WO2019128491A1

WO2019128491A1 - Tension adjusting and fixing device for surgical mesh, and surgical application thereof

Info

Publication number: WO2019128491A1
Application number: PCT/CN2018/114751
Authority: WO
Inventors: 李建民; 李根云; 波恩⋅乔治; 白瑞博姆⋅迈克; 陆静丽; 顾奇巍; 韦建宇
Original assignee: 苏州优迈医疗器械有限公司
Priority date: 2017-12-27
Filing date: 2018-11-09
Publication date: 2019-07-04
Also published as: CN108209991B; CN108209991A; CN117481865A; CN117481866A; CN117752461A

Abstract

A tension adjusting and fixing device for a surgical mesh, and a surgical application thereof. The tension adjusting and fixing device for a surgical mesh comprises: a tension adjusting cord (3a) and a positioner (02, 03, 04, 05, 06, 07, 08, 09, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19). The tension adjusting cord (3a) is guided to pass through the positioner (02, 03, 04, 05, 06, 07, 08, 09, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19) and is associated with an end portion of a sling (1) and a subsequently implanted pubis obturator anchor (2) to adjust the tension of the sling (1). The tension adjusting cord (3a) cooperates, or a locking suture (4, 41) is additionally provided to cooperate, with the positioner (02, 03, 04, 05, 06, 07, 08, 09, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19) to fix the tension and position of the sling (1). According to the tension adjusting and fixing device for a surgical mesh, the operation difficulty and surgery duration of single-incision tension-free vaginal tape are reduced, a reliable implementing solution of adjusting the tension of the sling (1) and locking the tension and position of the sling (1) using a single hand is provided, the tension of sling (1) is prevented from being changed in a surgery process, and diversified examples are provided to give options to doctors with different operating habits during the surgery.

Description

Surgical mesh device for adjusting and fixing tension and surgical application thereof

Technical field

The invention belongs to the technical field of surgical instruments and methods, and in particular relates to a device for adjusting and fixing tension of a surgical mesh and a surgical application thereof.

Background technique

Female urinary incontinence is a common disease in women. According to global statistics, the prevalence rate is close to 50%, and about half of them are Stress Urinary Incontinence (SUI). Stress urinary incontinence means that when the bladder pressure is greater than the maximum urethral pressure, in the absence of contraction of the bladder detrusor, the urine also involuntarily overflows from the external urethra, especially when the abdominal pressure suddenly increases, such as: laughing, sneezing, Coughing occurs at the same time. Postmenopausal populations are more susceptible to morbidity. Most of the causes of the disease are due to birth injury during childbirth, estrogen levels after menopause, and soft tissue relaxation at the pelvic floor. SUI began to be considered one of the top five diseases affecting human health in the mid-1990s and is known as "social cancer." Especially in China, with the further aging of the population, SUI has received more and more attention. A recent investigation on the incidence of urinary incontinence in Beijing alone found that 23%-45% of females had varying degrees of urinary incontinence, and about 7% had significant symptoms of urinary incontinence, of which about 50% were stress urinary incontinence. A group of foreigners reported 37.7% of women with urinary incontinence over 60 years of age. To this end, the search for effective methods for treating SUI has urgent and significant clinical significance.

In order to treat urinary incontinence, U.S. Patent No. 6,080,845, Japanese Patent Publication No. JP 1998-155897, and Korean Patent Publication No. KR2003-34218, etc., disclose the insertion of an elastic insert into the vagina or injection into the soft tissue around the urethra or ureter. Techniques for hydrogel particles (polymer: polymer). Tension-free vaginal tape (TVT) is the gold standard for SUI treatment in surgical treatment. At present, TVT is considered to have a high cure rate, simple operation, small trauma, rapid postoperative recovery, few complications, and low recurrence rate, and is widely used in clinical practice.

There are many methods for the treatment of stress urinary incontinence, among which the surgical treatment is the most effective, and the urethral or bladder neck suspension is the most effective method for surgical treatment. In recent years, with the advancement of science and technology and the deep understanding of the principle of urinary incontinence, a variety of minimally invasive methods have been applied, that is, the best therapeutic effect is obtained by taking the surgical operation and technical methods that minimize the damage to the patient. At present, one treatment for stress urinary incontinence is tension-free suspension in the middle of the transvaginal urethra, that is, a 2 cm incision is made in the anterior wall of the vagina, and a suspender placed at the bottom of the middle part of the urethra is inserted into the soft tissue of the body through a puncture device. In the gap, the pelvic floor soft tissue is enhanced to support the urethra. Thus, when the abdominal pressure is increased, the extent of the downward movement of the urethra is limited by the implanted sling, and the ureter is compressed and closed, so that the patient's leakage phenomenon is controlled.

The two ends of the implanted sling can generally travel in the body through two ways. After the skin is extracted, the outer part of the sling is cut off, and the inner part of the sling plays an anchoring role with the sling of the surrounding soft tissue. One is the posterior pubic approach. The puncture device carries the two ends of the sling from the abdominal wall along the back of the pubis. This approach may damage the bladder or other soft tissues behind the pubis, such as vascular plexus, resulting in serious complications. The other is through the closed hole approach, the puncture device passes through the closed hole, and both ends of the sling are pulled along the vaginal mucosa to the pelvic obturator in both directions, and are taken out from the inner skin of the thigh. Surgery using the latter approach is called mid-occipital urethral suspension. Due to the large blood vessels away from the bladder and pelvis, complications are rare, easy to operate, and easy to promote. This is the method currently used.

There are two ways to pass the obturator through the closed-cell urethral suspension. From the incision of the anterior wall of the vagina to the skin on the inside of the thigh (from the inside out) and from the outside of the thigh through the obturator to the incision of the anterior wall of the vagina, connect it with the sling and return it (from the outside to the inside). In both cases, surgical scissors are used to blunt or sharply separate the vaginal submucosa from the vaginal incision to the obturator to facilitate the passage of the puncture device and the placement of the sling. The vaginal submucosa is normally loose tissue, and there is little surgical bleeding when the separation level is correct.

In recent years, in order to reduce the wound surface, a single incision transvaginal tension-free urethral suspension (SIS) has emerged and matured practically. The slings with closed-cell anchors at both ends are used to position the closed-hole anchors on the corresponding closed-cell membranes, and the tension and position of the slings can be adjusted to complete the operation. The operation time is greatly reduced and the wound healing speed is faster. However, due to the limited width of the incision in the current surgical procedure, the difficulty in implanting the obturator anchor in the obturator is overcome, and the adjustment of the tension of the suspender and the locking of the positioning become a headache for the surgeon. The steps required, while the instruments required to use are cumbersome. That is to say, in the case of poor visual conditions, the tension adjustment of the sling is inconvenient, and when the sling tension adjustment is appropriate, the tension caused by the positioning and locking is large, which is not suitable for the physician to perform such surgery efficiently and reliably.

Summary of the invention

In view of the above-mentioned drawbacks of the prior art, the object of the present invention is to propose a device for adjusting and fixing tension of a surgical mesh and a surgical application thereof, and solving the one-hand operation executable problem of the tension adjustment and the positioning and locking of the sling in the SIS.

A technical solution for achieving the above first object of the present invention is a device for adjusting and fixing tension of a surgical mesh, characterized by comprising: a tension adjusting rope, a locking suture and a positioner, and the tension adjusting rope guides A closed-cell anchor that is coupled to the locator and associated with the sling end and the rear implant adjusts the sling tension, and the locking suture cooperates with the locator to permanently secure the sling position and tension.

Further, the positioner is a sleeve with a reel, and one end of the tension adjusting rope and the locking suture passes through the end of the strap and is fixed to the closed anchor, and the tension adjusting rope is further One end is connected to the sleeve and wound around the reel, and the other end of the locking suture is wound on the outside of the sleeve to form a knot, and the lock is connected to the end of the sling according to the tension of the tension adjusting rope. At the office.

Further, the tension adjusting rope is a single strand bare wire, and the tension adjusting rope is provided with a strong consolidation formed by winding more than one time at the locking knot of the locking stitch.

Further, the tension adjusting rope is a bead line with two or more locking balls, each of which is separated by 0.2 mm to 5 mm, and the locking stitch of the locking stitch is locked to one of the locking balls.

Further, the positioner is a hollow tube set in which the inner tube and the outer tube are sleeved and axially interacted, and the outer wall of the end portion of the inner tube is provided with a non-closed knot forming groove, and the outer tube is in the same direction as the knot forming groove. The inner wall of the end is seamlessly slidably connected to the outer wall of the inner tube, and the tension adjusting rope and the locking suture are respectively threaded into the axial cavity of the inner tube, and one end of the tension adjusting rope is fixed to the end of the sling and the other end is self-formed. The nozzle where the slot is located penetrates into the inner tube and passes through the end tube from the distal tube for tension adjustment. One end of the locking suture is fixed to the closed hole anchor and wound around the knot forming groove to form a virtual knot, and the other end is far from the inner tube. The end nozzle pierces out and hangs for the zipper to sag.

Further, the tension adjusting rope is a single strand bare wire, and the tension adjusting rope is provided with a strong stagnation formed by winding more than one time based on the outer tube and is pushed to the locking joint of the locking stitch.

Further, the positioner comprises a threading tube and a first locking knot fixed to the closed hole anchor, the first locking buckle is an annular body with an elastic strip in the inward direction and the end and the loop of the elastic strip An opening is formed between the shapes, the tension adjusting rope is a bead line with two or more locking balls, and each locking ball is separated by 0.2 mm-5 mm, and the diameter of the locking ball can be increased when the elastic card is bent under force. The opening of the opening and the elastic strip can stop at the smaller opening, and the tension adjusting rope and the locking suture are movably engaged in the threading tube and are freely suspended at the same end, and the other end of the tension adjusting rope passes through The first lock is fastened and fixed to the end of the strap, and the other end of the locking stitch is fixed to the elastic clip to pull the elastic clip to bend and deform.

Further, the positioner comprises a threading tube and a first locking knot fixed to the closed hole anchor, the first locking buckle is an annular body with an elastic strip in the inward direction and the end and the loop of the elastic strip An opening is formed between the shapes, and the tension adjusting rope and the locking suture are movably engaged in the threading tube and are freely suspended at the same end. The tension adjusting rope is a single strand of bare wire and the thickness meets the bending of the elastic strip. When it is passed through the enlarged opening, the elastic clip can be initially clamped to the smaller opening, and the other end of the locking stitch is fixed to the elastic strip to pull the elastic strip to bend and wrap. When the tension of the sling is moderate, the tension at the opening is adjusted on the rope.

