Curbstone anastomat, prefabricated curbstone knotting device and automatic knotting method thereofTechnical Field
The invention relates to the technical field of medical equipment, in particular to a curde knot anastomat, a prefabricated curde knot tying device and an automatic tying method thereof.
Background
In a nephropyeloureteral re-anastomosis for congenital hydronephrosis, the anastomosis of the ureter and the renal pelvis requires manual needle and line anastomosis, whether open surgery is performed after laparoscopic surgery. In the manual suturing process, each knot needs to be composed of three knots in order to prevent loosening of the suture, and is the longest time-consuming link in the operation process and also an important determining factor of the operation anesthesia time. The anesthesia time is reduced, and the influence on the brain, namely the nervous system of a patient can be reduced.
In addition, the knotting step in the surgical anastomosis process is labor-repeated, and has a high requirement on the proficiency of an operating doctor. The doctor performs the same suturing work for a long time, which is a damage to the body and spirit of the doctor, and the doctor can fully utilize the part of time to complete more important matters.
The existing proposal of knotting by needle and line is a field knotting mode, and the effect is only to help doctors to knotte on the operation field, and the operation is troublesome, and the knotting time saving degree also needs to be considered.
The utility model patent CN206275714U provides an automatic knotting device for a suture, which needs to manually wind the suture on a wire column and manufacture a knot by means of up-and-down movement of the wire column and the like when in use. However, in the actual operation process, the operation space is limited, and two ends of the wire need to be manually fixed on the device each time the wire is used, and one section of the wire needs to be wound, so that the wire is not simple and convenient to use, and the wire has small feasibility. The utility model patent CN102626331B provides a lasso knot-tying device which has simple structure and convenient operation, and can form a lasso knot in each operation, but the knot-tying device has narrow application range, is only suitable for occasions needing to tie the lasso knot, and has simple structure. At least three knots are required for each knot during surgical anastomosis, so the lasso knotter is not suitable.
Disclosure of Invention
The invention aims to provide a curde knot anastomat, a preformed curde knot tying device and an automatic tying method thereof, wherein the curde knot can be preformed, so that the rapid suture of wounds is realized, and the operation time is further greatly shortened.
The invention provides a curde anastomat, which comprises a winding post, a curde pushing device and a base, wherein the base is fixedly connected with the tail end of the winding post, the curde pushing device is sleeved on the winding post, a retaining ring is preset at the head end of the winding post, a prefabricated curde is wound on the winding post, and the prefabricated curde is positioned above the curde pushing device.
Furthermore, the size of the through hole used for being inserted into the winding post is matched with the diameter of the winding post, so that the prefabricated road junction is prevented from passing through a gap between the winding post and the knot pushing device.
Further, the winding post is made of flexible materials.
The invention also provides a prefabricated road junction knotting device which comprises a bottom plate, a wire holding clamp, a shell, a moving ring, a fixed disc, a moving clamp, a latch clamp, a hook clamp and a pulling clamp;
the bottom plate is arranged opposite to the shell, an operation groove is reserved between the bottom plate and the shell, and one surface of the shell, which is opposite to the bottom plate, is an operation surface;
the fixed disc is arranged in the shell, the moving ring and the fixed disc are concentrically arranged, and the moving ring realizes autorotation taking the circle center as the center;
The fixed end of the moving clamp is inserted into the surface of the moving ring, and the clamping end of the moving clamp extends out of the operation surface to the inside of the wire slot;
The center of the bottom plate is concentrically arranged with the circle center of the moving ring, and the distance between the wire holding clamp and the center of the bottom plate is larger than the distance between the moving clamp and the circle center of the moving ring;
the center of the bottom plate and the center of the fixed disc are respectively provided with a jack for plugging the winding column; the latch-shaped pliers are arranged on one side, facing the wire slot, of the fixed disc, the latch-shaped pliers are arranged around the jack, and a clamping mechanism is arranged on one side, facing away from the wire slot, of the fixed disc; the wire clamp is inserted into the jack, the clamping end of the wire clamp faces the wire slot, and the wire clamp stretches along the length direction;
The fixed part of the hook clamp penetrates through the slot hole to be connected with a driving mechanism, the driving mechanism is arranged on one side of the fixed disc, which is away from the wire slot, and the hook clamp is driven by the driving mechanism to realize displacement along the length direction of the slot hole, in addition, the hook clamp realizes expansion and contraction along the length direction of the hook clamp, and the clamping end of the hook clamp is arranged towards the wire slot;
Further, the latch pliers comprise a fixed block and a clamping rod, the fixed block is provided with a jogged groove in advance, the fixed block is fixed on the surface of the fixed disc, the clamping rod is jogged in the jogged groove, one end of the clamping rod is connected with the fixed block through a pin shaft, the pin shaft is connected with a servo motor, the pin shaft is driven by the servo motor to rotate in and out of the jogged groove, and the latch pliers are arranged on two opposite sides around the jack.
