WO2015061931A1 - 连发式组织穿孔缝合器 - Google Patents

连发式组织穿孔缝合器 Download PDF

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Publication number
WO2015061931A1
WO2015061931A1 PCT/CN2013/001598 CN2013001598W WO2015061931A1 WO 2015061931 A1 WO2015061931 A1 WO 2015061931A1 CN 2013001598 W CN2013001598 W CN 2013001598W WO 2015061931 A1 WO2015061931 A1 WO 2015061931A1
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WO
WIPO (PCT)
Prior art keywords
hemostatic
hemostatic clip
clip
clips
release
Prior art date
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PCT/CN2013/001598
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English (en)
French (fr)
Inventor
王东
李兆申
Original Assignee
王东
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Publication date
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Publication of WO2015061931A1 publication Critical patent/WO2015061931A1/zh

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/08Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0466Suture bridges
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122Clamps or clips, e.g. for the umbilical cord
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238Type of minimally invasive operation
    • A61B2017/00269Type of minimally invasive operation endoscopic mucosal resection EMR
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743Type of operation; Specification of treatment sites
    • A61B2017/00818Treatment of the gastro-intestinal system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0414Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0464Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue

Definitions

  • the invention relates to a burst-type tissue perforating stapler, belonging to the field of medical instruments, mainly used for suturing sutures of endoscopic tissue perforations.
  • tissue perforation such as gastric perforation and intestinal perforation. Once perforation occurs, the endoscope is very remedy. Difficulties can cause very high risk to patients. At present, there is no device that can treat perforation very quickly. The existing hemostatic clip can only cope with small bleeding wounds, so endoscopic perforation and suture technique is urgently needed. problem.
  • the technical problem to be solved by the present invention is to overcome the deficiencies of the prior art, and to provide a continuous-type tissue perforating suturing device capable of quickly suturing a perforated portion under a digestive endoscope, thereby avoiding a medical accident.
  • the first technical solution of the present invention is: a burst-type tissue perforating stapler comprising a pull wire, at least two hemostatic clips, and a releaser capable of sequentially releasing the hemostatic clip; wherein, adjacent In the two hemostatic clips, the head end of one of the hemostatic clips is detachably connected to the tail end of the other hemostatic clip; the tail end of the last stage hemostatic clip is detachably movable with the head end of the releaser
  • the hemostatic clip has a hemostatic clip assembly, one end of the pull wire is fixedly connected with the hemostir clip of the foremost stage, and the other end passes through the other hemostatic clips from front to back in sequence and the pull wire can move relative thereto.
  • the pull wire can pass through and move on the remaining hemostatic clip, and the other hemostatic clips except the foremost blood clip are provided with a threading hole, and the other end of the pull wire is from the front The threading holes of the hemostatic clip are sequentially passed through.
  • the length of the cable is defined to facilitate use during surgery, and the other end of the cable extends from the front to the rear through the other hemostatic clips and then to the tail of the release.
  • the release device includes a jacket, a handle, a movable release lever and a movable handle.
  • the movable release lever is axially movably inserted in the outer sleeve, and the movable handle is disposed at The tail end of the movable release lever, and the handle is disposed at the tail end of the outer sleeve.
  • the second technical solution of the present invention is: a burst-type tissue perforating stapler comprising at least two pull wires, at least two hemostatic clips, and a release device capable of sequentially releasing the hemostatic clips;
  • the head end of one of the hemostatic clips is detachably connected to the tail end of the other hemostatic clip;
  • the tail end of the stage hemostatic clip is detachably connected to the head end of the release device, and the hemostatic clip has a hemostatic clip assembly, each of the pull wires corresponding to a hemostatic clip, and one end of the pull wire corresponds to The hemostatic clip is fixedly connected.
  • the other end of the pull wire extends to the tail of the release.
  • the release device comprises a jacket, a handle, a movable release lever and a movable handle, the movable release lever is axially movably inserted in the outer sleeve, and the movable handle is disposed at a tail end of the movable release lever, The handle is placed at the end of the jacket.
  • the tissue perforation is found under the digestive endoscope, so that the foremost hemostatic clip fits the edge of the perforated tissue and clamps the tissue, and then the foremost blood clip is separated from the release device, and then According to this method, other hemostatic clips are attached to other edges of the perforated tissue, and the tissue is clamped, and then the hemostatic clips are separated from the release device, and all the hemostatic clips on the release device are clamped and released, and then tightened. Pull the wire, close the hemostatic clip, and tighten the perforated tissue.
  • the first technical solution can also install a locking block by following the pull wire. The locking block is fixed to the edge of the last stage hemostatic clip and the wire is fixed, and the locking block will stop bleeding.
  • the clip is closed and tightened.