Further, the proximal end portion of the elastic card strip is provided with a drop groove, and the locking stitch is provided with a locking ball at an end close to the first lock knot and is positioned in the drop groove by the locking ball.

Further, the proximal end portion of the elastic card strip is provided with a drop groove, and the locking stitch is a single strand of bare wire and is positioned and positioned in the drop groove.

Further, the positioner comprises a hollow column tube and a positioning plate fixed to the end of the sling, and the positioning plate is provided with a perforation for freely passing the two kinds of sutures, and the hollow column tube is open to the side wall of the end of the perforation. Pressing the positioning groove, the one end of the tension adjusting rope and the locking suture passing through the perforation and being fixed to the closed hole anchor, wherein the tension adjusting rope is a bead line with two or more locking balls, between the locking balls The other end of the tension adjusting rope is correspondingly placed under the tension of the sling and positioned in the pressure regulating positioning groove, and the other end of the locking stitch is wound around the locking stitch on the other side of the perforation, the tension adjusting rope or two. The sutures are single knotted or complexed.

Further, the positioner comprises a sleeve with two reels and a fixed anchor, the fixed anchor is a top ring, a bottom taper elastically polymerized inverted tapered sleeve, and is unidirectional on the strip mesh belt Passing, reverse locking, one end of the tension adjusting rope is fixed to the end of the sling, and the other end of the tension adjusting rope is inserted into the sleeve and the fixed anchor together with the preset hole of the sling self-closing hole anchor and is wound around a winding wire The locking thread penetrates into the predetermined hole of the closed-hole anchor and one end penetrates the sleeve to be connected with the fixed anchor, the other end penetrates the sleeve and is wound around another reel, in the case of moderate tension of the sling The fixed anchor is pulled against the closed-hole anchor, and the sling is reversely locked in the fixed anchor.

Further, the positioner comprises a sleeve with two reels and a fixed anchor, and the fixed anchor is a top ring, a bottom taper elastically polymerized inverted tapered sleeve, and one-way passage on the bead line, Reverse locking, the tension adjusting rope is a bead line with two or more locking balls, each locking ball is separated by 0.2mm-5mm, one end of the tension adjusting rope is fixed to the end of the sling, and the other end is self-closing hole anchor The hole is inserted into the sleeve and the fixed anchor and is wound around a reel. The locking suture penetrates into the predetermined hole of the closed-hole anchor, and one end penetrates the sleeve to connect with the fixed anchor, and the other end penetrates the sleeve. And being wound around another reel, the fixed anchor is pulled against the closed-hole anchor under moderate tension of the sling, and the tension adjusting rope is reversely locked in the fixed anchor.

Further, the positioner comprises a sleeve with two reels and a support piece fixed to the end of the sling, the support piece is provided with a circular hole and a one-way cone, the maximum diameter and the sleeve of the one-way cone The outer diameter of the tube is larger than the inner diameter of the circular hole, one end of the tension adjusting rope is fixed to the closed hole anchor, and the other end is inserted into the sleeve from the round hole and wound around a reel, and the locking suture is threaded into the sleeve at one end. The tube is wound around another reel, and the other end is pierced out of the round hole and connected to the one-way cone. The one-way cone is pulled by the locking suture to stop the round hole when the tension of the sling is moderate, the tension adjustment The rope is locked in the round hole and the support piece and the sling are positioned.

Further, the positioner comprises a sleeve with a reel and a support piece fixed to the end of the sling, the support piece is provided with a circular hole and a fixed fixed suture, the diameter of the sleeve is larger than the round hole The inner diameter, each end of the tension adjusting rope and the locking suture penetrates into the circular hole and is fixed on the closed hole anchor, and the other end of the tension adjusting rope penetrates into the sleeve and is wound around the reel for tension adjustment and locking The other end of the suture is suspended with the free end of the fixed suture; the fixed suture and the tensioned locking suture are tied to the round hole when the tension of the suspender is moderate.

Further, the positioner includes a pair of axially hollow tapered bore tubes and a taper plug, the tapered bore tube is fixed to the end of the strap and the flare is toward the middle of the strap, and the taper sleeve is sleeved to slide on the locking stitch And correspondingly flaring into the tapered hole tube, one end of the tension adjusting rope is fixed to the end of the tapered hole tube away from the flared end, the locking suture is fixed at one end of the cone tip of the taper plug, and the other two stitches are The preset hole of the self-closing hole anchor of one end passes back and hangs from the bottom of the cone of the cone plug to wrap or wrap the reel, the tension adjusting rope drives the taper hole tube and the end of the sling displacement adjusts the tension of the sling, and the tension of the sling is moderate The lower locking stitch drives the taper to press against the narrow opening of the tapered hole tube to lock the two kinds of sutures.

Another technical solution for achieving the above first object of the present invention is a device for adjusting and fixing a tension of a surgical mesh, comprising: a tension adjusting rope and a positioner, the tension adjusting rope guiding the threading to the positioner The end of the sling is associated with the end of the sling and the rear-implanted closed-hole anchor adjusts the tension of the sling, and the tension adjusting rope cooperates with the locator to fix the tension and position of the sling.

Further, the positioner is a locking unit comprising two threading slots, and the inner wall of at least one threading slot is provided with a barb, the positioner is opposite to the end of the strap; the tension adjusting rope is more than two Locking the ball bead line, each locking ball is separated by 0.2mm-5mm, one end of the tension adjusting rope penetrates into a threading groove and is fixed with the end of the sling, and the other end of the tension adjusting rope passes through the preset hole of the self-closing hole anchor Returning and draping from another threading groove for tension adjustment, and the locking ball of the tension adjusting rope is unidirectionally locked to the barb.

Further, the positioner is an annular frame with a middle waist, and the first side bar on the middle waist side is kept at a constant distance from the closed hole anchor, and the bottom side of the second side bar on the other side of the middle waist is pulled or provided. a spur, one end of the tension adjusting rope is fixed to the end of the sling, the other end is wound around the middle waist and is passed out from the bottom side of the second side rod, and the tension adjusting rope drives the sling to adjust the tension when the second side rod is suspended by the external force, The sling is locked to the bottom side of the second side bar when the second side bar external force is reset to zero.

Further, the positioner is a tapered mouth rubber plug with an elastic ratchet on the outer surface, a support piece is arranged at the end of the sling, and the support piece and the closed hole anchor are respectively provided with a threading hole, and the maximum diameter of the locator is larger than The inner diameter of the threading hole is opened, and the positioner is freely threaded into the threading hole under the elastic ratcheting state, and the elastic ratchet is blocked from the threading hole in the self-resetting state, and one end of the tension adjusting rope is fixed to the edge of the supporting piece and the other end The threading hole of the self-closing hole anchor passes through and penetrates into the positioner, and when the tension of the sling is moderate, the external force pushes the positioner into any threading hole and closes the opening, and locks the tension adjusting rope.

Further, the positioner comprises a sleeve with a reel and a support piece fixed to the end of the sling, the support piece is provided with a threading hole and a wire hole, and one end of the tension adjusting rope is fixed The hole anchor is closed, and the other end of the tension adjusting rope penetrates through the threading hole, passes through the wire hole, penetrates the sleeve and is wound around the reel, and the end of the sleeve is pressed against the wire hole to adjust the tension adjusting rope. The guiding freedom is adjusted by the tension, and when the tension of the sling is moderate, the end of the sleeve is separated from the wire hole, and the tension adjusting rope is locked into the hole of the wire hole.

Further, the positioner comprises a sleeve with a reel and a support piece fixed to the end of the sling, the support piece is provided with a threading hole and a wire hole, and the tension adjusting rope is provided with two More than one bead line of the locking ball, each locking ball is separated by 0.2mm-5mm, one end of the tension adjusting rope is fixed to the closed hole anchor, and the other end of the tension adjusting rope penetrates through the threading hole, bypasses the card hole, The sleeve is inserted into the sleeve and wound around the reel; the end of the sleeve is pressed against the wire hole, and the tension adjustment rope is guided freely for tension adjustment, and the end of the sleeve is separated from the cable hole when the tension of the sling is moderate The tension adjusting rope is redirected and positioned by the locking ball lock in the slot of the cable hole.

Further, the positioner is a support piece fixed to the end of the sling, the support piece is provided with a closed 蝌蚪-shaped hole, and the narrow slit of the 蝌蚪-shaped hole tends to the closed-hole anchor, the tension adjusting rope For a beaded line with two or more locking balls, each locking ball is separated by 0.2 mm to 5 mm, one end of the tension adjusting rope is fixed to the closed hole anchor, and the other end of the tension adjusting rope is pierced from the boring hole, and The external force is guided by the tension adjustment in the wide mouth of the 蝌蚪-shaped hole. When the sling tension is moderate, the tension adjusting rope slides into the narrow slit and is locked by the locking ball lock in the 蝌蚪-shaped hole.

Further, the positioner is a support piece fixed to the end of the sling, the support piece is provided with a vertical wing piece and the air piece is provided with an open ring extending from the root of the support piece toward the opening toward the opening. a groove, the tension adjusting rope is a bead line with two or more locking balls, each locking ball is separated by 0.2 mm-5 mm, one end of the tension adjusting rope is fixed to the end of the supporting piece, and the other end of the tension adjusting rope is autistic The preset hole of the hole anchor is passed out for adjusting the tension, and the tension adjusting rope is caught in the open ring groove when the tension of the sling is moderate, and the locking ball is locked at the root of the open ring groove.

Further, the positioner includes a sleeve with a reel and an axially hollow cylindrical lock fixed to the end of the strap, the cylindrical lock being axially slid by the main bracket and the sleeve The lock cylinder is formed, the surface of the main bracket is formed with a concave-convex guide surface, and the concave portion is partially connected to the axial hollow portion, and one end of the lock cylinder forms a jaw, and one end of the tension adjusting rope is fixed to the closed-hole anchor, and the tension adjusting rope is further One end penetrates the sleeve from the cylindrical lock and is wound around the reel. When the end of the sleeve abuts the main bracket and the cylindrical lock is unlocked, the tension adjustment rope is guided freely through the cylindrical lock for tension adjustment. When the tension of the sling is moderate, the lock cylinder is displaced by the external force, the jaws are clamped to the concave surface of the main bracket surface, and the tension adjusting rope is locked.

