CN217853215U

CN217853215U - Pericardium lifting device and pericardium intervention device

Info

Publication number: CN217853215U
Application number: CN202120939814.7U
Authority: CN
Inventors: 王云兵; 吴智明; 余越盛; 叶正宇; 邵南; 訾振军
Original assignee: Deke Medtech (hangzhou) Inc
Current assignee: Deke Medtech (hangzhou) Inc
Priority date: 2021-04-30
Filing date: 2021-04-30
Publication date: 2022-11-22
Anticipated expiration: 2031-04-30

Abstract

The application discloses ware and pericardium intervention device are carried to pericardium, the pericardium is carried and is drawn its include the sheath pipe and with sheath pipe sliding fit's traction needle, is provided with at the sheath pipe distal end and accepts the chamber, during the relative pericardium motion of sheath pipe, the pericardium gets into it realizes fixing in advance to accept the chamber, can switch between first state and second state in the traction needle slip process, wherein under the first state the traction needle paste in sheath pipe, under the second state the distal end deformation of traction needle do with it is right in order to realize accepting the drawing hook of chamber mutually supporting the colluding of pericardium holds. This application realizes the pericardium in the gathering of presetting the region through acceping the chamber, makes things convenient for the more stable realization of traction needle to the tractive of pericardium, avoids the injury to peripheral tissues such as myocardium.

Description

Pericardium lifting device and pericardium interventional device

Technical Field

The present application relates to the field of medical devices, and in particular, to a pericardial retractor and a pericardial access device.

Background

The heart comprises a ventricle, a myocardium and a pericardium, wherein the ventricle is enclosed by the myocardium, the pericardium is wrapped outside the myocardium, and the myocardium sequentially comprises a fiber layer, a wall layer and an internal organ layer from outside to inside, wherein the internal organ layer is also called as an epicardium, a pericardial cavity is arranged between the epicardium and the wall layer, and the pericardial cavity usually contains 20-25ml of physiological liquid.

The existing epicardial stem cell injection technology comprises open chest to perform direct-view operation, the direct-view operation has the defects of large wound and slow recovery, and is a great test for the old, so the injection of stem cells into the pericardium through the minimally invasive operation becomes a preferable treatment means.

The medical apparatus adopted by the minimally invasive surgery is a pericardium puncture outfit, after the pericardium is cut by a tissue engagement needle on the pericardium puncture outfit, the medical apparatus enters the pericardium cavity along the pericardium puncture outfit, so that medical personnel can carry out the medical surgery of epicardium stem cell injection in the pericardium cavity.

Of course, the medical operation after the pericardium is incised by the pericardium puncture outfit is not limited to the epicardial injection of stem cells, and also includes medical operations such as puncture drainage, myocardial excision, ablation, biological patch placement, left atrial appendage ligation, and cardiac pacemaker placement.

The inventor finds that the pericardium puncture device in the prior art easily penetrates the pericardium and scratches the cardiac muscle during the use process.

SUMMERY OF THE UTILITY MODEL

In order to solve the technical problem, the application discloses pericardium pulling apparatus, including the sheath and with sheath sliding fit's traction needle, be provided with at the sheath distal end and accept the chamber, during the relative pericardium motion of sheath, the pericardium gets into it realizes prefixing to accept the chamber, can switch between first state and second state among the traction needle slip process, wherein under the first state traction needle paste in the sheath, under the second state traction needle's distal end deformation be with it is right in order to realize accepting the drawing hook of chamber mutually supporting the pericardium collude and hold.

This application realizes the pericardium in the gathering of presetting the region through acceping the chamber, makes things convenient for the more stable realization of traction needle to the tractive of pericardium, avoids the injury to peripheral tissues such as myocardium.

Several alternatives are provided below, but not as an additional limitation to the above general solution, but merely as a further addition or preference, each alternative may be combined individually for the above general solution or between several alternatives without technical or logical contradictions.

Optionally, the traction needle comprises:

the rod part is attached to the sheath tube;

the hook part is connected with the rod part and is switched between the first state and the second state through deformation, and the hook part is deformed into a hook-shaped lifting hook in the second state.

The rod part is used for realizing the sliding of the traction needle relative to the sheath tube, the hook part is used for realizing the deformation so as to form a lifting hook, and the hook part and the rod part are structurally of an integral structure or a split structure.

Optionally, the restraining member does not pass over the receiving cavity. This construction avoids the restraint being deformed by the pericardium compression.

Optionally, the rod part and/or the hook part is/are an elastic part and elastically drives the hook part to keep in the second state;

the retractor needle further includes a restraint for maintaining the hook in a first state.

The rod part and/or the hook part formed by the elastic part can realize the automatic switching between the first state and the second state, the driving parts are reduced, and the cooperation restraint part can realize a stable working effect through a simple mechanism.

Optionally, the restraining element is a restraining tube disposed on the sheath tube, the restraining tube extends from the distal end to the proximal end along with the sheath tube, and the rod portion and the hook portion are movably inserted into the restraining tube;

the hook part in the second state extends out of the far end of the restraint tube;

the hook portion in the first state is accommodated in the restraint tube.

The sliding process of the traction needle relative to the sheath tube can be understood as the sliding process relative to the constraint tube, so that the switching of different states is realized, and meanwhile, the change of the far end position of the constraint tube can also realize the change of the specific forming position and the forming path of the lifting hook.

Optionally, the constraining tube is arranged as follows:

the sheath tube is attached to the inner side wall and/or the outer side wall of the sheath tube; or is arranged in the side wall of the sheath tube;

the hook portion in the second state is set as follows:

extending from the constraining tube away from or toward an axis of the sheath.

The constraining tube is arranged in the sheath tube and can provide a smooth and flat outer wall of the sheath tube, and the constraining tube is arranged outside the sheath tube and can provide a space for arranging more pipelines in the sheath tube; accordingly, different extending directions of the hook part can provide different technical advantages on the matching relation of the centering bag.

Optionally, the rod and/or the hook are flexible members and are switched between the first state and the second state by relative movement with the sheath.

The flexible shaft and/or the hook can satisfy different technical requirements of the traction needle in the first state and the second state. The flexibility here is in terms of relatively non-deformable rigidity, so the flexibility here still needs to meet certain mechanical properties, especially the mechanical property requirements of the hook part for the lifting operation of the pericardium.

Optionally, the distal end of the hook portion is provided with a first cutting edge capable of puncturing the pericardium.

The first cutting edge is used for realizing the force application of the hook part to the pericardium so as to realize lifting. The first cutting edge herein serves to enhance the interaction between the hook portion and the pericardium and is not limited to puncturing or puncturing the pericardium.

Optionally, the number of the traction needles is uniformly arranged on the circumference of the sheath.

The increase of the number of the traction needles can improve the effect of pulling the center bag and ensure the stability of operation.

Optionally, the distal end of the retractor needle is located on a deformation path during the process of entering the second state from the first state, and the deformation path is flush or retracted with respect to the distal end of the sheath.

The deformation path of the traction needle is flush or retracted compared with the far end of the sheath tube, so that damage to cardiac muscle caused by traction can be avoided, the arrangement can avoid the operation problem of operators, and the adaptability is improved.

Optionally, the lifting hook does not pass over the distal end of the sheath. Since the distal end of the sheath is close to the myocardium before lifting the pericardium, the lifting hook does not go over the distal end of the sheath in order to avoid scratching the myocardium by the traction needle crossing the sheath.

Optionally, during the process of the first state to the second state of the retracting needle, the distal end of the retracting needle does not pass over the distal end of the sheath.

