and be with in ramose blood vessel such as the aortic arch, and after withdrawing from conveyer device, myometrial suture is got final product.In the hybridization operation of aortic arch portion, adopt this conveyer device, compare, significantly reduced the quantity of anastomotic stoma in the operation with original hybridization operation; It is all right only to need to sew up an anastomotic stoma in the operation, has also simplified operation process thus, has shortened operating time; Reduced postoperative complication; Improve patient's survival rate, improved the effect of treatment, more effectively reduced the wound that the patient to aortic arch portion disease causes.
Description of drawings
Fig. 1 is the aortic arch art medium-height trestle sketch map that this utility model art medium-height trestle conveyer device relates to.
Fig. 2 is that the structure of this utility model art medium-height trestle conveyer device is formed sketch map.
Fig. 3 is the handle portion sketch map in this utility model art medium-height trestle conveyer device.
Fig. 4 is the parts sketch map of guide operation medium-height trestle main part in this utility model art medium-height trestle conveyer device.
Fig. 5 is the parts sketch map of guide operation medium-height trestle component in this utility model art medium-height trestle conveyer device.
Fig. 6 is the parts sketch map of related art medium-height trestle main body peplos part in this utility model art medium-height trestle conveyer device.
Fig. 7 is related art medium-height trestle branch's peplos parts sketch map partly in this utility model art medium-height trestle conveyer device.
Fig. 8 is that this utility model art medium-height trestle conveyer device is installed one of them ramose sketch map on the aortic arch art medium-height trestle.
Fig. 9 is the local enlarged diagram of this utility model art medium-height trestle conveyer device Fig. 8.
Figure 10 is that this utility model art medium-height trestle conveyer device is installed all ramose sketch maps on the aortic arch art medium-height trestle.
Figure 11 is the sketch map that this utility model art medium-height trestle conveyer device is installed aortic arch art medium-height trestle main body.
Figure 12 is that this utility model art medium-height trestle conveyer device is installed aortic arch art medium-height trestle sketch map afterwards.
Figure 13 is the sketch map that the main body seal wire in this utility model art medium-height trestle conveyer device stretches into aortic arch.
Figure 14 is this utility model art medium-height trestle conveyer device pushes aortic arch under the guiding of seal wire a sketch map.
Figure 15 is that this utility model art medium-height trestle conveyer device pushes the sketch map after putting in place with aortic arch art medium-height trestle.
Figure 16 is that this utility model art medium-height trestle conveyer device discharges ramose sketch map in the aortic arch art medium-height trestle.
Figure 17 is that this utility model art medium-height trestle conveyer device discharges all ramose sketch maps of aortic arch art medium-height trestle.
Figure 18 is the sketch map that this utility model art medium-height trestle conveyer device discharges aortic arch art medium-height trestle main body.
Figure 19 is the sketch map that discharges aorta posterior bow art medium-height trestle through this utility model art medium-height trestle conveyer device.
The specific embodiment
Below will combine accompanying drawing, the specific embodiment and the embodiment of this utility model specified, described specific embodiment in order to explain this utility model, is not the specific embodiment that is used to limit this utility model only.
A kind of art medium-height trestle conveyer device of this utility model is suitable for carrying and release aortic arch art medium-height trestle, and this conveyer device comprises handle, fixed bar and branch's sheath core, also comprises suture and backguy; Suture is made on the edge of peplos, and this peplos is wrapped in outside main body and/or the branch of aortic arch art medium-height trestle with compression and draws the art medium-height trestle in, prevents that temporarily the main body of art medium-height trestle and/or branch from flicking in the process of carrying; Suture forms and can free fast being connected of maybe can breaking off with the main body and/or the ramose peplos of art medium-height trestle with backguy; The art medium-height trestle is transferred and appropriately is positioned after the aortic arch; Through tearing backguy untiing simultaneously or to break off the suture of making on main body and/or ramose peplos, be released in aortic arch and the branch vessel and the main body of art medium-height trestle and/or branch flicked.
Based on above-mentioned art medium-height trestle conveyer device, this utility model has also proposed a kind of installation method of aortic arch art medium-height trestle, and a kind of method for releasing of aortic arch art medium-height trestle.
The installation method of a kind of aortic arch art of this utility model medium-height trestle; May further comprise the steps: earlier the fixed bar of conveyer device is passed the tube chamber of the main body of aortic arch art medium-height trestle, each branch's sheath core of conveyer device passes a branch of aortic arch art medium-height trestle respectively; The main body of aortic arch art medium-height trestle is compressed on the outer surface of fixed bar; With peplos main body is wrapped; Suture is made on the peplos of art medium-height trestle main body through backguy; Main body to prevent the art medium-height trestle flicks, and it is being connected of releasable that the peplos formation of suture and backguy and main body involves backguy; Branch with aortic arch art medium-height trestle is compressed on the outer surface of corresponding branch sheath core again; Branch with the art medium-height trestle wraps with another peplos; Suture is made on the ramose peplos of art medium-height trestle through another backguy; Branch to prevent the art medium-height trestle flicks, and the ramose peplos of suture and backguy and art medium-height trestle forms and involves backguy is being connected of releasable.Perhaps: earlier suture is made on the ramose peplos of art medium-height trestle, formed disengageable the connection with ramose peplos; Again suture is made on the peplos of the main body of art medium-height trestle, formed disengageable the connection with the peplos of main body.
