WO2017140166A1 - 一种动脉吻合器 - Google Patents

一种动脉吻合器 Download PDF

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Publication number
WO2017140166A1
WO2017140166A1 PCT/CN2016/110916 CN2016110916W WO2017140166A1 WO 2017140166 A1 WO2017140166 A1 WO 2017140166A1 CN 2016110916 W CN2016110916 W CN 2016110916W WO 2017140166 A1 WO2017140166 A1 WO 2017140166A1
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WO
WIPO (PCT)
Prior art keywords
bracket
lever
pressing arm
stapler
anastomotic
Prior art date
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PCT/CN2016/110916
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English (en)
French (fr)
Inventor
王清杰
周连海
周晓军
孟坚
可大年
Original Assignee
北京迈迪顶峰医疗科技有限公司
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Publication of WO2017140166A1 publication Critical patent/WO2017140166A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12027—Type of occlusion
    • A61B17/1204—Type of occlusion temporary occlusion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1103—Approximator
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B2017/12004—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for haemostasis, for prevention of bleeding
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205—Introduction devices

Definitions

  • the present invention relates to the field of medical device technology, and in particular to an arterial stapler.
  • Coronary artery bypass grafting commonly known as coronary artery bypass grafting, the English abbreviation CABG, is used to repair or replace obstructed coronary arteries to improve myocardial blood supply.
  • the surgical procedure is to establish a vascular access in the distal aorta of the aorta and obstruction using transplanted blood vessels (often the saphenous vein and the internal mammary artery).
  • transplanted blood vessels often the saphenous vein and the internal mammary artery.
  • the blood that the heart beats flows from the aorta through the bridge of the blood vessel to the distal end of the coronary artery that causes stenosis or obstruction to reach the ischemic myocardium, thereby improving the myocardial ischemia and hypoxia.
  • Coronary artery bypass grafting is a very effective treatment for patients with coronary artery multivessel disease, diffuse lesions, and coronary heart disease with valvular disease and ventricular aneurysm.
  • vascular anastomat has been vigorously developed, and the vascular stapler is a device that can achieve rapid and effective anastomosis of the blood vessel in the case of a beating heart.
  • vascular anastomotic device Compared with aortic occlusion forceps, it is more able to provide surgeons with a stable, bloodless surgical field. And better hemodynamics.
  • the current vascular anastomotic device still has problems such as easy damage to the aorta and inconvenience in operation during the operation, which is not conducive to postoperative recovery.
  • the technical problem to be solved by the present invention is how to solve the problem that the existing anastomotic device has great damage to the cardiac aorta and the operation is inconvenient.
  • an arterial stapler including an anastomosis housing and an anastomotic bracket, a compression arm, a bracket control lever, and a compression arm control respectively disposed on the stapler housing.
  • the front end of the anastomotic bracket is provided with a sealing disc that can be opened or closed;
  • the pressing arm is disposed above the anastomotic bracket, the front end of the pressing arm is provided with a pressing disc, and the pressing disc is disposed opposite to the sealing disc;
  • the bracket control rod is coupled to the anastomotic bracket for controlling the sealing disc to be opened or closed;
  • the pressing arm control rod is connected to the pressing arm for controlling the pressing arm to be pressed or raised.
  • the front end of the anastomotic bracket is provided with an elongated opening, and two elongated openings are arranged through the upper and lower sides, and two opposite sealing strips are formed on both sides of the elongated opening.
  • the outer surface of the elongated opening is covered with an elastic film, and the elastic film has a corresponding opening at a position corresponding to the elongated opening above the matching bracket,
  • the sealing strip can drive the elastic film to open or close from its opening under the action of an external force to form the sealing disc.
  • bracket support rod the bracket support rod from a lower side wall of the stapler housing Extending horizontally, the anastomotic bracket is tubular, the extended end of the bracket support rod is disposed in the anastomotic bracket, and the bracket support rod is fixedly connected with the anastomotic bracket at the front end of the sealing disc
  • the rear end of the anastomotic bracket is fixedly connected to the stapler housing, and the bracket support rod is connected to the lower end of the bracket control rod through an actuator, and is driven by the bracket control lever
  • the bracket support rod reciprocates to provide an external force to open or close the sealing disk on the anastomotic bracket.
  • the lower end of the bracket control rod is provided with an open slot
  • the bracket support rod is provided with a vertical fixed block
  • the fixed block is provided with a fixing pin matched with the open slot.
  • the opening slot is clamped on the fixing pin, and the fixing block is pushed to reciprocate by dialing the bracket control lever.
  • the first limiting slot and the second limiting slot are respectively disposed on the two sides of the upper surface of the stapler housing, and the first lever fixing shaft is disposed below the first limiting slot, and the second A second lever fixing shaft is disposed below the limiting slot, the pressing arm control rod passes through the first limiting slot, and a lower end thereof is rotatably connected to the first lever fixing shaft, the bracket The control rod passes through the second limiting slot, and the bracket control lever is rotatably connected to the second lever fixing shaft above the opening slot.
