WO2021253479A1 - 内窥镜子宫颈口捆扎系统 - Google Patents

内窥镜子宫颈口捆扎系统 Download PDF

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Publication number
WO2021253479A1
WO2021253479A1 PCT/CN2020/098476 CN2020098476W WO2021253479A1 WO 2021253479 A1 WO2021253479 A1 WO 2021253479A1 CN 2020098476 W CN2020098476 W CN 2020098476W WO 2021253479 A1 WO2021253479 A1 WO 2021253479A1
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WIPO (PCT)
Prior art keywords
strapping
cervical
endoscopic
tying
delivery sheath
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PCT/CN2020/098476
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English (en)
French (fr)
Inventor
周星
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周星
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Publication date
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Publication of WO2021253479A1 publication Critical patent/WO2021253479A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12009—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
    • A61B17/12013—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A61B2017/4216—Operations on uterus, e.g. endometrium
    • A61B2017/4225—Cervix uteri

Definitions

  • the invention relates to an endoscopic surgical instrument, in particular to an endoscopic cervix strapping system used in endoscopic surgery.
  • a strapping device that can be easily delivered into the body during laparoscopic surgery. After the uterus is separated from the surrounding tissues and ligaments, it can be strapped to the safe vaginal part of the ion cervix to completely seal the cervix. In order to completely avoid the spread of cancer cells, the vagina is cut off, and the removed diseased uterus is safely taken out of the body.
  • the purpose of the present invention is to design a strapping device that can be used for the cervix during total hysterectomy in endoscopic surgery.
  • the strap can be packed in the delivery device and delivered into the body through the surgical channel. After the strap is released, the vagina at the safe part of the cervix can be effectively strapped and the cervical cancer tissue can be completely sealed Or the channel through which the liquid flows out, so as to avoid the seeding of cancer cells in the abdominal cavity with the flow of carbon dioxide airflow, which is very suitable for total hysterectomy under endoscopic minimally invasive surgery.
  • the endoscopic mirror cervical strapping system of the present invention is characterized in that: the endoscopic mirror cervical strapping system 900 includes a strapping device 100 and a delivery device 200, and the strapping device 100 can be folded in the delivery device 200;
  • the strapping device 100 includes a strapping mechanism 11, a fixing mechanism 12, and a strapping hole 13;
  • the binding mechanism 11 is provided with at least one positioning groove 11-1;
  • the fixing mechanism 12 includes a through hole 12-1 and at least one positioning convex step 12-2;
  • the proximal end of the binding mechanism 11 101 is connected to the fixing mechanism 12,
  • the distal end 102 of the binding mechanism 11 passes through the through hole 12-1 to form a binding hole 13;
  • the positioning convex step 12-2 is embedded in the positioning groove 11 -1 prevents the distal end 102 of the strapping mechanism 11 from slackening or slipping off the fixing mechanism 12;
  • the delivery device 200 includes a delivery sheath 21, and the strapping device 100 can be folded in the delivery sheath 21.
  • the strapping device 100 When the strapping device 100 is in use, it can be folded in the delivery sheath 21, and it is very convenient to reach the surgical area through the surgical channel, and then the strapping device 100 can be pushed out of the delivery sheath 21 to release all the devices. ⁇ binding device 100. Then put the tissue to be strapped into the strapping hole 13, and continue to pull the strapping mechanism 11 to the distal end. The strapping hole 13 will continue to shrink, and finally the tissue will be strapped tightly until it is completely closed, which can effectively prevent tissue fluid from overflowing. , To prevent the seeding of cancer cells.
  • the strapping mechanism 11 is a strapping 1-1.
  • the strapping mechanism 11 is preferably a strapping belt 1-1 with a certain surface area, which can better ensure the firmness of the strapping process without easily cutting and breaking the tissue to be strapped.
  • the binding mechanism 11 can also design the binding mechanism 11 as a chain-like structure, a bead-chain-like structure and other types of binding mechanisms without departing from the scope of protection of the present application.
  • the strap 1-1 is made of soft elastic medical material.
  • the strapping band 1-1 made of soft elastic material can better fit the tissue while ensuring the firmness of the strapping, and further ensure the reliability of the cavity closure.
  • the positioning groove 11-1 is a continuous positioning groove 11-11 that can be continuously adjusted.
  • the positioning groove 11 is a continuous positioning groove 11-1, so that during the process of shrinking the strapping hole 13, it can be fixed at any position according to the size of the tissue and the degree of tension required for strapping.
  • the positioning groove 11-1 is a unidirectional movement groove 11-12.
  • the unidirectional movement design can ensure that the strapping mechanism 11 can only move in one direction during clinical use, and the reverse movement will not cause the tissue strapping process to accidentally loosen.
  • the delivery device 200 further includes a pushing mechanism 22 that can push out the strapping device 100 packed in the delivery sheath 21.
  • the pushing mechanism 22 may be a linkage pushing mechanism 201 connected to the fixing mechanism 12, or may be an independent pushing mechanism 202 that is designed separately and can push the strapping device 100 out through the delivery sheath 21.
  • the pushing mechanism 22 includes a through hole 22-1; the distal end 102 of the strapping mechanism 11 of the strapping device 100 passes through the through hole 22-1 and is exposed to the outside of the delivery device 200. The distal end 102 of the strapping mechanism 11 is exposed to the outside of the delivery device 200. During clinical use, the doctor can directly close the strapping hole 13 of the strapping device 100 outside the body, which makes the operation more convenient.
  • the distal end 102 of the binding mechanism 11 is provided with a pull ring 11-2.
  • the strapping mechanism 11 can be easily drawn to close the strapping hole 13 through the pull ring 11-2.
  • the binding mechanism 11 is provided with an anti-skid mechanism 11-3.
  • the strapping device of the present invention after the tissue strapping is completed, in clinical use, various surgical operations need to be performed near the strapped tissue. During the entire clinical operation process, the strapping mechanism 11 cannot loosen or fall off from the tissue. Therefore, the endoscopic mirror cervical strapping system of the present invention is provided with a non-slip mechanism 11-3 on the strapping mechanism 11, and its core purpose is to prevent the strapping mechanism 11 from loosening and slipping off the strapped tissue during the operation. .
  • the anti-slip mechanism 11-3 is an anti-slip pattern 11-31 or an anti-slip convex step 11-32 provided on the strapping mechanism 11.
  • the applicant here only lists the above two specific anti-skid structures. In practical applications, those skilled in the art can design different anti-skid structures as needed, but they do not deviate from the scope of protection of this application.
  • the anti-slip patterns 11-31 are distributed along the longitudinal direction of the strap 1-1. Because the continuous positioning groove 11-1 on the strap 1-1 has the function of preventing lateral slippage, the important function of the anti-skid mechanism 11-3 is to prevent the strapping mechanism 11 from slipping off along the tissue axis.
  • the anti-slip patterns 11-31 are usually distributed along the longitudinal direction of the strapping 1-1.
  • the binding mechanism 11 is provided with an expansion device 11-4. Because the strapping device 100 is folded in the delivery sheath 21 during the delivery process, due to the restraining effect of the delivery sheath 21 on the strapping device 100, when the strapping device 100 is removed from the After the delivery sheath 21 is released, the strapping mechanism 11 will not easily recover due to the compression and deformation of the strapping hole 13. Therefore, the designed expansion device 11-4 can be used in the strapping device 100. After the delivery sheath 21 is released, the strapping mechanism 11 is opened, and the shape of the strapping hole 13 is restored.
  • the expansion device 11-3 is an elastic expansion device 11-41.
  • the elastic expansion device 11-41 can automatically apply an elastic expansion force to the strapping mechanism 11.
  • the elastic expansion device 11 -41 Automatically applies an elastic opening force to the strapping mechanism 11, so that the strapping mechanism 11 automatically opens and restores the shape of the strapping hole 13, making the clinical use process more convenient.
  • the distal end of the pushing mechanism 22 is provided with a limiting device 22-2; the fixing mechanism 12 is connected to the limiting device 22-2 through a binding wire 121.
  • the fixing mechanism 12 is connected to the pushing mechanism 22 so that the pushing mechanism 22 can drive the strapping device 100 to move back and forth in the delivery sheath 21.
  • a limiting device 22-2 is provided at the distal end of the pushing mechanism 22, and the fixing mechanism 12 is connected to the limiting device 22-2 through the strapping wire 121, because the strapping device 100 and There is no relative movement between the pushing mechanisms 22, so that it can prevent the strapping mechanism 11 from accidentally causing the strapping mechanism 11 to move when the strapping device 100 is folded into the delivery sheath.