Further, the positioner comprises a sleeve with a reel and a clip, and the clip has an annular hole in the axial direction for the double-strength of the tension adjusting rope, and the two flaps of the clip-opening and closing are opposite The surface of the tension adjusting rope penetrates from the outer side of the ring hole into the end of the fixed sling, and the other end of the tension adjusting rope passes through the preset hole of the self-closing hole anchor, and the outer side of the ring hole The clip is inserted, inserted into the sleeve and wound around the reel for adjusting the tension. When the tension of the sling is moderate, the two wings are closed and the tension adjusting rope and the end of the sling are locked.

Further, the positioner comprises a one-way buckle with an elastic locking tongue and a ligating belt that matches the one-way locking and the reverse locking of the one-way locking, the one-way locking buckle is fixed to one end of the sling, one end of the sling Directly or indirectly fixed to the closed-cell anchor by a tension-free surgical line, and the cable tie is inserted into the one-way buckle, one end of the tension adjusting rope is fixed to the other end of the cable tie, and the other end of the tension adjusting rope is suspended or wound The reel is pulled by the tension adjusting rope to be tensioned by the one-way locking buckle when the elastic locking tongue is lifted by the external force, and the cable tie is locked when the external force releases the elastic locking tongue.

The technical solution for achieving the above second object of the present invention is a device for adjusting and fixing tension of a surgical mesh, connecting a closed-cell anchor and a sling implanted in the body, and being applied to an open surgery or a minimally invasive surgery.

The device of the present invention has outstanding substantive features and remarkable advancement compared with the conventional device: the device reduces the difficulty of operation and the operation time of the single-incision transvaginal tension-free urethral suspension, and provides a single The hand operates a reliable implementation of the sling tension adjustment and locking the sling tension and position to avoid changes in the sling tension during the procedure. And provide a variety of examples, to meet the different operating habits of physicians to choose the surgery.

DRAWINGS

BRIEF DESCRIPTION OF THE DRAWINGS Fig. 1 is a view showing the configuration and use state of a first embodiment of the present invention.

Figure 2 is a schematic view showing the structure and use state of the second embodiment of the present invention.

Fig. 3 is a view showing the structure and use state of a third embodiment of the present invention.

Fig. 4 is a view showing the structure and use state of a fourth embodiment of the present invention.

Fig. 5 is a view showing the structure and use state of a fifth embodiment of the present invention.

Figure 6 is a schematic view showing the structure and use state of a sixth embodiment of the present invention.

Fig. 7 is a view showing the structure and use state of the seventh embodiment of the present invention.

Figure 8 is a schematic view showing the structure and use state of the eighth embodiment of the present invention.

Figure 9 is a schematic view showing the structure and use state of the ninth embodiment of the present invention.

Figure 10 is a schematic view showing the structure and use state of the tenth embodiment of the present invention.

Figure 11 is a schematic view showing the structure and use state of the eleventh embodiment of the present invention.

Figure 12 is a schematic view showing the structure and use state of a twelfth embodiment of the present invention.

Figure 13 is a schematic view showing the structure and use state of a thirteenth embodiment of the present invention.

Figure 14 is a schematic view showing the structure and use state of the fourteenth embodiment of the present invention.

Figure 15 is a schematic view showing the structure and use state of the fifteenth embodiment of the present invention.

Figure 16 is a schematic view showing the structure and use state of a sixteenth embodiment of the present invention.

Figure 17 is a view showing the structure and use state of the seventeenth embodiment of the present invention.

Figure 18 is a schematic view showing the structure and use state of the eighteenth embodiment of the present invention.

Fig. 19 is a view showing the structure and use state of the nineteenth embodiment of the present invention.

Detailed ways

The embodiments of the present invention will be further described in detail with reference to the accompanying drawings, in which the claims

The designer of the present invention has conducted in-depth research on the problem that the existing sling implanting device for treating stress urinary incontinence causes difficulty in operation in a single-incision transvaginal tension-free urethral suspension suspension, and develops ideas from various advancements and The grafting application of the locking structure has improved the sling implant device, thereby proposing a device for adjusting and fixing the tension of the surgical mesh and its surgical application, thereby solving the cumbersome operation of the current sling implantation, and cannot be coordinated by one hand or multiple physicians. The operation completes the problem of surgery.

Usually, when performing such an operation, a 2 cm incision is made in the apical wall of the vagina until the ureter is visible. The closed-hole anchor pre-connected at one end of the sling is first inserted through the slit and positioned at one side of the closed-hole anchor. Can be left or right, depending on the doctor's choice. The technical solution created by the present invention is to facilitate the adjustment of the tension of the sling to a suitable degree and to lock the position while the occlusion anchor is being connected to the other side, and the surgical network is adjusted and described. The device for fixing tension is characterized in that: a tension adjusting rope and a positioner, the tension adjusting rope is guided to be connected to the positioner and associated with the end of the sling and the rear-implanted closed-hole anchor adjusts the tension of the sling, and the tension adjusting rope The locator can be used to fix the tension and position of the sling. Of course, the tension adjusting cord can be variously selected, for example, it can be a suture, a cable, a braided rope, a rope, a beaded wire, a cable tie, or the like. With the type and structure of the positioner, a locking stitch can be introduced, and the tension and position of the sling can be fixed by the locking stitching with the locator. In this way, after the completion of the implantation of a closed-cell anchor, the tension tension adjustment and the sling can be simply carried out to complete the sling tension adjustment within a limited range of the cut, and only the pre-piercing and pre-prevention are used. Wrap or other predefined means of winding the tensioning tether or locking the suture for convenient and smooth sling implantation.

In view of the versatile and feasible implementation of the positioner, the following embodiments are combined with the structure of the various types of positioners and the corresponding operation mode of the corresponding sutures.

Embodiment 1

As shown in FIG. 1, in the device for adjusting and fixing the tension of the surgical mesh, the positioner is a sleeve 011 with a reel 012, which integrally constitutes a surgical handle 01. The same end of the tension adjusting rope and the locking suture 4 passes through the end of the sling 1 and is fixed to the closed anchor 2, and the other end of the tension adjusting rope is threaded into the sleeve 011 and wound around the winding. The wheel 012, the other end of the locking suture 4 is wound into the imaginary knot 01A on the outer side of the sleeve, and is pushed to the junction 01B of the sling end portion when the sling tension is moderate.

As can be seen from the figure, the tension adjusting rope is a single strand bare wire 3a, in order to ensure the fastening strength of the locking stitch 4 to the single strand 3a, and to prevent the end portion of the sling 1 from coming off. The tension adjusting rope 3a is further provided with a strong consolidation formed by winding more than one time at the locking knot of the locking stitch.

In the operation of the embodiment, the tension adjusting rope and the locking suture are first passed through the end of the sling and fixed to the rear-implanted closed-cell anchor, and then the other end of the tension adjusting rope is inserted. The sleeve is wound to the reel. After the preparation work is completed, the closed-hole anchor is implanted into the body by a special tool, and then the tension adjusting rope wound on the reel is gradually tightened, so that the end of the sling is gradually pushed closer to the closed-hole anchor to adjust the tension of the sling. If the tension is too tight, the reel can be reversed to relax the tension adjusting rope, so that the end of the sling is slightly retracted. After the tension adjustment is completed, the other end of the hanging locking suture is wound on the sleeve to form a stagnation, and then the sling is slinged. The end of the sling is fixed and tightened to complete the positioning of the two wires at the end of the sling.

Derivative embodiment of the first embodiment

As an optimization of the first embodiment, the tension adjusting rope may also be a bead line with two or more locking balls, each of which is separated by 0.2 mm to 5 mm. Therefore, in the operation of the surgical operation, the locking knot of the locking suture 4 is locked to one of the locking balls to complete the positioning and fixing, but it is required to not escape from the end of the sling.

Embodiment 2

As shown in FIG. 2, in the device for adjusting and fixing the tension of the surgical mesh, the positioner 02 is a hollow tube group in which the inner tube 022 and the outer tube 021 are sleeved and axially interacted, and the outer wall of the end portion of the inner tube 022 is provided with non- The closed knot forming groove 0221, the outer tube 021 is seamlessly slidably connected to the outer wall of the inner tube in the same direction as the knot forming groove 0221, and the tension adjusting rope and the locking suture 4 are connected to the shaft of the inner tube 022. In the cavity, one end of the tension adjusting rope is fixed to the end of the sling 1 and the other end penetrates into the inner tube 022 from the nozzle where the forming groove 0221 is located, and is hanged from the distal nozzle for tension adjustment, and one end of the locking stitch 4 is locked. The closed-cell anchor 2 is fixed and wound around the forming groove 0211 to form a virtual knot 02A, and the other end is pierced from the distal end of the inner tube 022 for zip-locking.

As can be seen from the illustration, the tension adjusting rope is a bead line 3b with two or more locking balls 31b, and each locking ball 31b is separated by 0.2 mm to 5 mm, thereby locking the locking stitch 4 in the surgical operation. Pushing the lock to one of the locking balls completes the positioning fix.

In the operation of the embodiment, the tension adjusting rope is first fixed to the end of the sling and the inner tube is inserted from the end of the inner tube into the knot, and the locking stitch is wound into the knot on the knot forming groove. One end is fixed to the closed-hole anchor, and the other end is inserted into the inner tube in the same direction as the tension adjusting rope. After the preparation work is completed, the closed-hole anchor is implanted into the body with a special tool, and then the tension adjusting rope is gradually adjusted to adjust the distance between the sling and the closed-hole anchor to a suitable tension. At this time, the tension adjusting rope passes through the zero resistance in the inner tube, so It is convenient to put unrestricted tension adjustment. After the tension adjustment is completed, only the inner tube is retracted relative to the outer tube, and the end of the outer tube is pushed out to form a locking stitch wound by the knot groove, which is detached from the inner tube, and then the locking stitch is tightened to make the virtual The knot is tightly tightened and fixed between the locking balls corresponding to the moderate tension, so that the positioning and fixing of the two wires at the end of the sling can be completed.

Derivative embodiment of the second embodiment

As an optional optimization of the second embodiment, the tension adjusting rope may also be a single strand bare wire. Therefore, in the operation of the surgical operation, the tension adjusting rope needs to be further provided with a strong stagnation formed by winding more than one time based on the outer tube and pushing the lock to the locking knot of the locking suture, thereby completing the positioning and fixing.

