CN109381254B - Needle holder with electrocoagulation function for digestive endoscopy - Google Patents
Needle holder with electrocoagulation function for digestive endoscopy Download PDFInfo
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- CN109381254B CN109381254B CN201710650191.XA CN201710650191A CN109381254B CN 109381254 B CN109381254 B CN 109381254B CN 201710650191 A CN201710650191 A CN 201710650191A CN 109381254 B CN109381254 B CN 109381254B
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- 238000009297 electrocoagulation Methods 0.000 title claims abstract description 26
- 230000001079 digestive effect Effects 0.000 title claims abstract description 21
- 238000001839 endoscopy Methods 0.000 title claims abstract description 17
- 230000007246 mechanism Effects 0.000 claims abstract description 48
- 230000005540 biological transmission Effects 0.000 claims abstract description 34
- 230000015271 coagulation Effects 0.000 claims abstract description 14
- 238000005345 coagulation Methods 0.000 claims abstract description 14
- 230000006870 function Effects 0.000 claims description 11
- 239000010935 stainless steel Substances 0.000 claims description 5
- 229910001220 stainless steel Inorganic materials 0.000 claims description 5
- 239000004809 Teflon Substances 0.000 claims description 3
- 229920006362 Teflon® Polymers 0.000 claims description 3
- HZEWFHLRYVTOIW-UHFFFAOYSA-N [Ti].[Ni] Chemical compound [Ti].[Ni] HZEWFHLRYVTOIW-UHFFFAOYSA-N 0.000 claims description 3
- 239000000463 material Substances 0.000 claims description 3
- 229910001000 nickel titanium Inorganic materials 0.000 claims description 3
- 229910001285 shape-memory alloy Inorganic materials 0.000 claims description 3
- 239000000956 alloy Substances 0.000 claims description 2
- 238000009434 installation Methods 0.000 claims 2
- 208000037062 Polyps Diseases 0.000 abstract description 11
- 230000023597 hemostasis Effects 0.000 abstract description 11
- 230000000694 effects Effects 0.000 abstract description 3
- 210000001035 gastrointestinal tract Anatomy 0.000 description 15
- 208000032843 Hemorrhage Diseases 0.000 description 11
- 230000000740 bleeding effect Effects 0.000 description 9
- 210000003811 finger Anatomy 0.000 description 7
- 238000011282 treatment Methods 0.000 description 7
- 238000000034 method Methods 0.000 description 6
- 210000001519 tissue Anatomy 0.000 description 6
- 210000003813 thumb Anatomy 0.000 description 5
- 238000005516 engineering process Methods 0.000 description 4
- 206010028980 Neoplasm Diseases 0.000 description 3
- 230000007547 defect Effects 0.000 description 3
- 238000012277 endoscopic treatment Methods 0.000 description 3
- 230000002439 hemostatic effect Effects 0.000 description 3
- 229910052751 metal Inorganic materials 0.000 description 3
- 239000002184 metal Substances 0.000 description 3
- 210000004400 mucous membrane Anatomy 0.000 description 3
- 239000004033 plastic Substances 0.000 description 3
- 230000002792 vascular Effects 0.000 description 3
- 210000004204 blood vessel Anatomy 0.000 description 2
- 201000011510 cancer Diseases 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 201000010099 disease Diseases 0.000 description 2
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 2
- 210000001198 duodenum Anatomy 0.000 description 2
- 238000002674 endoscopic surgery Methods 0.000 description 2
- 210000003238 esophagus Anatomy 0.000 description 2
- 230000002496 gastric effect Effects 0.000 description 2
- 239000003292 glue Substances 0.000 description 2
- 238000002271 resection Methods 0.000 description 2
- 210000002784 stomach Anatomy 0.000 description 2
- 238000012327 Endoscopic diagnosis Methods 0.000 description 1
- 208000012671 Gastrointestinal haemorrhages Diseases 0.000 description 1
- 241000282414 Homo sapiens Species 0.000 description 1
- 241001465754 Metazoa Species 0.000 description 1
- 239000004677 Nylon Substances 0.000 description 1
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 1
- 239000000853 adhesive Substances 0.000 description 1
- 230000001070 adhesive effect Effects 0.000 description 1
- 230000032683 aging Effects 0.000 description 1
- 229940030225 antihemorrhagics Drugs 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 244000309466 calf Species 0.000 description 1
- 230000018109 developmental process Effects 0.000 description 1
- 210000002249 digestive system Anatomy 0.000 description 1
- 238000002224 dissection Methods 0.000 description 1
- 238000002474 experimental method Methods 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 230000036541 health Effects 0.000 description 1
- 239000002874 hemostatic agent Substances 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
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- 229920001778 nylon Polymers 0.000 description 1
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- 210000004935 right thumb Anatomy 0.000 description 1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/062—Needle manipulators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/50—Instruments, other than pincettes or toothpicks, for removing foreign bodies from the human body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
- A61B2017/12004—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord for haemostasis, for prevention of bleeding
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00482—Digestive system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00607—Coagulation and cutting with the same instrument