  • the upper surface of the stapler housing is located between the first limiting slot and the second limiting slot, and is further provided with a pressing arm release button, the pressing arm release button comprises a button body and is disposed at the A connecting spring at the lower end of the button body.
  • the first limiting slot and the second limiting slot are respectively disposed along the length direction of the stapler housing, and the lower side of the first limiting slot is correspondingly provided with a pressing arm positioning rack, the pressure One end of the tension arm positioning rack is positioned by a rack fixing shaft, and the other end of the pinch arm positioning rack is disposed between the button body of the pressing arm release button and the connecting spring, the pressing arm lever A pressing arm positioning pin is provided on the clamping arm positioning pinion.
  • the two ends of the second limiting slot are respectively provided with positioning for defining the position of the bracket control lever edge.
  • the lever assisting pen further includes a booster pen insertion hole at the upper end of the pressing arm control lever and the bracket control lever, and the lever assisting pen is coupled with the booster pen insertion hole, The lever assisting pen toggles the pressing arm lever and the bracket lever to rotate.
  • bracket support rod is hollow Tubular.
  • the present invention has the following advantages:
  • the invention provides an arterial stapler which is provided with a sealing disc which can be opened or closed at the front end of the anastomotic bracket, and is inserted into the aortic blood vessel when the sealing disc is in a closed state, and extends to a target point of the bypass vessel suture.
  • a disk-shaped sealing disc as an inner wall of the aorta; a compression arm is disposed above the anastomotic bracket, a front end of the compression arm is provided with a compression disc, and the compression disc and the anastomotic bracket
  • the position of the sealing disc on the seat is oppositely set; by controlling the downward movement of the pressing arm, the sealing disc is pressed on the outer wall of the artery by the pressing disc, thereby forming a closed isolation area at the target position of the side wall of the artery, and the isolation area will be There will be no blood flow or overflow, providing a stable foundation and a blood-free suture environment for subsequent opening, bridging and vascular sutures in the arterial wall of the isolated area.
  • the whole surgical procedure does not affect the normal flow of blood flow in the artery, and the vascular trauma Small, more conducive to postoperative recovery, and easy to operate.
  • Figure 1 is a perspective view showing the sealing disc of the arterial stapler in a closed state according to the present invention
  • FIG. 2 is a perspective view showing the sealing disc of the arterial stapler in a distracted state according to the present invention
  • Figure 3 is an overall cross-sectional view of an arterial stapler of the present invention.
  • 1 anastomotic bracket
  • 100 sealing strip
  • 110 elongated opening
  • 2 elastic film
  • 3 compression arm
  • 31 compression plate
  • 4 compression arm control rod
  • 51 button body
  • 52 connection spring
  • 6 bracket control lever
  • 61 booster pen insertion hole
  • 7 blood discharge conduit
  • 8 conduit connector
  • 9 sealing plug
  • 10 lever assist Pen
  • 11 bracket support rod
  • 12 stapler housing
  • 13 first limit groove
  • 14 second limit groove
  • 141 positioning edge
  • 15 first lever fixed shaft
  • 16 second The lever is fixed to the shaft
  • 17 the compression arm is positioned to the rack
  • 18 the rack fixed shaft
  • 19 the compression arm positioning pin
  • 20 the open slot
  • 21 the fixed block
  • 22 the fixed pin.
  • connection In the description of the present invention, it should be noted that the terms “installation”, “connected”, and “connected” are to be understood broadly, and may be fixed or detachable, for example, unless otherwise explicitly defined and defined. Connected, or integrally connected; can be mechanical or electrical; can be directly connected, or indirectly connected through an intermediate medium, can be the internal communication of the two components.
  • Connected, or integrally connected can be mechanical or electrical; can be directly connected, or indirectly connected through an intermediate medium, can be the internal communication of the two components.
  • the specific meaning of the above terms in the present invention can be understood in a specific case by those skilled in the art.
  • an arterial stapler As shown in FIG. 1-2, an arterial stapler according to the present invention includes a stapler housing 12 and an anastomotic bracket 1, a compression arm 3, and a supporter respectively disposed on the stapler housing 12.
  • the front end of the anastomotic bracket 1 is provided with a sealing disc which can be opened or closed; when the sealing disc is in a closed state, the anastomotic bracket 1 is straight tubular, which is convenient for insertion into the aortic blood vessel and has no damage to the blood vessel.
  • the sealing disc is opened, so that the vascular bypass target point is located at a center position of the sealing disc;
  • the pressing arm 3 is disposed above the anastomotic bracket 1 , and the front end of the pressing arm 3 is provided with a pressing disc 31 , and the sealing disc 31 and the sealing disc position on the anastomotic bracket 1 Relatively set; by controlling the pressing arm 3 to move downward and pressing the sealing disc on the outer wall of the arterial vessel by using the pressing disc 31, a closed isolation zone is formed at the target position of the side wall of the artery, and there will be no such isolation zone.
  • the blood flow passes or overflows, providing a stable foundation and a blood-free suture environment for subsequent opening, bridging and vascular suture in the arterial wall of the isolated area.
  • the pressing arm 3 is formed by bending two wires, and the ends of the two wires are arranged in two arc-shaped structures arranged laterally oppositely, two The opposing curved structures form the compression disk 31.