The distal end of the retractor needle may be provided with a structure such as a first cutting edge in order to lift the pericardium, and the pericardium attached to the myocardium is prevented from being affected by the arrangement without passing over the distal end of the sheath tube in this embodiment.

Optionally, during the process from the first state to the second state, the deformation path of the distal end of the retractor needle does not pass the distal end of the sheath.

The deformation path of the distal end of the traction needle can be understood as the motion path of the first cutting edge, namely, on the motion path of the first cutting edge, the tissue outside the distal end side of the sheath tube cannot be affected, and unnecessary injury is structurally reduced.

Optionally, the accommodating cavity is a closed channel or is open at the distal end of the sheath.

The accommodating cavity can be a circumferentially closed structure or a region with an opening at the far end of the sheath tube, and functionally, the pericardium needs to be gathered or stacked to facilitate traction of the pericardium.

Optionally, it is open to accept the chamber and sets up, it is in to accept the chamber be equipped with relative both sides in the week of sheath pipe, it has the barb to accept wherein at least one side in chamber, the barb is close to accept the open position in chamber, the barb for the axis slope setting of sheath pipe.

The pericardium can be guided by the barb to enter the accommodating cavity, and particularly when the pericardium moves relative to the barb, the movement is easily realized by rotating the sheath tube and the like.

Optionally, the relative both sides of accepting the chamber all are equipped with the barb, and the trend that two barbs inclined is unanimous.

Two barbs with consistent inclination trend can more conveniently realize the pericardium entering the accommodating cavity, the inclination trend is understood as the inclination direction rather than the inclination angle, and in an actual product, the specific structures of the two barbs may be the same or different.

Optionally, a receiving area for receiving at least a portion of the pericardium is disposed in the receiving cavity, and the receiving area extends in the axial direction of the sheath tube.

Optionally, the length of the accommodating area in the axial direction of the sheath is greater than the length of the accommodating area in the circumferential direction of the sheath. The containing area is used for realizing that the pericardium is gathered at the position, and the proportional setting can reserve deformation space in the multi-axial direction for the traction needle in the embodiment, so that the traction needle is prevented from crossing the far end of the sheath tube. The containing area can keep the pericardium entering the containing cavity in the containing cavity and realize certain gathering or stacking so as to facilitate the interaction of the traction needle and the pericardium.

Optionally, the accommodating area and the opening portion are in staggered communication in the circumferential direction of the sheath.

The containing area and the open part which are communicated in a staggered mode in the circumferential direction can prevent the pericardium entering the containing area from automatically separating out of the containing cavity, and the constraint capacity of the containing cavity on the pericardium is improved.

Optionally, at least one side of the receiving cavity is provided with a retaining rim for retaining the pericardium in the receiving cavity.

The retaining rim can provide a continuous driving effect on the pericardium to improve the restraining capability of the receiving cavity on the pericardium.

Optionally, the barb is convex relative to the side, and the shape converges to form a second cutting edge. The second cutting edge may be understood as a structure that enhances interaction with the pericardium and is not limited to puncturing or puncturing the pericardium.

Optionally, at least one of the barbs and the retaining rim are located on the same side of the accommodating cavity, and the barbs and the retaining rim are connected end to end.

The pericardium can be guided seamlessly by the end-to-end arrangement, so that the pericardium entering the accommodating cavity can be stably positioned.

Optionally, the side wall of the open portion is obliquely arranged to form an avoiding inclined surface for the pericardium to enter the accommodating area in the accommodating cavity. The avoidance inclined plane plays a role in guiding while avoiding, and the movement of the pericardium in the accommodating cavity is cooperatively realized; meanwhile, the avoiding inclined plane reserves space for the pericardium to enter the open area and the accommodating area.

Optionally, the avoiding inclined surface and the retaining edge are respectively located at two sides of the accommodating cavity, the avoiding inclined surface and the retaining edge are arranged in opposite directions, and a gap between the avoiding inclined surface and the retaining edge communicates the accommodating area and the opening portion.

The avoidance inclined plane and the retaining edge are matched to guide and position the pericardium entering the open part.

Optionally, on the axial projection of the sheath, a vertical gap is formed between the second cutting edge and the starting point of the avoiding inclined plane.

The vertical clearance provides release space for the motion of pericardium to in the easier entering is acceptd the district under the cooperation of barb, second blade, thereby be favorable to the traction needle to snatch the pericardium.

Optionally, the retaining edge is provided with a turning portion, and the turning portion is located between a starting point and an ending point of the avoiding inclined plane on a circumferential projection of the sheath.

The position relation of the turning part and the avoiding inclined plane can realize the uninterrupted guide of the accommodating port to the movement of the pericardium, thereby improving the grabbing effect of the accommodating port to the pericardium.

Optionally, the distal end of the second cutting edge is flush or retracted compared to the sheath.

Compared with the second cutting edge which is flush or retracted at the far end of the sheath tube, the tissue after the pericardium can be prevented from being influenced, and unnecessary damage is avoided.

Optionally, the accommodating cavity is uniformly provided with a plurality of cavities in the circumferential direction of the sheath tube.

The increase in the number of the accommodating cavities can improve the pre-matching capacity of the pericardium, so that a more stable traction matching effect is provided for the traction needle.

Optionally, a containing area for containing at least a part of the pericardium is arranged in the containing cavity; the far end of the traction needle is positioned on a deformation path in the process of entering the second state from the first state, and the deformation path penetrates through or is close to the containing area.

Compared with the prior art, the matching mode can effectively avoid the effect of the traction needle on the pericardium attached to the cardiac muscle, thereby protecting surrounding tissues and reducing injury.

The technical scheme in the embodiment provides a brand-new idea. Those skilled in the art often desire to achieve grasping of the pericardium in one motion, and therefore strike a balance between reducing surrounding tissue damage and grasping strength. In the embodiment, two seemingly contradictory requirements are considered through sectional grabbing, the accommodating cavity realizes weak grabbing, and the accommodating cavity realizes pre-fixing, so that subsequent operation is facilitated; the traction needle realizes strong grabbing on the basis of accommodating the cavity, and the sectional action takes safety and the requirement of grabbing strength into account.

Optionally, the deformation path extends from inside the sheath tube to outside the sheath tube via the housing region; or

The deformation path extends from the outside of the sheath tube to the inside of the sheath tube through the accommodating area.

The deformation path from the inside of the sheath to the outside of the sheath or from the outside of the sheath to the inside of the sheath can penetrate through the accommodating area, so that the traction is ensured to establish the mutual matching relation of the pericardium at the position, and the stability of the device is improved.

Optionally, during the process of the retracting needle entering the second state from the first state, the distal end of the retracting needle is everted relative to the axis of the sheath and passes through the receiving area.

In the specific structure of deformation, the far end of the traction needle is a main component, and the pericardium in the containing area is punctured in the moving process, so that the stable lifting effect is realized.

Optionally, the traction needles and the accommodating cavities are arranged in groups, and a plurality of groups of traction needles and accommodating cavities are uniformly arranged in the circumferential direction of the sheath tube.

The traction needle and the accommodating cavity are in one-to-one correspondence, so that the pericardium part interacting with the sheath can be increased under the condition that the size of the sheath is certain, and a better traction effect is achieved.

The application also discloses device is intervene to pericardium, including pericardium among the above-mentioned technical scheme pull-up ware and pericardium puncture ware, the pericardium puncture ware includes the puncture piece, puncture piece movable mounting in the sheath pipe just has towards the puncture state of distal end motion and the retraction state towards the near-end motion, puncture needle under the puncture state be used for the puncture with draw the pericardium of needle interact.

The pericardium is pulled by the pericardium pulling device to puncture the pericardium, and the puncturing operation is performed by the puncturing member.