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Public Health (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Physics & Mathematics (AREA)
- Otolaryngology (AREA)
- Plasma & Fusion (AREA)
- Reproductive Health (AREA)
- Vascular Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
The invention discloses needle holding forceps with an electrocoagulation function for digestive endoscopy, which comprise forceps heads, forceps bodies, control handles and an electrocoagulation mechanism, wherein the rear ends of the forceps heads are connected with one ends of the forceps bodies, the other ends of the forceps bodies are connected with the front ends of the control handles, the control handles control the forceps heads to clamp and release suture needles and sutures through the forceps bodies, and the electrocoagulation mechanism is connected with the control handles; the clamp head comprises a pair of clamp arms, a transmission mechanism, a clamp head main body and a fixed rotation mechanism; the pliers body comprises an inner core, a spring tube sleeved on the inner core and an insulating layer sleeved on the spring tube; the control handle comprises a handle main body, a slip ring assembly and a locking assembly; the electric coagulation mechanism comprises a high-frequency electric knife and an electrode plate. The invention is specially used under the operation of digestive endoscopy, the front end of the needle holding forceps can freely rotate and open and close, can clamp and lock the suture needle, and has the effects of electrocautery, polyp removal and electric coagulation hemostasis.
Description
Technical Field
The invention relates to medical surgical instruments, in particular to needle holding forceps with an electrocoagulation function for digestive endoscopy.
Background
Digestive tract malignant tumor is common and frequently-occurring diseases of digestive tract, which seriously threatens the life health of human beings, and the discovery rate of digestive tract malignant tumor is increased along with the gradual progress of society to the aging stage, and the curative effect can be achieved by resecting tumor of early tumor of digestive tract through endoscopic minimally invasive treatment.
With the continuous development of digestive endoscopy and endoscopic diagnosis and treatment technologies, endoscopy is becoming a conventional examination means for digestive tract diseases, so that early tumors of the digestive tract are increasingly found, endoscopic treatment is increased, complications related to treatment are correspondingly increased, and the damage to the most harmful of the digestive tract perforation is also increased. Digestive tract perforation can be divided into an endoscopic perforation complication and an active digestive system tube wall stoma, such as perforation generated during endoscopic examination, perforation generated by polyp removal, EMR, ESD and the like of the digestive tract, and gastric wall total resection (EFTR), natural cavity endoscopic surgery (NOTES) incision and the like, wherein the main treatment mode of the digestive tract perforation is surgical repair, and with the progress of endoscopic instruments and technology, a part of digestive tract perforation can be sutured under an endoscope.
The existing common alimentary canal perforation closing technology mainly comprises conventional hemostatic clip closing, large hemostatic clip closing, nylon snare hemostatic clip purse-string suture method, OTSC (over-the-scope-clip system) and metal clip closing technology, in addition, perforation of relatively small parts such as esophagus, duodenum and the like can be treated by a temporary covered metal bracket, but the treatment has the defects of high technical difficulty, complicated operation, long time, low reliability and the like, and some of the treatments are only in animal experiment stages.
Among all the perforation suturing techniques of the digestive tract, the surgical suturing technique is the most basic and reliable, and is the final suturing means selected after other techniques are difficult to complete. The surgical suture technique can achieve full-layer alignment suture of the wall of the digestive tract, which is an important factor for tissue healing and preventing leakage after the digestive cavity operation, and the suture technique is difficult to achieve. When the suture operation is carried out by means of the digestive endoscope, the forceps channel space of the digestive endoscope is very limited, the diameter of the gastroscope forceps channel is about 2.8mm, the diameter of the enteroscope forceps channel is about 3.2mm, the length of the forceps channel is about 1.2-1.4 mm, the surgical instruments which can be placed in the narrow and long space are very limited, and the conventional suture surgical instruments can not meet the requirements at present, so that an instrument special for the minimally invasive operation under the digestive endoscope needs to be manufactured.
Disclosure of Invention
Aiming at the defects in the prior art, the invention aims to provide needle holding forceps with an electrocoagulation function for a digestive endoscopy operation, which are special for being used under the digestive endoscopy operation, and the front end of the needle holding forceps can freely rotate and open and close, can clamp and lock a suture needle, and also has the effects of electrocautery and electric polyp removal and electrocoagulation hemostasis.