Embodiment 3

As shown in FIG. 3, in the device for adjusting and fixing the tension of the surgical mesh, the positioner 03 includes a threading tube 032 and a first locking knot 031 fixed to the closed-hole anchor, the first locking buckle 031 being inwardly elastic. An opening 0312 is formed between the end of the strip 0311 and the end of the elastic clip 0311 and the annular body. The tension adjusting rope as a conventionally necessary component is a beaded wire 3b having two or more locking balls 31b. Each of the locking balls 31b is spaced apart by 0.2 mm to 5 mm, and the diameter of the locking ball 31b satisfies when the elastic card bar 0311 is bent by force. When the enlarged opening 0312 passes through and the elastic clip 0311 is reset, the opening 0312 can be blocked, and the tension adjusting rope and the locking stitch 4 are movably engaged in the threading tube 032 and are freely suspended at the same end, and the tension is adjusted. The other end of the cord passes through the first lock knot 031 and fixes the end of the strap 1, and the other end of the lock stitch 4 is fixed to the elastic clip 0311 to pull the elastic clip 0311 to be bent and deformed.

Further details can be seen from the illustration, the proximal end of the elastic clip 0311 is provided with a drop groove 0311a, and the locking stitch 4 is provided with a locking ball at the end close to the first locking knot 031 and is positioned by the locking ball. In the drop line 0311a, the slight locking of the locking stitch 4 thereby causes the elastic clip 0311 to be bent or self-reset.

In the operation of the embodiment, the tension adjusting rope is first fixed to the end of the sling and the Threading tube is exposed from the opening of the first locking knot, and the locking ball at one end of the locking suture is snapped. The inlet is located in the drop line and the other end is inserted into the threading tube. After the preparation work is completed, the closed-hole anchor is implanted into the body by a special tool, and then the tension is adjusted by the moderate traction locking stitch to bend the elastic strip, and the distance between the adjusting strap and the closed-hole anchor is adjusted to the appropriate tension. At this time, the tension adjusting rope passes through the zero resistance in the threading pipe, so that it is convenient and convenient to adjust the tension without restriction. After the tension adjustment is completed, the elastic locking strip is automatically reset by simply operating the locking stitching, and the opening is contracted to block the locking ball of the tension adjusting rope, so that the positioning between the sling and the closed-hole anchor can be completed.

Derivative embodiment of the third embodiment

As an optional optimization of the third embodiment, the locator main body structure and the connection structure are similar to the embodiment, except that the tension adjusting rope and the locking suture are movably engaged in the threading tube and are freely suspended at the same end. The adjusting rope is a single strand of bare wire and the thickness is such that the elastic strip can pass through the enlarged opening when the bending force is bent, and the elastic clip can be initially clamped and positioned at the smaller opening, and the other end of the locking stitch is fixed. The elastic strip is connected to the elastic strip to bend and deform. Since the tension adjusting rope does not lock the positioning of the ball relative to the opening, the locking stitching in this embodiment completes the positioning and fixing between the sling and the closed-hole anchor on the tension adjusting rope wound around the opening under moderate tension of the sling.

Furthermore, the proximal end portion of the elastic clip strip 0311 is provided with a drop groove 0311a, and the locking suture 4 may also be a single strand bare wire without a locking ball, which needs to be tied and positioned in the surgical operation. In the trunking, the elastic strip can be pulled without accidental loosening.

Embodiment 4

As shown in FIG. 4, the locator 04 includes a hollow column tube 041 and a positioning plate 042 fixed to the end of the sling, and the positioning plate 042 is provided with two kinds of sutures. Through the through hole 0421, the hollow column tube 041 is provided with a pressure regulating positioning groove 0411 away from the side wall of one end of the through hole 0421. The tension adjusting rope as a conventionally necessary component is a beaded wire 3b with two or more locking balls, each of which is spaced apart from each other by 0.2 mm to 5 mm, and one end of the tension adjusting rope and the locking stitching 4 is pierced through the perforation 0421. The second end of the tension adjusting rope is fixedly connected to the pressure adjusting positioning groove 0411, and the other end of the locking stitch 4 is wound around the locking stitching on the other side of the through hole 0421. , tension adjustment rope or two kinds of sutures into a single knot or complex.

In the operation of the embodiment, the same end of the tension adjusting rope and the locking suture are respectively fixed on the closed hole anchor, and the other end of the same direction is passed out through the through hole, wherein the locking is performed. The suture naturally hangs and the tension adjustment string penetrates the hollow column tube. After the preparation work is completed, the closed-hole anchor is implanted into the body with a special tool, and then the tension adjusting rope is moderately pulled, and the distance between the sling and the closed-hole anchor is adjusted to the appropriate tension by the hollow column tube to push the positioning plate, and the tension adjusting rope is exposed at this time. The locking ball of the end is temporarily snapped into the pressure regulating positioning groove to complete the predetermined position, and then the locking stitch is wound around the locking stitch on the other side of the perforation, and the tension adjusting rope forms a single knot or a knot, and the sling and the closed hole anchor are completed. The positioning is fixed. Of course, it can also be formed on two kinds of sutures.

Embodiment 5

As shown in FIG. 5, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 05 includes a sleeve 051 with two reels 052 and a fixed anchor 053, which is a top ring and a bottom lock elastic. The polymerized inverted tapered sleeve is unidirectionally passed and reversely locked on the strip mesh belt (sling) (ie, the locking teeth penetrate the mesh and are positioned in one direction). The tension adjusting rope as a conventional essential component is a single strand bare wire 3a, one end of which is fixed to the end of the sling 1 and the other end of the tension adjusting rope is inserted into the sleeve 051 together with the preset hole 21 of the sling 1 self-closing hole anchor 2 And the fixing anchor 053 is wound around a reel, and the locking suture 4 penetrates into the predetermined hole 21 of the obturator anchor 2, and one end penetrates the sleeve 051 to be connected with the fixing anchor 053, and the other end penetrates the sleeve 051. And wound around another reel, whereby the two reels 052 respectively act to adjust the position and tension of the sling 1 and adjust the position of the fixed anchor 053, and the fixed anchor 053 is pulled against the sling 1 when the tension of the sling 1 is moderate The anchor 2 is closed and the sling 1 is locked in the fixed anchor 053.

In the operation of the embodiment, the tension adjusting rope is fixed at one end to the sling, and one end of the locking suture is fixed to the top ring of the fixed anchor, and the fixed anchor tip is inserted into the sleeve, and then the tension adjusting rope is inserted. The other end in the same direction as the locking suture passes through the predetermined hole, the sleeve and the fixed anchor of the closed-hole anchor in turn and is respectively wound around each reel. After the preparation work is completed, the closed-hole anchor is implanted into the body with a special tool, and then one of the reels is appropriately tightened to receive the tension adjusting rope, and the end of the sling is pulled together into the sleeve to achieve the appropriate sling tension. After the tension adjustment is completed, the two-way closed-hole anchor of the reel is operated to pull the fixed anchor. Due to the attachment mode of the fixed anchor and its own structural characteristics, the elastically-gated lock teeth are automatically extended during the displacement toward the closed-hole anchor. Therefore, the activity is not limited, and when the self-resetting effect of the elastic polymerization of the locking teeth is abutted against the closed-hole anchor, the fixed anchor is locked with respect to the sling, and the sling tension is also effectively fixed.

Embodiment 6

As shown in FIG. 6, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 06 includes a sleeve 061 with two reels 062 and a fixed anchor 063, which is a top ring and a bottom lock elastic. The polymerized inverted tapered sleeve has a one-way passage and a reverse lock on the bead line 3b (the ball of the beaded line has the ability to eject the lock teeth outward in the word, but cannot pass through the lock teeth from the outer state in the outer direction. ). The tension adjusting rope as a conventionally necessary component is a beaded wire 3b with two or more locking balls 31b, and each of the locking balls 31b is spaced apart by 0.2 mm to 5 mm, and one end of the tension adjusting rope is fixed to the end of the sling 1 and the other end is autistic. The predetermined hole 21 of the hole anchor 2 penetrates the sleeve 061 and the fixed anchor 063 and is wound around a reel, and the locking suture 4 penetrates into the predetermined hole 21 of the closed-hole anchor 2 and one end penetrates the sleeve 061 and The fixed anchor 063 is connected, the other end penetrates the sleeve 061 and is wound around the other reel, whereby the two reels 062 respectively act to adjust the position and tension of the sling 1 and adjust the position of the fixed anchor 063, in the sling 1 The tension anchor 063 is pulled against the closed-cell anchor 2 in a moderate tension, and the tension adjusting rope is reversely locked in the fixed anchor 063.

In the operation of the embodiment, the tension adjusting rope is fixed at one end to the sling, and one end of the locking suture is fixed to the top ring of the fixed anchor, and the fixed anchor tip is inserted into the sleeve, and then the tension adjusting rope is inserted. The other end in the same direction as the locking suture passes through the predetermined hole, the sleeve and the fixed anchor of the closed-hole anchor in turn and is respectively wound around each reel. After the preparation work is completed, the closed-hole anchor is implanted into the body by a special tool, and then one of the reels is appropriately tightened to receive the tension adjusting rope, and the locking ball of the bead line is pulled into the casing to drive the fixed anchor to the depth direction of the casing. Therefore, the proper tension of the sling is achieved. After the tension adjustment is completed, the two-way closed-hole anchor of the reel is pulled to fix the anchor. Due to the attachment mode of the anchor and its structural characteristics, it is elastically polymerized during its displacement toward the closed-hole anchor. The locking teeth are automatically externally stretched, so the movement is not restricted, the locking ball passes through the locking teeth of the fixed anchor one by one, and the fixed anchor is opposite to the sling one-way locking when abutting against the closed-hole anchor due to the self-resetting effect of the elastic polymerization of the locking teeth Dead, and the sling tension is also effectively fixed.

In addition to this, the embodiment can be further optimized to make an appropriate amount of improvement to the device itself. Specifically, the reel of the sleeve is changed to one, and a hollow cylindrical locking ring is disposed in front of the sleeve. The implementation line as the tension adjusting rope may be a single strand of bare wire or a braided braid. The tension adjusting rope is connected to the anchor at one end, and the other end is sequentially passed through the end of the strap, the locking ring, the sleeve and then wound on the reel. . The inner wall of the locking ring is provided with barbs, so that the one-way sliding on the tension adjusting rope can be reversely stopped. Therefore, in the operation of the surgical operation, after the respective preloading of the tension adjusting rope and the fixed anchor is completed, the reel is first operated to adjust the sling to the appropriate tension, and then the external locking tube is used to lock the locking ring to the end of the sling. Tension can be. The locking ring material has a plurality of selectable properties such as biocompatible plastic, stainless steel, nitinol or silicone rubber rings.