Optionally, the puncturing element includes a driving section extending from a distal end to a proximal end in the sheath, and a puncturing section disposed at the distal end of the driving section, and the driving section is movably engaged with the sheath and is configured to drive the puncturing section into the puncturing state or the retracted state.

The driving end is movably arranged in the sheath, the driving end is arranged in the sheath, the driving structure is similar to the traction needle, and the corresponding driving structure can be arranged.

Optionally, the distal ends of the piercing sections converge to form a sharp portion for cutting the pericardium.

Sharp-pointed portion can realize the puncture to the pericardium, and puncture section and drive end can set up the passageway of intercommunication in order to set up other pipelines inside simultaneously, and the convenience implements subsequent operation after the puncture.

Optionally, the puncturing section is a puncturing knife detachably mounted at the distal end of the driving section, and the distal ends of the puncturing knife are converged and furled to form a third cutting edge for cutting the pericardium.

The puncture knife can achieve a puncture effect different from that of a sharp part, and forms different shapes or sizes of pericardial puncture openings. Puncture sword detachable design can the adaptation with the scalpel etc. among the current product install to the pericardium in this application intervene the device, improves the adaptability of device.

Optionally, the pericardial puncture device further comprises a cannula, the cannula is arranged in the sheath in a penetrating manner, and the puncture piece is movably arranged in the cannula in a penetrating manner.

The sleeve pipe can provide accommodating space for the puncture section, avoids causing the influence to pipeline on every side at the puncture section of intervention in-process.

Optionally, the pericardial puncture device further includes:

the puncture piece is movably arranged in the sleeve in a penetrating way;

a puncture handle to which the cannula is mounted;

the driving part is movably arranged on the puncture handle;

the driven part is connected with the puncture part and driven by the driving part to enable the puncture part to enter the puncture state or the retraction state.

The puncture handle can realize the drive to the puncture piece thereby realize the stable puncture to the pericardium.

Optionally, the driving part is a rotating part rotatably mounted on the puncture handle, a first internal thread is arranged inside the driving part, and the driven part is matched with the first internal thread to realize movement.

The thread fit has better motion precision, and is convenient for controlling the motion of the puncture piece.

Optionally, the puncture handle includes a lower seat connected with the cannula and a detachably mounted upper seat, the upper seat and the lower seat are hollow and communicated with each other, the driving member is rotatably sleeved on the upper seat, the driven member is located between the upper seat and the driving member, a first guide hole is formed in a side wall of the upper seat, and the driving section is connected with the driven member through the first guide hole; the lower seat is provided with a second guide hole, a display panel is arranged in the second guide hole, and the driving section is in linkage with the display panel through the two guide holes.

The puncture piece driven by the structure in the embodiment has high movement precision and good puncture effect.

Optionally, the pericardial lifter further includes a sheath handle, and the sheath handle includes:

the lower fixing piece is connected with the near end of the sheath tube;

the upper fixing piece is connected with the lower fixing piece;

the force application part is movably arranged between the lower fixing part and the upper fixing part, the interior of the force application part is hollow to form a driving chamber, and the interior of the sheath tube is communicated with the driving chamber;

and the driving piece is movably arranged in the driving chamber, and the driving piece is acted by the force application piece to move and drive the traction needle to slide relative to the sheath tube.

The sheath tube handle can realize stable movement between the traction needle and the sheath tube, thereby accurately controlling the lifting and releasing of the pericardium.

Through the setting of each part, realized the inside compact arrangement of sheath pipe handle in this embodiment, provide the whole space performance of better operation feeling and sheath pipe handle.

Optionally, a first through hole for installing the sheath is formed in the lower fixing piece, a second through hole communicated with the driving chamber is formed in the upper fixing piece, a third through hole is formed in the driving piece, a pipeline in the sheath enters the driving chamber through the first through hole, and the third through hole and the second through hole extend to the proximal end side of the sheath handle.

Partial pipeline runs through the sheath pipe handle and provides a structural basis for the connection of other equipment and the center bag intervention device of the application.

The application discloses a pericardial interventional device, which comprises the pericardial puller in the technical scheme, wherein a pericardial puncture device is further arranged on the pericardial puller and used for puncturing a pericardium which interacts with the traction needle; an endoscope and a threading channel for the guide wire to penetrate are arranged in the sheath tube.

The pericardium puller is used for pulling the pericardium, the pericardium puncture outfit is used for puncturing the pericardium, the endoscope can realize real-time observation of the treatment process, and the guide wire provides a foundation for subsequent treatment through the threading channel.

Optionally, the pericardial puncture device includes a puncture element, and the puncture channel is disposed inside or outside the puncture element.

The puncture channel can bring different technical advantages, for example, the whole structure is more compact when the puncture channel is arranged in the puncture piece, and the puncture channel and the puncture piece move more independently when the puncture channel is arranged outside the puncture piece, so that the puncture channel has good adaptability.

Specific advantageous technical effects will be further explained in conjunction with specific structures or steps in the detailed description.

Drawings

FIG. 1a is a schematic view of a pericardial access device according to one embodiment;

fig. 1b is a schematic view of the distal end of the sheath of the pericardial lifter of fig. 1 a;

fig. 1c is a schematic view of another perspective of the distal end of the sheath of the pericardial lifter of fig. 1 a;

FIG. 1d is a schematic view of an embodiment of a receiving cavity;

fig. 1e is a schematic view of the pericardial access device of fig. 1a in a second state;

fig. 1f is a schematic view of the distal end of the sheath of the pericardial lifter of fig. 1 e;

fig. 1g is a schematic view of another perspective of the distal end of the sheath of the pericardial lifter in fig. 1 e;

FIGS. 1h to 1m are schematic views of different embodiments of an accommodating chamber;

FIG. 2a is a schematic view of a pericardial access device in one embodiment;

fig. 2b is a schematic view of the sheath distal end of the pericardial access device in fig. 2 a;

fig. 2c is a schematic view of another perspective of the sheath distal end of the pericardial access device in fig. 2 a;

fig. 2d is a schematic diagram of the internal structure of the sheath distal end of the pericardial access device in fig. 2 a;

fig. 2e is a schematic diagram of the pericardial access device in fig. 2a in a second state;

fig. 2f is a schematic view of the sheath distal end of the pericardial access device in fig. 2 e;

fig. 2g is a schematic diagram illustrating another perspective view of the sheath distal end of the pericardial access device in fig. 2 e;

FIG. 3a is a schematic view of a pericardial puncture device according to an embodiment;

FIG. 3b is a schematic view of another embodiment of a pericardial puncture device;

FIG. 3c is a schematic view of the distal end of the pericardial puncture device of FIG. 3 b;

fig. 3d is a schematic view of the internal structure of the distal end of the pericardial puncture device in fig. 3 b;

FIG. 3e is a schematic view of a puncture handle on the pericardial puncture instrument in FIG. 3 b;

FIG. 3f is a cross-sectional view of the piercing handle of FIG. 3 e;

FIG. 3g is a schematic view of the interior structure of the puncturing handle portion shown in FIG. 3 e;

FIG. 3h is a schematic view of the interior structure of the puncturing handle of FIG. 3 e;

FIG. 4a is a schematic view of an embodiment of the internal structure of the sheath handle;

FIG. 4b is a schematic view of the sheath handle of FIG. 4a from another perspective;

FIG. 4c is another perspective view of the force applying member and the upper retaining member shown in FIG. 4 a;

FIG. 4d is a schematic view of the internal structure of the sheath handle of FIG. 4a in a second state;

FIG. 4e is a schematic view of the internal structure of the sheath handle of FIG. 4a in a first state;

FIG. 4f is a schematic view of the internal structure of the pericardial access device in a first state according to an embodiment;

FIG. 4g is the inner structure of the sheath handle of FIG. 4 f;

FIG. 4h is a schematic view of the sheath handle of FIG. 4g in a mated relationship;

FIG. 5a is a schematic view of an embodiment of an access device attached to a pericardium;

FIG. 5b is a schematic view of an embodiment of an access device agitating pericardium;

FIG. 5c is a schematic view of a pericardium fixation portion of an access device according to an embodiment;

FIG. 5d is a schematic view of a pericardium being lifted by an access device according to an embodiment;

FIG. 5e is a schematic view of an embodiment of an access device puncturing the pericardium;

fig. 5f is a schematic view of an embodiment of an interventional device implanted with a guidewire.

