WO2023232037A1 - Suturing apparatus and suturing method - Google Patents

Abstract

A suturing apparatus (100) and a suturing method. The suturing apparatus (100) comprises a manipulation part (01); a first outer tube (804A), arranged at a distal end of the manipulation part (01); a puncture needle (604), arranged at the distal end of the manipulation part (01) and at least partially arranged in the first outer tube (804A), the puncture needle (604) being capable of moving relative to a proximal end of the manipulation part (01); and at least two implants (601), arranged at a distal end of the puncture needle (604), the implants (601) being connected by a suture (03) to form a line knot (06), wherein when the puncture needle (604) moves relative to the proximal end of the manipulation part (01), the first outer tube (804A) can push the line knot (06) towards the distal end of the manipulation part (01) for tightening.

Description

Suturing device and suturing method

Related applications

This application claims priority to the Chinese patent application filed on May 31, 2022, with application number 202210603106.5 and titled "Suture Device and Suture Method", the full text of which is hereby incorporated by reference.

Technical field

The present application relates to the technical field of suturing devices, and in particular, to a suturing device and a suturing method.

Background technique

During exercise, due to irregular movements and other reasons, it is easy for the force exerted by the femur on the meniscus to become unbalanced, leading to partial tearing of the meniscus. Clinically, there are three most common suturing methods for meniscal tears under knee arthroscopy, such as outside-in suture, inside-out suture and full-internal suture. Full-internal suture is mainly used to suture the meniscus. Body part and rear corner part.

In related art, in a total internal suturing operation for the body and posterior corner of the meniscus, after the meniscus tear is sutured with a total internal suturing instrument, the suturing instrument needs to be taken out of the knee joint cavity first, and then another medical instrument is used. The push knot and thread cutting device is used to pass the suture through the push knot and thread cutting device and push the knot and thread cutting device into the knee joint cavity to tighten the knot and cut the suture.

The use of two instruments undoubtedly increases the operating time of medical staff and the treatment time of patients. It also increases the frequency of the instruments entering and exiting the knee joint cavity, thereby increasing the possibility of tissue damage or infection.

Contents of the invention

The present application provides a suturing device and a suturing method.

An embodiment of the present application provides a suturing device, including:

control department;

a first outer tube provided at the distal end of the operating portion;

a puncture needle disposed at the distal end of the operating part and at least partially disposed within the first outer tube, the puncture needle being movable relative to the proximal end of the operating part; and

At least two implants are provided at the distal end of the puncture needle, and the implants are connected by sutures to form a knot; wherein, when the puncture needle moves relative to the proximal end of the manipulation part, the The first outer tube can push the wire knot toward the distal end of the operating portion to tighten.

In one embodiment, there is a push needle inside the puncture needle; and a side wall of the puncture needle that is in line with the center of the puncture needle. The first hole is connected with the empty holes, and the side wall of the first outer tube has a second hole; the implant is located on the puncture needle, and the suture passes through the first hole and the second hole; The puncture needle can move axially relative to the first outer tube, and the puncture needle can be retracted into the first outer tube; the push needle can move axially relative to the puncture needle, so as to The implant located on the puncture needle is pushed out from the puncture needle; the outside of the push-knot tube has a second outer tube, the push needle, the puncture needle, the first outer tube and the second outer tube. The outer tubes are coaxially arranged; the second outer tube has a first shearing structure, the first outer tube has a second shearing structure, and along the axial direction of the first outer tube, the first shearing structure A cutting structure, a suture passing through the second hole and a second shearing structure are arranged in sequence, the first shearing structure and/or the second shearing structure have a blade, and the second outer tube can face After the first outer tube moves in the axial direction and brings the first shearing structure and the second shearing structure into contact, the suture is cut by the blade.

In one embodiment, the wire shearing tube is provided with a blade, the blade includes a first blade and a second blade, the first blade and the second blade are facing toward each other, and are separated from the second shearing tube. In the direction of the cutting structure toward the first shearing structure, the distance between the first blade and the second blade gradually decreases until the distance between them is less than the thickness of the suture.

In one embodiment, the first blade portion includes a first blade surface facing away from the push-knot tube, in a direction from the first shearing structure toward the second shearing structure, and the first blade surface is in contact with the push-knot tube. The distance between the outer walls of the tube gradually decreases;

The second blade portion includes a second blade surface facing away from the push-knot tube. In the direction from the first shearing structure toward the second shearing structure, the distance between the second blade surface and the outer wall of the push-knot tube is slowing shrieking.

Along the axial direction of the push-knot tube, the second hole includes a first hole wall and a second hole wall that are spaced apart and facing opposite, and the first hole wall is close to the push-knot end of the push-knot tube, so The second hole wall is away from the push-knot end of the push-knot tube, and the first hole wall forms a second shearing structure.

In one embodiment, the operating part is provided with a first driving mechanism, and the first driving mechanism is connected to the puncture needle and used to drive the puncture needle to move in the axial direction.

In one embodiment, the first driving mechanism includes a trigger connected to the puncture needle, and the trigger is used to drive the puncture needle to move in the axial direction.

In one embodiment, the first driving mechanism includes a first sliding part connected to the puncture needle, the trigger is provided with a second sliding part connected to the first sliding part, and the first sliding part The first part and the second sliding part are slidingly connected, and the sliding direction of the trigger is perpendicular to the axial direction of the puncture needle.

In one embodiment, a second driving mechanism is provided on the operating part, and the second driving mechanism is connected with the push pin and is used to drive the push pin to move in the axial direction.

The second driving mechanism includes a button connected to the tail end of the push pin. A spring is provided between the button and the operating part. The spring enables the push pin to move away from the push tube. direction of movement.

In one embodiment, a locking structure is provided on the operating part, and the locking structure is used to lock the push pin in the initial position to prevent the push pin from moving axially.

