WO2016074330A1

WO2016074330A1 - Minimally invasive surgical instrument and method therefor for knotting and trimming

Info

Publication number: WO2016074330A1
Application number: PCT/CN2014/095799
Authority: WO
Inventors: 罗宗平; 张佩年; 赵春风; 王觉鸣; 杨惠林
Original assignee: 江苏江科知识产权运营有限公司; 罗宗平
Priority date: 2014-11-14
Filing date: 2014-12-31
Publication date: 2016-05-19

Abstract

Disclosed are a minimally invasive surgical instrument and a method therefor for knotting and trimming, wherein the minimally invasive surgical instrument is formed by a first clamp handle (11) and a second clamp handle (12) intersecting at a connection point, and has a clamping head (2) as the head end and a handle (3) as the tail end for opening or closing the clamping head; the end portion of the head end (121) of the second clamp handle has a thread spindle (4); when the first clamp handle (11) and the second clamp handle (12) are closed, the thread spindle (4) and the head end (111) of the first clamp handle abut each other; a flat straight spring (5) is connected to the inner side of the head end (111) of the first clamp handle, and a crack (7) is formed between the flat straight spring (5) and the first clamp handle (11) and is capable of accommodating a suture thread; the fixed end of the flat straight spring (5) is connected to the first clamp handle (11), and the free end (51) of the flat straight spring (5) leans against the thread spindle (4), and moves as the first clamp handle (11) moves without being restricted by the thread spindle (4). After using this minimally invasive surgical instrument for knotting in vitro, the knot is delivered to the suture in the body, and after tightening the knot, the suture thread is trimmed by the trimming part. This method has a high success rate for knotting.

Description

Minimally invasive surgical instrument and method for tying and trimming

Technical field

The invention relates to a minimally invasive surgical instrument and a method for knotting and trimming, belonging to the technical field of medical instruments.

Background technique

In minimally invasive surgery, at the end of the surgical suture, the suture is knotted at the suture and the excess suture is then sheared. Because the minimally invasive surgery is to insert the surgical instrument into the body through the incision of the body surface, the surgical knife is too small to directly view the part that needs to be knotted. It is limited by the operation space, and the operation of knotting and cutting usually needs to be separately adopted. Different surgical instruments can be completed, even if the operation process is completed, usually at least two kinds of surgical instruments need to cooperate with each other, and because the suture coil is easy to slip off the end of the surgical instrument, the tension of the suture is not easy to control and other factors. The suture knot is tied once, the success rate is low, the operation time is long, and the suture knotting effect is poor.

On the other hand, the surgical instruments used in the operation process are numerous, the operation is complicated, and the mobile phone devices are frequently replaced, which is not conducive to improving the operation efficiency.

Summary of the invention

OBJECT OF THE INVENTION The technical problem to be solved by the present invention is to overcome the deficiencies of the prior art, and to provide a minimally invasive surgical instrument and a method for tying and trimming the wire, which can complete the knotting operation conveniently and quickly; further, it can be knotted, The function of cutting the suture is integrated.

Technical Solution: In order to solve the above technical problem, the present invention provides a minimally invasive surgical instrument, characterized in that a first clamp and a second clamp are crossed at a connection point to form a head end as a chuck and an end as a control chuck. Open or closed handle;

The first end end of the second caliper has a set of wire portions; when the first caliper and the second caliper are closed, the ferrule portion abuts against the first shank end to form a closed inner space; When a tong handle and a second caliper are opened, the ferrule portion is separated from the first shank end to form an open port;

The inner side of the first end of the first shank is connected with a paddle, and the nip is formed between the paddle and the first shank to receive the suture; the fixed end of the paddle is connected to the first caliper, and the free end of the paddle On the line portion, and is not restricted by the movement of the first caliper;

A tangential portion that can cut the suture is cooperatively disposed on the first shank and the second shank; the tangential portion is opened or engaged with the opening or closing of the first shank and the second shank.

The tangential portion is a cutting tooth, a cutter or other structure capable of cutting the suture, and can be opened or engaged with the opening or closing of the first shank and the second shank, thereby cutting the suture.

