CN217723560U

CN217723560U - Integrated closing device for anchoring and traction wound surface under endoscope

Info

Publication number: CN217723560U
Application number: CN202123394842.4U
Authority: CN
Inventors: 黄其强
Original assignee: Individual
Current assignee: Individual
Priority date: 2021-12-31
Filing date: 2021-12-31
Publication date: 2022-11-04
Anticipated expiration: 2031-12-31

Abstract

The utility model relates to an anchor draws integral type closing device of surface of a wound under scope, including the operation portion, flexible sleeve and clip subassembly, the clip subassembly contains one to outer tong arm, be equipped with the slip subassembly of drive one to outer tong arm on the operation portion, the centre of a pair of outer tong arm is equipped with central puncture anchor, central puncture anchor contains puncture seal wire and fixer, be equipped with rotatory ring in the operation portion, it has the transmission line to link on the rotatory ring, the transmission line is connected with the one end of puncture seal wire after passing flexible sleeve, puncture seal wire other end and fixer middle part flexonics, a fixer end connection has and is used for spurring the fixer pendulum to change to the line of retrieving that parallels with the puncture seal wire. The device can effectively fix wound tissues with larger diameter, irregular shape and full-layer defect, realizes effective traction, enables two side edges of a larger wound to be close to each other, is favorable for the outer side tong arm to forcefully grab more tissues at two sides, and creates conditions for smoothly realizing quick and complete closure of the wound surface after operation, digestive tract perforation and digestive tract fistula.

Description

Integrated closing device for anchoring and traction wound surface under endoscope

The technical field is as follows:

the utility model belongs to the technical field of clinical gastroenteroscopic surgical instrument, especially, relate to an integral type closing device that surface of a wound was pull in the anchor under scope.

Background art:

with the continuous development of digestive endoscopy, endoscopic local gastrointestinal resection techniques such as endoscopic mucosal resection (ESD), endoscopic full-thickness resection (EFTR), natural orifice surgery (NOTES) and the like are increasingly mature and widely applied. The closing of the wound surface after the artificial digestive tract incision is a key step of endoscopic surgery. Digestive tract perforation and digestive tract fistula caused by ulcer, tumor, foreign body injury and other reasons are also indications for endoscopic closure treatment.

The development of endoscope closing technology depends on continuous updating and perfecting of endoscope closing instruments and methods. The existing endoscope closing technology comprises metal clip closing, suturing technology, an occluder and the like. Although the endoscope suturing and blocking system realizes full-layer suturing, the endoscope suturing and blocking system is limited by the defects of high operation difficulty, difficulty in controlling suturing strength, high instrument cost and the like, and cannot be widely popularized at present. The metal clip clamps focus and surrounding tissues through mechanical acting force, is the most common endoscope closing technology at present, but for complicated wound surfaces with large diameter, irregular shape, full-layer defect and the like, the wound surfaces are easy to move and can not be fixed, so that the operation time is long, and the difficulty is high. For granted published patent numbers: CN208625777U. Although the puncture needle can also be matched with the puncture needle to play a role in fixing and pulling tissues under an endoscope, the operation process is more complicated, the operation time is obviously prolonged, and the puncture needle is thicker and has great damage to the tissues. The present invention has been made in view of the deficiencies of the prior art.

The utility model has the following contents:

the utility model discloses make the improvement to the problem that above-mentioned prior art exists, promptly the utility model aims to solve the technical problem that an integral type closing device of the surface of a wound is pull in the anchor under the scope is provided, not only reasonable in design, easy and simple to operate moreover.

In order to realize the purpose, the utility model discloses a technical scheme is: the utility model provides an anchor pulls integral type closing device of surface of a wound under scope, is including the operating portion, flexible sleeve pipe and the clip subassembly that connect gradually, the clip subassembly contains a pair of outer tong arms that control the distribution, be equipped with the slip subassembly that is used for driving a pair of outer tong arm action in the operating portion, the centre of a pair of outer tong arm is equipped with central puncture anchor, central puncture anchor contains puncture seal wire and fixer, be equipped with rotatory ring in the operating portion, be connected with the transmission line on the rotatory ring, the transmission line is connected with the one end of puncture seal wire after passing flexible sleeve pipe, the other end of puncture seal wire and the middle part flexonics of fixer, a tip of fixer is connected with and is used for pulling the fixer pendulum to change to the recovery line that parallels the seal wire with the puncture.

