The knotting device and its knotting method of suture in a kind of heart valve surgeryTechnical field
The invention belongs to the suture of heart valve prosthesis or valve forming ring in the valve surgery of department of cardiac surgery to fix skillArt field, and in particular to the knotting device and its knotting method of suture in a kind of heart valve surgery.
Background technology
Valvulopathy is a kind of common heart disease in China, refers to the bicuspid valve, tricuspid valve, aorta petal of human heartValve with pulmonary valve is because of rheumatic fever, mucinous degeneration, degenerative change, congenital abnormality, ischemic necrosis, infection or woundEtc. there is lesion, influence the motion of blood flow, so as to cause cardiac function abnormal, ultimately result in heart failure single-lobe film orMultivalvular heart disease becomes.
The cardiac valves of lesion occurs for human body, can be controlled by cardiac valve replacement or valvular heart prosthesisTreat.Cardiac valve replacement is the method by operation, the cardiac valves of lesion in human body is cut off, using by synthetic material systemInto artificial mechanical valve prosthesis or made of biological tissue bioprosthesis valve substitutes, continue to the Ejection function of heart.The heartDirty valve reparation art, also known as cardiac valvuloplasty, i.e., the diseased valve of patient itself is subject to shaping with operation method and rescued,It is allowed to the remedy measures for being similar to normal anatomical structure and physiological function.
At present, the treatment of valvulopathy is main or valvular displacement is carried out by way of surgical operation.In Cardiac valve replacement, after the cardiac valves excision of lesion, then the artificial heart that will be matched with excision valve sizeValve, by way of suture, it is fixed on valve breach.It is sutured, fixing means is：Using crosspointer line, in excision lesionValvular valve mouth, the mattress suture being interrupted, then by crosspointer linear slit on the seam ring of artificial valve, go out pin in seam ringOutside.Then artificial valve to sympetalous mouth and is tensed into suture, knot by hand and fix.Because suture is smooth, Mei GejieNeed to make a call to 4~5 times, it is anti-loose.
According to the size of the artificial valve caliber size of selection, the pin number of suture is different, more than 15 pin, 30 the end of a thread.Because the end of a thread is a lot, and due to the location of previous anastomotic difference, while also bring manual knotting operation space sizeIt is different, it is easy to cause the end of a thread confusion to cause to remove from new suture knotting.This not only to patient cause bigger wound, pain andRisk, and increase time and the working strength of surgical.
The content of the invention
The purpose of the present invention is to be directed to above-mentioned current condition, is solved in heart valve surgery, easily causes the end of a thread confusionCause to remove from the problem of new suture knotting.
Therefore, the invention provides a kind of knotting device of suture in heart valve surgery, including suture knot withShearing mechanism and hollow nail installing mechanism, described hollow nail installing mechanism, which connects, to be drawn suture and is knotted installed in suture with cuttingKnotted and cut in breaking mechanism, knotted in the suture and shearing mechanism is provided with minisize pick-up head, minisize pick-up headIt is connected by data wire with computer.
Described suture knots uses gun type configuration design, including pistol handle, trigger and gun barrel, rifle with shearing mechanismSuture the end of a thread outlet is provided with tube end side wall, the minisize pick-up head includes being arranged near suture the end of a thread outletFirst minisize pick-up head, and the second minisize pick-up head inside gun barrel, push rod, spring clip are also equipped with inside gun barrelAnd shearing blade, push rod are connected through the hinge with trigger, shearing blade is movably arranged in gun barrel close to the position of suture the end of a thread outletPut, spring clip is located at gun barrel inner end position.
For described pistol by plastic pressing forming, gun barrel is medical stainless steel gun barrel.
Described hollow nail installing mechanism includes hollow nail, stainless steel draws hook and annular steel wire lead, described stainless steelDraw hook and annular steel wire lead and form one by linking, hollow nail is sleeved on stainless steel and draws hook bottom.
Described hollow nail is pure titanium hollow nail, and 3.0~8.0 millimeters of length, nail external diameter is 1.0~3.0 millimeters, wall thickness0.02~0.5 millimeter, 1.50~3.50 millimeters of ailhead diameter, 0.40~0.80 millimeter of ailhead height.
Described annular steel wire lead is fixed in a flexible installing ring, and the outer eaves of flexible installing ring is provided with groove, usesIn stationary ring steel wire lead.