Furthermore, the motion clamp, the hook clamp and the pull clamp are connected with the stepping motor through the tail ends to realize the expansion and contraction along the length direction of the motion clamp, the hook clamp and the pull clamp.
Further, the outer ring of the moving ring is gear-shaped, at least three servo motors are arranged in the shell along the periphery of the moving ring, gears are arranged on driving shafts of the servo motors, the moving ring is erected among a plurality of gears, and transmission is achieved through meshing between the gears and the outer ring clamping teeth of the moving ring.
Further, the driving mechanism comprises a sleeve moving groove and a stepping motor, a groove rail of the sleeve moving groove is arranged opposite to the groove hole, and the stepping motor is arranged on the sleeve moving groove and is in driving connection with the tail end of the hook clamp.
The invention also provides an automatic knotting method of the prefabricated road-bound knot, which comprises the following steps:
step 1, inserting a wrapping post through a jack, clamping and fixing the wrapping post by a clamping mechanism positioned at the rear part of a fixing disc, and reserving a retaining ring of the wrapping post at the jack position of a bottom plate;
step 2, placing the suture line along the line groove, wherein one end of the suture line is clamped by a holding wire clamp, the other end of the suture line is clamped by a moving wire clamp, and the middle of the suture line is fixed by a hook wire clamp;
step 3, the hook clamp moves backwards to the shell, and meanwhile, the driving mechanism drives the hook clamp to move to a position closest to the circle center of the fixed disc;
step 4, the latch-shaped pliers at two sides of the slot on the fixed disc are screwed out, the suture is clamped on the winding rod, and the suture can slide between the latch-shaped pliers and the winding rod but cannot slide out of the latch-shaped pliers;
Step 5, the hook clamp is driven by a driving mechanism, displacement away from the winding post is realized along the length direction of the slotted hole, and a suture line between the hook clamp and the bolt clamp is pulled to form a triangle shape due to the width of the hook clamp;
Step 6, after the moving clamp is retracted into the moving ring for a certain distance, the moving ring drives the moving clamp to rotate anticlockwise, the moving clamp uses the rotating motion of the moving clamp to keep the suture line in a tightening state all the time, and meanwhile, the moving clamp gradually stretches out to enable the suture line to be wound on the winding column neatly;
Step 7, the latch clamp is loosened and reset to rotate back to the control mechanism, the wire clamp extends out of the shell, passes through the through hole in the middle of the triangle formed in the step 5, and is displaced to the right front of the anticlockwise rotation track of the suture clamped by the moving clamp;
Step 8, the moving ring continues to rotate anticlockwise for at least one circle, the suture thread winds the wire clamp and the winding post together, the moving clamp continues to extend outwards, and when the moving ring stops rotating, the free end of the suture thread clamped by the moving clamp is blocked right in front of the clamping end of the wire clamp;
Step 9, the clamping end of the wire clamp is opened, the wire clamp moves forwards until the suture is clamped, at the moment, the moving clamp is loosened, the free end of the suture is pulled by the wire clamp to be contracted into the shell, and the suture clamped in the step 2 is released by the wire hook clamp;
and 10, retracting the wire holding clamp into the shell to tighten the prefabricated knot on the winding post, loosening the clamping clamp, taking out the winding post, and completing knotting of the prefabricated road-bound knot on the winding post.