  • the proximal end of the pushing mechanism 22 is provided with a push-pull handle 22-3.
  • the push-pull handle 22-3 provided at the proximal end of the push mechanism 22 can facilitate the push and pull of the push mechanism 22 to reciprocate in the delivery sheath 21.
  • the proximal end of the delivery sheath 21 is provided with a grip 21-1.
  • the medical staff can conveniently hold the grip 21-1, and it is not easy to slip off during the pushing and pulling process, and the use is more convenient and safer.
  • the pushing mechanism 22 also includes a locking mechanism 22-5; when the locking mechanism 22-5 is in the locked state, the strapping device 100 is fixed in the delivery sheath 21 and cannot be removed from the delivery sheath 21 Inside out. Because the locking mechanism 22-5 can fix the strapping device 100 in the delivery sheath 21, the strapping device 100 will not accidentally be removed from the delivery sheath during transportation and during clinical delivery. The sheath tube 21 is pulled out to ensure that the strapping device 100 is not contaminated, and the safety of the transportation and use process is ensured.
  • the locking mode of the locking mechanism 22-5 is a concave-convex card locking mode, a rotation locking mode, or an interference fit locking mode.
  • the applicant only lists the above-mentioned three specific locking methods. In practical applications, those skilled in the art can design different locking methods as required, without departing from the scope of protection of this application.
  • the pushing mechanism 22 also includes a retracting mechanism 22-6; the retracting mechanism 22-6 can tighten the tying device 100 after the tying device 100 bands the tissue, and remove the cut tying mechanism 11 The remaining part is taken out of the body through the pushing mechanism 22.
  • the folding mechanism 22-6 is usually arranged at the distal end of the delivery sheath 21 or the push rod 22-4, and the folding mechanism 22-6 may form a fixed connection with the binding mechanism 11, along with the With the recovery movement of the folding mechanism 22-6, the binding mechanism 11 moves accordingly, thereby tightening the binding hole 13 to form a binding to the tissue. After the strapping hole 13 is tightened, the strapping mechanism 11 can be cut, and the snipped strapping mechanism 11 can be taken out of the body with the pushing mechanism 22, which is very convenient for clinical use.
  • the endoscopic mirror cervical strapping system 900 is made of medical materials. Because the endoscopic mirror cervical strapping system of the present invention needs to enter the human body for use, the parts in contact with the human body need to be made of medical materials to ensure the biocompatibility requirements for clinical use.
  • the upper part of the vagina is ligated with the tying device 100 to prevent cervical and affected vaginal wall cancer cells 5-1 from entering the abdominal cavity, and then cut off Remove the specimen from the vagina.
  • the tissues and ligaments around the uterus are separated and cut, the uterus is freed, and the strapping device 100 is folded in the In the delivery sheath 21, the delivery sheath 21 reaches the surgical site through a surgical channel such as a trocar sheath, pushes the push mechanism 22 to release the strapping device 100 from the delivery sheath 21, and then passes through the
  • the strapping hole 13 sets the strapping device 100 on the vagina on the outer side of the cervix, pulls the pull ring 11-2 backward, pulls the strapping mechanism 11 to move, and closes the strapping hole 13 to the vaginal tissue on the outer side of the cervix Tighten and close together, then cut off the vagina 600 with an ultrasonic knife, remove the uterus 500 whose cervix has been banded and closed, and take it out of the body through the vagina; Take it out of the body through the vagina 600.
  • the endoscopic cervical strapping system of the present invention includes a strapping device 100 and a delivery device 200.
  • the strapping device 100 includes a strapping mechanism 11, a fixing mechanism 12 and a strapping hole 13.
  • the unidirectional movement design can ensure that the strapping mechanism 11 can only move in one direction during clinical use, and the reverse movement will not cause the tissue strapping process to accidentally loosen.
  • the delivery device includes a delivery sheath 21, and the strapping device 100 can be folded in the delivery sheath 21, and after reaching the surgical site through a surgical passage such as a trocar sheath, the strapping device can be transferred by the pushing mechanism 22 100 is released from the delivery sheath 21, the tissue that needs to be tied is placed in the tying hole 13, and the tying mechanism 11 is continuously pulled to the distal end, the tying hole 13 will continue to shrink, and finally the tissue will be tightened , Sealing can effectively prevent the tissue fluid from overflowing during the tissue removal process, avoid the seeding of tumor cells, and make the operation process safer.
  • the design of the delivery sheath is especially suitable for use under endoscopic surgery.
  • Fig. 1 is a front view of the strapping device of the endoscopic cervical strapping system of the present invention compressed in the delivery device.
  • Fig. 1-1 is a cross-sectional view taken along the line A-A in Fig. 1.
  • Fig. 1-2 is a front view of the strapping device of Fig. 1 after being released from the delivery device.
  • Fig. 1-3 is a B-B cross-sectional view of Fig. 1-2.
  • Figures 1-4 are schematic diagrams of the three-dimensional structure of the strapping device with non-slip convex steps.
  • Figure 1-5 is a schematic diagram of the three-dimensional structure of a strapping device with anti-skid patterns.
  • Figures 1-6 are diagrams of the working principle of the endoscopic mirror cervical strapping system of the present invention.
  • Fig. 2 is a front view of the strapping device of the endoscopic cervical strapping system of the present invention with an independent pushing mechanism compressed in the delivery device.
  • Fig. 2-1 is a cross-sectional view taken along line C-C in Fig. 2.
  • Fig. 2-2 is a front view of the strapping device of Fig. 2 after being released from the delivery device.
  • Fig. 2-3 is a cross-sectional view taken along the line D-D of Fig. 2-2.
  • Figure 2-4 is an enlarged view of E in Figure 2-3.
  • Fig. 3 is a schematic diagram of the three-dimensional structure of the endoscopic mirror cervical strapping system of the present invention including a linkage pushing mechanism.
  • Figure 3-1 is a front view of Figure 3.
  • Fig. 3-2 is a cross-sectional view taken along the line F-F in Fig. 3-1.
  • Fig. 3-3 is an enlarged view of G in Fig. 3-2.
  • Fig. 3-4 is a left side view of Fig. 3.
  • Fig. 3-5 is a cross-sectional view taken along the line H-H in Fig. 3-4.
  • Fig. 3-6 is an enlarged view of I in Fig. 3-5.
  • 3-7 are schematic diagrams of the three-dimensional structure of the strapping device of FIG. 3 compressed in the delivery device.
  • Figure 3-8 is the front view of Figure 3-7.
  • Fig. 3-9 is a J-J cross-sectional view of Fig. 3-8.
  • Figures 3-10 are schematic diagrams of putting the endoscopic mirror cervical strapping system of the present invention into the human body from the trocar.
  • Figure 3-11 is a schematic diagram of the strapping device when it is released in the human body.
  • Figure 3-12 is a schematic diagram of the working principle when the cervix is tightened.
  • Figure 3-13 is a schematic diagram of the working principle when the delivery device is removed.
  • Fig. 4 is a schematic diagram of the three-dimensional structure of the endoscopic cervical strapping system of the present invention including the expansion device.
  • Fig. 4-1 is a front view of Fig. 4.
  • Fig. 4-2 is a K-K cross-sectional view of Fig. 4.
  • Fig. 5 is a schematic diagram of the three-dimensional structure of the endoscopic cervical strapping system of the present invention in a locked state.
  • Fig. 5-1 is a cross-sectional view of Fig. 5.
  • Fig. 5-2 is an enlarged view of L in Fig. 5-1.
  • Figure 5-3 is an enlarged view of M in Figure 5-1.
  • Fig. 6 is a schematic diagram of the three-dimensional structure of the endoscopic cervical strapping system of the present invention in an unlocked state.
  • Fig. 6-1 is a cross-sectional view of Fig. 6.
  • Fig. 6-2 is an enlarged view of position N in Fig. 6-1.
  • Fig. 6-3 is an enlarged view of O in Fig. 6-1.
  • Fig. 7 is a schematic diagram of the three-dimensional structure of the endoscopic mirror cervical strapping system of the present invention when the push rod is retracted.
  • Fig. 7-1 is a P-P cross-sectional view of Fig. 7.
  • Fig. 7-2 is an enlarged view of Q in Fig. 7-1.
  • Fig. 8 is a schematic diagram of the three-dimensional structure of the endoscopic cervix strapping system of the present invention when the strapping device is folded with the strapping device after tissue strapping.
  • Fig. 8-1 is a cross-sectional view taken along the line R-R in Fig. 8.
  • Figure 8-2 is an enlarged view of the S part of Figure 8-1
  • 100 is a strapping device
  • 200 is a delivery device
  • 400 is a surgical forceps
  • 500 is a uterus
  • 900 is an endoscopic mirror cervical strapping system of the present invention
  • 5-1 is a cancer cell.
