CN212346609U

CN212346609U - Suturing device, treatment device with suturing device and treatment system

Info

Publication number: CN212346609U
Application number: CN202020661599.4U
Authority: CN
Inventors: 万平; 周兆腾; 万柔
Original assignee: Zhejiang Zuo Yuan Medical Technology Co ltd
Current assignee: Zhejiang Zuo Yuan Medical Technology Co ltd
Priority date: 2020-04-27
Filing date: 2020-04-27
Publication date: 2021-01-15
Anticipated expiration: 2030-04-27

Abstract

The utility model provides a stitching instrument, a treatment device with the stitching instrument and a treatment system. A treatment system includes an endoscope and a treatment device. The treatment device is used with an endoscope and comprises an operating handle and a stitching instrument. The stitching instrument comprises a main shell, a stitching needle, a needle feeding assembly and an anti-withdrawal needle assembly. One end of the suture needle is connected with a suture line, and the other end is a tip. The needle inserting component is arranged on the main shell and forms a separable clamping relationship with the suture needle so as to control the advance of the suture needle. The anti-retreat needle assembly is arranged on the main shell and forms a separable clamping relationship with the suture needle so as to prevent the retreat of the suture needle.

Description

Suturing device, treatment device with suturing device and treatment system

Technical Field

The present invention relates to a therapeutic device, and more particularly to a suturing device, a therapeutic device with the suturing device, and a therapeutic system.

Background

With the advancement of science and technology, surgery has been developed from traditional open surgery, minimally invasive surgery to non-invasive surgery. The non-invasive operation enters the operation area through the natural cavity (such as esophagus, rectum, uterus and the like) of the human body without external wounds, the bleeding is less, the physiological and psychological wounds of the patient are reduced, the anesthesia depth is reduced, and the risk brought by the anesthesia is greatly reduced. The non-invasive surgery can effectively reduce postoperative complications and is more beneficial to patients with higher risks.

Since the non-invasive surgery is mature in recent years, the corresponding matched equipment is scarce. Especially after in vivo operation, if in vivo wound tissue suturing is needed, most of the existing medical devices cannot achieve the purpose. US patent No. US 7344545 discloses an endoscopic suturing system for surgical operation, which is operated in vitro and sutured in vivo for therapeutic purposes. The suturing system includes an assembly having first and second arms and a needle recovery member that requires rigid alignment with the curved needle arm. The arrangement of the tissue grasping arm and the needle recovery member makes the system bulky, making it difficult to practically apply in endoscopic procedures.

Apollo intracorporeal surgical corporation also discloses an endoscopic suturing system. The stapler device may be inserted into the body through a natural body passageway in conjunction with an endoscope or other steerable guide device. The system has the advantages of complex structure, numerous equipment parts, complex manufacturing and high cost. When the system is used, 3 forceps channels need to be occupied simultaneously, and as the internal operation is only provided with 3 forceps channels at most, an operation device needs to be exchanged in one forceps channel in the operation process (the device occupying one forceps channel originally is taken out and then inserted into a new device), and the suturing step is complicated.

In particular, when suturing a wound tissue in vivo, a suturing device provided by apollo intracorporeal operation company needs to be matched with a special rotary drill hooking device to puncture the tissue and then hook the tissue, and then a suturing needle can penetrate the tissue to perform a suturing operation. This operation is required for each stitch. This puncturing action greatly increases the risk of surgery because it is difficult to accurately determine the depth of puncture in vivo outside the body. When the surgery is a gastric reduction surgery, the rotary drill hooking device can possibly cause damage to extraluminal tissues, and the surgical risk of a patient is greatly increased.

In addition, the suturing device provided by apollo intracorporeal operation company cannot perform the knotting operation of the suture thread without using other devices after the suturing is completed. Therefore, the suturing device must be equipped with a special knotter when knotting the suture thread. In practice, the device that originally occupied one of the channels is removed, the device is then used to insert the channel to deliver the knot device into the body, and the suture is then cut, leaving the knot device directly in the body of the surgical patient. The knotting operation is not only troublesome, but also leaves non-human rigid objects in the human body, which easily causes postoperative risks.

In addition, the problems faced by the existing soft endoscope for wound closure, tissue suture and fixation of the digestive tract stent are respectively as follows: some instruments are large in size and unsuitable in material, and easily damage digestive tract mucosa; some instruments, one action is divided into a plurality of step operations, a plurality of parts are used manually for completion, the auxiliary instruments are exchanged for a plurality of times, so that the action is frequent and the error is possible, some parts can be replaced only by withdrawing the endoscope, the operation repetition and the damage are possibly doubled by advancing the endoscope for the second time after the endoscope is withdrawn, and the operation process is prolonged; the size of the fixing clamp is not steplessly variable (only a few sizes), excessive clamping teeth damage tissues excessively, and the fixing clamp which is not placed in a clamping path is difficult to not shield the visual field of the endoscope; when the clamp is closed, the wound is torn, especially the fibrosis tissue or the scar tissue is difficult to close, and the fixed clamp mode also causes the tissue to be not well closed or to be closed too tightly; the suture range (large wound or small wound) or the suture depth (full layer or layered) is extremely difficult to adapt universally or randomly; the clip is too shallow and easy to fall off and too deep and easy to perforate, and the abdomen is forced to prevent hard object damage; excessive, too deep clamping (it is extremely difficult to accurately and objectively control the depth), which may damage or close extra-luminal organs; the soft endoscope is not supported (unlike the hard laparoscope which is supported), and is difficult to directly knot, and the knotting tension is difficult to randomly control; after operation, the granulation tissue is excessively proliferated, or the closure is incomplete, and the leakage is caused after the operation; post-operative rebleeding or ischemic necrosis, resulting in secondary surgery (even laparotomy); the components are numerous, time consuming to assemble, and expensive.

SUMMERY OF THE UTILITY MODEL

The utility model provides a suture device, a therapeutic device with the suture device and a therapeutic system, which overcome at least one deficiency in the prior art.

In one aspect, the present invention provides a suturing device comprising a main housing, a suturing needle, a needle insertion assembly and a needle withdrawal prevention assembly. One end of the suture needle with the thread is connected with a suture thread, and the other end is a tip. The needle inserting component is arranged on the main shell and forms a separable clamping relationship with the suture needle so as to control the advance of the suture needle. The anti-retreat needle assembly is arranged on the main shell and forms a separable clamping relationship with the suture needle so as to prevent the retreat of the suture needle.

According to the utility model discloses an embodiment, the needle inserting subassembly includes two stay cords, thereby the advancing of needle inserting subassembly is controlled to a stay cord and the advancing of driving the sewing needle advances, and the retreatment of needle inserting subassembly is controlled to another stay cord.

According to the utility model discloses an embodiment, the needle feeding subassembly includes stay cord, epitheca, spring, needle feeding tooth and slider, and the stay cord passes slider and epitheca respectively, and the needle feeding tooth is installed in the slider, and the one end of spring is supported and is leaned on the surface of needle feeding tooth, and needle feeding tooth, slider and spring mounting are in the spout of the main casing body, and the epitheca lid closes on the spout.

According to the utility model discloses an embodiment, prevent moving back the needle subassembly including preventing moving back pin tooth, inferior valve and shell fragment, prevent moving back the pin tooth and install in the inferior valve, prevent moving back pin tooth and inferior valve and install in the spout of the main casing body, inferior valve and shell fragment are fixed in the main casing body.

According to the utility model discloses an embodiment, the main casing body includes first casing and second casing, and first casing has the spread groove, and the second casing has the joint arch, and the joint arch inserts in the spread groove so that first casing and second casing link together.

In another aspect, the present invention further provides a therapeutic device, comprising an operating handle and a suturing device. The stitching instrument is fixed at the front end of the endoscope and comprises a main shell, a stitching needle, a needle inserting assembly and an anti-retreating needle assembly. One end of the suture needle with the thread is connected with a suture thread, and the other end is a tip. The needle inserting component is arranged on the main shell and forms a separable clamping relationship with the suture needle so as to control the advance of the suture needle. The anti-retreat needle assembly is arranged on the main shell and forms a separable clamping relationship with the suture needle so as to prevent the retreat of the suture needle. An operating handle is fixed at the operating end of the endoscope, and the operating handle controls the needle inserting assembly so as to control the advance of the suture needle.