The locking structure includes a rocker. One end of the rocker is rotatably connected to the operating part, and the other end has a baffle. The baffle can rotate to the side of the button to block the axial movement of the button.

In one embodiment, the state when the baffle of the rocker blocks the button is the first state, and the state when the baffle is completely separated from the button is the second state.

A ratchet mechanism is connected between the rocker plate and the operating part, and the ratchet mechanism is used to enable the rocker plate to move in one direction from the first state to the second state.

In one embodiment, one of the button and the control part has an impact structure and the other has a sound-emitting structure. When the push pin moves to the maximum displacement position, the impact structure and The sound-emitting structure collides, and the sound-emitting structure can emit a prompt sound.

In one embodiment, a third driving structure is provided on the operating part, and the third driving structure is connected to the wire trimming tube and is used to drive the wire trimming tube to move in the axial direction.

In one embodiment, the third driving structure includes a push button, and the push button is connected to the wire trimming tube. The operating part includes a side wall, the push button is slidingly connected to the side wall, and there is a locking structure between the side wall and the push button. After the locking structure is locked, the push button stationary relative to the side wall.

In one embodiment, the locking structure includes a first sawtooth structure, and the first sawtooth structure is connected to the push button with a gap therebetween.

The locking structure also includes a second sawtooth structure located on the side wall, the second sawtooth structure is located in the gap, and the first sawtooth structure and the second sawtooth structure are facing oppositely; The first sawtooth structure is connected to the trimmer tube through a diagonal rod.

The first sawtooth structure can be separated from the second sawtooth structure when the push button moves toward the side wall, so that the push button can move in the axial direction.

In a second aspect, an embodiment of the present application provides a suturing method, which uses the above-mentioned suturing device to perform suturing, including the steps:

Step 1. Use the puncture needle to penetrate one side of the tissue slit until the first implant on the puncture needle emerges from the rear wall of the tissue;

Step 2. Use the push needle to push the first implant from the puncture needle to the rear wall of the tissue;

Step 3. Pull out the puncture needle from the first puncture position, and use the puncture needle to puncture the other side of the tissue crack; use the push needle to push the second implant from the puncture needle to the posterior wall of the meniscus;

Step 4. Retract the puncture needle into the push-knot tube until the front end of the puncture needle does not exceed the push-knot tube;

Step 5. Use the push-knot end of the push-knot tube to press the knot on the back side of the second implant and tighten the suture outside the body. One end, to close the tissue tear;

Step 6. While pulling out the end of the suture located outside the body, move the suture cutting tube in the axial direction, and use the thread cutting tube and the push-knot tube to cut off the suture passing through the second hole.

The details of one or more embodiments of the application are set forth in the accompanying drawings and the description below. Other features, objects and advantages of the application will become apparent from the description, drawings and claims.

Description of the drawings

To better describe and illustrate embodiments and/or examples of those inventions disclosed herein, reference may be made to one or more of the accompanying drawings. The additional details or examples used to describe the drawings should not be construed as limiting the scope of any of the disclosed inventions, the embodiments and/or examples presently described, and the best modes currently understood of these inventions.

Figure 1 is a schematic diagram of a suturing device according to one or more embodiments.

Figure 2 is a schematic diagram of the internal structure of a suturing device according to one or more embodiments.

Figure 3 is a schematic diagram of the location of a depth limiting structure of a suturing device according to one or more embodiments.

Figure 4 is a schematic diagram of a push-knot tube position of a suturing device according to one or more embodiments.

Figure 5 is a schematic diagram of the second driving mechanism of the suturing device according to one or more embodiments (the rocker is in the first state).

Figure 6 is a schematic diagram of the second driving mechanism of the suturing device according to one or more embodiments (the rocker is in a second state).

Figure 7 is a schematic diagram of a third driving structure of the suturing device according to one or more embodiments from an angle.

Figure 8 is a top view of a puncture needle position of a suturing device according to one or more embodiments.

Figure 9 is a schematic diagram of the third driving structure of the suturing device according to one or more embodiments from another angle.

Figure 10 is a schematic view of the outside of a bobbin of a suturing device according to one or more embodiments.

Figure 11 is a schematic view of the inside of a bobbin of a suturing device according to one or more embodiments.

Figure 12 is a cross-sectional view of a puncture needle of a suturing device according to one or more embodiments.

Figure 13 is a schematic diagram of step 2 when performing meniscus suturing surgery using a suturing device according to one or more embodiments.

Figure 14 is a schematic diagram of step 3 when performing meniscus suturing surgery using a suturing device according to one or more embodiments.

Figure 15 is a schematic diagram of step 5 when performing meniscus suturing surgery using a suturing device according to one or more embodiments.

Figure 16 is a schematic diagram of step 6 when performing meniscus suturing surgery using a suturing device according to one or more embodiments.

Figure 17 is a schematic diagram of the internal structure of a suturing device according to one or more embodiments.

Figure 18 is a flowchart of a suturing method according to one or more embodiments.

Icon: 100, suturing device; 101, button; 102, rocker; 102A, baffle; 103, spring; 104, push Needle; 105, locking structure; 01, control part; 011, side wall; A, distal end; B, proximal end; 02, left gun body; 201, winding column; 03, suture; 04, ratchet mechanism; 05. Tissue tear; 06. Wire knot; 800. Locking structure; 801. Push button; 802. Second sawtooth structure; 803A. Second outer tube; 803. Trimming tube; 8030. First shearing structure ; 8031, blade; 8031A, first blade; 8031a, first blade; 8031B, second blade; 8031b, second blade; 804A, first outer tube; 804, push-knot tube; 8040, second Shear structure; 8041, second hole; 80411, first hole wall; 80412, second hole wall; 8042, push-knot end; 805, first sawtooth structure; 806, inclined rod; 601, implant; 603, First implant; 602, second implant; 604, puncture needle; 6040, hollow hole; 6041, first hole; 701, second driving mechanism; 702, third driving structure; 900, first driving mechanism ; 901A, first sliding part; 901, chute; 902, trigger; 902A, second sliding part; 903A, depth limit structure; 9030, depth limit part; 903, ladder structure; 903B, step surface; 10, right gun Body; 106A, impact structure; 106, small bump; 105A, sound-emitting structure; 105, metal shrapnel.

