CN214805154U

CN214805154U - Aorta interbed inner membrane resectoscope

Info

Publication number: CN214805154U
Application number: CN202120918715.0U
Authority: CN
Inventors: 郭宏伟; 刘红; 畅怡; 魏柯; 范舒雅; 刘创; 孙阳雪
Original assignee: Fuwai Hospital of CAMS and PUMC
Current assignee: Fuwai Hospital of CAMS and PUMC
Priority date: 2021-04-29
Filing date: 2021-04-29
Publication date: 2021-11-23
Anticipated expiration: 2031-04-29

Abstract

The utility model relates to the field of medical appliances, in particular to an aortic dissection inner diaphragm excider which comprises a knife handle and a blade; the knife handle is rod-shaped, and the lower end of the knife handle is provided with a notch part; the blade is fixed in the gap portion, and the cutting part of blade is towards the lower terminal surface of handle of a knife and does not surpass the lower terminal surface of handle of a knife. The utility model discloses be convenient for fully excise chronic intermediate layer iris, still be favorable to avoiding hindering the aorta wall simultaneously, improve the operation security.

Description

Aorta interbed inner membrane resectoscope

Technical Field

The utility model relates to the field of medical equipment, especially, relate to an aorta intermediate layer iris resectoscope.

Background

Chronic type a aortic dissection sometimes requires ascending aorta, total arch replacement, and implantation of a trunk stent (or soft trunk, i.e., artificial blood vessel); the implantation of the elephant trunk bracket simplifies the replacement of the second-stage thoracic and abdominal aorta, and the anastomosis is started from the far end of the elephant trunk bracket to complete the replacement of the thoracic and abdominal aorta.

In the chronic period of the aortic dissection, the intima is stiff, and in the case of narrow diameter of the true lumen of the thoracic descending aorta, the trunk stent can not be fully opened after being implanted into the true lumen, but the true lumen is further narrowed due to the implantation of the trunk stent; the narrow patient in true chamber usually because the broken mouth of near-end intima is big, the broken mouth of distal end is little, and the entry and the export of intima broken mouth mismatch lead to true chamber little, the false chamber is big promptly, and the implantation of trunk support has covered near-end intima broken mouth, makes the little intima broken mouth of distal end (former export) become the entry, considers that visceral artery (abdominal cavity trunk artery, superior mesentery artery, renal artery) and iliac artery are the dual blood supply of true and false chamber usually, and the broken mouth traffic is insufficient between true chamber and the false chamber can influence viscera blood supply. The implantation of the trunk support covers the large inner membrane laceration at the near end, leaves the small inner membrane laceration at the far end, and can cause the blood flow between the true and false cavities to be unsmooth due to the small laceration, so that the thrombus formed in the false cavity further influences the blood supply of the viscera.

For the reasons, in order to ensure the blood supply of the far end, an interlayer inner membrane at the near end of the thoracic descending aorta is generally required to be cut off, so that the far end of the trunk stent is spanned on an inner membrane of a true and false cavity after the trunk stent is implanted, the problem that the trunk stent mistakenly enters the false cavity to cause the blood supply obstacle of the far end is avoided, and the dual blood supply of the true and false cavity is formed; the trunk support is fully released and opened, and provides convenience for the second-stage thoracic and abdominal aorta replacement.

When the chronic interlayer intima piece at the proximal end of the thoracic descending aorta is resected, medical scissors and a scalpel are commonly used for resection at present; the proximal end of the thoracic descending aorta is small in caliber, bent towards the distal end and deep in position, so that the thoracic descending aorta is limited by the structure, the inner diaphragm is difficult to cut by using medical scissors or a scalpel, and the cutting is not sufficient; at deeper sites there is also a risk of injury to the arterial wall resulting in major bleeding due to poor exposure.

Therefore, in order to solve the above technical problems, there is a need for an aortic dissection endocyst resectoscope which can facilitate the full resection of the chronic dissection endocyst and simultaneously is beneficial to avoid injuring the aortic wall and improve the operation safety.