According to an embodiment of the utility model, operating handle includes insurance switch subassembly, interior ring subassembly, clutch assembly, action bars subassembly and torque limiter subassembly.

According to an embodiment of the present invention, the treatment device further comprises a connection ring, and the connection ring is sleeved on the endoscope.

According to an embodiment of the invention, the treatment device further comprises a snare loop, the snare loop performing a cutting action of the tissue at the distal end of the endoscope.

According to an embodiment of the present invention, the treatment device further comprises a hook forceps, the hook forceps performing a grasping operation of the tissue or a hooking pulling operation of the suture thread at the distal end of the endoscope.

In another aspect, the present invention also provides a treatment system including an endoscope and a treatment device. The treatment device is used with an endoscope and comprises an operating handle and a stitching instrument. The stitching instrument is fixed at the front end of the endoscope and comprises a main shell, a stitching needle, a needle inserting assembly and an anti-retreating needle assembly. One end of the suture needle is connected with a suture line, and the other end is a tip. The needle inserting component is arranged on the main shell and forms a separable clamping relationship with the suture needle so as to control the advance of the suture needle. The anti-retreat needle assembly is arranged on the main shell and forms a separable clamping relationship with the suture needle so as to prevent the retreat of the suture needle. An operating handle is fixed at the operating end of the endoscope, and the operating handle controls the needle inserting assembly so as to control the advance of the suture needle. An operating handle is fixed at the operating end of the endoscope, and the operating handle controls the needle inserting assembly so as to control the advance of the suture needle.

In another aspect, the present invention further provides a method for using a suturing device, comprising the steps of:

operating the needle insertion assembly to enable the suture needle and the needle insertion assembly to advance forwards together, wherein the sharp end of the suture needle is exposed out of the main shell and returns into the main shell after a certain stroke;

operating the needle inserting assembly to enable the needle inserting assembly to move backwards until the needle inserting assembly is clamped with the suture needle, wherein the clamped position is close to the tip end of the suture needle, and the suture needle does not move under the action of the anti-withdrawal needle assembly;

operating the needle insertion assembly such that the suture needle and the needle insertion assembly travel forward together until a pointed end of the suture needle is ready to be exposed from the main housing;

operating the needle feeding assembly to enable the anti-withdrawal needle assembly to move backwards until the anti-withdrawal needle assembly is clamped with the suture needle, wherein the clamped position is close to one end of the suture needle with the suture thread, and the suture needle is not moved under the action of the anti-withdrawal needle assembly;

the above four steps are repeated to perform suturing of a target sutured tissue (e.g., wound tissue, etc.) or knotting of a suture.

According to the utility model discloses an embodiment, the needle inserting subassembly includes first stay cord and second stay cord, and above-mentioned four steps correspond respectively for pulling first stay cord, pulling second stay cord, pulling first stay cord and pulling second stay cord.

According to an embodiment of the present invention, the operation of the needle insertion assembly is performed by operating the operating handle.

According to an embodiment of the present invention, prior to operating the needle insertion assembly, the method further comprises looping tissue with the snare loop at a distal end of the endoscope.

According to an embodiment of the present invention, after all the above steps are completed, the method further comprises the step of using the hook forceps to clamp the two ends of the suture thread at the front end of the endoscope, thereby completing the knotting operation of the suture thread.

To sum up, the suturing device, the therapeutic device and the therapeutic system of the utility model can be used for natural cavity surgery (non-invasive surgery), minimally invasive surgery or open surgery. The suture needle can be controlled to advance only by the needle inserting assembly, so that intermittent suture or continuous suture is performed in soft tissues, the operation is simple, and the risk of operation failure is greatly reduced. In addition, the stitching instrument of the utility model also comprises an anti-withdrawal needle component, so that the continuous advance of the stitching needle is possible. In particular, the needle insertion assembly and the anti-withdrawal needle assembly of the present invention are in a separable engagement with the suture needle, so that complicated functions (e.g., suturing of a target suture tissue and knotting of a suture thread) can be realized by a simple structure, and the suture instrument occupies a small volume and is low in manufacturing cost. If need sewing up of external operation internal tissue among the prior art, must whole supporting adoption rotary drill collude and get the device and just can realize sewing up the function to current rotary drill colludes and gets the device and directly carry out the rotary drill to the tissue and collude and catch then pull-up, the utility model discloses a sewing device need not to adopt the rotary drill to collude and get the device in the middle of the process of sewing up, can independently realize sewing up the function, has avoided the rotary drill to collude and gets the damage of device to the tissue, greatly reduced the operation risk.

In addition, in an embodiment, the needle insertion assembly can comprise two pull ropes, the two pull ropes are respectively controlled to control the movement of the needle insertion assembly in different directions, the operation is simple and clear, and the risk of operation failure is greatly reduced. In an embodiment, the treatment device and the treatment system of the present invention further comprise a ring-shaped ring and a hook forceps, and the suture device can be matched together to realize various functions of cutting, suturing, knotting, etc. of tissues. In one embodiment, the treatment device and the treatment system of the present invention may further include a connection ring, and when the external clamp tube is used, the connection ring may fix the external clamp tube and the endoscope together, and perform multi-point distribution along the flexible tube of the endoscope, thereby dispersing the force. The existing treatment device of Apollo intracorporeal operation company only fixes the front end and the operation end, which is easy to cause the passive bending of the endoscope.

In particular, the utility model provides a stitching instrument, a treatment device and a treatment system can tie a knot according to the operation close to the knotting habit of the operation of the initial operation after the target stitching tissue is stitched. Conventionally, knotting in vivo has been a difficult problem because the force applied in vivo is only upward, so that the target suture tissue is pulled, if the force is too strong, the tissue is damaged, if the force is too weak, the knotted knot is not tight, and if the tissue moves, the knotted knot is likely to be loose, and the suture needs to be sutured again. The utility model provides a suture instrument, treatment device and treatment system when knoing, carry out similar simple and direct operation with sewing up, constitute "knot" by suture needle guide stylolite, it is taut with both ends stylolite through the hook pincers ware at last, the power of exerting oneself when knoing is the level or is close horizontally. Therefore, the knot is moderate in tightness, the wound surface is accurately involuted, the operation is simple, the operation difficulty is reduced, any clamp is not left in a human body, and the difficult problem of knotting in the prior art is solved. Can be suitable for closing and suturing wounds or tissues in different ranges, and can select layered or full-layered suturing.

In order to make the aforementioned and other objects, features and advantages of the present invention comprehensible, preferred embodiments accompanied with figures are described in detail below.

Drawings

Fig. 1A is a schematic view of a suturing device according to an embodiment of the present invention.

Fig. 1B is a schematic view of another angle of the suturing device according to an embodiment of the present invention.

FIG. 2A is a schematic view of a main housing of a suturing device in accordance with an embodiment of the present invention.

Fig. 2B is a schematic view of the first housing and the second housing of fig. 2A after being separated.

FIG. 2C is another perspective view of the main housing of the suturing device in accordance with an embodiment of the present invention.

FIG. 3A is a schematic view of a needle insertion assembly of a suturing device according to an embodiment of the present invention (with the first and second pull cords shown only in part).

FIG. 3B is an exploded view of the needle insertion assembly of the suturing device in accordance with one embodiment of the present invention.

FIG. 3C is a schematic view of an assembled state of the needle insertion assembly and the main housing of the suturing device according to an embodiment of the present invention.

FIG. 4A is a schematic view of a suturing needle of the suturing device according to an embodiment of the present invention.

FIG. 4B is a schematic view of another embodiment of a suturing needle of the suturing device of the present invention.

FIG. 4C is a side view of a suturing needle of the suturing device in accordance with an embodiment of the present invention.