  • bracket control lever 6 is connected to the anastomotic bracket 1 for controlling the sealing disc to be opened or closed;
  • the pressing arm lever 4 is connected to the pressing arm 3 for The pressing arm is controlled to be pressed or raised.
  • the front end of the anastomotic bracket 1 is provided with an elongated opening 110, and may also be a long straight slit or the like, and the two elongated openings 110 are arranged up and down, in the long strip shape.
  • Two oppositely disposed sealing strips 100 are formed on both sides of the opening 110, and the anastomotic bracket 1 is located in the elongated strip shape
  • the outer surface of the opening 110 is covered with an elastic film 2 such as a PU film (polyurethane film) which is excellent in elasticity and light in height, and the elastic film 2 corresponds to the elongated opening 110 above the anastomotic holder 1.
  • the position has a corresponding opening, and the two sealing strips 100 can be opened or closed in a tubular shape under the action of an external force, thereby driving the elastic film 2 to open or close from the opening thereof to form an upper opening lower seal.
  • the sealing disk is provided with an elongated opening 110, and may also be a long straight
  • bracket support rod 11 As shown in FIG. 3, further comprising a bracket support rod 11 , one end of the bracket support rod 11 horizontally extending from the lower side wall of the stapler housing 12 out of the stapler housing 12 The other end of the seat support rod 11 is located in the stapler housing 12, the anastomotic bracket 1 is tubular, and the extended end of the bracket support rod 11 is disposed in the anastomotic bracket 1 for easy opening.
  • the sealing tray, the bracket supporting rod 11 and the matching bracket 1 are fixedly connected at the front end of the sealing disc, and the rear end of the stapling bracket 1 is fixedly connected with the stapler housing 12,
  • the seat support rod 11 is connected to the lower end of the bracket control rod 6 through an actuator, and the bracket support rod 11 is driven to reciprocate by the toggle of the bracket control rod 6, as shown in FIG.
  • the bracket support rod 11 When the control lever 6 is seated, the bracket support rod 11 is synchronously moved to the left by the external force of the bracket control lever 6, and at this time, the right end head (front end) of the stapling bracket 1 moves to the left in synchronization with the head of the bracket support rod 11, but The left end (rear end) of the anastomotic bracket 1 is caught by the stapler housing such that the anastomotic bracket 1 is from the elongated opening 110 The elastic film 2 sleeved on the surface of the anastomotic bracket 1 is stretched to be opened, thereby providing an external force to open or close the sealing disk on the anastomotic bracket 1.
  • the specific form of the actuator may be: the lower end of the bracket control rod 6 is provided with an open slot 20, and the bracket support rod 11 is fixedly provided with a vertically disposed fixing block 21 on the fixed block 21 And a fixing pin 22 matching the opening groove 20, the opening groove 20 is locked on the fixing pin 22, and the fixing block 21 is pushed by pushing the bracket control rod 6 Fixed block 21
  • the integrally connected bracket support rod 11 reciprocates along the stapler housing 12; or other actuators, as long as the movement of the bracket control lever 6 to move the bracket support rod 11 can be achieved, both in the present invention Within the scope of protection.
  • the first limiting slot 13 and the second limiting slot 14 are correspondingly disposed on opposite sides of the upper surface of the stapler housing 12, A first lever fixing shaft 15 is disposed below the first limiting slot 13 , and a second lever fixing shaft 16 is disposed below the second limiting slot 14 , and the pressing arm lever 4 passes through the a first limiting slot 13 having a lower end rotatably coupled to the first lever fixing shaft 15, the bracket lever 6 passing through the second limiting slot 14, the bracket lever 6 being located
  • the upper portion of the opening groove 20 is rotatably coupled to the second lever fixing shaft 16 to ensure that the pressing arm lever 4 and the bracket lever 6 are axially rotatable along the respective lever fixing shafts by an external force.
  • the upper surface of the stapler housing 12 is located between the first limiting slot 13 and the second limiting slot 14 and is further provided with a pressing arm release button 5, the pressing
  • the arm release button 5 includes a button body 51 and a connecting spring 52 disposed at a lower end of the button body 51; preferably, the first limiting slot 13 and the second limiting slot 14 are all along the stapler housing 12
  • the length direction is inclined, and is preferably arranged in an arc shape (as shown in FIG. 2 ).
  • a pressing arm positioning rack 17 corresponding to the shape thereof is disposed, and the pressing arm positions the rack rail.
  • the lever 4 is provided with a pressing arm positioning pin 19 which is coupled with the pressing arm positioning rack 17; when the pressing arm release button 5 is pressed, the connecting spring 52 is compressed, and the pressing arm positions the rack rail 17
  • the rack fixing shaft 18 is rotated downward to be disengaged from the pressing arm positioning pin 19, releasing the positioning constraint of the pressing arm lever 4 At this time, the pinch arm can freely rapid movements, Save on surgery time.
  • the two ends of the second limiting slot 14 are respectively provided with positioning ribs 141 for defining the position of the bracket control lever 6 for clamping the bracket lever 6 when it is pushed to both ends, thereby achieving an anastomosis.
