技术领域Technical field
本发明涉及医疗器械技术领域，尤其涉及一种经血管的打结装置及其使用方法。The present invention relates to the technical field of medical devices, and in particular to a transvascular knotting device and a method of using the same.
背景技术Background technique
医疗领域，尤其是心脏修复手术中需要对器械使用到的线材、绳或线缆进行打结(或称作锁紧)操作。对于需要经过长距离且弯曲的血管进行术后打结操作的场景，当前缺乏相应的柔性器械。并且，现有的常规器械采用弹簧提供锁紧力，存在弹簧衰减或锁紧力不足等问题。鉴于当前器械存在的问题和医护人员的迫切需求，本领域急需一种全新的医用打结装置，尤其是需要一种用于经血管进行长距离打结的装置，以克服上述至少一个问题，从而降低手术操作难度，便于使用，提高手术成功率。In the medical field, especially in heart repair surgery, it is necessary to knot (or lock) the wires, ropes or cables used in the equipment. For scenarios that require postoperative knotting operations through long and tortuous blood vessels, there is currently a lack of corresponding flexible instruments. Moreover, existing conventional instruments use springs to provide locking force, but there are problems such as spring attenuation or insufficient locking force. In view of the problems existing in current instruments and the urgent needs of medical staff, there is an urgent need in this field for a brand new medical knotting device, especially a device for long-distance knotting through blood vessels, to overcome at least one of the above problems, thereby Reduce the difficulty of surgical operation, make it easier to use, and improve the success rate of surgery.
发明内容Contents of the invention
为克服上述问题，本发明提供一种经血管的打结装置及其使用方法。其充分利用内芯单元的内部空间以装配打结单元，不仅不增加结构尺寸，降低留置于人体内的元件的体积，而且降低手术风险和患者负担。能够使器械沿血管弯曲延伸，实现远距离、小空间的线缆打结。提高了打结器械的可靠性和安全性，并便于同步锁紧多根线缆。In order to overcome the above problems, the present invention provides a transvascular knotting device and a method of using the same. It makes full use of the internal space of the core unit to assemble the knotting unit, which not only does not increase the structural size and reduces the volume of components left in the human body, but also reduces surgical risks and patient burden. It can make the instrument bend and extend along the blood vessels to achieve long-distance and small space cable knotting. It improves the reliability and safety of knotting equipment and facilitates simultaneous locking of multiple cables.
为实现上述目的，根据本发明实施例的一个方面，提供了一种经血管的打结装置，包括：In order to achieve the above object, according to one aspect of the embodiment of the present invention, a transvascular knotting device is provided, including:
内芯单元，其内孔上部用于穿设线缆，内孔下部安装有打结单元；Inner core unit, the upper part of the inner hole is used for passing cables, and the lower part of the inner hole is equipped with a knotting unit;
打结单元，其在所述内孔内运动以控制线缆的工作状态；A knotting unit that moves within the inner hole to control the working state of the cable;
驱动单元，其用于控制打结单元运动；a driving unit used to control the movement of the knotting unit;
驱动单元具有柔性以沿着所述血管形变延伸，所述驱动单元在所述血管内轴向运动以推动所述打结单元将线缆挤压至所述内孔的内壁，实现对所述线缆的打结。The driving unit has flexibility to extend along the deformation of the blood vessel, and the driving unit moves axially within the blood vessel to push the knotting unit to squeeze the cable to the inner wall of the inner hole to achieve the purpose of tightening the cable. Cable knotting.
可选的，所述的打结单元包括压板、滑块和驱动螺杆，其中，Optionally, the knotting unit includes a pressure plate, a slide block and a driving screw, wherein,
所述压板的下部与滑块的上部之间的接触面为斜面，驱动螺杆与内芯单元螺纹连接，且驱动螺杆的前端面与滑块的后端面接触从而推动滑块使压板抬升以控制线缆的工作状态。The contact surface between the lower part of the pressure plate and the upper part of the slider is an inclined plane, the driving screw is threadedly connected to the inner core unit, and the front end surface of the driving screw contacts the rear end surface of the slider to push the slider to lift the pressure plate to control the line. The working status of the cable.
可选的，所述斜面与内芯单元的轴线之间的夹角为10°～15°。Optionally, the angle between the inclined surface and the axis of the inner core unit is 10° to 15°.
可选的，所述的滑块为半球体，驱动螺杆的前端面与半球体的后端面固定连接，或者驱动螺杆与半球体为一体化元件。Optionally, the slider is a hemisphere, and the front end surface of the driving screw is fixedly connected to the rear end surface of the hemisphere, or the driving screw and the hemisphere are integrated components.
可选的，所述压板上远离所述斜面的顶部上依次设置有连接部、凸起部和穿线部，其中，Optionally, a connecting part, a protruding part and a threading part are provided in sequence on the top of the pressure plate away from the inclined surface, wherein,
所述连接部与所述内孔的通道部连接后使内孔与压板的上表面之间形成穿线通道；After the connecting portion is connected to the channel portion of the inner hole, a threading channel is formed between the inner hole and the upper surface of the pressure plate;
所述凸起部用于挤压线缆；The raised portion is used to squeeze the cable;
所述穿线部用于引导线缆穿入所述穿线通道。The threading part is used to guide cables to penetrate into the threading channel.
可选的，在打结装置的纵剖面内，凸起部与内芯单元的内孔之间的纵向距离小于压板的斜面两端之间的纵向距离，以避免滑块脱离内孔。Optionally, in the longitudinal section of the knotting device, the longitudinal distance between the protrusion and the inner hole of the inner core unit is smaller than the longitudinal distance between the two ends of the inclined surface of the pressure plate to prevent the slider from escaping from the inner hole.
可选的，所述驱动螺杆的后端与驱动单元中的驱动杆的前端可拆卸的卡扣连接；所述的驱动杆包括卡扣部和抗扭转的柔性部，卡扣部设置有卡扣以实现与驱动螺杆的卡扣连接，抗扭转的柔性部控制驱动螺杆旋转以推动滑块移动。Optionally, the rear end of the driving screw is detachably buckled to the front end of the driving rod in the driving unit; the driving rod includes a buckling portion and an anti-torsion flexible portion, and the buckling portion is provided with a buckle. To achieve a snap connection with the driving screw, the anti-torsion flexible part controls the rotation of the driving screw to push the slider to move.