FIG. 5A is an exploded view of an anti-backup needle assembly of a suturing device according to an embodiment of the present invention.

FIG. 5B is a partially assembled view of an anti-backup needle assembly of a suturing device according to an embodiment of the present invention.

FIG. 5C is a schematic view of an assembled state of the anti-retreat needle assembly, the suturing needle and the main housing of the suturing device according to an embodiment of the present invention.

FIGS. 6A-6D are schematic views showing different states of the anti-retreat needle assembly, the suturing needle and the needle insertion assembly of the suturing device according to an embodiment of the present invention during actuation.

Fig. 7A is a schematic view of an operating handle according to an embodiment of the present invention.

Fig. 7B is a schematic view of another angle of the operating handle according to an embodiment of the present invention.

Fig. 8A is an exploded view of a safety switch assembly of an operating handle according to an embodiment of the present invention.

Fig. 8B is a schematic view illustrating an installation of the safety switch assembly of the operating handle according to an embodiment of the present invention.

Fig. 9A is an exploded view of an inner ring assembly of an operating handle according to an embodiment of the present invention.

Fig. 9B is a schematic view illustrating an installation of an inner ring assembly of an operating handle according to an embodiment of the present invention.

Fig. 10A is an exploded view of a clutch assembly of an operating handle according to an embodiment of the present invention.

Fig. 10B-10F are schematic views illustrating an installation of the clutch assembly and the front and rear cases of the operating handle according to an embodiment of the present invention.

Fig. 11A is an exploded view of a lever assembly of an operating handle according to an embodiment of the present invention.

Fig. 11B to 11D are schematic views illustrating installation of the operation lever assembly and the front and rear cases of the operation handle according to an embodiment of the present invention.

Fig. 12A is an exploded view of a torque limiter assembly of an operating handle according to an embodiment of the present invention.

Fig. 12B and 12C are schematic views illustrating an installation of the torque limiter assembly of the operating handle with the front case and the rear case according to an embodiment of the present invention.

Fig. 13A is a schematic view illustrating an installation of an operating handle and an endoscope according to an embodiment of the present invention.

Fig. 13B is a schematic view illustrating another angle installation of the operating handle and the endoscope according to an embodiment of the present invention.

Fig. 14A to 14G are schematic assembly views illustrating an operating handle according to another embodiment of the present invention.

Fig. 15A is a schematic view illustrating an installation of a connection ring and an endoscope according to an embodiment of the present invention.

Fig. 15B is a schematic view illustrating an installation of the coupling ring, the suture instrument and the endoscope according to an embodiment of the present invention.

Fig. 16A and 16B are schematic views illustrating an installation process of the operating handle and the endoscope according to an embodiment of the present invention.

Fig. 17A and 17B are schematic views illustrating an installation process of the suturing device and the endoscope according to an embodiment of the present invention.

Fig. 18A and 18B, fig. 19A-19C, fig. 20A and 20B, fig. 21A-21C, fig. 22A-22C, and fig. 23A-23M are schematic diagrams illustrating a process of using a therapy system according to an embodiment of the present invention.

Figure 24 is a schematic view of a snare loop of a treatment device according to an embodiment of the present invention.

FIG. 25 is a schematic view of a suturing device in accordance with another embodiment of the present invention.

FIG. 26 is an exploded view of a suturing device in accordance with another embodiment of the present invention.

Detailed Description

The utility model provides a stitching instrument, an operating handle matched with the stitching instrument, a treatment device consisting of the stitching instrument and the operating handle, and a treatment system consisting of the treatment device and an endoscope matched with the treatment device. The stapler can be used to perform in vivo suturing on mammalian tissue, whether the subject is a human or not and whether the object being sutured is live or not. The utility model provides a stitching instrument not only can use with the endoscope cooperation, can also cooperate other devices that can realize turning to the guide to use.

As shown in FIGS. 1A and 1B, the present invention provides a stapler 1 for piercing and stapling tissue for performing a surgical procedure within a body. The suturing device 1 comprises a main housing 11, a needle inserting assembly 12, a suturing needle 13 and a withdrawal prevention needle assembly 14.

In the present embodiment, as shown in fig. 2A to 2C, the main housing 11 includes a first housing 111 and a second housing 112. When the suturing device of the present embodiment is used with a single-channel endoscope, the middle of the first housing 111 may have two

channels

1111, 1112, the first channel 1111 may be sleeved on the distal end of the endoscope, and the second channel 1112 may be used for an external channel tube to pass through to fix the external channel tube. However, the present invention is not limited to this. When the suturing device is used with an endoscope having two forceps channels, the first housing may have only one channel, so that the suturing device can be sleeved on the distal end of the endoscope. In another embodiment, the first housing may not have a channel, but may be secured to the distal end of the endoscope by other means, such as a securing strap.

The present invention does not limit the shape of the first housing 111 and the second housing 112. Preferably, the outer surfaces of the first shell 111 and the second shell 112 of the present embodiment are both smooth surfaces, and have no edges and corners. Through the arrangement, the stitching instrument does not influence the visual field of the front end of the endoscope as far as possible, the front end is convenient for stitching operation in vivo, and the damage caused by touching the tissues in vivo is reduced. In addition, the outer surface is arc-shaped, and the damage to the internal tissues caused by the edges of the shell during operation is also avoided.

In the present embodiment, the first housing 111 has the connection groove 1113, the second housing 112 has the connection protrusion 1123, and the shape and size of the connection protrusion 1123 match the shape and size of the connection groove 1113. The coupling protrusion 1123 is inserted into the coupling groove 1113 to couple the second housing 112 and the first housing 111 together. In the present embodiment, the coupling groove 1113 is formed in an arc shape, and by arranging this, the main housing 11 of the stapler can be brought as close as possible to the distal end of the endoscope without having a convex structure to affect the visual field of the distal end of the endoscope. However, the present invention is not limited to this. In other embodiments, the connecting groove may have other shapes as long as the connecting relationship between the first housing 111 and the second housing 112 is realized. In other embodiments, the second housing has a connecting groove, and the first housing has a connecting protrusion.

In this embodiment, in order to firmly connect the first casing 111 and the second casing 112, a laser welding method may be used to weld the connecting slot 1113 and the connecting protrusion 1123 together to form a connecting seam. The present invention does not limit the fixing manner of the first casing 111 and the second casing 112. In another embodiment, the main housing may not be divided into two parts, i.e., the first housing 111 and the second housing 112, and the main housing may be formed by integral molding. The main housing 56 is divided into two parts to be manufactured, so that each component is simpler to manufacture, easy to standardize and lower in production cost.

In the present embodiment, the second housing 112 has a first sliding slot 1121 and a second sliding slot 1122, and the first sliding slot 1121 and the second sliding slot 1122 are respectively located at two sides of the main body portion of the second housing 112.

In the present embodiment, as shown in fig. 3A to 3C, the needle inserting assembly 12 is disposed on the main housing 11 and forms a detachable engagement relationship with the suture needle 13 to control the advancement of the suture needle 13, so as to perform a suture operation of a target suture tissue (such as a wound tissue, etc.) or a knotting operation of a suture. In the present embodiment, the needle inserting assembly 12 includes a first pulling rope 121, a second pulling rope 122, an upper shell 123, a spring 124, a needle inserting tooth 125 and a sliding block 126.

In the present embodiment, the needle inserting assembly 12 includes two pulling ropes, namely a first pulling rope 121 and a second pulling rope 122. The two pull ropes are controlled to control the movement of the needle inserting assembly in different directions, the operation is simple and understandable, and the risk of operation failure is greatly reduced. However, the present invention is not limited thereto, and in other embodiments, the needle inserting assembly 12 may have only one pull rope, and the advancing control of the suture needle is realized by the retraction and pulling of one pull rope. In this case, other structures of the needle insertion assembly are changed correspondingly, for example, a gear slide or a connecting rod rotation mode is adopted to enable a pull rope to realize bidirectional control. In another embodiment, the needle insertion assembly 12 may be configured without a pull cord, and the control of the suture needle may be achieved by other structural alternatives.