Example 7

As shown in FIG. 7, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 07 includes a sleeve 071 with two reels 072 and a support piece 073 fixed to the end of the sling 1 on the support piece 073. A circular hole 0731 and a one-way cone 0732 are provided, and the maximum diameter of the one-way cone 0732 and the outer diameter of the sleeve 071 are larger than the inner diameter of the circular hole 0731. The tension adjusting rope as a conventionally necessary component is selected in the present embodiment as a braided cord 3c having a certain thickness and surface roughness. One end of the braided rope 3c is fixed to the closed-cell anchor 2, and the other end is inserted into the sleeve 071 from the circular hole 0731 and wound around a reel. The locking suture 4 is inserted into the sleeve 071 at one end and wound around the other. The reeling wheel and the other end pass through the circular hole 0731 and are connected with the one-way cone 0732. When the tension of the sling is moderate, the one-way cone 0732 is pulled by the locking suture 4 to pull the circular hole 0731, thereby adjusting the tension rope (ie, the tension adjusting rope) The braided rope is locked in the round hole 0731 and the support piece and the sling are positioned.

In the operation of the embodiment, the braided rope is first fixed to the closed-hole anchor, and then the other end is pierced through the round hole and penetrated into the sleeve as a single-stranded lead wire and then wound around a reel. One end of the locking suture is threaded out of the round hole and connected to the one-way cone, and the other end of the locking suture is threaded into the sleeve and then wound around the other reel. At this time, the one-way cone is in a suspended state with respect to the circular hole, that is, the braided rope can freely pass through the round hole. After the preparation work is completed, the closed-hole anchor is implanted into the body by a special tool, and then the reel is appropriately tensioned to pass through the woven rope in the round hole, and the support piece is pushed by the sleeve to adjust the appropriate tension position, and the hollow column tube is passed through Push the positioning plate to adjust the distance between the sling and the closed-hole anchor to the appropriate tension. After the tension adjustment is completed, simply operate the other reel to tighten the locking stitch, drive the one-way cone to move toward the hole and completely close the hole. The braided rope is effectively clamped in the round hole to complete the positioning and fixing between the sling and the closed-hole anchor.

Example eight

As shown in FIG. 8, the locator 08 includes a sleeve 082 with a reel 081 and a support piece 083 fixed to the end of the sling 1 in the apparatus for adjusting and fixing the tension. The support piece 083 is provided. There is a circular hole 0831 and a consolidated fixed suture 42 having a diameter greater than the inner diameter of the circular hole 0831. The tension adjusting rope as a conventional essential component is a single strand bare wire 3a, and each end of the tension adjusting rope and the locking stitch 41 penetrates into the circular hole 0831 and is both fixed to the closed hole anchor 2, and the other end of the tension adjusting rope is worn. The sleeve 082 is wound and wound around the reel 081 for tension adjustment, and the other end of the locking suture 41 is suspended from the free end of the fixed suture 42; the fixed suture 42 is tightened under moderate tension of the sling 1 The locking stitch 41 of the state is tied to the circular hole 0831.

In the operation of the embodiment, the one end of the tension adjusting rope and the locking suture are respectively fixed on the closed hole anchor, and the other end of the same direction is inserted out from the circular hole, wherein the locking is performed. The suture naturally hangs and the tensioning tether penetrates the cannula and is wound around the reel. After the preparation work is completed, the closed-hole anchor is implanted into the body by a special tool, and then the reel is pulled to pull the tension adjusting rope, and the distance between the sling and the closed-hole anchor is adjusted by the sleeve to push the supporting piece to the appropriate tension. Based on the preliminary positioning of the rope and the casing, the locking stitch is tightened, and then the fixed stitch and the locking stitch are wound into a virtual knot and pushed to the round hole to complete the positioning between the sling and the closed hole anchor. fixed.

Example nine

As shown in FIG. 9, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 09 includes a pair of axially hollow tapered bore tubes 091 and tapered plugs 092, wherein the tapered bore tubes 091 are fixed to the ends of the harness 1 and The flare is toward the middle of the sling, and the taper 092 is sleeved and slid over the locking stitch 4 and correspondingly flared into the tapered tube 091. The tension adjusting rope as a conventional essential component is a single strand bare wire 3a, and one end of the tension adjusting rope is fixed to the end of the tapered hole pipe 091 away from the flare, and one end of the locking stitch 4 is fixed to the taper end of the taper 092, And the other end of the two kinds of sutures is passed back through the predetermined hole 21 of the self-closing hole anchor 2 and is passed over the hanging or winding reel from the bottom of the cone of the taper plug 092. Therefore, the tension adjusting rope can drive the taper hole tube 091 and the end of the sling 1 to adjust the tension of the sling, and the locking stitch 4 can be pulled by the traction taper 092 toward the narrow hole of the tapered hole tube 091 when the sling tension is moderate. Tight, thus locking the two types of stitching.

In the operation of the embodiment, the tension adjusting rope and the locking suture are respectively positioned on the tapered hole tube and the taper plug, and then one end portion of the sling is integrally fixed to the tapered hole tube, and then the tension is adjusted. The free ends of the cord and the locking suture are respectively passed through the predetermined holes of the closed-cell anchor and folded back into the taper tip of the taper plug, which is passed out from the bottom of the cone and suspended for external operation. After the preparation work is completed, the closed-hole anchor is implanted into the body by a special tool, and then the reel is directly operated or the tension adjusting rope is directly pulled by the fixed pulley of the closed-hole anchor to adjust the distance between the sling and the closed-hole anchor to the appropriate tension, and then Operate the reel or directly pull the locking suture so that the taper is pressed toward the narrow opening of the conical tube, so that the taper tip of the taper is pressed and tightened, which can effectively lock the two sutures. The positioning between the sling and the closed-cell anchor is fixed.

Example ten

As shown in FIG. 10, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 10 is a locking unit including two threading

grooves

101, 102, and the inner wall of at least one threading groove is provided with barbs, in the illustrated embodiment. A barb 1021 is provided for the inner wall of the threading groove 102, and the locator is usually in abutment or integral with the end of the sling. The tension adjusting rope as a conventionally necessary component is a beaded wire 3b with two or more locking balls, each of which is separated by 0.2 mm to 5 mm, and one end of the tension adjusting rope penetrates into a threading groove 101 and the sling 1 The other end of the tension adjusting rope is retracted from the predetermined hole 21 of the self-closing hole anchor 2 and is hanged from the other threading groove 102 for tension adjustment, and the locking ball of the tension adjusting rope is unidirectionally locked. Barb 1011, that is, when the locking ball passes forward, the barb is easily expanded to allow the locking ball to pass under certain resistance, and when the locking ball needs to move in the opposite direction, the closed barb will no longer be forced to expand, but will be locked The ball is firmly fixed in it.

In the operation of the embodiment, the one end of the tension adjusting rope is first inserted into a threading groove of the locking unit, and is also connected to the end of the sling, and then the other end of the tension adjusting rope is passed through. The preset hole of the closed-hole anchor penetrates into another threading groove, in which the passage resistance of the tension adjusting rope increases, and is prohibited from moving backward, and the tension adjusting rope passing through the threading groove 102 can hang External or attached to the handle of the reel. After the preparation work is completed, the closed-hole anchor is implanted into the body with a special tool, and then the reel is directly operated or the tension adjusting rope is directly pulled by the fixed pulley of the closed-hole anchor to adjust the distance between the sling and the closed-hole anchor to a suitable tension. The barb resistance and the reverse stop action, the tension adjustment of the tension adjustment rope has a unidirectional property, that is, when the required moderate tension is reached, the traction needs to be stopped immediately, and naturally, the lock ball of the tension adjustment rope is immediately Once clamped in the barb, the positioning and fixing between the sling and the closed-hole anchor can be completed.

Embodiment 11

As shown in FIG. 11, in the device for adjusting and fixing the tension of the surgical mesh, the positioner 11 is an annular frame with a middle waist 112, and the first side bar 111 on the side of the middle waist 112 is kept at a constant distance from the closed hole anchor 2. The bottom surface of the second side bar 113 on the other side of the middle waist 112 is provided with a burr 114. Of course, the bottom surface can also be set as a high friction surface for pulling the hair, and only needs to be able to prevent adhesion to the mesh material. The strap can be displaced. The tension adjusting rope as a conventionally necessary component is an extended mesh belt 3d at the end of the sling itself, and the locating manner of the locator 11 is such that one end integrally extends at the end of the sling and the other end is wound around the waist 112 and from the second The bottom side of the side bar 13 is pierced. And based on the aforementioned spurs 114, the tension adjusting rope can be freely stretched and relaxed around the middle waist when the second side bar is suspended by the external force, and the sling is adjusted to adjust the tension, and the second side bar is zeroed to the second side. The rod sinks and breaks through the spur and engages the extended webbing 3d so that the sling is locked to the bottom side of the second side rail.

In the operation of the embodiment, the tension adjusting rope (ie, the extension mesh belt 3d) is firstly taken out from the bottom side between the waist of the positioning device and the first side bar and wound around the middle waist, and then taken from the middle The top side line between the waist and the second side bar penetrates below and exits from the bottom side of the second side bar. After the preparation work is completed, the closed-hole anchor is implanted into the body by a special tool, and then the second side bar is lifted by an external instrument, so that the spur is separated from the extended mesh belt. Therefore, the extended mesh belt is freely stretched and relaxed around the middle waist, and the two-way displacement of the sling is adjusted to adjust the tension. When the required moderate tension is reached, only the external force of lifting the second side rod is released, so that the second side rod is reset and sinked. The positioning and fixing between the sling and the closed-hole anchor can be completed by piercing and engaging the extended mesh belt by the burr.

Example twelve

As shown in FIG. 12, in the device for adjusting and fixing the tension of the surgical mesh, the positioner 12 is a tapered mouth rubber plug with an elastic ratchet 121 on the outer surface, and the support piece 5 is provided at the end of the sling 1 and the support piece 5 is provided. There is a threading hole 51, and the closed hole anchor 2 is provided with a threading hole 21, the maximum diameter of the positioner 12 is larger than the inner diameter of any threading hole, and the positioner 12 is free to penetrate the threading hole under the elastic state of the elastic ratchet 121, in the elastic spine The teeth 121 are blocked from threading in the reset state. The tension adjusting cord as a conventionally necessary component is a single strand bare wire 3a. One end of the tension adjusting rope is fixed to the edge of the supporting piece 5, and the other end passes through the threading hole 21 of the self-closing hole anchor 2 and passes through the positioner 12 to pass freely. When the tension of the sling is moderate, the positioner 12 needs to be pushed by the external force. A threading hole is inserted into the hole and the opening is closed, thereby locking the further action of the tension adjusting rope.