SUMMERY OF THE UTILITY MODEL

In view of this, the present invention provides an aortic dissection endocyst resectoscope to facilitate the full resection of the chronic dissection endocyst, and at the same time, to avoid injuring the aortic wall, and to improve the operation safety.

In order to achieve the above object, the utility model particularly provides an aortic dissection endocyst excider, which comprises a handle and a blade; the knife handle is rod-shaped, and the lower end of the knife handle is provided with a notch part; the blade is fixed in the gap portion, and the cutting part of blade is towards the lower terminal surface of handle of a knife and does not surpass the lower terminal surface of handle of a knife.

As a further improvement to the technical proposal of the utility model, the upper end of the knife handle is provided with a curved handle with an arc structure, and the angle of the curved handle is 80-160 degrees.

As a further improvement, the utility model discloses technical scheme, handle of a knife and curved handle integrated into one piece.

As a further improvement, the utility model discloses technical scheme, the transversal circular or oval-shaped of personally submitting of handle of a knife.

As right the utility model discloses technical scheme's further improvement, breach portion is "U" shape or "V" shape, the left and right sides that the lower extreme of handle of a knife is located breach portion all is equipped with the extension handle, the lower terminal surface of extension handle is the arc surface structure.

As a further improvement, the utility model discloses technical scheme, the blade is connected in the handle of a knife with removable mode.

As right the utility model discloses technical scheme's further improvement, the lower extreme of handle of a knife is equipped with the mounting groove with breach portion intercommunication, the mounting groove extends to the lower terminal surface of handle of a knife, the blade inserts in the mounting groove and stabilizes the location.

As a further improvement, the blade is rectangular, and the cutting part is disposed on one side of the blade.

As right the utility model discloses technical scheme's further improvement, the lower extreme of handle of a knife still is equipped with the locating hole that runs through to the mounting groove, and will after the setting element penetrates the locating hole the blade fastening is positioned the mounting groove.

As right the utility model discloses technical scheme's further improvement, the lower extreme of handle of a knife is equipped with heavy groove, the locating hole is located in heavy groove.

Compared with the prior art, the utility model provides a pair of aorta interbedded endocyst excising device has following beneficial technological effect:

the utility model is specially used for cutting off the intima of the aortic dissection, when in use, the incision knife with proper specification is selected according to the descending aorta shape of a patient, the knife handle is placed in the aorta and close to the aorta wall, the blade part of the blade is aligned with the top of the intima, then the blade moves downwards to perform incision operation from one side of the intima, the incision knife returns to a specified position, then the blade moves downwards to perform incision operation from the other side of the intima, finally, the complete intima is cut off, and the intima is drawn out by pulling through a suture; it is thus clear that compare in the current mode that adopts medical scissors and scalpel to excise, the utility model discloses operating space is big, excision scope is wide, is convenient for fully excise chronic intermediate layer internal diaphragm, simultaneously because blade and cutting part all hide in the breach portion, the blade can not contact the aorta wall in the excision process, is favorable to avoiding hindering the aorta wall, improves the operation security.

The utility model provides high operation security and operation efficiency accord with the social needs, have very strong practicality, especially do benefit to the further development that promotes cardiovascular medical treatment technique.

Drawings

Fig. 1 is a schematic structural view of the present invention;

FIG. 2 is an enlarged view of FIG. 1 at A;

FIG. 3 is a schematic view of the structure of the blade of the present invention;

fig. 4 is a usage state diagram of the present invention.

Detailed Description

In order to make the technical solution of the present invention better understood, the present invention will be further described in detail with reference to the accompanying drawings and specific embodiments; of course, the drawings are simplified schematic drawings, and the scale of the drawings does not limit the patented products.

Examples

As shown in fig. 1 to 4: the embodiment provides an aortic dissection endocyst resectoscope which comprises a knife handle 1 and a blade 2; the knife handle 1 is rod-shaped, and the lower end of the knife handle 1 is provided with an upwardly concave notch part 3; the blade 2 is fixed to the notch 3, and the cutting part 21 of the blade 2 faces the lower end face of the holder 1 and does not exceed the lower end face of the holder 1.

