WO2022267998A1

WO2022267998A1 - Laparoscopic trocar having fascial closure function

Info

Publication number: WO2022267998A1
Application number: PCT/CN2022/099594
Authority: WO
Inventors: 李宏博; 张家智; 王卫东; 王桃红; 夏大卫
Original assignee: 浙江优亿医疗器械股份有限公司
Priority date: 2021-06-24
Filing date: 2022-06-17
Publication date: 2022-12-29
Also published as: CN216221533U

Abstract

A laparoscopic trocar having a fascial closure function, comprising a puncture rod (1), a suture positioning mechanism (2), and a puncture hooking mechanism (3). The suture positioning mechanism (2) comprises two wing parts (21, 22) pivotally connected to a far end of the puncture rod (1), and a driving member (23). The wing part (21) has a first wing piece (211) and a second wing piece (212) arranged opposite to each other. A needle groove (213) having a free end opening is formed between the first wing piece (211) and the second wing piece (212). The first wing piece (211) and the second wing piece (212) are respectively provided with threading holes (215, 216) for the suture line to pivot through. The puncture hooking mechanism (3) comprises a first needle (31), a second needle (32) and an actuator (33). The first needle (31) and the second needle (32) have an initial state of being constrained in an inner cavity of the puncture rod (1), and a thread hooking state of being respectively inserted into the needle groove (213) of the two wing parts (21, 22). The first needle (31) and the second needle (32) are respectively provided with a first thread hooking groove (311) and a second thread hooking groove (321). The first thread hooking groove (311) and the second thread hooking groove (321) each have an opening (310, 320) facing away from the central axis of the puncture rod (1). The actuator (33) controls the first needle (31) and the second needle (32) to transition from the initial state to the thread hooking state.

Description

Laparoscopic trocar with fascia closure

technical field

The invention relates to a medical device for suturing fascia, in particular to a laparoscopic trocar with the function of fascia closure.

Background technique

Laparoscopic surgery is a newly developed minimally invasive method, and it is an inevitable trend in the development of future surgical methods. Compared with traditional surgery, laparoscopic surgery is popular among patients, especially because the postoperative scar is small and meets the aesthetic requirements. Young patients are more willing to accept it. Minimally invasive surgery is the general trend and goal of surgical development. At present, the gold standard of laparoscopic surgery is cholecystectomy. Generally speaking, most of the general surgical operations can be completed by laparoscopic surgery. Such as appendectomy, gastroduodenal ulcer perforation repair, hernia repair, colectomy, splenectomy, adrenalectomy, ovarian cyst removal, ectopic pregnancy, hysterectomy, etc. In laparoscopic surgery, the doctor first uses 3-5 laparoscopic trocars with a size of about 5-12mm to penetrate the patient's abdominal wall, and then pulls out the puncture rod on the trocar. Finally, the doctor uses the puncture cannula left on the patient's abdominal wall as a channel for surgical instruments to enter and exit the human body to perform the operation. After the operation is completed, the doctor needs to suture these puncture holes and the epidermis after removing the puncture sleeve. The most commonly used suturing method is to use Reverdin needles for suturing. The abdominal wall skin can be roughly divided into epidermis layer, subcutaneous fat layer, muscle layer, fascia layer and so on from top to bottom. Due to the deep position of the muscle layer and fascia layer, the Reverdin needle is difficult to operate, which makes the suture operation very difficult. Therefore, postoperative bleeding and puncture hole hernia often occur due to incomplete suture, which affects the healing of the patient and other pains. .

At present, there is a special device for fascia suturing on the market, called: minimally invasive fascia closure device, the device includes a locator and a suture guide needle, the locator includes a body, a pair of wings and a guide core, the body is A first channel and a second channel are provided, and the first channel and the second channel respectively have an inlet and an outlet along the outer surface of the body; one end of a pair of fins is connected to the body, and the other end is respectively provided with a through hole; the guide core is provided Inside the body, and the upper end of the guide core is exposed outside the body, a pair of fins can move between an open state and a closed state through the guide core, in the open state, a pair of fins are respectively located on both sides of the body , and the through hole on the fins is located on the extension line of the first channel or the second channel. In the closed state, a pair of fins close together and coincide with the axis of the body, and the ends of the pair of fins that are not connected to the body contact each other . A circular hole is arranged on the fin, and the hole is filled with silica gel. An open slot for guiding suture is provided at the position of the needle tip on the suture guide needle, and the opening direction of the open slot faces the needle tip one. How to use: When suturing is required after surgery, the doctor inserts the locator into the puncture channel, and at the same time opens the flaps through the guiding core. Next, the doctor snaps the suture into the open slot on the suture guide needle, and then inserts the suture guide needle into the first or second channel on the locator. Until the opening groove of the suture guide needle passes through the fins, the guide needle is pulled out at this time, and the suture thread will be blocked by the silicone in the circular hole of the fins. Then pull out the locator after the fins are closed by the guide core. Finally, the doctor will tie the suture out according to the regulations. Finally, a simple suture is performed on the epidermis. The above operation method has several disadvantages: 1. When using a minimally invasive fascial closure device for suturing, it is necessary to remove the puncture sleeve and then insert the closure device. While the closer is in place, the patient's wound is irritated. 2. The opening slot on the suture guide needle is too small, the distance is only 0.5-0.8mm, which is not conducive to the doctor to snap the suture into the opening slot. 3. The silicone in the hole on the flap cannot hold the suture well. If the suture guide needle is inserted too shallow, the thread clamping operation cannot be completed. If it is too deep, it may stab the internal organs, cause internal bleeding, and seriously cause the death of the patient. The doctor needs to observe and confirm through other observation channels before proceeding to the next step; 4. Due to the principle of silicone clamping, the reserved length of the suture guide needle is relatively long. If the doctor is using the minimally invasive fascial closure for the first time When the needle is inserted, the specific position of the inserted suture guide needle cannot be predicted, and it is likely to be inserted to the end, causing visceral bleeding.

