CN211156115U - Subcutaneous tunnel device for internal arteriovenous fistula of artificial blood vessel - Google Patents
Subcutaneous tunnel device for internal arteriovenous fistula of artificial blood vessel Download PDFInfo
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- CN211156115U CN211156115U CN201921250751.3U CN201921250751U CN211156115U CN 211156115 U CN211156115 U CN 211156115U CN 201921250751 U CN201921250751 U CN 201921250751U CN 211156115 U CN211156115 U CN 211156115U
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- 210000004204 blood vessel Anatomy 0.000 title claims abstract description 49
- 239000002473 artificial blood Substances 0.000 title claims abstract description 47
- 238000007920 subcutaneous administration Methods 0.000 title claims abstract description 24
- 206010003226 Arteriovenous fistula Diseases 0.000 title description 3
- 239000002184 metal Substances 0.000 claims abstract description 8
- 229910052751 metal Inorganic materials 0.000 claims abstract description 8
- 206010016717 Fistula Diseases 0.000 claims abstract description 6
- 230000003890 fistula Effects 0.000 claims abstract description 6
- 206010040007 Sense of oppression Diseases 0.000 claims description 4
- 208000007101 Muscle Cramp Diseases 0.000 claims description 3
- 239000011295 pitch Substances 0.000 claims 1
- 238000007906 compression Methods 0.000 description 7
- 230000006835 compression Effects 0.000 description 5
- 230000000916 dilatatory effect Effects 0.000 description 5
- 230000000149 penetrating effect Effects 0.000 description 5
- 238000010586 diagram Methods 0.000 description 4
- 230000003872 anastomosis Effects 0.000 description 3
- XEEYBQQBJWHFJM-UHFFFAOYSA-N Iron Chemical compound [Fe] XEEYBQQBJWHFJM-UHFFFAOYSA-N 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 230000006870 function Effects 0.000 description 2
- 238000009434 installation Methods 0.000 description 2
- 229910001220 stainless steel Inorganic materials 0.000 description 2
- 239000010935 stainless steel Substances 0.000 description 2
- 230000007704 transition Effects 0.000 description 2
- 239000010963 304 stainless steel Substances 0.000 description 1
- RYGMFSIKBFXOCR-UHFFFAOYSA-N Copper Chemical compound [Cu] RYGMFSIKBFXOCR-UHFFFAOYSA-N 0.000 description 1
- 229910000589 SAE 304 stainless steel Inorganic materials 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 229910052802 copper Inorganic materials 0.000 description 1
- 239000010949 copper Substances 0.000 description 1
- 230000007797 corrosion Effects 0.000 description 1
- 238000005260 corrosion Methods 0.000 description 1
- 229910052742 iron Inorganic materials 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
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Abstract
A kind of artificial blood vessel arteriovenous internal fistula uses the subcutaneous tunnel device, it is made up of removable hand grip, tunnel device king post and expander that connect sequentially, the front end of the king post of the tunnel device is integrated with the threaded spindle, the expander has anterior diameter continuously reduced tube-shape expansion cover, the front end of the expansion cover has threaded expansion cover screw hole of internal thread, the expansion cover is connected with threaded spindle; the front part of the screw is provided with an annular groove for carrying an artificial blood vessel; and a limiter in threaded connection with the screw is arranged in the expansion cover. The utility model is convenient to disassemble, assemble and clean; the dilator of the head can be used in two directions after being adjusted, so that the connector of the artificial blood vessel is protected from falling off under force; the main rod of the tunneler is made of bendable metal with certain strength and toughness, and can be bent in advance to be operated at different design radians, and the arrangement of a sleeve is omitted. Therefore, the whole structure is simple and easy to use, and the use is convenient and the efficiency is high.
Description
Technical Field
The utility model relates to a surgical instrument, a subcutaneous tunnel ware is used to artificial blood vessel arteriovenous internal fistula specifically says so.