  • 1-1 is the strapping.
  • 101 is the proximal end of the strapping mechanism, and 102 is the distal end of the strapping mechanism.
  • 11 is a binding mechanism
  • 12 is a fixing mechanism
  • 13 is a binding hole.
  • 11-1 is the positioning groove
  • 11-2 is the pull ring
  • 11-3 is the anti-skid mechanism
  • 11-4 is the opening device
  • 11-5 is the clamping mechanism
  • 11-6 is the limit slot
  • 12-1 is the Through holes
  • 12-2 is a positioning convex step
  • 12-3 is a clamping part.
  • 11-11 is a continuous positioning groove
  • 11-12 is a one-way motion groove
  • 11-31 is a non-slip pattern
  • 11-32 is a non-slip convex step
  • 11-41 is an elastic expansion device
  • 11-51 is a non-slip clamping Surface
  • 12-31 is the clamping groove.
  • 12-31-1 is a clampable polygon, 12-31-2 is a stopper; 11-41-1 is a shrapnel.
  • 201 is a linked push mechanism
  • 202 is an independent push mechanism
  • 21 is the delivery sheath, and 22 is the pushing mechanism.
  • 21-1 is the holding part, 21-2 is the sealing device, 21-3 is the locking groove; 22-1 is the movement through hole, 22-2 is the limit mechanism, 22-3 is the push-pull handle, and 22-4 is the push The lever, 22-5 is the locking mechanism, and 22-6 is the retracting mechanism.
  • 121 is the strapping line.
  • Example 1 Endoscopic mirror cervical strapping system of the present invention
  • the endoscopic cervical strapping system of this embodiment includes a strapping device 100 and a delivery device 200.
  • the strapping device 100 includes a strapping mechanism 11, a fixing mechanism 12 and a strapping hole 13.
  • the binding mechanism 11 is provided with at least one positioning groove 11-1, the fixing mechanism 12 includes a through hole 12-1 and at least one positioning convex step 12-2; the proximal end 101 of the binding mechanism 11 is connected On the fixing mechanism 12, the distal end 102 of the strapping mechanism 11 can pass through the through hole 12-1; when the positioning convex step 12-2 is embedded in the positioning groove 11, the The distal end 102 of the strapping mechanism 11 loosens or slips away from the fixing mechanism 12.
  • the strapping mechanism 11 is a strap 1-1.
  • the strapping mechanism 11 is preferably a strapping belt 1-1 with a certain surface area, which can better ensure the firmness of the strapping process without easily cutting and breaking the tissue to be strapped.
  • those skilled in the art can also design the strapping mechanism 11 as a strapping device with a chain-like structure, a bead-chain-like structure and other structures. The applicant will not list them all here, but none of them deviates from the present invention. The scope of protection applied for.
  • the strap 1-1 is made of soft elastic medical material.
  • the soft elastic material can better fit the tissue while ensuring the firmness of the strapping, and further ensure the reliability of the cavity closure.
  • the positioning groove 11-1 of the binding mechanism 11 is a continuous positioning groove 11-11 that can be continuously adjusted. In the process of folding up the strapping device, it can be fixed at any position according to the size of the tissue and the degree of tension to be strapped.
  • the positioning groove 11 is a one-way movement groove 11-12 that can only move in one direction, which ensures that the strapping mechanism 11 can only move in one direction during clinical use, and does not move in the opposite direction to cause tissue strapping. The process loosened unexpectedly.
  • the distal end 102 of the strapping mechanism 11 is provided with a clamping mechanism 11-5 that facilitates the clamping of surgical instruments.
  • a clamping mechanism 11-5 is provided at the distal end 102 of the strapping mechanism 11 to facilitate the clamping of surgical instruments.
  • the clamping mechanism 11-5 can ensure that when the distal end of the binding mechanism 11 is clamped by the surgical instrument, the distal end of the binding mechanism 11 is not easily loosened, and the accuracy of the surgical tightening operation is improved.
  • the clamping mechanism 11-5 is a non-slip clamping surface 11-51.
  • those skilled in the art can design different clamping mechanisms according to their needs. The structure does not deviate from the scope of protection of this application.
  • the strapping mechanism 11 is provided with a non-slip mechanism 11-3.
  • various surgical operations need to be performed near the tied tissue.
  • the tying device 100 cannot be detached from the tissue. Therefore, the tissue tying of this embodiment
  • the device is provided with a non-slip mechanism 11-3 on the strapping mechanism 11, the core purpose of which is to prevent the strapping device 100 from slipping off the strapped tissue during the operation.
  • the anti-slip mechanism 11-3 may be an anti-slip pattern 11-31 or an anti-slip convex step 11-32 provided on the strapping mechanism 11.
  • the applicant here only lists the above two specific anti-skid structures. In practical applications, those skilled in the art can design different anti-skid structures as required, but they do not deviate from the scope of protection of this application.
  • the anti-slip patterns 11-31 are distributed along the longitudinal direction of the strap 1-1. Because the continuous positioning groove 11-1 on the strap 11 has the effect of preventing lateral slippage, the important function of the anti-skid mechanism 11-3 is to prevent the strapping device 100 from slipping off along the tissue axis. Therefore, The anti-slip patterns 11-31 are usually distributed along the longitudinal direction of the strapping 1-1.
  • the fixing mechanism 12 is provided with a clamping portion 12-3 that is convenient for clamping surgical instruments.
  • the fixing mechanism 12 needs to be clamped by the surgical forceps 400 to draw and close the strapping mechanism 11. Therefore, the fixing mechanism 12 needs to be provided with a clamping part that facilitates the clamping of surgical instruments. 12-3.
  • the clamping portion 12-3 is a clamping groove 12-31
  • the middle of the clamping groove 12-31 is a clamping polygon 12-31-1, and anti-slip stoppers 12-31-2 are provided at both ends.
  • the clampable polygon 12-31-1 is a hexahedron.
  • the groove structure of the H-shaped hexahedron with convex on both sides and concave in the middle is an optimized structure in the specific clamping grooves 12-31 that are convenient for clamping by the laparoscopic surgical forceps.
  • those skilled in the art can design different polygonal structures according to their needs, all without departing from the scope of protection of the present application.
  • the delivery device 200 includes a delivery sheath 21, and the strapping device 100 can be folded in the delivery sheath 21.
  • the strapping device 100 is made of medical materials. Because the tissue strapping device of this embodiment needs to enter the human body for use, the parts in contact with the human body need to be made of medical materials to ensure the biocompatibility requirements for clinical use.
  • the upper part of the vagina is ligated with the tying device 100 to prevent cervical and affected vaginal wall cancer cells 5-1 from entering the abdominal cavity, and then cut off 600 vagina, take out the specimen.
  • the uterus is freed, and the strapping device 100 is folded in the delivery sheath 21, which is reached through surgical channels such as a trocar sheath.
  • surgical channels such as a trocar sheath.
  • the strapping device 100 on the cervix through the strapping hole 13
  • the vaginal tissues on the outside of the cervix are tightly tied together and completely closed, and then cut off the vagina 600 with an ultrasonic knife.
  • the endoscopic cervix strapping system of this embodiment can tighten and seal the tissue during surgery, effectively prevent blood or tissue fluid from overflowing during tissue removal, avoid tumor cell transplantation, and make the surgery safer. Because the strapping device 100 is packed in the delivery sheath 21, it is very convenient to use the delivery sheath 21 to deliver the strapping device 100 to the surgical area through a surgical channel such as a trocar sheath, especially It is suitable for use in minimally invasive endoscopic surgery.
  • Embodiment 2 Endoscopic mirror cervical strapping system of the present invention including a pushing mechanism
  • the delivery device 200 further includes a pushing mechanism 22.
  • the pushing mechanism 22 can push and release the strapping device 100 from the delivery sheath 21.
  • the pushing mechanism 22 may be a linked pushing mechanism 201 connected to the fixing mechanism 12, or an independent pushing mechanism 202 that can push the strapping device 100 out through the delivery sheath 21.
  • the proximal end of the independent push mechanism 202 may be provided with a push-pull handle 22-3 to push the push-pull handle 22-3, the push rod 22-4 of the independent push mechanism 202 can be The inner movement of the delivery sheath 21 pushes out and releases the strapping device 100 packed in the delivery sheath 21.
  • the pushing mechanism 22 is a linkage pushing mechanism 201.
  • the pushing mechanism 22 includes a limiting device 22-2, a push-pull handle 22-3, and a pushing rod 22-4.