Further, in step 6, the moving ring drives the moving clip to rotate anticlockwise, and the moving ring stops after rotating anticlockwise by 3×360+40°;
in step 8, the movement ring continues to move counter-clockwise for 1 turn +10°, in which turn the suture winds the pull wire clip and the winding post together.
Compared with the prior art, the invention has the advantages that the curde anastomat is matched with the prefabricated curde, so that knotting operation of doctors in the surgical anastomosis process is omitted during surgery, rapid and efficient anastomosis is realized, and the surgery time is greatly reduced.
The prefabricated curettage structure has wide application range, can be applied to the suturing of renal pelvis and ureter, and can also be used for the operation of suturing by needle and line.
The operation suture speed can be further improved by a mode of connecting the single knots in series to form a plurality of knots.
The road junction anastomat is simple in structure, simple to operate, capable of being recycled, economical and high in practicability.
The prefabricated road-knot knotting device can automatically realize the knotting step of the prefabricated road-knot on the winding post through a series of operation steps, so that the winding post wound with the prefabricated road-knot can realize mass industrial production, the winding efficiency is high, and a large amount of labor cost is reduced.
Drawings
FIG. 1 is a schematic view of a single junction-knot stapler wrapped with a prefabricated knot in accordance with an embodiment of the present invention;
FIG. 2 is a schematic view of a multi-section curde anastomat wrapped with prefabricated curde knots according to an embodiment of the present invention;
FIG. 3 is a schematic view of a construction of a prefabricated road junction knotting apparatus in accordance with an embodiment of the present invention;
FIG. 4 is a schematic view showing a back structure of a prefabricated road junction knotting apparatus according to an embodiment of the present invention;
FIG. 5 is a schematic diagram of step 1 in an automatic knotting method of a prefabricated road junction in an embodiment of the present invention;
FIG. 6 is a schematic diagram of step 2 in the automatic knotting method of the prefabricated road junction in the embodiment of the present invention;
FIG. 7 is a schematic diagram of step 3 in the automatic knotting method of the prefabricated road junction in the embodiment of the present invention;
FIG. 8 is a schematic diagram of step 4 in the automatic knotting method of the prefabricated road junction in the embodiment of the present invention;
FIG. 9 is a schematic diagram of step 5 in the automatic knotting method of the prefabricated road junction in the embodiment of the present invention;
FIG. 10 is a schematic diagram of step6 in the automatic knotting method of the prefabricated road junction in the embodiment of the present invention;
FIG. 11 is a schematic diagram of step 7 in the automatic knotting method of the prefabricated road junction in the embodiment of the present invention;
FIG. 12 is a schematic diagram of step 8 of the automatic knotting method of the prefabricated road junction in the embodiment of the present invention;
Fig. 13 is a schematic diagram of step 9 in the automatic knotting method of the prefabricated road-bound knot in the embodiment of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the technical solutions of the present invention will be further described below.
As shown in FIG. 1, the invention provides a curde anastomat, which comprises a winding post 1, a knot pusher 2 and a base 3, wherein the base 3 is fixedly connected with the tail end of the winding post 1, the knot pusher 2 is sleeved on the winding post 1, a retaining ring is preset at the head end of the winding post 1, a prefabricated curde is wound on the winding post 1, and the prefabricated curde is positioned above the knot pusher 2. The size of the through hole on the knot pusher 2 for inserting the winding post 1 is matched with the diameter of the winding post 1, so that the prefabricated road junction is prevented from passing through a gap between the winding post 1 and the knot pusher 2.
