CN111839626B - Suture knot locking device with improved locking mode and suture knot locking device - Google Patents
Suture knot locking device with improved locking mode and suture knot locking device Download PDFInfo
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- CN111839626B CN111839626B CN201910366557.XA CN201910366557A CN111839626B CN 111839626 B CN111839626 B CN 111839626B CN 201910366557 A CN201910366557 A CN 201910366557A CN 111839626 B CN111839626 B CN 111839626B
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- 239000012207 thread-locking agent Substances 0.000 description 4
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Classifications
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- 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
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
-
- 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
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
- A61B2017/0488—Instruments for applying suture clamps, clips or locks
-
- 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
- A61B2017/0496—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
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Abstract
The invention provides a suture thread lock catch with an improved locking mode, which comprises a lock body and a locking assembly movably connected in the lock body, wherein the lock body is provided with a threading channel for threading a suture thread, the locking assembly comprises a pushing piece and a pressing block, and the pushing piece pushes the pressing block to extrude the suture thread threaded in the threading channel so as to lock the suture thread in the suture thread lock catch. The invention also provides a suture knot device provided with the suture knot lock catch.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a suture lock catch for improving a locking mode and a suture lock knot device provided with the suture lock catch.
Background
The procedure of tying and fixing the suture is often required in surgery, where traditional surgery is performed under open direct vision, typically manually by a physician. However, with the progress of technology, various minimally invasive and interventional procedures, such as endoscopic procedures, transcatheter interventions, etc., have become increasingly popular, requiring only a small operating window to be cut through the patient's body, thereby extending the endoscope or interventional catheter, etc., into the patient's body to the intended site for treatment. In such procedures, if a knot or fixation operation is to be performed on a suture in a patient, it is often necessary for an operator to remotely operate outside the patient through a small operating window.
The prior art discloses suture securement devices that secure a suture by two cooperatively locking tabs that exert a compressive force on the suture passing therebetween to limit the suture from sliding in a longitudinal direction through the opening. However, when the suture fixing device with the structure is used for fixing a plurality of sutures, an overlapped area exists among the plurality of sutures, and each suture cannot be ensured to be in effective contact with the lug, so that slipping easily occurs, and the locking capability is weak.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provides a suture lock catch with an improved locking mode and a suture lock device provided with the suture lock catch.
In order to solve the technical problems, the invention firstly provides a suture thread lock catch with an improved locking mode, which comprises a lock body and a locking component movably connected in the lock body, wherein the lock body is provided with a threading channel for threading a suture thread, the locking component comprises a pushing piece and a pressing block, and the pushing piece pushes the pressing block to extrude the suture thread threaded in the threading channel so as to lock the suture thread in the suture thread lock catch.
The invention also provides a suture knot locking device, which comprises a suture knot and a knot pushing mechanism; the suture thread lock catch comprises a lock body and a locking assembly movably connected in the lock body, the lock body is provided with a threading channel for threading a suture thread, the locking assembly comprises a pushing piece and a pressing block, and the pushing piece pushes the pressing block to extrude the suture thread threaded in the threading channel so as to lock the suture thread in the suture thread lock catch; the lock catch pushing mechanism comprises a mandrel, a push rod movably sleeved outside the mandrel and a handle connected with the proximal end of the push rod, and the suture line lock catch is accommodated in the distal end of the push rod and is detachably connected with the distal end of the mandrel; the handle drives the push rod to move relative to the mandrel, and when the pushing piece pushes the pressing block to press the suture line, the suture line is locked on the suture line lock catch.
The suture lock catch of the suture lock device provided by the invention comprises a lock body, a pushing piece and a pressing block, wherein the pushing piece and the pressing block are movably arranged in the lock body, the lock body is provided with a threading channel for threading a suture, and the pushing piece can push the pressing block to extrude the suture threaded in the threading channel under the action of a mandrel, so that the suture is locked between the pressing block and the lock body. Because the abutting surface between the pressing block and the lock body for locking the suture is larger, the overlapping probability of a plurality of sutures can be reduced, so that each suture is ensured to be subjected to locking force; and the extrusion force of the pressing block to the suture thread can be adjusted by adjusting the pushing piece, each suture thread can be ensured to be locked on the suture thread lock catch, the suture thread is effectively prevented from being separated from the suture thread lock catch, and the locking force of the suture thread lock catch is improved.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings that are needed in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
Fig. 1 is a schematic perspective view of a suture locking device according to a first embodiment of the present invention.