  • the pushing rod 22-4 of the pushing mechanism 22 is provided with a movement through hole 22-1, and the distal end of the pushing rod 22-4 is connected with the limiting device 22-2.
  • the limiting device 22-2 is provided with a center hole 22-21.
  • the central hole 22-21 communicates with the movement through hole 22-1.
  • the distal end 102 of the strapping mechanism 11 of the strapping device 100 may pass through the central hole 22-21 and the through hole 22-1 and then be exposed to the outside of the delivery device 200.
  • the fixing mechanism 12 is connected to the limiting device 22-2 through a binding wire 121. Because the fixing mechanism 12 is connected to the pushing mechanism 22, the pushing mechanism 22 can drive the strapping device 100 to move back and forth in the delivery sheath 21. At the same time, there is no relative movement between the strapping device 100 and the pushing mechanism 22, so it is possible to prevent the strapping device 100 from accidentally causing the strapping mechanism 11 to retract during the process of folding into the delivery sheath 21. .
  • the distal end 102 of the strapping mechanism 11 is provided with a pull ring 11-2 that is convenient to move the strapping mechanism 11.
  • the proximal end of the delivery sheath 21 is provided with a grip 21-1 and a sealing device 21-2.
  • the medical staff can conveniently hold the grip 21-1, and it is not easy to slip off during the pushing and pulling process, and the use is more convenient and safer.
  • the sealing device 21-2 can ensure that the delivery sheath 21 is in the sealing device during the delivery and release process of the strapping device 100, reducing the influence of the operation process on the pneumoperitoneum.
  • the push device 22 drives the strapping device 100 to move backwards, and the strapping device 100 is folded into the delivery sheath, refer to Figure 3-7 Go to Figure 3-9.
  • the tissues and ligaments around the uterus are separated and cut, the uterus is freed, and then the delivery sheath 21 compressed with the strapping device 100 reaches the surgical site through the surgical channel such as the trocar sheath, refer to Figure 3- 10.
  • Push the pushing mechanism 22 to release the strapping device 100 from the delivery sheath 21, refer to Figs. 3-11.
  • the uterus 500 whose cervix has been banded and closed is taken out of the body through the vagina; or the uterus 500 whose cervix has been banded and closed is placed in an endoscopic retrieval belt and taken out of the body through the vagina.
  • Example 3 Endoscopic mirror cervical strapping system of the present invention containing a dilation device
  • the binding mechanism 11 further includes an expansion device 11-4.
  • the spreading device 11-4 is provided outside the binding mechanism 11.
  • the strapping mechanism 11 may also be a composite structure, such as being composed of an elastic covering film with a soft surface layer and a spreading device 11-4 embedded in it.
  • Those skilled in the art can also design other structures of various expansion devices. The applicant will not illustrate them one by one here, but they do not deviate from the scope of protection of the present application.
  • the expansion device 11-4 is an elastic expansion device 11-41.
  • the elastic expansion device 11-41 contains elastic pieces 11-41-1.
  • the elastic piece 11-41-1 is arranged on the binding mechanism 11.
  • the elastic piece 11-41-1 can automatically apply an elastic opening force to the binding mechanism 11.
  • the strapping device 100 can be pre-compressed and folded in the delivery sheath 21. In clinical use, only the strapping device 100 can be directly released for use. The use process is more convenient.
  • Embodiment 4 Endoscopic mirror cervical strapping system of the present invention with locking mechanism
  • the pushing mechanism 22 further includes a locking mechanism 22-5.
  • the pushing mechanism 22 includes a push-pull handle 22-3, a push rod 22-4, and a locking mechanism 22-5.
  • the proximal end of the push rod 22-4 is provided with a locking block 22-41, and the locking groove 21-3 provided at the proximal end of the delivery sheath 21 constitutes a concave-convex engagement structure