The reference numbers in the figures are as follows:

1. a sheath tube; 11. an accommodating cavity; 111. a barb; 112. an open site; 113. a housing area; 114. a retention lip; 115. a second cutting edge; 116. avoiding the inclined plane; 1161. a starting point; 1162. a terminal point; 117. a turning part; 2. a traction needle; 21. a rod portion; 22. a hook portion; 221. a first cutting edge; 23. a restraint tube; 3. a piercing member; 31. a drive section; 32. a piercing section; 33. a third cutting edge; 34. a sleeve; 351. a puncture handle; 3511. a lower seat; 3512. an upper seat; 3513. a first guide hole; 3514. a second guide hole; 3515. a display panel; 352. a driving member; 3521. a first internal thread; 353. a driven member; 36. a threading channel; 4. a sheath handle; 41. a lower fixing member; 411. a first through hole; 42. a force application member; 421. a second internal thread; 43. a drive member; 431. a third through hole; 432. a confinement groove; 44. an upper fixing member; 441. a second through hole; 442. a sealing plug; 45. a drive chamber; 451. a guide bar; 9. a guide wire; 10. the pericardium.

Detailed Description

The technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only a part of the embodiments of the present application, and not all of the embodiments. All other embodiments obtained by a person of ordinary skill in the art based on the embodiments in the present application without making any creative effort belong to the protection scope of the present application.

It will be understood that when an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. When a component is referred to as being "disposed on" another component, it can be directly on the other component or intervening components may also be present.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs. The terminology used in the description of the present application herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the application. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.

Referring to fig. 1a to 2g, the present application discloses a pericardial lifting device, which includes a sheath 1 and a traction needle 2 slidably engaged with the sheath 1, wherein the traction needle 2 can be switched between a first state (refer to fig. 1 a) and a second state (refer to fig. 1 e) during sliding, wherein the traction needle 2 is attached to the sheath 1 in the first state, and a distal end of the traction needle 2 is deformed into a lifting hook for hooking the pericardium in the second state; a receiving cavity 11 adjacent to the lifting hook is arranged at the far end of the sheath tube 1.

According to the technical scheme in the embodiment, the pericardium is gathered in the preset area through the containing cavity 11, so that the pericardium can be conveniently pulled by the traction needle 2 more stably, and the damage to peripheral tissues such as the myocardium is avoided.

Functionally, the housing chamber 11 is used to collect the pericardium, and the traction needle 2 is used to pull up the pericardium. Referring to an embodiment, the traction pin 2 includes:

a rod part 21, which is attached to the sheath tube 1;

hook portion 22 is connected and switches between first state and second state through deformation with pole portion 21, and hook portion 22 deforms the lift hook that colludes the form under the second state.

The change between the different states of the traction needle 2 may be represented by the change of the hook 22 only, or may be realized by the change of both the rod 21 and the hook 22. The rod 21 is used to slide the needle 2 relative to the sheath 1, and the sliding of the hook 22 is actually transmitted mechanically by the rod 21. The hook portion 22 is adapted to deform to form a lifting hook for interacting with the pericardium to perform a lifting effect. Structurally, the hook 22 and the rod 21 are integrated or separated.

The change of the traction needle 2 between the two states is mainly embodied as the change of the self-form, the change can be realized by changing the position of the traction needle 2 by a driving mechanism, or in an embodiment, the rod part 21 and/or the hook part 22 are elastic parts, and the elastic driving hook part 22 is kept in the second state under the action of the self elasticity;

the traction needle 2 further comprises a restraining member for keeping the hook portion 22 in the first state, the restraining member not passing over the housing cavity 11.

The rod part 21 and/or the hook part 22 formed by the elastic part can realize the automatic switching between the first state and the second state, reduce the driving parts, and realize stable working effect by a simple mechanism in cooperation with the restraint part. Memory metal is a conventional choice in the art for the material of the pull pin 2, wherein the memory metal comprises nitinol.

The traction needle 2 can be switched between two states by changing the material property thereof, and can also be switched by a driving mechanism. For example, in one embodiment, the constraining member is a constraining tube 23 disposed on the sheath tube 1, the constraining tube 23 extends from the distal end to the proximal end along with the sheath tube 1, and the rod portion 21 and the hook portion 22 are movably disposed in the constraining tube 23; the hook 22 in the second state protrudes out of the distal end of the restraining tube 23; the hook portion 22 in the first state is accommodated in the restraint tube 23.

The sliding process of the traction needle 2 relative to the sheath tube 1 can be understood as the sliding process relative to the constraint tube 23, so that the switching of different states is realized, and meanwhile, the change of the far end position of the constraint tube 23 can also realize the change of the specific forming position and the forming path of the lifting hook. The restraining tube 23 drives the traction needle 2 to enter the first state by guiding the traction needle 2, and meanwhile, the restraining tube 23 can also accommodate the traction needle 2, so that the traction needle 2 is prevented from being influenced by surrounding pipelines or tissues in the intervention process.

In the arrangement of the restraint pipe 23, there are various options according to the pipeline arrangement inside the product and the use scene.

In the embodiment disclosed with reference to fig. 2b, the constraining tube 23 is applied to the inner side wall of the sheath 1. The constraining tube 23 is arranged in the sheath tube 1 to provide a smooth outer wall of the sheath tube 1, so that the intervention process is convenient to implement.

In the embodiment disclosed with reference to fig. 1b, the constraining tube 23 is applied to the outer sidewall of the sheath 1. The placement of the constraint tube 23 outside the sheath 1 provides space for more lines within the sheath 1, providing a structural foundation for complex procedures, particularly for embodiments requiring multiple devices to enter the sheath 1. Meanwhile, the restraining tube 23 itself can increase the roughness and surface area of the sheath surface, thereby increasing the contact area of the pericardium and the sheath and the winding force.

In other embodiments, the constraining tube 23 is disposed within the sheath 1 sidewall. This arrangement is advantageous in that both the above embodiments are compatible, but there is a certain requirement for the wall thickness of the sheath 1, and accordingly, the mechanical properties of the sheath 1 are also affected to a certain extent.

The hook 22 in the second state has a plurality of independent arrangements with respect to the arrangement relationship between the constraining tube 23 and the sheath tube 1.

In the embodiment disclosed with reference to fig. 1g, the hook 22 in the second state extends from the constraining tube 23 away from the axis of the sheath 1. The arrangement extending away from the sheath axis enables the hook 22 to form a larger active area than the sheath diameter in the second state, especially when there are multiple hooks 22. The increase of the projection area of the hook part 22 in the sheath tube 1 axial direction in the second state can act on a larger area of the pericardium, and the pulling effect is improved.

In other embodiments, the hook 22 in the second state extends from the constraining tube 23 toward the axis of the sheath 1. This arrangement can avoid the hook 22 in the second state from interfering with the surrounding tissue, but the extension toward the axis of the sheath 1 may interfere with the line of the device entering the human body along with the sheath 1. Therefore, different setting modes are adjusted according to different treatment cases, so that better treatment effect is obtained in a synergistic manner.