Background
When the tunneller of the arteriovenous internal fistula is operated, a tunnel line is designed in advance, the tunneller moves from a skin incision at one end to an incision at the other end under the skin with a certain radian, then the artificial blood vessel is pulled back to the penetrated incision from the penetrated incision at one end, and then the blood vessel anastomosis and the subsequent operation at the two ends of the artificial blood vessel are implemented. However, in the prior art, part of the tunneler 1 is not provided with an expansion cover or a sleeve, and the blood vessel is directly dragged after being fixed, so that the tunneler is stressed greatly and is easy to fall off. 2. The artificial blood vessel is bound on the tunnel device and then operated, the operation is relatively complex, and the efficiency is reduced. 3. The tunnel device with the sleeve at the part is suitable for tunnels with different radians, and a main rod and a sleeve (especially a sleeve) with different radians need to be prepared in advance, so that the tunnel device is numerous in accessories and troublesome to carry and store. 4, the main rod needs to be matched with the sleeve for use, the length of the main rod and the length of the sleeve are close, the reserved space for fixing the artificial blood vessel is small, and the operation is relatively inconvenient.
Disclosure of Invention
The utility model aims to solve the technical problem that a subcutaneous tunnel ware is used to artificial blood vessel arteriovenous internal fistula is provided, can overcome above-mentioned problem, make the artificial blood vessel of taking back can not drop and connect and take off convenient quick, and the different crookedness requirements can be used to only one tunnel ware mobile jib, and each part can disinfect the use repeatedly, can independently change.
Artificial blood vessel arteriovenous internal fistula use subcutaneous tunnel ware, constitute its characterized in that by handle, tunnel ware mobile jib, screw rod and the expander that connects gradually:
the screw is arranged at the front end part of the main rod of the tunneler, and the expander is provided with an expanding cover;
the rear part of the expansion cover is cylindrical, the diameter of the expansion cover is continuously and smoothly reduced towards the front end, the front end of the expansion cover is provided with an expansion cover screw hole with a through internal thread, the axis of the expansion cover screw hole is superposed with the axis of the expansion cover, the expansion cover is in threaded connection with the screw rod through the expansion cover screw hole, and the threads on the two sides of the groove are provided with matched diameter and thread pitch relative to the expansion cover screw holes on the two sides of the crossing groove;
the diameter of the main rod of the tunneler is 0-1 mm smaller than the diameter of the thread root of the screw, and the screw is provided with an annular groove to divide the thread into at least two sections.
Further, the expander still is equipped with the stopper, the stopper front portion be the cylindrical tube-shape of axle center in-band screw thread for with screw rod threaded connection, at the inside stable expansion cover of expansion cover, the rear portion of stopper is equipped with a plurality of cramps that stretch out backward for be fixed in the artificial blood vessel in stopper rear in the tunneller mobile jib.
Preferably, the tail end of the clamping sheet is provided with a clamping head which protrudes inwards; when the limiter is in threaded connection with the screw rod, the radial distance between the clamping head and the side face of the screw rod is 0.2-2 mm.
As a first embodiment, the groove is provided with two circles, threads on two sides of the groove are provided with the same turning direction, one circle at the rear part is a rear groove, and when the front end of the expansion cover is forward opposite to the front end of the cylindrical surface of the screw rod, and the front end of the stopper abuts against the tail end of the screw hole of the expansion cover, the clamping heads are aligned and embedded in the rear groove; the front circle is a front groove, when the front end of the expansion cover is backwards opposite to the thread rear end of the screw rod, and the front end of the limiter is abutted against the tail end of the screw hole of the expansion cover, the clamping head is aligned and embedded in the front groove.
When the clamping head is aligned to the groove, the alignment errors of the front end of the expansion cover facing forward to the front end of the thread of the screw rod and the alignment errors of the front end of the expansion cover facing backward to the rear end of the thread of the screw rod are respectively 0-2 mm.
In this embodiment, the outer surface of the clamping piece is provided with a circle of wire binding groove, and the wire binding groove is positioned outside the position of the clamping head.
As a second embodiment, the groove is a reversing groove, front threads and rear threads which have opposite rotation directions and can be matched with the screw holes of the expansion cover are arranged on two sides of the reversing groove, and the width of the reversing groove is 0.5-2 mm greater than the width of the internal threads of the expansion cover and the internal threads of the stopper; when the front end of the expansion cover is forwards positioned on the front thread and the front end of the limiter is abutted against the tail end of the screw hole of the expansion cover, the clamping head is positioned in the rear screw rod area of the rear thread; when the front end of the expansion cover is backwards positioned in the rear thread area and the front end of the limiter is abutted against the tail end of the screw hole of the expansion cover, the clamping head is positioned in the front screw rod area of the front thread.