A sleeve is disposed on the first shank and the second shank, and the sleeve has a groove therein, and a hook for hooking the suture into the groove is disposed in the groove.

a sleeve is disposed on the first shank and the second shank between the tangential portion and the handle, the sleeve has a groove therein, and a groove is formed in the groove for hooking the suture into the groove;

A wire groove connecting the tangential portion and the groove is disposed along the axial direction of the sleeve, so that the suture passing through the tangential portion enters the groove along the wire groove.

A rotatable roller is sleeved on the sleeve portion. When the suture is being fed, the roller can be rolled and it is easy to feed.

A first sliding end of the first shank and the second end of the shank are respectively connected to a sliding bar, and the ends of the two sliding bars are slidably coupled to each other.

The nip formed between the paddle and the first caliper is tapered inwardly by the port.

The sleeve is sleeved outside the connection point. The sleeve may be in the shape of a cylinder (such as a cylinder, a prism), a cone or other cylinder.

The first shank and the second shank on one side of the handle are further provided with engageable engaging teeth, and the opening resistance of the first tong handle and the second tong handle is increased by the engaging teeth.

The ferrule is a semi-closed topology having an opening toward the leading end of the first caliper, such as a semi-closed ring or the like.

A method for tying a trimming line based on a minimally invasive surgical instrument, characterized in that it comprises the following steps:

(1) On-line: the suture remaining after surgical suturing in the body is knotted in vitro to form a slack stitching coil; the first pliers and the second pliers are opened by the handle to open the collet, and the suture is sutured The coil is sleeved on the sleeve portion and is located between the paddle and the nip formed by the first caliper, and closes the first caliper and the second caliper;

a suture extending outward from the suture loop passes through the outer surface of the closed tangential portion into the slot, and is hooked into the recess by the retaining hook, and the suture is placed at the outer end of the external body;

(2) Feeding line: the suture coil is pushed to the body along the suture extending from the body, and the suture coil gradually moves along the suture to the body as the sheath portion is pushed until it is pushed to the suture at the body for knotting. position;

(3) Knotting: opening the first pliers handle and the second pliers handle, so that the collet is opened, the paddle moves outward with the first pliers, and the sewing coil sleeved on the sleeve portion is outwardly disengaged The threaded portion is detached from the opened collet; while the first caliper and the second caliper are opened, the tangential portion is opened, so that the suture originally on the outer surface of the tangential portion enters the tangential portion;

Pulling the suture to tighten the stitching coil that is detached from the threaded portion to form a final knot;

(4) Trimming: Controlling the first caliper and the second caliper are closed, and the tangential portions are meshed together to cut the suture that has entered the tangential portion.

Beneficial effects:

The minimally invasive surgical instrument of the present invention changes the currently used in vivo knotting mode, and after manual knotting in vitro, the knot is delivered to the suture in the body by the surgical instrument of the present invention, and the knot is tightened, and then the suture is cut by the tangential portion. shear. By adopting the surgical instrument of the invention, the suture coil is prevented from slipping off from the end of the surgical instrument, and the success rate of knotting is very high, and can reach almost 100%, and the knotting operation can be completed conveniently and quickly, and the function of knotting and cutting the suture is integrated. It reduces the number of instruments used during surgery and helps to improve the efficiency of surgery.

DRAWINGS

Figure 1 is a schematic view of a minimally invasive surgical instrument of the present invention;

Figure 2 is a large open view of the chuck and the incisors in Figure 1;

Figure 3 is an enlarged view of the chuck and the cutting teeth of Figure 1;

Figure 4 is a schematic view of another embodiment of the sleeve portion;

Fig. 5 is a schematic view showing still another embodiment of the socket portion.

detailed description

The invention is further described below in conjunction with the drawings. The following examples are only intended to more clearly illustrate the technical solutions of the present invention, and are not intended to limit the scope of the present invention.

Example 1

As shown in FIG. 1, FIG. 2 and FIG. 3, the minimally invasive surgical instrument of the present invention and the general surgical forceps are roughly shaped. The same, in the shape of a scissors, the two pliers handles 1 intersect with a connecting point to form a handle 3 with a head end for the collet 2 and a finger control operation. The collet 2 is controlled to open or close by the handle 3, and the collet 2 After closing, an internal space is formed that can accommodate the suture.