Detailed ways

The technical solution of the present application will be clearly and completely described below with reference to the embodiments. Obviously, the described embodiments are part of the embodiments of the present application, rather than all of them. Based on the embodiments in this application, all other embodiments obtained by those of ordinary skill in the art without creative efforts fall within the scope of protection of this application.

The purpose of this application is to provide a suturing device 100 and a suturing method, so as to alleviate the need for two different tools to perform the suturing and knot-pushing and thread-cutting steps during the suturing operation in related technologies, thereby increasing the number of surgical instruments entering and exiting the knee joint cavity. The frequency results in technical problems that result in long surgery times and an increased risk of tissue damage or infection.

As shown in Figures 1 to 18, the suturing device 100 provided by the embodiment of the present application can be used to suture cracks in tissues such as the meniscus. In this embodiment, the structure and function of the suturing device 100 are explained by taking suturing the meniscus as an example. To explain, this device is not only suitable for suturing meniscal cracks.

As shown in Figures 1, 2, 8 and 15, the suturing device 100 includes: a control part 01, a first outer tube 804A provided at the distal end A of the control part 01, A and a puncture needle 604 at least partially disposed in the first outer tube 804A, the puncture needle 604 is movable relative to the proximal end B of the manipulation part 01; and at least two puncture needles 604 are disposed distally An implant at end A, the implants are connected by sutures 03 to form a knot 06; wherein, when the puncture needle 604 moves relative to the proximal end B of the manipulation part 01, the first outer The tube 804A can push the knot 06 toward the distal end A of the manipulation portion 01 to tighten.

It should be noted that, with reference to Figure 1, in this application, it should be noted that the “proximal end” and “proximal side” are used herein to refer to the end or side closer to the operator during the suturing process. And it is the opposite position or direction to the terms "distal end" and "distal side";"distalend" and "distal side" refer to the end or side farther away from the operator during the suturing process, and are the same as the terms "distal end" and "distal side". "Proximal", the opposite position or direction of "near side".

Wherein, the first outer tube 804A may be a push-knot tube. Specifically, the control part 01 is connected to a push-knot tube 804, the push-knot tube 804 has a puncture needle 604 inside, the puncture needle 604 has a push needle 104, and the outside of the push-knot tube 804 has a second Outer tube 803A. The control part 01 may be in the shape of a pistol, which is convenient for the user to hold. The control part 01 may include a left gun body 02 and a right gun body 10 that are connected to each other. The push-knot tube 804 is fixedly connected to the control part 01, and there is no relative movement between the two.

In some embodiments, the push needle 104, the puncture needle 604, the first outer tube 804A and the second outer tube 803A may be coaxially arranged. In other embodiments, the push needle 104, the puncture needle 604, the first outer tube 804A and the second outer tube 803A may be arranged non-coaxially. When the push needle 104, the puncture needle 604, the first outer tube 804A and the second outer tube 803A can be arranged non-coaxially, the axes of the push needle 104, the puncture needle 604, the first outer tube 804A and the second outer tube 803A are parallel to each other. . In some embodiments, the pushing needle 104, the puncture needle 604, the pushing tube 804 and the thread trimming tube 803 can be arranged coaxially or non-coaxially.

The side wall of the puncture needle 604 has a first hole 6041 connected with the hollow hole 6040 of the puncture needle 604. The side wall of the push-knot tube 804 has a second hole 8041. The first hole 6041 and The orientations of the second holes 8041 along the circumferential directions of the puncture needle 604 and the push-knot tube 804 respectively can be the same. The suturing device 100 includes at least two implants 601. In this embodiment, the number of implants 601 is two. One implant 601 can be located in the hollow hole 6040 of the puncture needle 604, and the other implant 601 can be located in the hollow hole 6040 of the puncture needle 604. The implant 601 can be stuck in the first hole 6041; or, both implants 601 are located in the hollow hole 6040, and they are arranged front to back along the axis. The two implants 601 are connected by suture 03 . Two adjacent implants 601 are connected by sutures. After the suture 03 is connected to the two implants 601, the outer end of the suture 03 passes through the first hole 6041 and the second hole 8041 and is located outside the puncture needle.

The control part 01 may be provided with a first driving mechanism 900. The first driving mechanism 900 is connected to the puncture needle 604 and is used to drive the puncture needle 604 to move in the axial direction. The user can also directly apply external force to the puncture needle 604. Acts on the puncture needle 604 to drive the puncture needle 604 to move in the axial direction without relying on the first driving mechanism 900; the control part 01 can be provided with a second driving mechanism 701, and the second driving mechanism 701 and The push pin 104 is connected to drive the push pin 104 to move in the axial direction, so that the push pin 104 pushes the implant 601 out of the puncture needle 604. Similarly, the user can also apply The external force acts on the push pin 104 to drive the push pin 104 to move in the axial direction without relying on the second driving mechanism 701 .

In some embodiments, second outer tube 803A is made of rigid material. The second outer tube 803A is provided with a first shearing structure 8030, and the first outer tube 804A is provided with a second shearing structure 8040. Along the axial direction of the first outer tube 804A, the first shearing structure 8030 is provided. The structure 8030, the suture and the second shearing structure 8040 are arranged in sequence. The first shearing structure 8030 and/or the second shearing structure 8040 have a blade 8031. The second outer tube can be positioned relative to the first shearing structure 8030. The outer tube 804A moves in the axial direction, and after the first shearing structure 8030 and the second shearing structure 8040 are in contact, the blade 8031 is used to cut The suture is cut.