The method for releasing of a kind of aortic arch art of this utility model medium-height trestle; May further comprise the steps: the conveyer device that uses aortic arch art medium-height trestle; The main body of the art medium-height trestle under the compressive state is positioned in the aortic arch, the branch of the art medium-height trestle under the compressive state is positioned in the branch vessel of aortic arch; Tear earlier with art medium-height trestle main body on the backguy that is connected of suture, to untie the suture of making on the peplos of compressed art medium-height trestle main body, main body flicked be released in the aortic arch; Tear again with art medium-height trestle branch on the backguy that is connected of suture, to untie the suture of making on the ramose peplos of compressed art medium-height trestle, branch flicks in the branch vessel that is released in aortic arch with the art medium-height trestle.Perhaps: tear earlier with art medium-height trestle branch on the backguy that is connected of suture; To untie the suture of making on the ramose peplos of compressed art medium-height trestle; Art medium-height trestle branch is flicked the location to be released in the branch vessel of aortic arch; Tear again with art medium-height trestle main body on the backguy that is connected of suture, to untie the suture of making on the peplos of compressed art medium-height trestle main body, main body is flicked the location is released in the aortic arch.
In the preferred implementation of this utility model art medium-height trestle conveyer device and installation of aortic arch art medium-height trestle and method for releasing; In conjunction with accompanying drawing, the installation and the method for releasing of this utility model art medium-height trestle conveyer device and aortic arch art medium-height trestle are done further detailed description.
As shown in Figure 1; The overall structure of aortic arch art medium-height trestle is usually designed to the self-expanding formula structure that is consistent with aortic arch portion form; Aortic arch art medium-height trestle is made up of a main body 1 and one to three branch 2,3,4; The main body 1 corresponding human aortic bow of art medium-height trestle, one to three brachiocephalic trunk, LCC, these three branch vessel of left subclavian artery that branch 2,3,4 is distinguished on the corresponding aortic arch.Aortic arch art medium-height trestle main body 1 generally is the compressible tube with elastic tube wall with branch 2,3,4, and successive secluding film covers on the tube wall, main body 1 and each branch 2,3, between 4 for flexibly connecting.Therefore, after each branch 2,3,4 of art medium-height trestle expanded and launches, each branch 2,3,4 can be that fulcrum is all around swung with flexibly connecting separately, makes the direction of branch 2,3,4 aim at corresponding branch vessel respectively.
The course of conveying more complicated of aortic arch art medium-height trestle; At first the otch through ascending aorta one end sends to the main body 1 of aortic arch art medium-height trestle in the tube chamber at aortic arch position and the bifurcated artery tube chamber on it with each branch 2,3,4 simultaneously; Discharge the main body 1 and each branch 2,3,4 of aortic arch art medium-height trestle then successively; At last conveyer device safety is withdrawn from, but can not be influenced the location that has discharged support.
As shown in Figure 2, the conveyer device of aortic arch art medium-height trestle comprises sheath 19, female luer 20, branch's sheath core 21 and main body seal wire 22 (referring to Figure 13) etc. in handle 5, fixed bar 6, target seeker 7, branch's seal wire 8, branch's peplos 9, main body peplos 10, suture 11, backguy 12, plug 13, plug 14, plug 15, plug 16, nut 17, the main body.In this article, the far-end of each parts is meant the end away from handle 5, is called near-end with respect to the other end of far-end.
As shown in Figure 3, handle 5 is the tube shape component of two open ends, and plug 13, plug 14, plug 15, plug 16 are arranged on the handle 5.The near-end of (among Fig. 2) each bar backguy 12 is connected to a fixed with its plug separately respectively; For example: (among Fig. 2) backguy 12 of corresponding (among Fig. 1) art medium-height trestle branch 2 is fixing with plug 13; (among Fig. 2) backguy 12 of corresponding (among Fig. 1) art medium-height trestle branch 3 is fixing with plug 14; (among Fig. 2) backguy 12 of corresponding (among Fig. 1) art medium-height trestle branch 4 is fixing with plug 15, and (among Fig. 2) backguy 12 of the main body 1 of corresponding (among Fig. 1) art medium-height trestle is fixing with plug 16.Each all is provided with a nut 17 above the plug 13,14,15,16, be used for corresponding plug 13,14,15,16 is fixed on the handle 5, prevents that the backguy corresponding with it 12 from being involved extraction.After unscrewing nut 17, can the plug of correspondence 13,14,15,16 be taken off from handle 5, and then the backguy 12 that will be connected with this plug 13,14,15,16 is taken out.In addition, each nut 17 on the plug 13,14,15 or 16 is all replaceable to be the disengageable fixed connecting piece of other form, as: buckle, magnetic piece, sucker etc.
