Background technology
Epidermis suture is surgical common method for the treatment of, the epidermis suture of its purposes such as wound, mostly postoperativeWound sutures, in addition, now Minimally Invasive Surgery with its original wound little, healing is fast, the maximum spy such as protection nervus vasculairsPoint has obtained extensive popularization, but, doctor faces many epidermis suture difficult problems at this stage：
A) suture formed secondary insult
Sewing needle used by doctor mostly is circular arc, and mostly 210 degree about, the most accurately suture takes the needle should be that arcuation is walkedPin, but be limited to the brain of people, nerve, muscle control ability and be difficult to.
For example：Assume a length of 210 degree of pin, sewing needle is 120 degree in intraepidermal needle-like suture radian, in units of 1 degree,The direction at least needing more than 120 times changes, but most of doctor is only capable of accomplishing that the direction of three times about changes, intraepidermalIn suture action it is difficult to the appearance that avoids horizontal draw, horizontal pull, horizontal pushing away and the hypodermic secondary insult of formation table.
B) it is difficult to carry out suture under the conditions of Minimally Invasive Surgery
For example：Minimally Invasive Surgery need to cut the tumor tissues within liver removal, needs liver myometrial suture afterwards, this is controlledTreat and operate enforcement difficulty under the conditions of minimally invasive very big, Minimally Invasive Surgery is bored a hole on abdominal cavity surface generally by the passage of tubulose, narrowLong communication conduits define huge bottleneck to the medical apparatus and instruments needing suture.
C) efficiency of suture action is low
Necessity of hypothesis table intradermic suture takes the needle radian for 120 degree, and the length of pin is 210 degree, and existing sewing method isSyringe needle backshank will all in epidermis (at least 210 degree of stroke), and backshank still needs to strain the stitching thread of backshank, seam after going out epidermisZygonema is changed into nearly straight line from arcuation under epidermis, cuts off unnecessary stitching thread after the stitching thread knotting completing epidermis；Then, doctorAgain thread a needle for the second pin again.
Content of the invention
The present invention provides a kind of secondary damage and epidermis stiching instrument improving suture efficiency when can effectively reduce suture.
The present invention provides a kind of epidermis stiching instrument, and including pedestal, sewing needle and the first drive mechanism, described pedestal has positionIn the inner the circular arc needle tray in portion, the first of corresponding described needle tray one end thread a needle and the second of mouth and the corresponding described needle tray other end wearPin mouth, described sewing needle is circular arc, and described sewing needle mates and load described needle tray, described first driving machine with described needle trayStructure is installed on described pedestal, during original state, described sewing needle retraction base interior；During suture, the first of described pedestal threads a needleMouthful, the second mouth of threading a needle be pressed in the both sides of wound to be stapled, described first drive mechanism drives described sewing needle along described needle trayMobile, so that described sewing needle is penetrated epidermis, to be passed epidermis and penetrate described second and thread a needle by the described first mouth of threading a needle successivelyMouthful.
Described first thread a needle mouth and second thread a needle the arc section between mouth angle be less than described sewing needle angle.SutureThe needle point of pin is an arc section from penetrating epidermis to the motion track passing epidermis, and this arc section is equivalent to first and threads a needleMouthful and second thread a needle the arc section between mouth.
The diameter of described needle point is to be gradually increased backward from its cusp, described needle point is cased with diameter and fixes and can connectThe suture loop of stitching thread, thus when sewing needle stretches out, stitching thread is with moving together；When sewing needle is return, suture loop andStitching thread is not with movement.
The second of described pedestal is provided with knot that can be undone by a pull at threading a needle mouthful, and described knot that can be undone by a pull includes the variable clasp of diameter, described claspBy tightening up line traffic control, described line of tightening up is connected diameter with the second drive mechanism, described clasp with diameter greater than described suture loopDiameter.
Described first drive mechanism includes motor and driving member, and driving member described in described Motor drive rotates, described transmissionPart and described sewing needle frictional fit or rack-and-pinion cooperation.Driving member such as live-roller, this live-roller can be driven using frictional forceDynamic sewing needle moves in needle tray.Driving member can also be gear, and sewing needle is correspondingly provided with sawtooth, by this gear and zigzagThe rack-and-pinion cooperation becoming, to drive sewing needle to move.