Fig. 2 is a sectional view taken along line II-II in fig. 1.
Fig. 3 is an enlarged view of the portion III in fig. 2.
Fig. 4 is a schematic perspective view of a suture shackle of the suture knot device of fig. 1.
Fig. 5 is a schematic perspective view of another view of the suture clasp of fig. 3.
Fig. 6 is an exploded perspective view of the suture clasp of fig. 3.
Fig. 7 is a perspective view of another perspective of the lock body of the suture shackle of fig. 6.
Fig. 8 is a cross-sectional view taken along line VIII-VIII in fig. 7.
Fig. 9 is a cross-sectional view taken along line IX-IX in fig. 6.
Fig. 10 is a cross-sectional view taken along line X-X in fig. 4.
Fig. 11 is a perspective view showing a locked state of the suture locker of fig. 4.
Fig. 12 to 13 are schematic views of a suture thread locking process of a suture thread lock according to a first embodiment of the present invention.
Fig. 14 is a schematic view of a suture shackle of a suture knot tying device according to a second embodiment of the present invention.
Fig. 15 is a schematic view of the suture clasp of fig. 14 in a locked state.
Fig. 16 is a schematic view of a suture shackle of a suture knot tying device according to a third embodiment of the present invention.
Fig. 17 is a schematic view of a suture shackle of a suture knot tying device according to a fourth embodiment of the present invention.
Fig. 18 is a schematic view of a suture shackle of a suture knot tying device according to a fifth embodiment of the present invention.
Fig. 19 is a schematic perspective view of the lock body of the suture shackle of fig. 18.
Fig. 20 is a schematic perspective view of another view of the lock body of the suture shackle of fig. 18.
Fig. 21 is a cross-sectional view taken along line XXI-XXI in fig. 20.
Fig. 22 is a schematic perspective view of a lateral slider of the suture clasp of fig. 18.
Fig. 23 is a schematic perspective view of a vertical briquette of the suture clasp of fig. 18.
Fig. 24 is a cross-sectional view taken along line XXVI-XXVI in fig. 18.
Fig. 25 is a schematic perspective view showing a locked state of the suture locker of fig. 18.
Fig. 26 is a cross-sectional view taken along line XXVI-XXVI in fig. 25.
Fig. 27 to 28 are schematic views of a suture thread locking process of a suture thread lock according to a suture thread locking device according to a fifth embodiment of the present invention.
Fig. 29 is a schematic view showing a structure of a suture locker device according to a sixth embodiment of the present invention.
Fig. 30 is a schematic view of the suture clasp of fig. 29 in a locked state.
Fig. 31 is a schematic perspective view of a suture shackle of a suture knot tying device provided by a seventh embodiment of the present invention.
FIG. 32 is a schematic cross-sectional view of the suture clasp of FIG. 31 in a perspective configuration.
Fig. 33 is a schematic cross-sectional view of the lock body of the suture shackle of fig. 32.
Fig. 34 is a schematic perspective view of another view of the pusher of the suture clasp of fig. 32.
Fig. 35 is a cross-sectional view taken along line XXXV-XXXV in fig. 34.
Fig. 36 is a schematic perspective view of a suture shackle connector according to a seventh embodiment of the present invention.
Fig. 37 is a cross-sectional view taken along line XXXVII-XXXVII in fig. 36.
FIG. 38 is a schematic perspective view of another view of the compact of the suture clasp of FIG. 32.
Fig. 39 is a cross-sectional view of the compact of fig. 38.
Fig. 40 is a schematic perspective view of a pushing member, a connecting member and a pressing block of a suture lock according to a seventh embodiment of the present invention.
Fig. 41 is a cross-sectional view taken along line LI-LI in fig. 40.
Fig. 42-44 are schematic views of a suture thread locking process of a suture thread lock according to a seventh embodiment of the present invention.