In order to achieve the above purpose, the invention adopts the following technical scheme:
the needle holding forceps with the electrocoagulation function for the digestive endoscopy operation comprises forceps heads, forceps bodies, a control handle and an electrocoagulation mechanism, wherein the rear ends of the forceps heads are connected with one ends of the forceps bodies, the other ends of the forceps bodies are connected with the front ends of the control handle, the control handle controls the forceps heads to clamp and release suture needles and sutures through the forceps bodies, and the electrocoagulation mechanism is connected with the control handle;
the forceps head comprises a pair of forceps arms, a transmission mechanism, a forceps head main body and a fixed rotating mechanism, wherein the pair of forceps arms are fixedly connected to the front end of the forceps head main body through the transmission mechanism, the transmission mechanism is connected with the forceps body, the rear end of the forceps head main body is connected with the fixed rotating mechanism, the front ends and the outer side surfaces of the pair of forceps arms are all in a blunt arc shape, the surfaces of the forceps arms are smooth surfaces, the inner side surfaces of the forceps arms are clamping surfaces, the surfaces of the clamping surfaces are in grid cross tooth shapes, the clamping surfaces are used for clamping and releasing suture needles, and clamping grooves are formed in the rear parts of the clamping surfaces of the forceps arms;
the pliers body comprises an inner core, a spring tube sleeved on the inner core and an insulating layer sleeved on the spring tube, wherein one end of the inner core penetrates through the fixed rotating mechanism and then is connected with the transmission mechanism, and one end of the spring tube is connected with the fixed rotating mechanism;
the control handle comprises a handle body, a slip ring component and a locking component, wherein a movable chute is axially arranged on the handle body, a through hole is formed in the front end of the handle body, the through hole is communicated with the movable chute, the slip ring component is arranged in the movable chute and is locked and positioned in the movable chute through the locking component, the other end of the inner core penetrates through the through hole in the front end of the handle body and is connected with the slip ring component in the movable chute, the other end of the spring tube is connected with the front end of the handle body, when the slip ring component moves towards the rear end of the handle body in the movable chute, the inner core is driven to tighten a transmission mechanism, so that the transmission mechanism drives a pair of clamp arms to clamp a suture needle, when the slip ring component moves towards the front end of the handle body in the movable chute, the inner core is driven to push the transmission mechanism, the transmission mechanism drives the pair of clamp arms to release the suture needle, and an electrode is further arranged on the slip ring component;
the electric coagulation mechanism comprises a high-frequency electric knife and an electrode plate, wherein the positive electrode of the high-frequency electric knife is connected with an electrode on the slip ring assembly through a connecting wire, and the negative electrode of the high-frequency electric knife is also connected with the electrode plate through the connecting wire.
The front end of the clamp head main body is provided with a mounting groove, the rear end of the clamp head main body is provided with a through hole, and the through hole is communicated with the mounting groove.
The transmission mechanism is arranged in the mounting groove and comprises a transmission arm and a connecting rod, the transmission arm is of a scissor-fork structure, the front end of the transmission arm is connected with a pair of clamp arms and is movably connected to the front end of the clamp head main body through a key shaft, one end of the connecting rod is connected with the rear end of the transmission arm, and the other end of the connecting rod is connected with one end of the inner core.
The fixed rotating mechanism comprises a bearing inner sleeve, a bearing outer sleeve sleeved on the bearing inner sleeve, a gasket, a first fixed ring, a second fixed ring and a connecting sleeve, wherein the first fixed ring is arranged at one end of the bearing inner sleeve and connected with the rear end of the clamp head main body, the second fixed ring is arranged at the other end of the bearing inner sleeve, the gasket is arranged at one side of the first fixed ring, the bearing outer sleeve is arranged between the gasket and the second fixed ring, the connecting sleeve is sleeved outside the bearing outer sleeve, the gasket and the second fixed ring, one end of the connecting sleeve is connected with one end of the spring tube, and the other end of the connecting sleeve is connected with the bearing outer sleeve.
The slip ring assembly comprises a slip ring body and a spring fixing tube, wherein the slip ring body is arranged in the movable sliding groove, a clamping head and a fixing hole are formed in the front end face of the slip ring body, the spring fixing tube is inserted into the slip ring body, and the other end of the inner core penetrates through a through hole in the front end of the handle body and then penetrates through the spring fixing tube to be connected with the slip ring body.
The locking assembly comprises saw teeth and a torsion spring, the torsion spring is sleeved on the spring fixing tube, one end of the torsion spring is inserted into the fixing hole, the saw teeth are arranged in the movable sliding groove, when the other end of the torsion spring is clamped on the clamping head, the slip ring assembly is in an unlocking state, and when the other end of the torsion spring is clamped on the saw teeth, the slip ring assembly is in a locking state.
The slip ring body comprises a pair of slip ring blocks, the slip ring blocks are respectively arranged on two sides of the movable chute, so that the slip ring body moves on the handle body along the movable chute, an inner core fixing hole is formed in one slip ring block, an electrode is embedded in the other slip ring block, and the electrode is connected with the spring fixing pipe.
