CN110151242B

CN110151242B - Knotter for suture of laparoscopic surgery

Info

Publication number: CN110151242B
Application number: CN201910469773.7A
Authority: CN
Inventors: 熊治荣; 张矛; 郭鹏; 熊嘉陆
Original assignee: Xi'an Zhirong Electromechanical Technology Co ltd
Current assignee: Xi'an Zhirong Electromechanical Technology Co ltd
Priority date: 2019-05-31
Filing date: 2019-05-31
Publication date: 2025-02-18
Anticipated expiration: 2039-05-31
Also published as: CN110151242A

Abstract

The present invention provides a knotter for laparoscopic suture, which belongs to the field of laparoscopic surgery and includes a knotter guide sleeve; a telescopic hook, which penetrates the axial direction of the knotter guide sleeve and is movably arranged, and is provided with a head end for hooking a suture to tighten the suture; a telescopic hook guide sleeve, which is sleeved on the telescopic hook and can be moved axially along the knotter guide sleeve, and is used to sleeve a pre-tied slipknot and make the slipknot sleeved on the suture to form a suture knot; an auxiliary tensioning rod, which penetrates the axial direction of the knotter guide sleeve and is rotatably arranged, and is used to fix the end of the slipknot to reinforce the firmness of the suture knot. The present invention can achieve knotting in one time, and the knotting is firmly fastened and will not loosen or rebound, thereby shortening the laparoscopic surgery time and reducing the risk of blood loss in patients.

Description

Knotter for suture of laparoscopic surgery

Technical Field

The invention belongs to the field of laparoscopic surgery, and particularly relates to a knotter for laparoscopic surgery suture.

Background

Laparoscopic surgery is a minimally invasive surgical method, and has been widely used for cholecystectomy, appendectomy, gastric, duodenal ulcer perforation repair, hernia repair, colectomy, splenectomy, adrenalectomy, etc. because of its advantage of small postoperative scar. However, the retrospective technique of laparoscopic suturing and knot tying restricts the development of laparoscopic surgery.

Aiming at the problem that the existing knotting and suturing are inflexible, the prior art (CN 101449989B) discloses a laparoscopic suturing knotter which consists of a suturing device and a thread holding and cutting pliers which are matched for use, wherein the suturing device comprises a suturing needle, a suturing device main rod, a suturing device handle, a locking screw, a locking mechanism, a suture and a handle, a spool and the locking mechanism are arranged on the handle, the pull rod is positioned in an inner cavity of the main rod, the front end of the pull rod is hinged with the suturing needle, the rear end of the pull rod is fixedly connected with the collarbone screw, the front side and the side of the suturing needle can be rotated by 120 degrees by rotating the collarbone screw, the thread holding pliers and the thread cutting pliers play the role of assisting in clamping and cutting threads. Although the prior art can flexibly deliver and suture in the abdominal cavity, the knotting problem is not solved at all, as shown in fig. 1, the thread ends on two sides of the wound are tensioned and a single knot is tied firstly in the operation, but the elasticity of the muscle tissue of the human body can be loosened before the square knots are knotted by the reverse secondary intersection, so that the knotting is not firm. The above prior art cannot achieve the maintenance of the tensioned state of the single knot before the completion of the knotting of the square knot, thus resulting in the need of repeated operations of knotting at the same position and weak knotting.

Disclosure of Invention

Based on the background problems, the invention aims to provide the knotter for the laparoscopic surgery suture, which solves the problems that repeated operation is needed for knotting and knotting is easy to loose in the prior art, can shorten laparoscopic surgery time, and can reduce the risk of blood loss of a patient.

In order to achieve the above purpose, the technical scheme provided by the invention is as follows:

The knotter for the laparoscopic surgery suture comprises a knotter guide sleeve, a telescopic hook guide sleeve, an auxiliary tensioning rod and a tightening rod, wherein the telescopic hook penetrates through the knotter guide sleeve to be axially and movably arranged, the head end is used for hooking a suture line to tighten the suture line, the telescopic hook guide sleeve is sleeved on the telescopic hook and can axially move along the knotter guide sleeve and is used for sleeving a preset looper and enabling the looper to be sleeved on the suture line to form the suture knot, and the auxiliary tensioning rod penetrates through the knotter guide sleeve to be axially and rotatably arranged and is used for fixing the end part of the looper to strengthen the firmness of the suture knot.

When the telescopic hook guide sleeve moves away from the head end, the slipknot can be sleeved on the suture.

The telescopic hook guide sleeve and the auxiliary tensioning rod are distributed up and down, and the central axis of the telescopic hook guide sleeve and the central axis of the auxiliary tensioning rod are in the same vertical plane.

Preferably, one side of the telescopic hook guide sleeve, which is far away from the head end, is also connected with a telescopic hook guide sleeve operating handle.

Preferably, an end of the auxiliary tensioning rod, which is far away from the head end, is further provided with an auxiliary tensioning rod rotating handle.

Wherein, the head end is equipped with the fastener that is used for fixing the suture line.

The knotter guide sleeve is further sleeved with a handle for a user to hold on at one side of the knotter guide sleeve away from the head end.