In the second embodiment, the front part inside the expansion cover is provided with the compression wall with the section inner diameter smoothly reduced forwards until the section inner diameter is 1-3 mm smaller than the outer diameter of the limiting stopper, and when the front end of the limiting stopper abuts against the tail end of the screw hole of the expansion cover, the inner diameter of the compression wall corresponding to the position of the clamping head is the minimum inner diameter, so that the clamping head just clamps the artificial blood vessel.
In a second embodiment, an end cap is matched with the expansion cover, the front end surface of the end cap is a smooth cambered surface gradually enlarging backwards, the rear end surface of the end cap is a concave cambered surface, and the radian is not less than that of the front end of the expansion cover; the axis of the rear part of the end cap is provided with a thread groove matched with the front thread, so that when the expansion cover is meshed with the front thread forwards and the front end of the screw rod extends out, the end cap is meshed with the front thread and the outer surface of the end cap is connected with the expansion cover;
the outer side surface of the limiter is provided with a compression groove which is concave when viewed on the longitudinal section, so that the clamping head is compressed and folded inwards when the compression wall moves towards the clamping head at the position of the compression groove.
The main rod of the tunneler is a metal polish rod which is provided with no outer sleeve and can be bent into a required radian.
The utility model is composed of three parts of simple structure, which is convenient to carry and clean; the dilator of the head can be reused in two using directions, the tip of the dilating cover is arranged forwards for connection when the tunnel is firstly dilated, and the dilating cover is connected reversely when the tunnel is returned, so that the connector of the artificial blood vessel can be protected from falling off due to stress; the artificial blood vessel is conveniently carried back by the clamping piece. The main rod of the tunneler is made of bendable metal and can be bent to a designed radian for operation in advance, and the sleeve is omitted from being arranged and various different bent models are selected. Therefore, the whole structure is simple and easy to use, the use is convenient, the efficiency is high, the cost is low and the use effect is good.
Drawings
Figure 1 is a schematic view of the whole structure of the utility model,
figure 2 is an enlarged view of a first embodiment at a in figure 1,
figure 3 is a schematic diagram of the use state upon return of the embodiment,
figure 4 is an enlarged view of embodiment two at a in figure 1,
figure 5 is a schematic diagram of the use state when returning to the second embodiment,
figure 6 is a schematic diagram of a main stem structure of the tunneler of the first embodiment,
fig. 7 is a schematic diagram of the main stem and the expandable cover of the tunneler according to the second embodiment.
In the figure: 1-handle, 2-tunneler main rod, 3-expander, 4-expanding cover, 5-groove, 5 a-front groove, 5 b-rear groove, 5 c-reversing groove, 6-end cap, 7-expanding cover screw hole, 8-limiter, 9-clamping piece, 10-rear thread, 11-artificial blood vessel, 12-clamping head, 13-front thread, 14-compression wall, 15-wire binding groove, 16-compression groove and 17-screw rod.
Detailed Description
The invention will be further described with reference to the following figures and examples: as shown in figure 1, the subcutaneous tunneller for the internal arteriovenous fistula of the artificial blood vessel only comprises a handle 1, a main tunneler rod 2, a screw 17 and an expander 4 which are connected in sequence to form a tunneler main body, and the subcutaneous tunneler does not have other accessories when in use.
Handle 1 can dismantle with tunneler mobile jib 2 and be connected, and handle 1 can be the cylinder that the lateral surface established anti-skidding line for handheld. The connection mode can be threaded connection, and the rear end of the main rod 2 of the tunnel device is provided with external threads which are in threaded connection with a handle screw hole in the middle of the front end of the handle 1. A snap connection may also be used.
The main rod 2 of the tunneler is a metal polish rod without a jacket sleeve and capable of being bent into a required radian. The main rod 2 of the tunneler is a metal polished rod, has the hardness equivalent to metal iron or copper, the manual bending characteristic and the memory characteristic of metal, is resistant to disinfection and corrosion and high temperature, and can be made of 303 stainless steel. The arc of the tunneler main shaft 2 may be temporarily bent.
The front end part of the main rod 2 of the tunneler is integrally provided with a screw 17, the expander 4 is provided with a cylindrical expansion cover 4 with the diameter of the front part continuously reduced, and a matched stopper 8 is arranged inside the expansion cover in the preferred scheme.