The clamp head and the spring tube are made of stainless steel.
The inner core is made of nickel-titanium super-elastic memory alloy material, and the insulating layer is made of rubber material.
And the clamp head main body and the connecting sleeve are also coated with a Teflon insulating layer.
In the technical scheme, the needle holder with the electrocoagulation function for the digestive endoscopy operation has the following beneficial effects:
1. the invention is used under the digestive endoscope, the forceps head can freely rotate, can be opened and closed freely, and is convenient to operate and control;
2. the invention can clamp and lock the suture needle, clamp the suture thread and knotte the suture thread to suture the defect of the digestive tract tube wall in the whole course;
3. the invention can suture mucous membrane in alimentary canal mucous membrane stripping operation (ESD) and whole course suture for various perforation in alimentary canal (endoscopic perforation, treatment concurrent perforation, gastric wall total layer Excision (EFTR) and natural cavity endoscopic operation (NOTES) incision);
4. the invention can perform splayed suture for hemostasis on intractable hemorrhage of digestive tract (hemorrhage in polypectomy, EMR, ESD or post-operation, difficult to successfully stop bleeding by using an electrocoagulation and metal clip), and can directly clip the electrocoagulation for hemostasis of small blood vessel hemorrhage, and the wound surface bleeding can be in electrocoagulation for hemostasis;
5. the invention can be used for the electric picking and burning removal operation of small polyps;
6. the invention can also be used as a foreign body forceps.
Drawings
FIG. 1 is a schematic diagram of the structure of the present invention;
FIG. 2 is a schematic view of the structure of the binding clip of the present invention;
FIG. 3 is a schematic view of the structure of the caliper body of the present invention;
FIG. 4 is a schematic view of the structure of the control handle of the present invention;
FIG. 5 is a schematic view of the direction a of FIG. 2;
FIG. 6 is an enlarged schematic view of the position b of FIG. 4;
FIG. 7 is a schematic view of the invention in a jaw engaged condition;
FIG. 8 is a schematic view of the clamping face of the binding clip of the present invention;
FIG. 9 is a front view of the slip ring assembly of the present invention;
fig. 10 is a schematic circuit diagram of the present invention.
Detailed Description
The technical scheme of the invention is further described below with reference to the accompanying drawings and examples.
Referring to fig. 1 to 10, the needle holder with an electrocoagulation function for a digestive endoscopy operation provided by the invention comprises a forceps head 1, a forceps body 2, a control handle 3 and an electrocoagulation mechanism, wherein the rear end of the forceps head 1 is connected with one end of the forceps body 2, the other end of the forceps body 2 is connected with the front end of the control handle 3, the control handle 3 controls the forceps head 1 to clamp and release a suture needle and a suture through the forceps body 2, the electrocoagulation mechanism is connected with the control handle 3, in the embodiment, the total length of the control handle 3 is 165mm, the total length of the forceps body 2 is 1600mm, and the total length of the forceps head 1 is about 13mm, so that the needle holder is convenient for being inserted into an endoscope forceps channel to perform operation.
Preferably, the clamp head 1 comprises a pair of clamp arms 101, a transmission mechanism, a clamp head main body 102 and a fixed rotating mechanism, wherein the transmission mechanism comprises a transmission arm 103 and a connecting rod 104, the transmission arm 103 is in a scissor-fork structure, the fixed rotating mechanism comprises a bearing inner sleeve 105, a bearing outer sleeve 106 sleeved on the bearing inner sleeve 105, a gasket 107, a first fixed ring 108 and a second fixed ring 109, and a connecting sleeve 112, a mounting groove 110 is formed at the front end of the clamp head main body 102, a through hole is formed at the rear end of the clamp head main body 102 and is communicated with the mounting groove 110, the pair of clamp arms 101 are fixed in the mounting groove 110 at the front end of the clamp head main body 102 through a key shaft hinge, the tail part of the clamp arm 101 is also fixed at the front end of the transmission arm 103 through the key shaft hinge, the rear end of the transmission arm 103 is connected with one end of the connecting rod 104 through the key shaft, the clamp arm 101 and the driving arm 103 can partially rotate around the key shaft as the center, so that the clamp arm 101 can be snapped and opened, one end of the bearing inner sleeve 105 is fixedly connected with the rear end of the clamp head main body 102, then the bearing outer sleeve 106, the gasket 107, the first fixing ring 108 and the second fixing ring 109 are sleeved on the bearing inner sleeve 105, the first fixing ring 108 is sleeved on one end of the bearing inner sleeve 105 and is connected with the rear end of the clamp head main body 102, the second fixing ring 109 is sleeved on the other end of the bearing inner sleeve 105, the gasket 107 is sleeved on one side of the first fixing ring 108, the bearing outer sleeve 106 is sleeved between the gasket 107 and the second fixing ring 109, so that the bearing outer sleeve 106 can flexibly rotate without slipping, then the connecting sleeve 112 is sleeved outside the bearing outer sleeve 106, the gasket 107 and the second fixing ring 109, one end of the connecting sleeve 112 is connected with one end of the spring tube 202, and the other end of the connecting sleeve 112 is fixed with the bearing outer sleeve 106, at this time, the fixed connection sleeve 112 is pinched with a finger, and the jaw 1 can be freely rotated by rotating the inner core 201 through the bearing housing 106. In addition, the fixed rotation mechanism is made of stainless steel, so that the fixed rotation mechanism is uniform, the inner and outer tube walls are smooth, and the main setting parameters (outer diameter, inner diameter, thickness, length) are as follows:
bearing inner sleeve 105: 1.7X1.3×0.28mm,
bearing housing 106:2.1 x 1.8 x 0.15 x 3.5mm,
gasket 107:2.1 x 1.8 x 0.15 x 1mm,
first fixing ring 108, second fixing ring 109:2.1 x 1.8 x 0.15 x 1mm,
the connection sleeve 112:2.4 x 2.2 x 0.1 x 12mm.