In the operation of the embodiment, the tension adjusting rope is first fixed to the edge of the supporting piece, and then the self-closing hole anchor is passed through the predetermined hole, and then the cone is penetrated from the narrow diameter to the wide diameter. The mouth is opened and the end is exposed to the outside of the body. After the preparation work is completed, the closed-hole anchor is implanted into the body by a special tool, and then the tension adjusting rope is pulled by an external force, and the distance between the sling and the closed-hole anchor is adjusted to a proper tension by the fixed pulley of the closed-hole anchor, when the required moderateness is achieved. Under tension, only the external tool is used to push the taper plug into any one of the threading holes, so that the mouth is closed, thereby locking the tension adjusting rope, and at the same time completing the positioning and fixing between the sling and the closed hole anchor.

Example thirteen

As shown in FIG. 13, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 13 includes a sleeve 132 having a reel (not shown) and a support piece 131 fixed to the end of the sling, and the support The piece 131 is provided with a threading hole 1311 and a wire hole 1312. The tension adjusting rope as a conventional essential component is a single strand bare wire 3a, and one end of the tension adjusting rope is fixed to the closed hole anchor 2, and the tension adjusting rope is another. One end penetrates through the threading hole 1311, passes through the wire hole 1312, penetrates the sleeve 132 and is wound around the reel, and the end of the sleeve 132 abuts the wire hole 1312, and the tension adjusting rope guides freely through the tension The adjustment is made, and when the tension of the sling is moderate, the end of the sleeve 132 is disengaged from the wire hole 1312, and the tension adjusting rope is locked in the hole of the wire hole 1312.

In the operation of the embodiment, the end of the tension adjusting rope is first fixed to the closed-hole anchor, and then the above-mentioned threading and winding operation is completed. After the preparation work is completed, the closed-hole anchor is implanted into the body by a special tool, and then the reel is operated to pull the tension adjusting rope, and the distance between the sling and the closed-hole anchor is adjusted by the sleeve to push the supporting piece to the proper tension, and the supporting piece is maintained at this time. On the basis of the position, the sleeve is withdrawn, and the tension adjusting rope is locked into the hole of the card hole, so that the positioning and fixing between the sling and the closed-hole anchor can be completed, and the operation is simple and convenient.

Embodiment 14

As shown in FIG. 14, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 14 includes a sleeve 142 with a reel and a support piece 141 fixed to the end of the sling, and the support piece 141 is provided thereon. a threading hole 1411 and a wire hole 1412, the tension adjusting rope as a conventional necessary component is a bead line 3b with two or more locking balls, each of which is separated by 0.2 mm to 5 mm, and one end of the tension adjusting rope is fixed The hole anchor 2 is closed, and the other end of the tension adjusting rope penetrates from the threading hole 1411, passes through the wire hole 1412, penetrates the sleeve 142 and is wound around the reel (not shown); the end of the sleeve 142 In the state of resisting the card hole 1412, the tension adjusting rope guide is freely adjusted by the tension, and when the tension of the sling is moderate, the end of the sleeve 142 is separated from the wire hole 1412, the tension adjusting rope is redirected, and the card is locked by the locking ball. Positioned in the slot of the wire hole 1412.

The operation of the apparatus of this embodiment is substantially the same as that of the thirteenth embodiment. The one end of the tension adjusting rope is first fixed to the closed-hole anchor, and then the above-mentioned threading and winding operation is completed. After the preparation work is completed, the closed-hole anchor is implanted into the body by a special tool, and then the reel is operated to pull the tension adjusting rope. Here, the size of the locking ball is free to pass through the sleeve, and the support piece is adjusted by the sleeve to adjust the sling and the closed hole. The spacing of the anchors is to a suitable tension. At this time, the sleeve is withdrawn on the basis of the position of the support piece, and the locking ball of the tension adjusting rope is redirected into the hole of the card hole, so that the sling and the closed-hole anchor can be completed. The positioning between the two is fixed, and the operation is as simple as above.

Example fifteen

As shown in FIG. 15, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 15 is a support piece 15 fixed to the end of the sling 1, and the support piece 15 is provided with a closed 蝌蚪-shaped hole 151, so-called 蝌蚪The shape of the hole 151 is such that the one side of the round hole extends outward to form a narrow slit, and the shape is very similar to that of the crucible. And the narrow slit 1512 of the beak hole 151 tends to the closed hole anchor 2. The tension adjusting rope as a conventionally necessary component is a beaded wire 3b with two or more locking balls, each of which is spaced apart by 0.2 mm to 5 mm, one end of the tension adjusting rope is fixed to the closed hole anchor 2, and the other of the tension adjusting rope One end passes through the shank hole 151, and is guided by an external force to freely pass the tension adjustment in the wide opening 1511 of the 蝌蚪-shaped hole. When the tension of the sling is moderate, the tension adjusting rope slides into the narrow slit 1512 and passes the locking ball. The card lock is positioned in the mortise hole.

In the surgical operation of the device of this embodiment, one end of the tension adjusting rope is first fixed to the closed-hole anchor, and then the above-mentioned threading operation is completed. After the preparation work is completed, the closed-hole anchor is implanted into the body with a special tool, and then an external tool such as a support sleeve is operated to make the bead line align with the wide-mouth ring of the 蝌蚪-shaped hole, and the tension adjusting rope adjusts the distance between the sling and the closed-hole anchor to the appropriate Tension, at this time, the external tool is withdrawn on the basis of maintaining the position of the support piece, and the locking ball that removes the supporting force naturally slides into the narrow groove of the 蝌蚪-shaped hole, and the locking ball cannot be detached from the 蝌蚪-shaped hole under a certain tension of the sling, by This completes the positioning and fixing between the sling and the closed-cell anchor.

Example sixteen

As shown in FIG. 16, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 16 is a support piece 16 fixed to the end of the sling 1, and the support piece 16 is provided with a vertical wing 161 and a flap. The 161 is provided with an open ring groove 1611 which is gradually closed from the root of the support piece 16 toward the opening. The tension adjusting rope as a conventional necessary component is a bead line 3b with two or more locking balls, and the locking balls are separated from each other. 0.2mm-5mm, one end of the tension adjusting rope is fixed to the end of the supporting piece 16, and the other end of the tension adjusting rope passes through the preset hole 21 of the self-closing hole anchor 2 for adjusting the tension, and the tension is adjusted under the moderate tension of the sling The cord is snapped into the open ring groove 1611, and the locking ball is locked to the root of the open ring groove 161 and is not easily tripped.

In the surgical operation of the device of this embodiment, one end of the tension adjusting rope is first fixed to the closed-hole anchor, and then the above-mentioned threading operation is completed. After the preparation work is completed, the closed-hole anchor is implanted into the body with a special tool, and then an external tool such as a support sleeve is operated so that the bead line can freely pass outside the airfoil, and the tension adjusting rope is adjusted to adjust the distance between the sling and the closed-hole anchor to a proper tension. At this time, the external tool is withdrawn on the basis of maintaining the position of the support piece, and the locking ball that removes the supporting force naturally slides along the narrow opening of the open ring groove into the root portion near the supporting piece, and the locking ball cannot be opened from the ring under a certain tension of the sling. The groove is disengaged, thereby completing the positioning and fixing between the sling and the closed-hole anchor.

Example seventeen

As shown in Fig. 17, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 17 includes a sleeve 171 having a reel and an axially hollow cylindrical lock fixed to the end of the strap, the cylindrical shape The latch is composed of a main bracket 172 and a locking post 173 axially sliding thereon. The main bracket 172 has a concave-concave guiding surface formed thereon and the recess 1721 partially communicates with the axial hollow portion, and the locking post 173 forms a jaw at one end. In 1731, the jaws 1731 can be opened and closed on the guiding surface of the main bracket. The tension adjusting rope as a conventional essential component is a single strand bare wire 3a, and one end of the tension adjusting rope is fixed to the closed hole anchor 2, and the other end of the tension adjusting rope penetrates the sleeve 171 from the cylindrical lock and is wound around the roll A reel (not shown), when the end of the sleeve 171 abuts against the main bracket 172 and the cylindrical lock is unlocked, the tension adjusting rope is guided freely through the cylindrical lock for tension adjustment, and the lock is moderate when the tension of the sling is moderate The column 173 is displaced by an external force, and the jaws 1731 clamp the recess 1721 of the main bracket surface and lock the tension adjusting rope.

In the operation of the embodiment, the one end of the tension adjusting rope is first fixed to the closed hole anchor, and the other end is axially penetrated from the cylindrical locking bolt and penetrates into the sleeve, and then hangs or directly wraps. Above the reel. At this time, the lock cylinder of the cylindrical lock is exposed in the outermost section, that is, a recess of the main bracket, and the tension adjusting rope connected in series is in a visible state. After the preparation work is completed, the closed-hole anchor is implanted into the body by a special tool, and then the tension adjusting rope is adjusted by direct manual traction or reeling, and the tension of the sling is adjusted by the anti-pushing action of the sleeve and the main bracket, when the tension is reached. After the moderate tension is required, the main bracket of the cylindrical latch needs to be initially positioned, and then the external locking instrument is used to operate the lower locking post to move toward the sling. During this process, the jaws of the locking post are changed along the guiding surface of the main bracket until the tension is changed. The tension adjusting rope is bitten into the depression, and the positioning and fixing between the sling and the closed-hole anchor are completed at the same time.

Example 18

As shown in Fig. 18, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 18 includes a sleeve 181 having a reel and a clip 182, and the clip 182 is axially provided with a tension adjusting cord. The ring-piercing ring hole 1822, the opposite side of the two wings of the clip 182 open and close, is provided with a snap-locking convex tooth 1821. The tension adjusting rope as a conventional essential component is a single strand bare wire 3a, and one end of the tension adjusting rope penetrates the end of the fixing sling 1 from the outside of the ring hole 1822, and the other end of the tension adjusting rope is a preset of the self-closing hole anchor 2 The hole 21 passes through, passes through the clip 182 from the outer side of the ring hole 1822, penetrates the sleeve 181 and is wound around the reel (not shown) for adjusting the tension. When the tension of the sling is moderate, the external force presses the two flaps to close and Lock the tension adjustment cord and the end of the strap.