可选的，驱动单元还包括连接元件、连接杆和编织软管；其中，Optionally, the drive unit also includes connecting elements, connecting rods and braided hoses; where,
连接杆穿过连接元件的第一通孔后与所述内芯单元螺纹连接；The connecting rod is threadedly connected to the inner core unit after passing through the first through hole of the connecting element;
编织软管前端面与连接元件的后端面固定连接，且编织软管的内孔与连接元件的第二通孔贯通而形成贯通孔，所述驱动螺杆与驱动杆设置于所述贯通孔内；所述的卡扣连接位于所述第二通孔内以被所述第二通孔的内壁约束；The front end surface of the braided hose is fixedly connected to the rear end surface of the connecting element, and the inner hole of the braided hose penetrates the second through hole of the connecting element to form a through hole, and the driving screw and the driving rod are arranged in the through hole; The snap connection is located in the second through hole to be constrained by the inner wall of the second through hole;
连接元件的前端面抵靠内芯单元的后端面，连接元件的后端面与连接杆的台阶面抵靠以使连接元件固定在连接杆与内芯单元之间。The front end surface of the connecting element abuts the rear end surface of the inner core unit, and the rear end surface of the connecting element abuts the step surface of the connecting rod so that the connecting element is fixed between the connecting rod and the inner core unit.
根据本发明实施例的第二方面，提供一种经血管的打结装置的使用方法，包括：According to a second aspect of the embodiment of the present invention, a method of using a transvascular knotting device is provided, including:
内芯单元，其内孔上部用于穿设线缆，内孔下部安装有打结单元；Inner core unit, the upper part of the inner hole is used for passing cables, and the lower part of the inner hole is equipped with a knotting unit;
打结单元，其在所述内孔内运动以控制线缆的工作状态；A knotting unit that moves within the inner hole to control the working state of the cable;
驱动单元，其用于控制打结单元运动；a driving unit used to control the movement of the knotting unit;
驱动单元具有柔性以沿着所述血管形变延伸，使用时，控制所述驱动单元在所述血管内轴向运动，以推动所述打结单元将线缆挤压至所述内孔的内壁，实现对线缆的打结。The driving unit has flexibility to extend along the deformation of the blood vessel. When in use, the driving unit is controlled to move axially within the blood vessel to push the knotting unit to squeeze the cable to the inner wall of the inner hole, Realize the knotting of cables.
可选的，所述的打结单元包括压板、滑块和驱动螺杆，其中，Optionally, the knotting unit includes a pressure plate, a slide block and a driving screw, wherein,
所述压板的下部与滑块的上部之间的接触面为斜面，驱动螺杆与内芯单元螺纹连接，且驱动螺杆的前端面与滑块的后端面接触，驱动螺杆在内芯单元内转动以推动滑块移动，使压板抬升以控制线缆的工作状态。The contact surface between the lower part of the pressure plate and the upper part of the slider is a slope, the driving screw is threadedly connected to the inner core unit, and the front end surface of the driving screw is in contact with the rear end surface of the slider, and the driving screw rotates in the inner core unit to Push the slider to move and lift the pressure plate to control the working status of the cable.
可选的，所述斜面与内芯单元的轴线之间的夹角为10°～15°。Optionally, the angle between the inclined surface and the axis of the inner core unit is 10° to 15°.
可选的，所述的滑块为半球体，驱动螺杆的前端面与半球体的后端面固定连接，或者驱动螺杆与半球体为一体化元件。Optionally, the slider is a hemisphere, and the front end surface of the driving screw is fixedly connected to the rear end surface of the hemisphere, or the driving screw and the hemisphere are integrated components.
可选的，所述压板上远离所述斜面的顶部上依次设置有连接部、凸起部和穿线部，其中，Optionally, a connecting part, a protruding part and a threading part are provided in sequence on the top of the pressure plate away from the inclined surface, wherein,
所述连接部与内芯单元的内孔的通道部连接后使内孔与压板的上表面之间形成穿线通道；After the connecting portion is connected to the channel portion of the inner hole of the inner core unit, a threading channel is formed between the inner hole and the upper surface of the pressure plate;
所述凸起部用于挤压线缆；The raised portion is used to squeeze the cable;
所述穿线部用于引导线缆穿入所述穿线通道。The threading part is used to guide cables to penetrate into the threading channel.
可选的，在打结装置的纵剖面内，凸起部与内芯单元的内孔之间的纵向距离小于压板的斜面两端之间的纵向距离，以避免滑块脱离内孔。Optionally, in the longitudinal section of the knotting device, the longitudinal distance between the protrusion and the inner hole of the inner core unit is smaller than the longitudinal distance between the two ends of the inclined surface of the pressure plate to prevent the slider from escaping from the inner hole.
可选的，所述驱动螺杆的后端与驱动单元中的驱动杆的前端可拆卸的卡扣连接；所述的驱动杆包括卡扣部和抗扭转的柔性部，卡扣部设置有卡扣以实现与驱动螺杆的卡扣连接，抗扭转的柔性部控制驱动螺杆旋转以控制滑块的位置。Optionally, the rear end of the driving screw is detachably buckled to the front end of the driving rod in the driving unit; the driving rod includes a buckling portion and an anti-torsion flexible portion, and the buckling portion is provided with a buckle. To achieve a snap connection with the driving screw, the torsion-resistant flexible portion controls the rotation of the driving screw to control the position of the slider.