technical problem

For the above-mentioned shortcoming of existing minimally invasive fascia closure device, the present invention provides a kind of laparoscopic puncture device with fascia closure function, it is characterized in that, this puncture device comprises: puncture rod, and described puncture rod internally forms an axially extending lumen; a suture positioning mechanism comprising two wings pivotally connected to the distal end of the piercing rod and an actuation for controlling transition of the two wings between a folded state and an unfolded state The wing part has a first wing and a second wing that are oppositely arranged, and a needle threading groove with an open free end is formed between the first wing and the second wing, and the first wing and the second wing The two wings are respectively provided with threading holes for sutures to pivot through; the puncture rod is provided with a slot A that allows the two wings to expand outward from the puncture rod; the puncture hook mechanism, the puncture hook The mechanism includes a first crochet needle, a second crochet needle and an actuator, the first crochet needle and the second crochet needle extend apart and their extension tracks intersect, the first crochet needle and the second crochet needle have The initial state and the state of the hook thread respectively inserted in the needle grooves of the two wings; The wire slots respectively have openings facing away from the central axis of the puncture rod, and the actuating member controls the first crochet needle and the second crochet needle to switch from the initial state to the thread hooking state, and the first crochet needle and the second crochet needle are configured to be able to switch from the initial state to the thread hooking state. The sutures of the two wing parts from the unfolded state to the folded state are guided to the first hook groove and the second hook groove; the piercing rod is provided with a perforation that allows the first hook and the second hook to extend out of the piercing rod A; the puncture sleeve, the puncture sleeve is set on the outside of the puncture rod, and the puncture sleeve is provided with a slot B that allows the two wings to expand outward from the puncture sleeve and allows the first crochet, the second The hook protrudes through the piercing hole of the piercing sleeve B.

In some embodiments, the puncture hooking mechanism includes a needle seat and a guide seat positioned in the inner cavity, the first crochet needle and the second crochet needle are elastic members; the guide seat has a first hook on the positive side The oblique channel and the second oblique channel on the opposite side, the first oblique channel and the second oblique channel extend obliquely from the proximal end to the distal end, and the extension tracks of the first oblique channel and the second oblique channel intersect The proximal end of the needle base is connected with the actuator, the proximal parts of the first crochet hook and the second crochet hook are respectively fixed on both sides of the needle base, and the distal part runs through the first oblique passage and the second crochet Two oblique passages are provided, and the actuating member drives the first crochet needle and the second crochet needle to slide in the first oblique passage and the second oblique passage respectively through the needle seat.

In some embodiments, the driving member includes a knob that rotates with the puncture rod fixing seat and a pull rod that is positioned in the inner cavity and is screwed with the knob. The left and right sides of the distal end of the pull rod have rack segments. The two wings each have a gear segment meshing with the rack segment.

In some embodiments, the left and right sides of the inner wall of the distal end of the puncture rod are respectively provided with a first pivot shaft and a second pivot shaft, and the first wing and the second wing pass through the first pivot shaft and the second pivot respectively. The pivot shaft is pivotally connected to the piercing rod.

In some embodiments, the guide seat further has a limit cover that covers the first oblique passage and the second oblique passage.

In some embodiments, the pull rod has an end seat located at the proximal part, a transmission part located at the distal part, and a frame-shaped guide rail extending axially between the end seat and the transmission part, and the outer wall of the end seat is in contact with the transmission part. The inner wall of the knob is screwed, and the transmission part has a rod and rack segments formed on both sides of the rod.

In some embodiments, the piercing rod has a hollow tubular body and a piercing tip communicating with the hollow tubular body, and the inner wall of at least the proximal part of the hollow tubular body is provided with a plurality of axially extending Limiting guide groove, the frame-shaped guide rail has at least a first slide plate and a second slide plate opposite to each other, the proximal ends of the first slide plate and the second slide plate are connected to the end seat, and the first slide plate and the second slide plate can respectively be Axially slidingly snapped into the limit guide groove.

In some embodiments, the actuator includes a push rod, and the push rod cooperates with the needle hub to push the needle hub to slide axially in the inner cavity.

In some embodiments, the actuator includes a push rod and a handle at the head end of the push rod, the push rod has a first push plate and a second push plate oppositely arranged, and the first push plate and the second push plate are A first protrusion and a second protrusion are respectively provided on the inner wall of the plate, and a first limit block and a second limit block are respectively provided on the far side thereof. The first movable block that swings on the central axis of the rod, and the second movable block that can swing relative to the central axis of the puncture rod is provided above the opposite side of the needle seat; the front and back sides of the needle seat are respectively on the first A first limit fitting block and a second limit fitting block are arranged above the movable block and the second movable block.