Preferably, the pair of forceps arms 101 are made of stainless steel, the front end and the outer side surfaces of the forceps arms 101 are all in a blunt arc shape, the surfaces of the forceps arms are smooth surfaces, so that the inner wall of the forceps channel is not easy to damage when the forceps channel is accessed, in addition, tissues are not easy to damage, the inner side surfaces of the forceps arms 101 are clamping surfaces, the surfaces of the clamping surfaces are in a grid cross tooth shape, the clamping surfaces are used for clamping and releasing suture needles, tissues, sutures and the like, the length of the forceps arms 101 is 3.2-6 mm, the width is 2.2mm, the height is 1.2mm, the length of the forceps arms 101 can be adjusted according to different requirements, and the corresponding length of the transmission arms 103 is 2.3mm, the width is 1.2 and the height is 0.3mm.
Because the clamp body 2 is slender, when the clamp arm 101 is used for clamping the suture needle in a control manner, the clamping force is limited, so that the suture needle is poor in stability, easy to slide back and forth and roll, and difficult to operate. Therefore, the clamping grooves 111 are also formed in the rear of the clamping surfaces of the clamp arms 101, after the clamp arms 101 are engaged, the inner diameter of the clamping grooves 111 is about 0.5-0.6 mm, the inner walls of the clamping grooves 111 are provided with rough irregular surfaces, and the suture needle is clamped in the clamping grooves 111, when the clamp arms 101 are engaged and tightened, the suture needle can be clamped and pressed, the suture needle is difficult to rotate or slide, the stability of the suture needle is greatly improved, and the operability is obviously enhanced.
Preferably, the body 2 includes an inner core 201, a spring tube 202 sleeved outside the inner core 201, and an insulating layer 203 sleeved on the spring tube 202, so that the body 2 is mainly composed of an inner layer structure, an intermediate layer structure and an outer layer structure, one end of the inner core 201 passes through a through hole at the rear end of the binding clip main body 102 and then is connected with the other end of the connecting rod 104, one end of the spring tube 202 is fixedly connected with one end of the connecting sleeve 112, the inner core 201 is made of nickel-titanium super-elastic memory alloy, the diameter is 0.8mm, the length is about 1680mm, the spring tube 202 is made of stainless steel, and parameters (external diameter, internal diameter, length) are mainly set: 2×1×1630mm, the insulating layer 203 is made of rubber, and the main setting parameters (outer diameter×inner diameter×length): 2.5 x 2 x 1630mm.
Preferably, the control handle 3 includes a handle body 301, a slip ring assembly 302 and a locking assembly 303, a moving chute 304 is axially formed on the handle body 301, an axial through hole is formed at the front end of the handle body 301, the through hole is communicated with the moving chute 304, the slip ring assembly 302 is installed in the moving chute 304, and when the slip ring assembly 302 is adjusted to a proper position in the moving chute 304, the slip ring assembly 302 is locked and positioned in the moving chute 304 by the locking assembly 303. The other end of the inner core 201 passes through the through hole at the front end of the handle main body 301 and then is connected with the slip ring assembly 302 in the moving chute 304, the other end of the spring tube 202 is sleeved with the miniature bearing 204 and the fixed sleeve 205, the spring tube 202 is sleeved and fixed on the inner ring of the miniature bearing 204, the fixed sleeve 205 is fixed on the spring tube 202, the other end of the spring tube 202 and the fixed sleeve 205 are inserted into the through hole at the front end of the handle main body 301 together, then the outer ring of the miniature bearing 204 and the end at the front end of the handle main body 301 are fixed, in this way, the spring tube 202 cannot rotate when the control handle 3 is rotated, and the inner core 201 rotates along with the control handle 3 in the same direction, so that the control clamp head 1 is driven to rotate along the same direction.