可选的，驱动单元还包括连接元件、连接杆和编织软管；其中，Optionally, the drive unit also includes connecting elements, connecting rods and braided hoses; where,
连接杆穿过连接元件的第一通孔后与所述内芯单元螺纹连接；The connecting rod is threadedly connected to the inner core unit after passing through the first through hole of the connecting element;
编织软管前端面与连接元件的后端面固定连接，且编织软管的内孔与连接元件的第二通孔贯通而形成贯通孔，所述驱动螺杆与驱动杆设置于所述贯通孔内；所述的卡扣连接位于所述第二通孔内以被所述第二通孔的内壁约束；The front end surface of the braided hose is fixedly connected to the rear end surface of the connecting element, and the inner hole of the braided hose penetrates the second through hole of the connecting element to form a through hole, and the driving screw and the driving rod are arranged in the through hole; The snap connection is located in the second through hole to be constrained by the inner wall of the second through hole;
连接元件的前端面抵靠内芯单元的后端面，连接元件的后端面与连接杆的台阶面抵靠以使连接元件固定在连接杆与内芯单元之间。The front end surface of the connecting element abuts the rear end surface of the inner core unit, and the rear end surface of the connecting element abuts the step surface of the connecting rod so that the connecting element is fixed between the connecting rod and the inner core unit.
可选的，打结时，则转动驱动杆使驱动螺杆同步旋转以推动滑块前进；Optionally, when tying knots, turn the drive rod to rotate the drive screw synchronously to push the slider forward;
压板与滑块之间的斜面接触位置改变而使压板的凸起部挤压线缆实现对线缆的固定；The contact position of the inclined surface between the pressure plate and the slider changes so that the convex part of the pressure plate squeezes the cable to fix the cable;
打结完成，则转动连接杆使其与内芯单元分离；After the knotting is completed, rotate the connecting rod to separate it from the inner core unit;
撤离编织软管和连接元件使驱动杆与驱动螺杆之间的卡扣连接解除外部约束；Evacuating the braided hose and connecting element releases the snap connection between the drive rod and the drive screw from external constraints;
解除驱动杆与驱动螺杆之间的卡扣连接，并撤离驱动杆。Release the snap connection between the drive rod and the drive screw, and remove the drive rod.
本发明的技术方案具有如下优点或有益效果：The technical solution of the present invention has the following advantages or beneficial effects:
(1)本发明的内芯单元的内孔上部用于穿设线缆，内孔下部安装有打结单元，从而充分利用内芯单元的内部空间以装配打结单元，不仅不增加结构尺寸，降低留置于人体内的器械的体积，而且降低手术风险和患者负担。(1) The upper part of the inner hole of the inner core unit of the present invention is used for passing cables, and the lower part of the inner hole is installed with a knotting unit, thereby making full use of the internal space of the inner core unit to assemble the knotting unit without increasing the structural size. Reduce the volume of devices left in the human body, and reduce surgical risks and patient burden.
(2)本发明的驱动单元采用柔性结构，并采用小型化设计的内芯单元能够使器械沿血管弯曲延伸，实现远距离、小空间的线缆打结。(2) The driving unit of the present invention adopts a flexible structure and adopts a miniaturized designed inner core unit to enable the instrument to bend and extend along the blood vessel to achieve long-distance and small space cable knotting.
(3)通过驱动螺杆的螺纹自锁结构以及滑块与压板之间的斜面自锁结构，形成双重自锁，提高了打结的可靠性和安全性。(3) The threaded self-locking structure of the driving screw and the inclined surface self-locking structure between the slider and the pressure plate form a double self-locking, which improves the reliability and safety of knotting.
(4)压板的连接部与内芯单元的内孔的通道部连接后使内孔与压板的上表面之间形成穿线通道；而穿线部用于引导线缆穿入所述穿线通道；上述设计便于体外穿线，且可同时穿入多根线缆，并便于同步锁紧多根线缆。(4) After the connection part of the pressure plate is connected to the channel part of the inner hole of the inner core unit, a threading channel is formed between the inner hole and the upper surface of the pressure plate; and the threading part is used to guide the cable to penetrate the threading channel; the above design It is convenient for threading outside the body, multiple cables can be threaded in at the same time, and multiple cables can be locked simultaneously.
(5)滑块为半球体，驱动螺杆的前端面与半球体的后端面固定连接，或者驱动螺杆与半球体为一体化元件；该设计结构能够反复操作打结装置，以获得所需的打结位置，提高了操作的便捷性和打结位置的精度。(5) The slider is a hemisphere, and the front end surface of the driving screw is fixedly connected to the rear end surface of the hemisphere, or the driving screw and the hemisphere are integrated components; this design structure can repeatedly operate the knotting device to obtain the required knotting The knot position improves the convenience of operation and the accuracy of the knot position.
附图说明Description of the drawings
附图用于更好地理解本发明，不构成对本发明的不当限定。其中：The accompanying drawings are used to better understand the present invention and do not constitute an improper limitation of the present invention. in:
图1是本发明实施例的打结装置的装配结构沿轴线的剖视图；Figure 1 is a cross-sectional view along the axis of the assembly structure of the knotting device according to the embodiment of the present invention;
图2和3是根据本发明实施例的内芯单元的不同视角的立体结构的示意图；Figures 2 and 3 are schematic views of the three-dimensional structure of the core unit from different viewing angles according to embodiments of the present invention;
图4是根据本发明实施例的滑块的示意图；Figure 4 is a schematic diagram of a slider according to an embodiment of the present invention;
图5是根据本发明实施例的压板的示意图；Figure 5 is a schematic diagram of a pressure plate according to an embodiment of the present invention;
图6是根据本发明实施例的连接元件的示意图；Figure 6 is a schematic diagram of a connecting element according to an embodiment of the present invention;
图7是根据本发明实施例的打结装置留置于人体内的结构的示意图；Figure 7 is a schematic diagram of the structure of a knotting device left in the human body according to an embodiment of the present invention;
图8是根据本发明实施例的打结装置的局部剖视图的放大图；Figure 8 is an enlarged view of a partial cross-sectional view of a knotting device according to an embodiment of the present invention;
图9是根据本发明实施例的打结装置的穿线细节示意图；Figure 9 is a detailed schematic diagram of the threading of the knotting device according to an embodiment of the present invention;
图10是根据本发明实施例的连接杆的示意图；Figure 10 is a schematic diagram of a connecting rod according to an embodiment of the present invention;
图11是根据本发明实施例的驱动杆的示意图；Figure 11 is a schematic diagram of a driving rod according to an embodiment of the present invention;
图12是根据本发明实施例的驱动螺杆的示意图；Figure 12 is a schematic diagram of a driving screw according to an embodiment of the present invention;
图13是根据本发明的打结装置的另一实施例的示意图。Figure 13 is a schematic diagram of another embodiment of the knotting device according to the present invention.