In some embodiments, the frame-shaped guide rail has an upper frame-shaped guide rail located on the upper side and a lower frame-shaped guide rail located on the lower side, the plane where the upper frame-shaped guide rail and the lower frame-shaped guide rail are located is vertical, and the The upper frame-shaped guide rail is slidingly matched with the limit guide groove inside the hollow pipe body, and the opposite sides of the guide seat are provided with slide grooves slidingly matched with the lower frame-shaped guide rail. When there is no need for wound suturing, it is a laparoscopic trocar, which has the same function as a general laparoscopic trocar. When wound suturing is required, there is no need to pull out the puncture sleeve, just put the puncture rod in again. The wound can be sutured after the corresponding operation is performed after the cannula is inserted. Since the puncture sleeve isolates the wound tissue, the post-insertion puncture rod will not re-irritate the patient's wound.

Compared with the minimally invasive fascia closure devices currently on the market, which only have 0.5-0.8mm suture thread slots, the newly designed laparoscopic trocar with fascia closure device has a thread clip slot size of about 2mm, which is more conducive to thread clipping .

The method of hooking the thread is used instead of the method of using the silicone thread to prevent the problem of too deep or too shallow insertion of the suture guide; improve the efficiency of suturing.

The reserved length is short, and it is equipped with protective measures. Inserting the suture guide needle to the end in time will not cause damage to internal organs.

In one operation, trocars of various brands may be used together. If it is necessary to use the puncture device mentioned in this patent to sew up the puncture holes of other brand puncture devices, it can also sew up the puncture holes of other brand puncture devices.

Compared with the traditional minimally invasive fascial closure device, it has the following advantages: when there is no need for wound suturing, it is a laparoscopic trocar, which has the same function as the general laparoscopic trocar, and when wound suturing is required, no Pull out the puncture cannula, only need to put the puncture rod into the cannula again and perform corresponding operations to suture the wound. Due to the puncture sleeve to isolate the wound tissue, the post-inserted puncture rod will not irritate the patient's wound again; compared with the minimally invasive fascial closure devices currently on the market, which only have 0.5-0.8mm suture slots, the new The designed laparoscopic puncture device with fascia closure device has a slot size of about 2mm, which is more conducive to thread clipping; the method of thread hooking is used instead of using silicone thread clipping to prevent the suture guide from being inserted too deep or too shallow The problem. Improve suturing efficiency; the reserved length is short, and it is equipped with protective measures, so that the suture guide needle can be inserted to the end in time without causing damage to internal organs; in one operation, multiple brands of trocars may be used together. If it is necessary to use the puncture device mentioned in this patent to sew up the puncture holes of other brand puncture devices, it can also sew up the puncture holes of other brand puncture devices.

Description of drawings

Fig. 1 is a schematic structural view of a peritoneal puncture device provided by the present invention.

Fig. 2 is a schematic disassembly diagram of the structure of the abdominal puncture rod and the puncture sleeve provided by the present invention.

Fig. 3 is a schematic disassembly diagram of the structure of the puncture rod provided by the present invention.

Fig. 4 is a structural schematic diagram of the first crochet needle and the second crochet needle provided by the present invention.

Fig. 5 is a schematic structural view of the puncture cannula provided by the present invention.

Fig. 6 is a schematic structural view of the needle holder provided by the present invention.

Fig. 7 is a structural schematic diagram of the push rod provided by the present invention.

Fig. 8 is a schematic diagram of the working process of the push rod and the needle holder provided by the present invention.

Fig. 9 is a schematic structural view of the limit cover provided by the present invention.

10-11 are cross-sectional views of partial structures of the trocar provided by the present invention.

12-24 are schematic diagrams of the usage method of the trocar provided by the present invention.

BEST MODE FOR CARRYING OUT THE INVENTION

In the description of the present invention, it should be understood that the orientation or positional relationship indicated by the terms "upper", "lower", "inner", "outer" and the like are based on the orientation or positional relationship shown in the drawings, and are only for It is convenient to describe the present invention and simplify the description, but does not indicate or imply that the device or element referred to must have a specific orientation, be constructed and operate in a specific orientation, and thus should not be construed as limiting the present invention. In the description of the present invention, "plurality" means at least two, such as two, three, etc., unless otherwise specifically defined.

In the present invention, terms such as "installation", "connection", "connection" and "fixation" should be interpreted in a broad sense, for example, it can be a fixed connection or a detachable connection, unless otherwise clearly specified and limited. , or integrated; can be mechanically connected, can also be electrically connected or can communicate with each other; can be directly connected, can also be indirectly connected through an intermediary, can be the internal communication of two components or the interaction relationship between two components, Unless expressly defined otherwise. Those of ordinary skill in the art can understand the specific meanings of the above terms in the present invention according to specific situations.

Referring to Figures 1-3, this embodiment provides a laparoscopic trocar with fascia closure function, the trocar includes a puncture rod 1, a suture positioning mechanism 2, a puncture thread hooking mechanism 3 and a puncture sleeve 5. An axially extending lumen is formed inside the puncture rod 1, so that a suture device can be installed inside the laparoscopic trocar to realize the function of automatically suturing fascia on the trocar; in this embodiment, please refer to FIG. 2, The puncture rod has a fixing seat 11 , a hollow tube body 12 and a puncture tip 13 communicating with the hollow tube body 12 , and the fixing seat is snap-fitted with the mounting seat 51 of the puncture sleeve.