In the practical application process of the curde anastomat, a doctor is connected with a suture needle at the free end of a prefabricated curde knot, after the suture needle passes through human tissues and passes through a buckle at the top of a wrapping post 1, the doctor holds a base 3 at the bottom of the wrapping post 1 with one hand and holds a knot pusher 2 with the other hand to pull out the wrapping post 1 from a through hole of the knot pusher 2, and the curde knot prefabricated on the wrapping post 1 cannot pass through a gap between the through hole of the knot pusher 2 and the wrapping post 1, so that the curde knot is separated from the wrapping post 1, and because the wrapping post 1 adopts flexible materials such as iron wires, the buckle at the top of the curde knot can correspondingly deform to be pulled out from the through hole of the wrapping post 1, and when the buckle is pulled out from the through hole, the prefabricated curde knot passes through the middle of the prefabricated line, so that the surgical anastomosis process is realized.
In addition, as shown in fig. 2, the road-knot anastomat of the invention can be made into a multi-junction structure, the multi-junction road-knot anastomat adopts an extended knot pusher 2, two through holes or a plurality of through holes can be arranged on the knot pusher 2, a winding column 1 is inserted into each through hole, and the plurality of winding columns 1 are connected in series in the knot pusher 2 to form the multi-junction road-knot anastomat. The use method of the prefabricated multijunction is similar to that of a single junction, and a doctor passes through the buckle at the top of the winding post 1 after passing the free end suture through human tissues, and then pulls out the corresponding winding post 1 from the knot pusher 2.
As shown in fig. 3, the invention further provides a prefabricated road-bound knot tying device, which comprises a bottom plate 4, a wire holding clamp 5, a shell 6, a moving ring 7, a fixed disc 8, a moving clamp 9, a latch clamp 10, a hook clamp 11 and a wire pulling clamp 12;
The bottom plate 4 is arranged opposite to the shell 6, an operation groove is reserved between the bottom plate 4 and the shell 6, and one surface of the shell 6 opposite to the bottom plate 4 is an operation surface;
The fixed disk 8 is arranged in the shell 6, the moving ring 7 and the fixed disk 8 are concentrically arranged, and the moving ring 7 realizes autorotation taking the circle center as the center;
The fixed end of the moving clamp 9 is inserted into the surface of the moving ring 7, and the clamping end of the moving clamp 9 extends out of the operation surface into the wire slot, and the moving clamp 9 stretches along the length direction;
the fixed end of the wire holding clamp 5 is fixedly connected with the bottom plate 4, and the clamping end of the wire holding clamp 5 is arranged in the wire slot, the center of the bottom plate 4 is concentrically arranged with the circle center of the moving ring 7, and the distance between the wire holding clamp 5 and the center of the bottom plate 4 is larger than the distance between the moving clamp 9 and the circle center of the moving ring 7;
the center of the bottom plate 4 and the center of the fixed disk 8 are both preset with jacks for inserting the winding post 1, one side of the fixed disk 8 facing the wire slot is provided with a latch-shaped clamp 10, the latch-shaped clamp 10 is arranged around the jacks, and one side of the fixed disk 8 facing away from the wire slot is provided with a clamping mechanism;
The fixed part of the hook clamp 11 penetrates through the slot hole to be connected with a driving mechanism, the driving mechanism is arranged at one side of the fixed disc 8, which is opposite to the wire slot, and the hook clamp 11 is driven by the driving mechanism to realize displacement along the length direction of the slot hole, in addition, the hook clamp 11 is telescopic along the length direction of the hook clamp, and the clamping end of the hook clamp 11 is arranged towards the wire slot;
In this embodiment, the latch pliers 10 comprise a fixed block and a clamping rod, wherein an embedding groove is preset on the fixed block, the fixed block is fixed on the surface of the fixed disk 8, the clamping rod is embedded in the embedding groove, one end of the clamping rod is connected with the fixed block through a pin shaft, the pin shaft is connected with a servo motor, the pin shaft is driven by the servo motor to realize the screwing-in and the unscrewing-out of the embedding groove, and the latch pliers 10 are arranged on two opposite sides around the jack.
In this embodiment, the moving clip 9, the hook clip 11 and the pull clip 12 are each extended and contracted along their own length direction by a tail end connection stepping motor (not shown).