具体实施方式Detailed ways
以下结合附图对本发明的示范性实施例做出说明，其中包括本发明实施例的各种细节以助于理解，应当将它们认为仅仅是示范性的。因此，本领域普通技术人员应当认识到，可以对这里描述的实施例做出各种改变和修改，而不会背离本发明的范围和精神。同样，为了清楚和简明，以下的描述中省略了对公知功能和结构的描述。Exemplary embodiments of the present invention are described below with reference to the accompanying drawings, which include various details of the embodiments of the present invention to facilitate understanding and should be considered to be exemplary only. Accordingly, those of ordinary skill in the art will recognize that various changes and modifications can be made to the embodiments described herein without departing from the scope and spirit of the invention. Also, descriptions of well-known functions and constructions are omitted from the following description for clarity and conciseness.
根据本发明实施例的一个方面，提供了一种经血管的打结装置。所述的打结装置用于对人体内植入的线缆、绳、线材等线缆状元件进行打结操作。尤其适用于对通过血管植入的线材等进行打结操作，且采用柔性材料制作驱动单元，以实现远距离操作。所述的距离根据使用场景的不同而不同，如经过颈部血管操作时可以为0.5m左右，经过股部血管时可以为1m左右。具体的，如图1所示，所述的打结装置包括内芯单元102，其内孔上部用于穿设线缆105，内孔下部安装有打结单元。使用时，打结单元在所述内孔内运动以控制线缆的工作状态；例如打结单元的某个组成部件可在内孔的径向方向上下移动，以挤压所述线缆或解锁所述线缆。还包括驱动单元，其用于控制打结单元的状态。为了便于操作器械，降低医护人员打结植入人体内部的线缆，本发明的一个实施例的驱动单元具有柔性，从而使驱动单元可以沿着血管形变，并沿着血管通道延伸，并最终达到目标区域进行线缆打结或锁紧操作。如图1所示，打结操作时，所述驱动单元在血管内轴向运动以推动所述打结单元将线缆挤压至所述内孔的内壁，例如图1所示的将线缆挤压至内孔的上壁面，实现对线缆的固定，即完成打结操作。需要说明的是：本发明的内芯单元的内孔上部用于穿设线缆，内孔下部安装有打结单元，从而充分利用内芯单元的内部空间以装配打结单元，不仅不增加结构尺寸，降低留置于人体内的器械的体积，而且降低手术风险和患者负担。再者，本发明的驱动单元采用柔性结构，并采用小型化设计的内芯单元能够使器械沿血管弯曲延伸，实现远距离、小空间的线缆打结。According to one aspect of an embodiment of the invention, a transvascular tying device is provided. The knotting device is used to knot cable-like components such as cables, ropes, and wires implanted in the human body. It is especially suitable for knotting wires implanted through blood vessels, and the drive unit is made of flexible materials to achieve long-distance operation. The distance varies according to different use scenarios. For example, it can be about 0.5m when operating through the blood vessels in the neck, and about 1m when operating through the blood vessels in the femoral area. Specifically, as shown in Figure 1, the knotting device includes an inner core unit 102, the upper part of the inner hole is used for passing the cable 105, and the lower part of the inner hole is equipped with a knotting unit. When in use, the knotting unit moves within the inner hole to control the working state of the cable; for example, a certain component of the knotting unit can move up and down in the radial direction of the inner hole to squeeze the cable or unlock it. The cable. Also included is a driving unit for controlling the state of the knotting unit. In order to facilitate the operation of instruments and reduce the risk of medical personnel knotting the cables implanted inside the human body, the driving unit of one embodiment of the present invention is flexible, so that the driving unit can deform along the blood vessels and extend along the blood vessel channels, and finally reach Target areas for cable knotting or locking operations. As shown in Figure 1, during the knotting operation, the driving unit moves axially within the blood vessel to push the knotting unit to squeeze the cable to the inner wall of the inner hole. For example, as shown in Figure 1, the cable Squeeze to the upper wall of the inner hole to fix the cable, that is, to complete the knotting operation. It should be noted that the upper part of the inner hole of the inner core unit of the present invention is used for passing cables, and the lower part of the inner hole is installed with a knotting unit, thereby making full use of the internal space of the inner core unit to assemble the knotting unit, without increasing the structure. size, reducing the volume of devices left in the human body, and reducing surgical risks and patient burden. Furthermore, the driving unit of the present invention adopts a flexible structure and adopts a compactly designed inner core unit to enable the instrument to bend and extend along the blood vessel, thereby realizing cable knotting over long distances and in small spaces.
可选的，如图1，4-5所示，所述的打结单元包括压板104、滑块103和驱动螺杆101，所述压板104的下部与滑块的上部之间的接触面为斜面，具体的如图4所示的滑块的上顶面301，以及图5所示的压板的下底面404。装配后，以及实际使用中，所述的上顶面301和下底面404贴合以构成所述斜面。所述的斜面与内芯单元的轴线之间的夹角为α，即图4和图5所示的α角度。驱动螺杆101与内芯单元螺纹连接，图1-3所示的一个实施例中，内芯单元的下部设置有第二螺纹孔201，驱动螺杆101螺纹连接在所述第二螺纹孔201内。驱动螺杆101的前端面与滑块103的后端面接触，从而在使用中可以旋转驱动螺杆101前进以推动滑块103移动。由于使斜面具有α角，滑块103使压板104抬升以控制线缆105的工作状态；例如使线缆105抵靠在内芯单元的内孔的顶部壁面，实现对线缆的打结或锁定。合理设置α角的大小也能够实现滑块与压板之间的自锁。需要说明的是：通过驱动螺杆的螺纹自锁结构以及滑块与压板之间的斜面自锁结构，形成双重自锁，提高了打结的可靠性和安全性。Optionally, as shown in Figures 1 and 4-5, the knotting unit includes a pressure plate 104, a slider 103 and a driving screw 101. The contact surface between the lower part of the pressure plate 104 and the upper part of the slider is an inclined surface. , specifically the upper top surface 301 of the slider as shown in Figure 4, and the lower bottom surface 404 of the pressure plate as shown in Figure 5. After assembly, and during actual use, the upper top surface 301 and the lower bottom surface 404 fit together to form the inclined surface. The angle between the inclined plane and the axis of the inner core unit is α, that is, the α angle shown in Figures 4 and 5. The driving screw 101 is threadedly connected to the inner core unit. In one embodiment shown in Figures 1-3, a second threaded hole 201 is provided at the lower part of the inner core unit, and the driving screw 101 is threadedly connected in the second threaded hole 201. The front end surface of the driving screw rod 101 is in contact with the rear end surface of the slide block 103, so that in use, the driving screw rod 101 can be rotated and advanced to push the slide block 103 to move. Because the inclined surface has an α angle, the slider 103 lifts the pressure plate 104 to control the working state of the cable 105; for example, the cable 105 is pressed against the top wall of the inner hole of the inner core unit to knot or lock the cable. . Properly setting the size of the α angle can also achieve self-locking between the slider and the pressure plate. It should be noted that the threaded self-locking structure of the driving screw and the inclined self-locking structure between the slider and the pressure plate form a double self-locking, which improves the reliability and safety of knotting.