In this embodiment, the first rope 121 and the second rope 122 have

stoppers

1211 and 1221 at one end thereof, respectively. In practical applications, the

stoppers

1211 and 1221 may be knots or specially made plastic blocks. The utility model discloses do not do any restriction to the form and the material of dog, as long as the diameter of dog is greater than the diameter of the rope body part of first stay cord 121 and second stay cord 122 can. In other embodiments, the first pulling rope 121 and the second pulling rope 122 may not have a stopper, and one end of the first pulling rope 121 and one end of the second pulling rope 122 may be fixed on the sliding block 126 by adhesion.

In the present embodiment, the upper case 123 has two through holes 1231 and two upper fixing holes 1232. The through hole 1231 allows the string body portions of the first and

second strings

121 and 122 to pass therethrough, and the upper fixing hole 1232 allows a fixing member (e.g., a screw) to pass therethrough so as to fix the upper case 123 to the second case 112 of the main case 11. Preferably, the upper shell 123 also has two extensions 1233. When the upper shell 123 is covered on the second sliding slot 1122 of the second housing 112, the extension 1233 just wraps the side surface, so as to reduce the possible damage to the tissue in the body caused by the gaps or corners formed after the elements and the elements are assembled. However, the present invention does not limit the specific shape of the upper case 123.

In the present embodiment, the needle insertion teeth 125 include a tooth portion 1251 and a stopper 1252. The top end of the tooth 1251 is a slope and can be engaged with a slot of the needle 13 (described in detail below). One end of the spring 124 abuts against the stopper 1252 and the other end abuts against the upper case 123.

In this embodiment, the slider 126 has two side holes 1261 and a central hole 1262. The two side holes 1261 may allow the string body portions of the first and

second strings

121 and 122 to pass through, but catch the

stoppers

1211 and 1221 of the first and

second strings

121 and 122, that is, the outer diameters of the

stoppers

1211 and 1221 are larger than the inner diameters of the side holes 1261. The central bore 1262 allows the tooth 1251 of the needle inlet tooth 125 to pass through, but the stop 1252 of the needle inlet tooth 125 cannot pass through the central bore 1262.

In practical use, the first pulling rope 121 and the second pulling rope 122 respectively pass through the side hole 1261 of the sliding block 126 and then pass through the through hole 1231 of the upper shell 123. The needle feed dog 125 is mounted in a central bore 1262 of the slider 126 and one end of the spring 124 abuts against a surface of the needle feed dog 125. The needle feeding teeth 125, the sliding block 126, and the spring 124 are mounted in the second sliding slot 1122 of the second housing 112 and can slide in the second sliding slot 1122, and the upper housing 123 covers the second sliding slot 1122. One end of the first pulling rope 121 and the second pulling rope 122 is fixed on the sliding block 126, the other end is fixed on the operating handle, and the needle inserting tooth 125 penetrates through the sliding block 126. When the pull rope is pulled, one end of the tooth portion of the needle insertion tooth 125 is clamped with the clamping groove on the suture needle, and then the suture needle is driven to move forward, so that the needle insertion, the needle pulling and the threading are performed in a circulating reciprocating manner.

In this embodiment, as shown in FIGS. 4A-4C, the suture 131 can be fixedly or detachably fixed to one end of the needle 13, and the other end of the needle 13 is pointed to pierce the tissue. In this embodiment, one side of the needle 13 has four slots 132, and the other side has three slots 132. By the arrangement, the needle feeding teeth of 60 degrees and 120 degrees can be realized, so that the forward stroke control of the sewing needle 13 is more flexible. If only 180 degrees of needle insertion of the suture needle needs to be controlled, a plurality of clamping grooves are not needed. In this embodiment, in order to prevent the suture needle from being thinned, the two side notches are arranged in a staggered manner, that is, the two sides of the same place are not completely provided with corresponding notches. With this arrangement, the suture needle is not easily bent, deformed or broken. However, the present invention is not limited to this.

The tooth 1251 of the needle feeding tooth 125 is detachably engaged with the notch 132 of the suture needle 13. The utility model discloses do not do any restriction to the quantity of draw-in groove 132. In this embodiment, each slot 132 is asymmetric, and has a first side with a larger inclined plane a for blocking, and a second side with a smaller inclined plane b, which is matched with the inclined plane at the top end of the tooth 1251. The tooth 1251 is inclined at the top end, and the tooth 1251 can slide out of the engaging groove 132 through the inclined surface b under the action of the pulling rope, thereby releasing the engagement between the needle feeding teeth 125 and the suture needle 13. In this embodiment, the angle between the inclined surface a of each engaging groove 132 and one side surface c of the needle 13 is 60 ° to 90 °, and the angle between the inclined surface b of the other side surface b and the side surface c of the needle 13 is 10 ° to 45 °. However, the present invention does not limit the specific degree of the tilt angle. In this embodiment, the inclined plane b is not a plane but an arc-shaped plane, which is more beneficial to sliding the top end of the tooth portion 1251 out of the slot 132 so as to release the engagement relationship between the needle feeding tooth 125 and the slot 132.

The sewing needle 13 of the present embodiment is a suture needle with thread. Specifically, the tail of the needle 13 has a conical recess into which one end of the suture thread 131 is inserted, and then the tail of the needle 13 is pressed, thereby fixing the suture thread 131 to the tail of the needle 13. However, the present invention is not limited to this. In other embodiments, the suture may be removably secured to one end of the needle by other means, such as by conventional needle threading. In this embodiment, the suture needle 13 can be made of stainless steel, and the diameter of the cross section of the suture needle 13 can be 8mm, 10mm, 12mm, etc., however, the present invention does not limit this, and the suture needle with proper size can be selected according to the actual treatment requirement. In this embodiment, the length of the suture line 131 is 30cm-60cm, and the suture line 131 may be polypropylene line, nylon line, etc., and the present invention is not limited to the length and material of the suture line. In other embodiments, a bioabsorbable suture may be used, which may eliminate the need to remove the suture, reducing the risk of a secondary operation on the patient.

In the present embodiment, as shown in fig. 5A to 5C, the retreat preventing needle assembly 14 is provided on the main casing 11 and detachably engaged with the suture needle 13 to prevent retreat of the suture needle 13. The needle insertion assembly 12 and the needle withdrawal prevention assembly 14 are respectively located on both sides of the suture needle 13.

In the present embodiment, the anti-back needle assembly 14 includes a lower shell 141, an anti-back needle tooth 142, and a spring plate 143. The lower case 141 has two positioning holes 1411 and two lower fixing holes 1412, the two needle-withdrawal prevention teeth 142 are respectively installed in the two positioning holes 1411, and the lower fixing holes 1412 are penetrated by fixing members (e.g., screws) to fix the lower case 141 to the second case 112 of the main case 11. The elastic sheet 143 also has a fixing hole for a fixing member (e.g., a screw) to pass through so as to fix the elastic sheet 143 to the second housing 112 of the main housing 11. In the actual assembly, the suture needle 13 is first disposed in the first sliding slot 1121 of the second housing 112, then the lower shell 141 with the needle-withdrawal prevention teeth 142 is covered on the first sliding slot 1121, and then the elastic piece 143 is fixed to the second housing 112.

The tip of the needle withdrawal prevention tooth 142 can be engaged with the engaging groove 132 of the suture needle 13. In this embodiment, the top ends of the two needle withdrawal prevention teeth 142 are set to be inclined planes. The inclined plane is matched with the inclined plane b of the clamping groove 132 in inclination angle, so that the anti-withdrawing needle teeth 142 can slide out of the clamping groove 132 through the inclined plane b under the acting force of the pull rope. Specifically, the needle insertion teeth 125 and the needle withdrawal prevention teeth 142 are respectively located on both sides of the suture needle 13, and are respectively detachably engaged with the engaging groove 132 of the suture needle 13. The term detachably engaged in this context means that the engagement relationship may be formed or released. The needle inlet teeth 125 and the needle withdrawal prevention teeth 142 are in a detachable clamping relationship with the suture needle, so that complex functions (such as suture of target suture tissue and knotting of suture thread) can be realized through a simple structure, and the suture instrument occupies a small volume and is low in manufacturing cost. The utility model does not limit the shape of the top ends of the needle inserting teeth 125 and the needle withdrawing preventing teeth 142. In other embodiments, the tips of the needle insertion teeth 125 and the needle withdrawal prevention teeth 142 may also be curved to facilitate sliding. As long as can form the block relation and can remove the structure of mutually supporting of block relation with sewing up the aciculiform, can both realize the utility model discloses a function is also the utility model discloses the within range that wants the protection.