Please refer to FIG. 3 , the suture positioning mechanism 2 includes two wings 21, 22 pivotally connected to the distal end of the puncture rod and a drive for controlling the switching between the folded state and the unfolded state of the two wings 21, 22. 23, the "folded state" here means that the wings coincide with the central axis of the puncture rod at zero degrees, and the "expanded state" here means that the wings are unfolded toward the outside and aligned with the central axis of the puncture rod. form an included angle of 90 degrees; in this embodiment, the two wings are arranged on opposite sides of the puncture rod, and when the two wings are in an unfolded state, the two wings form an included angle of 180 degrees; the two wings form an angle of 180 degrees; The structure of the two wing parts of 21 is the same, so only the structure of one of the wing parts will be described in detail below. A needle threading groove 213 with an open free end is formed between the sheet 211 and the second wing 212. The first wing 211 and the second wing 212 are respectively provided with threading holes 215, 216 for sutures to pivot through. Threading holes 215, 216 are passed to achieve suture positioning.

The puncture hook thread mechanism 3 includes a first crochet needle 31, a second crochet needle 32 and an actuator 33. The first crochet needle 31 and the second crochet needle 32 have an initial state constrained in the inner cavity of the puncture rod and are respectively inserted in the The hook thread state of the two wing needle grooves 213, the "initial state" here refers to the first crochet needle and the second crochet needle being accommodated in the inner chamber of the puncture rod, at this time the first crochet needle 31 and The second crochet needle 32 does not interfere with the puncture function of the puncture rod; the "hook state" here refers to the first crochet needle 31 and the second crochet needle 32 protruding outward from the puncture rod lumen and piercing the abdominal cavity tissue and then inserting the piercing arm. In the needle groove, the actuating member 33 controls the first crochet needle and the second crochet needle to switch from the initial state to the hook thread state; Above, the first crochet needle 31 and the second crochet needle 32 have a first hook thread groove 311 and a second hook thread groove 321 respectively, and the first hook thread groove 311 and the second hook thread groove 321 respectively have openings facing away from the central axis of the puncture rod 310, 320, the openings 310, 320 are located inside the sutures of the threading hole when the first crochet needle 31 and the second crochet needle 32 are inserted into the needle passage grooves 213 of the two wing parts. During the transition from the unfolded state to the folded state, the first crochet needle and the second crochet needle inserted in the needle threading groove can guide the suture thread passing through the needle threading groove to the first hook thread groove and the second hook thread groove In this way, the function of suturing can be obtained by pulling out the first crochet needle and the second crochet needle from the abdominal cavity tissue and then tying a knot.

Specifically, referring to Fig. 4, the extension length of the first crochet hook and the second crochet hook is about 50-150mm, and the diameter D of the crochet hook is about 0.8-1.5mm; It is about 0.6-1.2 mm, and the opening direction of the opening slot is set on the back. The larger opening width of the first hooking slot 311 and the second hooking slot 321 can be more conducive to clamping the thread; in this embodiment, the first hooking needle 31 and the second crochet needle 32 have the tip that is positioned at the distal end, and the first crochet groove 311 and the second crochet groove 321 are arranged on the upper area of the tip 312, 322 of the first crochet needle 31 and the second crochet needle 32, and they all have a The openings 3110, 3210 and the slots 3111, 3211 extending longitudinally from the openings, so that after the suture thread enters the slot along the opening, the suture thread enters the slot due to the upward passing of the first crochet needle and the second crochet needle The deep part of the far end is not easy to come out, and the clamping line is more firm.

Please refer to Figure 2, the opposite sides of the puncture rod are respectively provided with slots A 15 that allow the two wings to expand outward from the puncture rod, and the two sides of the puncture rod are respectively provided with slots A 15 that allow the first crochet needle and the second crochet needle Stretch out the perforation A 17 of the puncture sleeve; the puncture sleeve 5 is sleeved on the outside of the puncture rod 1, the function of the puncture sleeve is to block the wound tissue, in order to realize the wing 21, the first crochet 31 and the second crochet 32 acts on the abdominal cavity tissue; please refer to Fig. 5, the opposite sides of the puncture sleeve are respectively provided with slots B 52 that allow the two wings to expand outward from the puncture sleeve, and the two sides of the puncture sleeve are respectively provided with There is a perforation B 52 that allows the first crochet needle and the second crochet needle to extend out of the puncture sleeve; Injury to the patient when piercing the cannula.