The knotting device of suture obtains knotting method in a kind of heart valve surgery, comprises the following steps：
1) after suture of the artificial valve with human heart annulus is completed, first, all crosspointer linear slits conjunctions is put in order and are stayed inArtificial valve stitches the two-wire head on the outside of ring and tensed, and artificial valve is got togather with human heart annulus tone；
2) hollow nail installing mechanism is taken, is firmly pinched after pressing flexible installing ring to be allowed to deformation, takes out annular steel wire lead, and willThe two-wire head for needing to knot passes through annular steel wire lead；
3) hold and hook is drawn by the stainless steel of suture on annular steel wire lead band, worn via the spring clip jaws of gun barrel endEnter, passed from suture the end of a thread outlet on gun barrel head, hollow nail is stayed in spring clip, make suture in annular steel wire leadGuiding under penetrate hollow nail, and passed by suture the end of a thread outlet on gun barrel head；
4) suture for passing suture the end of a thread outlet is tensed, hollow nail ailhead is close to people under the push of gun barrel terminationOn the seam ring of work valve, pistol trigger is pulled, push rod moves forward in gun barrel, so as to apply pressure to spring clip, makes to be arranged on bulletHollow nail deformation in spring folder, locked suture must not be deviate from, meanwhile, push rod promotes shearing blade to cut unnecessary suture, completeThe operation that two-wire head knots in a pair；
5) repeat the above steps 1) to operation 4), be sequentially completed the knotting of other two-wire heads, be finally completed artificial valveWith the suture and fixation of human heart annulus；
Above-mentioned steps 1) image can be passed through by number by the first minisize pick-up head and the second minisize pick-up head to operation 4)It is sent to according to line in computer, passes through observation guiding operating process after the display amplification on computer.
Beneficial effects of the present invention：The knotting device of suture and its beaten in this heart valve surgery provided by the inventionKnot method, the suture after artificial implantation and the suture of human heart annulus can be effectively avoided to knot, in fixation procedure, due toThe end of a thread is more, knots by hand and easily causes the end of a thread confusion and cause to remove the risk for suturing, knotting again, while it also avoid because handThe art visual field limits and is difficult to situation about manually knotting and occurs, and makes heart valve surgery more simple, conveniently, safely.
Brief description of the drawings
The present invention is described in further details below with reference to accompanying drawing.
Fig. 1 is the structural representation that inventive suture knots with shearing mechanism.
Fig. 2 is gun barrel internal structure schematic diagram.
Fig. 3 is hollow nail installing mechanism structural representation.
Description of reference numerals：1st, suture knotting and shearing mechanism；11st, pistol handle；12nd, trigger；13rd, gun barrel；14th, sutureThe end of a thread outlet；131st, push rod；132nd, spring clip；133rd, shearing blade；2nd, hollow nail installing mechanism；21st, hollow nail；22nd, it is stainlessSteel draws hook；23rd, annular steel wire lead；24th, flexible installing ring；241st, groove.
Embodiment
Embodiment 1：
The present embodiment provides a kind of knotting device of suture in heart valve surgery, including suture knots and cutting machineStructure 1 and hollow nail installing mechanism 2, described hollow nail installing mechanism 2, which connects, to be drawn suture and knots and cut installed in sutureKnotted and cut in mechanism 1, knotted in the suture and shearing mechanism 1 is provided with minisize pick-up head 3, minisize pick-up head3 are connected by data wire 4 with computer.
By the device that suture knots in heart valve surgery provided by the invention, can effectively avoid in Artificial InterventionThing knots, in fixation procedure with the suture after the suture of human heart annulus, and because the end of a thread is more, knotting by hand easily causes the end of a thread and mixedDisorderly cause to remove the risk for suturing, knotting again, while it also avoid being difficult to what is manually knotted because surgical field of view limitsSituation occurs, and makes heart valve surgery more simple, conveniently, safely.Have again due to used the suture knot withMinisize pick-up head 3 is provided with shearing mechanism 1, the image that minisize pick-up head 3 can provide operation technique is sent to computer in real timeOn, because operation propagation space is very narrow and small, operation technique local space can be amplified by computer, be so both easy to graspMake, the accurate fixed of operation can be improved again, while the efficiency of operation can also be improved.
Embodiment 2：
The present embodiment is very described in further details to the hollow nail installing mechanism 2 in above-described embodiment, as shown in figure 3,Hollow nail installing mechanism 2 includes hollow nail 21, stainless steel draws hook 22 and annular steel wire lead 23, and described stainless steel draws the He of hook 22Annular steel wire lead 23 forms one by linking, and hollow nail 21 is sleeved on stainless steel and draws the bottom of hook 22.
The main function of hollow nail installing mechanism 2 in the present embodiment is to complete the draw to suture, main to utilizeAnnular steel wire lead 23 is completed, it would be desirable to which the two-wire head of knotting passes through annular steel wire lead 23, fixed suture end, Ran HoulaDynamic stainless steel draws hook 22 to drive annular steel wire lead 23 and suture to move together, is finally squeezed locked seam by hollow nail 21Zygonema must not deviate from, and formed and knotted.
The present embodiment additionally provides a specific hollow nail 21, and hollow nail 21 is pure titanium hollow nail, length 3.0~8.0Millimeter, nail external diameter are 1.0~3.0 millimeters, 0.02~0.5 millimeter of wall thickness, 1.50~3.50 millimeters of ailhead diameter, ailhead height0.40~0.80 millimeter.