Described pedestal includes circular arc housing and pressing plate, and described housing forms breach and is in major arc shape, and described pressing plate is fixedIn described breach, the middle part indent of described pressing plate, the described first mouth and second of threading a needle threads a needle mouth all located at described pressing plate, described pinGroove is located at described housing.
Described pressing plate includes the first pressing plate and the second pressing plate, and described first pressing plate and the second pressing plate constitute V-arrangement, and described theFirst, two mouths of threading a needle are respectively arranged on described first and second pressing plate.
The purpose of knot that can be undone by a pull setting is equivalent to ties a knot to stitching thread after suture terminates, and during this epidermis staplers, takes the needle, beatsKnot is carried out automatically, first calculates the wire length between suture loop and clasp during use, then option setting knot that can be undone by a pull and control are livedSecond drive mechanism of button elastic threads.
The invention has the beneficial effects as follows：Sewing needle is driven to make circular motion by the first drive mechanism, it is right to effectively reduceThe secondary insult that circular arc motion track appearance skin tissue causes, and also improve suture efficiency.
Specific embodiment
Combine accompanying drawing below by specific embodiment the present invention is described in further detail.
As shown in Figures 1 to 6, present embodiment epidermis stiching instrument includes pedestal 1, sewing needle 2 and the first drive mechanism 3.Pedestal 1 includes housing 4, pressing plate 5 and end cap 6.Housing 4 is circular arc, and it forms breach and is in major arc shape, and the inwall of housing is provided withCircular arc needle tray 41.This breach closed by pressing plate 5, and it includes the first pressing plate 51 and the second pressing plate 52, the first pressing plate connection breachSide, the opposite side of the second pressing plate connection breach, and this first pressing plate 51 and the second pressing plate 52 form V-arrangement, and the first pressing plate 51 is openedConnect with enclosure interior first is had to thread a needle mouth 53, the second pressing plate 52 is had second being connected with enclosure interior and threads a needle mouth 54, pinOne end linking first of groove 41 is threaded a needle mouth 53, and the other end linking second of needle tray 41 is threaded a needle mouth 54.The homonymy of housing and pressing plateEdge is connected by end cap 6.
Sewing needle 2 is in major arc shape, and it is mated with the needle tray 41 of housing, and this sewing needle 2 can be stuck in this needle tray 41 and energyEnough mobile along this needle tray 41, that is, the motion track of sewing needle is arc section.Sewing needle inwardly can penetrate from the first mouth of threading a needleHuman epidermal, can penetrate second after epidermis passes and thread a needle mouth.Sewing needle has needle point 21 and backshank 23, and the shape of this needle point isFrom cusp 22, diameter becomes larger backward, and this is the direction to backshank 23 backward.
The needle point of sewing needle can be cased with the fixing suture loop 7 of diameter, and this suture loop 7 is connected with stitching thread 8.This seamZygonema ring and stitching thread can be made up with suture of surgical operation, such as gutstring.
First drive mechanism 3 includes power source 31 and drive mechanism 32, power source such as motor, drive mechanism such as live-roller,This motor and pedestal are fixed, and are such as directly anchored on end cap, live-roller is fixed with motor shaft, live-roller be pressed on sewing needle and withSewing needle frictional fit.
During original state, sewing needle contracts completely in base interior, and that is, sewing needle is all stuck in needle tray, and now, needle point canTo thread a needle mouth against first, backshank can be threaded a needle mouth against second, and suture loop is enclosed within needle point.During suture, by stiching instrument pressureOn the epidermis around wound, now, pressing plate directly bears against on epidermis, and pressing plate covers wound and wound is located at the movement of sewing needleOn track；Then, start motor, live-roller utilizes frictional force to move along needle tray with sewing needle, thus threading a needle mouth from firstEnter epidermis internal layer, and finally can penetrate second and thread a needle mouth.When carrying out Minimally Invasive Surgery suture, this stiching instrument passes through micro-wound needle holderPositioning.During non-Minimally Invasive Surgery, this stiching instrument can be positioned on epidermis by doctor is hand-held.