The actuating member 33 controls the conversion of the first crochet hook and the second crochet hook from the initial state to the hook thread state. The proximal ends of the two crochets are fixed on the push rod, and the push and pull of the push rod can drive the first crochet and the second crochet to move axially; in some preferred embodiments, please refer to FIG. The needle seat 34 and the guide seat 35 positioned in the inner cavity, the first crochet needle 31 and the second crochet needle 32 are elastic; The oblique channel 352, the first oblique channel 351 and the second oblique channel (not shown in the figure) extend from the proximal end toward the distal end, and the extension tracks of the first oblique channel and the second oblique channel intersect, That is to say, the two are located on the front and back sides of the needle base, but their extension directions are intersected, so that the first crochet needle 31 and the second crochet needle 32 that are vertically parallel are deformed through the action of the first oblique passage and the second oblique passage. The state of intersecting but not actually intersecting and contacting; the proximal end of the needle base 34 is coupled with the actuator 33, and the proximal parts of the first crochet hook 31 and the second crochet hook 32 are respectively fixed on both sides of the needle base 34 and Its distal end part is set through the first oblique passage 351 and the second oblique passage 352, and the actuating member 33 drives the first crochet needle 31 and the second crochet needle 32 respectively through the needle base to move between the first oblique passage 351 and the second oblique passage 352. Sliding occurs in the second oblique passage 352; like this, the elastic first crochet needle and the second crochet needle are transformed from vertical to cross arrangement under the guidance of the first oblique passage 351 and the second oblique passage 352, due to the first The oblique channel 351 and the second oblique channel 352 are respectively located on the positive side and the opposite side of the needle base, so although the two crochet hooks are arranged crosswise but do not intersect; the two crochet hooks that cross but do not intersect in this way will not interfere with each other, It can better complete the function of piercing into the tissue and obliquely inserting into the needle threading groove 23 for thread hooking; in this embodiment, the first oblique channel 351 and the second oblique channel 352 are both from top to bottom in the Y direction , one in the X direction is from left to right, and the other is from right to left; there is an eccentricity between the two oblique channels, which is greater than the diameter of the oblique channel, so the two oblique channels will not interfere with each other.

In some embodiments, the actuator 33 is a push rod, the push rod is inserted into the inner cavity of the puncture rod and a handle 331 is provided at its proximal end, the push rod is fixedly connected with the needle hub, and the push rod is driven by the needle hub. The first crochet hook and the second crochet hook slide obliquely in the first oblique channel and the second oblique channel; however, abdominal trocars are mostly disposable products. If this method is used, the handle needs to be reserved for a push-out height. At this time, the handle will protrude from the puncture fixing seat itself. At this time, the operator is likely to collide with the handle, and the problem of pushing out the first crochet hook and the second crochet hook by mistake will occur; based on this, in some preferred implementation methods, please 6 and 7, the actuating member 33 includes a push rod 331 and a handle 330 located at the head end of the push rod 331. device, when the distal part of the push rod is in limited fit with the needle seat limit device, the handle and part of the push rod protrude outwards compared with the proximal end of the puncture rod, so that the operator can push down the push rod to push out the second One crochet hook and the second crochet hook; when the proximal part of the push rod cooperates with the limit device of the needle base, the push rod is located in the inner cavity as a whole, that is, the operator cannot push out the push rod; the limit device provided by this embodiment It is configured to be able to release its limited fit with the proximal part of the push rod and to be limitedly engaged with the proximal part of the push rod; specifically, in this embodiment, the push rod has a first push plate 3311 and a first push plate 3311 set oppositely. The second push plate 3312, the inner walls of the first push plate 3311 and the second push plate 3312 are respectively provided with a first protrusion 3313 and a second protrusion 3314 and are respectively provided with a first limiting block 3315 and a second protrusion 3314 on the far side thereof. The second limit block 3316; the front and back sides of the needle seat 34 are respectively provided with a first limit fit block 3411 and a second limit fit block which are limitedly matched with the first protrusion 3313 and the second protrusion 3314 3413, the upper and lower sides of the needle base 34 are provided with a first movable block 3412 that can swing relative to the central axis of the puncture rod, and the opposite side of the needle base 34 is provided with a first movable block 3412 that can swing relative to the central axis of the puncture rod The second movable block 3414; the front and back sides of the needle holder are respectively provided with a first limit fitting block 3411 and a second limit fitting block 3413 above the first movable block 3412 and the second movable block; The first limit fit block 3411 and the second limit fit block 3413 have a first state of limit fit with the first protrusion 3313 and the second protrusion 3314 respectively, and respectively cooperate with the first limit block 3315 and the second limit fit block. The second state of the limited fit of the limit block 3316; the first limit block 3315 and the second limit block 3316 have an initial state located at the far side of the needle hub and an activated state of respectively limited fit with the needle hub; The first stop block 3315 and the second stop block 3316 move upward to drive the first movable block and the second movable block to rotate toward the central axis of the puncture rod to release the first movable block and the second movable block to lock it , the first protrusion 3313 and the second protrusion 3314 and the first limit fit block 3411 and the second limit fit block 3413 have weak limit fit forces So that the limit fit is released by upward thrust; the first protrusion 3313 and the second protrusion 3314 are convex lines extending laterally, and the first limit fit block 3411 and the second limit fit block 3413 are under the action of an external force The limit fit with the raised strip can be released quickly; in this way, the push rod can be easily turned from the initial state to the activated state.