Generally, the length of the main rod 2 of the tunneler is set to be 25-35 cm, the length of the expansion cover 4 is 3-5 cm, and the length of the screw 17 is 1-2 cm. The external diameter of the thickest part of the expansion cover is 8mm-12mm, and the expansion cover can be selected by various specifications, and 303 stainless steel or 304 stainless steel material can be used as the expansion cover 4.
The front end of the expansion cover 4 is provided with an expansion cover screw hole 7 with a through internal thread, the axis of the expansion cover screw hole 7 coincides with the axis of the expansion cover 4, the rear end of the expansion cover 4 is open, and the front end communicates the interior of the expansion cover 4 with the outside through the expansion cover screw hole 7. The expansion cover 4 is in threaded connection with the screw 17 through the expansion cover screw hole. The utility model discloses in, expansion cover 4 is coming and going all can use, when establishing the tunnel and returning, expansion cover 4 is rotated down and is connected with the screw rod backward again, carries artificial blood vessel 11 to return the tunnel entry when returning.
Fig. 2 and 3 are enlarged views of the dilator according to an embodiment, the cross-sectional diameter of the front end of the dilating mask 4 is continuously reduced until the dilating mask is screwed, and the outer surface is smooth, so that the resistance during the advancing process is reduced. The front end of the screw rod is in an outward convex arc shape, and the outer surface of the front end of the outward convex arc shape of the screw rod is smooth. After the expansion cover 4 is in threaded connection with the screw, when the tip of the expansion cover 4 is forward, the outer surface of the expansion cover 4 and the outer surface of the front end of the screw can be in continuous transition or have a smaller gap, which is beneficial to reducing forward resistance and reducing damage to tissues. The expansion cover with different front end inclination angles and shapes can be provided, for example, the front end of the expansion cover is blunt round, bullet-shaped or pointed, and is selected when needed.
The shape of the rear part of the edge of the front end surface of the screw rod is cylindrical, and the screw rod is a thread or a polished rod. When the front end of the expansion cover 4 is rotated to the edge of the cambered surface at the front end of the screw rod through threads, the cambered surface at the front end of the screw rod and the cambered surface of the expansion cover 4 are in smooth transition. The convex arc edge of the screw is the boundary between the arc end surface and the cylindrical screw.
In the embodiment shown in fig. 2 and 3, the rear part of the expansion housing 4 is cylindrical or smoothly curved when viewed in longitudinal section. So as to create a subcutaneous tunnel under pull-down in front of external forces.
The diameter of the main rod 2 of the tunneler is 0-1 mm smaller than the diameter of the thread root of the screw 17, so that when the expansion cover 4 is reversely installed, the front end of the main rod can exceed the range of the screw and then be screwed back.
In the embodiment of the present invention, the dilator 3 is used in cooperation with the stopper 8, and the stopper 8 is used to limit and fix the position of the dilating mask 4, and has the function of fixing the artificial blood vessel 11.
The thread of the screw 17 is provided with an annular groove 5 perpendicular to the axis of the screw 17. The groove 5 plays an important role in the bi-directional mounting of the expansion cap, which will be explained below with reference to the embodiments.
As shown in fig. 2, 3 and 6, the structure of the first embodiment is that the groove 5 has two circles, both sides of the groove are provided with threads with the same turning direction, and the circle at the rear is a rear groove 5b, which is arranged when the front end of the expansion cover 4 faces forward the front end of the cylindrical surface of the screw rod, and the front end of the stopper 8 abuts against the tail end of the expansion cover screw hole 7 of the expansion cover 4, as shown in the state of fig. 2, the clamping head 12 is aligned with the rear groove 5 b; the front circle is a front groove 5a, when the front end of the expansion cover 4 faces backwards to the rear end of the screw thread of the screw rod and the front end of the stopper 8 abuts against the tail end of the expansion cover screw hole 7 of the expansion cover 4, as shown in the state of fig. 3, the clamping head 12 is located at the position of the front groove 5 a.
The alignment errors of the front end of the expansion cover 4 facing forward to the front end of the thread of the screw 17 and the front end of the expansion cover 4 facing backward to the rear end of the thread of the screw 17 are respectively 0-2 mm. In the first embodiment, the clamping head 12 is embedded in the groove 5, the artificial blood vessel 11 is clamped between the clamping head 12 and the groove 5, and the artificial blood vessel 11 is clamped and carried back to the subcutaneous tunnel.