The knife handle 1 can be made of medical stainless steel; the knife handle 1 can be in a straight rod shape, the cross section of the knife handle 1 can be in a circular or oval shape, the diameter can be 12mm for example, and the smooth structure can avoid injuring the wall of the aorta; the length of the knife handle 1 can be determined according to the requirement, for example, 80 mm; the directions of the upper part, the lower part, the left part and the right part are all based on the directions shown in the figure 1; the notch portion 3 is a missing piece of the tool holder 1, that is, the notch portion 3 penetrates in the longitudinal direction of the tool holder 1, and the notch portion 3 extends to the lower end face of the tool holder 1.

The blade 2 can also be made of stainless steel, and the edge 21 is a side edge for cutting; the edge part 21 of the blade 2 faces the lower end face of the cutter handle 1, and the interlayer inner film can be contacted with the edge part 21 after entering from the gap part 3, so that cutting is realized; the edge part 21 of the blade 2 does not exceed the lower end surface of the handle 1, and at the moment, the blade 2 and the edge part 21 thereof are hidden in the notch part 3, so that the blade 2 does not contact the aorta wall in the cutting process.

The aortic dissection intimal membrane resectoscope provided by the embodiment is specially used for resecting an aortic dissection intimal membrane, when the resectoscope is used, as shown in fig. 4, a proper-specification incising knife is selected according to the descending aorta shape of a patient, the knife handle 1 is placed in an aorta and close to the aortic wall, the blade part 21 of the blade 2 is aligned with the top of the intimal membrane 10, then the cutter moves downwards to perform incising operation from one side of the intimal membrane 10, the incising operation is performed when the cutter moves to a specified position and is backed, then the cutter moves downwards to perform incising operation from the other side of the intimal membrane, finally, the complete intimal membrane is resected to form a notch 11, and the intimal membrane is pulled and led out through a suture 12; after the trunk support is implanted, the trunk support straddles on the inner membrane, and the true and false cavities supply blood dually; it is thus clear that compare in the current mode that adopts medical scissors and scalpel to excise, the utility model discloses operating space is big, excision scope is wide, is convenient for fully excise chronic intermediate layer internal diaphragm, simultaneously because blade 2 and cutting part 21 all hide in breach portion 3, blade 2 can not contact the aorta wall in the excision process, is favorable to avoiding hindering and the aorta wall, improves the operation security.

In the embodiment, the upper end of the tool holder 1 is provided with the curved handle 4 with an arc structure, the length of the curved handle 4 can be 40mm, the curved handle can adopt a round rod structure, and the diameter of the curved handle can be 12mm, for example; the angle B of the bent handle 4 is 80-160 degrees, so that the cutting tool is suitable for the requirement of cutting intima of the descending thoracic aorta interbedded with different shapes, and the range of cutting the intima of the interbedded is larger and farther. The defects of small operation space and limited excision range of the traditional scissors and scalpel for excising the inner membrane are avoided; for example, the angle B of the bent shank 4 may be 90 °, 120 ° or 150 °. Preferably, the tool shank 1 and the bent handle 4 are integrally formed, so that the tool shank 1 is convenient to machine and form, and the structural strength of the tool shank 1 is improved.

In this embodiment, the notch portion 3 is U-shaped or V-shaped, the lower end of the tool holder 1 is provided with extending handles 5 on the left and right sides of the notch portion 3, and the lower end surfaces of the extending handles 5 are arc surface structures; the two extension handles 5 are respectively formed by extending the cutter handle 1 towards the left lower side and the right lower side, and the two extension handles 5 can be symmetrically arranged based on the axis of the cutter handle 1, so that the cutter handle 1 forms a Y-shaped structure; the cross-section of the elongate shaft 5 may also be circular, and its diameter may be, for example, 6 mm; at the moment, the lower end surface of the extension handle 5 is the lower end surface of the cutter handle 1; the lower end surface of the extension handle 5 is of an arc surface structure, thereby avoiding injuring the wall of the aorta and further improving the use safety.