Fig. 45-47 are schematic illustrations of a suture locking device for use in a valve repair procedure for a diseased mitral valve according to a seventh embodiment of the present invention.
Fig. 48 is an enlarged view of the LVIII portion of fig. 46.
Fig. 49 is an enlarged view of the LIX portion in fig. 47.
Fig. 50 is a schematic view showing a state after suture locker implantation of a suture locker device according to a seventh embodiment of the present invention.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without undue burden, are within the scope of the invention.
Furthermore, the following description of the embodiments refers to the accompanying drawings, which illustrate specific embodiments in which the invention may be practiced. Directional terms, such as "upper", "lower", "front", "rear", "left", "right", "inner", "outer", "side", etc., in the present invention are merely referring to the directions of the attached drawings, and thus, directional terms are used for better, more clear explanation and understanding of the present invention, rather than indicating or implying that the apparatus or element being referred to must have a specific orientation, be constructed and operated in a specific orientation, and thus, should not be construed as limiting the present invention.
Orientation definition: for clarity of description, the end proximal to the operator and the end distal to the operator will be referred to as the "proximal end" in the surgical procedure; axial refers to a direction parallel to the line connecting the distal center and the proximal center of the medical instrument; the above definitions are for convenience of description only and are not to be construed as limiting the invention.
Referring to fig. 1-3, the present invention provides a suture knot locking device 100, which includes a suture knot 20 and a knot pushing mechanism 50 for improving locking mode; the suture lock 20 comprises a lock body 22 and a locking component 21 movably connected in the lock body 22, the lock body 22 is provided with a threading channel 220 for threading a suture, and the locking component 21 comprises a pushing piece 23 and a pressing block 25. The latch pushing mechanism 50 includes a spindle 51, a push rod 53 movably sleeved outside the spindle 51, and a handle 55 connected to a proximal end of the push rod 53. Suture clasp 20 is received within the distal end of push rod 53 and is removably coupled to the distal end of mandrel 51; the handle 55 drives the push rod 53 and the mandrel 51 to move relatively, i.e. the mandrel 51 and the push rod 53 can slide and rotate relatively. The mandrel 51 drives the pusher 23 to push the pusher 25 against the suture threaded in the threading channel 220 to lock the suture to the suture clasp 20.
Specifically, the lock body 22 is detachably connected to the push rod 53, the pushing member 23 is detachably connected to the push rod 51, and the handle 55 can drive the push rod 53 and the mandrel 51 to move relatively, so that the pushing member 23 and the lock body 22 move relatively. When pusher 53 is moved in a proximal to distal direction of lock 22 to push against briquette 25 to compress a suture, and in particular when mandrel 51 is moved distally to drive pusher 23 distally relative to lock 22 to push against briquette 25 to move relative to lock 22 until briquette 25 moves to compress a suture threaded in threading channel 220 to lock the suture between briquette 25 and lock 22.
The suture lock catch 20 of the suture lock device 100 provided by the invention comprises a lock body 22, a pushing piece 23 and a pressing block 25, wherein the pushing piece 23 and the pressing block 25 are movably arranged in the lock body 22, the lock body 22 is provided with a threading channel 220 for threading a suture, the pushing piece 23 can push the pressing block 25 to squeeze the suture threaded in the threading channel 220 under the action of the mandrel 51, and the suture is locked between the pressing block 25 and the lock body 22. Because the abutting surface between the pressing block 25 and the lock body 22 for locking the suture is larger, the overlapping probability of a plurality of sutures can be reduced, so that each suture is ensured to be subjected to locking force; and through adjusting the extrusion force of push piece 23 adjustable briquetting 25 to the suture, can ensure that every suture all locks in suture hasp 20, prevent effectively that the suture from deviating from suture hasp 20, improve the locking force of suture hasp 20.