Furthermore, the lateral wall of fixer has seted up the logical groove of stepping down along the axial, the one end flexible connection of puncture seal wire is in the logical groove of stepping down, when the fixer swung to and is paralleled with the puncture seal wire, the puncture seal wire holding was in the logical inslot of stepping down.

Further, the fixer and the puncture guide wire are both made of hard materials; the recycling line is made of a soft material.

Further, the operating part comprises an operating handle and a connecting pipe, and external threads are arranged on the outer side wall of one end of the operating handle adjacent to the connecting pipe; the inner wall of the rotating ring is provided with an internal thread matched with the external thread, and the inner wall of the rotating ring is connected with the transmission line through a connecting rod arranged along the radial direction.

Furthermore, a threading hole is formed in the side wall of the operating handle; one end of the recovery line, which is far away from the fixer, sequentially penetrates through the flexible sleeve and the connecting pipe and then extends out of the threading hole.

Furthermore, the sliding assembly comprises a sliding block connected with the operating handle in a sliding manner, the sliding block is connected with a pull wire, and the pull wire penetrates through the flexible sleeve and then is connected with the pair of outer forceps arms; and an upper finger retaining ring and a lower finger retaining ring are respectively arranged at two ends of the sliding block.

Furthermore, the stay wire, the transmission wire and the recovery wire are distributed in a vertically staggered manner.

Furthermore, a radial screw hole is formed in the side wall of one end, connected with the operating handle, of the rotating ring, and a locking screw is screwed in the radial screw hole.

Furthermore, the clamp assembly also comprises a clamp arm base, and a pair of outer clamp arms are connected to the left end and the right end of the clamp arm base; one end of the flexible sleeve, which is far away from the operation part, is connected with the clamp arm base; the puncture guide wire penetrates through the middle of the clamp arm base and is connected with the transmission line.

Furthermore, the outer forceps arm is in an obtuse arc shape, and the surface of the clamping surface at the front end of the outer forceps arm is in a straight tooth shape.

Compared with the prior art, the utility model discloses following effect has: the utility model has reasonable design, controls the direction of the fixer through the recovery wire, and pushes the rotating ring to draw and fix the tissue, thereby effectively fixing the wound surface tissue with larger diameter, irregular shape and full-layer defect, and effective traction is realized, the edges of two sides of a larger wound surface are close, more tissues on two sides of the wound surface can be effectively grabbed by the outer forceps arms, and conditions are created for smoothly realizing quick and complete closure of the postoperative wound surface, digestive tract perforation and digestive tract fistula.

Description of the drawings:

fig. 1 is a schematic front view of the embodiment of the present invention;

FIG. 2 is a schematic view of the construction of a clip assembly according to an embodiment of the present invention;

FIG. 3 is a schematic view of the fitting structure of the rotating ring and the operating part in the embodiment of the present invention;

fig. 4 is a first schematic view illustrating a state of the engagement between the holder and the puncture guide wire according to the embodiment of the present invention;

fig. 5 is a schematic view illustrating a state of the engagement between the fixator and the puncture guide wire according to an embodiment of the present invention.

The specific implementation mode is as follows:

the present invention will be described in further detail with reference to the accompanying drawings and specific embodiments.

In the description of the present invention, it is to be understood that the terms "longitudinal", "lateral", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are merely for convenience of description of the present invention, and do not indicate or imply that the device or element referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus, are not to be construed as limiting the present invention.