可选的，如图4-5所示的实施例中，所述斜面与内芯单元的轴线之间的夹角为10°～15°。实际使用中，驱动螺杆101的螺纹与内芯单元的螺纹通孔的螺纹能够自锁，实现对滑块的定位，最终锁定压板104的位置。而为了避免螺纹之间的间隙(如因加工误差导致的间隙)，导致上述的自锁结构松动，降低了打结的质量，本发明的一个实施例中优选α角为10°～15°，上述较小的夹角可以保证压板与滑块之间的自锁，即保证在打结完成后，压板和滑块之间不会沿着所述斜面移动。可以理解的是，根据材料物理属性的不同，尤其是加工工艺导致表面粗糙度的不同，可以适当调整上述α角的大小，以获得所需的自锁效果。如适当调大所述角度，以便快速抬升压板以实现打结目的；或者适当减小所述夹角，此时虽然打结速度或效率降低，但斜面的自锁效果提高了。Optionally, in the embodiment shown in Figures 4-5, the angle between the inclined surface and the axis of the inner core unit is 10° to 15°. In actual use, the threads of the driving screw 101 and the threads of the threaded through holes of the inner core unit can self-lock to position the slider and ultimately lock the position of the pressure plate 104. In order to avoid the gap between threads (such as the gap caused by processing errors), which will cause the above-mentioned self-locking structure to loosen and reduce the quality of knotting, in one embodiment of the present invention, the α angle is preferably 10° to 15°. The above-mentioned smaller included angle can ensure the self-locking between the pressure plate and the slider, that is, it can ensure that after the knotting is completed, the pressure plate and the slider will not move along the inclined plane. It can be understood that according to the difference in physical properties of the material, especially the difference in surface roughness caused by the processing technology, the size of the above-mentioned α angle can be appropriately adjusted to obtain the required self-locking effect. For example, if the angle is appropriately increased to quickly lift the pressure plate to achieve the purpose of knotting; or if the angle is appropriately reduced, although the knotting speed or efficiency is reduced, the self-locking effect of the inclined surface is improved.
可选的，如图13所示的一个实施例中，所述的滑块为半球体1203，驱动螺杆的前端面与半球体的后端面固定连接，或者驱动螺杆与半球体为一体化元件。上述设计能够保证驱动螺杆控制半球体的滑块前进或后退，从而反复调整打结的位置。该设计能够灵活调整打结位置，以获得所需的打结位置，提高手术效果。Optionally, in one embodiment as shown in Figure 13, the slider is a hemispherical body 1203, and the front end surface of the driving screw is fixedly connected to the rear end surface of the hemispherical body, or the driving screw and the hemispherical body are integrated components. The above design can ensure that the driving screw controls the slider of the hemisphere to advance or retreat, thereby repeatedly adjusting the knotting position. This design can flexibly adjust the knotting position to obtain the desired knotting position and improve the surgical effect.
可选的，如图5所示的实施例中，所述压板上远离所述斜面的顶部上依次设置有连接部401、凸起部402和穿线部403。参见图1-3，所述连接部401与所述内孔的通道部202连接后使内芯单元的内孔与压板的上表面之间形成穿线通道，线缆105可穿设在所述穿线通道内。实际使用中，连接部401与通道部的连接方式可为常规的固定连接方式，如焊接、胶接等。所述凸起部402可以设置为一个或多个，其顶面可为弧面、平面或锥面等，通过所述顶面挤压线缆以将其抵靠在内芯单元的内孔内壁上。所述穿线部403可为光滑平面，且与内芯单元的轴线存在一定夹角，用于引导线缆快速而便捷的穿入所述穿线通道。如图7所示，所示的线缆可以为多条，不限于一条。需要说明的是：压板的连接部与内芯单元的内孔的通道部连接后使内孔与压板的上表面之间形成穿线通道；而穿线部用于引导线缆穿入所述穿线通道；上述设计便于体外穿线，且可同时穿入多根线缆，并便于同步锁紧多根线缆。Optionally, in the embodiment shown in FIG. 5 , a connecting portion 401 , a protruding portion 402 and a threading portion 403 are provided in sequence on the top of the pressure plate away from the inclined surface. Referring to Figures 1-3, after the connection part 401 is connected to the channel part 202 of the inner hole, a threading channel is formed between the inner hole of the inner core unit and the upper surface of the pressure plate, and the cable 105 can be threaded through the threading channel. inside the channel. In actual use, the connection method between the connecting part 401 and the channel part may be a conventional fixed connection method, such as welding, gluing, etc. The protruding portion 402 can be provided in one or more numbers, and its top surface can be an arc surface, a flat surface, a tapered surface, etc., and the cable is squeezed through the top surface to press it against the inner wall of the inner hole of the core unit. superior. The threading portion 403 can be a smooth plane and have a certain angle with the axis of the inner core unit, so as to guide the cable to quickly and conveniently penetrate the threading channel. As shown in Figure 7, there can be multiple cables, not limited to one. It should be noted that: after the connection part of the pressure plate is connected to the channel part of the inner hole of the inner core unit, a threading channel is formed between the inner hole and the upper surface of the pressure plate; and the threading part is used to guide the cable to penetrate the threading channel; The above design is convenient for threading outside the body, can thread multiple cables at the same time, and facilitates simultaneous locking of multiple cables.