  • the locking ends 22-51 of the locking mechanism 22-5 At the same time, the distal end of the push rod 22-4 is provided with a positioning elastic piece 22-42, and the strapping mechanism 11 is provided with a limit slot 11-6 near the fixing device 12 to push the strapping mechanism 11 into the place.
  • the positioning elastic piece 22-42 bounces and is embedded in the In the limiting slot 11-6, the strapping device 100 is positioned in the pushing rod 22-4.
  • the positioning elastic piece 22-42 and the limiting groove 11-6 constitute the positioning end 22-52 of the locking mechanism 22-5.
  • the locking method of the locking mechanism 22-5 is a concave-convex card locking method.
  • those skilled in the art can design different locking methods such as a rotary locking method or an interference-fit locking method as required.
  • the applicant will not give examples one by one here, but they do not deviate from the scope of protection of this application.
  • the pushing mechanism 22 is disposed in the delivery sheath 21, and the fixing device 12 is exposed outside the delivery sheath 21.
  • the locking ends 22-51 are in a locked state
  • the strapping device 100 is positioned in the pushing rod 22-4
  • the pushing mechanism 22 is fixed in the delivery sheath 21. Slippage will occur.
  • the positioning spring 22-42 is provided with a limiting convex step 22-42-1, the limiting convex step 22-42-1 and the binding mechanism 11
  • the positioning groove 11-1 is matched with each other. After the strapping device 100 straps the tissue, the strapping mechanism 11 is inserted into the object with the positioning groove 11-1 at the distal end facing downward. In the space 22-43, the positioning groove 11-1 and the limiting convex step 22-42-1 are inlaid together to form a fixed connection, forming a retracting mechanism 22-6.
  • the folding mechanism 22-6 will drive the binding mechanism 11 to move backwards, and under the blocking action of the end of the delivery sheath 21, it will be exposed to the delivery sheath 21
  • the strapping hole 13 formed by the outer strapping mechanism 11 and the fixing device 12 is gradually closed to realize the strapping of the tissue. After the strapping is completed, the strapping mechanism 11 is cut with surgical forceps, and the strapping mechanism is cut off. 11 can be taken out of the body along with the delivery sheath 21 and the push rod 22-4, and the clinical use process is very convenient.

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Abstract

内窥镜子宫颈口捆扎系统（900），含捆扎装置（100）和递送装置（200）。捆扎装置（100）含捆扎机构（11）、固定机构（12）及捆扎孔（13）。单向运动的设计，可以保证在临床使用过程中捆扎机构（11）只能向一个方向运动，不会反向运动造成组织捆扎过程意外松脱。递送装置（200）含递送鞘管（21），捆扎装置（100）可收拢在递送鞘管（21）内，经穿刺器鞘管等手术通道到达手术部位后通过推送机构（22）可以将捆扎装置（100）从递送鞘管（21）内释放，将需要捆扎的组织放入捆扎孔（13）内，持续向远端拉动捆扎机构（11），捆扎孔（13）会持续收拢，最终将组织扎紧、封闭，可以有效防止组织取出过程中组织液的溢出，避免肿瘤细胞的播种，使得手术过程更加安全。递送鞘管的设计，尤其适合于内窥镜手术下使用。

Description

内窥镜子宫颈口捆扎系统 技术领域
本发明涉及一种腔镜手术器械，特别是用于腔镜手术中内窥镜子宫颈口捆扎系统。
背景技术
随着腔镜技术的发展，越来越多的手术在腔镜手术下完成，包括非常多的恶性肿瘤手术也是在腔镜下完成，其中就包括宫颈癌的全子宫切除手术。
利用腹腔镜进行宫颈癌手术时，由于形成气腹压的二氧化碳气流的流动，如果子宫颈癌的组织或癌细胞发生泄露，就容易造成癌细胞在腹腔内的播种，现有技术对这个问题没有有效的解决方法，因此临床上建议进行开腹手术，以避免癌细胞在随二氧化碳气流的流动而在腹腔内的播种。
因此，需要开发一种捆扎装置，在腹腔镜手术时，能轻松地递送入体内，在子宫与周围的组织和韧带分离后，能在离子宫颈安全的阴道部位，进行捆扎，完全封闭子宫颈前的阴道，从而完全避免癌细胞扩散，然后再切断阴道，将切除的病变子宫安全地取出体外。本发明的目的就在于设计一种能用于内窥镜手术中全宫切除时的子宫颈口的捆扎装置。
发明内容
本发明之内窥镜子宫颈口捆扎系统，捆扎带可以收拢在递送装置内，经手术通道递送入体内，释放捆扎带后，能对宫颈前安全部位的阴道进行有效捆扎，并完全封闭宫颈癌组织或液体流出的通道，从而避免癌细胞在随二氧化碳气流的流动而在腹腔内的播种，非常适合于内窥镜微创手术下的全子宫切除手术。
本发明之内窥镜子宫颈口捆扎系统，其特征在于：所述内窥镜子宫颈口捆扎系统900含捆扎装置100和递送装置200，所述捆扎装置100能收拢在所述递送装置200内；
A、所述捆扎装置100含捆扎机构11、固定机构12及捆扎孔13；
B、所述捆扎机构11上设有至少1个定位凹槽11-1；所述固定机构12含通孔12-1和 至少1个定位凸阶12-2；所述捆扎机构11的近端101连接在所述固定机构12上，所述捆扎机构11的远端102穿过所述通孔12-1后形成捆扎孔13；所述定位凸阶12-2镶嵌在所述定位凹槽11-1内阻止所述捆扎机构11的远端102从所述固定机构12中松弛或滑脱；
C、所述递送装置200含递送鞘管21，所述捆扎装置100能收拢在所述递送鞘管21内。
所述捆扎装置100在使用时，能被收拢在所述递送鞘管21内，非常方便地经手术通道抵达手术区域，再将所述捆扎装置100推出所述递送鞘管21，即可释放所述捆扎装置100。然后将需要捆扎的组织放入所述捆扎孔13内，持续向远端拉动所述捆扎机构11，所述捆扎孔13会持续收拢，最终将组织捆扎紧，直至完全封闭，可以有效防止组织液溢出，防止癌细胞播种。
进一步，所述捆扎机构11是捆扎带1-1。所述捆扎机构11优选的是具有一定表面积的捆扎带1-1，可以更好地保证捆扎过程的牢固性，而又不会轻易将要捆扎的组织切割断裂。当然，本领域的技术人员也可以将所述捆扎机构11设计成链条状结构、珠链状结构等各种其它的结构的捆扎机构，都并不脱离本申请的保护范围。