As shown in fig. 1-5, the utility model relates to an anchor integral type closing device who pulls surface of a wound under scope, including the operating portion 1, the flexible sleeve 2 and the clip subassembly 3 that connect gradually, clip subassembly 3 contains a pair of outer tong arm 5 of controlling the distribution, be equipped with the slip subassembly that is used for driving a pair of outer tong arm 5 action on the operating portion 1, the slip subassembly includes slider 10 with 1 sliding connection of operating portion, slider 10 is connected with and acts as go-between 11, act as go-between 11 and be connected with a pair of outer tong arm 5 after passing flexible sleeve 2, slider 10 drives a pair of outer tong arm 5 through acting as go-between 11 and opens or press from both sides tightly. The middle of one pair of tong arms 5 is provided with a central puncture anchor 4, the central puncture anchor 4 comprises a puncture guide wire 7 and a fixer 8, the operating part 1 is provided with a rotating ring 12, the rotating ring 12 is connected with a transmission line 13, the transmission line 13 penetrates through the flexible sleeve 2 and then is connected with one end of the puncture guide wire 7, the rotating ring 12 is rotated to drive the puncture guide wire 7 through the transmission line 13, the other end of the puncture guide wire 7 is flexibly connected with the middle part of the fixer 8, and one end part of the fixer 8 is connected with a recovery line 9 for pulling the fixer 8 to swing to be parallel to the puncture guide wire 7. When the device is used, the recovery wire 9 is tensioned, so that the fixator 8 and the puncture guide wire 7 are in a linear state, the puncture guide wire 7 and the fixator 8 are driven by the transmission wire 13 to pass through the stomach/intestine wall full layer and then release the recovery wire when the rotating ring 12 rotates, the fixator 8 and the puncture guide wire 7 are in a vertical state, tissue approaching and anchoring are realized by rotating the rotating ring 12, the slider 10 is operated to move back and forth, the slider 10 drives the pair of outer forceps arms 5 to grab tissues on two sides of a wound surface to fold and fix, and the slider 10 is pulled backwards to release the pair of outer forceps arms 5; the method can be suitable for the treatment of complex wound surfaces which are difficult to completely close by common metal clips.

In this embodiment, the side wall of the fixer 8 is provided with a yielding through groove 80 along the axial direction, one end of the puncture guide wire 7 is flexibly connected in the yielding through groove 80, when the recovery wire 9 is tightened, the recovery wire 9 pulls the fixer 8 to swing to be parallel to the puncture guide wire 7, the puncture guide wire 7 is accommodated in the yielding through groove 80, and the puncture guide wire and the fixer are in a linear state, as shown in fig. 5. When the recovery wire is released, the puncture guide wire and the fixer can be in a T-shaped state, as shown in fig. 4.

In this embodiment, the flexible connection between the puncture guide wire 7 and the middle of the fixator 8 may be, for example, a hinged connection, and an axially extending abdicating through groove is formed in a side wall of the fixator, so that the fixator and the puncture guide wire are in a straight line state during pushing, and the outer diameter is not increased, thereby improving the possibility that the central puncture anchor passes through the flexible sleeve.

In this embodiment, the holder 8 and the puncture guide wire are both made of hard materials, and have a certain pushing strength. Preferably, the holder 8 is made of a rod or a tube.

In this embodiment, the recycling line 9 is made of a soft material, that is, the recycling line is a soft line.

In this embodiment, the operating portion 1 includes an operating handle 15 and a connecting pipe 16, which are sequentially arranged, the operating handle 15 is provided with a sliding track 17, the slider 10 can slide back and forth along the sliding track 17, and the outer side wall of one end of the operating handle 15 adjacent to the connecting pipe 16 is provided with an external thread; the inner wall of the rotating ring 12 is provided with an internal thread for matching with the external thread, and the inner wall of the rotating ring 12 is connected with the transmission line 13 through a connecting rod 18 arranged along the radial direction. Rotatory ring adopts threaded connection with connecting pipe, operating handle, not only makes things convenient for rotatory ring's rotation, and connection structure is stable moreover.

In this embodiment, a threading hole 151 is formed in a side wall of the operating handle 15, and the threading hole is located on one side of the slider 10 away from the operating portion 1; one end of the recovery thread 9 far away from the fixer 8 sequentially passes through the flexible sleeve 2 and the connecting pipe 16 and then extends out of the threading hole 151.

In this embodiment, for convenience of operation, the two ends of the slider 10 are respectively provided with an upper finger-fastening ring 20 and a lower finger-fastening ring 21, which are used for facilitating the finger to pass through.

In this embodiment, the pull wire, the transmission wire and the recovery wire are distributed in a staggered manner.

In this embodiment, a radial screw hole is formed in a side wall of one end of the rotating ring 12, which is connected to the operating handle 15, and a locking screw 19 is screwed into the radial screw hole, so that the rotating ring 12 and the operating handle 15 can be locked by the locking screw, thereby achieving locking of the rotating ring.

In this embodiment, the clamp assembly further includes a clamp arm base 6, and a pair of outer clamp arms 5 are respectively connected to the left and right ends of the clamp arm base 6; one end of the flexible sleeve 2, which is far away from the operating part 1, is connected with the clamp arm base 6; the puncture guide wire 7 penetrates through the middle of the clamp arm base 7 to be connected with the transmission line, and the pull wire, the transmission line and the recovery line penetrate through the clamp arm base 6.