In this embodiment, the elastic sheet 143 applies elastic pressure to the anti-withdrawal pin teeth 142 by means of its own elastic force, so that the anti-withdrawal pin teeth 142 can slide out of the slot 132 under the action of external force, and can press the anti-withdrawal pin teeth 142 by means of the elastic force to be clamped in the slot 132.

In order to more clearly illustrate how the suturing device provided by the embodiment of the present invention performs the suturing operation of the target sutured tissue, the following description is made with reference to fig. 6A to 6D. The left side (a) and right side (b) of each of fig. 6A-6D are in a top and bottom relationship. Not all elements are shown in the drawings to clearly illustrate the location of the internal components. The "back" mentioned in the following description is from the viewpoint of the left side (a) in fig. 6A to 6D, for example, the upper side in (a) is defined as the front side, and the lower side is the back side, which is shown as the upper side in (b) since (a) and (b) are in a mirror-image-like relationship.

FIG. 6A shows the positions of the needle feeding teeth, the needle and the needle withdrawal prevention teeth of the suturing device in the initial state, wherein the needle feeding teeth 125 of the needle feeding assembly 12 are engaged with one of the engaging grooves 132 of the needle 13 at the tail end of the needle 13, i.e., near one end of the suture thread, in the initial state. One of the needle withdrawal prevention teeth 142 of the needle withdrawal prevention assembly 14 (the needle withdrawal prevention tooth 142 on the right side as shown in fig. 6A (b)) is engaged with one of the engaging grooves 132 on the back surface of the needle 13 at the tip end of the needle 13, i.e., the end near the tip end of the needle. At this time, when the first pull cord 121 is pulled, the needle feeding teeth 125 are engaged with the engaging grooves 132 of the suture needle 13, and the force is applied in such a direction that the tip ends of the needle feeding teeth 125 abut against the side of the engaging grooves 132 having a large inclination angle. Under the action of external force, the pulling rope 121 pulls the needle feeding teeth 125, thereby carrying the entire suture needle 13 forward in the clockwise direction as shown in fig. 6A (a). The needle withdrawal prevention teeth 142 are counterclockwise with respect to the running direction of the sewing needle 13 (actually, the needle withdrawal prevention teeth 142 do not move, but the sewing needle 13 moves clockwise), and the needle withdrawal prevention teeth 142 can slide out of the clamping groove through the inclined surface of the clamping groove 132 without causing any obstruction to the running of the sewing needle 13. In this process, the sharp end of the needle 13 is exposed from the main housing 11, and then pierces the tissue to be sutured, and the suture thread is driven through the target sutured tissue, and then after half a turn, the sharp end of the needle 13 is returned to the first sliding groove 1121 of the main housing 11.

At this time, as shown in fig. 6B, the needle feeding teeth 125 have already slid to the end of the second sliding slot 1122 and cannot advance further, and the first rope 121 cannot be pulled further. The force applied by the first pull cord 121 and the force applied by the second pull cord 122 are in opposite directions for the needle feed dog 125. The user then pulls the second pull cord 122, and the needle insertion teeth 125 will slide out of the notch 132 past the slope of the notch 132, and then back in the counterclockwise direction as shown in fig. 6B (a), until they return to the initial position. In this process, the other needle withdrawal prevention tooth 142 (the needle withdrawal prevention tooth 142 located on the left side as shown in fig. 6B) is caught in one catching groove 132 on the back surface of the suture needle 13, and since the tip of the needle withdrawal prevention tooth 142 abuts against the side of the catching groove 132 having a larger inclination angle, the needle withdrawal prevention tooth 142 does not disengage from the catching groove 132, and therefore, the suture needle 13 does not move backward.

As shown in fig. 6C, the needle feeding teeth 125 return to the initial position, and the second pull rope 122 cannot pull the needle feeding teeth 125 any more. At this time, the needle feeding tooth 125 is engaged again with one of the engaging grooves 132 of the needle 13 at the end near the tip end of the needle. Correspondingly, the needle withdrawal prevention tooth 142 on the left side shown in fig. 6C (b) continues to be caught in the catching groove 132 on the back surface of the needle 13, i.e., the catching position is located at the end close to the tip end of the needle. Then, the first pulling rope 121 is pulled, and the direction of the force is such that the tip of the needle insertion tooth 125 abuts against the side of the catching groove 132 where the inclination angle is large. Under the action of external force, the pulling rope 121 pulls the needle feeding teeth 125, so as to drive the whole sewing needle 13 to continue to move clockwise. In this process, the needle withdrawal prevention tooth 142 which has just been engaged slides out of the card slot 132 through the inclined surface of the card slot 132 without causing any hindrance to the travel of the suture needle 13.

When the needle inserting tooth 125 has slid to the end of the second sliding slot 1122 and cannot advance further, the first pulling rope 121 cannot be pulled further, and is located at the position shown in FIG. 6D, so that the sewing needle completes one round of travel. At this time, the engagement position of the needle feeding tooth 125 and the needle 13 is located at one end close to the tip end of the needle, and the needle withdrawal preventing tooth 142 located at the right side shown in fig. 6D (b) is engaged with the engaging groove 132 of the needle 13.

The second pull cord 122 is then pulled to repeat the above-described operations, and the suturing needle carries the suture thread to complete the suturing of the target tissue or the knot-threading of the suture (threading needle). As can be seen from fig. 6A to 6D, the needle insertion teeth 125 are alternately engaged with the engaging grooves at the tip or the tail end of the suture needle, and the needle insertion teeth 125 and the suture needle 13 move together and also move relatively (the suture needle 13 does not move, and the needle insertion teeth 125 move). The needle withdrawal preventing teeth 142 do not move, and the suture needle 13 moves relative to the needle withdrawal preventing teeth 142, so that the two needle withdrawal preventing teeth 142 are alternately engaged with one of the engaging grooves 132 of the suture needle 13.

The utility model also provides a use method of stitching instrument, including following step:

the above four steps are repeated to perform the suturing of the target suture tissue or the knotting operation of the suture.

Particularly, the utility model provides a use method of stitching instrument, including following step:

in the initial state, the needle inserting teeth of the needle inserting component are clamped on the clamping groove of the suture needle. The first pull cord of the needle insertion assembly is operated so that the suture needle and the needle insertion assembly travel together forward along the slide groove. In this process, the needle insertion assembly moves within the main housing from one end of the chute to the other, and the sharp end of the suturing needle emerges from the main housing and travels a stroke (e.g., a half-turn) back into the main housing. The term "forward" in the context of "forward travel" as used herein is not a straight direction. When "front" refers to movement in a clockwise direction, "rear" refers to movement in a counterclockwise direction. When "front" refers to movement in a counter-clockwise direction, "rear" refers to movement in a clockwise direction.

At this time, the needle insertion unit cannot be slid further, and the first cord cannot be pulled further. Then the second pull rope of the needle inserting assembly is pulled, so that the needle inserting assembly moves backwards, and the needle inserting assembly moves from the other end of the chute where the needle inserting assembly just locates to the first end in the main shell until the needle inserting assembly can not move any more. In the process, the anti-withdrawal needle assembly is clamped with the suture needle, the clamped position is close to the tip end of the suture needle, and the suture needle is fixed under the action of the anti-withdrawal needle assembly in the process.