As shown in fig. 2 and 3, as an embodiment, an annular binding-wire groove 15 is formed on the outer side surface of the clamping head 12 of the clamping piece, and the clamping head 12 of the clamping piece can be tightened by positioning a binding-wire in the binding-wire groove 15, so that the clamping head 12 can be inserted into the artificial blood vessel 11 to clamp the artificial blood vessel in a return state.
The specific operation is that a tunnel path needs to be preset, when a subcutaneous tunnel is created, the tunnel path needs to be preset, the radian of the main rod 2 of the tunnel device is pre-bent to be matched with the preset path, then the main rod penetrates into and out of the notch, the expander is installed in the forward direction, the limiting device 8 and the expanding cover 4 are sequentially screwed in from the front end of the screw rod, the limiting device 8 is rotated to a preset position on the screw rod, then the expanding cover 4 is screwed in, and the front end of the limiting device 8 is enabled to tightly prop against the tail end of the screw hole of the expanding cover 4. And then, the tunnel is penetrated and penetrated out of the incision, the handle 1 of the subcutaneous tunneler is held, the tip of the dilator 3 of the tunneler is forwards, the tunnel enters from the penetrating incision, the tunnel path is expanded according to the planned route, and the dilator 3 penetrates out of the penetrating incision, and the state of the dilator 3 is shown in figure 2. Then, sequentially performing:
1. rotating the expansion cap 4 out of the front end of the screw;
2. rotating the stopper 8 out of the front end of the screw;
3. the expansion cover 4 is reversed, the pointed end faces to the near end (see figure 3), the expansion cover screw hole of the expansion cover 4 is in threaded connection with the screw rod 17, and the front end of the expansion cover 4 is moved out of the left end of the screw rod 17;
4. the stopper 8 is reversed with the holding head 12 of the stopper 8 facing the distal end (right side in fig. 3), the stopper 8 is screwed with the screw 17, and is moved leftward until the holding head 12 is positioned at the front groove 5 a;
5. sleeving the artificial blood vessel 11 from the far end of the screw rod 17, dragging the artificial blood vessel to the position of the front groove 5a, pressing the front end of the artificial blood vessel 11 by the clamping head 12, and clamping the artificial blood vessel between the front groove 5a and the clamping head 12; when the artificial blood vessel is not firmly fixed, the clamping head 12 can be folded at the wire binding groove 15 by wire binding;
6. rotating the expansion cap 4 in the right (distal) direction until abutting against the stopper 8;
7. the tunneler is held by the handle 1, and the tunneler is returned from the distal incision along the expanded tunnel path, and the artificial blood vessel 11 is pulled out of the proximal incision, thereby performing the anastomosis and the subsequent operation.
As shown in FIGS. 4, 5 and 7, in the second embodiment, a pressing wall 14 having a cross section whose inner diameter is smoothly reduced forward to 1 to 3mm smaller than the outer diameter of the stopper 8 is provided at the front portion inside the expansion cap 4.
In the second embodiment, a front thread 13 and a rear thread 10 with opposite screwing directions are arranged, the front thread 13 and the rear thread 10 are spaced by a reversing groove 5c, and the width of the reversing groove 5c is larger than the width of the internal thread of the expansion cover 4 and the width of the internal thread of the stopper. In fig. 7, a typical width dimension embodiment is shown, the front thread 13, the rear thread 10 and the reversing groove 5c having a width of 8mm, and the expansion cage screw hole 7 having a length of 7.5mm and the stopper 8 having a thread length of 7.5 mm. When the front end of the expansion housing 4 is forward against the front thread 13 part and the front end of the stopper 8 abuts against the rear end of the expansion housing screw hole 7 of the expansion housing 4 (see fig. 4), the clamping head 12 is aligned with the rear position of the rear thread 10. When the front end of the expansion housing 4 is directed backwards towards the rear thread 10 part and the front end of the stopper 8 abuts against the rear end of the expansion housing screw hole 7 of the expansion housing 4 (see fig. 5), the clamping head 12 is aligned with the front position of the front thread 13. The opposite direction of the front thread 13 and the back thread 10 is to prevent the stopper from rotating synchronously under the action of the pressing wall 14 when the expansion cover 4 is screwed down, thereby losing the fixing function of the expansion cover, the stopper and the artificial blood vessel.