Stiching instrument can also include knot that can be undone by a pull 9, and this knot that can be undone by a pull 9 is placed on the second pressing plate 52.Knot that can be undone by a pull includes the variable clasp of diameter91 and tighten up line 92, this clasp 91 is located at second and threads a needle at mouth, and the diameter of this clasp can be more than the diameter of suture loop.ReceiveStringing is driven by the second drive mechanism, under the driving of the second drive mechanism, tightens up line and can tighten up clasp, make the diameter of claspReduce.Clasp 91 can slightly be bonded in second and thread a needle at mouth 54, due to, during suture, not interfering with external force, typically at clasp 91Only needle point can rip this slight bonding.The bore of the mouth 54 of threading a needle with diameter greater than second of clasp 91, its can around thisTwo thread a needle mouth 54.
The work process of epidermis stiching instrument is as follows：
1) suture loop is enclosed within needle point；Knot that can be undone by a pull is located at the second of pressing plate and threads a needle at mouth；
2) start motor, live-roller utilizes frictional force drives sewing needle to move, and needle point penetrates mouth with stitching thread from firstEnter epidermis internal layer, then pass from epidermis internal layer in opposite side, and penetrate clasp and second successively and thread a needle mouth, now, claspEntangle stitching thread and needle point, and clasp is located between epidermis and suture loop；
3) the second drive mechanism starts, and pulls and tightens up line, so that the diameter of clasp is progressively reduced to prevent suture loop from returningInside epidermis, while line is tightened up in pulling, the first drive mechanism drives the former road of sewing needle progressively to return；
4), when clasp is tightened up knotting completely and completed, base interior return by sewing needle, and so far suture action completes.
For epidermis stiching instrument, it has housing, and inner walls are provided with circular arc needle tray, and circular arc sewing needle is stuck in this pinGroove is interior and can move along this needle tray.Housing can be for circular arc or other shapes it is only necessary to circular arc can be providedThe needle tray of shape.Pressing plate is fixed with housing, pressing plate is used for the epidermis being pressed in around wound in suture, in the middle part of this pressing plateCan be with indent, thus avoiding directly bearing against wound.Pressing plate can have the first mouth and second of threading a needle and thread a needle mouth, and this first is threaded a needle mouthCan be connected with one end of needle tray, this second mouth of threading a needle can be connected with the other end of needle tray.
For epidermis stiching instrument, it has the first drive mechanism for driving sewing needle.First drive mechanism can be wrappedInclude drive mechanism and power source, power source makees circular motion (the i.e. movement locus of sewing needle by drive mechanism with sewing needleIt is one section of circular arc).Power source such as motor, drive mechanism is such as fixed on the live-roller on motor shaft, and this live-roller utilizes frictional forceSewing needle is driven to move.When initial, live-roller can be pressed in the middle part of sewing needle.Motor can have multiple, the electricity of each motorLive-roller all can be fixed with arbor, each live-roller can correspond to the different parts of needle tray, the two ends of such as corresponding needle tray and inPortion.Gear can also be fixed with motor shaft, sewing needle is correspondingly provided with sawtooth, drives this suture by the engagement of gear and sawtoothPin moves.
For epidermis stiching instrument, it has the second drive mechanism tightening up line for driving knot that can be undone by a pull, the second drive mechanismDuring work, tighten up the clasp of knot that can be undone by a pull with tightening up line movement.
For epidermis stiching instrument, the needle point of sewing needle can be defined as to passing the track that epidermis passed through from penetrating epidermisSuture arc section, the angle of this suture arc section is A.The angle of circular arc needle tray is B, A+B=360 degree, and such as angle A is 120 degreeWhen, then the angle B of needle tray is 240 degree.Because sewing needle moves in needle tray, needle tray can extend to from the first mouth of threading a needleSecond threads a needle mouth, now, A+B=360 degree.Certainly, thread a needle the position of mouth or also may be used near the second position threading a needle mouth near firstTo be not provided with needle tray, now, A+B<360 degree.General, A is less than 180 degree, and A<B.
For epidermis stiching instrument, when not suturing, sewing needle retraction base interior, now, needle point does not stretch out first and wearsPin mouth, backshank can stretch out or not stretch out second threads a needle mouth.In order to avoid scratching epidermis when entering human body it is preferable that pinTail does not stretch out second and threads a needle mouth.
For epidermis stiching instrument, multiple can be assembled into one, and form an epidermis stiching instrument group, as shown in Figure 7.
Above content is to further describe it is impossible to assert this with reference to specific embodiment is made for the present inventionBright it is embodied as being confined to these explanations.For general technical staff of the technical field of the invention, do not taking offOn the premise of present inventive concept, some simple deduction or replace can also be made.