Specifically, the second outer tube 803A may be a wire trimming tube 803. The thread trimming tube 803 is provided with a first shearing structure 8030, and the push-knot tube 804 is provided with a second shearing structure 8040. Along the axial direction of the push-knot tube 804, the first shearing structure 8030, The suture 03 passing through the second hole 8041 and the second shearing structure 8040 are arranged in sequence, and the first shearing structure 8030 and/or the second shearing structure 8040 have a blade 8031. The control part 01 may be provided with a third driving structure 702. The third driving structure 702 is connected to the thread trimming tube 803 and is used to drive the thread trimming tube 803 to move in the axial direction to make the first trimming tube 803 move in the axial direction. After the cutting structure 8030 and/or the second shearing structure 8040 contacts the suture 03, the blade 8031 is used to cut the suture 03. Similarly, the user can also apply external force on the thread cutting tube 803 to drive the suture 03. The trimmer tube 803 moves in the axial direction without relying on the third driving structure 702 .

According to the diameter from small to large, they are: push needle 104, puncture needle 604, push knot tube 804 and thread trimming tube 803. Among them, the push pin 104 can be solid, and the rest can be hollow. The push pin 104 is used to excite the implant 601, so the push pin 104 needs to move and is a moving part. The puncture needle 604 can adjust the extension length relative to the push-knot tube 804, so it also needs to move and is a moving part. When entering the thread-cutting stage, the thread-cutting tube 803 needs to be moved forward to cut the suture 03, so the thread-cutting tube 803 is also a moving part. Only the push-knot tube 804 is a fixed component. The push-knot tube 804 is fixed between the left gun body 02 and the right gun body 10 and does not cause relative movement. And a second hole 8041 is provided in the middle and upper part of the push-knot tube 804 for passing the suture 03 .

The specific steps are as follows:

Step 1. Insert the puncture needle 604 into the crack side of the meniscus until the first implant 603 in the hollow hole 6040 of the puncture needle 604 emerges from the posterior wall of the meniscus, as shown in Figure 13;

Step 2: The second driving mechanism can be used to drive the push pin 104 to move outward, thereby pushing the first implant 603 from the puncture needle 604 to the posterior wall of the meniscus. For the solution in which one implant is located in the hollow hole 6040 of the puncture needle 604 and the other implant is stuck in the first hole 6041, the push pin directly contacts the first implant and pushes it For the solution in which the two implants are arranged in the hollow hole 6040 in sequence along the axial direction, the push pin contacts the second implant, and the first implant is pushed out through the second implant.

Step 3. For the solution in which one implant is located in the hollow hole 6040 of the puncture needle 604 and the other implant is stuck in the first hole 6041, pull out the puncture needle 604 from the first puncture position, and Then move the push needle 104 and allow the second implant 602 to enter the hollow hole 6040 of the puncture needle 604 from the first hole. The puncture needle 604 will puncture the other side of the meniscus crack and be driven by the second driving mechanism. The pushing needle 104 moves outward, thereby pushing the second implant 602 from the puncture needle 604 to the posterior wall of the meniscus, as shown in FIG. 14 .

For the solution in which the two implants are arranged in the hollow hole 6040 sequentially along the axial direction, the puncture needle 604 is pulled out from the first puncture position, punctures the other side of the meniscus crack, and is driven and pushed through the second driving mechanism. The needle 104 continues to move outward, thereby pushing the second implant 602 from the puncture needle 604 to the posterior meniscus wall.

Step 4: The first driving mechanism can be used to drive the puncture needle 604 to retract into the push-knot tube 804 until the front end of the puncture needle 604 does not exceed the push-knot tube 804;

Step 5. Use the push-knot end 8042 of the push-knot tube 804 to press the knot 06 on the back side of the second implant 602, and tighten the end of the suture 03 outside the body to close the meniscus tear, as shown in the figure Shown in 15;

Step 6: While pulling out the end of the suture 03 outside the body, the thread trimming tube 803 can be driven to move in the axial direction through the third driving structure 702, and the first shearing structure 8030 and the second shearing structure 8040 are used to remove the suture from the second shearing structure 8030. Cut the suture 03 through hole 8041, as shown in Figure 16;

Step 7: Finally, take out the suturing device 100 to complete the meniscus suturing.

The suturing device 100 can be used to perform operations such as suturing meniscus cracks, pushing knots, and cutting threads. During the operation, there is no need to change tools, which reduces the operation time and avoids meniscus damage caused by multiple surgical instruments repeatedly entering and exiting the human body. Injury or infection.

There is a blade 8031 on the wire cutting tube. The blade 8031 includes a first blade 8031A and a second blade 8031B. The first blade 8031A and the second blade 8031B are facing toward each other and separated from the second blade. The cutting structure 8040 faces the direction of the first cutting structure 8030, and the distance between the first blade portion 8031A and the second blade portion 8031B gradually decreases until the distance between them is less than the thickness of the suture 03.

As long as one of the first shearing structure 8030 and the second shearing structure 8040 has a blade 8031, when the two are in contact, the blade 8031 can cut the suture 03. In this embodiment, the thread cutting tube has a blade 8031. The first blade 8031A and the second blade 8031B forming the blade 8031 can be in a "V" shape, and the opening of the blade 8031 faces the suture 03. When the cutting tube moves toward the suture 03, the blade 8031 can drive the suture 03 to move toward the direction of the second shearing structure 8040, and during the movement, guide the suture 03 to the first blade 8031A and The intersection position of the second blade portion 8031B. When the suture 03 is pushed into contact with the second shearing structure 8040, the second shearing structure 8040 blocks the suture 03 from continuing to move, so the blade 8031 can cut the suture 03.