可选的，如图1和8所示，在打结装置的纵剖面内(即图8所示的剖面内)，凸起部与内芯单元的内孔之间的纵向距离b小于压板的斜面两端之间的纵向距离a。也即图8所示的距离a大于距离b，从而限制滑块在内孔内的滑动距离，以避免滑块脱离内孔。如图1和3所示，内芯单元的内孔内具有台阶状的斜面204，斜面204与下底面404配合。进一步的，所述的内孔中还设置有凹槽205，所述滑块装配在所述凹槽内，并被凹槽的侧面定位以沿着凹槽的轴向移动。Optionally, as shown in Figures 1 and 8, in the longitudinal section of the knotting device (i.e., the section shown in Figure 8), the longitudinal distance b between the protrusion and the inner hole of the inner core unit is smaller than that of the pressure plate. The longitudinal distance a between the two ends of the slope. That is, the distance a shown in Figure 8 is greater than the distance b, thereby limiting the sliding distance of the slider in the inner hole to prevent the slider from leaving the inner hole. As shown in Figures 1 and 3, the inner hole of the inner core unit has a stepped inclined surface 204, and the inclined surface 204 cooperates with the lower bottom surface 404. Further, a groove 205 is also provided in the inner hole, and the slider is assembled in the groove and positioned by the side of the groove to move along the axial direction of the groove.
可选的，如图1,11-12所示，所述驱动螺杆101的后端与驱动单元中的驱动杆108的前端可拆卸的卡扣连接；所述的驱动杆108包括卡扣部901和抗扭转的柔性部902，卡扣部设置有卡扣以实现与驱动螺杆的卡扣连接，抗扭转的柔性部控制驱动螺杆旋转以推动滑块移动。本发明的一个实施例中采用抗扭转的柔性部制作驱动杆大部分特征，从而保证打结装置可以沿着血管弯曲延伸，同时其具有抗扭转特性保证了驱动杆能够传递扭矩。也即，操作者可以在远端扭转驱动杆的端部，将扭矩传递至卡扣部901，从而带动驱动螺杆101旋转。驱动螺杆101和卡扣部901的卡扣结构相同，均具有突起结构和卡接凹槽1002，从而可以对接卡合实现卡接。图12还进一步展示了驱动螺杆外表面的螺纹结构1001，其用于与内芯单元螺纹连接。Optionally, as shown in Figures 1, 11-12, the rear end of the drive screw 101 is detachably snap-connected to the front end of the drive rod 108 in the drive unit; the drive rod 108 includes a snap portion 901 and an anti-torsion flexible part 902. The buckle part is provided with a buckle to realize a buckle connection with the driving screw. The anti-torsion flexible part controls the rotation of the driving screw to push the slider to move. In one embodiment of the present invention, anti-torsion flexible parts are used to make most features of the driving rod, thereby ensuring that the knotting device can bend and extend along the blood vessel, and its anti-torsion properties ensure that the driving rod can transmit torque. That is, the operator can twist the end of the driving rod at the distal end to transmit the torque to the buckle portion 901 to drive the driving screw 101 to rotate. The driving screw 101 and the buckling portion 901 have the same buckling structure, and both have protruding structures and buckling grooves 1002, so that they can be butted and engaged to achieve buckling. Figure 12 further shows the thread structure 1001 on the outer surface of the driving screw, which is used for threaded connection with the inner core unit.
可选的，如图1所示，驱动单元还包括连接元件106、连接杆107和编织软管109。其中，连接杆107和编织软管109均为柔性结构，确保打结器械可以沿着血管弯曲延伸。如图1和6所示，连接杆107穿过连接元件106的第一通孔601后与所述内芯单元螺纹连接。编织软管109前端面与连接元件106的后端面固定连接，如采用焊接等固定方式。且编织软管109的内孔与连接元件106的第二通孔602贯通而形成贯通孔，所述驱动螺杆与驱动杆设置于所述贯通孔内，并可在所述贯通孔内旋转和移动。所述的卡扣连接位于所述第二通孔内以被所述第二通孔的内壁约束。实际使用中，需要合理设计第二通孔602的长度，确保打结操作时卡扣连接在使用中始终位于第二通孔内，从而利用第二通孔的内壁约束卡扣连接，避免卡扣连接的分离。此外，如图6所示，连接元件的前端面为台阶状结构，而内芯单元的后端面也为台阶结构。两个所述的台阶结构配合使用，以使连接元件的前端面抵靠在内芯单元的后端面。连接元件的后端面与连接杆的台阶面抵靠以使连接元件固定在连接杆与内芯单元之间。具体的，参见图1-2和10所示，内芯单元的台阶结构的上部设置有第一螺纹孔203，下部设置有第二螺纹孔201，连接杆包括第一连接段703、台阶面702和第二连接段701，其中第一连接段的直径大于第二连接段的直径。第二连接段具有螺纹段，从而与内芯单元的第一螺纹孔203连接。使用中，第二连接段701与第一螺纹孔203螺纹连接后，连接元件的后端面与连接杆的台阶面702抵靠以使连接元件固定在连接杆与内芯单元之间。打结时，可按图1所示的结构将各个元件装配完毕，并将待打结的线缆穿入打结装置，具体的穿设细节如图7和9所示。随后，即可转动驱动杆108进行打结。Optionally, as shown in Figure 1, the driving unit also includes a connecting element 106, a connecting rod 107 and a braided hose 109. Among them, the connecting rod 107 and the braided hose 109 are both flexible structures, ensuring that the knotting instrument can be bent and extended along the blood vessels. As shown in Figures 1 and 6, the connecting rod 107 passes through the first through hole 601 of the connecting element 106 and is threadedly connected to the inner core unit. The front end surface of the braided hose 109 is fixedly connected to the rear end surface of the connecting element 106, such as by welding or other fixing methods. And the inner hole of the braided hose 109 and the second through hole 602 of the connecting element 106 pass through to form a through hole. The driving screw and the driving rod are arranged in the through hole and can rotate and move in the through hole. . The snap connection is located in the second through hole to be constrained by the inner wall of the second through hole. In actual use, the length of the second through hole 602 needs to be reasonably designed to ensure that the snap connection is always located within the second through hole during knotting operation, so that the inner wall of the second through hole is used to constrain the snap connection and avoid snapping. The separation of connections. In addition, as shown in Figure 6, the front end surface of the connecting element has a stepped structure, and the rear end surface of the core unit also has a stepped structure. The two step structures are used in conjunction so that the front end surface of the connecting element abuts the rear end surface of the core unit. The rear end surface of the connecting element abuts against the step surface of the connecting rod so that the connecting element is fixed between the connecting rod and the inner core unit. Specifically, as shown in Figures 1-2 and 10, the upper part of the stepped structure of the inner core unit is provided with a first threaded hole 203, and the lower part is provided with a second threaded hole 201. The connecting rod includes a first connecting section 703 and a stepped surface 702. and a second connecting section 701, wherein the diameter of the first connecting section is greater than the diameter of the second connecting section. The second connecting section has a threaded section to connect with the first threaded hole 203 of the inner core unit. In use, after the second connecting section 701 is threadedly connected to the first threaded hole 203, the rear end surface of the connecting element abuts against the step surface 702 of the connecting rod so that the connecting element is fixed between the connecting rod and the inner core unit. When knotting, each component can be assembled according to the structure shown in Figure 1, and the cable to be knotted can be threaded into the knotting device. The specific threading details are shown in Figures 7 and 9. Then, the driving rod 108 can be rotated to tie the knot.