  • the bracket 1 is open and closed and can be positioned.
  • the lever assisting pen 10 is further included, and the lever assisting pen 10 is integrally injection molded, and the upper ends of the pressing arm control rod 4 and the bracket control rod 6 are respectively provided with a booster pen insertion hole 61,
  • the lever assisting pen 10 is coupled with the booster pen insertion hole 61, and the lever assisting pen 10 toggles the pressing arm control lever 4 and the bracket control lever 6 to rotate, which can provide assistance for the dialing process.
  • the left and right toggle bracket 6 can control the extension of the bracket and the contraction
  • the left and right toggle lever 4 can control the lifting and lowering of the compression arm, thereby improving the quality and efficiency of the operation. .
  • a blood discharge conduit 7 connected to one end of the socket support rod 11 in the stapler housing 12 via a catheter joint 8 such as a push-in fitting, the end of the blood discharge conduit 7
  • the sealing plug 9 is provided; the bracket supporting rod 11 is hollow tubular. After the sealing plug 9 is opened, the blood between the bracket supporting rod 11 and the anastomotic bracket 1 can overflow along the blood discharging conduit 7; The plug 9 can observe whether or not blood is overflowing from the catheter, thereby judging whether or not the anastomosis area is sealed.
  • the operation process of the present invention is as follows: 1.
  • the anastomotic bracket 1 is placed: after determining the suture point of the heart artery bypassing blood vessel, the puncture needle is used for perforating at a distance of about 2 to 2.5 cm from the point; first, the compression arm 3 is raised, Then, the closed anastomotic bracket 1 is inserted into the inner side of the artery wall from the puncture hole along the head end thereof; 2.
  • the blood vessel anastomosis the bracket holder 6 is pushed to open the anastomotic bracket 1, as shown in FIG.