The two pliers handles are a first pliers handle 11 and a second pliers handle 12, respectively. Wherein, the end of the first end 121 of the second caliper 12 has a set of wire portions 4, and a sleeve is sleeved on the sleeve portion 4, and when the sewing coil is sleeved on the sleeve portion 4 of the chuck 2, the body is transported to the body. The roller 41 can roll with the movement of the sewing coil, reducing the wire feeding resistance and facilitating the wire feeding. When the first caliper 11 and the second caliper 12 are closed, the ferrule 4 abuts against the first shank end 111, and the sewing coil that blocks the sleeve 4 is disengaged; the first caliper 11 and When the second caliper 12 is opened, the ferrule 4 is separated from the first shank end 111, so that the sewing coil in the collet 2 can be detached from the port 6.

In order to prevent the first caliper 11 and the second caliper 12 from being opened, the stitching coil in the collet 2 is still sleeved on the ferrule 4, and is not easily detached from the collet 2, and the first caliper in the internal space of the collet 2 A paddle 5 is connected to the inner side of the first end 111, and the paddle 5 extends from the port to the inner space of the collet 2, and extends in the same direction as the first caliper 11. The fixed end of the paddle 5 located inside the collet 2 is connected to the first tong. On the shank 11, the other end is a free end close to the 6-port 6 of the collet 2 port. Between the paddle 5 and the first shank 11, a nip 7 is formed which can accommodate the suture, and the nip 7 is tapered inwardly by the port. The paddle 5 moves with the movement of the first caliper 11 . When the operating handle 3 controls the first caliper 11 and the second caliper 12 is opened, the paddle 5 moves outwardly with the first caliper 11 and can be placed over The stitching loop on the threaded portion 4 is outwardly disengaged, causing the stitching coil to disengage from the sleeve portion 4 of the second caliper handle 12 and disengage from the opened collet 2. The distance between the free end 51 of the paddle 5 and the first jaw 11 is such that when the chuck 2 is opened to the maximum opening, that is, when the free end 51 of the paddle 5 is moved outward by a maximum distance, the free end 51 of the paddle 5 remains It is preferable that the sleeve portion 4 is not separated from the sleeve portion 4 to prevent the first caliper 11 and the second caliper 12 from being opened before the start of the thread feeding, and the sewing coil is sleeved on the sleeve portion 4 In the upper case, the stitching stitch is held between the paddle 5 and the second pliers 12, rather than between the paddle 5 and the nip 7 formed by the first pliers 11.

A cylindrical sleeve 9 is disposed on the first shank 11 and the second shank 12 at the connection point for covering the connection point, and at the same time, the sleeve 9 limits the maximum opening degree at which the chuck 2 can be opened. According to the principle of the lever, usually the connection point is set closer to the direction of the chuck 2, which facilitates the operation of the handle 3 at the end, and the operation of the chuck 2 performs a small opening and closing. In order to restrict the opening degree of the handle 3 to a small extent, the opening of the handle 3 is not blocked, and A relief groove 91 is provided at one end of the sleeve 9 near the handle 3 to avoid the first caliper 11 and the second caliper 12 when the handle 3 is opened.

The first shank 11 and the second shank 12 between the fixed end of the pick 5 and the sleeve 9 are also cooperatively provided with cutting teeth 8 for cutting the suture entering the cutting teeth 8. When the operating handle 3 controls the first caliper 11 and the second caliper 12 to open, the cutting teeth 8 on the first caliper 11 and the second caliper 12 are simultaneously opened, and the suture can enter the slit 81 of the cutting tooth 8 when the tooth is cut. When the suture is interposed in the slit 81 of 8, the incision 8 can cut the suture when the first pliers 11 and the second pliers 12 are closed.

In other embodiments, the incisor 8 may be a member such as a knife that can cut the suture.