The first blade portion 8031A includes a first blade surface 8031a facing away from the push-knot tube 804 in a direction from the first shearing structure 8030 toward the second shearing structure 8040. The first blade surface 8031a is in contact with the push-knot tube 804. The distance between the outer walls of the tubes 804 gradually decreases; the second blade 8031B includes a second blade surface 8031b pushing away from the tube 804, in the direction from the first shearing structure 8030 toward the second shearing structure 8040 , the distance between the second blade surface 8031b and the outer wall of the push-knot tube 804 gradually decreases. Along the axial direction of the push-knot tube 804 , the second hole 8041 includes a first hole wall 80411 and a second hole wall 80412 that are spaced apart and facing oppositely, and the first hole wall 80411 is close to the push-knot tube 804 The push-knot end 8042, the second hole wall 80412 is away from the push-knot end 8042 of the push-knot tube 804, and the first hole wall 80411 can form a second shearing structure 8040.

The cutting edges of the first blade 8031A and the second blade 8031B are close to the outer wall of the push-knot tube 804. When the thread-cutting tube faces the seam, During the movement of thread 03, the blade 8031 can drive the suture 03 to move in the direction of the first hole wall 80411, and during the movement, the blade 8031 guides the suture 03 to the first blade 8031A and the second blade 8031B. intersection location. The suture 03 moves toward the first hole wall 80411 driven by the thread trimming tube, and when it contacts the first hole wall 80411, the first hole wall 80411 prevents the suture 03 from continuing to move, and the first blade 8031A and the second The blade 8031B cuts the suture 03.

As shown in Figures 3 and 4, the first driving mechanism 900 includes a trigger 902 connected to the puncture needle 604. The user can pull the trigger 902 to drive the puncture needle 604 to move forward and backward in the axial direction. , so that the puncture needle 604 extends from the push-knot tube 804 or retracts into the push-knot tube 804. When the suturing device 100 leaves the factory, the puncture needle 604 is in a state with its tip extending outside the push-knot tube 804. The puncture needle 604 can puncture the meniscus, and the puncture needle 604 is retracted to the push-knot tube 804, and the puncture needle 604 is pushed back to the push-knot tube 804. Tube 804 can be held against wire knot 06 to perform a crack closing operation.

The first driving mechanism 900 also includes a depth-limiting structure 903A. The depth-limiting structure 903A has at least two gears. A limited-depth portion 9030 is provided corresponding to the gears. The depth-limiting portion 9030 is used to block the puncture needle 604 from being manipulated toward the Part 01 moves, and the length of the puncture needle 604 extending out of the push-knot tube 804 corresponds to the gear it is in.

Before puncture, the thickness and crack width of the meniscus can be measured using a trench or other instrument, and the length of the puncture needle 604 extended from the push-out tube 804 can be adjusted according to the meniscus thickness and crack width, so that the implant can enter the meniscus. The implant can be activated smoothly when the posterior wall is plated. The depth limiter 9030 corresponding to each gear on the depth limiter structure 903A can block the puncture needle 604. When the puncture needle 604 is adjusted to a certain gear, the depth limiter 9030 corresponding to the gear will block the puncture needle 604. Retreat so that the puncture needle 604 can pass through the meniscus smoothly.

Specifically, the first driving mechanism 900 includes a first sliding part 901A connected to the puncture needle 604, and the trigger 902 is provided with a second sliding part 902A connected to the first sliding part 901A. The first sliding part 901A and the second sliding part 902A are slidingly connected, and the sliding direction of the trigger 902 is perpendicular to the axial direction of the puncture needle 604; the depth limiting structure 903A includes a step provided on the operating part 01 Structure 903. The ladder structure 903 includes at least two step surfaces 903B arranged sequentially along the sliding direction of the trigger 902. The step surfaces 903B face the direction of the push-knot end 8042 of the push-knot tube 804, and two adjacent steps 903B. A step surface 903B has a different axial distance from the push-knot end 8042 of the push-knot tube 804. The step surface 903B is used to block the trigger 902 from moving away from the push-knot tube 804 along the axial direction of the puncture needle 604. Push the directional movement of the knot end 8042.

As shown in Figure 3, the first sliding part 901A may include a chute 901, which may extend in the left-right direction, with an opening of the chute 901 downward, and the second sliding part 902A may include a protrusion slidably connected in the chute 901. structure, the cross section of the protruding structure can be "T" shaped, so that the trigger 902 can move in the left and right direction relative to the chute 901. That is to say, the trigger 902 can move relative to the chute 901 in the left and right direction. movement, while the two are relatively fixed in the front-to-back direction. There is a notch on the control part 01 that allows the trigger 902 to move forward, backward, left and right. There is a ladder structure 903 on the rear side of the notch. Along the left and right direction, the ladder structure 903 has a plurality of step surfaces 903B. The trigger slides along the left and right direction. By using the trigger 902, the trigger 902 can be pressed against different step surfaces 903B, thereby adjusting the extension length of the puncture needle 604.

As shown in Figure 4, there is a guide groove below the push-knot tube 804. The slide groove 901 and the puncture needle 604 are connected through a connecting column. The connecting column can slide back and forth in the guide groove, and the guide groove plays a guiding role so that the sliding The groove 901, the connecting post and the puncture needle 604 can only move along the length direction of the push-knot tube 804.

When the puncture needle 604 punctures the meniscus, it will encounter a certain resistance, thus causing the puncture needle 604 to move backward. The puncture needle 604 is connected to the chute 901 through the connecting column, so the resistance encountered by the puncture needle 604 directly acts on the chute 901. The trigger 902 in the chute 901 is against the step surface 903B, which ensures that the puncture needle 604 will not move backward due to resistance.

When the puncture needle 604 is adjusted to a suitable length, the puncture needle 604 begins to puncture the meniscus, and the extended part of the puncture needle 604 can pass through the meniscus until the end of the push-knot tube 804 contacts the meniscus surface and the puncture stops. Therefore, the push knot tube 804 has two functions: the first function is to push the knot 06 and tighten the suture 03; the second function is to limit the depth.