In general, referring to an embodiment, the rod portion 21 and/or the hook portion 22 are flexible members and are switched between the first state and the second state by relative movement with the sheath 1.

The flexible shaft 21 and/or the hook 22 can satisfy different technical requirements of the pull needle 2 in the first state and the second state. The flexibility here is in terms of relatively non-deformable rigidity, and therefore the flexibility here still needs to meet certain mechanical properties, in particular the mechanical property requirements of the hook portion 22 for the pulling operation of the pericardium.

The final purpose of the hook 22 is to lift the pericardium, so it needs to interact with the pericardium, and at a specific action site, referring to an embodiment, the distal end of the hook 22 is provided with a first cutting edge 221 capable of puncturing the pericardium.

The first cutting edge 221 is used to apply a force to the pericardium by the hook 22 to achieve lifting. In certain embodiments, the first cutting edge 221 punctures a portion of the pericardium to achieve a stable pull-up. In other embodiments, the first cutting edge 221 functions to enhance the interaction between the hook 22 and the pericardium and is not limited to puncturing or puncturing the pericardium. For example, the first cutting edge 221 has a rough surface to interact with the pericardium, and especially after the pericardium is gathered and stacked in cooperation with the receiving cavity 11, the first cutting edge 221 can avoid damage to the pericardium.

The increase in the number of the pulling needles 2 can improve the effect of pulling the pericardium and ensure the stability of the operation. Therefore, in one embodiment, the plurality of the traction needles 2 are uniformly arranged in the circumferential direction of the sheath 1.

In the prior art, the pericardium attached to the myocardium needs to be pulled, and thus the myocardium is easily affected. Referring to an embodiment, the distal end of the retracting needle 2 is located on a deformation path during the process of the retracting needle 2 from the first state to the second state, and the deformation path is flush or retracted with respect to the distal end of the sheath 1.

In this embodiment, the arrangement of the accommodating cavity 11 can realize that the pericardium is lifted when the deformation path of the traction needle 2 is flush or retracted compared with the distal end of the sheath tube 1, so as to avoid the damage of the traction needle 2 to the myocardium, and the arrangement can structurally avoid the operation problem of an operator, reduce the learning cost, and improve the adaptability.

In specific parts, referring to an embodiment, the lifting hook does not go beyond the distal end of the sheath 1.

The lifting hook is a part which actually interacts with the pericardium, and the lifting hook can avoid acting on the pericardium attached to the cardiac muscle under the matching of the accommodating cavity 11, so that the possibility of influencing the cardiac muscle is reduced. Especially in embodiments where the lifting hook is provided with a corresponding piercing structure.

In combination with the specific location, the end surface of the distal end of the retracting needle 2 is a location that is easy to affect the myocardium, and referring to an embodiment, the distal end of the retracting needle 2 does not cross the distal end of the sheath 1 all the time during the process from the first state to the second state of the retracting needle 2.

The distal end of the retractor needle 2 may be provided with a structure such as the first cutting edge 221 in order to lift the pericardium, and the pericardium attached to the myocardium is prevented from being affected by the arrangement without passing over the distal end of the sheath tube 1 in this embodiment.

From the view point of the motion track, referring to an embodiment, during the process of the traction needle 2 from the first state to the second state, the deformation path of the distal end of the traction needle 2 does not cross the distal end of the sheath 1 at all times.

The deformation path of the distal end of the retracting needle 2 can be understood as the moving path of the first cutting edge 221, that is, the moving path of the first cutting edge 221 does not affect the tissue other than the distal end of the sheath 1, thereby structurally avoiding the retracting needle 2 from scratching the cardiac muscle during the process from the first state to the second state.

With reference to fig. 1a to 2g, the present application discloses a pericardial retractor, which includes a sheath 1 and a traction needle 2 slidably engaged with the sheath 1, wherein the traction needle 2 can be switched between a first state and a second state during sliding, wherein the traction needle 2 is attached to the sheath 1 in the first state, and a distal end of the traction needle 2 is deformed into a retractor hook for hooking the pericardium in the second state; a receiving cavity 11 adjacent to the lifting hook is arranged at the far end of the sheath tube 1.

In this embodiment, the accommodating cavity 11 is open, two opposite sides of the accommodating cavity 11 are arranged in the circumferential direction of the sheath tube 1, at least one side of the accommodating cavity has a barb 111, the barb 111 is adjacent to the open portion 112 of the accommodating cavity 11, and the barb 111 is inclined with respect to the axis of the sheath tube 1.

The barb 111 can guide the pericardium into the housing cavity 11, and particularly when the pericardium moves relative to the barb 111, the movement is easily achieved by rotating the sheath tube 1 or the like. When the barb 111 is obliquely arranged relative to the axis of the sheath tube 1, the barb 111 can generate acting force far away from cardiac muscle to the pericardium acted by the barb 111, so that the pericardium is gathered, and the traction needle 2 is convenient to realize the next operation.

Functionally, the receiving cavity 11 can stir, even hook, and lift the pericardium, and the specific shape of the receiving cavity 11 may be changed in various ways, even in a hook shape (not shown), so that the function can be understood. The present application illustrates various ways shown in fig. 1d, 1h to 1 m.

The embodiment of fig. 1d differs from the embodiment of fig. 1h in the direction of extension of the receiving area 113, enabling a better lateral pericardial accumulation in the embodiment of fig. 1g and a better vertical pericardial accumulation in the embodiment of fig. 1 d.

The embodiments of fig. 1j and 1L differ in the extension depth of the receiving areas 113 and the number of receiving areas 113, in the embodiments of fig. 1L and 1m the depth of the receiving areas 113 is increased and the number of receiving areas 113 is decreased, and in the embodiments of fig. 1j and 1k the depth of the receiving areas 113 is decreased and the number of receiving areas 113 is increased.

In the following description, the accommodating cavity 11 in fig. 1d is taken as an example to explain the functions and design concepts of the structures in the accommodating cavity 11, and the accommodating cavities 11 in the other embodiments are the same and will not be described again.

The number of the housing areas 113 in the circumferential direction can be adjusted and changed accordingly, similarly to the form change. As embodied by the varying number of barbs 111. The increased number of barbs 111 can improve the nesting and effectiveness of the housing 11 on the pericardium. In an embodiment, two opposite sides of the accommodating cavity 11 are provided with barbs 111, and the two barbs 111 have the same inclination tendency.

The two barbs 111 with the same inclination tendency can more conveniently realize the pericardium entering into the containing cavity 11, and the inclination tendency is understood as the inclined orientation rather than the inclined angle. The barb that the inclination trend is unanimous can realize the quick release of pericardium, for example when sheath pipe counter-rotation, the pericardium can break away from under the effect of barb and accept chamber 11, avoids releasing the in-process damage pericardium.

The receiving cavity 11 needs to gather the pericardium to a small extent in addition to the pericardium so as to facilitate the interaction of the traction needle 2 with the pericardium. In one embodiment, a receiving area 113 for receiving at least a portion of the pericardium is disposed in the receiving cavity 11, and the receiving area 113 extends in the axial direction of the sheath 1.

The receiving area 113 can retain the pericardium entering the receiving cavity 11 within the receiving cavity 11 and achieve a certain gathering or stacking.

In a specific arrangement of the housing area 113, referring to an embodiment, the housing area 113 and the opening portion 112 are in staggered communication in the circumferential direction of the sheath 1.

The receiving area 113 and the open part 112 which are in staggered communication in the circumferential direction can prevent the pericardium entering the receiving area 113 from being separated from the receiving cavity 11 by itself, and the pericardium restraining capability of the receiving cavity 11 is improved.