The sleeve 9 has a recess 92 in which a retaining hook 93 is provided to wrap the suture around the recess 92 and is hooked by the retaining hook 93 without disengaging the sleeve 9. A groove 10 is formed in the sleeve 9 between the groove 92 and the cutting tooth 8, and the cutting tooth 8 is communicated with the groove 92 by the wire groove 10, so that the suture passing through the cutting tooth 8 enters the groove 92 along the wire groove 10. The slot is arranged axially along the sleeve 9, i.e., by the collet 2 toward the handle 3.

The handle 3 is configured as a set of rings 31 respectively disposed at the ends of the first shank 11 and the second shank 12, each of which can accommodate a finger therein for control operation.

The first caliper 11 and the second caliper 12 between the collar and the sleeve 9 are further provided with cooperating engaging

teeth

131, 132 for preventing the closed first caliper 11 And the second caliper 12 is accidentally opened. To open the closed first caliper 11 and the second caliper 12, the resistance of the teeth should be overcome to avoid the first caliper 11 and the second caliper 12 during the wire feeding process. After the middle error is opened, the stitching loop wound on the sleeve portion 4 is detached from the chuck 2.

The operation of knotting and shearing the suture after minimally invasive surgery using the minimally invasive surgical instrument of the present invention is:

1. On-line: The suture remaining after surgical suture in the body is knotted in vitro to form a suture coil, and the suture coil is not tightened (the final knot is formed only after being tightened); The first caliper 11 and the second caliper 12 open the collet 2, and the suture coil is sleeved on the ferrule 4 and is located between the plucking pad 5 and the nip 7 formed by the first caliper 11 The handle 3 closes the first caliper 11 and the second caliper 12, causing the collet 2 to close, and the engagement of the latches ensures that the closure is not opened by mistake.

The suture extending outward from the suture loop passes through the outer surface of the closed incisor 8 into the slot 10 and is hooked into the recess 92 by the retaining hook 93. The suture is placed at the outer end of the body by a doctor holding the surgical instrument. Control.

2. Feeding line: the surgical instrument is pushed to the body along the suture extending from the body. With the pushing of the sheathing part 4, the suture coil gradually moves along the suture to the body until it is pushed to the suture at the body for knotting. position.

3, knotting: the tensioning suture is located at the outer end of the body, so that the stitching coil is changed from a relaxed state to a slightly tight small coil;

The first shank 11 and the second shank 12 are controlled to be opened by the handle 3, so that the yoke 2 is opened, and the yoke 5 is moved outwardly with the first shank 11, and the stitching coil sleeved on the ferrule 4 is oriented. Outwardly, the slightly tight small coil is separated from the sleeve portion 4 and detached from the opened chuck 2; while the first caliper 11 and the second caliper 12 are opened, the cutting teeth 8 are opened, so that the original The suture of the outer surface of the cutting tooth 8 enters the slit 81 of the cutting tooth 8.

At this time, the suture can be tightened again, so that the small coil detached from the sheath portion 4 is pulled tight to form the final knot.

4. Trimming: The first pliers 11 and the second pliers 12 are closed by the handle 3, and the incisors 8 are meshed together to cut the suture that has entered the incisors 8.

Example 2

In order to prevent the suture coil that is placed on the sleeve portion 4 from sliding from the sleeve portion 4 to the first shank 11 or the second shank 12 on the side, preferably, The sleeve portion 4 is designed according to the topography. As shown in FIG. 4, the first end portion of the first shank 11 and the second shank 12 are respectively connected to a sliding

rod

112, 122, and the ends of the two sliding rods are opposite. When the first clamping jaw 11 and the second clamping handle 12 are moved together, the overlap between the two sliding bars is still not separated to generate a gap, and the sewing coil is prevented from the two sliding

bars

112, 122. The gap between the gaps slips onto the first caliper 11 or the second caliper 12.

The rest is the same as in the first embodiment.

Example 3

In order to prevent the suture coil that is placed on the sleeve portion 4 from sliding from the sleeve portion 4 to the first shank 11 or the second shank 12 on the side, preferably, The sleeve portion 4 is designed according to the topology, and as shown in FIG. 5, the sleeve portion 4 is designed to face only the first end 111 of the first caliper 11 The end portion has a semi-closed ring 42 having an opening 421 to isolate the sleeve portion 4 from the first shank 11 or the second shank 12 on both sides, preventing the sewing coil from sliding toward the first shank 11 or the second shank 12.