When the front end of the expansion cover 4 is faced backwards to the rear thread 10 part of the screw rod and the front end of the stopper 8 is abutted against the tail end of the expansion cover screw hole 7 of the expansion cover 4, the inner diameter of the pressing wall 14 corresponding to the position of the clamping head 12 is the minimum inner diameter, and the inner diameter of the pressing wall 14 at this position becomes gradually larger towards the rear part of the expansion cover. The effect of oppression wall 14 is to press the tight artificial blood vessel 11 of centre gripping head 12 clamp, and when oppression wall 14 did not oppress centre gripping head 12, there was 0.2 ~ 2 mm's clearance between centre gripping head and the screw rod, typical value is 0.2 ~ 0.3mm to artificial blood vessel 11 can embolia the front end of screw rod directly very conveniently, inserts between centre gripping head 12 and the screw rod. Then when the expansion cover 4 is screwed, the pressing wall 14 presses the clamping head 12, and the clamping sheet has the elasticity that can be deformed and recovered after the pressure is released, so that the clamping head 12 clamps the artificial blood vessel 11.
And a polished rod with the diameter equal to the diameter of the thread root and the tolerance less than 1mm can be arranged between the front end of the front thread 13 and the front end of the screw rod, and when the front end of the expansion cover 4 is backwards opposite to the rear thread 10 of the screw rod and the front end of the limiter 8 is abutted against the tail end of the expansion cover screw hole 7 of the expansion cover 4, the clamping head 12 is positioned at the polished rod position of the screw rod. When the artificial blood vessel is reversely installed, a radial gap is reserved between the clamping head and the polish rod, so that the artificial blood vessel is convenient to install. The width of the reversing groove 5c is larger than the width of the internal thread of the expansion cover 4 or the internal thread of the stopper 8, so that the expansion cover can be rotated in a sufficient space when passing through the groove during reverse installation.
When the front end of the expansion cover is installed forwards, an end cap 6 is further arranged in front of the expansion cover, as shown in fig. 4, the front end surface of the end cap 6 is a smooth arc surface gradually enlarged backwards, the rear end surface is an inwards concave arc surface, and the radian is not smaller than the radian of the front end of the expansion cover; the axis of the rear part of the end cap 6 is provided with a thread groove matched with the front thread, so that when the expansion cover is meshed with the front thread forwards and the front end of the screw rod extends out, the end cap is meshed with the front thread and the outer surface of the end cap is connected with the expansion cover. A variety of end caps of different curvatures may be provided for use. The end cap 6 is not required for reverse installation.
In the second embodiment, the outer surface of the stopper 8 is provided with a concave pressing groove 16 when viewed from the longitudinal section, so that when the position with the smallest inner diameter of the pressing wall 14 is in the pressing groove 16, the clamping head 12 is gradually pressed to be radially tightened when the expansion cover moves to the position of the clamping head 14.
The second specific operation of the embodiment is that when a subcutaneous tunnel is created, a tunnel path needs to be preset, the main rod of the tunneler is pre-bent to be a planned tunnel path radian, the expander is installed in the forward direction after penetrating into and out of the notch, the stopper 8 and the expanding cover 4 are sequentially screwed in from the front end of the screw rod, when the expander is screwed in, the front end of the stopper is located at the position of the reversing groove 5c, the rear end of the stopper is located at the position of the rear thread 10, the expanding cover rotates backwards to abut against the front end of the stopper 8, and the end cap 6 is screwed in outside the expanding cover. Holding the handle 1 part of the subcutaneous tunneler, the dilator 3 of the tunneler enters from the penetrating incision with the pointed end forward, expands the tunnel path according to the planned route, and penetrates from the penetrating incision, and the state of the dilator 3 is shown in figure 4. Then, sequentially performing:
1. the end cap 6 and the expansion cover 4 are sequentially screwed off and are moved out from the front end of the screw 17;
2. the stopper 8 is reversely rotated to be removed from the front end of the screw 17;
3. the expansion cover 4 is reversed, the pointed end faces to the near end (see figure 5), the expansion cover screw hole of the expansion cover 4 is connected with the front thread 13 of the screw rod and rotates to move backwards, when the expansion cover 4 is completely moved out of the front thread 13, the expansion cover is reversely rotated to be sleeved with the rear thread 10 and moves backwards (the left side in figure 5), so that the expansion cover 4 is connected with the rear thread 10 until the front end of the expansion cover is moved out of the rear thread 10, and the position of the expansion cover is set with the position limiter 8;