Then operating the first pull rope of the needle inserting assembly to enable the suture needle and the anti-withdrawal needle assembly to advance forwards together, and in the process, the needle inserting assembly moves from one end of the sliding chute to the other end in the main shell again, and the sharp end of the suture needle is ready to be exposed out of the main shell;

and continuing to operate the second pull rope of the needle inserting assembly, so that the needle inserting assembly moves backwards until the needle is clamped on the sewing needle and cannot move, and the clamping position is close to one end of the sewing needle with the sewing thread. In the process, the anti-withdrawal needle assembly is clamped with the suture needle, the clamped position is close to the tip end of the suture needle, and the suture needle is fixed under the action of the anti-withdrawal needle assembly in the process.

In one embodiment, the operation of the needle insertion assembly is performed by operating the operating handle.

In one embodiment, prior to operating the needle insertion assembly, the method further comprises looping tissue with a snare loop at a distal end of the endoscope.

In one embodiment, after all the above steps are completed, the method further comprises the step of clamping two ends of the suture thread at the front end of the endoscope by using a hook forceps so as to complete the knotting action of the suture thread.

In another aspect, the present invention also provides a therapeutic device comprising the above-mentioned suturing device 1 and the operating handle 6. As shown in FIGS. 7A and 7B, the operating handle 6 of the present embodiment is used in conjunction with the suture instrument 1 of the present embodiment. In the present embodiment, the operating handle 6 includes a safety switch assembly 61, an inner ring assembly 62, a clutch assembly 63, an operating rod assembly 64, a torque limiter assembly 65, a rear housing 66, and a front housing 67.

As shown in fig. 8A and 8B, the safety switch assembly 61 includes a safety switch 611 and a compression spring 612. The compression spring 612 is fitted into a hole of the safety switch 611 and is then fitted into the safety switch groove 661 of the rear case 66 together.

As shown in fig. 9A and 9B, the inner circular ring assembly 62 includes an inner circular ring 621, a washer 622, and a screw 623. The inner ring 621 is inserted into the central hole 6521 of the central shaft 652, fitted with the washer 622, and screwed down with the screw 623. In this embodiment, the inner circular ring 621 has a square hole 6211 and two knotting holes 6212 (see fig. 7A).

As shown in fig. 10A-10F, the clutch assembly 63 includes compression springs 631 and 632, a limit pin 633, a screw 634, a limit 635, and an operating handle clutch lever 636. The compression spring 632 is fitted into the hole of the operating handle clutch lever 636, fitted together into the stopper 635, fitted together into the side hole 671 of the front case 67, and the screw 634 is fitted into the screw hole 672 and tightened. The compression spring 631 is fitted into the stopper pin 633 together with the square hole 662 of the rear case 66.

As shown in fig. 11A to 11D, the operation lever assembly 64 includes a tension spring 641, a transmission gear 642, an operation handle lever 643 and a gear connection block 644. A tension spring 641 is fitted to a hook 6431 of the operating handle lever 643 to be fitted together into a side groove 672 of the front case 67 and a bottom circular hole 673, the tension spring 641 is fitted into a cylinder 674 of the front case 67, and the transmission gear 642 is fitted into a bottom circular hole 675 of the front case 67. The compression spring 631 is fitted into the stopper pin 633 together with the square hole 662 of the rear case 66. After the rear case 66 is covered, the gear connecting block 644 is inserted into the operating handle lever 643 and the transmission gear 642.

As shown in fig. 12A-12C, the torque limiter assembly 65 includes a slotted gear 651, a central shaft 652, an outer ring 653, a compression spring 654, and a hex nut 655. The center shaft 652 is fitted into the center circular hole 676 of the front case 67, the grooved gear 651 is fitted into the center shaft 652, the center circular hole 663 of the rear case 66 is fitted into the center shaft 652, and the outer ring 653, the compression spring 654, and the hexagonal nut 655 are fitted into the center shaft 652. In this embodiment, the outer ring 653 has a square hole 6531 and two tie holes 6532 (see fig. 7B).

In another aspect, the present invention also provides a therapeutic system comprising the above-mentioned therapeutic device and an endoscope 2. The treatment device is used with an endoscope and comprises an operating handle and a stitching instrument. Fig. 13A and 13B are schematic views of the operating handle 6, the first pull cord 121, and the second pull cord 122 attached to the flexible endoscope 2.

The first pulling rope 121 and the second pulling rope 122 pass through the insertion jaw 23 of the flexible endoscope 2, pass through the hole of the operation handle 6, and are respectively tied to the inner circular ring 621 and the outer circular ring 653. The operating handle 6 is mounted to the insertion jaw 23 of the flexible endoscope 2 and fixed by a handle fastener.

The operating principle of the operating handle is as follows: pushing the safety switch assembly 61 open, pulling the operating handle pull rod 643 in the operating rod assembly 64, transmitting the force to the transmission gear 642 through the gear connecting block 644, and then to the grooved gear 651 in the torque limiter assembly 65, driving the outer ring 653 to rotate, and thus driving the first pull cord 121. Wherein the tension spring 641 can reset the operation rod assembly 64 to realize continuous pulling. The compression spring 654 can restrict the transmission of an excessive force to disengage the grooved gear 651 and the outer ring 653, thereby protecting the first cord 121 from being broken by the excessive force. The operating handle lever 635 of the slip clutch assembly 63 is then slid to disengage the limit pin 632 from the outer ring 653, so that the outer ring 653 is free to rotate. The inner hoop 621 of the inner hoop assembly 62 is rotated to drive the second pull cord 122.

The utility model discloses do not do any restriction to operating handle's concrete structure, as long as can realize this embodiment operating handle's function, the ware of sewing up that all can cooperate this embodiment to provide uses. In other embodiments, the stapler is contemplated to be used alone without the operating handle. The stapler may have a pull ring provided at an end of the pull cord, and the pull cord is pulled by pulling the pull ring.

As shown in fig. 14A to 14G, another embodiment of the present invention provides an operating handle 8. The operating handle comprises a spring cap 811, a screw 812, a driving wheel 813, a spring 821, an anti-back tooth 822, a shaft 831, springs 832 and 833, a pull rod 834, a screw 835, a key 841, a rear shell 842, a first connecting piece 851, a second connecting piece 852, a driven wheel 86, a front shell 87, a torsion spring 881, a cover plate 882, a screw 883, a shaft 891 and a sliding block 892. The connection between the elements can be clearly seen in the assembly process shown in the figure, and the detailed description is omitted here.

Pulling the pull rod 834 drives the driving wheel 813 to rotate counterclockwise. When the pull rod 834 is released, the spring 832 resets the pull rod 834 to realize reciprocating pulling, and the driving wheel 813 continuously rotates anticlockwise. The anti-back teeth 822 are intended to prevent the drive wheel 813 from rotating clockwise when the pull rod 834 is released. The push button 841 is pressed to drive the driving wheel to move along the axis (along the left side of the axis in the drawing) through the first connecting piece 8511 and the second connecting piece 852. The driving wheel 813 rotates counterclockwise continuously, and drives the driven wheel 86 to rotate together. The key 841 is pressed to drive the driving wheel 813 to move along the axis (along the left side of the axis in the figure) through the first connecting piece 8511 and the second connecting piece 852, and the driving wheel 813 is separated from the driven wheel 86 at the moment. The driving wheel 813 rotates counterclockwise continuously, and drives the driven wheel 86 to rotate together. The key 841 is pressed to drive the driving wheel to move along the axis (along the left side of the axis in the drawing) through the first connecting piece 8511 and the second connecting piece 852, and the driving wheel 813 is separated from the driven wheel 86. The torsion spring 881 drives the driven wheel 86 to rotate clockwise to reset. And finishing the installation of the operating handle. Rotation of follower 86 causes slider 892 to slide along axis 891. Thereby driving the tightening and loosening of the two pull ropes of the stitching instrument.

Compare the operating handle of the previous embodiment, the operating handle that this embodiment provided only needs slightly hard when the operation to can realize one-hand operation, and only need two fingers of one hand to accomplish, the action direction is changed into one-way by the multiaspect, and the volume reduces, and the preparation link reduces, cost reduction.