  • the moving anastomotic bracket 1 positions the vascular bypass target point at a center position of the sealing disc region; the pressing pressing arm control rod 4 presses the pressing arm 3 downward on the outside of the artery blood vessel wall, so that the pressing disc 31 of the pressing arm 3 is sealed. Below the plane of the disc, at this time, the sealing plug 9 at the end of the blood discharge catheter 7 is removed, and if there is no continuous blood flow overflow, the sealing disc area is sealed. Good, if the blood continues to overflow, indicating that the sealing disc area has not been sealed, the pressing arm 3 should continue to be pressed down to ensure that the sealing disc area is sealed and then punched at the target point of the arterial wall using a puncher, and the bypass vessel can be sutured; 3.
  • Unloading Move the pressing arm control rod 4 to raise the pressing arm 3 to the highest point. Move the bracket control rod 6 so that the anastomotic bracket 1 extends to the sealing disc and closes into a straight tube, which is slowly along the puncture hole. Exit to the stapler and separate from the arterial vessel.
  • the structural design of the invention is novel, the damage to the cardiovascular tissue is small, the operation is simple, the suture environment can be established, the operation time is shortened, and the function is safe, stable and effective.

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Abstract

一种动脉吻合器，其包括吻合器壳体（12）和分别设于所述吻合器壳体（12）上的吻合托座（1）、压紧臂（3）、托座控制杆（6）和压紧臂控制杆（4）；所述吻合托座（1）的前端设有可撑开或闭合的密封盘；所述压紧臂（3）设于所述吻合托座（1）的上方，所述压紧臂（3）的前端设有压紧盘（31），所述压紧盘（31）与所述密封盘相对设置；所述托座控制杆（6）与所述吻合托座（1）连接，用于控制所述密封盘撑开或闭合；所述压紧臂控制杆（4）与所述压紧臂（3）连接，用于控制所述压紧臂（3）下压或抬起。该吻合器能够解决现有吻合器械对心脏主动脉血管损伤大及操作不便的问题。

Description

一种动脉吻合器 技术领域
本发明涉及医疗器械技术领域，特别是涉及一种动脉吻合器。
背景技术
冠状动脉旁路移植术，俗称冠脉搭桥术，英文缩写CABG，是用于修复或替换梗阻的冠状动脉以改善心脏心肌血供的手术。手术方法为用移植的血管(常为大隐静脉及乳内动脉)在主动脉及梗阻的冠状动脉远端建立一条血管通路。让心脏搏出的血从主动脉经过所架的血管桥，流向因引起狭窄或梗阻的冠状动脉远端而到达缺血的心肌，从而改善心肌的缺血、缺氧状态。一般来说，冠状动脉管腔狭窄低于50％时，对血流的影响不大，使用药物治疗既可有满意的疗效。当狭窄达到75％时就会明显影响血流的通畅而产生心绞痛症状。此时就需要进行介入支架手术或是外科搭桥手术治疗。对有冠状动脉多支血管病变、弥漫性病变，以及合并瓣膜病变、室壁瘤的冠心病患者而言，冠状动脉搭桥术是相当有效的治疗方法。
随着患者对手术治疗要求和水平的日益提高，手术过程中应用的器械也在不断的进步、更新。通过辅助器械的应用，更好的配合医生完成高质的手术，便于医生运用、操作，且不易在使用过程中对患者造成损伤。越来越多的研究表明，广泛存在的各式各样的冠脉搭桥手术后，近期和远期并发症是由于手术中完全或部分钳夹主动脉所致，于是减少主动脉阻断钳使用的血管吻合器被大力开发，血管吻合器是一种可以在心脏跳动情况下实现血管快速有效吻合的装置。与主动脉阻断钳相比，更加能够给外科医生提供一个稳定的、无血的术野 以及更好的血流动力学。但目前的血管吻合器械在手术过程中仍存在容易损伤主动脉以及操作不便等问题，不利于患者术后恢复。
发明内容
(一)要解决的技术问题
本发明要解决的技术问题是如何解决现有吻合器械对心脏主动脉血管损伤大及操作不便的问题。
(二)技术方案
为了解决上述技术问题，本发明提供一种动脉吻合器，其包括吻合器壳体和分别设于所述吻合器壳体上的吻合托座、压紧臂、托座控制杆和压紧臂控制杆；
所述吻合托座的前端设有可撑开或闭合的密封盘；