Please refer to Fig. 8, the first limiting block 3315 and the second limiting block 3316 have a limiting surface A located on the proximal side and a limiting surface B located on the far side; when the push rod is pulled, the push rod moves upward, and the The first limit fit block 3411 and the second limit fit block 3413 release the limit fit with the first protrusion 3313 and the second protrusion 3314, and the first limit block 3315 and the second limit block 3316 are then Moving upward successively pushes away the blocking effect of the first movable block 3412 and the second movable block 3414, the limiting surface A of the first limiting block 3315 and the second limiting block 3316 and the first limiting surface A located on the upper side thereof A limit fit block 3411 and a second limit fit block 3413 limit fit, the limit surface B of the first limit block 3315 and the second limit block 3316 and the first movable block 3412 located on the lower side thereof Cooperate with the second movable block 3414 in a limited position, so that the first limit block 3315 and the second limit block 3316 of the push rod are snapped together with the needle base through two parts of limit fit, and the push rod and the needle base are stably being fixed together, so that the first crochet hook and the second crochet hook can slide obliquely downward for a predetermined distance.

In this embodiment, in order to release the locking of the first movable block and the second movable block to the first limit block 3315 and the second limit block 3316 conveniently, the first movable block and the second movable block The clamping block has a swingable slope interacting with the first limiting block 3315 and the second limiting block 3316 and a horizontal limiting surface that cooperates with the first limiting block 3315 and the second limiting block 3316, And the limit surface A and the limit surface B of the first limit block 3315 and the second limit block 3316 are horizontal planes, so, the limit surface A and the limit surface B of the first limit block 3315 and the second limit block 3316 The cooperation of the slope of a movable block and the second movable block can quickly release the locking of the first movable block and the second movable block to the first limiting block 3315 and the second limiting block 3316; and the limiting surface The horizontal planes of A and the limit surface B make the first limit block 3315 and the second limit block 3316 cooperate with the first limit fit block 3411 and the second limit fit block 3413, the first movable block and the second movable block. The block limit cooperation is stronger.

In some embodiments, please refer to FIG. 9 , the guide seat also has limit covers 353 and 354 respectively covering the first oblique channel and the second oblique channel, and the limit cover restricts the crochet needle from going out of the first oblique channel. channel and the second oblique channel; specifically, the structure of the limit cover is as follows: see Figure 2 for details, the limit cover 353 is provided with a pressing piece 3531 for covering the second oblique channel, The pressing piece 3531 is consistent with the shape of the second oblique passage to accommodate the second crochet, and the limit cover 353 is provided with a number of limit shafts 3532, 3533, 3544 fixedly connected with the shaft holes on the guide seat, so that the first The first crochet needle and the second crochet needle are prevented from falling out of the first oblique passage and the second oblique passage while sliding in a predetermined direction.

In some embodiments, please refer to FIG. 8 again, the driving member 23 includes a knob 231 and a pull rod 232, the knob 231 is screwed to the proximal part of the pull rod 232, and the left and right sides of the far end Rack segments 2335, 2336, the two wings 21, 22 respectively have gear segments 210, 220 meshed with the rack segments 2335, 2336; in this way, the rotation of the knob 231 can drive the pull rod 232 to slide axially, further The engagement transmission between the rack segments 2335, 2336 and the gear segments of the two wings 21, 22 drives the two wings to swing relative to the central axis of the puncture rod; in some embodiments, the wings are pivoted in the following manner The inner wall of the puncture rod, the left and right sides of the distal inner wall of the puncture rod are respectively provided with a first pivot shaft 1211 and a second pivot shaft 1212, and the first wing and the second wing are respectively passed through the first pivot shaft 1211 and the second pivot shaft. Two pivot shafts 1212 are pivotally connected to the piercing rod.

In this embodiment, the pull rod 232 has an end seat 2321 located at the proximal part, a transmission part 2323 located at the distal part, and a frame-shaped guide rail 2322 extending axially between the end seat and the transmission part. The outer wall of the seat 2321 is screwed to the inner wall of the knob, and the frame-shaped guide rail defines an accommodation channel. The knob 231 and the end seat 2321 have an opening, so that the push rod passes through the opening and enters the inner cavity of the puncture rod, and the lower end of the handle is in the In the initial state, it is against the upper side of the knob; the transmission part has a rod and rack segments formed on the opposite sides of the rod; specifically, there are many ways to screw the knob 231 and the pull rod 232, and some In the embodiment, the end seat of the pull rod is screwed to the knob; in this embodiment, the way the knob 231 is screwed to the pull rod 232 is as follows: the end seat 2321 is provided with two helical guide grooves 23211 opposite to each other. The knob 2321 is provided with a guide post sliding in the spiral guide groove 23211, so that the rotation of the knob is converted into the axial movement of the draw rod through the cooperation of the guide post of the knob and the spiral guide groove of the end seat of the tie rod.