  • the second technical solution can put a locking block on all the pull wires after all the hemostatic clips are clamped, and close the hemostatic clip by the locking block, which can be quickly realized under the digestive endoscope.
  • the suturing of the perforation site allows the tissue wound to be closed for the purpose of surgical treatment, thereby avoiding the occurrence of medical accidents.
  • Figure 1 is a schematic view showing the structure of a first structure of the burst-type tissue perforating stapler of the present invention
  • Figure 2 is an enlarged view of a portion A of Figure 1;
  • FIG. 3 is a flow chart of a suturing method using the burst-type tissue perforating stapler of the first embodiment
  • FIG. 4 is a flow chart of a suturing method using the burst-type tissue perforating stapler of the first embodiment
  • 5 is a flow chart of a suturing method using the burst-type tissue perforating stapler of the first embodiment
  • FIG. 6 is a flow chart of a suturing method using the burst-type tissue perforating stapler of the first embodiment
  • Figure 7 is a flow chart showing a suturing method using the burst-type tissue perforating stapler of the first embodiment
  • Figure 8 is a schematic view showing the structure of the second structure of the burst-type tissue perforating stapler of the present invention.
  • 5 is the organization
  • 6 is the tissue wound.
  • a burst-type tissue perforating stapler includes a pull wire 1, two hemostatic clips 2, and a releaser 3 that can sequentially release the hemostatic clip 2 ; wherein, the head of the second hemostatic clip 2 The end is detachably connected to the tail end of the first hemostatic clip 2; the tail end of the second hemostatic clip 2 is detachably connected to the head end of the release 3
  • Both of the hemostatic clips 2 have a hemostatic clip assembly 2-1, one end of which is fixedly connected to the first hemostatic clip 2, and the other end passes through the second hemostatic clip 2 and the pull wire 1 is movable relative thereto.
  • the second hemostatic clip 2 has a threading hole 2-2, and the other end of the cable 1 passes through the threading hole 2-2 of the hemostatic clip 2, so that the cable 1 can be on the second hemostatic clip 2 Passing through and moving, the present stapler is moved to the other side of the perforated tissue.
  • the length of the pull wire 1 can be extended to the tail of the release 3 to facilitate operation during surgery.
  • the number of the hemostatic clips 2 is not limited thereto.
  • one end of the pull wire 1 passes through the threading holes 2-2 of the other hemostatic clips 2 from the front to the rear, and may also be extended to release.
  • the tail of the device 3 can be extended to the handle 3-2.
  • the release device 3 includes a jacket 3-1, a handle 3-2, a movable release lever 3-3 and a movable handle 3-4, and the movable release lever 3-3 is axially movably inserted in the outer casing 3-
  • the movable handle 3-4 is disposed at the end of the movable release lever 3-3
  • the handle 3-2 is disposed at the rear end of the outer casing 3-1.
  • the suturing method of the burst-type tissue perforating stapler of this embodiment is as follows:
  • the perforation is found under the digestive endoscope, so that the first hemostatic clip 2 is attached to the edge of the perforated tissue to clamp the tissue, and then the first hemostatic clip 2 is separated from the release 3.
  • the locking block 4 and the cable 1 can be fixed in the manner that the cable 1 is sleeved outside the locking block 4, and then the external force is applied by the pliers to tighten and fix, or the male and female sleeves are used to engage the clamping cable 1.
  • the implementation manner can be various. Not limited to this.
  • a continuous hair tissue perforating stapler comprises at least two pull wires 1, at least two hemostatic clips 2, and a release device 3 which can sequentially release the hemostatic clip 2; wherein, two adjacent hemostasis In the clip 2, the head end of one of the hemostatic clips 2 is detachably connected to the tail end of the other hemostatic clip 2; the tail end of the last stage hemostatic clip 2 is separably coupled to the head end of the release 3
  • the movable connection has a hemostatic clip assembly 2-1 on each of the hemostatic clips 2, and each of the pull wires 1 corresponds to a hemostatic clip 2, and one end of the pull wire 1 is fixedly connected to the corresponding hemostatic clip 2.
  • the other end of the pull wire 1 extends to the tail of the release 3.
  • the release device 3 includes a jacket 3-1, a handle 3-2, a movable release lever 3-3, and a movable handle 3-4, and the movable release lever 3-3 is axially movably inserted in the outer casing 3- Inside 1, the movable handle 3-4 is disposed at the end of the movable release lever 3-3, and the handle 3-2 is disposed at the rear end of the outer casing 3-1.
  • the perforation is found under the digestive endoscope, so that the first hemostatic clip 2 is attached to the edge of the perforated tissue to clamp the tissue, and then the first hemostatic clip 2 is separated from the release 3.
  • the first hemostatic clip 2 and the second hemostatic clip 2 of the pull wire 1 can be extended through the endoscopic forceps hole, then tighten the two pull wires 1, slowly the first hemostatic clip 2 and the first The two hemostatic clips 2 are closed, and then the locking block 4 is fastened along the two pull wires 1 .
  • the locking block 4 is fixed to the edge of the hemostatic clip 2 and the pull wire 1 is fixed, and the pull wire 1 is cut, so that the perforated tissue of the large opening is substantially closed, and the operation risk is It is greatly reduced, and then it can be handled by conventional hemostasis.
  • the locking block 4 and the cable 1 can be fixed in the manner that the cable 1 is sleeved outside the locking block 4, and then the external force is applied by the pliers to tighten and fix, or the male and female sleeves are used to engage the clamping cable 1.
  • the implementation manner can be various. Not limited to this.