In this embodiment, the outer ring of the moving ring 7 is gear-shaped, at least three servomotors are arranged along the outer periphery of the moving ring 7 in the housing 6, a gear is arranged on the driving shaft of each servomotor, the moving ring 7 is erected between a plurality of gears, and transmission is realized through engagement between the gears and the outer ring latch teeth of the moving ring 7 (not shown in the figure).
In this embodiment, as shown in fig. 4, the driving mechanism includes a sleeve moving slot 13, and a stepping motor, where a slot rail of the sleeve moving slot 13 is disposed opposite to a slot hole, and the stepping motor is disposed on the sleeve moving slot 13 and is in driving connection with the tail end of the hook clamp 11.
For the convenience of understanding of the person skilled in the art, the specific working steps of the prefabricated road junction knotting device are as follows:
Step1, as shown in fig. 5, inserting the winding post 1 from an inserting hole, clamping and fixing the winding post 1 by a clamping mechanism positioned at the rear part of a fixing disc 8, and reserving a retaining ring of the winding post at the inserting hole position of a bottom plate 4;
Step 2, as shown in fig. 6, placing a suture line along the wire slot, wherein one end of the suture line is clamped by the wire clamping clip 5, the other end of the suture line is clamped by the moving clip 9, and the middle of the suture line is fixed by the hook wire clamping clip 11;
Step 3, as shown in fig. 7, the hook clamp 11 is moved backwards into the shell, and at the same time, the driving mechanism drives the hook clamp 11 to move to a position closest to the center of the circle of the fixed disc 8;
step 4, as shown in fig. 8, the latch-shaped pliers 10 on two sides of the slot on the fixed disc 8 are screwed out to clamp the suture on the winding rod, and the suture can slide between the latch-shaped pliers 10 and the winding rod but cannot slide out of the latch-shaped pliers 10;
step 5, as shown in fig. 9, the hook clamp 11 is driven by a driving mechanism, displacement away from the winding post 1 is realized along the length direction of the slot, and the suture line between the hook clamp 11 and the latch clamp 10 is pulled to form a triangle shape due to the width of the hook clamp 11;
step 6, as shown in fig. 10, after the moving clamp 9 is retracted into the moving ring 7 for a certain distance, the moving ring 7 drives the moving clamp 9 to rotate anticlockwise, and the moving ring 7 rotates anticlockwise by 3 x 360 degrees+40 degrees and then stops;
Step 7, as shown in fig. 11, the latch clamp 10 is released and reset to rotate back to the control mechanism, the wire clamp 12 extends out of the shell, passes through the through hole in the middle of the triangle formed in the step 5 of the suture thread, and is displaced to the right front of the anticlockwise rotation track of the suture thread clamped by the moving clamp 9;
Step 8, as shown in fig. 12, the moving ring 7 continues to move anticlockwise for 1 circle +10°, in this circle, the suture thread winds the wire clamp 12 and the winding post 1 together, the moving clamp 9 continues to extend outwards, and when the moving ring 7 stops rotating, the free end of the suture thread clamped by the moving clamp 9 is blocked right in front of the clamping end of the wire clamp 12;
Step 9, as shown in fig. 13, the clamping end of the wire clamp 12 is opened, the wire clamp moves forwards until the suture is clamped, at the moment, the moving clamp 9 is loosened, the free end of the suture is pulled by the wire clamp 12 to be contracted into the shell, and the suture clamped in step 2 is released by the hook clamp 11;
and 10, retracting the wire holding clamp 5 into the shell to tighten the prefabricated knot on the winding post 1, loosening the clamping pliers, taking out the winding post 1, and completing knotting of the prefabricated knot on the winding post 1.
The foregoing is merely a preferred embodiment of the present invention and is not intended to limit the present invention in any way. Any person skilled in the art will make any equivalent substitution or modification to the technical solution and technical content disclosed in the invention without departing from the scope of the technical solution of the invention, and the technical solution of the invention is not departing from the scope of the invention.