Referring to fig. 4 to 11 together, the suture locker 20 of the first embodiment of the suture locking device 100 of the present invention includes a lock body 22, a pushing member 23 and a pressing block 25, wherein the pushing member 23 and the pressing block 25 are movably disposed on the lock body 22. The lock body 22 is a cylinder with a kidney-shaped cross section (namely, an oblong shape), the lock body 22 comprises a kidney-shaped distal end surface 2201, a kidney-shaped proximal end surface 2202, two opposite first side walls 2203 and two opposite second side walls 2204 which are positioned between the distal end surface 2201 and the proximal end surface 2202, the outer surfaces of the two first side walls 2203 are parallel opposite planes, and the outer surfaces of the other two second side walls 2204 are opposite arc surfaces; one end of the threading channel 220 extends through the distal end surface 2201 of the lock body 22 and the other end of the threading channel 220 extends through the proximal end surface 2202 of the lock body 22.
The threading channel 220 on the lock body 22 in this embodiment includes a threading aperture 201 at the distal end of the lock body 22 and passing through the distal face 2201, and a connecting aperture 203 at the proximal end of the lock body 22 and passing through the proximal face 2202; a guide chute 205 is arranged between the threading hole 201 and the connecting hole 203 in the lock body 22, the guide chute 205 is communicated with the threading hole 201 and the connecting hole 203, and a propping platform 225 is arranged between the guide chute 205 and the threading hole 201 in the lock body 22. The pressing block 25 is slidingly accommodated in the guide chute 205, the pushing piece 23 moves along the connecting hole 203 to push the pressing block 25 to slide along the guide chute 205 until the pressing block 25 abuts against the abutting table 225, and the suture thread in the threading channel 220 is locked between the pressing block 25 and the abutting table 225.
The pushing member 23 is detachably connected to the connection hole 203, the connection hole 203 extends from the proximal end toward the distal end, an inner thread 2031 is provided on an inner circumferential surface of the connection hole 203, and the pushing member 23 is screwed to the inner thread 2031. The connecting line between the axial line of the connecting hole 203 and the axial line of the threading hole 201 is not parallel to the axial direction of the lock body 22, specifically, the axial line of the connecting hole 203 is parallel to the axial direction of the lock body 22, and the axial line of the threading hole 201 is inclined to the axial direction of the lock body 22. The insertion of the suture is facilitated by the fact that the threading aperture 201 extends in an axial direction oblique to the lock body 22. The sliding guide groove 205 extends from the proximal end to the distal end along the axial direction of the lock body 22, two opposite ends of the sliding guide groove 205 respectively penetrate through two first side walls 2203 of the lock body 22, the proximal end of the sliding guide groove 205 extends along the axial direction of the lock body 22 and is communicated with the connecting hole 203, the distal end of the sliding guide groove 205 extends along the axial direction of the lock body 22 and is communicated with the threading hole 201, and the abutting platform 225 is located at the intersection of the distal end face of the sliding guide groove 205 and the inner surface of the threading hole 201. The side surface of the guide chute 205 facing the connecting hole 203 is smaller than the diameter of the connecting hole 203 along the radial length of the lock body 22, one end of the guide chute 205 close to the threading hole 201 is provided with a sinking groove 206, and the abutting platform 225 is positioned between the sinking groove 206 and the threading hole 201. The sinking groove 206 is communicated with the guide sliding groove 205, and two opposite ends of the sinking groove 206 are respectively penetrated through the two corresponding first side walls 2203, so that the space of the proximal end part of the guide sliding groove 205 is smaller than that of the distal end part, the threading hole 201 of the suture thread self-locking body 22 penetrates into the sinking groove 206 and the guide sliding groove 205, the connecting hole 203 of the self-locking body 22 penetrates out, the suture thread at least partially covers the propping platform 225, and the pressing block 25 can be propped against the suture thread covered on the propping platform 225.
The lock body 22 may be made of a metal material such as stainless steel, nickel titanium, or pure titanium, or a polymer material such as ABS, PS, PEEK. The lock body 22 in this embodiment is made of pure titanium material.