As shown in Figure 4, for installing and guide the parts of aortic arch art medium-height trestle main body 1 part, comprise sheath 19, female luer 20 and main body seal wire 22 (referring to Figure 13) in fixed bar 6, the main body.The far-end of sheath 19 is connected with the near-end 18 of fixed bar 6 in the main body; Female luer 20 is arranged on the near-end of sheath 19 in the main body; The major part of sheath 19 is fixed on the inside of handle 5 in the near-end 18 of fixed bar 6 and the main body; In fixed bar 6 and main body, all has the inner chamber that passes through in the sheath 19 so that main body seal wire 22 passes through; The far-end of main body seal wire 22 can come out from the remote extension of fixed bar 6, and the main body 1 of main body seal wire 22 and fixed bar 6 common guiding aortic arch art medium-height trestles gets in the aortic arch blood vessel from the cut ends of ascending aorta.Fixed bar 6 can be flexible straight-bar, and sheath 19 can be more softish bend pipe in the main body, and main body seal wire 22 can adopt 0.035 inch superhard seal wire to make.In addition, the target seeker (accompanying drawing is not shown) of the tapered constant current contour type of head outline can be set also at the far-end of fixed bar 6, the frictional resistance during with reduction fixed bar 6 intravasations, the main body 1 of being convenient to aortic arch art medium-height trestle is through in the target seeker intravasation.For improving the whole seriality of sheath 19 in fixed bar 6 and the main body; Also can adopt sheath 19 in the long main body; And 22 of main body seal wires pass the inner chamber of sheath 19 in the main body; Complete fixed bar 6 is made in injection moulding on one of sheath 19 section outer wall in main body, the far-end of sheath 19 in the main body that target seeker is provided with, and this target seeker also connects the far-end of fixed bar 6.
As shown in Figure 5; The main body peplos 10 of approximate strip is wrapped on the aortic arch art medium-height trestle main body 1 under the compressive state; The axial both sides of the edge that are parallel to main body 1 of main body peplos 10 are sewn to one through suture 11 and backguy 12, stitch points uniformly-spaced or unequal interval ground along the edge aligning of main body peplos 10.Backguy 12 is along axial suture 11 each stitch points on main body peplos 10 of passing successively of main body 1; The near-end of backguy 12 passes handle 5 inner hollow wire casing (not shown) and is connected with plug 16 from the outside of main body peplos 10.Suture 11 can adopt the multiple mode of freeing easily to sew up with backguy 12; The near-end that only need pull backguy 12 is extracted out from main body peplos 10 outsides; Suture 11 will be freed because of the constraint that loses backguy 12 voluntarily; And then cause main body peplos 10 to unclamp voluntarily because of the constraint that loses suture 11; Aortic arch art medium-height trestle main body 1 is because of the constraint that loses main body peplos 10 automatically springs open expansion, and the fixed bar 6 that was close to originally on the aortic arch art medium-height trestle main body 1 separates with the lumen wall of main body 1, so that recall sheath 19 and fixed bar 6 in the main body.
With branch's 4 corresponding plugs 15 is example; As shown in Figure 6; Main body peplos 10 with being wrapped on the aortic arch art medium-height trestle main body 1 is the same; Branch's peplos 9 of an approximate strip is wrapped in the branch 4 of the aortic arch art medium-height trestle under the compressive state, and the both sides of the edge of branch's peplos 9 also are stitched together through suture 11 and another root backguy 12, stitch points uniformly-spaced or unequal interval ground along the edge aligning of branch's peplos 9.Backguy 12 is along axial suture 11 each stitch points on its branch's peplos 9 of passing successively of branch 4; The near-end of backguy 12 passes handle 5 inner hollow wire casing (not shown) and is connected with corresponding plug 15 from the outside of branch's peplos 9.Suture 11 also can adopt the multiple mode of freeing easily to sew up with backguy 12; Only need pull the near-end of backguy 12 extracts out from its corresponding branch's peplos 9 outsides; Suture 11 on these branch's 4 peplos will be freed because of the constraint that loses backguy 12 voluntarily; And then cause this branch's peplos 9 to unclamp voluntarily because of the constraint that loses suture 11; This branch automatically springs open expansion because of the constraint that loses branch's peplos 9, and the target seeker 7 that was close to originally on branch's sheath core 21 of branch 4 of aortic arch art medium-height trestle separates with the lumen wall of this branch 4, so that recall branch's sheath core 21 and target seeker 7 thereof.
As shown in Figure 7, be the parts of each branch's 2,3,4 parts of guiding aortic arch art medium-height trestle, each group parts comprises target seeker 7, branch's sheath core 21, female luer 20 and branch's seal wire 8.The head of target seeker 7 has taper constant current contour type outline; Target seeker 7 and female luer 20 are separately positioned on the far-end and the near-end of branch's sheath core 21; The proximal part of branch's sheath core 21 is fixed on the inside of handle 5; In target seeker 7 and branch's sheath core 21, all has the inner chamber that passes through so that branch's seal wire 8 passes through; The far-end of branch's seal wire 8 can extend out from the head of target seeker 7, in the brachiocephalic trunk of each the group of branches seal wire 8 and the corresponding aortic arch of corresponding branch 2,3,4 entering of target seeker 7 common guiding aortic arch art medium-height trestles, LCC, these three branch vessel of left subclavian artery.Be preferably; Branch's sheath core 21 is set to the bending conduit of adaptive aortic arch art medium-height trestle respective branch 2,3,4 shapes and position thereof, and branch's sheath core 21 locates to be approximately the bent angle of 90 degree at aortic arch art medium-height trestle branch 2,3,4 nodes (being flexibly connecting of branch 2,3,4 and main body 1).