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Abstract

一种连发式组织穿孔缝合器包括拉线(1)、至少两个止血夹(2)、以及可依次释放止血夹(2)的释放器(3);其中,相邻的两个止血夹(2)中,其中一个止血夹(2)的头端与另一个止血夹(2)的尾端可分离式地相连接;最末级的止血夹(2)的尾端可分离式地与释放器(3)的头端相活动连接,止血夹(2)上均具有止血夹片组件(2-1),所述拉线(1)的一端与最前级的止血夹(2)相固定连接,另一端由前至后依次穿过其他止血夹(2)并且拉线(1)可相对其移动。该连发式组织穿孔缝合器能够在消化内镜下快速实现对穿孔部位的缝合,从而避免发生医疗事故的现象。

Description

连发式组织穿孔缝合器 技术领域
本发明涉及一种连发式组织穿孔缝合器, 属于医疗器械领域, 主要用于消化内镜下 组织穿孔的缝合。
背景技术
目前, 在消化内镜, 特别是软式内镜下做消化道手术时, 尤其做粘膜剥离手术时, 很容易造成组织穿孔, 如胃穿孔、 肠穿孔, 一旦发生穿孔, 在内镜下补救非常困难, 会 给病人造成非常大的风险, 目前没有一种器械可以很快速的治疗穿孔, 现有的止血夹仅 能应对较小的出血创面, 所以内镜下穿孔缝合技术是现在急待解决的难题。
发明内容
本发明所要解决的技术问题是克服现有技术的缺陷, 提供一种连发式组织穿孔缝合 器, 它能够在消化内镜下快速实现对穿孔部位的缝合, 从而避免发生医疗事故的现象。
为了解决上述技术问题,本发明的第一种技术方案是:一种连发式组织穿孔缝合器, 它包括拉线、 至少两个止血夹、 以及可依次释放止血夹的释放器; 其中, 相邻的两个止 血夹中, 其中一个止血夹的头端与另一个止血夹的尾端可分离式地相连接; 最末级的止 血夹的尾端可分离式地与释放器的头端相活动连接, 止血夹上均具有止血夹片组件, 所 述拉线的一端与最前级的止血夹相固定连接, 另一端由前至后依次穿过其他止血夹并且 拉线可相对其移动。
进一步提供了一种拉线可在其余止血夹上穿过并可移动的结构, 所述的除最前级的 止血夹外其余的止血夹上均开有穿线孔, 所述的拉线的另一端由前至后依次穿过止血夹 的穿线孔。
进一歩限定了拉线的长度以方便在手术中使用, 所述的拉线的另一端由前至后依次 穿过其他止血夹后延伸至释放器的尾部。
更进一歩提供了一种释放器的结构, 所述的释放器包括外套、 手柄、 活动释放杆和 活动手柄, 活动释放杆可轴向移动地插装在外套内, 所述的活动手柄设置在活动释放杆 的尾端, 所述的手柄设置在外套的尾端。
为了解决上述技术问题,本发明的第二种技术方案是:一种连发式组织穿孔缝合器, 它包括至少两根拉线、 至少两个止血夹以及可依次释放止血夹的释放器; 其中, 相邻的 两个止血夹中, 其中一个止血夹的头端与另一个止血夹的尾端可分离式地相连接; 最末 级的止血夹的尾端可分离式地与释放器的头端相活动连接, 止血夹上均具有止血夹片组 件, 所述的每根拉线对应一个止血夹, 并且拉线的一端与相对应的止血夹相固定连接。
进一歩, 所述的拉线的另一端延伸至释放器的尾部。