In the operation of the embodiment, the one end of the tension adjusting rope is firstly inserted into the sling from the outer side of the ring hole, and the outer side refers to the side close to the closed hole anchor. The other end of the tension adjusting rope is pierced from the preset hole 21 of the self-closing hole anchor 2, and then the clip is passed out from the outside of the ring hole, and is passed over the sleeve or wound around the reel. At this time, the two flaps that hold the clips are open. After the preparation work is completed, the closed-hole anchor is implanted into the body by special tools, and then the tension adjusting rope is adjusted by direct manual traction or reeling, and the tension of the sling is adjusted by the pushing action of the sleeve and the ring hole to adjust the tension. After the moderate tension is required, the initial positioning of the clips needs to be maintained, and then the two flaps of the clips are closed by the external surgical instruments, and the convex teeth are engaged with each other, thereby clamping the tension adjusting rope so that it cannot be axially displaced, and the sling and the closed hole are completed at the same time. The positioning between the anchors is fixed. In order to further improve the clamping strength, the above ring hole can be set as an axially displaced elastic apron, which can be displaced and clamped after the two wings are closed.

Example 19

As shown in FIG. 19, in the apparatus for adjusting and fixing the tension of the surgical mesh, the positioner 19 includes a one-way lock 191 with an elastic lock tongue 1911 and a tie belt that matches the one-way lock and the one-way lock and reverse lock. The one-way lock 191 is fixed to one end of the sling 1 , and one end of the ties 192 is directly fixed to the closed-hole anchor 2 directly or through a tension-free surgical line, and the cable 192 is inserted into the one-way lock 191 in another direction. The tension adjusting rope as a conventional essential component is a single strand bare wire 3a, and one end of the tension adjusting rope is fixed to the other end of the cable tie 192, and the other end of the tension adjusting rope is suspended or wound around the reel, based on the above structure, usually The lower strap is pulled by the tension adjusting rope when the elastic locking tongue is lifted by the external force, and the tension adjusting rope can freely adjust the tension of the strap, and the locking strap is locked in the state where the external force releases the elastic locking tongue.

Further, in the illustrated embodiment, the external locking force for providing the elastic locking tongue is a set of sleeve-sliding inner locking sleeve 61 and outer fixing sleeve 62. The inner locking sleeve 61 is sleeved on the cable 192 and adjacent to the one end latch 191 is provided with a pair of mouth-shaped embracing arms 612 and a tongue card 611 therebetween. The tongue card 611 is slidingly inserted and supported by the tongue card 611. The bottom of the elastic locking tongue 1911 of the one-way latch 191. The tongue card 611 has a sharpness in thickness at the end edge, and the flexural strength of the tongue card 611 is greater than the flexural strength of the embracing arm. The outer fixing sleeve 62 is shorter than the inner locking sleeve 61, and the outer fixing sleeve 62 is elastically tensioned at the socket where the embracing arm 612 covers the one-way latch 191.

In the operation of the embodiment, the device needs to be performed one by one according to the following steps: one end of the sling is connected to the pre-implanted closed-cell anchor, and the other end of the sling is integrally connected to the bottom surface of the one-way lock. Then, one end of the cable tie is connected and then implanted into the closed hole anchor, and the other end of the cable tie is inserted out from the one-way lock buckle, and simultaneously passes through the inner and outer fixed sleeves and is wound around the handle reel through the tension adjusting wire. Or directly exposed. When the elastic locking tongue is not jacked up, the cable tie is positioned and locked in the one-way locking buckle, and the cable tie is prohibited from moving toward the rear implanted closed-hole anchor, adjusting and receiving the tension adjusting line, and the inner locking sleeve The tube pushes forward, and a pair of embracing arms hoist the one-way latch with the forward pushing stroke and the tongue card is gradually inserted into the bottom of the elastic locking tongue to lift it up. Then manually push the outer fixing sleeve forward, so that the socket portion of the one-way locking clasp is tensioned. Thus, the one-way lock can be freely displaced relative to the strap, adjusting the position of the one-way lock and the sling, and driving the sling to adjust the tension. After the preparation work is completed, the two closed-hole anchors are attached to the position from the upper wall of the vagina by special tools, and the tension adjusting line is pulled or the tension of the sling is adjusted by moving the one-way lock with the tool. When the tension of the sling is adjusted properly, the outer fixing sleeve is retracted, then the pair of embracing arms of the inner locking sleeve are loosened, and the inner locking sleeve is withdrawn, the elastic locking tongue is reset by the unloading force, the one-way locking buckle and the sling position It is naturally fixed permanently; the excess part of the strap can be removed after the one-way lock is removed.

In view of the detailed description of various embodiments of the present invention in conjunction with the drawings, it can be seen that the device of the present invention has outstanding substantive features and significant advancement compared to conventional such devices: the device reduces the single incision through the vagina. The operational difficulty and operative time of the tension mid-urethral suspension provides a reliable implementation of one-handed manipulation of the sling tension adjustment and locking of the sling tension and position, avoiding changes in sling tension during the procedure. And provide a variety of examples, to meet the different operating habits of physicians to choose the surgery.