所述捆扎带1-1采用柔软的弹性医用材料制成。采用柔软的弹性材料制造所述捆扎带1-1在保证捆扎牢固性的同时，可以更好地贴合组织，进一步保证腔道封闭的可靠性。
所述定位凹槽11-1是可以连续调节的连续定位凹槽11-11。所述定位凹槽11是连续定位凹槽11-1，这样在收拢所述捆扎孔13的过程中，可以根据组织大小以及需要捆扎紧张的程度，固定在任何位置。
所述定位凹槽11-1是单向运动凹槽11-12。单向运动的设计，可以保证在临床使用过程中所述捆扎机构11只能向一个方向运动，不会反向运动造成组织捆扎过程意外松脱。
所述递送装置200还含有推送机构22，所述推送机构22能将收拢在所述递送鞘管21内的所述捆扎装置100推出。所述推送机构22可以是连接在所述固定机构12上的联动推送机构201，也可以是单独设计，能通过所述递送鞘管21将所述捆扎装置100推出的独立推送机构202。
所述推送机构22含通孔22-1；所述捆扎装置100的捆扎机构11的远端102穿过所述通孔22-1后暴露在所述递送装置200外部。所述捆扎机构11的远端102暴露在所述递送装置200的外部，在临床使用过程中，医生可以直接在体外对所述捆扎装置100的捆扎孔13进行收拢，操作过程更加方便。
所述捆扎机构11的远端102设有拉环11-2。通过所述拉环11-2可以很方便地对所述捆扎机构11进行牵拉收拢所述捆扎孔13。
所述捆扎机构11上设有防滑机构11-3。本发明之捆扎装置，当对组织捆扎完成后，临床使用中，需要在被捆扎的组织附近进行各种手术操作，在整个临床手术过程中，所述捆扎机构11不能从组织上松弛、脱落，因此，本发明之内窥镜子宫颈口捆扎系统在所述捆扎机构11上设有防滑机构11-3，其核心目的就在于防止手术过程中所述捆扎机构11从被捆扎的组织上松弛、滑脱。
所述防滑机构11-3是设置在所述捆扎机构11上的防滑纹11-31、或防滑凸阶11-32。申请人在此只列举了上述2种具体防滑结构，实际应用中，本领域的技术人员可以根据需要设计出不同的防滑结构，但都不脱离本申请的保护范围。
所述防滑纹11-31沿所述捆扎带1-1的纵向分布。因所述捆扎带1-1上的连续定位凹槽11-1具有防止横向滑脱的作用，因此，所述防滑机构11-3的重要作用是防止所述捆扎机构11沿组织轴向滑脱，因此，所述防滑纹11-31通常沿所述捆扎带1-1的纵向分布。
所述捆扎机构11设有张开装置11-4。因在递送过程中，所述捆扎装置100是收拢在所述递送鞘管21内，由于所述递送鞘管21对所述捆扎装置100的约束作用，因此，当所述捆扎装置100从所述递送鞘管21中被释放后，所述捆扎机构11会因为挤压变形而造成所述捆扎孔13不易恢复，因此，设计的所述张开装置11-4可以在所述捆扎装置100从所述递送鞘管21中释放后将所述捆扎机构11张开，恢复所述捆扎孔13的形状。
所述张开装置11-3是弹性张开装置11-41。所述弹性张开装置11-41可以对所述捆扎机构11自动施加弹性张开力，临床使用过程中，当所述捆扎装置100从所述递送鞘管21中释放后，所述弹性张开装置11-41自动对所述捆扎机构11施加弹性张开力，使得所述捆扎机构11自动张开，恢复所述捆扎孔13的形状，临床使用过程更加方便。
所述推送机构22的远端设有限位装置22-2；所述固定机构12通过捆扎线121连接在所述限位装置22-2上。所述固定机构12连接在所述推送机构22上，这样所述推送机构22可以带动所述捆扎装置100在所述递送鞘管21内来回运动。同时，在所述推送机构22的远端设有限位装置22-2，将所述固定机构12通过所述捆扎线121连接在所述限位装置22-2上，由于所述捆扎装置100和所述推动机构22之间不产生相对运动，因此可以防止所述捆扎装置100向所述递送鞘管内收拢的过程中意外造成所述捆扎机构11的收拢运动。
所述推送机构22的近端设有推拉手柄22-3。所述推送机构22的近端设有的推拉手柄22-3可以方便推拉所述推送机构22在所述递送鞘管21内往复运动。
所述递送鞘管21的近端设有握持部21-1。临床使用过程中，医护人员可以方便地握在所述握持部21-1上，不容易在推拉的过程中滑脱，使用更方便、安全。
所述推送机构22还含锁定机构22-5；所述锁定机构22-5在锁定状态时，所述捆扎装 置100被固定在所述递送鞘管21内，不会从所述递送鞘管21内脱出。因为所述锁定机构22-5能将所述捆扎装置100固定在所述递送鞘管21内，因此，在运输途中以及临床使用的递送过程中，所述捆扎装置100不会意外从所述递送鞘管21中脱出，从而保证所述捆扎装置100不受污染，保证运输和使用过程的安全性。
所述锁定机构22-5的锁定方式是凹凸卡配合锁定方式、或旋转锁定方式、或过盈配合锁定方式。申请人在此只列举了上述三种具体的锁定方式，实际应用中，本领域的技术人员可以根据需要设计出不同的锁定方式，都不脱离本申请的保护范围。
所述推送机构22还含收拢机构22-6；所述收拢机构22-6可以在所述捆扎装置100将组织套扎后，将所述捆扎装置100收紧，并将剪断后的捆扎机构11的剩余部分通过所述推送机构22带出体外。所述收拢机构22-6通常设置在所述递送鞘管21或所述推送杆22-4的远端，所述收拢机构22-6可以与所述捆扎机构11形成固定连接，随着所述收拢机构22-6的回收运动，所述捆扎机构11随之运动，从而将所述捆扎孔13收紧，对组织形成捆扎。所述捆扎孔13收紧后，将所述捆扎机构11剪断，即可将被剪断的所述捆扎机构11随所述推送机构22带出体外，临床使用非常方便。
所述内窥镜子宫颈口捆扎系统900采用医用材料制造。因本发明之内窥镜子宫颈口捆扎系统需要进入人体进行使用，因此，与人体接触的部位都需要采用医用材料制造，以保证临床使用时的生物相容性要求。
临床使用时，将子宫500周围组织和韧带以及阴道旁组织分离切断后，然后用所述捆扎装置100将阴道上段套扎，以防止宫颈及受累阴道壁癌细胞5-1进入腹腔，之后再切断阴道，取出标本。
以带所述推送机构22的本发明之内窥镜子宫颈口捆扎系统为例，具体操作时，先将子宫周围的组织和韧带分离切断之后，游离子宫，将所述捆扎装置100收拢在所述递送鞘管21内，所述递送鞘管21通过穿刺器鞘管等手术通道到达手术部位，推动所述推送机构22将所述捆扎装置100从所述递送鞘管21内释放，然后通过所述捆扎孔13将所述捆扎装置100套在宫颈口外侧的阴道，向后拉所述拉环11-2，拉动所述捆扎机构11运动，收拢所述捆扎孔13，直至宫颈口外侧的阴道组织一起扎紧、完全封闭，然后用超声刀切断阴道600，将宫颈口已经捆扎封闭的子宫500，经阴道取出体外；或者是将宫颈口已经捆扎封闭的子宫500放置在内镜取物带内，经阴道600取出体外。
本发明之内窥镜子宫颈口捆扎系统含捆扎装置100和递送装置200。所述捆扎装置100含捆扎机构11、固定机构12及捆扎孔13。单向运动的设计，可以保证在临床使用过程中所述捆扎机构11只能向一个方向运动，不会反向运动造成组织捆扎过程意外松脱。所述递 送装置含递送鞘管21，所述捆扎装置100可收拢在所述递送鞘管21内，经穿刺器鞘管等手术通道到达手术部位后通过所述推送机构22可以将所述捆扎装置100从所述递送鞘管21内释放，将需要捆扎的组织放入所述捆扎孔13内，持续向远端拉动所述捆扎机构11，所述捆扎孔13会持续收拢，最终将组织扎紧、封闭，可以有效防止组织取出过程中组织液的溢出，避免肿瘤细胞的播种，使得手术过程更加安全。递送鞘管的设计，尤其适合于内窥镜手术下使用。
附图说明
图1是本发明之内窥镜子宫颈口捆扎系统的捆扎装置压缩在递送装置内的主视图。
图1-1是图1的A-A剖视图。
图1-2是图1的捆扎装置从递送装置内释放后的主视图。
图1-3是图1-2的B-B剖视图。
图1-4是含防滑凸阶的捆扎装置的立体结构示意图。
图1-5是含防滑纹的捆扎装置的立体结构示意图。
图1-6是本发明之内窥镜子宫颈口捆扎系统的工作原理图。
图2是含独立推送机构的本发明之内窥镜子宫颈口捆扎系统的捆扎装置压缩在递送装置内的主视图。
图2-1是图2的C-C剖视图。
图2-2是图2的捆扎装置从递送装置内释放后的主视图。
图2-3是图2-2的D-D剖视图。
图2-4是图2-3的E处放大图。
图3是含联动推送机构的本发明之内窥镜子宫颈口捆扎系统的立体结构示意图。
图3-1是图3的主视图。
图3-2是图3-1的F-F剖视图。
图3-3是图3-2的G处放大图。
图3-4是图3的左视图。
图3-5是图3-4的H-H剖视图。
图3-6是图3-5的I处放大图。
图3-7是图3的捆扎装置压缩在递送装置内的立体结构示意图。
图3-8是图3-7的主视图。
图3-9是图3-8的J-J剖视图。
图3-10是将本发明之内窥镜子宫颈口捆扎系统从穿刺器置入人体内的示意图。
图3-11是捆扎装置在人体内被释放时的示意图。
图3-12是将子宫颈口扎紧时的工作原理示意图。
图3-13是将递送装置撤除时的工作原理示意图。
图4是含张开装置的本发明之内窥镜子宫颈口捆扎系统的立体结构示意图。
图4-1是图4的主视图。
图4-2是图4的K-K剖视图。
图5是锁定状态的本发明之内窥镜子宫颈口捆扎系统的立体结构示意图。
图5-1是图5的剖视图。
图5-2是图5-1的L处放大图。
图5-3是图5-1的M处放大图。
图6是解锁状态的本发明之内窥镜子宫颈口捆扎系统的立体结构示意图。
图6-1是图6的剖视图。
图6-2是图6-1的N处放大图。
图6-3是图6-1的O处放大图。
图7是推送杆后撤时的本发明之内窥镜子宫颈口捆扎系统的立体结构示意图。
图7-1是图7的P-P剖视图。
图7-2是图7-1的Q处放大图。
图8是组织捆扎后用收拢装置收拢捆扎装置时的本发明之内窥镜子宫颈口捆扎系统的立体结构示意图。
图8-1是图8的R-R剖视图。
图8-2是图8-1的S处放大图
上述图中：