In an implementation in which the pericardium is held in a certain position, other structures may be provided in addition to the housing area 113. Referring to an embodiment, the receiving cavity 11 is open, and the receiving cavity 11 is provided with two opposite sides on the circumference of the sheath 1, wherein at least one side is provided with a retaining edge 114, and the retaining edge 114 is used for retaining the pericardium in the receiving cavity 11.

The retaining rim 114 can provide a constant driving effect on the pericardium to increase the ability of the receiving cavity 11 to restrain the pericardium.

The receiving chamber 11 can achieve pre-fixing of the pericardium, in addition to the above-described accumulation of the pericardium. In one embodiment, the barbs 111 are relatively convex with respect to the side and converge to form a second cutting edge 115.

The second cutting edge 115 is used to apply a force to the pericardium by the barbs 111 to achieve pre-fixation. In certain embodiments, the second cutting edge 115 punctures a portion of the pericardium to achieve a stable pull-up. In other embodiments, the second cutting edge 115 is provided with a friction-increasing retaining structure. The arrangement mode is to overcome the technical problem that the pericardium is easy to separate from the second cutting edge in the lifting process or the pericardium puncturing process of the puncturing piece. Accordingly, in some embodiments, the second cutting edge 115 is provided as a friction enhancing retention feature. This structure serves to improve the interaction between the hook portion 22 and the pericardium, reducing the effect on the pericardium. The retention structure can provide good retention while reducing damage to the pericardium, for example, by the rough surface interacting with the pericardium, particularly after gathering and stacking of the barbs 111 to the pericardium.

In the embodiment disclosed with reference to fig. 1d, at least one of the barbs 111 and the retaining rim 114 are located on the same side of the receiving cavity 11, and they are connected end to end.

The arrangement, which shows the barbs 111 and retaining rim 114 on the left side of the figure end to end, enables a seamless guidance of the pericardium, thereby ensuring a stable positioning of the pericardium into the receiving cavity 11. Similarly, in the other side of the figure, the side wall of the open portion 112 is obliquely arranged to form an avoiding inclined surface 116 for the pericardium to enter the accommodating area 113 in the accommodating cavity 11, at least one of the barbs 111 and the avoiding inclined surface 116 are located on the same side of the accommodating cavity 11, and the two are connected end to end.

The avoiding inclined plane 116 plays a role of guiding while avoiding, and cooperatively realizes the movement of the pericardium in the accommodating cavity 11; meanwhile, the avoiding inclined plane 116 reserves space for the pericardium to enter the open area and the accommodating area 113,

in one embodiment, the avoiding slope 116 and the retaining edge 114 are respectively located at two sides of the receiving cavity 11, and the avoiding slope and the retaining edge are arranged oppositely, and a gap between the avoiding slope and the retaining edge communicates with the receiving area 113 and the opening portion 112.

The avoidance ramp 116 and retention rim 114 cooperate to guide and position the pericardium into the open space.

In the mutual position relation, referring to an embodiment, in an axial projection of the sheath, the second cutting edge 115 is located between the start point 1161 and the end point 1162 of the avoiding inclined plane 116, and a vertical gap D1 is provided between the second cutting edge 115 and the start point 1161 of the avoiding inclined plane 116.

The vertical clearance provides a release space for the movement of the pericardium, so that the pericardium can be more easily entered into the accommodating area 113 under the matching of the barb 111 and the second cutting edge 115, and the pericardium can be grabbed by the traction needle.

In an embodiment, the turning portion 117 is disposed on the retaining edge 114, and the turning portion 117 is located between the starting point 1161 and the ending point 1162 of the avoiding slope 116 on the projection of the circumferential direction of the sheath.

The position relation of the turning part 117 and the avoiding inclined plane 116 can realize the uninterrupted guidance of the accommodating port on the movement of the pericardium, thereby improving the grabbing effect of the pericardium by the accommodating port.

In order to avoid the influence on the myocardium, similar to the traction needle 2, in an embodiment, the distal end of the second cutting edge 115 is flush or retracted compared to the sheath 1.

Compared with the second cutting edge 115 which is flush or retracted at the far end of the sheath tube 1, the tissue behind the pericardium can be prevented from being influenced, and unnecessary damage can be avoided.

The increase in the number of the housing chambers 11 can improve the pre-fitting ability to the pericardium, thereby providing a more stable pulling-fit effect to the traction needle 2. In one embodiment, the accommodating cavities 11 are uniformly arranged in the circumferential direction of the sheath tube 1.

With reference to fig. 1a to 2e, the present application discloses a pericardial retractor, which includes a sheath 1 and a traction needle 2 slidably engaged with the sheath 1, wherein the traction needle 2 can be switched between a first state and a second state during sliding, wherein the traction needle 2 is attached to the sheath 1 in the first state, and a distal end of the traction needle 2 is deformed into a retractor hook for hooking the pericardium in the second state; a receiving cavity 11 adjacent to the lifting hook is arranged at the far end of the sheath tube 1.

In this embodiment, a receiving area 113 for receiving at least a part of the pericardium is arranged in the receiving cavity 11; the far end of the traction needle 2 is located on a deformation path in the process of the traction needle 2 entering the second state from the first state, and the deformation path passes through or is close to the accommodating area 113.

When the deformation path of the traction needle 2 passes through or is close to the accommodating area 113, the deformation path interacts with the pericardium in the accommodating area 113, so that the traction effect is achieved, compared with the prior art, the matching mode can effectively avoid the effect of the traction needle 2 on the pericardium outside the accommodating port, compared with the prior art that the traction needle directly operates the pericardium attached to the myocardium in the prior art, the implementation mode in the embodiment can effectively protect surrounding tissues and reduce injuries.

The traction needle 2 interacts with the pericardium in the receiving area 113 in a number of ways. For example, in the embodiment disclosed in fig. 2f, the deformation path extends from inside the sheath 1 to outside the sheath 1 through the accommodating area 113; for example, in the embodiment disclosed in fig. 1f, the deformation path extends from the side of the sheath 1 through the accommodating area 113 to the axis of the sheath 1; for another example, in other embodiments, the deformation path extends from the outside of the sheath 1 to the inside of the sheath 1 through the accommodating area 113; for another example, in another embodiment, the deformation path extends from the inside of the sheath 1 to the axis of the sheath 1 through one side of the receiving area 113

The penetration of the accommodating area 113 can be realized from the inside of the sheath tube 1 to the outside of the sheath tube 1 or from the outside of the sheath tube 1 to the inside of the sheath tube 1 by the deformation path, so that the establishment of the mutual matching relation of the traction needle 2 to the pericardium at the position is ensured, and the stability of the device is improved; the deformation path through one side of the receiving area 113 can avoid excessive damage to the pericardium. Abundant setting mode can cooperate the nimble setting of first blade 221 to provide better adaptability, provides better treatment.

From the viewpoint of stable pulling effect, referring to an embodiment, during the process of the traction needle 2 entering the second state from the first state, the distal end of the traction needle 2 is everted compared to the axis of the sheath 1 and passes through the housing area 113.

In the specific structure of the deformation, the far end of the traction needle 2 is a main component, and the pericardium in the containing area 113 is punctured in the moving process, so that the stable lifting effect is realized.

The traction needles 2 and the accommodating cavities 11 are in one-to-one correspondence, so that the pericardium part interacting with the sheath 1 can be increased under the condition that the size of the sheath is fixed, and a better traction effect is achieved. Referring to an embodiment, the traction needles 2 and the accommodating cavities 11 are arranged in groups, and a plurality of groups of traction needles 2 and accommodating cavities 11 are uniformly arranged in the circumferential direction of the sheath 1.