所述压紧臂设于所述吻合托座的上方，所述压紧臂的前端设有压紧盘，所述压紧盘与所述密封盘相对设置；
所述托座控制杆与所述吻合托座连接，用于控制所述密封盘撑开或闭合；
所述压紧臂控制杆与所述压紧臂连接，用于控制所述压紧臂下压或抬起。
其中，所述吻合托座的前端的上、下方各设有一个长条形开口，且两个长条形开口上下贯穿设置，在该长条形开口的两侧形成两个相对设置的密封条，所述吻合托座位于所述长条形开口的外表面包覆有一层弹性薄膜，所述弹性薄膜与位于所述吻合托座上方的长条形开口对应的位置开有相应的开口，两个所述密封条在外力作用下能够带动所述弹性薄膜从其开口处撑开或闭合，形成所述密封盘。
其中，还包括托座支撑杆，所述托座支撑杆从所述吻合器壳体的下部侧壁 水平延伸出，所述吻合托座呈管状，所述托座支撑杆的延伸端穿设在所述吻合托座内，所述托座支撑杆与所述吻合托座位于密封盘的前端固定连接，所述吻合托座的后端与所述吻合器壳体固定连接，所述托座支撑杆通过执行机构与所述托座控制杆的下端连接，通过拨动所述托座控制杆带动所述托座支撑杆往复移动，从而提供外力使得所述吻合托座上的密封盘撑开或闭合。
其中，所述托座控制杆的下端设有开口槽，所述托座支撑杆上设有竖直设置的固定块，所述固定块上设有与所述开口槽相匹配的固定销，所述开口槽卡设在所述固定销上，通过拨动所述托座控制杆来推动所述固定块往复移动。
其中，所述吻合器壳体的上表面两侧对应设有第一限位槽和第二限位槽，所述第一限位槽的下方设有第一拨杆固定轴，所述第二限位槽的下方设有第二拨杆固定轴，所述压紧臂控制杆穿过所述第一限位槽，其下端与所述第一拨杆固定轴可转动连接，所述托座控制杆穿过所述第二限位槽，所述托座控制杆位于所述开口槽的上方与所述第二拨杆固定轴可转动连接。
其中，所述吻合器壳体的上表面位于所述第一限位槽和第二限位槽之间还设有压紧臂释放按钮，所述压紧臂释放按钮包括按钮本体和设于所述按钮本体下端的连接弹簧。
其中，所述第一限位槽和第二限位槽均沿所述吻合器壳体的长度方向设置，所述第一限位槽的下方对应设有压紧臂定位齿轨，所述压紧臂定位齿轨的一端通过齿轨固定轴定位，所述压紧臂定位齿轨的另一端设于所述压紧臂释放按钮的按钮本体和连接弹簧之间，所述压紧臂控制杆上设有与所述压紧臂定位齿轨配合连接的压紧臂定位销钉。
其中，所述第二限位槽的两端分别设有用于限定托座控制杆位置的定位 棱。
其中，还包括拨杆助力笔，所述压紧臂控制杆和托座控制杆的上端均设有助力笔插接孔，所述拨杆助力笔与所述助力笔插接孔配合连接，由所述拨杆助力笔拨动所述压紧臂控制杆和托座控制杆转动。
其中，还包括排血导管，所述排血导管通过快插接头与所述托座支撑杆的端部连接，所述排血导管的端部设有密封塞；所述托座支撑杆为中空的管状。
(三)有益效果
与现有技术相比，本发明具有以下优点：
本发明提供的一种动脉吻合器，采用在吻合托座的前端设有可撑开或闭合的密封盘，在密封盘处于闭合状态时插入主动脉血管，延伸至搭桥血管缝合的目标点后撑开呈盘状，作为主动脉血管内壁的密封盘；压紧臂设于所述吻合托座的上方，所述压紧臂的前端设有压紧盘，所述压紧盘与所述吻合托座上的密封盘位置相对设置；通过控制压紧臂向下移动利用压紧盘在动脉血管外壁压紧密封盘，从而在动脉血管侧壁的目标位置形成一个密闭隔离区，此隔离区内将不会有血流通过或溢出，为后续在该隔离区动脉血管壁上开孔、搭桥及血管缝合提供稳定基础和无血缝合环境，整个手术过程不影响动脉内血流正常流动，对血管创伤小、更利于术后恢复，而且操作简便。
附图说明
图1为本发明一种动脉吻合器的密封盘处于闭合状态的立体示意图；
图2为本发明一种动脉吻合器的密封盘处于撑开状态的立体示意图；
图3为本发明一种动脉吻合器的整体剖视图。
图中：1：吻合托座；100：密封条；110：长条形开口；2：弹性薄膜；3：压紧臂；31：压紧盘；4：压紧臂控制杆；5：压紧臂释放按钮；51：按钮本体；52：连接弹簧；6：托座控制杆；61：助力笔插接孔；7：排血导管；8：导管接头；9：密封塞；10：拨杆助力笔；11：托座支撑杆；12：吻合器壳体；13：第一限位槽；14：第二限位槽；141：定位棱；15：第一拨杆固定轴；16：第二拨杆固定轴；17：压紧臂定位齿轨；18：齿轨固定轴；19：压紧臂定位销钉；20：开口槽；21：固定块；22：固定销。
具体实施方式
下面结合附图和实施例，对本发明的具体实施方式作进一步详细描述。以下实例用于说明本发明，但不用来限制本发明的范围。
在本发明的描述中，需要说明的是，术语“中心”、“纵向”、“横向”、“上”、“下”、“左”、“右”、“竖直”、“水平”、“顶”、“底”“内”、“外”等指示的方位或位置关系为基于附图所示的方位或位置关系，以吻合托座1的刺入方向作为“前”、以刺入方向的相反方向作为“后”，仅是为了便于描述本发明和简化描述，而不是指示或暗示所指的装置或元件必须具有特定的方位、以特定的方位构造和操作，因此不能理解为对本发明的限制。此外，术语“第一”、“第二”、“第三”等仅用于描述目的，而不能理解为指示或暗示相对重要性。
在本发明的描述中，需要说明的是，除非另有明确的规定和限定，术语“安装”、“相连”、“连接”应做广义理解，例如，可以是固定连接，也可以是可拆卸连接，或一体地连接；可以是机械连接，也可以是电连接；可以是直接相连，也可以通过中间媒介间接相连，可以是两个元件内部的连通。对于本领域的普通技术人员而言，可以具体情况理解上述术语在本发明中的具体含义。