Compared with the prior art, the invention has the following effects:

1. The telescopic hook, the telescopic hook guide sleeve and the auxiliary tensioning rod are axially arranged in the knotter guide sleeve, the slipknot is sleeved at the end part of the telescopic hook guide sleeve before use, the suture is fixed through the telescopic hook and is tightened through pulling the telescopic hook during use, and then the slipknot is sleeved on the suture through moving the telescopic hook guide sleeve, so that the suture knot is formed, one-time knotting is achieved, the laparoscopic surgery time is shortened, and the blood loss risk of a patient is reduced;

2. According to the invention, the other thread end of the slipknot is fixed on the auxiliary tensioning rod, when the slipknot is sleeved on the suture line to form a suture knot, the suture knot can be tensioned by rotating the auxiliary tensioning rod, so that the knotting is converted into a firm knot in other forms such as a square knot or a crossed knot from a sliding knot, and the fastening degree of the knotting is improved.

3. The invention has simple and convenient operation and can enlarge the application range of laparoscopic surgery.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings that are required to be used in the description of the embodiments will be briefly described below.

FIG. 1 is a schematic illustration of a single knot and a square knot being tied during a surgical procedure;

FIG. 2 is a schematic view showing the structure of a knotter for laparoscopic surgical suture in an embodiment of the present invention;

FIG. 3 is an enlarged view of a portion of FIG. 2 at A;

FIG. 4 is a schematic view of a knotter for laparoscopic surgical suturing in accordance with an embodiment of the present invention.

Detailed Description

For the purpose of making the objects, technical solutions and advantages of the embodiments of the present invention more apparent, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention, and it is apparent that the described embodiments are some embodiments of the present invention, but not all embodiments of the present invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention. It should be noted that, in this embodiment, the term "head" refers to an end extending into a wound to be sutured in a patient, and "tail" refers to an end located outside the patient and operable by a user.

As shown in fig. 1, in the operation, the thread ends on both sides of the wound are pulled to be fastened and a single knot is tied firstly (as shown in fig. 1 (a)), but the first single knot is loosened before the square knot is tied by the reverse secondary crossing due to the elasticity of the muscle tissue of the human body (as shown in fig. 1 (b)), so that the knot is not firm. The prior art cannot realize the maintenance of the tension state of the single knot before the square knot is knotted, so that the same position needs to be knotted repeatedly and the knotting is not firm.

Accordingly, the present embodiment provides a knotter for laparoscopic surgical suture, as shown in fig. 2, including a knotter guide 1, a telescopic hook guide 2, a telescopic hook 3, and an auxiliary tension rod 4. In this embodiment, the knotter guide sleeve 1 is cylindrical, may be a hollow structure, or may be a through hole axially formed for the telescopic hook guide sleeve 2 and the auxiliary tensioning rod 4 to pass through, and this embodiment is not particularly limited. As shown in fig. 2, the tail end of the knotter guide sleeve 1 is further sleeved with a handle 5 for a user to hold.

In this embodiment, the telescopic hook guide sleeve 2 is disposed along the axial direction of the knotter guide sleeve 1, and the telescopic hook guide sleeve 2 penetrates through the knotter guide sleeve 1, the telescopic hook guide sleeve 2 can move along the axial direction of the knotter guide sleeve 1, specifically, in this embodiment, positioning mounting heads are disposed at positions corresponding to positions of the left and right ends of the knotter guide sleeve 1 and the telescopic hook guide sleeve 2, the telescopic hook guide sleeve 2 penetrates through the positioning mounting heads to be mounted in the knotter guide sleeve 1, a head end of the telescopic hook guide sleeve 2 extends out of the knotter guide sleeve 1 to be used for sleeving a pre-knotted slipknot, and a tail end of the telescopic hook guide sleeve 1 extends out of the knotter guide sleeve 1 to be operated by a user, and for convenience of operation, the tail end is also connected with the telescopic hook guide sleeve operating handle 201.

The telescopic hook 3 is arranged along the axial direction of the telescopic hook guide sleeve 2, the telescopic hook 3 can move along the axial direction of the telescopic hook guide sleeve 2, a suture line fixed on the telescopic hook 3 can be tightened by moving the telescopic hook 3 along the axial direction of the telescopic hook guide sleeve 2, the telescopic hook 3 is of a round rod structure, the whole telescopic hook 3 comprises a head end and a tail end, the telescopic hook 3 penetrates through the telescopic hook guide sleeve 2, the head end and the tail end are convenient to fix the suture line and the tail end for a user to operate, in particular, as shown in fig. 3, the head end is provided with a wire clamp 301 for fixing the suture line, the wire clamp 301 is made of a corrosion-resistant and rust-free elastic material, the wire clamp is approximately inverted-shaped, the opening is slightly larger, the suture line is tightened beyond the top end, and the suture line is clamped through elasticity.