As shown in Figures 5 and 6, the second driving mechanism 701 includes a button 101 connected to the tail end of the push pin 104, and a spring 103 is provided between the button 101 and the operating part 01. The spring 103 is used to make the push pin 104 tend to move in a direction away from the push knot end 8042 of the push knot tube 804 .

The button 101 can be located at the tail of the operating part 01. Pressing the button 101 forward can cause the push pin 104 to push out the implant. The spring 103 plays a restoring role. After the user releases the button 101, the spring 103 can drive the button 101 and the push pin 104 to move backward, so that the second implant 602 enters the puncture needle 604. It should be noted that, as shown in Figure 12, the two implants are arranged sequentially in the radial direction. Initially, the first implant 603 is located at the axial position of the puncture needle 604, while the second implant 602 is arranged in the radial direction. Outside the axis of the puncture needle 604, keep out of the way of the push needle 104. Only when the first implant 603 in the puncture needle 604 is fired and the push needle 104 retreats can the second implant 602 enter the puncture needle 604. .

In order to avoid false triggering, the operating part 01 is provided with a locking structure 105. The locking structure 105 is used to lock the push pin 104 in the initial position to prevent the push pin 104 from moving in the axial direction. In the initial state , the pushing needle 104 has not been pushed to the extreme position, that is, the first implant 603 is still inside the puncture needle 604 at this time. The locking structure 105 can lock the button 101 inside the control part 01. At this time, the spring 103 is in a compressed state. The rear wall of the control part 01 has a pressing hole. The pressing hole is aligned with the button 101. After the locking structure 105 is removed, the spring 103 Driven by the button 101, the button 101 moves backward, thereby pressing against the rear wall, and the pressing hole is directly opposite to the button 101, making it convenient for the user to push the button 101.

The locking structure 105 includes a rocker 102. One end of the rocker 102 is rotatably connected to the control part 01, and the other end has a baffle 102A. The baffle 102A can rotate to the side of the button 101 to block all the buttons. The button 101 moves in the axial direction.

One end of the rocker 102 is rotatably connected to the control part 01, and the other end hooks the end surface of the button 101 to rotate the rocker upward. 102 can separate the baffle 102A from the button 101. Furthermore, the state when the baffle 102A of the rocker 102 blocks the button 101 is the first state. When the baffle 102A is completely separated from the button 101, The state is the second state; a ratchet mechanism 04 is connected between the rocker plate 102 and the control part 01. The ratchet mechanism 04 is used to make the rocker plate 102 only rotate in one direction, that is, it can only rotate from the first state to the second state. One-way movement to the second state, thereby preventing the rocker 102 from falling and affecting the user's manipulation of the button 101 during surgery.

Among the button 101 and the control part 01, one has an impact structure 106A, and the other has a sound-emitting structure 105A. When the push pin 104 moves to the maximum displacement position, the impact structure 106A and The sound-emitting structure 105A collides, and the sound-emitting structure 105A can emit a prompt sound.

In this embodiment, the impact structure 106A is a small protrusion 106, and the generating structure can be a metal shrapnel 105. After the button 101 is pressed to the bottom, the small protrusion 106 hits the metal shrapnel 105 to emit a prompt sound, which prompts medical personnel to implant when activated. The object has been successfully activated.

As shown in Figures 7, 8 and 9, the third driving structure 702 includes a push button 801, which is connected to the wire trimming tube 803; the operating part 01 includes a side wall 011, and the The push button 801 is slidingly connected to the side wall 011, and there is a locking structure 800 between the side wall 011 and the push button 801. After the locking structure 800 is locked, the push button 801 and the push button 801 are Side wall 011 is relatively stationary.

The push button 801 can be located on the side of the operating part 01. When the locking structure 800 is unlocked, the push button 801 can be pushed forward and backward, thereby driving the thread trimming tube 803 to move forward and backward. After the locking structure 800 is locked, the thread trimming tube 803 is fixed relative to the operating part 01 to avoid misoperation.

The locking structure 800 includes a first sawtooth structure 805 which is connected to the push button 801 with a gap between them; the locking structure 800 also includes a first sawtooth structure 805 located on the operating part 01 The second sawtooth structure 802 on the side wall 011, the second sawtooth structure 802 is located in the gap, and the first sawtooth structure 805 and the second sawtooth structure 802 are facing opposite; the first sawtooth structure 805 is connected to the trimming tube 803 by an inclined rod 806; the first sawtooth structure 805 can be separated from the second sawtooth structure 802 when the push button 801 moves toward the side wall 011, so as to The push button 801 is allowed to move in the axial direction.

The first sawtooth structure 805 is located inside the control part 01. The first sawtooth structure 805 and the push button 801 are relatively fixed. The first sawtooth structure 805 and the push button 801 are respectively located on the inner and outer sides of the side wall 011 of the control part 01. In the natural state When the first sawtooth structure 805 and the second sawtooth structure 802 press together, the push button 801 cannot move forward and backward, and the user can press the push button 801 inward, so that the push button 801 and the first sawtooth structure 805 move along the By moving toward the inside of the control part 01 in the left and right direction, the first sawtooth structure 805 and the second sawtooth structure 802 can be separated, and the push button 801 can slide in the front and rear direction. The number of the push button 801 , the first sawtooth structure 805 and the second sawtooth structure 802 can each be two, which are located on the left and right sides of the control part 01 respectively. When in use, press the push buttons 801 on both sides with your hands, so that the push buttons 801 move toward The inner movement of the operating part 01 causes the first sawtooth structure 805 connected to the push button 801 to disengage from the second sawtooth structure 802 on the side wall 011 . At this time, push the push button 801 forward to drive the thread trimming tube 803 to move forward along the push knot tube 804. Since the suture 03 passes through the second hole 8041 above the push-knot tube 804, the blade 8031 can be used to cut the suture 03 when the suture cutting tube 803 is moved forward, thereby achieving the effect of cutting the suture directly in the joint cavity and reducing the need for intraoperative medical treatment. Instrument replacement frequency reduces operation time.