如图1-2所示，为本发明提供的一种动脉吻合器，其包括吻合器壳体12和分别设于所述吻合器壳体12上的吻合托座1、压紧臂3、托座控制杆6和压紧臂控制杆4；
所述吻合托座1的前端设有可撑开或闭合的密封盘；所述密封盘处于闭合状态时，所述吻合托座1呈直管状，方便插入主动脉血管中，且对血管无损伤；当所述吻合托座1插入主动脉血管内且延伸至搭桥血管缝合的目标点后，撑开所述密封盘，使血管搭桥目标点位于密封盘的居中位置；
所述压紧臂3设于所述吻合托座1的上方，所述压紧臂3的前端设有压紧盘31，所述压紧盘31与所述吻合托座1上的密封盘位置相对设置；通过控制压紧臂3向下移动并利用压紧盘31在动脉血管外壁压紧密封盘，从而在动脉血管侧壁的目标位置形成一个密闭隔离区，此隔离区内将不会有血流通过或溢出，为后续在该隔离区动脉血管壁上开孔、搭桥及血管缝合提供稳定基础和无血缝合环境，整个手术过程不影响动脉内血流正常流动，对血管创伤小、更利于术后恢复，而且操作简便；具体地，所述压紧臂3由两根金属丝弯折而成，两根所述金属丝的端部设置成横向相对设置的两个弧形结构，两个相对的所述弧形结构形成所述压紧盘31。
具体地，所述托座控制杆6与所述吻合托座1连接，用于控制所述密封盘撑开或闭合；所述压紧臂控制杆4与所述压紧臂3连接，用于控制所述压紧臂下压或抬起。
其中，所述吻合托座1的前端的上、下方各设有一个长条形开口110，也可以为长直的缝等，且两个长条形开口110上下贯穿设置，在该长条形开口110的两侧形成两个相对设置的密封条100，所述吻合托座1位于所述长条形 开口110的外表面包覆有一层弹性薄膜2例如PU膜(聚氨酯薄膜)，其弹性好，轻度高，所述弹性薄膜2与位于所述吻合托座1上方的长条形开口110对应的位置开有相应的开口，两个所述密封条100在外力作用下能够撑开呈环状或闭合呈管状，从而带动所述弹性薄膜2从其开口处撑开或闭合，形成上部开口下部密封的所述密封盘。
如图3所示，进一步地，还包括托座支撑杆11，所述托座支撑杆11的一端从所述吻合器壳体12的下部侧壁水平延伸出吻合器壳体12，所述托座支撑杆11的另一端位于所述吻合器壳体12内，所述吻合托座1呈管状，所述托座支撑杆11的延伸端穿设在所述吻合托座1内，为了方便打开所述密封盘，所述托座支撑杆11与所述吻合托座1位于密封盘的前端固定连接，所述吻合托座1的后端与所述吻合器壳体12固定连接，所述托座支撑杆11通过执行机构与所述托座控制杆6的下端连接，通过拨动所述托座控制杆6带动所述托座支撑杆11往复移动，如图3中，当向右拨动托座控制杆6时，托座支撑杆11受托座控制杆6外力作用同步向左移动，此时吻合托座1右端头部(前端)与托座支撑杆11头部同步向左移动，但吻合托座1的左端(后端)被吻合器外壳卡住，从而使吻合托座1从长条形开口110处被憋开撑起，同时使套在吻合托座1表面的弹性薄膜2被撑开，从而提供外力使得所述吻合托座1上的所述密封盘撑开或闭合。
所述执行机构的具体形式可以为：所述托座控制杆6的下端设有开口槽20，所述托座支撑杆11上固定设有竖直设置的固定块21，所述固定块21上设有与所述开口槽20相匹配的固定销22，所述开口槽20卡设在所述固定销22上，通过拨动所述托座控制杆6来推动所述固定块21以及与所述固定块21 一体连接的托座支撑杆11沿吻合器壳体12往复移动；也可以为其他的执行机构，只要能够实现拨动所述托座控制杆6带动托座支撑杆11移动，均在本发明的保护范围内。
为了方便所述托座控制杆6和压紧臂控制杆4的安装，所述吻合器壳体12的上表面两侧对应设有第一限位槽13和第二限位槽14，所述第一限位槽13的下方设有第一拨杆固定轴15，所述第二限位槽14的下方设有第二拨杆固定轴16，所述压紧臂控制杆4穿过所述第一限位槽13，其下端与所述第一拨杆固定轴15可转动连接，所述托座控制杆6穿过所述第二限位槽14，所述托座控制杆6位于所述开口槽20的上方与所述第二拨杆固定轴16可转动连接；以保证压紧臂控制杆4和托座控制杆6通过外力可沿各自的拨杆固定轴轴向转动。
为了进一步控制压紧臂3，所述吻合器壳体12的上表面位于所述第一限位槽13和第二限位槽14之间还设有压紧臂释放按钮5，所述压紧臂释放按钮5包括按钮本体51和设于所述按钮本体51下端的连接弹簧52；优选地，所述第一限位槽13和第二限位槽14均沿所述吻合器壳体12的长度方向倾斜设置，优选呈弧形设置(如图2所示)，所述第一限位槽13的下方设有与其形状对应的压紧臂定位齿轨17，所述压紧臂定位齿轨17的一端通过齿轨固定轴18定位，所述压紧臂定位齿轨17的另一端设于所述压紧臂释放按钮5的按钮本体51和连接弹簧52之间，所述压紧臂控制杆4上设有与所述压紧臂定位齿轨17配合连接的压紧臂定位销钉19；当按下压紧臂释放按钮5后，连接弹簧52被压缩，压紧臂定位齿轨17沿齿轨固定轴18向下转动，从而与压紧臂定位销钉19脱离，释放了压紧臂控制杆4的定位束缚，此时可使压紧臂自由快速升降， 节省手术时间。
其中，所述第二限位槽14的两端分别设有用于限定托座控制杆6位置的定位棱141，用于托座控制杆6拨动到两端时将其卡住，从而实现吻合托座1撑开和闭合两种功能状态并能够定位。
优选地，还可以包括拨杆助力笔10，拨杆助力笔10为一体注塑成型，所述压紧臂控制杆4和托座控制杆6的上端均设有助力笔插接孔61，所述拨杆助力笔10与所述助力笔插接孔61配合连接，由所述拨杆助力笔10拨动所述压紧臂控制杆4和托座控制杆6转动，可为拨动过程提供助力及精准定位，左右拨动托座控制杆6可控制托座前伸闭合和收缩撑开，左右拨动压紧臂控制杆4可控制压紧臂抬起和下压，从而提高手术质量和效率。