In this embodiment, the length of the flexible sleeve 2 is a suitable length longer than the length of the gastrointestinal tract. The length of the puncture guide wire 7 is less than that of the outer forceps arm.

In this embodiment, the pair of outer arms 5 have the same length, and are shaped like an obtuse arc, and the surface of the front end holding surface of the outer arm is shaped like a straight tooth. It should be noted that the number and length of the insections on the surface of the front end holding face of the outer forceps arm are designed and adjusted according to clinical requirements, and the insections on the two sides are embedded when the forceps are closed. Preferably, the maximum opening angle of a pair of outer jawarms is 135 °.

In this embodiment, it should be noted that the structure in which the sliding block drives the pair of external forceps arms to open or clamp through the pull wire is the same as the structure of the existing dual-arm forceps, and the detailed description of the specific structure is not repeated here. The central puncture anchor is the same as the existing puncture anchor structure (published patent number: CN 208625777U), and the detailed structure and the using method thereof are not repeated here.

In this embodiment, when in use: the medical staff holds the operating handle 15 with one hand and delivers the integrated device to the focus by using the endoscope treatment channel. The medical staff controls the upper finger retaining ring 20 and the lower finger retaining ring 21 to push the slide block 10 to move forwards on the sliding track 17, the slide block 10 drives the pair of outer forceps arms 5 to open through a pair of pull wires 11, and the maximum opening angle of the outer forceps arms 5 at two sides is 135 degrees; when the outer forceps arm 5 is close to one side of the wound surface, the recovery wire 9 is tensioned to make the fixer 8 and the puncture guide wire 7 in a linear state, as shown in fig. 5; then the locking screw 19 is turned to release the locking of the rotating ring 12, the rotating ring 12 is rotated towards the connecting pipe 16, and the fixing device 8 and the puncture guide wire 7 are driven by the driving wire 13 to pass through the whole layer of the stomach/intestinal wall when the rotating ring 12 is rotated; the recovery wire 9 is released, and the fixator 8 and the puncture guide wire 7 are in a vertical state, as shown in fig. 4; the rotary ring 12 is rotated in the direction of the operation part to realize anchoring and closing of tissues and the distance between the rotary ring and the metal clamp, the tissues on two sides of the wound surface are grabbed to be folded and fixed by controlling the back and forth movement of the slide block 10, the slide block 10 is pulled backwards to release the metal clamp, the fixer 8 and the puncture guide wire 7 are in a straight line by tensioning the recovery line 9, the anchor is retracted to a gastrointestinal cavity by rotating the rotary ring 8 in the direction of the operation part 1, and the anchor is withdrawn through a gastrointestinal endoscope channel. The method can be suitable for treating complicated wound surfaces which are difficult to completely close by common metal clips, and shortens the operation time.

By adopting the device, the central puncture anchor can be fixed on the gastrointestinal serosa side, the anchoring and the drawing-in of tissues are realized at a distance from the metal clamp, the outer forceps arms are favorable for forcefully grabbing more tissues on two sides of the wound surface, and conditions are created for smoothly realizing the quick and complete closure of the wound surface, the perforation of the digestive tract and the fistula of the digestive tract after the operation. The utility model discloses the principle is simple, can be applied to great, complicated surface of a wound such as dark, irregular shape and handle, and the perforated surface of a wound of specially adapted full-thickness can realize quick, the complete sealing of the surface of a wound, and the operation is simple and easy.

The utility model has the advantages that: the direction of the anchoring fixator can be controlled by the recovery wire, and when the recovery wire is loosened, the puncture guide wire is pulled, so that the fixator and the puncture guide wire are vertical to form a T shape and can pull tissues; when the fixer needs to be taken out, the puncture guide wire is slightly sent to the deep part, and after the recovery wire is tightened, the fixer is parallel to the puncture guide wire and can be smoothly pulled out. The cooperation promotes rotatory ring and comes to carry out tractive, fixed to the tissue, can effectively fix the great, irregular, full-thickness defective surface of a wound tissue of shape of diameter to realize effectual tractive, make the both sides edge of great surface of a wound close to, be favorable to the outside tong arm to grab more tissues of surface of a wound both sides forcefully, create the condition for realizing the quick complete closure of postoperative surface of a wound, alimentary canal perforation, alimentary canal fistula smoothly.