根据本发明实施例的第二个方面，提供了一种经血管的打结装置的使用方法。需要说明的是，第二方面涉及的各个使用方法操作的打结装置和第一方面描述的相同。所述的使用方法包括：内芯单元，其内孔上部用于穿设线缆，内孔下部安装有打结单元；打结单元，其在所述内孔内运动以控制线缆的工作状态；驱动单元，其用于控制打结单元运动；驱动单元具有柔性以沿着所述血管形变延伸，使用时，控制所述驱动单元在所述血管内运动，以推动所述打结单元将线缆挤压至所述内孔的内壁，实现对线缆的打结。According to a second aspect of an embodiment of the present invention, a method of using a transvascular knotting device is provided. It should be noted that each knotting device operated by the method involved in the second aspect is the same as that described in the first aspect. The described usage method includes: an inner core unit, the upper part of the inner hole of which is used to thread cables, and the lower part of the inner hole is equipped with a knotting unit; a knotting unit moves in the inner hole to control the working state of the cable. ; Driving unit, which is used to control the movement of the knotting unit; the driving unit has flexibility to extend along the deformation of the blood vessel. When used, the driving unit is controlled to move within the blood vessel to push the knotting unit to wire the thread. The cable is squeezed to the inner wall of the inner hole to realize knotting of the cable.
可选的，所述的打结单元包括压板、滑块和驱动螺杆，其中，所述压板的下部与滑块的上部之间的接触面为斜面，驱动螺杆与内芯单元螺纹连接，且驱动螺杆的前端面与滑块的后端面接触，驱动螺杆在内芯单元内转动以推动滑块移动，使压板抬升以控制线缆的工作状态。Optionally, the knotting unit includes a pressure plate, a slider and a driving screw, wherein the contact surface between the lower part of the pressure plate and the upper part of the slider is an inclined plane, the driving screw is threadedly connected to the inner core unit, and the driving screw The front end surface of the screw is in contact with the rear end surface of the slider, and the screw is driven to rotate in the inner core unit to push the slider to move and lift the pressure plate to control the working status of the cable.
可选的，所述斜面与内芯单元的轴线之间的夹角为10°～15°。Optionally, the angle between the inclined surface and the axis of the inner core unit is 10° to 15°.
可选的，所述的滑块为半球体，驱动螺杆的前端面与半球体的后端面固定连接，或者驱动螺杆与半球体为一体化元件。Optionally, the slider is a hemisphere, and the front end surface of the driving screw is fixedly connected to the rear end surface of the hemisphere, or the driving screw and the hemisphere are integrated components.
可选的，所述压板上远离所述斜面的顶部上依次设置有连接部、凸起部和穿线部，其中，Optionally, a connecting part, a protruding part and a threading part are provided in sequence on the top of the pressure plate away from the inclined surface, wherein,
所述连接部与内芯单元的内孔的通道部连接后使内孔与压板的上表面之间形成穿线通道；After the connecting portion is connected to the channel portion of the inner hole of the inner core unit, a threading channel is formed between the inner hole and the upper surface of the pressure plate;
所述凸起部用于挤压线缆；The raised portion is used to squeeze the cable;
所述穿线部用于引导线缆穿入所述穿线通道。The threading part is used to guide cables to penetrate into the threading channel.
可选的，在打结装置的纵剖面内，凸起部与内芯单元的内孔之间的纵向距离小于压板的斜面两端之间的纵向距离，以避免滑块脱离内孔。Optionally, in the longitudinal section of the knotting device, the longitudinal distance between the protrusion and the inner hole of the inner core unit is smaller than the longitudinal distance between the two ends of the inclined surface of the pressure plate to prevent the slider from escaping from the inner hole.
可选的，所述驱动螺杆的后端与驱动单元中的驱动杆的前端可拆卸的卡扣连接；所述的驱动杆包括卡扣部和抗扭转的柔性部，卡扣部设置有卡扣以实现与驱动螺杆的卡扣连接，抗扭转的柔性部控制驱动螺杆旋转以控制滑块的位置。Optionally, the rear end of the driving screw is detachably buckled to the front end of the driving rod in the driving unit; the driving rod includes a buckling portion and an anti-torsion flexible portion, and the buckling portion is provided with a buckle. To achieve a snap connection with the driving screw, the torsion-resistant flexible portion controls the rotation of the driving screw to control the position of the slider.