Annular steel wire lead 23 is fixed in a flexible installing ring 24, and 24 outer eaves of flexible installing ring is provided with groove 241,For stationary ring steel wire lead 23.Firmly pinch pressure flexible installing ring 24 and be allowed to deform, annular steel wire lead 23 can be taken off.
Embodiment 3：
The present embodiment very knots to the suture in embodiment 1 and is described in further details with shearing mechanism 1, with reference to Fig. 1Shown in Fig. 2, described suture knots uses gun type configuration design with shearing mechanism 1, including pistol is the and of 11, trigger 12Gun barrel 13, wherein, for pistol 11 by plastic pressing forming, gun barrel 13 is medical stainless steel gun barrel, in the end sidewalls of gun barrel 13It is provided with suture the end of a thread outlet 14, what minisize pick-up head 3 included being arranged near suture the end of a thread outlet 14 first miniature takes the photographAs first 3.1, and the second minisize pick-up head 3.2 inside gun barrel 13, push rod 131, spring are installed inside gun barrel 13Folder 132 and shearing blade 133, push rod 131 are connected through the hinge with trigger 12, and shearing blade 133 is movably arranged on close in gun barrel 13The position of the end of a thread outlet 14 is sutured, spring clip 132 is located at the inner end position of gun barrel 13.
With reference to the structure of the hollow nail installing mechanism 2 in above-described embodiment 2, the opposite joint of hollow nail installing mechanism 2 is being realizedAfter the traction of zygonema, stainless steel is drawn into hook 22 and penetrated via the jaws of spring clip 132 of the end of gun barrel 13, then from the head of gun barrel 13Suture the end of a thread outlet 14 pass, hollow nail 21 is stayed in spring clip 132, suture in the case where stainless steel draws the guiding of hook 22 byAnnular steel wire lead 23 is passed by suture the end of a thread outlet 14 on the head of gun barrel 13 with penetrating hollow nail 21；Then pullPistol trigger 12, by the extrusion spring of push rod 131 folder 132 hollow nail 21 is deformed, locked suture must not be deviate from, meanwhile, push awayBar 131 promotes shearing blade 133 to cut unnecessary suture, completes a pair of operations that two-wire head knots.
Embodiment 4：
The knotting device that the present embodiment provides suture in a kind of heart valve surgery obtains knotting method, with reference to Fig. 1, Fig. 2Shown in Fig. 3, comprise the following steps：
1) after suture of the artificial valve with human heart annulus is completed, first, all crosspointer linear slits conjunctions is put in order and are stayed inArtificial valve stitches the two-wire head on the outside of ring and tensed, and artificial valve is got togather with human heart annulus tone；
2) hollow nail installing mechanism 2 is taken, is firmly pinched after pressing flexible installing ring 24 to be allowed to deformation, takes out annular steel wire lead23, and the two-wire head for needing to knot is passed through into annular steel wire lead 23；
3) the hand-held stainless steel that suture is taken by annular steel wire lead 23 draws hook 22, via the spring clip of the end of gun barrel 13132 jaws penetrate, and are passed from suture the end of a thread outlet 14 on the head of gun barrel 13, hollow nail 21 is stayed in spring clip 132, makes seamZygonema penetrates hollow nail 21 under the guiding of annular steel wire lead 23, and is worn by suture the end of a thread outlet 14 on the head of gun barrel 13Go out；
4) suture for passing suture the end of a thread outlet 14 is tensed, makes the ailhead of hollow nail 21 under the push of the termination of gun barrel 13It is close on the seam ring of artificial valve, pulls pistol trigger 12, push rod 131 moves forward in gun barrel 13, so as to apply to spring clip 132Pressure, the hollow nail 21 for making to be arranged in spring clip 132 deform, and locked suture must not be deviate from, meanwhile, push rod 131 is promoted and cutBlade 133 cuts unnecessary suture, completes a pair of operations that two-wire head knots；
5) repeat the above steps 1) to operation 4), be sequentially completed the knotting of other two-wire heads, be finally completed artificial valveWith the suture and fixation of human heart annulus；
Above-mentioned steps 1) image can be passed through by number by the first minisize pick-up head and the second minisize pick-up head to operation 4)It is sent to according to line in computer, passes through observation guiding operating process after the display amplification on computer.
In summary, during knotting operation is carried out using suture knotting device provided by the invention：First, useHollow nail installing mechanism will complete artificial implantation and suture the end of a thread of human heart annulus suture, in pairs successively to be incorporated intoIn pure titanium hollow nail and knotting and shearing mechanism, and drawn by suture the end of a thread outlet on gun barrel head.Tense dual sutureLine, pulls pistol trigger, and push rod moves forward robbing in pipe, so as to give spring clip to apply sufficiently large pressure, makes to be arranged in spring clipThe deformation of pure titanium hollow nail, locked suture must not deviate from.Meanwhile shearing blade cuts unnecessary suture, the behaviour to knot is completedMake.
It is described above be only to the present invention for example, do not form the limitation to protection scope of the present invention, it is allIt is to be belonged to the same or analogous design of the present invention within protection scope of the present invention.