The utility model discloses if disclose or related to mutual fixed connection's spare part or structure, then, except that other has declared, fixed connection can understand: a detachable fixed connection (for example using bolts or screws) is also understood as: non-detachable fixed connections (e.g. riveting, welding) can, of course, also be replaced by one-piece structures (e.g. manufactured in one piece using a casting process) (unless it is obvious that one-piece processes cannot be used).

In addition, the terms used in any aspect of the present disclosure as described above to indicate positional relationships or shapes include similar, analogous, or approximate states or shapes unless otherwise stated.

The utility model provides an arbitrary part both can be assembled by a plurality of solitary component parts and form, also can be the solitary part that the integrated into one piece technology was made.

Finally, it should be noted that: the above embodiments are only used to illustrate the technical solution of the present invention and not to limit it; although the present invention has been described in detail with reference to preferred embodiments, it should be understood by those skilled in the art that: modifications can still be made to the embodiments of the invention or equivalents may be substituted for some of the features; without departing from the spirit of the present invention, it should be understood that the scope of the claims is intended to cover all such modifications and variations.

Claims

1. The utility model provides an anchor draws integral type closing device of surface of a wound under scope, includes operating portion, flexible sleeve and the clip subassembly that connects gradually, the clip subassembly contains a pair of outer tong arms that distribute about, be equipped with the slip subassembly that is used for driving a pair of outer tong arm action on the operating portion, its characterized in that: the middle of one pair of outer tong arms is provided with a central puncture anchor, the central puncture anchor comprises a puncture guide wire and a fixer, the operating part is provided with a rotating ring, the rotating ring is connected with a transmission line, the transmission line penetrates through the flexible sleeve and then is connected with one end of the puncture guide wire, the other end of the puncture guide wire is flexibly connected with the middle part of the fixer, and one end part of the fixer is connected with a recovery line used for pulling the fixer to swing to be parallel to the puncture guide wire.

2. The integrated endoscopic traction wound closure device according to claim 1, wherein: the lateral wall of fixer has seted up the logical groove of stepping down along the axial, the one end flexible connection of puncture seal wire is in the logical groove of stepping down, when the fixer swung to and parallels with the puncture seal wire, the puncture seal wire holding was in the logical inslot of stepping down.

3. The integrated endoscopic traction wound closure device according to claim 1 or 2, wherein: the fixer and the puncture guide wire are both made of hard materials; the recycling line is made of a soft material.

4. The integrated endoscopic traction wound closure device according to claim 1, wherein: the operating part comprises an operating handle and a connecting pipe, and external threads are arranged on the outer side wall of one end of the operating handle adjacent to the connecting pipe; the inner wall of the rotating ring is provided with an internal thread matched with the external thread, and the inner wall of the rotating ring is connected with the transmission line through a connecting rod arranged along the radial direction.

5. The integrated endoscopic traction wound closure device according to claim 4, wherein: the side wall of the operating handle is provided with a threading hole; one end of the recovery line, which is far away from the fixer, sequentially penetrates through the flexible sleeve and the connecting pipe and then extends out of the threading hole.

6. The integrated endoscopic traction wound closure device according to claim 4, wherein: the sliding assembly comprises a sliding block connected with the operating handle in a sliding manner, the sliding block is connected with a pull wire, and the pull wire penetrates through the flexible sleeve and then is connected with the pair of outer forceps arms; and an upper finger retaining ring and a lower finger retaining ring are respectively arranged at two ends of the sliding block.

7. The integrated endoscopic traction wound closure device according to claim 6, wherein: the pull wire, the transmission wire and the recovery wire are distributed in a vertically staggered manner.

8. The integrated endoscopic traction wound closure device according to claim 4, wherein: the side wall of one end of the rotating ring, which is connected with the operating handle, is provided with a radial screw hole, and a locking screw is screwed in the radial screw hole.

9. The integrated endoscopic anchoring and traction wound closure device according to claim 1, wherein said device comprises: the clamp assembly further comprises a clamp arm base, and a pair of outer clamp arms are connected to the left end and the right end of the clamp arm base; one end of the flexible sleeve, which is far away from the operation part, is connected with the clamp arm base; the puncture guide wire penetrates through the middle of the clamp arm base and is connected with the transmission line.

10. The integrated endoscopic traction wound closure device according to claim 1, wherein: the outer forceps arms are in an obtuse arc shape, and the surfaces of the clamping surfaces at the front ends of the outer forceps arms are in a straight tooth shape.