4. reversing the stopper 8 with the gripping head 12 of the stopper 8 facing distally (to the right in fig. 5), connecting the stopper 8 with the front thread 13 of the screw 17 and moving back to a position where the gripping head 12 is located in front of the front thread 13 of the polish rod or screw;
5. referring to fig. 5, the expansion cap 4 moved out of the rear screw thread 10 to the left is moved back to the right and is coupled to the initial position of the rear screw thread 10;
6. sleeving the artificial blood vessel 11 from the far end of the screw rod 17, dragging the artificial blood vessel to the inner side of the clamping head 12, inserting the front end of the artificial blood vessel 11 into the position below the clamping head 12, and clamping the artificial blood vessel between the screw rod and the clamping head 12;
7. the expansion cover 4 is rotationally moved towards the far end direction until abutting against the stopper 8, and meanwhile, the pressing wall 14 presses the clamping head 12 and presses the artificial blood vessel 11;
8. the tunneler is held by the handle 1, and the tunneler is returned from the distal incision along the expanded tunnel path, and the artificial blood vessel 11 is pulled out of the proximal incision, thereby performing the anastomosis and the subsequent operation.
Claims (10)
1. The utility model provides an artificial blood vessel arteriovenous internal fistula is with subcutaneous tunnel ware comprises handle (1), tunnel ware mobile jib (2), screw rod (17) and expander (3) that connect gradually, its characterized in that:
the screw (17) is arranged at the front end part of the main rod (2) of the tunneler, the expander (3) is provided with an expanding cover (4), and the screw (17) is provided with an annular groove (5) to divide the thread into at least two sections;
the rear part of the expansion cover (4) is cylindrical, the diameter of the expansion cover is continuously and smoothly reduced towards the front end, the front end of the expansion cover (4) is provided with an expansion cover screw hole (7) with a through internal thread, the axis of the expansion cover screw hole (7) is overlapped with the axis of the expansion cover (4), the expansion cover (4) is in threaded connection with a screw rod (17) through the expansion cover screw hole, and the threads on the two sides of the groove (5) are provided with matched diameters and thread pitches relative to the expansion cover screw holes (7) on the two sides of the cross groove;
the diameter of the main rod (2) of the tunneler is 0-1 mm smaller than the diameter of the thread root of the screw (17).
2. The subcutaneous tunneler as recited in claim 1, wherein: expander (3) still are equipped with stopper (8), and stopper (8) front portion is the cylindrical tube-shape of axle center in-band screw thread for with screw rod (17) threaded connection, at the inside stable expansion cover of expansion cover, the rear portion of stopper (8) is equipped with a plurality of cramps (9) that stretch out backward for be fixed in tunneler mobile jib (2) with artificial blood vessel (11) at stopper (8) rear.
3. The subcutaneous tunneler as recited in claim 2, wherein: the tail end of the clamping sheet (9) is provided with a clamping head (12) which protrudes inwards; when the limiter (8) is in threaded connection with the screw rod (17), the radial distance between the clamping head (12) and the side surface of the screw rod (17) is 0.2-2 mm.
4. The subcutaneous tunneler as recited in claim 3, wherein: the groove (5) is provided with two circles, threads on two sides of the groove are provided with the same turning direction, one circle at the rear part is a rear groove (5b), and when the front end of the expansion cover (4) faces forwards to the front end of the cylindrical surface of the screw rod (17) and the front end of the limiter (8) abuts against the tail end of the expansion cover screw hole (7) of the expansion cover (4), the clamping head (12) is aligned and embedded in the rear groove (5 b); the front circle is a front groove (5a), when the front end of the expansion cover (4) faces backwards to the rear end of the thread of the screw rod (17) and the front end of the limiter (8) abuts against the tail end of the expansion cover screw hole (7) of the expansion cover (4), the clamping heads (12) are aligned and embedded in the front groove (5 a).
5. The subcutaneous tunneler as recited in claim 4, wherein: when the clamping head (12) is aligned to the groove position, the alignment errors of the front end of the expansion cover (4) facing forward to the front end of the thread of the screw rod (17) and the front end of the expansion cover (4) facing backward to the rear end of the thread of the screw rod (17) are respectively 0-2 mm.