The rest is the same as in the first embodiment.

The above is only a preferred embodiment of the present invention, and it should be noted that those skilled in the art can make several improvements and modifications without departing from the technical principles of the present invention. It should also be considered as the scope of protection of the present invention.

Claims

A minimally invasive surgical instrument characterized in that a first shank and a second shank are crossed at a connecting point to form a handle with a head end as a collet and an end end to open or close the control collet;

The first end end of the second caliper has a set of wire portions; when the first caliper and the second caliper are closed, the ferrule portion abuts against the first shank end to form a closed inner space; When a tong handle and a second caliper are opened, the ferrule portion is separated from the first shank end to form an open port;

The inner side of the first end of the first shank is connected with a paddle, and the nip is formed between the paddle and the first shank to receive the suture; the fixed end of the paddle is connected to the first caliper, and the free end of the paddle On the line portion, and is not restricted by the movement of the first caliper;

A tangential portion that can cut the suture is disposed on the first shank and the second shank; the tangential portion is simultaneously opened or closed with the first shank and the second shank.
The minimally invasive surgical instrument according to claim 1, wherein a sleeve is disposed on the first shank and the second caliper, the sleeve has a groove therein, and a groove is arranged in the groove to hook the suture to A stop hook in the groove.
The minimally invasive surgical instrument according to claim 1 or 2, wherein a sleeve is disposed on the first shank and the second shank between the tangential portion and the handle, and the sleeve has a groove and a groove Providing a hook for hooking the suture into the groove;

A wire groove connecting the tangential portion and the groove is disposed along the axial direction of the sleeve, so that the suture passing through the tangential portion enters the groove along the wire groove.
The minimally invasive surgical instrument of claim 1 wherein said ferrule portion is a semi-closed topology having an opening toward a leading end of said first caliper.
The minimally invasive surgical instrument according to claim 1 or 4, wherein the sleeve portion is provided with a rotatable roller.
The minimally invasive surgical instrument according to claim 1, wherein the first end surface of the first shank and the second shank are respectively connected to a sliding rod, and the ends of the two sliding rods are overlapped with relative movement Together.
The minimally invasive surgical instrument of claim 1 wherein the paddle is between the paddle and the first handle The resulting nip is tapered inwardly from the port.
The minimally invasive surgical instrument of claim 2 wherein the sleeve is sleeved outside the attachment point.
The minimally invasive surgical instrument according to claim 1, wherein the first shank and the second shank on one side of the handle are further provided with engaging teeth.
A method of knotting a trimming line of a minimally invasive surgical instrument according to claim 1, comprising the steps of:

(1) On-line: the suture remaining after surgical suturing in the body is knotted in vitro to form a slack stitching coil; the first pliers and the second pliers are opened by the handle to open the collet, and the suture is sutured The coil is sleeved on the sleeve portion and is located between the paddle and the nip formed by the first caliper, and closes the first caliper and the second caliper;

a suture extending outward from the suture loop passes through the outer surface of the closed tangential portion into the slot, and is hooked into the recess by the retaining hook, and the suture is placed at the outer end of the external body;

(2) Feeding line: the suture coil is pushed to the body along the suture extending from the body, and the suture coil gradually moves along the suture to the body as the sheath portion is pushed until it is pushed to the suture at the body for knotting. position;

(3) Knotting: opening the first pliers handle and the second pliers handle, so that the collet is opened, the paddle moves outward with the first pliers, and the sewing coil sleeved on the sleeve portion is outwardly disengaged The threaded portion is detached from the opened collet; while the first caliper and the second caliper are opened, the tangential portion is opened, so that the suture originally on the outer surface of the tangential portion enters the tangential portion;

Pulling the suture to tighten the stitching coil that is detached from the threaded portion to form a final knot;

(4) Trimming: Controlling the first caliper and the second caliper are closed, and the tangential portions are meshed together to cut the suture that has entered the tangential portion.