In this embodiment, the treatment device may further comprise a connection ring 4. The connecting ring 4 is made of silica gel and has elasticity. However, the utility model discloses do not do any restriction to the material of go-between. As shown in FIGS. 15A and 15B, the external forceps tube 3, the knotting tube 5, the attachment ring 4, and the stapler 1 are attached to the endoscope 2. Specifically, the external forceps tube 3 is fixed to the flexible tube portion 21 of the endoscope 2 via the coupling ring 4, and the knotting tube 5 is fitted into an inner hole of the external forceps tube 3. Another attachment ring 4 is fitted over the distal end 22 of the endoscope 2, and the stapler 1 is fitted over the attachment ring 4 to fix the stapler 1 to the distal end 22 of the endoscope 2. The head end 31 of the external forceps tube 3 is inserted into the stapler 1. The coupling ring 4 in this embodiment can function to fix both the external forceps tube 3 and the endoscope 2, and also can increase the coupling strength of the distal end 22 of the endoscope 2, so that the suture instrument 1 can be firmly fixed to the distal end 22 of the endoscope 2. In practical use, the plurality of connecting rings can be distributed along the hose of the endoscope at multiple points, thereby dispersing the stress. The existing treatment device of Apollo intracorporeal operation company only fixes the front end and the operation end, and is very easy to assist the endoscope to bend passively.

In this embodiment, the treatment device may further comprise a snare loop 7, as shown in fig. 24. The snare loop 7 performs a loop cut of tissue at the tip of the endoscope or cuts the tissue by electric current. Then, the suturing device provided by the embodiment is used for suturing the target sutured tissue. The ring-surrounding ring 7 can enter through the forceps channel of the endoscope itself or enter through the external forceps channel of the endoscope, and is not limited at all.

In this embodiment, the treatment device may further include a hook forceps 9 (as shown in fig. 18B), the hook forceps 9 performs a tissue grasping operation or a suture hooking operation at the distal end of the endoscope, and finally may grasp both ends of the suture to complete a knotting operation of the suture. The hook forceps can enter through the forceps channel of the endoscope and can also enter through the external forceps channel of the endoscope, and no limitation is made here. In practical use, the hook clamp can simultaneously extend into two hook clamps through two clamp paths to work, and also can work by only using one hook clamp. In this embodiment, the front end of the hook forceps is in the shape of a forceps with a hook.

Through the ring lantern ring, stitching instrument and hook forceps ware, the treatment device and the treatment system that this embodiment provided can realize multiple functions such as the cutting of tissue, suture, knot. In addition, the treatment device and the treatment system provided by the embodiment can further comprise biological glue, plugging glue, a stent, an anastomosis nail and an anastomosis clip, so that the diversification of functions is realized.

Next, how to attach the treatment device of the present invention to the endoscope will be described. Optionally, the endoscope can be matched with an endoscope with the end diameter of 98mm, the diameter of the forceps channel of less than or equal to 2mm and the working length of less than or equal to 1300 mm. The utility model does not limit the model of the endoscope.

First, as shown in fig. 16A and 16B, the operation handle 6 is attached to the operation end of the endoscope 2, and the operation handle 6 and the endoscope 2 are firmly fixed together by the handle fastener 68. In the present embodiment, the handle fastener 68 is in the form of a band, and fastens the operation handle 6 and the endoscope 2 by passing the band around the endoscope 2. However, the present invention is not limited to any shape of the handle fastener 68, and any shape may be used as the handle fastener as long as the shape can achieve the fixing function.

Next, as shown in FIGS. 17A and 17B, the coupling ring 4 is fitted over the distal end 22 of the endoscope 2, and the suture instrument 1 is fitted over the coupling ring 4 at the distal end 22 of the endoscope 2. The endoscope 2 is turned on, and the direction of the stapler 1 is adjusted to the C-shaped opening downward under the monitor. After the position is adjusted, the stapler 1 is tightly sleeved until the step surface of the sleeve ring of the stapler 1 is tightly pressed against the front end 22 of the endoscope 2.

As shown in fig. 18A and 18B, the hook forceps 9 is inserted from the insertion jaw of the endoscope 2, reaches the distal end of the endoscope 2 through the forceps channel, and then the first pull cord 121 of the suture instrument is grasped, and the first pull cord 121 located near the distal end is pulled into the forceps channel. The hook forceps 9 is then removed and pulled out from the insertion jaw 23, thereby bringing one end of the first cord 121 out of the insertion jaw 23 (the arrow in the figure indicates the direction of movement of the hook forceps 9). The two pull ropes are distinguished at the thread outlet on the stitching instrument 1. Preferably, the ends of the first and second drawstrings may be marked differently. The present invention is not limited to this, and in other embodiments, the first pulling rope and the second pulling rope may be identical and distinguished by the operator. In other embodiments, the first and second pulling ropes can be marked by material, color, etc. for easy distinction.

As shown in fig. 19A to 19C, the square hole 6211 of the inner circular ring 621 of the operating handle 6 is aligned with the side hole 671 of the front case. The first pulling rope 121 pulled out of the inserting jaw 23 is threaded into the square hole 6211 of the operating handle and then tightened through the two binding holes 6212 on the wing of the inner circular ring 621). The inner ring is rotated clockwise to wind the first pull cord 121 loose the cord outside the operating handle into the circular groove of the inner ring 621.

As shown in fig. 20A and 20B, the hook forceps 9 is inserted again from the insertion jaw 23 of the endoscope 2, reaches the distal end of the endoscope 2 through the forceps channel, and then the second pull cord 122 of the suture instrument is grasped to pull the second pull cord 122 located near the distal end into the forceps channel. The hook forceps 9 are then removed and pulled from the insertion jaw, thereby pulling one end of the second pull cord 122 out of the insertion jaw.

As shown in fig. 21A-21C, the square hole 6531 of the outer ring of the operating handle is aligned with the side hole 664 of the rear housing. The first pulling rope 121 pulled out of the inserting jaw is threaded into the square hole of the operating handle and then tightened through the two binding holes 6532 on the wheel wing of the outer ring 653. Rotating the outer ring clockwise loosens the second pull cord 122 from the cord on the outside of the handle, wrapping into the circular groove of the outer ring 653.

In one embodiment, the endoscope 2 may be a single-channel endoscope. As shown in FIGS. 22A-22C, an external clamp tube 10 is first attached to the endoscope 2. The leading end of the external forceps tube 10 is inserted into the second channel 1112 at the edge of the first housing of the stapler until it abuts against the stepped surface 1114 of the second channel 1112. A plurality of coupling rings are distributed along the forceps channel direction, and the external forceps channel tube 10 and the hose portion of the endoscope 2 are fastened by the coupling rings. The knotter tube 20 is inserted into the external clamp tube 10.

In another embodiment, the endoscope may be a dual-channel endoscope. In this case, no external clamp tube is required to be installed. Because the endoscope has two forceps channels, the push-knot tube only needs to be inserted into the vacant forceps channels.

Next, how the suture instrument of the present invention performs the suture will be described.

First, as shown in fig. 23A, the hook forceps 9 is inserted from the insertion jaw of the endoscope, reaches the tip of the endoscope through the forceps channel, and then finds and grips the suture 131. The other grasper 9 is inserted into the knot pushing tube, reaches the distal end of the endoscope, grasps the edge of the target suture tissue 30, and is withdrawn in a direction to bring the target suture tissue 30 in the middle of the C-shaped opening of the stapler (two strings are not shown in the drawing). As shown in FIGS. 23B and 23C, the handle pull 643 is continuously pulled back to advance the needle through the tissue. The depth of the suture (full or layered) depends on the wound or non-invasive tissue treatment.