With reference to fig. 1a to 4h, the present application further discloses a pericardial access device, including the pericardial lifting device and the pericardial puncture device in the above technical solutions, the pericardial puncture device includes a puncture element 3, the puncture element 3 is movably mounted on the sheath tube 1 and has a puncture state moving towards the distal end and a retraction state moving towards the proximal end, and the puncture needle in the puncture state is used for puncturing the pericardium interacting with the traction needle 2.

The pericardial-drawing device draws the pericardium to puncture the pericardium, and the puncture device 3 performs the puncturing operation.

In the implementation of the puncturing element 3, referring to an embodiment, the puncturing element 3 includes a driving section 31 extending from the distal end to the proximal end in the sheath 1 and a puncturing section 32 disposed at the distal end of the driving end, and the driving section 31 is movably engaged with the sheath 1 and is used for driving the puncturing section 32 into a puncturing state or a retracting state.

The driving end is movably arranged in the sheath tube 1, a corresponding driving structure can be arranged similarly to the traction needle 2, and after the traction needle 2 is matched with the accommodating cavity 11 to complete the lifting and pulling of the pericardium, the puncturing section 32 can stably realize the puncturing of the pericardium, so that a further treatment process can be carried out.

Different designs of the piercing member 3 can meet different treatment requirements. In the embodiment disclosed with reference to fig. 3a, the distal ends of the piercing section 32 converge to form a sharp for cutting the pericardium.

The sharp part can realize the puncture to the pericardium, and puncture section 32 and drive end can set up the passageway of intercommunication in order to set up other pipelines simultaneously, conveniently implements subsequent operation after the puncture.

In the embodiment disclosed with reference to fig. 3b to 3d, the puncturing section 32 is a puncturing blade detachably mounted on the distal end of the driving section 31, and the distal ends of the puncturing blade converge to form a third cutting edge 33 for cutting the pericardium.

In the embodiment disclosed with reference to fig. 3c, the pericardial puncture device further includes a sleeve 34, the sleeve 34 is disposed inside the sheath 1, and the puncture element 3 is movably disposed inside the sleeve 34 during the intervention of the puncture element 3, which may affect the surrounding pipeline.

The sleeve 34 can provide a housing space for the puncture section 32, and the puncture section 32 is prevented from influencing the surrounding pipeline during the intervention.

In one embodiment, the pericardial puncture device further comprises:

a sleeve 34, wherein the puncture element 3 is movably arranged in the sleeve 34;

a puncture handle 351, to which the cannula 34 is attached;

an active member 352 movably mounted on the puncture handle 351;

a follower 353 connected to the puncturing member 3 and driven by the follower 352 to put the puncturing member 3 into a puncturing state or a retracted state.

The puncture handle 351 can drive the puncture element 3 to stably puncture the pericardium. The driving member 352 moves the driven member 353 during movement to effect movement of the driving end relative to the sleeve 34.

In the driving relationship, referring to an embodiment, the driving member 352 is a rotating member rotatably mounted on the puncture handle 351 and internally provided with a first internal thread 3521, and the driven member 353 is provided with a first external thread (not numbered) engaged with the first internal thread 3521.

Structurally, referring to an embodiment, the puncture handle 351 includes a lower seat 3511 connected to the cannula 34 and a detachably mounted upper seat 3512, the upper seat 3512 and the lower seat 3511 are hollow and are communicated with each other, the driving member 352 is rotatably sleeved on the upper seat 3512, the driven member 353 is located between the upper seat 3512 and the driving member 352, a first guiding hole 3513 is formed in a side wall of the upper seat 3512, and the driving section 31 is connected to the driven member 353 through the first guiding hole 3513. The first guide hole 3513 provides a movement limit while guiding the movement of the driving segment 31 and the follower 353. The lower block 3511 is provided with a second guide hole 3514, and the driving section 31 is provided with a display panel 3515 disposed in the second guide hole 3514. The display panel 3515 is used for being matched with the lower seat 3511 to indicate the movement stroke of the puncture piece 3, so that an operator can conveniently control the length of the puncture piece extending out of the sleeve, and the operator can observe the specific puncture progress in cooperation with an endoscope, and accurate control can be realized.

With reference to fig. 4a to 4h, the present application further discloses a pericardial access device, including the pericardial lifting device and the pericardial puncture device in the above technical solutions, the pericardial puncture device includes a puncture element 3, the puncture element 3 is movably mounted on the sheath tube 1 and has a puncture state moving towards the distal end and a retraction state moving towards the proximal end, and the puncture needle in the puncture state is used for puncturing the pericardium interacting with the traction needle 2.

In this embodiment, the pericardial retractor further includes a sheath handle 4, and the sheath handle 4 includes:

a lower fixing member 41 connected to the proximal end of the sheath tube 1;

an upper fixing member 44 connected to the lower fixing member 41;

the force application piece 42 is movably arranged between the lower fixing piece 41 and the upper fixing piece 44, the force application piece 42 is internally hollow to form a driving chamber 45, and the interior of the sheath tube 1 is communicated with the driving chamber 45;

and a driving member 43 movably installed in the driving chamber 45, wherein the driving member 43 is moved by the force applying member 42 to drive the drag needle 2 to slide relative to the sheath 1.

The sheath tube handle 4 can realize stable movement between the traction needle 2 and the sheath tube 1, thereby accurately controlling the lifting and releasing of the pericardium.

In terms of transmission, referring to an embodiment, the force applying member 42 is a rotary knob rotatably mounted on the lower fixing member 41, and is internally provided with a second internal thread 421, and the driving member 43 is provided with a second external thread (not numbered) which is matched with the second internal thread 421 to realize axial movement.

Through the arrangement of each part, the internal compact arrangement of the sheath tube handle 4 is realized, and better operation hand feeling and overall space performance of the sheath tube handle 4 are provided.

The driving chamber 45 provides a relatively closed space for the movement of the driving member 43, and in order to improve the stability of the movement of the driving member 43, compared with the embodiment disclosed in fig. 4a and 4g, a guide bar 451 is installed between the lower fixing member 41 and the upper fixing member 44, and the driving member 43 is slidably disposed on the guide bar 451. The guide bar 451 guides the movement of the driving member 43 to provide a more stable driving effect of the traction needle 2. The guide bar 451 extends through the driving member 43 in a fitting relationship.

In the fitting relationship of the pull pin 2 and the drive element 43, in one exemplary embodiment, the proximal end of the pull pin 2 is bent to overlap the proximal end face of the drive element 43. During the movement of the driving member 43, the transmission can be realized through the end surfaces of the two which are opposite to each other. For stability improvement, a proximal end surface of the driving member 43 is provided with a restraining groove 432 for attaching the proximal end of the traction needle 2.

In the communication relation, referring to an embodiment, the lower fixture 41 is provided with a first through hole 411 for installing the sheath tube 1, the upper fixture 44 is provided with a second through hole 441 communicated with the driving chamber 45, the driving member 43 is provided with a third through hole 431, and a pipeline in the sheath tube 1 enters the driving chamber 45 through the first through hole 411 and extends to the proximal end side of the sheath tube handle 4 through the third through hole 431 and the second through hole 441.

The arrangement of part of the pipeline running through the sheath handle 4 provides a structural basis for the connection of other equipment with the center bag intervention device of the application. In order to realize a more closed driving chamber 45, the sheath tube 1 is in sealing fit with the first through hole 411, the second through hole 441 is provided with a sealing plug 442, and the sealing plug 442 is provided with a pipeline hole (not numbered) for a pipeline to pass through.