可选的，驱动单元还包括连接元件、连接杆和编织软管；其中，Optionally, the drive unit also includes connecting elements, connecting rods and braided hoses; where,
连接杆穿过连接元件的第一通孔后与所述内芯单元螺纹连接；The connecting rod is threadedly connected to the inner core unit after passing through the first through hole of the connecting element;
编织软管前端面与连接元件的后端面固定连接，且编织软管的内孔与连接元件的第二通孔贯通而形成贯通孔，所述驱动螺杆与驱动杆设置于所述贯通孔内；所述的卡扣连接位于所述第二通孔内以被所述第二通孔的内壁约束；The front end surface of the braided hose is fixedly connected to the rear end surface of the connecting element, and the inner hole of the braided hose penetrates the second through hole of the connecting element to form a through hole, and the driving screw and the driving rod are arranged in the through hole; The snap connection is located in the second through hole to be constrained by the inner wall of the second through hole;
连接元件的前端面抵靠内芯单元的后端面，连接元件的后端面与连接杆的台阶面抵靠以使连接元件固定在连接杆与内芯单元之间。The front end surface of the connecting element abuts the rear end surface of the inner core unit, and the rear end surface of the connecting element abuts the step surface of the connecting rod so that the connecting element is fixed between the connecting rod and the inner core unit.
可选的，打结时，则转动驱动杆108使驱动螺杆101同步旋转，驱动螺杆螺纹旋进以推动滑块前进。压板104与滑块103之间的斜面接触位置改变而使压板的前端抬升，凸起部挤压线缆实现对线缆的固定。本发明采用螺纹和斜面的双重自锁结构确保打结的稳定性。打结完成，则转动连接杆107使其与内芯单元分离；然后撤离编织软管和连接元件使驱动杆108与驱动螺杆101之间的卡扣连接解除外部约束；最后解除驱动杆与驱动螺杆之间的卡扣连接，并撤离驱动杆。留置于人体内的部分如图7所示。上述撤离完成后，对于多余的线缆可采用剪线器械进行修剪。如图1-13所示，尤其参见图7，本发明充分利用内芯单元的内部结构和空间以及装配各个元件，保证留置于人体内的结构的直径小于等于5mm，轴向长度小于等于5mm；留置部分的尺寸十分微小，降低了患者的负担和术后风险。Optionally, when tying a knot, the driving rod 108 is rotated to cause the driving screw 101 to rotate synchronously, and the driving screw screws in to advance the slider. The inclined contact position between the pressure plate 104 and the slider 103 changes, causing the front end of the pressure plate to lift, and the protruding portion presses the cable to secure the cable. The invention adopts a double self-locking structure of threads and bevels to ensure the stability of knotting. After the knotting is completed, rotate the connecting rod 107 to separate it from the inner core unit; then evacuate the braided hose and connecting elements to release the external constraints from the snap connection between the driving rod 108 and the driving screw 101; finally release the driving rod and the driving screw snap connection between the two and evacuate the drive rod. The part left in the human body is shown in Figure 7. After the above evacuation is completed, the excess cables can be trimmed with a wire trimmer. As shown in Figures 1-13, especially Figure 7, the present invention makes full use of the internal structure and space of the inner core unit and assembles various components to ensure that the diameter of the structure left in the human body is less than or equal to 5mm, and the axial length is less than or equal to 5mm; The size of the indwelling part is very small, which reduces the patient's burden and postoperative risks.
上述具体实施方式，并不构成对本发明保护范围的限制。本领域技术人员应该明白的是，取决于设计要求和其他因素，可以发生各种各样的修改、组合、子组合和替代。任何在本发明的精神和原则之内所作的修改、等同替换和改进等，均应包含在本发明保护范围之内。The above-mentioned specific embodiments do not constitute a limitation on the scope of the present invention. It will be understood by those skilled in the art that various modifications, combinations, sub-combinations and substitutions may occur depending on design requirements and other factors. Any modifications, equivalent substitutions and improvements made within the spirit and principles of the present invention shall be included in the protection scope of the present invention.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111267751.6ACN114027902B (en) | 2021-10-29 | 2021-10-29 | Transvascular knotting device and method of using the same |
| CN202311151031.2ACN117281562A (en) | 2021-10-29 | 2021-10-29 | Transvascular knotting device and application method thereof |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111267751.6ACN114027902B (en) | 2021-10-29 | 2021-10-29 | Transvascular knotting device and method of using the same |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202311151031.2ADivisionCN117281562A (en) | 2021-10-29 | 2021-10-29 | Transvascular knotting device and application method thereof |
| Publication Number | Publication Date |
|---|---|
| CN114027902A CN114027902A (en) | 2022-02-11 |
| CN114027902Btrue CN114027902B (en) | 2023-10-27 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202311151031.2APendingCN117281562A (en) | 2021-10-29 | 2021-10-29 | Transvascular knotting device and application method thereof |
| CN202111267751.6AActiveCN114027902B (en) | 2021-10-29 | 2021-10-29 | Transvascular knotting device and method of using the same |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202311151031.2APendingCN117281562A (en) | 2021-10-29 | 2021-10-29 | Transvascular knotting device and application method thereof |
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| CN (2) | CN117281562A (en) |
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| JPH0795983A (en)* | 1993-07-28 | 1995-04-11 | Terumo Corp | Knot forming device |
| CN201219907Y (en)* | 2008-07-03 | 2009-04-15 | 华斌 | Blind type suture knotter |
| CN212630823U (en)* | 2020-07-06 | 2021-03-02 | 杭州德晋医疗科技有限公司 | Bendable suture locking device |
| Publication number | Priority date | Publication date | Assignee | Title |
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| US8491629B2 (en)* | 2008-02-15 | 2013-07-23 | Rex Medical | Vascular hole closure delivery device |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH0795983A (en)* | 1993-07-28 | 1995-04-11 | Terumo Corp | Knot forming device |
| CN201219907Y (en)* | 2008-07-03 | 2009-04-15 | 华斌 | Blind type suture knotter |
| CN212630823U (en)* | 2020-07-06 | 2021-03-02 | 杭州德晋医疗科技有限公司 | Bendable suture locking device |
| Publication number | Publication date |
|---|---|
| CN114027902A (en) | 2022-02-11 |
| CN117281562A (en) | 2023-12-26 |
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