In above each embodiment; Handle 5 can adopt polyformaldehyde (POM) material to process with plug 13,14,15 and 16; Fixed bar 6 can adopt low density polyethylene (LDPE) (LDFE) material to process; Target seeker 7 can adopt nylon elastomer (Pebax) material to process; Sheath 19, branch's sheath core 21, main body seal wire 22 and branch's seal wire 8 can adopt the SUS304 stainless steel material to process in the main body, and main body peplos 10 can adopt the polytetrafluoroethylene (PTFE) material to process with branch's peplos 9, and suture 11 can adopt politef suture, backguy 12 can adopt polypropylene material to process.
Because fixed bar 6 requires to have certain pliability; Can be out of shape accordingly along with the bending shape of main body seal wire 22 in aortic arch; Therefore fixed bar 6 can adopt the macromolecular material with good biocompatibility to process; Like low density polyethylene (LDPE) (LDFE) material, nylon elastomer (Pebax) material, perhaps other has the macromolecular material of identical performance etc.
Because the far-end of target seeker 7 is designs of a fairing (for example taper); And can with the far-end of art medium-height trestle main body 1 under the compressive state and the smooth even transition of end portion of branch 2,3,4; Therefore target seeker 7 also can adopt the macromolecular material with good biocompatibility to process; Like LDFE material, Pebax material, perhaps other has the macromolecular material of identical performance.
And main body peplos 10 and branch's peplos 9 all can adopt at least a material in polytetrafluoroethylene (PTFE) with good biocompatibility, PETG (PET) etc. and the derivant thereof.After the art medium-height trestle discharges completion, both can main body peplos 10 and/or branch's peplos 9 be withdrawn from, also can main body peplos 10 and/or branch's peplos 9 be retained in the blood vessel; For example, main body peplos 10 and/or branch's peplos 9 can be sandwiched between art medium-height trestle outer wall and the blood vessel, and main body peplos 10 and/or branch's peplos 9 can not be subjected to displacement under the effect of the radial support power of art medium-height trestle; Perhaps, also can the two ends of main body peplos 10 or branch's peplos 9 be sewed up with the art medium-height trestle mutually, can not be subjected to displacement to guarantee main body peplos 10 and/or branch's peplos 9.
Suture 11 can adopt the stitching thread that uses in the surgical operation, and like PTFE suture, PET suture, prolene suture, suture 11 both can be drawn out after the art medium-height trestle discharged and accomplishes, and also can stay in the blood vessel.And backguy 12 can be adopted the suture for surgery with desirable strength, and like PTFE suture, PET suture, prolene suture, after operation was accomplished, backguy 12 need be withdrawn from external.
Before the hybridization operation; Need earlier the art medium-height trestle to be assembled on the conveyer device; When aortic arch art medium-height trestle was installed on conveyer device, main body 1 was compressed in its diametric(al) respectively with each branch 2,3,4, used peplos separately to coat again respectively; Unite by a seam with the auxiliary following both sides of the edge of peplos separately of suture 11 in backguy 12 then, suture 11 is made with the mode that can free fast with backguy 12.In the main body of art medium-height trestle 1 and each branch 2,3,4, a backguy 12 is set respectively; Backguy 12 basically along main body 1 or separately branch 2,3,4 axially pass each stitch points at peplos edge separately; Extract 12 of backguys respectively out and can free the suture 11 on the corresponding peplos and this peplos is scattered, the near-end of every backguy 12 extends respectively and is fixed on the handle 5.The fixed bar 6 of far-end band target seeker 7 passes the tube chamber of art medium-height trestle main body 1, and the tube chamber inside of each branch 2,3,4 then has branch's sheath core 21 of a far-end band target seeker 7 to pass respectively.The near-end of the near-end of fixed bar 6 and each branch's sheath core 21 passes from the tube chamber near-end of art medium-height trestle main body 1, and the far-end of art medium-height trestle main body 1 and each branch 2,3,4 then contacts with the target seeker 7 of fixed bar 6 and respective branch sheath core 21 respectively and forms the outline that seamlessly transits.The near-end of fixed bar 6 and every branch's sheath core 21 all fits together with handle 5, and the axis of sheath 19 and fixed bar 6 (and target seeker 7) is provided with the inner chamber that passes through in the main body, is used for sliding body seal wire 22 in this inner chamber; Every branch's sheath core 21 and target seeker 7 thereof also all have the inner chamber that passes through, and branch's seal wire 8 is used to slide in this inner chamber.