As shown in FIGS. 23D and 23E, the pulling back lever 643 is stopped after the needle 13 is rotated 180 degrees in the needle track (i.e., the first sliding groove). The knob of the inner circular ring 621 of the operating handle is then gently lifted by hand to pull out about 3mm while rotating clockwise to tighten the second cord 122. Further pulling back the handle rod 643 rotates the needle 13 180 ° in the first chute to the initial position. The knob of the inner ring 621 of the operating handle is then lifted slightly to pull out about 3mm, while rotating clockwise to tighten the second cord 122. For larger sutured objects, one side of the target tissue may be sutured first, the other side of the target tissue may be sutured, the suture may be appropriately tightened, and tied. As shown in fig. 23F, the two grapple devices 9 are released. As shown in FIG. 23G, the grasper 9 of the internal channel grasps the suture 131 at the leading end (near the needle) and pulls the suture 131 through the tissue. As shown in FIG. 23H, the grasper 9 of the other knotting tube grasps the trailing end of the suture thread 131, and adjusts the position of the stapler on the endoscope 2 so that the trailing end of the suture thread 131 is inside the C-shaped opening of the stapler and the leading end of the suture thread 131 is outside the C-shaped opening of the stapler.

As shown in FIG. 23I, the handle is continuously pulled back, and the resistance of the pull rod is increased after the monitor sees that the suture needle is inserted for about half a turn, i.e. the pull rod is stopped. The inner ring knob of the operating handle is lifted by hand to be pulled out, and simultaneously, the clockwise rotation makes the second pull rope tensioned. As shown in FIG. 23J, the handle is continuously pulled back, and the resistance to pulling back the handle is increased after the suture needle is inserted for about half a turn under the monitor, i.e., the pulling back of the handle is stopped. The inner ring knob of the operating handle is lifted by hand to be pulled out, and simultaneously, the clockwise rotation makes the second pull rope tensioned. As shown in FIG. 23K, the needle has been returned to its initial position by one rotation of the needle. The steps described in this paragraph are repeated, i.e., the needle is operated to rotate one more revolution. The above-described sewing steps are repeated to continuously perform the sewing.

As shown in FIG. 23L, the hook forceps 9 for grasping the suture thread tip is released, and after the suture needle passes over and half-knots, the needle is moved forward of the suture thread tip quickly, and the suture thread 131 is grasped again. As shown in FIG. 23M, the two loopers 9 are pulled tight while observing through the monitor, and the knot is gradually pushed tight by the knot pushing pipe 20 to perform knotting. In order to ensure that the knotted knot is firm enough, the knotting operation in the section can be repeated to complete the triple knot.

The knot pushing pipe 20 and the two hooked forceps 9 are withdrawn, the scissors for the endoscope are inserted into the empty forceps channel of the endoscope, and the suture is cut off. And after the suturing is completely finished, withdrawing the endoscope and the auxiliary tool, and detaching the suturing device.

As shown in FIGS. 25 and 26, another embodiment of the present invention provides a stapler. The stapler 1' provided in the present embodiment has substantially the same structure as the stapler 1 provided in the previous embodiment. The same elements as those of the previous embodiment are given the same reference numerals, and only the differences will be described below. The components of the stitching instrument 1' of the embodiment are connected by laser welding, so that the arrangement of screws and lugs is omitted, the number of parts of the device is reduced, the production cost is reduced, and the assembly time is saved. Specifically, the upper shell 123 'of the suturing device provided by the present embodiment does not need to be provided with two upper fixing holes 1232, the lower shell 141' does not need to be provided with two lower fixing holes, and the elastic piece 143 'does not need to be provided with fixing holes, so that the second shell 112' does not need to be provided with three corresponding screw holes.

The "hole" mentioned in the present invention is not necessarily circular, and may be square, oval, etc., and all included in the scope of the "hole" to be expressed by the present invention. The terms "first" and "second" as used herein are used merely for convenience of description for distinguishing between names, and do not necessarily mean that the first and second must exist simultaneously. The upper and lower parts of the utility model are relative positions without any limitation.

To sum up, the suturing device, the therapeutic device and the therapeutic system of the utility model can be used for natural cavity surgery (non-invasive surgery), minimally invasive surgery or open surgery. The suture needle can be controlled to advance only by the needle inserting assembly, so that intermittent suture or continuous suture is performed in soft tissues, the operation is simple, and the risk of operation failure is greatly reduced. In addition, the stitching instrument of the utility model also comprises an anti-withdrawal needle component, so that the continuous advance of the stitching needle is possible. In particular, the needle insertion assembly and the anti-withdrawal needle assembly of the present invention are in a separable engagement with the suture needle, so that complicated functions (e.g., suturing of a target suture tissue and knotting of a suture thread) can be realized by a simple structure, and the suture instrument occupies a small volume and is low in manufacturing cost. If need sewing up of external operation internal tissue among the prior art, must whole supporting adoption rotary drill collude and get the device and just can realize sewing up the function to current colluding rotary drill and getting the device and directly carry out rotary drill to the tissue and collude and then pull up, the utility model discloses a sewing device need not to adopt rotary drill to collude and get the device in the middle of the process of sewing up, can independently realize sewing up the function, has avoided rotary drill to collude and gets the damage of device to the tissue, greatly reduced the operation risk.

Although the present invention has been described with reference to the preferred embodiments, it is to be understood that the invention is not limited to the disclosed embodiments, but is capable of other modifications and variations without departing from the spirit and scope of the invention as defined by the appended claims.

Claims

1. A stapler, comprising:

a main housing;

one end of the suture needle is connected with a suture line, and the other end of the suture needle is a tip end;

the needle inserting component is arranged on the main shell and forms a separable clamping relationship with the suture needle so as to control the advance of the suture needle;

and a withdrawal prevention needle unit which is provided in the main casing and which prevents withdrawal of the suture needle by forming a detachable engagement with the suture needle.

2. The suturing device of claim 1, wherein the main housing has a sliding slot, the needle insertion assembly includes a pull cord, a top case, a spring, a needle insertion tooth and a sliding block, the pull cord passes through the sliding block and the top case, the needle insertion tooth is mounted in the sliding block, one end of the spring abuts against the surface of the needle insertion tooth, the other end of the spring abuts against the top case, the needle insertion tooth, the sliding block and the spring are mounted in the sliding slot of the main housing, and the top case covers the sliding slot.

3. The suturing device of claim 1, wherein the main housing has a slide slot, the anti-withdrawal needle assembly includes anti-withdrawal teeth, a lower housing, and a resilient tab, the anti-withdrawal teeth being mounted to the lower housing, the anti-withdrawal teeth and the lower housing being mounted in the slide slot of the main housing, the lower housing and the resilient tab being secured to the main housing.

4. The stapler of claim 1, wherein the main housing includes a first housing and a second housing, the first housing having a coupling groove, the second housing having a coupling projection inserted into the coupling groove to couple the first housing and the second housing together.

5. A treatment device for use with an endoscope, the treatment device comprising:

a stapler fixed to a distal end of an endoscope, the stapler comprising:

a main housing;

a retreat prevention needle assembly which is arranged on the main shell and forms a separable clamping relationship with the suture needle so as to prevent the retreat of the suture needle;

and the operating handle is fixed at the operating end of the endoscope and controls the needle inserting assembly so as to control the advance of the suture needle.

6. The treatment device of claim 5, further comprising an attachment ring that is mounted on the endoscope.

7. The treatment device of claim 5 further comprising a snare loop, the snare loop performing a cutting action of tissue at a distal end of the endoscope.

8. The treatment device of claim 5, further comprising a hook forceps that performs a tissue grasping action or a suture hook pulling action at a distal end of the endoscope.

9. A therapeutic system, comprising:

an endoscope is provided with a plurality of endoscope heads,

a treatment device used together with an endoscope, the treatment device comprises a stitching instrument and an operating handle,

a stapler is fixed to a distal end of the endoscope, the stapler including:

a main housing;

10. The treatment system of claim 9, wherein the treatment device further comprises an attachment ring, a snare loop, and a grasper, the attachment ring being mounted on the endoscope, the snare loop performing a tissue cutting action at a distal end of the endoscope, the grasper performing a tissue grasping action or a suture hooking action at the distal end of the endoscope.