It is easy to find that, as the position relationship between the restriction tube 23 and the sheath tube 1 changes, the mounting position of the proximal end of the sheath tube 1 can also change correspondingly, and compared with the embodiment shown in fig. 4d and fig. 4g, when the restriction tube 23 is disposed outside the sheath tube 1, the engagement of the traction needle 2 with the restriction groove 432 can be conveniently realized, so that the sheath tube 1 can extend all the way to the vicinity of the sealing plug 442, and the fixing effect of the sheath tube 1 is correspondingly improved.

With reference to fig. 1a to 5f, the present application discloses a pericardial access device, which includes the pericardial puller in the above technical solution, and a pericardial puncture outfit is further provided on the pericardial puller, and is used for puncturing the pericardium interacting with the traction needle 2; the sheath tube 1 is provided with an endoscope and a threading channel 36 for threading a guide wire.

The pericardium puller is used for pulling the pericardium, the pericardium puncture device is used for puncturing the pericardium, the endoscope can realize real-time observation of the treatment process, and the guide wire provides a foundation for subsequent treatment through the threading channel 36.

Referring to one embodiment, the pericardial puncture device includes a puncture element 3, and a puncture channel 36 is provided inside the puncture element 3 or outside the puncture element 3.

The puncture channel can bring different technical advantages, for example, the whole structure is more compact when the puncture channel is arranged in the puncture piece 3, and the motion of the puncture channel and the motion of the puncture piece 3 are more independent and the adaptability is good.

The specific operation of the pericardium 10 interventional device in the present application is specifically illustrated in the following with reference to fig. 5a to 5 f:

referring to fig. 5a, the pericardial access device is attached to the pericardium 10, with emphasis on the distal side of the sheath 1 resting on the pericardium 10.

Referring to fig. 5b, the sheath 1 of the pericardial interventional device rotates forward, the pericardium 10 attached to the myocardium is stirred up by the accommodating cavity 11, and the pericardium 10 is pre-fixed by the accommodating cavity 11, during which, whether the accommodating cavity 11 is an open structure and whether the second cutting edge 115 is provided can achieve the function.

Referring to fig. 5c, the traction needle 2 pierces the pericardium 10, and the traction needle 2 leaves the restriction tube 23 and enters the second state by being driven by the sheath tube handle 4, so as to fix the pericardium 10 near the accommodation cavity 11;

referring to fig. 5d, the pericardium 10 is lifted, and the pericardium 10 is far away from the myocardium by the movement of the sheath tube 1, that is, the pericardium 10 is lifted.

Referring to fig. 5e, the puncturing member 3 punctures the pericardium 10, and the puncturing handle 351 or the puncturing member 3 is directly driven to move the puncturing member 3 relative to the sheath 1 to puncture at the preset position.

Referring to fig. 5f, the guide wire 9 is inserted, and the guide wire 9 is inserted through the threading guide, thereby facilitating the subsequent treatment operation.

After the treatment is finished, the traction needle 2 retracts into the restraint tube 23 and is in a first state under the driving of the sheath tube handle 4, so that the traction needle 2 is separated from the pericardium 10; the sheath tube 1 of the pericardial access device is reversely rotated, the pericardium 10 in the containing cavity 11 is released, and the pericardial access device can be withdrawn away from the focus.

The technical features of the embodiments described above may be arbitrarily combined, and for the sake of brevity, all possible combinations of the technical features in the embodiments described above are not described, but should be considered as being within the scope of the present specification as long as there is no contradiction between the combinations of the technical features. When technical features in different embodiments are represented in the same drawing, it can be seen that the drawing also discloses a combination of the embodiments concerned.

The above-mentioned embodiments only express several embodiments of the present application, and the description thereof is more specific and detailed, but not construed as limiting the claims. It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the concept of the present application, which falls within the scope of protection of the present application.

Claims

1. The pericardium lifting device is characterized by comprising a sheath tube and a traction needle in sliding fit with the sheath tube, wherein the far end of the sheath tube is provided with an accommodating cavity, when the sheath tube moves relative to the pericardium, the pericardium enters the accommodating cavity to realize pre-fixation, the traction needle can be switched between a first state and a second state in the sliding process, the traction needle is attached to the sheath tube in the first state, and the far end of the traction needle is deformed into a lifting hook matched with the accommodating cavity to realize hooking of the pericardium in the second state.

2. The pericardial puller of claim 1, wherein the retractor needle includes:

the rod part is attached to the sheath tube;

the hook part is connected with the rod part and is switched between the first state and the second state through deformation, and the hook part is deformed into a hook-shaped lifting hook in the second state;

the retractor needle further includes a restraint for maintaining the hook in the first state.

3. The pericardial puller of claim 2, wherein the restraint does not pass over the receiving cavity.

4. The pericardial puller of claim 1, wherein the distal end of the retractor needle does not pass beyond the distal end of the sheath at all times during the retraction needle from the first state to the second state.

5. The pericardial puller of claim 1, wherein the receiving cavity is a closed channel or open to a distal end of a sheath.

6. The pericardial lifter according to claim 5, wherein the receiving cavity is open, the receiving cavity is provided with two opposite sides in the circumferential direction of the sheath, at least one side of the receiving cavity has a barb, the barb is adjacent to the open portion of the receiving cavity, and the barb is inclined relative to the axis of the sheath.

7. The pericardial lifter of claim 6, wherein a receiving area for receiving at least a portion of the pericardium is provided in the receiving cavity, the receiving area extending in an axial direction of the sheath, and a length of the receiving area in the axial direction of the sheath is greater than a length of the receiving area in a circumferential direction of the sheath.

8. The pericardial lifter of claim 7, wherein at least one side of the receiving cavity has a retention rim for retaining the pericardium within the receiving cavity, and wherein at least one of the barbs and the retention rim are on the same side of the receiving cavity and are end-to-end.

9. The pericardial lifter according to claim 8, wherein the side wall of the opening portion is obliquely arranged to form an avoiding inclined surface for the pericardium to enter the receiving cavity, the avoiding inclined surface and the retaining edge are respectively located at two sides of the receiving cavity, the avoiding inclined surface and the retaining edge are oppositely arranged, and a gap between the avoiding inclined surface and the retaining edge communicates the receiving cavity and the opening portion.

10. The pericardial lifter according to claim 9, wherein the barbs are convex with respect to the sides, and have a shape converging to form a second cutting edge, and a vertical gap is provided between the second cutting edge and the starting point of the avoiding slope on the axial projection of the sheath.

11. The pericardial lifter of claim 1, wherein a receiving area for receiving at least a portion of the pericardium is disposed within the receiving cavity; the far end of the traction needle is positioned on a deformation path in the process of entering the second state from the first state, and the deformation path penetrates through or is close to the containing area.

12. The pericardial puller of claim 1, further comprising a sheath handle comprising:

the lower fixing piece is connected with the proximal end of the sheath tube;

the upper fixing piece is connected with the lower fixing piece;

the force application part is movably arranged between the lower fixing part and the upper fixing part, the force application part is hollow to form a driving chamber, and the interior of the sheath tube is communicated with the driving chamber;

13. A pericardial access device comprising the pericardial lifter of any of claims 1-12 and a pericardial piercer comprising a piercing member movably mounted to the sheath and having a distally moved piercing state and a proximally moved retracted state, the piercing member in the piercing state being adapted to pierce the pericardium interacting with the pull needle.

14. The pericardial access device of claim 13, wherein the pericardial puncture instrument further comprises:

the puncture piece is movably arranged in the sleeve in a penetrating way;

a puncture handle to which the cannula is mounted;

the driving part is movably arranged on the puncture handle;

the driven part is connected with the puncture part and is driven by the driving part to drive the puncture part to enter the puncture state or the retraction state.