Concrete; Be example still with the aortic arch art medium-height trestle among Fig. 1; At first with fixed bar 6, all branch's sheath core 21 and separately with target seeker 7 insert from the near-end of aortic arch art medium-height trestle main body 1; Each gets into the respective branch 2,3 of aortic arch art medium-height trestle respectively with the target seeker 7 that branch sheath core 21 is connected, within 4; The part of each target seeker 7 far-end is exposed at beyond the end openings of respective branch 2,3,4, and the target seeker 7 of fixed bar 6 far-ends is exposed at outside the distal openings of main body 1.Compress the main body 1 and respective branch 2,3,4 of aortic arch art medium-height trestle respectively; Make the target seeker 7 of fixed bar 6 have the outline that seamlessly transits and cooperate, make the target seeker 7 of each branch's sheath core 21 have the outline that seamlessly transits and cooperate with the contact site of respective branch 2,3,4 with the contact site of main body 1.Then, three groups of different branches peplos 9 are wrapped in the corresponding branch 2,3,4 of aortic arch art medium-height trestle, and make with suture 11 and backguy 12; One group of main body peplos 10 is wrapped in aortic arch art medium-height trestle main body 1, and also makes with suture 11 and backguy 12.
As shown in Figure 8, be wherein a branch 4 and the effect sketch map made with suture 11 and backguy 12 on branch's peplos 9 parcel aortic arch art medium-height trestles.This branch 4 of compression earlier, the corresponding branch of reuse peplos 9 is wrapped in this branch 4 under the compressive state, and the edge in these branch's peplos 9 both sides is equally spaced made this branch's peplos 9 in this branch 4 with suture 11 and backguy 12; Suture 11 is made on this branch's peplos 9 with disengageable mode, simultaneously, strings together with the stitch points of backguy 12 with suture 11, and backguy 12 is in the outside of aortic arch art medium-height trestle.As shown in Figure 9, branch's peplos 9 is wrapped in outside the branch 4 after the compression, and all on the equitant both sides of the edge of branch's peplos 9, the backguy 12 of drawing strings together these stitch points to all stitch points of suture 11.
Next, unite by a seam with suture 11 and backguy 12 accordingly both sides of the edge with all the other two branches 2,3 compressions on the aortic arch art medium-height trestle and with each branch's peplos 9 parcel back branch's peplos 9.Shown in figure 10, branch 2, branch 3, branch 4 have all been coated by separately branch's peplos 9, have drawn three backguys 12 this moment altogether.Need to prove that branch 2, branch 3 and branch 4 be the not restriction of priority on operating sequence.
Next; The main body 1 of recompression aortic arch art medium-height trestle; And wrap up with main body peplos 10, uniting by a seam with suture 11 and the both sides of the edge of another backguy 12 then main body peplos 10, suture 11 is made on main body peplos 10 with disengageable mode; The stitch points of suture 11 strings together through backguy 12, the side relative with its branch 2,3,4 that these stitch points preferably all are arranged on aortic arch art medium-height trestle; Effect sketch map after making is shown in figure 11, and in fact, the main body 1 of aortic arch art medium-height trestle is compressed on the outer surface of fixed bar 6, and the part of main body 1 near-end also tightly encases all branch's sheath cores 21.
At last, handle 5 is drawn and guided into to the backguy 12 that is connected on each branch's peplos 9 suture 11 from the near-end of aortic arch art medium-height trestle main body 1, the backguy 12 on connection main body peplos 10 sutures 11 is being pasted the outer surface of main body peplos 10 and also guiding handle 5 into; Shown in figure 12, aortic arch art medium-height trestle tightly is wrapped on the fixed bar 6 and each branch's sheath core 21 of conveyer device, and the near-end part of fixed bar 6 and each branch's sheath core 21 is fixedly installed on the handle 5; The near-end of each bar backguy 12 respectively with handle 5 on a plug 13,14,15,16 be connected; This aortic arch art medium-height trestle and conveyer device fit together, and locate through handle 5 thus and discharge aortic arch art medium-height trestle.
Be preferably; Involve for what minimizing backguy 12 possibly receive; Can be at axial passage of set inside of handle 5 with protection backguy 12, passage has an axially open at the far-end of handle 5, and another opening of passage is then near the installed position of plug 13,14,15,16 on handle 5.Near-end from each the bar backguy 12 on aortic arch art medium-height trestle branch 2,3,4 or the main body 1 all can pass this passage on the handle 5; The backguy 12 of respective branches 2,3,4 is connected with plug 13,14,15 respectively, and the backguy 12 of corresponding main body 1 links together with plug 16; Can the nut 17 on each plug 13,14,15,16 all be screwed respectively plug 13,14,15,16 is fixed on the handle 5; The fixed bar 6 that connects sheath 19 in the main body also passes handle 5 with each branch's sheath core 21, and the female luer 20 of each branch's sheath core 21 near-end all is positioned at outside the near-end of handle 5.Main body seal wire 22 can penetrate from the far-end of fixed bar 6, through 19 backs of sheath in the main body from main body in the female luer 20 that links to each other of sheath 19 pass; Each branch's seal wire 8 can be respectively penetrates from the far-end of the target seeker 7 of each branch's sheath core 21, passes from the female luer 20 that links to each other with each branch's sheath core 21 respectively through behind each branch's sheath core 21.