Preferably, the slip ring assembly 302 includes a slip ring body 305 and a spring fixing tube 306, the slip ring body 305 is mounted in the moving chute 304, the front end surface of the slip ring body 305 is provided with a chuck 307 and a plurality of fixing holes 308, the spring fixing tube 306 is inserted and mounted in the center position of the slip ring body 305, and the other end of the inner core 201 penetrates through the through hole at the front end of the handle body 301 and then penetrates into the spring fixing tube 306 to be connected with the inside of the slip ring body 305.
Preferably, the slip ring body 305 includes a pair of slip ring blocks 311, the slip ring blocks 311 are assembled from two sides of the moving chute 304, so that the slip ring body 305 can move along the moving chute 304, an inner core fixing hole is formed in one of the slip ring blocks 311, a hole is drilled in the other slip ring block 311, a plastic part of the electrode 313 is adhered to the slip ring block 311 by AB adhesive, the electrode 313 is welded on the spring fixing tube 306, the proximal end of the spring fixing tube 306 is welded and fixed with the inner core 201, and the distal end of the spring fixing tube 306 is wrapped by insulating plastic, so that the torsion spring 310 is insulated, electric shock risks to operators are avoided, and surgical safety is improved.
Preferably, the locking component 303 comprises a saw tooth 309 and a torsion spring 310, the saw tooth 309 is fixed in a saw tooth fixing groove formed in the moving chute 304 by using AB glue, the saw tooth 309 faces the tail end of the control handle 3, the torsion spring 310 is mounted on the spring fixing tube 306 and is subjected to local spot welding, the torsion spring 310 is conveniently fixed, slipping is prevented, one end of the torsion spring 310 is inserted into one of the fixing holes 308, and the other end of the torsion spring 310 is matched with the clamping head 307 and the saw tooth 309, so that the slip ring component 302 is released and locked.
The other end of the inner core 201 is inserted into the lumen of the spring fixing tube 306, after the proper length is adjusted, the end is folded to 90 degrees, inserted into the inner core fixing hole, and then a proper amount of AB glue is added for fixing.
After the assembly, the clamping groove 111 of the binding clip 1 is used for clamping the suture needle, the slip ring assembly 302 is moved and tensioned towards the tail end of the control handle 3, the binding clip 1 clamps the suture needle, the other end of the torsion spring 310 is released from the beginning 307, the other end of the torsion spring 310 is embedded into the inverted tooth of the saw tooth 309 by utilizing the elasticity of the torsion spring, the slip ring assembly 302 is locked, the slip ring assembly is prevented from sliding in the moving sliding groove 304, further acting force is conducted through the inner core 201 to conduct the binding clip 1, the suture needle is locked, the suture operation is convenient, the hand of an operator can be prevented from being slightly loosened during the suture operation, the suture needle can be shifted, the direction of the suture needle needs to be readjusted by taking time, and the subsequent operation is influenced. The end of the other end of the torsion spring 310 is provided with a spherical shape with a smooth surface, which is convenient for thumb operation.
The total length of the control handle 3 is 165mm, the tail of the handle main body 301 is also connected with an elliptical ring 312, the inner diameter of the elliptical ring 312 is 23 x 25mm, the outer diameter of the elliptical ring 312 is 32.5 x 30mm, and the elliptical ring is movably connected with the tail of the handle main body 301 and can rotate freely. The control handle 3 is mainly made of plastic, the slip ring assembly 302 moves back and forth on the handle main body 301, driving force can be transmitted to the position of the clamp head 1 through the inner core 201, the clamp arms 101 are controlled to open or bite, the elliptical ring 312 is fixed, the handle main body 301 is rotated, the inner core 201 rotates in the same direction along with the driving force, and the spring tube 202 does not rotate along with the spring tube 202 because bearings are arranged at two ends of the spring tube 202, and the clamp head 1 also rotates along with the inner core 201 in the same direction.
Preferably, the electric coagulation mechanism comprises a high-frequency electric knife 4 and an electrode plate 5, wherein the positive electrode of the high-frequency electric knife 4 is connected with an electrode 313 on the slip ring assembly 302 through a connecting wire 6, the negative electrode of the high-frequency electric knife 4 is also connected with the electrode plate 4 through the connecting wire 6, and the electrode plate 4 is adhered to the calf. Thus, during treatment, the needle holding forceps can play a role in electric coagulation and hemostasis, can electrically burn and pluck polyps, reduces switching of instruments in operation, and saves operation time.
Preferably, teflon insulating layers are further coated on the forceps head main body 102 and the connecting sleeve 112, so that surrounding tissues can be protected from being burned by mistake when the electric coagulation hemostasis is used.