As shown in Figures 10 and 11, a winding post 201 can be provided on the control part 01. After the end of the suture 03 located outside the body passes through the second hole 8041, it is wound around the winding post 201 to facilitate the user to tighten it. Suture 03. In the thread-cutting stage, one end of the suture 03 located outside the body needs to be pulled with the left hand and the thread-cutting tube 803 is pushed at the same time to cut the suture 03. The winding post 201 is assembled on the left side wall 011 of the control part 01 and is used to coil the suture 03. The end of the suture 03 located outside the body needs to be long enough to facilitate grasping.

There is a knot 06 on the suture 03 on the posterior side of the second implant 602, and the knot 06 is a slip knot. When both implants are attached to the posterior wall of the meniscus, pull the end of the suture 03 located outside the body, and use the push knot tube 804 to push the sliding knot close to the meniscus to tighten the suture. 03 effect, closing the meniscal cracks. Among them, the knotting process of the sliding knot is a related technology and will not be described again here.

As shown in Figure 18, the suturing method provided by the embodiment of the present application uses the above-mentioned suturing device 100 to perform suturing, including the steps:

Step 1. Use the puncture needle 604 to pierce one side of the slit of the tissue until the first implant 603 in the hollow hole 6040 of the puncture needle 604 emerges from the rear wall of the tissue, as shown in Figure 13 .

Step 2. Use the pushing needle 104 to push the first implant 603 from the puncture needle 604 to the rear wall of the tissue. The pushing needle 104 can be driven to move outward through the second driving mechanism, thereby pushing the first implant 603 out of the puncture needle 604 to the rear wall of the tissue. For the solution in which one implant is located in the hollow hole 6040 of the puncture needle 604 and the other implant is stuck in the first hole 6041, the push pin directly contacts the first implant and pushes it For the solution in which the two implants are arranged in the hollow hole 6040 in sequence along the axial direction, the push pin contacts the second implant, and the first implant is pushed out through the second implant.

Step 3. For the solution in which one implant is located in the hollow hole 6040 of the puncture needle 604 and the other implant is stuck in the first hole 6041, pull out the puncture needle 604 from the first puncture position, and The push needle 104 is then moved, and the second implant 602 enters the hollow hole 6040 of the puncture needle 604 from the first hole. The puncture needle 604 punctures the other side of the tissue slit, and drives the push needle through the second driving mechanism. 104 moves outward, thereby pushing the second implant 602 out of the puncture needle 604 to the rear wall of the tissue, as shown in FIG. 14 .

For the solution in which the two implants are arranged in the hollow hole 6040 in sequence along the axial direction, the puncture needle 604 is pulled out from the first puncture position, and the puncture needle 604 punctures the other side of the crack in the tissue and passes through the second driving mechanism. The pushing needle 104 is driven to continue to move outward, thereby pushing the second implant 602 out of the puncture needle 604 to the rear wall of the tissue.

Step 4. Retract the puncture needle 604 into the push-knot tube 804 until the front end of the puncture needle 604 does not exceed the push-knot tube 804. The first driving mechanism can be used to drive the puncture needle 604 to retract into the push-knot tube 804 until the front end of the puncture needle 604 does not exceed the push-knot tube 804 .

Step 5. Use the push-knot end 8042 of the push-knot tube 804 to press the knot 06 on the back side of the second implant, and tighten the end of the suture 03 outside the body to close the tissue tear 05 . Use the push knot tube 804 to press the knot 06 on the back side of the second implant 602, and tighten the end of the suture 03 outside the body to close the tissue tear 05, as shown in Figure 15.

Step 6. While pulling out the end of the suture 03 outside the body, move the thread trimming tube 803 in the axial direction, and use the thread trimming tube 803 and the push-knot tube 804 to cut the suture 03 passing through the second hole 8041. While pulling out the end of the suture 03 located outside the body, the third driving structure 702 can be used to drive the thread trimming tube 803 to move in the axial direction, and the blade 8031 and push tube 804 of the thread trimming tube 803 will be used to pass through the second hole 8041 Cut suture 03, as shown in Figure 16.

In some embodiments, the suturing method may further include: step 7: finally taking out the suturing device 100 to complete the suturing of the tissue.

Finally, it should be noted that the above embodiments are only used to illustrate the technical solution of the present application, but not to limit it; although the present application has been described in detail with reference to the foregoing embodiments, those of ordinary skill in the art should understand that: The technical solutions described in the foregoing embodiments can still be modified, or some or all of the technical features can be equivalently replaced; and these modifications or substitutions do not deviate from the essence of the corresponding technical solutions from the technical solutions of the embodiments of the present application. scope.