During operation, can earlier a main body seal wire 22 be penetrated aortic arch along the otch of ascending aorta one end, the far-end of main body seal wire 22 is deep in the descending aorta; The near-end of main body seal wire 22 is penetrated in the distal openings and inner chamber of aortic arch art medium-height trestle conveyer device fixed bar 6 (and target seekers), the fixed bar 6 that makes conveyer device along main body seal wire 22 to front slide; And the conveyer device that will assemble aortic arch art medium-height trestle is transported to the position near the ascending aorta otch along main body seal wire 22.At this moment, can each branch's seal wire 8 be penetrated the inner chamber of respective branch sheath core 21 from the female luer 20 of branch's sheath core 21 of each branch 2,3,4 of aortic arch art medium-height trestle respectively among; The position of catching handle 5 and adjusting conveyer device, the far-end that makes each branch's seal wire 8 passes from target seeker 7 far-ends of aortic arch art medium-height trestle respective branch 2,3,4, and penetrates respectively in the corresponding branch vessel of aortic arch; Along main body seal wire 22 and all branch's seal wires 8 inside of conveyer device integral body to aortic arch is pushed then.Under the guiding of main body seal wire 22 and branch's seal wire 8; Auxiliary through taper target seeker 7 streamlined outlines, conveyer device with the main body 1 of aortic arch art medium-height trestle and each branch 2,3,4 suitably be positioned respectively aortic arch portion and on each bifurcated artery blood vessel in.At this moment, the position that maintains handle 5 is also taken out aortic arch art medium-height trestle main body 1 and the backguy 12 in each branch 2,3,4 respectively, and aortic arch art medium-height trestle main body 1 automatically springs open with branch 2,3,4 and attaches with corresponding blood vessel wall.Then, again conveyer device and all seal wires are withdrawn from, and lumped together, sew up the blood vessel otch at last at the cut ends of ascending aorta near-end and aorta vessel parietal suture with art medium-height trestle main body 1.
Concrete, shown in figure 13, at first at the end-grain cutting mouth of patient's aortic arch, and penetrate a superhard seal wire (being main body seal wire 22) in the operation from the position of otch near ascending aorta, the far-end of superhard seal wire extend in the tube chamber of descending aorta.
Then; Shown in figure 14; The near-end of the superhard seal wire distal openings from the conveyer device fixed bar 6 that assembles aortic arch art medium-height trestle is penetrated, through fixed bar 6 and with main body that fixed bar 6 is connected in behind the sheath 19, pass from a female luer 20 of conveyer device handle 5 near-ends; Simultaneously; The far-end of three branch's seal wires 8 on the conveyer device is penetrated from remaining female luer 20 respectively; Through behind corresponding branch sheath core 21 and the target seeker 7 thereof, pass from the far-end of corresponding target seeker 7 in the tube chamber of the innominate artery that gets into respectively on the aortic arch, LCC, left subclavian artery; Get in the aortic arch processes in the branch that advances the art medium-height trestle 4,3,2, corresponding branch 4,3,2 is tilted towards main body side.
Shown in figure 15; Under the guiding of superhard seal wire and three branch's seal wires 8; Profile through taper target seeker 7 seamlessly transits is auxiliary; The main body 1 that is assembled in the aortic arch art medium-height trestle on the conveyer device the most at last suitably is positioned the correspondence position of aortic arch respectively with branch 2,3,4, and global shape and position and the aortic arch of aortic arch art medium-height trestle and branch vessel are matched.
Shown in figure 16; After aortic arch art medium-height trestle entirely accurate is positioned at the appropriate location of aortic arch blood vessel; Can unscrew the nut 17 on the plug 15, plug 15 is released from handle 5, and catch plug 15 that the backguy on the respective branches 4 12 is extracted out; To free the suture of making on branch's peplos 9 of this branch 4 11, afterwards this branch 4 expand automatically flick and stable support in corresponding branch vessel.
Shown in figure 17, according to identical method for releasing, extract backguy 12 corresponding in two other branch 3 and 2 respectively out; With three branches of aortic arch art medium-height trestle 2,3,4 all discharge and stable support in three branch vessel of aortic arch.
Shown in figure 18, unscrew the nut 17 on the plug 16 at last, plug 16 is removed from handle 5, backguy 12 corresponding on the aortic arch art medium-height trestle main body 1 to be taken out, aortic arch art medium-height trestle main body 1 flicks and is supported in the tube chamber of aortic arch.
Because aortic arch art medium-height trestle has better elastic, on the outer wall appropriateness applying aortic arch of aortic arch art medium-height trestle and the inwall of branch vessel, the secluding film of aortic arch art medium-height trestle self can be blocked the seepage place on the corresponding blood vessel.
Shown in figure 19; After aortic arch art medium-height trestle discharges fully; Again conveyer device is withdrawn from from blood vessel; Near the ascending aorta otch, the near-end and the aorta vessel parietal suture of aortic arch art medium-height trestle main body 1 lumped together then, can not be shifted with aortic arch art medium-height trestle after guaranteeing; At last, sew up the aorta otch, accomplish operation.