The needle holding forceps are inserted into the gastroscope forceps channel, an operator holds the gastroscope operating handle by left hand, and can operate and control the needle holding forceps by right hand with one hand: the slip ring component is pinched by the index finger and the thumb of the right hand, the control handle is held in the hand by the middle finger and the ring finger, the slip ring component can slide back and forth by the index finger and the thumb, and the clamp head is controlled to open and bite, so that the suture needle is loosened and clamped. Suture needle clamping: the assistant inserts the vascular forceps through another forceps channel to assist in transferring the suture needle to the needle holding forceps and clamping the tail end of the suture needle. Locking the suture needle: after the needle holding forceps clamp the suture needle and the proper angle is adjusted, the slip ring component can be pulled backwards at the moment, the other end of the torsion spring is slightly pulled out by the clamping head by the thumb of the right hand, and the elasticity of the torsion spring is utilized to enable the end of the torsion spring to be embedded into the sawtooth inverted tooth for locking, so that the slip ring component can be prevented from moving forwards, and the suture needle can be locked. Stitching: after the suture needle is locked, the right thumb and the index finger screw the slip ring component, the forceps head can be controlled to rotate clockwise or anticlockwise, an assistant can assist in clamping tissues through the vascular forceps, an operator can adjust the needle inserting direction, the suture is convenient in the clockwise direction generally, the forceps head can be controlled to rotate clockwise through the thumb and the index finger screw the slip ring component, the suture needle head penetrates through the tissues and exposes the needle head, the assistant assists in clamping the needle head through the vascular forceps, and rotates out in the clockwise direction, then the suture is clamped through the needle holding forceps, the suture is gradually tightened, the suture is provided with barbs, after the suture is tightened, the suture tail end cannot retract, a knot is reserved before the suture, slipping is prevented, the suture is continuously performed until the wound surface is completely sutured, the extra suture is cut off through scissors, the suture needle is taken out, and the operation is completed.
Fulgurating electrical plucking polyps: small polyps (the length and the diameter of common polyps are less than or equal to 0.5 cm) are found under an endoscope, the needle holding forceps are connected with the positive electrode of a high-frequency electrotome, the electrode plate is stuck on the surface of a patient, then the needle holding forceps and the negative electrode of the high-frequency electrotome are blended with proper power (electric cutting is carried out by 30 watts and electric coagulation is carried out by 20 watts), the polyps are clamped by using forceps heads, and the needle holding forceps are slightly lifted, and an operator steps on an electric coagulation electric cutting switch to perform electric coagulation electric cutting and burn polyps.
Bleeding of mucosal wound surface: the wound surface is bleeding, a high-frequency electrotome is opened, the needle holding forceps are placed in the wound surface bleeding position, the forceps head is directly contacted with the wound surface bleeding position, and the electric coagulation switch is stepped on by feet to perform electric coagulation hemostasis. For small blood vessel pulsating bleeding, the forceps head is opened, the bleeding part is clamped, and the electric coagulation and hemostasis are carried out by slightly lifting and stepping an electric coagulation and electroincision switch by the operator. For the means such as electrocoagulation and titanium clips, which are difficult to control hemostasis, the splayed suture can be adopted for hemostasis.
The indications of the invention are as follows:
1. stitching that can be used for the following perforations:
(1) The digestive tract (esophagus, stomach, duodenum, colorectal) examined for perforation;
(2) Post-endoscopic treatment perforation: polypectomy, mucoectomy (EMR), mucosals dissection (ESD);
(3) Total resection of the stomach wall (EFTR) and natural cavity endoscopic surgery (NOTES) incisions;
2. the hemostatic agent is used for stopping bleeding of a mucous membrane wound;
3. fulgurating electrical plucking polyps;
4. can also be used as a foreign body forceps.
It will be appreciated by persons skilled in the art that the above embodiments are provided for illustration only and not for limitation of the invention, and that variations and modifications of the above described embodiments are intended to fall within the scope of the claims of the invention as long as they fall within the true spirit of the invention.