In this embodiment, the frame-shaped guide rail 2322 has an upper frame-shaped guide rail 23220 on the upper side and a lower frame-shaped guide rail 23221 on the lower side, the lower frame-shaped guide rail 23221 and the upper frame-shaped guide rail 23220 are fixedly connected, so The plane where the lower frame-shaped guide rail 23221 and the upper frame-shaped guide rail 23220 are located is vertical, the plane where the needle hub is located is perpendicular to the plane where the push rod is located; Extended limit guide groove, the upper frame-shaped guide rail 23220 is slidably matched with the limit guide groove inside the hollow pipe body, and the opposite sides of the guide seat 35 are provided with slides that are slidably matched with the lower frame-shaped guide rail 23221 Groove 3541, specifically, the sliding groove 3541 is formed on the limit cover 354, so that the circumferential movement of the frame-shaped guide rail in the inner cavity of the puncture rod is avoided; the upper frame-shaped guide rail 23220 has an opposite first slide plate 23222 and the second slide plate 23223, the proximal end of the first slide plate 23222 and the second slide plate 23223 is connected with the end seat 2321, and the first slide plate 23222 and the second slide plate 23223 can be axially slidably snapped into a puncture rod limit guide respectively. In the groove; the lower frame-shaped guide rail 23221 has a third slide plate 23225 and a fourth slide plate 23226 opposite to each other. Slot 3541 sliding fit; more specifically, the line between the first slide plate 23221 and the second slide plate 23222 and the line between the first push plate 3311 and the second push plate 3312 perpendicularly intersect; the hollow Four axially extending limiting guide grooves are provided on the inner wall of at least the proximal part of the tubular body, and the first push plate, the first slide plate, the second push plate and the second slide plate are circumferentially distributed in the four axial directions. Extended limit guide groove; through the sliding fit of the upper frame-shaped guide rail 23220, the push rod and the inner wall of the puncture rod, and the sliding fit of the lower frame-shaped guide rail and the guide seat, the circumferential rotation of the push rod, needle holder and pull rod is avoided. Make the whole device work more stable and smooth.

In addition, the hollow tube body of the puncture rod provided in this embodiment has an upper tube body 1200 and a lower tube body 1201, the lower tube body 1201 is formed by snapping together two half shells 121, 122, and the guide seat Positioning in the lower tubular body, specifically, can be positioned in the lower tubular body by buckling, bonding and other fixing methods; the piercing tip 13 is also snap-fitted with the lower tubular body 1201 .

Please refer to Fig. 10-11, the ring buckle 111 on the puncture rod fixing base 11 is locked with the ring groove on the upper sleeve, and the vertical buckle on the upper sleeve is connected to the vertical buckle on the puncture rod fixing base. vertical slot, and the guide seat is buckled and fixed with the inner wall of the puncture rod.

The knob is rotatably mounted on the puncture rod fixing seat. Specifically, the knob is provided with an annular protrusion in the circumferential direction, and the inner ring of the opening of the puncture rod fixing seat forms an annular groove that rotatably fits with the annular protrusion.

Please refer to Fig. 3, for the assembly stability of the whole device, the plane where the lower frame-shaped guide rail 23221 and the upper frame-shaped guide rail 23220 are located is vertical, the plane where the needle hub is located is perpendicular to the plane where the push rod is located, and each action mechanism operates stably. 1. The puncture suture mechanism and the puncture positioning mechanism have a clear division of labor and complement each other during operation.

In addition, a square hole is opened in the center of the end seat 2321 so that the push rod can axially slide into it, and the setting of the square hole prevents the push rod from moving in the circumferential direction.

Based on the laparoscopic puncture device provided above, the present invention provides the following usage method: Step 1) Please refer to Figure 12 and 13, according to the usage method specified in laparoscopic surgery, insert the puncture device into the abdominal wall, and take out the puncture rod; , use the puncture cannula left on the abdominal wall to perform surgical operations; Step 2) Please refer to Figure 14, when the wound needs to be sutured after the operation, put two sutures 10 into the threading holes in the wings, and Pull the suture up; step 3) see Figure 15, then reinsert the piercer into the cannula; turn the knob to spread the two wings 180 degrees; step 4) see Figure 16, pull the handle so that the push The rod extends out of the puncture rod, changing the needle holder from the initial state to the activated state; step 5) Please refer to Figure 17, press the handle down to push the push rod down to a predetermined height, and push out the first crochet hook 311 and the second crochet hook 312 , the first crochet needle 311 and the second crochet needle 312 are pushed out from the puncture rod and the puncture sleeve to penetrate the abdominal wall and pass through the needle groove between the two wings; ; Step 6) Turn the knob again, see Figure 18 and Figure 19, fold the two wings, and the suture will snap into the first hook thread groove and the second hook thread groove on the first hook 311 and the second hook 312 Inside the hook slot; step 7) see Figure 20, pull out the push rod, retract the first hook 311 and the second hook 312; step 7) see Figure 21-23, pull out the piercer, one end of the suture It will be taken out of the body together with the trocar; at this time, please refer to Figure 24, take the suture hooked on the puncture hook and use the conventional knotting method to close the wound; finally, simply suture the epidermis. Surgery can be done.

In the description of this specification, descriptions referring to the terms "one embodiment", "some embodiments", "example", "specific examples", or "some examples" mean that specific features described in connection with the embodiment or example , structure, material or characteristic is included in at least one embodiment or example of the present invention. In this specification, the schematic representations of the above terms are not necessarily directed to the same embodiment or example. Furthermore, the described specific features, structures, materials or characteristics may be combined in any suitable manner in any one or more embodiments or examples. In addition, those skilled in the art can combine and combine different embodiments or examples and features of different embodiments or examples described in this specification without conflicting with each other.

Although the embodiments of the present invention have been shown and described above, it can be understood that the above embodiments are exemplary and should not be construed as limiting the present invention, and those skilled in the art can make the above-mentioned The embodiments are subject to changes, modifications, substitutions and variations.