In the embodiment, the blade 2 is detachably connected to the handle 1; the blade 2 is of a replaceable structure, and sterilization and disinfection are facilitated. Specifically, the lower end of the cutter handle 1 is provided with an installation groove 6 communicated with the notch part 3, the installation groove 6 extends to the lower end surface of the cutter handle 1 (namely the lower end surface of the extension handle 5), and the blade 2 is inserted into the installation groove 6 and is stably positioned; the mounting groove 6 is arranged along the axial direction of the cutter handle 1, and the length and the width of the mounting groove can be adapted to the blade 2; the blade 2 may take any suitable shape, depending on the requirements of use; preferably, as shown in fig. 3, the blade 2 may have a rectangular shape with a length of 20mm, a width of 8mm and a thickness of 0.5mm, and the blade portion 21 is provided on one side surface of the blade 2. The lower end of the knife handle 1 is further provided with a positioning hole 7 penetrating through the mounting groove 6, the positioning piece 8 penetrates through the positioning hole 7 and then fastens and positions the blade 2 in the mounting groove 6, the positioning piece 8 can be a screw, the positioning hole 7 can be a screw hole structure, and the blade 2 is simultaneously provided with a connecting hole 22 corresponding to the positioning hole 7. Meanwhile, in order to prevent the positioning piece 8 from protruding out of the surface of the knife handle 1, the lower end of the knife handle 1 can be provided with a sinking groove 9, and the sinking groove 9 is lower than the surface of the knife handle 1; the positioning hole 7 is arranged in the sinking groove 9, and the positioning part 8 is also arranged in the sinking groove 9 after installation.

Finally, it is stated that the specific individual example is used herein to explain the principle and the implementation of the present invention, and the explanation of the above embodiment is only used to help understand the core idea of the present invention, without departing from the principle of the present invention, it is also possible to make the present invention undergo several improvements and modifications, and these improvements and modifications also fall into the protection scope of the present invention.

Claims

1. An aortic dissection endoiris resectoscope characterized by:

comprises a knife handle and a blade; the knife handle is rod-shaped, and the lower end of the knife handle is provided with a notch part; the blade is fixed in the gap portion, and the cutting part of blade is towards the lower terminal surface of handle of a knife and does not surpass the lower terminal surface of handle of a knife.

2. The aortic dissection endoluminal membrane resectoscope according to claim 1, wherein:

the upper end of the knife handle is provided with a curved handle with an arc structure, and the angle of the curved handle is 80-160 degrees.

3. The aortic dissection endoluminal membrane resectoscope according to claim 2, wherein:

the knife handle and the bent handle are integrally formed.

4. The aortic dissection endoluminal membrane resectoscope according to claim 1, wherein:

the cross section of the knife handle is circular or oval.

5. An aortic dissection endoluminal membrane resectoscope according to any one of claims 1 to 4, wherein:

the notch part is U-shaped or V-shaped, the lower end of the cutter handle is positioned at the left side and the right side of the notch part and is provided with an extension handle, and the lower end face of the extension handle is of an arc surface structure.

6. An aortic dissection endoluminal membrane resectoscope according to any one of claims 1 to 4, wherein:

the blade is removably attached to the handle.

7. The aortic dissection endoluminal membrane resectoscope according to claim 6, wherein:

the lower extreme of handle of a knife is equipped with the mounting groove with breach portion intercommunication, the mounting groove extends to the lower terminal surface of handle of a knife, the blade inserts in the mounting groove and fixes a position firmly.

8. The aortic dissection endoluminal membrane resectoscope according to claim 7, wherein:

the blade is rectangular, and the cutting part is arranged on one side surface of the blade.

9. The aortic dissection endoluminal membrane resectoscope according to claim 6, wherein:

the lower end of the knife handle is further provided with a positioning hole penetrating through the mounting groove, and the positioning piece penetrates through the positioning hole and then fastens and fixes the blade in the mounting groove.

10. The aortic dissection endoluminal membrane resectoscope according to claim 9, wherein:

the lower end of the knife handle is provided with a sinking groove, and the positioning hole is arranged in the sinking groove.