Claims

The device for adjusting and fixing the tension of the surgical mesh is characterized in that: a tension adjusting rope, a locking wire and a positioner, the tension adjusting rope is guided through the positioner and associated with the end of the strap and the rear implanted The closed-cell anchor adjusts the sling tension, and the locking suture cooperates with the locator to permanently fix the sling position and tension.
A device for adjusting and fixing tension of a surgical mesh according to claim 1, wherein said positioner is a sleeve with a reel, and said one end of said tension adjusting rope and said locking line passes through a section of the end of the strap. The distance is fixed with the closed-hole anchor, the other end of the tension adjusting rope is threaded into the sleeve and wound around the reel, and the other end of the locking line is wound around the outside of the sleeve to form a knot, and the lock is adjusted to the tension adjustment. The rope is connected to the end of the sling at the appropriate tension of the sling, and the tension is permanently locked.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 2, wherein the tension adjusting rope is a single strand of bare wire, and the tension adjusting rope is formed by winding more than one time at the locking knot of the locking line. Strong consolidation.
The device for adjusting and fixing tension according to claim 2, wherein the tension adjusting rope is a bead line with two or more locking balls, and each locking ball is spaced apart by 0.2 mm to 5 mm, and the locking line is The lock lock is fixed between the two locking balls.
The device for adjusting and fixing tension of a surgical mesh according to claim 1, wherein the positioner is a hollow tube group in which an inner tube and an outer tube are sleeved and axially interact, and an outer wall of the end portion of the inner tube is provided with a closed knot forming groove, the outer tube is seamlessly slidably connected to the outer wall of the inner tube at the end inner wall opposite to the knot forming groove, and the tension adjusting rope and the locking suture are respectively penetrated into the axial cavity of the inner tube, One end of the tension adjusting rope is fixed to the end of the sling and the other end penetrates into the inner tube from the nozzle where the knot is located, and hangs from the distal tube for tension adjustment, and one end of the locking line is fixed to the closed hole anchor and is formed The knot is wound into a virtual knot, and the other end is hanged from the distal end of the inner tube, and the zipper is imaginary.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 5, wherein the tension adjusting rope is a single strand of bare wire, and the tension adjusting rope is provided with a strong stagnation formed by winding one or more times based on the outer tube and Push the lock to the lock of the lock line.
The device for adjusting and fixing tension according to claim 5, wherein the tension adjusting rope is a bead line with two or more locking balls, and each locking ball is spaced apart by 0.2 mm to 5 mm, and the locking slit is The lock of the wire is locked and fixed between the two locking balls.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 1, wherein the positioner comprises a threading tube and a first lock knot fixed to the closed hole anchor, and the first lock buckle is an inward belt An annular body of the elastic strip and an opening formed between the end of the elastic strip and the annular body, wherein the tension adjusting rope is a bead line with two or more locking balls, each of which is separated by 0.2 mm to 5 mm. The diameter of the locking ball is such that the elastic card can pass through the enlarged opening when the bending force is bent, and the opening can be blocked when the elastic card is reset. The tension adjusting rope and the locking stitch are movably connected to the threading pipe. The other end of the tension adjusting rope is freely suspended, and the other end of the tension adjusting rope passes through the first locking knot and fixes the end of the strap, and the other end of the locking stitch is fixed to the elastic strip to guide the elastic strip to bend and deform.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 1, wherein the positioner comprises a threading tube and a first lock knot fixed to the closed hole anchor, and the first lock buckle is an inward belt An annular body of the elastic strip and an opening formed between the end of the elastic strip and the annular body, the tension adjusting rope and the locking suture are movably engaged in the threading tube and are freely suspended at the same end, the tension adjustment The rope is a single strand of bare wire and the thickness is such that the elastic strip can pass through the enlarged opening when the elastic strip is bent, and the elastic strip can be initially clamped to the smaller opening, and the other end of the locking suture is The elastic strip is fixed to bend and deform the elastic strip, and is wound around the tension adjusting rope at the opening under the condition that the tension of the strap is moderate.
The device for adjusting and fixing tension of a surgical mesh according to claim 8 or 9, wherein a proximal end portion of the elastic card strip is provided with a drop groove, and the locking stitch is at an end close to the first lock knot. A locking ball is provided and is positioned in the drop groove by the locking ball.
The device for adjusting and fixing tension of a surgical mesh according to claim 8 or 9, wherein the proximal end of the elastic clip is provided with a drop groove, and the locking stitch is a single strand and is tied and positioned. In the drop line.
The device of claim 1 , wherein the positioner comprises a hollow column tube and a positioning plate fixed to the end of the strap, and the positioning plate is provided with two. a perforation through which the suture is freely passed, and a side wall of the hollow column tube away from the perforation is provided with a pressure regulating positioning groove, and the same end of the tension adjusting rope and the locking suture penetrates the perforation and is fixed with the closed hole anchor, The tension adjusting rope is a bead line with two or more locking balls, each of which is separated by 0.2mm-5mm, and the other end of the tension adjusting rope is correspondingly disposed under the tension of the sling and positioned in the pressure regulating positioning groove, and the locking stitch is locked. The other end is wound into a single knot or a double knot on a locking stitch, tension adjusting rope or both stitches on the other side of the perforation.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 1, wherein said positioner comprises a sleeve with two reels and a fixed anchor, said fixed anchor being a top ring and a bottom lock elastic The polymerized inverted tapered sleeve is unidirectionally and reversely locked on the strip mesh belt, one end of the tension adjusting rope is fixed to the end of the sling, and the other end of the tension adjusting rope is combined with the sling self-closing hole anchor The hole is inserted into the sleeve and the fixed anchor and is wound around a reel. The locking suture penetrates into the predetermined hole of the closed-hole anchor, and one end penetrates the sleeve to connect with the fixed anchor, and the other end penetrates the sleeve. And being wound around another reel, the fixed anchor is pulled against the closed-hole anchor under moderate tension of the sling, and the sling is reversely locked in the fixed anchor.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 1, wherein said positioner comprises a sleeve with two reels and a fixed anchor, said fixed anchor being a top ring and a bottom lock elastic The polymerized inverted tapered sleeve is unidirectionally and reversely locked on the bead line, and the tension adjusting rope is a bead line with two or more locking balls, each of which is separated by 0.2 mm to 5 mm, and the tension adjusting rope One end of the sling is fixed to the end of the sling, and the other end of the self-closing hole anchor is inserted into the sleeve and the fixed anchor and is wound around a reel which penetrates into the preset hole of the closed-hole anchor and one end The piercing sleeve is connected to the fixed anchor, the other end is inserted into the sleeve and is wound around the other reel, and the anchor anchor is pulled against the closed-hole anchor under moderate tension of the sling, the tension adjusting rope is Reverse locking in the anchor.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 1, wherein said positioner comprises a sleeve with two reels and a support piece fixed to an end of the sling, said support sheet being provided a circular hole and a one-way cone, the maximum diameter of the one-way cone and the outer diameter of the sleeve are larger than the inner diameter of the circular hole, one end of the tension adjusting rope is fixed to the closed-hole anchor, and the other end is inserted into the sleeve from the round hole and wound Connected to a reel, one end of the locking suture penetrates into the sleeve and is wound around the other reel, and the other end passes through the circular hole and is connected with the one-way cone. The locking cone is pulled toward the cone to lock the circular hole, and the tension adjusting rope is locked to the circular hole and the supporting piece and the sling are positioned.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 1, wherein said positioner comprises a sleeve with a reel and a support piece fixed to an end of the sling, said support piece being provided with a circle a hole and a fixed fixed suture, the diameter of the sleeve is larger than the inner diameter of the circular hole, and each end of the tension adjusting rope and the locking suture penetrates into the circular hole and is fixed on the closed hole anchor, and the other end of the tension adjusting rope The sleeve is threaded and wound around the reel for tension adjustment, and the other end of the locking suture is suspended with the free end of the fixed suture; the fixed suture and the tensioned locking seam are in the case of moderate tension of the suspender The wire is tied to the round hole.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 1, wherein said positioner comprises a pair of axially hollow tapered bore tubes and tapered plugs, said tapered bore tubes being fixed to the ends of the straps and expanded The mouth is facing the middle of the sling, the taper sleeve is slidably sliding on the locking suture and correspondingly flared into the tapered tube, one end of the tension adjusting rope is fixed to one end of the tapered tube away from the flare, and one end of the locking suture Fixing the taper tip of the taper plug, and the other end of the two kinds of sutures is self-returning from the preset hole of the self-closing hole anchor and passing through the hanging or winding reel from the bottom of the taper of the taper, and the tension adjusting rope drives the taper hole The end of the tube and the sling displacement adjusts the tension of the sling, and when the tension of the sling is moderate, the locking suture is driven to push the taper toward the narrow opening of the tapered hole tube to lock the two sutures.
The device for adjusting and fixing the tension of the surgical mesh is characterized in that: a tension adjusting rope and a positioner, the tension adjusting rope is guided to be connected to the positioner and associated with the end of the strap and the rear-mounted closed-hole anchor adjusting strap Tension, and the tension adjusting rope cooperates with the positioner to fix the tension and position of the strap.
The device for adjusting and fixing tension according to claim 18, wherein the positioner is a locking unit comprising two threading slots, and the inner wall of at least one threading slot is provided with a barb, the positioner and The end of the sling is abutted; the tension adjusting rope is a beaded line with two or more locking balls, each of which is separated by 0.2 mm to 5 mm, and one end of the tension adjusting rope penetrates into a threading groove and is fixed to the end of the sling The other end of the tension adjusting rope passes through the preset hole of the self-closing hole anchor and passes through the other threading groove for tension adjustment, and the locking ball of the tension adjusting rope is unidirectionally locked to the barb.
The device for adjusting and fixing tension according to claim 18, wherein the positioner is a ring frame with a middle waist, and the first side bar and the closed hole anchor on the middle waist side are kept at a constant distance. The bottom surface of the second side bar on the other side of the middle waist is pulled or provided with a spur, and one end of the tension adjusting rope is fixed to the end of the sling, and the other end is wound around the middle waist and is passed out from the bottom side of the second side. When the side bar is suspended by the external force, the tension adjusting rope drives the sling to adjust the tension, and when the external force of the second side bar is zero, the sling is locked to the bottom side of the second side bar.
The device for adjusting and fixing tension of a surgical mesh according to claim 18, wherein the positioner is a tapered mouth rubber plug having an elastic ratchet on the outer surface, and the support piece and the support piece are closed at the end of the sling. The hole anchors are respectively provided with threading holes, the maximum diameter of the positioner is larger than the inner diameter of the threading holes, and the positioner is free to penetrate the threading hole under the elastic ratcheting state, and the elastic needle teeth are blocked from the threading holes in the self-resetting state. One end of the tension adjusting rope is fixed to the edge of the supporting piece, and the other end of the self-closing hole anchor is pierced and penetrated into the positioner, and the external force pushes the positioner to any threading hole and makes the mouth open when the tension of the sling is moderate Close and lock the tension adjustment cord.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 18, wherein said positioner comprises a sleeve with a reel and a support piece fixed to an end of the sling, said support sheet being provided with a support a threading hole and a wire hole, one end of the tension adjusting rope is fixed to the closed hole anchor, and the other end of the tension adjusting rope penetrates from the threading hole, passes through the wire hole, penetrates the sleeve and is wound around the reel When the end of the sleeve is in the state of resisting the wire hole, the tension adjusting rope guide is freely adjusted by the tension, and when the tension of the sling is moderate, the end of the sleeve is separated from the cable hole, and the tension adjusting rope is locked to the cable. In the hole of the hole.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 18, wherein said positioner comprises a sleeve with a reel and a support piece fixed to an end of the sling, said support sheet being provided with a support a threading hole and a card hole, the tension adjusting rope is a bead line with two or more locking balls, each locking ball is separated by 0.2mm-5mm, one end of the tension adjusting rope is fixed with a closed hole anchor, and the tension adjustment The other end of the rope penetrates through the threading hole, passes through the cable hole, penetrates the sleeve and is wound around the reel; the end of the sleeve is in the state of resisting the cable hole, and the tension adjusting rope is guided freely for tension adjustment. And when the tension of the sling is moderate, the end of the sleeve is separated from the wire hole, the tension adjusting rope is redirected, and is positioned by the locking ball lock in the hole of the wire hole.
The device for adjusting and fixing tension according to claim 18, wherein the positioner is a support piece fixed to an end of the sling, the support piece is provided with a closed 蝌蚪-shaped hole and a dome shape The narrow mouth slit of the hole tends to be a closed hole anchor, and the tension adjusting rope is a bead line with two or more locking balls, each of which is separated by 0.2 mm to 5 mm, and one end of the tension adjusting rope is fixed to the closed hole anchor The other end of the tension adjusting rope is pierced from the 蝌蚪-shaped hole, and is guided by the external force to freely pass the tension adjustment in the wide ring of the 蝌蚪-shaped hole, and the tension adjusting rope slides into the narrow slit when the sling tension is moderate Position by locking the ball lock in the boring hole.
The apparatus for adjusting and fixing tension of a surgical mesh according to claim 18, wherein the positioner is a support piece fixed to an end of the sling, the support piece is provided with a vertical wing and the wing is provided There is an open loop groove which gradually closes from the root of the support piece toward the opening, and the tension adjusting rope is a bead line with two or more locking balls, each of which is separated by 0.2 mm to 5 mm, the tension adjusting rope One end of the tension adjusting wire is fixed to the end of the supporting piece, and the other end of the tension adjusting rope passes through the preset hole of the self-closing hole anchor for adjusting the tension, and the tension adjusting rope is caught in the open ring groove when the tension of the sling is moderate, the locking ball card Locked to the root of the open ring groove.
A device for adjusting and fixing tension of a surgical mesh according to claim 18, wherein said positioner comprises a sleeve with a reel and a cylindrical lock which is fixed to the end of the strap and is axially hollow. The cylindrical lock is composed of a main bracket and a lock cylinder axially sliding thereon. The main support surface is formed with a concave-convex guide surface and the recess is partially connected to the axial hollow portion, and one end of the lock cylinder forms a jaw. One end of the tension adjusting rope is fixed to the closed hole anchor, and the other end of the tension adjusting rope penetrates from the cylindrical lock into the sleeve and is wound around the reel, the main bracket is abutted at the end of the sleeve and the cylindrical lock is not locked In the state, the tension adjusting rope guide is freely adjusted by the cylindrical lock for tension adjustment, and when the tension of the sling is moderate, the lock cylinder is displaced by the external force, the jaw clamps the concave surface of the main bracket surface and locks the tension adjusting rope.
A device for adjusting and fixing tension of a surgical mesh according to claim 18, wherein said positioner comprises a sleeve with a reel and a clip, and said clip is axially provided with a tension adjusting cord a double-stranded ring hole, the opposite side of the two wings of the clip-opening and closing is provided with a snap-toothed convex tooth, one end of the tension adjusting rope penetrates from the outer side of the ring hole into the end of the fixed strap, and the tension adjusting rope is another The preset hole of the self-closing hole anchor at one end passes through, the clip is passed out from the outside of the ring hole, the sleeve is inserted into the sleeve and wound around the reel for adjusting the tension. When the tension of the sling is moderate, the two wings are closed and locked. Tension adjustment cord and sling end.
The device for adjusting and fixing tension of a surgical mesh according to claim 18, wherein the positioner comprises a one-way lock with an elastic locking tongue and a tie for matching one-way locking and one-way locking, and reverse locking. The one-way locking buckle is fixed to one end of the sling, and one end of the ligature is directly fixed to the closed-hole anchor directly or through a tension-free surgical line, and the ligature is threaded into the one-way locking buckle, and one end of the tension adjusting rope Fixing the other end of the cable tie, and the other end of the tension adjusting rope is suspended or wraps around the reel. The cable tie is pulled by the tension adjusting rope in the state where the elastic locking tongue is lifted by the external force, and the tension adjusting wire is freely passed through the one-way locking buckle for tension adjustment. And lock the cable tie in the state where the external force releases the elastic locking tongue.
The device for adjusting and fixing tension of a surgical mesh according to claim 1 or 18, wherein the device for adjusting and fixing the tension of the surgical mesh is connected to the closed-cell anchor and the sling in the implant for open surgery or minimally invasive surgery. .