更进一步, 所述的释放器包括外套、 手柄、 活动释放杆和活动手柄, 活动释放杆可 轴向移动地插装在外套内, 所述的活动手柄设置在活动释放杆的尾端, 所述的手柄设置 在外套的尾端。
采用了上述技术方案后, 在消化内镜下找到组织穿孔处, 使最前级的止血夹贴合穿 孔组织边缘, 并使其夹紧组织, 然后将最前级的止血夹从释放器上分离, 然后按照该方 法使其他止血夹贴合在穿孔组织其他边缘, 并使其夹紧组织, 然后将这些止血夹从释放 器上分离, 待释放器上的所有止血夹都夹紧组织释放后, 拉紧拉线, 将止血夹合拢, 收 紧穿孔组织, 当然第一种技术方案也可以通过顺着拉线装一个锁定块, 锁定块紧靠最末 级的止血夹的边缘与拉线固定, 通过锁定块将止血夹合拢收紧, 第二种技术方案可以在 所有的止血夹夹紧后,在所有的拉线上套装一个锁定块,通过锁定块将止血夹合拢收紧, 这就能够在消化内镜下快速实现对穿孔部位的缝合, 使组织创口合拢达到手术治疗的目 的, 从而避免发生医疗事故的现象。
附图说明
图 1为本发明的连发式组织穿孔缝合器的第一种结构的结构示意图;
图 2为图 1的 A部放大图;
图 3为使用实施例一中的连发式组织穿孔缝合器的缝合方法的流程图之一; 图 4为使用实施例一中的连发式组织穿孔缝合器的缝合方法的流程图之一; 图 5为使用实施例一中的连发式组织穿孔缝合器的缝合方法的流程图之一; 图 6为使用实施例一中的连发式组织穿孔缝合器的缝合方法的流程图之一; 图 7为使用实施例一中的连发式组织穿孔缝合器的缝合方法的流程图之一; 图 8为本发明的连发式组织穿孔缝合器的第二种结构的结构示意图。
其中, 5为组织, 6为组织创口。
具体实施方式
为了使本发明的内容更容易被清楚地理解, 下面根据具体实施例并结合附图, 对本 发明作进一歩详细的说明。
实施例一
如图 1、 2所示, 一种连发式组织穿孔缝合器, 它包括拉线 1、 两个止血夹 2以及可 依次释放止血夹 2的释放器 3 ; 其中, 第二个止血夹 2的头端与第一个止血夹 2的尾端 可分离式地相连接; 第二个止血夹 2的尾端可分离式地与释放器 3的头端相活动连接, 两个止血夹 2上均具有止血夹片组件 2-1,拉线 1的一端与第一个止血夹 2相固定连接, 另一端穿过第二个止血夹 2并且拉线 1可相对其移动。
如图 2所示, 第二个止血夹 2上开有穿线孔 2-2, 拉线 1的另一端穿过止血夹 2的 穿线孔 2-2, 这样拉线 1可在第二个止血夹 2上穿过并可移动, 方便本缝合器移动到穿 孔组织的另一侧, 当然, 拉线 1的长度可以延伸至释放器 3的尾部, 以方便在手术中操 作。
当然, 止血夹 2的数量不限于此, 当止血夹 2的数量为三个以上时, 拉线 1的 一 端由前至后依次穿过其他止血夹 2的穿线孔 2-2, 也可以延伸至释放器 3的尾部或者是 延伸至手柄 3-2处均可。
如图 1所示, 释放器 3包括外套 3-1、 手柄 3-2、 活动释放杆 3-3和活动手柄 3-4, 活动释放杆 3-3可轴向移动地插装在外套 3-1 内, 活动手柄 3-4设置在活动释放杆 3-3 的尾端, 手柄 3-2设置在外套 3-1的尾端。
如图 3〜7所示, 本实施例的连发式组织穿孔缝合器的缝合方法如下:
1、 消化内镜下找到穿孔处, 使第一个止血夹 2贴合在穿孔组织边缘, 使其夹紧组 织, 然后将第一个止血夹 2从释放器 3上分离。
2、 将第二个止血夹 2贴合穿孔组织另一侧边缘, 使其夹紧组织, 然后将第二个止 血夹 2从释放器 3上分离。
3、拉线 1一头可以通过内镜钳道孔伸出人体外, 然后拉紧拉线 1, 慢慢将第一个止 血夹 2和第二个止血夹 2合拢, 再顺着拉线 1下锁定块 4, 锁定块 4紧靠止血夹 2的边 缘与拉线 1固定, 剪断拉线 1, 这样大幵口的穿孔组织基本合拢, 手术风险就大大降低, 接下来就用常规止血方法就能处理好。
锁定块 4与拉线 1的固定方式可以是拉线 1外面套锁定块 4, 然后用钳子施加外力 收紧固定, 也可以是采用公母套啮合卡死拉线 1的方式实现, 实现方式可以多种, 不限 于此。
实施例二
如图 8所示, 一种连发式组织穿孔缝合器, 它包括至少两根拉线 1、 至少两个止血 夹 2以及可依次释放止血夹 2的释放器 3 ; 其中, 相邻的两个止血夹 2中, 其中一个止 血夹 2的头端与另一个止血夹 2的尾端可分离式地相连接; 最末级的止血夹 2的尾端可 分离式地与释放器 3的头端相活动连接, 止血夹 2上均具有止血夹片组件 2-1, 每根拉 线 1对应一个止血夹 2, 并且拉线 1的一端与相对应的止血夹 2相固定连接。
拉线 1的另一端延伸至释放器 3的尾部。
图 8中的拉线 1为两根, 止血夹 2也为两个, 但是拉线 2和止血夹 2的数量并不局 限于实施例二的数量。
如图 8所示, 释放器 3包括外套 3-1、 手柄 3-2、 活动释放杆 3-3和活动手柄 3-4, 活动释放杆 3-3可轴向移动地插装在外套 3-1 内, 活动手柄 3-4设置在活动释放杆 3-3 的尾端, 手柄 3-2设置在外套 3-1的尾端。
本实施例的连发式组织穿孔缝合器的缝合方法如下:
1、 消化内镜下找到穿孔处, 使第一个止血夹 2贴合在穿孔组织边缘, 使其夹紧组 织, 然后将第一个止血夹 2从释放器 3上分离。
2、 将第二个止血夹 2贴合穿孔组织另一侧边缘, 使其夹紧组织, 然后将第二个止 血夹 2从释放器 3上分离。
3、 第一个止血夹 2和第二个止血夹 2的拉线 1一头可以通过内镜钳道孔伸出人体 外, 然后拉紧两个拉线 1, 慢慢将第一个止血夹 2和第二个止血夹 2合拢, 再顺着两根 拉线 1下锁定块 4, 锁定块 4紧靠止血夹 2的边缘与拉线 1固定, 剪断拉线 1, 这样大 开口的穿孔组织基本合拢,手术风险就大大降低,接下来就用常规止血方法就能处理好。
锁定块 4与拉线 1的固定方式可以是拉线 1外面套锁定块 4, 然后用钳子施加外力 收紧固定, 也可以是采用公母套啮合卡死拉线 1的方式实现, 实现方式可以多种, 不限 于此。
以上所述的具体实施例, 对本发明解决的技术问题、 技术方案和有益效果进行了进 一歩详细说明, 所应理解的是, 以上所述仅为本发明的具体实施例而已, 并不用于限制 本发明, 凡在本发明的精神和原则之内, 所做的任何修改、 等同替换、 改进等, 均应包 含在本发明的保护范围之内。