6. The subcutaneous tunneler as recited in claim 4, wherein: the outer surface of the clamping piece (9) is provided with a circle of wire binding groove (15), and the wire binding groove (15) is positioned on the outer side of the position of the clamping head (12).
7. The subcutaneous tunneler as recited in claim 3, wherein: the groove (5) is a reversing groove (5c), front threads (13) and rear threads (10) which have opposite rotation directions and can be matched with the expansion cover screw hole (7) are arranged on two sides of the reversing groove (5c), and the width of the reversing groove (5c) is 0.5-2 mm larger than the width of the internal threads of the expansion cover (4) and the internal threads of the stopper (8); when the front end of the expansion cover (4) is forwards positioned on the front thread (13) and the front end of the limiter (8) abuts against the tail end of the expansion cover screw hole (7), the clamping head (12) is positioned in the rear screw rod area of the rear thread (10); when the front end of the expansion cover is backwards positioned in the rear thread (10) area and the front end of the limiter (8) abuts against the tail end of the expansion cover screw hole (7), the clamping head (12) is positioned in the front screw rod area of the front thread (13).
8. The subcutaneous tunneler as recited in claim 7, wherein: in the inside front portion of expansion cover (4), be equipped with the cross-section internal diameter and smoothly dwindle forward, until less 1 ~ 3 mm's oppression wall (14) than stopper (8) external diameter, and when stopper (8) front end leaned on when expanding cover screw (7) tail end of expansion cover (4), oppression wall (14) internal diameter that corresponds clamping head (12) position was minimum internal diameter, made the clamping head just in time grasp artificial blood vessel.
9. The subcutaneous tunneler as recited in claim 8, wherein: an end cap (6) is matched with the expansion cover, the front end surface of the end cap is a smooth cambered surface which is gradually enlarged backwards, the rear end surface of the end cap is an inwards concave cambered surface, and the radian is not less than that of the front end of the expansion cover; the axis of the rear part of the end cap (6) is provided with a thread groove matched with the front thread, so that when the expansion cover is meshed with the front thread forwards and the front end of the screw rod (17) extends out, the end cap is meshed with the front thread and the outer surface of the end cap is connected with the expansion cover;
a pressing groove (16) which is concave when seen from the longitudinal section is formed in the outer side face of the limiting stopper (8), so that when the pressing wall (14) moves towards the clamping head (12) at the position of the pressing groove (16), the clamping head is pressed to be folded inwards.
10. The subcutaneous tunneler as in claim 1 or 2, wherein: the main rod (2) of the tunneler is a metal polish rod without an outer sleeve and capable of being bent into a required radian.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201921250751.3U CN211156115U (en) | 2019-08-02 | 2019-08-02 | Subcutaneous tunnel device for internal arteriovenous fistula of artificial blood vessel |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201921250751.3U CN211156115U (en) | 2019-08-02 | 2019-08-02 | Subcutaneous tunnel device for internal arteriovenous fistula of artificial blood vessel |
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| CN211156115U true CN211156115U (en) | 2020-08-04 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201921250751.3U Active CN211156115U (en) | 2019-08-02 | 2019-08-02 | Subcutaneous tunnel device for internal arteriovenous fistula of artificial blood vessel |
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110353782A (en) * | 2019-08-02 | 2019-10-22 | 武汉市第一医院 | Artifical internal arteriovenous fistula maintenance hypodermic tunnel device |
| CN116570329A (en) * | 2023-04-20 | 2023-08-11 | 中国人民解放军总医院第一医学中心 | Subcutaneous tunnel dilator for ventriculo-abdominal shunt operation |
-
2019
- 2019-08-02 CN CN201921250751.3U patent/CN211156115U/en active Active
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110353782A (en) * | 2019-08-02 | 2019-10-22 | 武汉市第一医院 | Artifical internal arteriovenous fistula maintenance hypodermic tunnel device |
| CN110353782B (en) * | 2019-08-02 | 2024-05-03 | 武汉市第一医院 | Subcutaneous tunnel device for artificial blood vessel arteriovenous internal fistula |
| CN116570329A (en) * | 2023-04-20 | 2023-08-11 | 中国人民解放军总医院第一医学中心 | Subcutaneous tunnel dilator for ventriculo-abdominal shunt operation |
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