In addition; In the dispose procedure of aortic arch art medium-height trestle, also can earlier backguy 12 corresponding on the aortic arch art medium-height trestle main body 1 be taken out, let main body 1 flick earlier earlier; And then respectively backguy 12 corresponding in the branch 2,3,4 is taken out, let branch 2,3,4 flick successively again.
Be preferably,, can adopt the main body 1 of the peplos parcel art medium-height trestle more than two for the main body 1 that makes the art medium-height trestle flicks more easily.Be example still, can adopt four peplos that the main body 1 of aortic arch art medium-height trestle is wrapped up with aortic arch art medium-height trestle with three branches 2,3,4.Wherein, from the part between far-end to the branch 4 of main body 1, available first peplos 10 coats; Part between branch 3 and branch 4 coats with second peplos; Part between branch 2 and branch 3 coats with the 3rd peplos; From the part between near-end to the branch 2 of main body 1, coat with the 4th peplos.The both sides of the edge of each piece peplos are sewed up with a suture 11 respectively, and four peplos can a shared backguy 12.It mainly is that main body 1 is flicked more easily that the art medium-height trestle adopts the advantage of polylith main body peplos.Generally, the size of these four peplos is different, and second peplos and the 3rd peplos are all less than first peplos and the 4th peplos.In addition; According to the needs of reality, guaranteeing also can the main body 1 of art medium-height trestle to be divided into two parts or three parts under the basic premise that main body 1 flicks easily; And adopting two peplos or three peplos to wrap up and sew up respectively, this is simpler than sewing up four main body peplos 10.
The art medium-height trestle conveyer device that this utility model provided; Owing to adopted the technological means of disengageable suture and backguy; Only needing to extract backguy out is the corresponding suture of releasable, and then will be with ramose art medium-height trestle to discharge to be positioned at and be with in ramose blood vessel such as the aortic arch; Compared with techniques with treatment arotic disease in the prior art; Utilize the conveyer device of this utility model; Only need aorta be cut in the end of aortic arch portion lesion locations; The art medium-height trestle that is installed on the conveyer device is implanted to corresponding lesion locations quickly and easily, comprises the lesion locations of branch vessel, only needing to extract backguy out is the corresponding suture of releasable; And then will be with ramose art medium-height trestle to discharge to be positioned at and be with in ramose blood vessel such as the aortic arch, and after withdrawing from conveyer device, myometrial suture is got final product.In the hybridization operation of aortic arch portion, adopt this conveyer device, compare, significantly reduced the quantity of anastomotic stoma in the operation with original hybridization operation; It is all right only to need to sew up an anastomotic stoma in the operation, has also simplified operation process thus, has shortened operating time; Reduced postoperative complication; Improve patient's survival rate, improved the effect of treatment, more effectively reduced the wound that the patient to aortic arch portion disease causes.
Adopt the art medium-height trestle conveyer device that this utility model provided; Can make that aortic arch art medium-height trestle can practicability, make the bonded hybridization operation of blood vessel inner cavity insulation technology and surgical operation can be used for aortic arch portion treatment of diseases more effectively, operation can once be completed successfully; And needed three to five anastomotic stoma in the traditional surgery are reduced to an anastomotic stoma; Reduce the difficulty and the risk of operation greatly, shorten operating time, reduce wound patient.The art medium-height trestle conveyer device of this utility model can only be transported to aortic arch portion through the single otch of ascending aorta one end simultaneously with main body and a plurality of branch of aortic arch art medium-height trestle, and is positioned in the branch vessel after making each branch of aortic arch art medium-height trestle aim at the respective branch blood vessel of aortic arch portion one by one again.The main body that discharges aortic arch art medium-height trestle through the mode of extracting backguy out respectively with its on each branch, conveyer device can be withdrawn from safely then, and can not have influence on the location of aortic arch art medium-height trestle.
Should be understood that; The preferred embodiment that the above is merely this utility model is not sufficient to limit the technical scheme of this utility model, concerning those of ordinary skills; Within the spirit and principle of this utility model; Can increase and decrease according to above-mentioned explanation, replacement, conversion or improvement, for example, the conveyer device of this utility model art medium-height trestle is not limited only to carry and discharges aortic arch art medium-height trestle; After suitable distortion and transforming, equally also can be used to make, carry and discharge other and be with a ramose art medium-height trestle at least; And all these increases and decreases, replacement, conversion or improve after technical scheme, all should belong to the protection domain of this utility model accompanying claims.
Claims (10)
1. an art medium-height trestle conveyer device is characterized in that, is used for installing and discharging said art medium-height trestle, comprises peplos, suture and backguy; Two side seams of said peplos are closed in suture and backguy, so that said art medium-height trestle is drawn in and is wrapped in the said peplos, it is being connected of releasable that suture forms the extraction backguy with said peplos.
2. art medium-height trestle conveyer device according to claim 1 is characterized in that: said art medium-height trestle comprises a main body and more than one branch.
3. art medium-height trestle conveyer device according to claim 1 and 2 is characterized in that: said peplos adopts a kind of material in polyester, the politef or derivatives thereof.
4. art medium-height trestle conveyer device according to claim 2 is characterized in that: have main body peplos and more than one branch peplos; Main body peplos is used to wrap up said main body, and each branch's peplos is respectively applied in the said branch of parcel; Main body peplos is connected with a backguy respectively with each branch's peplos.