In this embodiment, the auxiliary tensioning rod 4 is also disposed along the axial direction of the knotter guide sleeve 1 and is rotatably disposed, but cannot move along the knotter guide sleeve 1 axially, specifically, the auxiliary tensioning rod 4 and the telescopic hook guide sleeve 2 are disposed in a vertically distributed manner, and the central axis of the telescopic hook guide sleeve 2 and the central axis of the auxiliary tensioning rod 4 are in the same vertical plane. The auxiliary tensioning rod 4 is installed in the knotter guide sleeve 1 through the positioning installation head, the auxiliary tensioning rod 4 is of a round rod structure and penetrates through the knotter guide sleeve 1, the auxiliary tensioning rod 4 also comprises a head end and a tail end, the head end is used for fixing the other thread end of the slipknot, and the tail end is further provided with an auxiliary tensioning rod rotating handle 401 for convenience in operation.

The method comprises the specific working processes of the invention, as shown in fig. 4, pre-tying one needleless end of a catgut for laparoscopic surgery in advance on the front end of a telescopic guide sleeve 2, fixing the needleless head 601 of the catgut 6 on the front end of an auxiliary tensioning rod 4, wherein the front end of the auxiliary tensioning rod 4 is a small-opening wedge-shaped elastic mechanism, the thread head is clamped in an elastic wedge-shaped groove through multi-circle winding to realize thread head fixing and tensioning, then the front end of a knotter together with a needle and the suture are sent to a wound 7 which needs to be sutured in a patient body through a laparoscopic surgery catheter (a catheter with the inner diameter not smaller than 8mm in the abdominal wall in the surgery), completing wound suturing through other auxiliary laparoscopic surgery instruments, then clamping the needleless head 602 of the suture on a wire clamp 301 at the front end of the telescopic hook 3, applying laparoscope scissors to cut off redundant suture, taking out redundant suture and taking the redundant suture out through other laparoscopic channels, then slowly pulling outwards the telescopic hook 3 until the wound 7 is completely tensioned to a proper degree, then pulling the handle slightly to the front end of the knotter together with the needle and the suture, pulling the needle and the needle, and the needle are pre-tied 6 is pre-tied on the abdominal wall of the patient, the needle and the needle 3 is pulled to rotate until the redundant suture is pulled off by the telescopic hook 3, and the redundant suture is pulled by the aid of the telescopic hook 3, and finally, the tension 3 is pulled by pulling the handle and the handle is turned to be turned and the suture 3, and the redundant by rotating 3, and the auxiliary operation hook is finally, and the operation is completed. Other more needle wound stitches were completed following the same procedure as described above.

The invention solves the problems of difficult knotting and time and labor waste when the wound is sewn due to the elastic factors of human muscle tissues under the existing laparoscopic surgery condition, simultaneously reduces the labor intensity of doctors, improves the operation capacity of unit working days, solves the problem that the laparoscopic surgery cannot be widely popularized due to the operation reasons, and can greatly improve the efficiency of the laparoscopic surgery due to simple operation.

It should be noted that modifications and improvements can be made by those skilled in the art without departing from the inventive concept, and these are all within the scope of the present invention.

Claims

1. A knotter for suturing laparoscopic surgery, comprising a knotter guide sleeve, characterized in that it also comprises:

A telescopic hook is axially penetrated through the knotter guide sleeve and is movably arranged, and is provided with a head end for hooking the suture to tighten the suture; the head end is provided with a wire clamp for fixing the suture;

A telescopic hook guide sleeve, which is sleeved on the telescopic hook and can move axially along the knotter guide sleeve, and is used to sleeve a pre-tied slipknot and make the slipknot sleeved on the suture to form a suture knot;

An auxiliary tensioning rod, which penetrates the knotter guide sleeve axially and is rotatably arranged, and is used to fix the end of the slipknot to reinforce the firmness of the suture knot;

An auxiliary tension rod rotating handle is also provided at one end of the auxiliary tension rod away from the head end;

Before the operation, a slipknot is tied at one end of the catgut without a needle used for laparoscopic surgery and is sleeved on the front end of the telescopic guide sleeve, and the end of the slipknot without a needle is fixed to the front end of the auxiliary tensioning rod. The front end of the auxiliary tensioning rod is a small-opening wedge-shaped elastic mechanism. The thread end is wrapped in multiple circles and stuck in the elastic wedge-shaped groove to fix and tighten the thread end; then the front end of the knotter together with the needle and suture thread are sent into the wound that needs to be sutured in the patient's body through the laparoscopic surgical catheter.

2. The laparoscopic surgical suturing knotter according to claim 1 is characterized in that when the telescopic hook guide sleeve moves away from the head end, the slipknot can be placed on the suture line.

3. The knotter for suturing in laparoscopic surgery according to claim 1 is characterized in that the telescopic hook guide sleeve and the auxiliary tensioning rod are distributed up and down, and the central axis of the telescopic hook guide sleeve and the central axis of the auxiliary tensioning rod are in the same vertical plane.

4. According to the laparoscopic surgical suturing knotter of claim 3, a telescopic hook guide sleeve operating handle is also connected to the side of the telescopic hook guide sleeve away from the head end.

5. The knotter for suturing laparoscopic surgery according to claim 1, wherein a handle for a user to hold is also provided on a side of the knotter guide sleeve away from the head end.