Claims

权 利 要 求 书
1、 一种连发式组织穿孔缝合器, 其特征在于: 它包括拉线 (1)、 至少两个止血夹 (2) 以及可依次释放止血夹 (2) 的释放器 (3); 其中, 相邻的两个止血夹 (2) 中, 其中一个止血夹 (2) 的头端与另一个止血夹 (2) 的尾端可分离式地相连接; 最末级的 止血夹 (2) 的尾端可分离式地与释放器 (3) 的头端相活动连接, 止血夹 (2) 上均具 有止血夹片组件 (2-1), 所述拉线 (1) 的一端与最前级的止血夹 (2) 相固定连接, 另 一端由前至后依次穿过其他止血夹 (2) 并且拉线 (1) 可相对其移动。
2、 根据权利要求 1 所述的连发式组织穿孔缝合器, 其特征在于: 所述的除最前级 的止血夹 (2) 外其余的止血夹 (2) 上均开有穿线孔 (2-2), 所述的拉线 (1) 的另一 端由前至后依次穿过止血夹 (2) 的穿线孔 (2-2)。
3、 根据权利要求 1或 2所述的连发式组织穿孔缝合器, 其特征在于: 所述的拉线 (1) 的另一端由前至后依次穿过其他止血夹 (2) 后延伸至释放器 (3) 的尾部。
4、根据权利要求 1所述的连发式组织穿孔缝合器, 其特征在于: 所述的释放器(3) 包括外套(3-1)、 手柄(3-2)、 活动释放杆(3-3)和活动手柄(3-4), 活动释放杆(3-3) 可轴向移动地插装在外套 (3-1) 内, 所述的活动手柄 (3-4) 设置在活动释放杆 (3-3) 的尾端, 所述的手柄 G-2) 设置在外套 (3-1) 的尾端。
5、 一种连发式组织穿孔缝合器, 其特征在于: 它包括至少两根拉线 (1)、 至少两 个止血夹(2)以及可依次释放止血夹(2)的释放器(3); 其中, 相邻的两个止血夹(2) 中, 其中一个止血夹 (2) 的头端与另一个止血夹 (2) 的尾端可分离式地相连接; 最末 级的止血夹 (2) 的尾端可分离式地与释放器 (3) 的头端相活动连接, 止血夹 (2) 上 均具有止血夹片组件(2-1), 所述的每根拉线 (1)对应一个止血夹(2), 并且拉线(1) 的一端与相对应的止血夹 (2) 相固定连接。
6、 根据权利要求 5所述的连发式组织穿孔缝合器, 其特征在于: 所述的拉线 (1) 的另一端延伸至释放器 (3) 的尾部。
7、根据权利要求 5所述的连发式组织穿孔缝合器, 其特征在于: 所述的释放器(3) 包括外套(3-1)、 手柄(3-2)、 活动释放杆(3-3)和活动手柄(3-4), 活动释放杆(3-3) 可轴向移动地插装在外套 (3-1) 内, 所述的活动手柄 (3-4) 设置在活动释放杆 (3-3) 的尾端, 所述的手柄 (3-2) 设置在外套 (3-1) 的尾端。
PCT/CN2013/001598 2013-10-31 2013-12-19 连发式组织穿孔缝合器 WO2015061931A1 (zh)

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