100为捆扎装置，200为递送装置，400为手术钳，500为子宫，900为本发明之内窥镜子宫颈口捆扎系统；5-1为癌细胞。
捆扎装置上：
1-1为捆扎带。
101为捆扎机构的近端，102为捆扎机构的远端。
11为捆扎机构，12为固定机构，13为捆扎孔。
11-1为定位凹槽，11-2为拉环，11-3为防滑机构，11-4为张开装置，11-5为夹持机 构，11-6为限位槽；12-1为通孔，12-2为定位凸阶,12-3为夹持部。
11-11为连续定位凹槽，11-12为单向运动凹槽，11-31为防滑纹，11-32为防滑凸阶，11-41为弹性张开装置，11-51为防滑夹持面；12-31为夹持槽。
12-31-1为可夹持多边形，12-31-2为挡块；11-41-1为弹片。
递送装置上：
201为联动推送机构，202为独立推送机构。
21为递送鞘管，22为推送机构。
21-1为握持部，21-2为密封装置，21-3为锁定槽；22-1为运动通孔，22-2为限位机构，22-3为推拉手柄，22-4为推送杆，22-5为锁定机构，22-6为收拢机构。
22-21为中心孔；22-41为锁定块，22-42为定位弹片，22-43为纳物空间；22-51为锁定端，22-52为定位端。
22-42-1为限位凸阶。
121为捆扎线。
具体实施方式
实施例1：本发明之内窥镜子宫颈口捆扎系统
参考图1至图1-6，本实施例之内窥镜子宫颈口捆扎系统含捆扎装置100和递送装置200。
参考图1-4和图1-5，所述捆扎装置100含捆扎机构11、固定机构12和捆扎孔13。
所述捆扎机构11上设有至少1个定位凹槽11-1，所述固定机构12含通孔12-1和至少1个定位凸阶12-2；所述捆扎机构11的近端101连接在所述固定机构12上，所述捆扎机构11的远端102能穿过所述通孔12-1；所述定位凸阶12-2镶嵌在所述定位凹槽11内时能阻止所述捆扎机构11的远端102从所述固定机构12中松弛或滑脱。
本实施例中，所述捆扎机构11是捆扎带1-1。所述捆扎机构11优选的是具有一定表面积的捆扎带1-1，可以更好地保证捆扎过程的牢固性，而又不会轻易将要捆扎的组织切割断裂。当然，本领域的技术人员也可以将所述捆扎机构11设计成链条状结构、珠链状结构等各种其它的结构的捆扎装置，申请人在此不一一列举，但都并不脱离本申请的保护范围。
所述捆扎带1-1采用柔软的弹性医用材料制成。柔软的弹性材料在保证捆扎牢固性的同时，可以更好地贴合组织，进一步保证腔道封闭的可靠性。
本实施例中，所述捆扎机构11的定位凹槽11-1是可以连续调节的连续定位凹槽11-11。在收拢所述捆扎装置的过程中，可以根据组织大小以及需要捆扎紧张的程度，固定在任何 位置。
进一步，所述定位凹槽11是只能单向运动的单向运动凹槽11-12，保证在临床使用过程中所述捆扎机构11只能向一个方向运动，不会反向运动造成组织捆扎过程意外松脱。
本实施例中，所述捆扎机构11的远端102设有方便手术器械夹持的夹持机构11-5。为方便在腹腔镜下用手术器械拉紧所述捆扎机构11，在所述捆扎机构11的远端102设有方便手术器械夹持的夹持机构11-5。所述夹持机构11-5可以保证手术器械夹持住所述捆扎机构11的远端向外拉拉紧时，不容易松脱，提高手术扎紧操作的精准性。
参考图1-5，本实施例中，所述夹持机构11-5是防滑夹持面11-51，在实际应用中，本领域的技术人员可以根据需要设计出不同的夹持机构的具体结构，都并不脱离本申请的保护范围。
本实施例中，所述捆扎机构11上设有防滑机构11-3。当对组织捆扎完成后，临床使用中，需要在被捆扎的组织附近进行各种手术操作，在整个临床手术过程中，所述捆扎装置100不能从组织上脱落，因此，本实施例之组织捆扎装置在所述捆扎机构11上设有防滑机构11-3，其核心目的就在于防止手术过程中所述捆扎装置100从被捆扎在组织上滑脱。
参考图1-4和图1-5，所述防滑机构11-3可以是设置在所述捆扎机构11上的防滑纹11-31、或防滑凸阶11-32。申请人在此只列举了上述2种具体的防滑结构，实际应用中，本领域的技术人员可以根据需要设计出不同的防滑结构，但都不脱离本申请的保护范围。
本实施例中，所述防滑纹11-31沿所述捆扎带1-1的纵向分布。因所述捆扎带11上的连续定位凹槽11-1具有防止横向滑脱的作用，因此，所述防滑机构11-3的重要作用是防止所述捆扎装置100沿组织轴向滑脱，因此，所述防滑纹11-31通常沿所述捆扎带1-1的纵向分布。
参考图1-4，本实施例中，所述固定机构12上设有方便手术器械夹持的夹持部12-3。临床使用过程中，需要用手术钳400夹持住所述固定机构12才能对所述捆扎机构11进行抽拉、收拢，因此，所述固定机构12上需要设有方便手术器械夹持的夹持部12-3。
参考图1-4和图1-5，本实施例中，所述夹持部12-3是夹持槽12-31
所述夹持槽12-31的中间是可夹持多边形12-31-1，在两端设有防滑的挡块12-31-2。
所述可夹持多边形12-31-1是六面体。这种两边凸起、中间凹下的H型六面体的凹槽结构，是方便腹腔镜手术钳夹持的具体夹持槽12-31中的一种优化结构。在具体产品设计中，本领域的技术人员可以根据需要设计出不同的多边形结构，都并不脱离本申请的保护范围。
实际应用中，本领域的技术人员可以根据需要设计出不同的夹持结构，申请人在此不 一一列举、举例说明，但都并不脱离本申请的保护范围。
参考图1和图1-1，所述递送装置200含递送鞘管21，所述捆扎装置100能收拢在所述递送鞘管21内。
所述捆扎装置100采用医用材料制造。因本实施例之组织捆扎装置需要进入人体进行使用，因此，与人体接触的部位都需要采用医用材料制造，以保证临床使用的生物相容性要求。
临床使用时，将子宫500周围组织和韧带以及阴道旁组织分离切断后，然后用所述捆扎装置100将阴道上段套扎，以防止宫颈及受累阴道壁癌细胞5-1进入腹腔，之后再切断阴道600，取出标本。
具体操作时，先将子宫周围的组织和韧带分离切断之后，游离子宫，将所述捆扎装置100收拢在所述递送鞘管21内，所述递送鞘管21通过穿刺器鞘管等手术通道到达手术部位，用手术器械将所述捆扎装置100从所述递送鞘管21内释放，参考图1-2和图1-3，然后通过所述捆扎孔13将所述捆扎装置100套在宫颈口外侧的阴道，然后用一把手术钳400夹持在所述固定机构12，另一把手术钳400夹持住所述捆扎机构11的远端102，拉动所述捆扎机构11运动，收拢所述捆扎孔13，直至宫颈口外侧的阴道组织一起扎紧、完全封闭，然后用超声刀切断阴道600，参考图1-6，将宫颈口已经捆扎封闭的子宫500，经阴道取出体外；或者是将宫颈口已经捆扎封闭的子宫500放置在内镜取物带内，经阴道600取出体外。
本实施例之内窥镜子宫颈口捆扎系统可以在手术过程中将组织扎紧、封闭，有效防止组织取出过程中血液或组织液的溢出，避免肿瘤细胞移植，手术过程更加安全。因将所述捆扎装置100收拢在所述递送鞘管21内，因此，能非常方便地用所述递送鞘管21通过穿刺器鞘管等手术通道将所述捆扎装置100递送至手术区域，尤其适合于内窥镜微创手术中使用。
实施例2：含推送机构的本发明之内窥镜子宫颈口捆扎系统
参考图,2至图3-13，本实施例与实施例1的区别在于，本实施例中，所述递送装置200还含推送机构22。
所述推送机构22可以将所述捆扎装置100从所述递送鞘管21中推出释放。
,所述推送机构22可以是连接在所述固定机构12上的联动推送机构201，也可以是独立的，能通过所述递送鞘管21将所述捆扎装置100推出的独立推送机构202。
参考图2至图2-4，所述独立推送机构202的近端可以设有推拉手柄22-3，推动所述推拉手柄22-3，所述独立推送机构202的推送杆22-4能在所述递送鞘管21内运动，将收 拢在所述递送鞘管21中的所述捆扎装置100推出、释放。
参考图3至图3-6，所述推送机构22是联动推送机构201。所述推送机构22含限位装置22-2、推拉手柄22-3和推送杆22-4。所述推送机构22的推送杆22-4上设有运动通孔22-1，所述推送杆22-4的远端与所述限位装置22-2连接。
所述限位装置22-2上设有中心孔22-21。所述中心孔22-21和所述运动通孔22-1相连通。所述捆扎装置100的捆扎机构11的远端102可穿过所述中心孔22-21和所述通孔22-1后暴露在所述递送装置200外部。
参考图3-5和图3-6，本实施例中，所述固定机构12通过捆扎线121连接在所述限位装置22-2上。因所述固定机构12连接在所述推送机构22上，这样所述推送机构22可以带动所述捆扎装置100在所述递送鞘管21内来回运动。同时，所述捆扎装置100和所述推动机构22之间不产生相对运动，因此可以防止所述捆扎装置100向所述递送鞘管21内收拢的过程中意外造成所述捆扎机构11的收拢运动。
本实施例中，所述捆扎机构11的远端102设有方便打动所述捆扎机构11的拉环11-2。
所述递送鞘管21的近端设有握持部21-1和密封装置21-2。临床使用过程中，医护人员可以方便地握在所述握持部21-1上，不容易在推拉的过程中滑脱，使用更方便、安全。所述密封装置21-2可以保证所述捆扎装置100在被递送和释放过程中所述递送鞘管21处于密封装置，减少操作过程对气腹的影响。
临床使用时，首先向后拉所述推拉手柄22-3，所述推送装置22带动所述捆扎装置100向后运动，将所述捆扎装置100收拢至所述递送鞘管内，参考图3-7至图3-9。手术时，先将子宫周围的组织和韧带分离切断之后，游离子宫，然后将压缩有所述捆扎装置100的所述递送鞘管21通过穿刺器鞘管等手术通道到达手术部位，参考图3-10。推动所述推送机构22将所述捆扎装置100从所述递送鞘管21内释放，参考图3-11。然后通过所述捆扎孔13将所述捆扎装置100套在宫颈口外侧的阴道，向后拉所述拉环11-2，拉动所述捆扎机构11运动，收拢所述捆扎孔13，直至宫颈口外侧的阴道组织一起扎紧、完全封闭，然后用超声刀切断阴道600，参考图3-12。此时剪断所述捆扎线121，并将所述拉环11-2从所述捆扎机构11的远端102剪下，将所述递送装置200经手术通道撤除，参考图3-13。然后将宫颈口已经捆扎封闭的子宫500，经阴道取出体外；或者是将宫颈口已经捆扎封闭的子宫500放置在内镜取物带内，经阴道取出体外。