5. art medium-height trestle conveyer device according to claim 4 is characterized in that: suture forms equally spaced stitch points along the edge of main body peplos or branch's peplos; Said stitch points is basic along said main body or said ramose axial distribution; The all stitch points on corresponding main body peplos or the branch's peplos are passed in said each root backguy successively one by one.
6. art medium-height trestle conveyer device according to claim 5 is characterized in that: said art medium-height trestle is for having three ramose aortic arch art medium-height trestles; Said main body peplos is divided into four independent sectors; Four independent sectors of said main body peplos are with the boundary that branches into of aortic arch art medium-height trestle, and a shared backguy.
7. art medium-height trestle conveyer device according to claim 6 is characterized in that: comprise handle, the fixed bar of flexibility and branch's sheath core of three flexibilities; The near-end of the near-end of said fixed bar and said branch sheath core all is fixed on the handle; Said fixed bar is used to install said aortic arch art medium-height trestle main body, and each of said three branch's sheath cores is respectively applied for the branch that said aortic arch art medium-height trestle is installed; The said branch that is installed on the said branch sheath core can be a spot wobble with the connecting portion of itself and said main body.
8. art medium-height trestle conveyer device according to claim 7 is characterized in that: handle is provided with the wire casing and the separable plug of hollow; Backguy on corresponding main body peplos and the branch's peplos is all passed from wire casing, and the near-end of backguy is fastened on the plug.
9. art medium-height trestle conveyer device according to claim 7 is characterized in that: at the far-end of said fixed bar or the far-end of said branch sheath core target seeker is set respectively, the far-end of said target seeker is streamlined outline.
10. according to claim 7 or 8 or 9 described art medium-height trestle conveyer devices, it is characterized in that: the core at said fixed bar is provided with sheath in the main body, and sheath has inner chamber in the said main body, and the inner chamber of sheath is provided with slidably main body seal wire in main body; Said each branch's sheath core has inner chamber respectively, at the inner chamber of said each branch's sheath core slidably branch's seal wire is set respectively.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201120165550U CN202128575U (en) | 2011-05-23 | 2011-05-23 | Support conveying device during operation |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201120165550U CN202128575U (en) | 2011-05-23 | 2011-05-23 | Support conveying device during operation |
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| CN202128575U true CN202128575U (en) | 2012-02-01 |
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Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN102166143A (en) * | 2011-05-23 | 2011-08-31 | 先健科技(深圳)有限公司 | Device for conveying bracket in operation and method for mounting and releasing bracket in aortic arch operation |
| CN103690282A (en) * | 2013-12-31 | 2014-04-02 | 先健科技(深圳)有限公司 | Lumen stent conveying system |
| CN105662650A (en) * | 2016-03-21 | 2016-06-15 | 中国医科大学附属第一医院 | Integrated coated branched vascular stent and conveying system thereof |
| CN109223268A (en) * | 2018-10-18 | 2019-01-18 | 大连科万维医疗科技有限公司 | One kind having branch stent conveying device |
| CN110944604A (en) * | 2017-07-25 | 2020-03-31 | 汉阳大学校产学协力团 | Support transfer device |
| CN111228010A (en) * | 2020-01-10 | 2020-06-05 | 北京天助瑞畅医疗技术有限公司 | Stent implantation conveyor and implantation system |
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2011
- 2011-05-23 CN CN201120165550U patent/CN202128575U/en not_active Expired - Lifetime
Cited By (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102166143A (en) * | 2011-05-23 | 2011-08-31 | 先健科技(深圳)有限公司 | Device for conveying bracket in operation and method for mounting and releasing bracket in aortic arch operation |
| WO2012159524A1 (en) * | 2011-05-23 | 2012-11-29 | 先健科技(深圳)有限公司 | Conveying device of intraoperative stent |
| CN102166143B (en) * | 2011-05-23 | 2014-04-09 | 先健科技(深圳)有限公司 | Device for conveying bracket in operation |
| CN103690282A (en) * | 2013-12-31 | 2014-04-02 | 先健科技(深圳)有限公司 | Lumen stent conveying system |
| CN103690282B (en) * | 2013-12-31 | 2016-02-17 | 先健科技(深圳)有限公司 | Lumen bracket conveying system |
| CN105662650A (en) * | 2016-03-21 | 2016-06-15 | 中国医科大学附属第一医院 | Integrated coated branched vascular stent and conveying system thereof |
| CN110944604A (en) * | 2017-07-25 | 2020-03-31 | 汉阳大学校产学协力团 | Support transfer device |
| CN109223268A (en) * | 2018-10-18 | 2019-01-18 | 大连科万维医疗科技有限公司 | One kind having branch stent conveying device |
| CN111228010A (en) * | 2020-01-10 | 2020-06-05 | 北京天助瑞畅医疗技术有限公司 | Stent implantation conveyor and implantation system |
| CN111228010B (en) * | 2020-01-10 | 2023-03-10 | 北京天助瑞畅医疗技术有限公司 | Stent implantation conveyor and implantation system |
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