Claims (5)
1. The needle holding forceps with the electrocoagulation function for the digestive endoscopy operation is characterized by comprising forceps heads, forceps bodies, control handles and an electrocoagulation mechanism, wherein the rear ends of the forceps heads are connected with one ends of the forceps bodies, the other ends of the forceps bodies are connected with the front ends of the control handles, the control handles control the forceps heads to clamp and release suture needles and sutures through the forceps bodies, and the electrocoagulation mechanism is connected with the control handles;
the clamp head comprises a pair of clamp arms, a transmission mechanism, a clamp head main body and a fixed rotating mechanism, wherein the pair of clamp arms are fixedly connected to the front end of the clamp head main body through the transmission mechanism, the transmission mechanism is connected with the clamp body, the rear end of the clamp head main body is connected with the fixed rotating mechanism, the front ends and the outer side surfaces of the pair of clamp arms are all in a blunt arc shape, the surfaces of the clamp arms are smooth surfaces, the inner side surfaces of the clamp arms are clamping surfaces, the surfaces of the clamping surfaces are in grid cross tooth shapes, the clamping surfaces are used for clamping and releasing suture needles, and clamping grooves are formed below the clamping surfaces of the clamp arms;
the pliers body comprises an inner core, a spring tube sleeved on the inner core and an insulating layer sleeved on the spring tube, wherein one end of the inner core penetrates through the fixed rotating mechanism and then is connected with the transmission mechanism, and one end of the spring tube is connected with the fixed rotating mechanism;
the control handle comprises a handle body, a slip ring component and a locking component, wherein a movable chute is axially arranged on the handle body, a through hole is formed in the front end of the handle body, the through hole is communicated with the movable chute, the slip ring component is arranged in the movable chute and is locked and positioned in the movable chute through the locking component, the other end of the inner core penetrates through the through hole in the front end of the handle body and is connected with the slip ring component in the movable chute, the other end of the spring tube is connected with the front end of the handle body, when the slip ring component moves towards the rear end of the handle body in the movable chute, the inner core is driven to tighten a transmission mechanism, so that the transmission mechanism drives a pair of clamp arms to clamp a suture needle, when the slip ring component moves towards the front end of the handle body in the movable chute, the inner core is driven to push the transmission mechanism, the transmission mechanism drives the pair of clamp arms to release the suture needle, and an electrode is further arranged on the slip ring component;
the electric coagulation mechanism comprises a high-frequency electric knife and an electrode plate, wherein the positive electrode of the high-frequency electric knife is connected with an electrode on the slip ring assembly through a connecting wire, and the negative electrode of the high-frequency electric knife is also connected with the electrode plate through the connecting wire;
the front end of the clamp head main body is provided with an installation groove, the rear end of the clamp head main body is provided with a through hole, and the through hole is communicated with the installation groove;
the transmission mechanism is arranged in the mounting groove and comprises a transmission arm and a connecting rod, the transmission arm is of a scissor-fork structure, the front end of the transmission arm is connected with a pair of clamp arms and is movably connected to the front end of the clamp head main body through a key shaft, one end of the connecting rod is connected with the rear end of the transmission arm, and the other end of the connecting rod is connected with one end of the inner core;
the fixed rotating mechanism comprises a bearing inner sleeve, a bearing outer sleeve sleeved on the bearing inner sleeve, a gasket, a first fixed ring, a second fixed ring and a connecting sleeve, wherein the first fixed ring is arranged at one end of the bearing inner sleeve and is connected with the rear end of the clamp head main body;
the sliding ring assembly comprises a sliding ring body and a spring fixing pipe, the sliding ring body is arranged in the movable sliding groove, a clamping head and a fixing hole are formed in the front end face of the sliding ring body, the spring fixing pipe is inserted into the sliding ring body, and the other end of the inner core penetrates through a through hole in the front end of the handle body and then penetrates through the spring fixing pipe to be connected with the sliding ring body;
and the clamp head main body and the connecting sleeve are also coated with a Teflon insulating layer.
2. The needle holder with electrocoagulation function for digestive endoscopy as claimed in claim 1, wherein the locking assembly comprises a saw tooth and a torsion spring, the torsion spring is sleeved on the spring fixing tube, one end of the torsion spring is inserted into the fixing hole, the saw tooth is arranged in the movable sliding groove, the slip ring assembly is in an unlocked state when the other end of the torsion spring is clamped on the chuck, and the slip ring assembly is in a locked state when the other end of the torsion spring is clamped on the saw tooth.
3. The needle holder with electrocoagulation function for digestive endoscopy as claimed in claim 1, wherein the slip ring body comprises a pair of slip ring blocks, the pair of slip ring blocks are respectively arranged at two sides of the moving chute, so that the slip ring body moves on the handle body along the moving chute, wherein an inner core fixing hole is formed in one slip ring block, an electrode is embedded in the other slip ring block, and the electrode is connected with the spring fixing tube.
4. The needle holder with the electrocoagulation function for the digestive endoscopy operation of claim 1, wherein the forceps head and the spring tube are made of stainless steel materials.
5. The needle holder with the electrocoagulation function for the digestive endoscopy operation of claim 1, wherein the inner core is made of a nickel-titanium super elastic memory alloy material, and the insulating layer is made of a rubber material.
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| CN201710650191.XA CN109381254B (en) | 2017-08-02 | 2017-08-02 | Needle holder with electrocoagulation function for digestive endoscopy |
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| CN201710650191.XA CN109381254B (en) | 2017-08-02 | 2017-08-02 | Needle holder with electrocoagulation function for digestive endoscopy |
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| CN109381254B true CN109381254B (en) | 2024-02-13 |
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| CN109381254A (en) | 2019-02-26 |
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