实施例3：含张开装置的本发明之内窥镜子宫颈口捆扎系统
参考图4和图4-1，本实施例和实施例2相比，本实施例中，所述捆扎机构11还含张开装置11-4。
参考图4-2，本实施例中，所述张开装置11-4设置在所述捆扎机构11外部。
实际应用中，所述捆扎机构11也可以是复合结构，如用表层柔软的弹性覆膜和包埋在其中的张开装置11-4构成。本领域的技术人员也还可以设计出其它各种张开装置的结构，申请人在此不一一举例说明，但都不脱离本申请的保护范围。
所述张开装置11-4是弹性张开装置11-41。所述弹性张开装置11-41含弹片11-41-1。所述弹片11-41-1设置在所述捆扎机构11上。所述弹片11-41-1可以对所述捆扎机构11自动施加弹性张开力。
临床使用过程中，当所述捆扎装置100从所述递送鞘管21中释放后，所述弹片11-41-1自动弹开，对所述捆扎机构11施加弹性张开力，使得所述捆扎机构11自动张开，恢复所述捆扎孔13的形状，参考图4和图4-2
由于设置有所述张开装置，因此，可以将所述捆扎装置100预先压缩、收拢在所述递送鞘管21内，临床使用时只需直接将所述捆扎装置100释放即可进行使用，临床使用过程更加方便。
实施例4：含锁定机构的本发明之内窥镜子宫颈口捆扎系统
参考图5至图6-3，本实施例与实施例2的区别在于，本实施例中，所述推送机构22还含锁定机构22-5。
本实施例中，所述推送机构22含推拉手柄22-3、推送杆22-4和锁定机构22-5。
参考图5至图5-3，所述推送杆22-4的近端设有锁定块22-41，和设置在所述递送鞘管21近端的锁定槽21-3构成凹凸卡配合结构的所述锁定机构22-5的锁定端22-51。同时，所述推送杆22-4的远端设有定位弹片22-42，所述捆扎机构11靠近所述固定装置12的部位设有限位槽11-6，将所述捆扎机构11推入所述推送杆22-4的纳物空间22-43内，当所述限位槽11-6推至所述定位弹片22-42下方时，所述定位弹片22-42弹起，镶嵌在所述限位槽11-6内，所述捆扎装置100被定位在所述推送杆22-4内。所述定位弹片22-42和所述限位槽11-6构成所述锁定机构22-5的定位端22-52。
本实施例中，所述锁定机构22-5的锁定方式是凹凸卡配合锁定方式实际应用中，本领域的技术人员可以根据需要设计出旋转锁定方式、或过盈配合锁定方式等不同的锁定方式，申请人在此不一一举例说明，但都不脱离本申请的保护范围。
参考图5和图5-1，所述推送机构22设置在所述递送鞘管21内，所述固定装置12暴露在所述递送鞘管21外。运输和转移途中，所述锁定端22-51处于锁定状态，所述捆扎装置100被定位在所述推送杆22-4内，所述推送机构22被固定在所述递送鞘管21内，不会发生滑脱。
参考图6至图6-3，临床使用时，旋转所述推送杆22-4，所述锁定块22-41从所述锁定槽21-3中滑出，所述锁定端22-51的锁定状态解除。向后退所述推送杆22-4，由于所述固定装置12暴露在所述递送鞘管21外，所述固定装置12被所述递送鞘管21的远端阻挡，所述推送杆22-4向后运动的过程中，所述定位弹片22-42被压迫回收，所述推送杆22-4退出，但所述捆扎装置100停留在原位，不会随着所述推送杆22-4向后运动，至所述推送杆22-4退出所述递送鞘管21，所述捆扎装置100即从所述递送鞘管21中脱离进入体内，参考图7至图7-2。或将所述推送杆22-4后退一段距离后，再次向前推送所述推送杆22-4，利用所述纳物空间22-43与所述捆扎机构11之间的摩擦力，将所述捆扎装置100推入体内一段距离后，用手术钳将所述捆扎装置100夹持带入体内。
参考图8至图8-2，本实施例中，所述定位弹片22-42上设有限位凸阶22-42-1，所述限位凸阶22-42-1与所述捆扎机构11上设置的定位凹槽11-1相匹配，在所述捆扎装置100对组织进行捆扎后，将所述捆扎机构11以远端的定位凹槽11-1朝下的方向置入所述纳物空间22-43内，所述定位凹槽11-1和所述限位凸阶22-42-1镶嵌在一起形成固定连接，构成收拢机构22-6。向后退所述推送杆22-4，所述收拢机构22-6将带动所述捆扎机构11向后运动，在所述递送鞘管21端部的阻挡作用下，暴露在所述递送鞘管21外部的所述捆扎机构11和所述固定装置12形成的所述捆扎孔13逐渐收拢，实现对组织的捆扎，捆扎完毕后，用手术钳剪断所述捆扎机构11，被剪断的所述捆扎机构11即可随所述递送鞘管21和所述推送杆22-4被带出体外，临床使用过程非常方便。
应该注意，本文中公开和说明的结构可以用其它效果相同的结构代替，同时本发明所介绍的实施例并非实现本发明的唯一结构。虽然本发明的优先实施例已在本文中予以介绍和说明，但本领域内的技术人员都清楚知道这些实施例不过是举例说明而己，本领域内的技术人员可以做出无数的变化、改进和代替，而不会脱离本发明，因此，应按照本发明所附的权利要求书的精神和范围来的界定本发明的保护范围。

Claims (20)

  1. 内窥镜子宫颈口捆扎系统，其特征在于：所述内窥镜子宫颈口捆扎系统(900)含捆扎装置(100)和递送装置(200)，所述捆扎装置(100)能收拢在所述递送装置(200)内；
    A、所述捆扎装置(100)含捆扎机构(11)、固定机构(12)及捆扎孔(13)；
    B、所述捆扎机构(11)上设有至少1个定位凹槽(11-1)；所述固定机构(12)含通孔(12-1)和至少1个定位凸阶(12-2)；所述捆扎机构(11)的近端(101)连接在所述固定机构(12)上，所述捆扎机构(11)的远端(102)能穿过所述通孔(12-1)后形成捆扎孔(13)；所述定位凸阶(12-2)镶嵌在所述定位凹槽(11-1)内阻止所述捆扎机构(11)的远端(102)从所述固定机构(12)中松弛或滑脱；
    C、所述递送装置(200)含递送鞘管(21)，所述捆扎装置(100)能收拢在所述递送鞘管(21)内。
  2. 根据权利要求1所述内窥镜子宫颈口捆扎系统，其特征在于：所述捆扎机构(11)是捆扎带(1-1)。
  3. 根据权利要求2所述内窥镜子宫颈口捆扎系统，其特征在于：所述捆扎带(1-1)采用柔软的弹性医用材料制成。
  4. 根据权利要求1所述内窥镜子宫颈口捆扎系统，其特征在于：所述定位凹槽(11-1)是可以连续调节的连续定位凹槽(11-11)。
  5. 根据权利要求1所述内窥镜子宫颈口捆扎系统，其特征在于：所述定位凹槽(11-1)是单向运动凹槽(11-12)。
  6. 根据权利要求1所述内窥镜子宫颈口捆扎系统，其特征在于：所述递送装置(200)还含有推送机构(22)，所述推送机构(22)能将收拢在所述递送鞘管(21)内的所述捆扎装置(100)推出。
  7. 根据权利要求1所述内窥镜子宫颈口捆扎系统，其特征在于：所述推送机构(22)含运动通孔(22-1)；所述捆扎装置(100)的捆扎机构(11)的远端(102)穿过所述运动通孔(22-1)后暴露在所述递送装置(200)外部。
  8. 根据权利要求7所述内窥镜子宫颈口捆扎系统，其特征在于：所述捆扎机构(11)的远端(102)设有拉环(11-2)。
  9. 根据权利要求1所述内窥镜子宫颈口捆扎系统，其特征在于：所述捆扎机构(11) 上设有防滑机构(11-3)。
  10. 根据权利要求9所述内窥镜子宫颈口捆扎系统，其特征在于：所述防滑机构(11-3)是设置在所述捆扎机构(11)上的防滑纹(11-31)、或防滑凸阶(11-32)。
  11. 根据权利要求10所述内窥镜子宫颈口捆扎系统，其特征在于：所述防滑纹(11-31)沿所述捆扎带(1-1)的纵向分布。
  12. 根据权利要求1所述内窥镜子宫颈口捆扎系统，其特征在于：所述捆扎机构(11)设有张开装置(11-4)。
  13. 根据权利要求12所述内窥镜子宫颈口捆扎系统，其特征在于：所述张开装置(11-3)是弹性张开装置(11-41)。
  14. 根据权利要求6所述内窥镜子宫颈口捆扎系统，其特征在于：所述推送机构(22)的远端设有限位装置(22-2)；所述固定机构(12)通过捆扎线(121)连接在所述限位装置(22-2)上。
  15. 根据权利要求6所述内窥镜子宫颈口捆扎系统，其特征在于：所述推送机构(22)的近端设有推拉手柄(22-3)。
  16. 根据权利要求1所述内窥镜子宫颈口捆扎系统，其特征在于：所述递送鞘管(21)的近端设有握持部(21-1)。
  17. 根据权利要求6所述内窥镜子宫颈口捆扎系统，其特征在于：所述推送机构(22)还含锁定机构(22-5)；所述锁定机构(22-5)在锁定状态时，所述捆扎装置(100)被固定在所述递送鞘管(21)内，不会从所述递送鞘管(21)内脱出。
  18. 根据权利要求17所述内窥镜子宫颈口捆扎系统，其特征在于：所述锁定机构(22-5)的锁定方式是凹凸卡配合锁定方式、或旋转锁定方式、或过盈配合锁定方式。
  19. 根据权利要求6所述内窥镜子宫颈口捆扎系统，其特征在于：所述推送机构(22)还含收拢机构(22-6)；所述收拢机构(22-6)可以在所述捆扎装置(100)将组织套扎后，将所述捆扎装置(100)收紧，并将剪断后的捆扎机构(11)的剩余部分通过所述推送机构(22)带出体外。
  20. 根据权利要求1所述内窥镜子宫颈口捆扎系统，其特征在于：所述内窥镜子宫颈口捆扎系统(900)采用医用材料制造。
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