其中，还包括排血导管7，所述排血导管7通过导管接头8如快插接头与所述托座支撑杆11位于吻合器壳体12内的一端连接，所述排血导管7的端部设有密封塞9；所述托座支撑杆11为中空的管状，打开密封塞9后，托座支撑杆11与吻合托座1之间血液可沿排血导管7溢出；通过拔出密封塞9可观察有无血液从导管溢出，从而判断吻合区域是否密闭。
本发明的操作过程为：1、吻合托座1置入：在确定心脏动脉搭桥血管缝合点后，用穿刺针在距离该点2～2.5cm左右处穿孔；先将压紧臂3抬高，再将闭合状态的吻合托座1沿其头端从穿刺孔处插进动脉血管壁内侧；2、血管吻合：拨动托座控制杆6将吻合托座1撑开，如图2所示，移动吻合托座1使血管搭桥目标点位于密封盘区域居中位置；拨动压紧臂控制杆4将压紧臂3下压在动脉血管壁外侧，使压紧臂3的压紧盘31至于密封盘所在平面以下，此时拔开排血导管7末端的密封塞9，如无持续血流溢出则证明密封盘区域已密闭 良好，如有血液持续溢出表明密封盘区域尚未密闭，应将压紧臂3继续下压，确保密封盘区域密闭后使用打孔器在动脉血管壁目标点打孔，进行搭桥血管缝合即可；3、卸载：拨动压紧臂控制杆4将压紧臂3升起约至最高点，拨动托座控制杆6使吻合托座1前伸至密封盘闭合成直管，沿穿刺孔缓慢退出至吻合器与动脉血管分离。
由以上实施例可以看出，本发明结构设计新颖，对心血管组织损伤微小、操作简单、能够建立良好的缝合环境缩短手术时间，且功能安全稳定有效。
以上所述仅为本发明的较佳实施例而已，并不用以限制本发明，凡在本发明的精神和原则之内，所作的任何修改、等同替换、改进等，均应包含在本发明的保护范围之内。

Claims (10)

  1. 一种动脉吻合器，其特征在于，包括吻合器壳体和分别设于所述吻合器壳体上的吻合托座、压紧臂、托座控制杆和压紧臂控制杆；
    所述吻合托座的前端设有可撑开或闭合的密封盘；
    所述压紧臂设于所述吻合托座的上方，所述压紧臂的前端设有压紧盘，所述压紧盘与所述密封盘相对设置；
    所述托座控制杆与所述吻合托座连接，用于控制所述密封盘撑开或闭合；
    所述压紧臂控制杆与所述压紧臂连接，用于控制所述压紧臂下压或抬起。
  2. 根据权利要求1所述的动脉吻合器，其特征在于，所述吻合托座的前端的上、下方各设有一个长条形开口，且两个长条形开口上下贯穿设置，在该长条形开口的两侧形成两个相对设置的密封条，所述吻合托座位于所述长条形开口的外表面包覆有一层弹性薄膜，所述弹性薄膜与位于所述吻合托座上方的长条形开口对应的位置开有相应的开口，两个所述密封条在外力作用下能够带动所述弹性薄膜从其开口处撑开或闭合，形成所述密封盘。
  3. 根据权利要求2所述的动脉吻合器，其特征在于，还包括托座支撑杆，所述托座支撑杆从所述吻合器壳体的下部侧壁水平延伸出，所述吻合托座呈管状，所述托座支撑杆的延伸端穿设在所述吻合托座内，所述托座支撑杆与所述吻合托座位于密封盘的前端固定连接，所述吻合托座的后端与所述吻合器壳体固定连接，所述托座支撑杆通过执行机构与所述托座控制杆的下端连接，通过拨动所述托座控制杆带动所述托座支撑杆往复移动，从而提供外力使得所述吻合托座上的密封盘撑开或闭合。
  4. 根据权利要求3所述的动脉吻合器，其特征在于，所述托座控制杆的 下端设有开口槽，所述托座支撑杆上设有竖直设置的固定块，所述固定块上设有与所述开口槽相匹配的固定销，所述开口槽卡设在所述固定销上，通过拨动所述托座控制杆来推动所述固定块往复移动。
  5. 根据权利要求4所述的动脉吻合器，其特征在于，所述吻合器壳体的上表面两侧对应设有第一限位槽和第二限位槽，所述第一限位槽的下方设有第一拨杆固定轴，所述第二限位槽的下方设有第二拨杆固定轴，所述压紧臂控制杆穿过所述第一限位槽，其下端与所述第一拨杆固定轴可转动连接，所述托座控制杆穿过所述第二限位槽，所述托座控制杆位于所述开口槽的上方与所述第二拨杆固定轴可转动连接。
  6. 根据权利要求5所述的动脉吻合器，其特征在于，所述吻合器壳体的上表面位于所述第一限位槽和第二限位槽之间还设有压紧臂释放按钮，所述压紧臂释放按钮包括按钮本体和设于所述按钮本体下端的连接弹簧。
  7. 根据权利要求6所述的动脉吻合器，其特征在于，所述第一限位槽和第二限位槽均沿所述吻合器壳体的长度方向设置，所述第一限位槽的下方对应设有压紧臂定位齿轨，所述压紧臂定位齿轨的一端通过齿轨固定轴定位，所述压紧臂定位齿轨的另一端设于所述压紧臂释放按钮的按钮本体和连接弹簧之间，所述压紧臂控制杆上设有与所述压紧臂定位齿轨配合连接的压紧臂定位销钉。
  8. 根据权利要求7所述的动脉吻合器，其特征在于，所述第二限位槽的两端分别设有用于限定托座控制杆位置的定位棱。
  9. 根据权利要求1-8任一项所述的动脉吻合器，其特征在于，还包括拨杆助力笔，所述压紧臂控制杆和托座控制杆的上端均设有助力笔插接孔，所述拨 杆助力笔与所述助力笔插接孔配合连接，由所述拨杆助力笔拨动所述压紧臂控制杆和托座控制杆转动。
  10. 根据权利要求3所述的动脉吻合器，其特征在于，还包括排血导管，所述排血导管通过快插接头与所述托座支撑杆的端部连接，所述排血导管的端部设有密封塞；所述托座支撑杆为中空的管状。
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