Claims

A laparoscopic puncture device with fascia closure function, characterized in that the puncture device includes

a puncture rod, an axially extending lumen is formed inside the puncture rod;

A suture positioning mechanism, the suture positioning mechanism includes two wings pivotally connected to the distal end of the puncture rod and a driving member for controlling the switching between the folded state and the unfolded state of the two wings, the wings have The first fin and the second fin are oppositely arranged, and a needle threading groove with an open free end is formed between the first fin and the second fin, and the first fin and the second fin are respectively provided with A threading hole through which the suture thread pivots; the piercing rod is provided with a slot A allowing two wings to expand outward from the piercing rod;

The puncture hooking mechanism, the puncture hooking mechanism includes a first crochet needle, a second crochet needle and an actuator, the first crochet needle and the second crochet needle extend apart and their extension tracks intersect, and the first crochet needle and the second crochet needle intersect with each other. The second crochet needle has an initial state of being constrained in the inner cavity of the puncture rod and a hooking state of being respectively inserted into the needle passage grooves of the two wings; the first hook needle and the second hook needle have a first hook thread groove and a second hook thread groove respectively , the first hooking groove and the second hooking groove respectively have openings facing away from the central axis of the puncture rod, the actuator controls the first crochet needle and the second hook needle to switch from the initial state to the hooking state, and the first crochet needle and the second crochet needle is configured to be able to guide the sutures of the two wing parts from the unfolded state to the folded state to the first hook thread groove and the second hook thread groove; 1. The second crochet needle stretches out of the piercing hole A of the piercing rod;

A puncture sleeve, the puncture sleeve is set on the outside of the puncture rod, and the puncture sleeve is provided with a slot B that allows the two wings to expand outward from the puncture sleeve and allows the first hook and the second hook to extend Exit the puncture of piercing cannula B.
The laparoscopic trocar according to claim 1, wherein the puncture hooking mechanism includes a needle seat and a guide seat positioned in the inner cavity, and the first crochet needle and the second crochet needle are elastic members;

The guide seat has a first oblique passage on the positive side and a second oblique passage on the reverse side, the first oblique passage and the second oblique passage extend obliquely from the proximal end to the distal end, and the first oblique passage The passage intersects with the extended trajectory of the second oblique passage;

The proximal end of the needle base is connected with the actuator, the proximal parts of the first crochet hook and the second crochet hook are respectively fixed on both sides of the needle base, and the distal parts thereof pass through the first oblique passage and the second An oblique channel is provided, and the actuating member drives the first crochet needle and the second crochet needle to slide in the first oblique channel and the second oblique channel respectively through the needle seat.
The laparoscopic trocar according to claim 1, wherein the driving member includes a knob that is rotatably engaged with the puncture rod fixing seat and a pull rod that is positioned in the inner cavity and is screwed to the knob, and the distal portion of the pull rod There are rack segments on the left and right sides, and the two wing parts respectively have gear segments meshing with the rack segments.
The laparoscopic trocar according to claim 3, wherein the left and right sides of the inner wall of the distal end of the puncture rod are respectively provided with a first pivot shaft and a second pivot shaft, and the first wing and the second wing The parts are pivotally connected to the piercing rod through the first pivot shaft and the second pivot shaft respectively.
The laparoscopic trocar according to claim 2, wherein the guide seat further has a limit cover covering the first oblique channel and the second oblique channel.
The laparoscopic trocar according to claim 3, wherein the pull rod has an end seat located at the proximal part, a transmission part located at the distal part, and a frame extending axially between the end seat and the transmission part. The guide rail, the outer wall of the end seat is screwed to the inner wall of the knob, and the transmission part has a rod and rack segments formed on both sides of the rod.
The laparoscopic trocar according to claim 3, wherein the puncture rod has a hollow tube body and a puncture tip communicating with the hollow tube body, and at least the proximal part of the hollow tube body The inner wall is provided with a plurality of axially extending limiting guide grooves in the circumferential direction. The frame-shaped guide rail has at least a first slide plate and a second slide plate opposite to each other. The proximal ends of the first slide plate and the second slide plate are connected to the end seat. The first slide plate and the second slide plate are axially slidably snapped into the position-limiting guide grooves respectively.
The laparoscopic trocar according to claim 7, wherein the actuating member comprises a push rod, and the push rod cooperates with the needle seat to push the needle seat to slide axially in the inner cavity.
The laparoscopic trocar according to claim 7, wherein the actuator comprises a push rod and a handle at the head end of the push rod, the push rod has a first push plate and a second push plate oppositely arranged, The inner walls of the first push plate and the second push plate are respectively provided with a first protrusion and a second protrusion and are respectively provided with a first limit block and a second limit block on their far sides, and the needle seat A first movable block that can swing relative to the central axis of the puncture rod is provided below the upper front side, and a second movable block that can swing relative to the central axis of the puncture rod is provided above the opposite side of the needle seat; the needle The positive and negative sides of the seat are respectively provided with a first limit fitting block and a second limit fitting block above the first movable block and the second movable block.
The laparoscopic trocar according to claim 7, wherein the frame-shaped guide rail has an upper frame-shaped guide rail on the upper side and a lower frame-shaped guide rail on the lower side, and the upper frame-shaped guide rail and the The plane where the lower frame-shaped guide rail is located is vertical, and the upper frame-shaped guide rail is slidingly matched with the limit guide groove inside the hollow pipe body, and the opposite sides of the guide seat are provided with slide grooves that slide and fit with the lower frame-shaped guide rail.