Claims (15)

1. A suturing device, characterized in that it includes:

   control department;

   a first outer tube provided at the distal end of the operating portion;

   a puncture needle disposed at the distal end of the operating part and at least partially disposed within the first outer tube, the puncture needle being movable relative to the proximal end of the operating part; and

   At least two implants are provided at the distal end of the puncture needle, and the implants are connected by sutures to form a knot; wherein, when the puncture needle moves relative to the proximal end of the manipulation part, the The first outer tube can push the wire knot toward the distal end of the operating portion to tighten.
2. The suturing device according to claim 1, further comprising:

   There is a push needle inside the puncture needle;

   The side wall of the puncture needle has a first hole connected to the hollow hole of the puncture needle, and the side wall of the first outer tube has a second hole;

   The implant is positioned on the puncture needle, and the suture passes through the first hole and the second hole;

   The puncture needle is axially movable relative to the first outer tube, and the puncture needle is retractable into the first outer tube;

   The push needle can move axially relative to the puncture needle to push the implant located on the puncture needle out of the puncture needle;

   A second outer tube is provided outside the first outer tube, and the push needle, the puncture needle, the first outer tube and the second outer tube are coaxially arranged;

   The second outer tube has a first shearing structure, the first outer tube has a second shearing structure, and along the axial direction of the first outer tube, the first shearing structure, sutures and Second shearing structures are arranged in sequence. The first shearing structure and/or the second shearing structure have blades. The second outer tube can move axially relative to the first outer tube and make the second shearing structure move axially relative to the first outer tube. After the first shearing structure contacts the second shearing structure, the suture is cut off by the blade.
3. The suturing device according to claim 2, wherein the first outer tube is a push-knot tube, the second outer tube is a thread-cutting tube, and the thread-cutting tube has a blade, and the blade includes a first blade. and a second blade portion, the first blade portion and the second blade portion facing opposite and in the direction from the second shearing structure toward the first shearing structure, the first blade portion and the second blade portion The distance between them gradually decreases until the distance between them is less than the thickness of the suture.
4. The suturing device according to claim 3, wherein the first blade includes a first blade surface facing away from the push-knot tube, in a direction from the first shearing structure toward the second shearing structure, the The distance between the edge surface and the outer wall of the push-knot tube is gradually decrease;

   The second blade portion includes a second blade surface facing away from the push-knot tube. In the direction from the first shearing structure toward the second shearing structure, the distance between the second blade surface and the outer wall of the push-knot tube is slowing shrieking;

   Along the axial direction of the push-knot tube, the second hole includes a first hole wall and a second hole wall that are spaced apart and facing opposite, and the first hole wall is close to the push-knot end of the push-knot tube, so The second hole wall is away from the push-knot end of the push-knot tube, and the first hole wall forms a second shearing structure.
5. The suturing device according to claim 2, wherein the operating part is provided with a first driving mechanism, the first driving mechanism is connected with the puncture needle and is used to drive the puncture needle to move in the axial direction.
6. The suturing device according to claim 5, wherein the first driving mechanism includes a trigger connected to the puncture needle, and the trigger is used to drive the puncture needle to move in an axial direction.
7. The suturing device according to claim 6, wherein the first driving mechanism includes a first sliding part connected to the puncture needle, and the trigger is provided with a second sliding part connected to the first sliding part. , the first sliding part and the second sliding part are slidingly connected, and the sliding direction of the trigger is perpendicular to the axial direction of the puncture needle.
8. The suturing device according to claim 3, wherein the operating part is provided with a second driving mechanism, the second driving mechanism is connected with the push pin and is used to drive the push needle to move in the axial direction;

   The second driving mechanism includes a button connected to the tail end of the push pin. A spring is provided between the button and the operating part. The spring enables the push pin to move away from the push tube. direction of movement.
9. The suturing device according to claim 8, wherein the operating part is provided with a locking structure, the locking structure is used to lock the push pin in the initial position to prevent the push pin from moving in the axial direction;

   The locking structure includes a rocker. One end of the rocker is rotatably connected to the operating part, and the other end has a baffle. The baffle can rotate to the side of the button to block the axial movement of the button.
10. The suturing device according to claim 9, wherein the state when the baffle of the rocker blocks the button is the first state, and the state when the baffle is completely separated from the button is the second state;

    A ratchet mechanism is connected between the rocker plate and the operating part, and the ratchet mechanism is used to enable the rocker plate to move in one direction from the first state to the second state.
11. The suturing device according to claim 8, wherein one of the button and the operating part has an impact structure and the other has a sound-emitting structure. When the push pin moves to the maximum displacement position, , the impact structure collides with the sound-emitting structure, and the sound-emitting structure can emit a prompt sound.
12. The suturing device according to claim 3, wherein the operating part is provided with a third driving mechanism, the third driving mechanism is connected to the thread trimming tube and is used to drive the thread trimming tube to move in the axial direction. .
13. The suturing device according to claim 12, wherein the third driving mechanism includes a push button, the push button Connected to the trimming pipe;

    The operating part includes a side wall, the push button is slidingly connected to the side wall, and there is a locking structure between the side wall and the push button. After the locking structure is locked, the push button stationary relative to the side wall.
14. The suturing device according to claim 13, wherein the locking structure includes a first sawtooth structure, the first sawtooth structure is connected to the push button, and there is a gap between the two;

    The locking structure also includes a second sawtooth structure located on the side wall, the second sawtooth structure is located in the gap, and the first sawtooth structure and the second sawtooth structure are facing oppositely; The first sawtooth structure is connected to the trimming tube through a diagonal rod;

    The first sawtooth structure can be separated from the second sawtooth structure when the push button moves toward the side wall, so that the push button can move in the axial direction.
15. A suturing method, characterized in that the suturing device according to any one of claims 1-14 is used for suturing, including the steps:

    Step 1. Use the puncture needle to penetrate one side of the tissue slit until the first implant on the puncture needle emerges from the rear wall of the tissue;

    Step 2. Use the push needle to push the first implant from the puncture needle to the rear wall of the tissue;

    Step 3. Pull out the puncture needle from the first puncture position, and use the puncture needle to puncture the other side of the tissue crack; use the push needle to push the second implant from the puncture needle to the rear wall of the tissue;

    Step 4. Retract the puncture needle into the push-knot tube until the front end of the puncture needle does not exceed the push-knot tube;

    Step 5. Use the push-knot end of the push-knot tube to press the knot on the back side of the second implant, and tighten the end of the suture outside the body to close the tissue tear;

    Step 6. While pulling out the end of the suture located outside the body, move the suture cutting tube in the axial direction, and use the thread cutting tube and the push-knot tube to cut off the suture passing through the second hole.