As shown in fig. 6 and 9, the pushing member 23 is in threaded engagement with the connecting hole 203, in this embodiment, the pushing member 23 is a hollow cylindrical pushing shaft, an external thread 231 engaged with an internal thread 2031 of the connecting hole 203 is provided on an outer surface of the pushing shaft, a through hole 233 is provided along an axial direction of the pushing shaft, a proximal end of a suture thread can pass through the through hole 233, the through hole 233 can be used as a threading hole of the suture thread, and can also be used for abutting an external connecting member, and the pushing member 23 is driven to rotate in the connecting hole 203 in a remote manner outside a patient through the external connecting member, so that the pushing member 23 is screwed in distally, and further, a pressing block 25 connected with the pushing member 23 is pushed to squeeze the suture thread. The cross section of the through hole 233 may be regular or irregular, so long as the external connection member is conveniently detachably connected in the through hole 233 and can drive the pushing member 23 to rotate. In this embodiment, the cross section of the through hole 233 is square with a chamfer.
The pushing member 23 may be made of a metal material such as stainless steel, nickel titanium, or pure titanium, or a polymer material such as ABS, PS, PEEK. In this embodiment, the pushing member 23 is made of pure titanium material.
The pressing block 25 is cuboid, the pressing block 25 is accommodated in the guide chute 205 of the lock body 22 through interference fit or friction force, the proximal end face of the pressing block 25 is contacted with the distal end face of the pushing piece 23, and the distal end of the pressing block 25 is used for extruding a suture line. The length of the pressing block 25 is greater than the diameter of the connection hole 203, when the pressing block 25 receives the pushing force of the pushing member 23, the pressing block 25 moves unidirectionally from the proximal end to the distal end along the guide chute 205 until the distal end portion of the pressing block 25 falls into the sinking groove 206, and the distal end face of the pressing block 25 presses against the suture thread on the table 225, so that the suture thread falling into the sinking groove 206 is deformed and fixed. The pressing block 25 is made of metal materials such as stainless steel, nickel titanium, pure titanium, etc., or polymer materials such as ABS, PS, PEEK. The PEEK polymer material is preferably selected for manufacturing in the embodiment.
When the suture shackle 20 of the first embodiment is assembled, the pressing block 25 is inserted into the guide chute 205 from one of the first side walls 2203 of the lock body 22, so that opposite end surfaces of the pressing block 25 are aligned with the two first side walls 2203 of the lock body 22, and opposite side surfaces of the pressing block 25 are in interference fit or friction contact with opposite side surfaces of the guide chute 205. The distal end of the pushing member 23 is threaded into the connection hole 203 until the distal end of the pushing member 23 contacts the pressing block 25.
Referring to fig. 12 and 13 together, when the suture thread 300 is locked by using the suture thread locker 20 in the first embodiment, the threading hole 201 of the proximal self-locking body 22 of the suture thread 300 penetrates into the guiding groove 205 and the sinking groove 206, then enters into the connecting hole 203 and penetrates out of the through hole 233 of the pushing member 23; the external connector drives the pusher 23 to screw distally into the connector bore 203 to push the pusher 23 distally until the distal portion of the compact 25 drops into the sink 206, the distal face of the compact 25 compresses the suture 300 on the abutment 225, thereby locking the suture between the compact 25 and the abutment 225.
The pushing member 23 in this embodiment is connected with the connecting hole 203 of the lock body 22 by a threaded connection manner, and by controlling the screw thread feeding amount of the pushing member 23, the force of the pressing block 25 to press the suture thread 300 on the propping platform 225 can be controlled, so as to control the locking tightness of the suture thread lock catch 20; secondly, since the pushing piece 23 is screwed in the lock body 22, the pushing piece 23 can be prevented from loosening, so that the loosening of the pressing block 25 can be prevented, and the suture 300 is prevented from being separated from the suture clasp 20; in addition, because the area of the propping platform 225 is larger, the multiple sutures 300 can be conveniently dispersed, and the overlapping probability of the sutures 300 is reduced, so that the contact area between the sutures 300 and the pressing block 25 is also larger, each suture 300 can be extruded, and the locking force is improved.
Referring to fig. 14 and 15, the suture locker according to the second embodiment of the present invention has a similar structure to that of the first embodiment, except that: in the second embodiment, the structure of the lock body 22a of the suture shackle is slightly different from that of the lock body 22 in the first embodiment. In the second embodiment, the lock body 22a is provided with a wire outlet 207 adjacent to the propping platform 225, one end of the wire outlet 207 is communicated with the guiding chute 205 and the threading hole 201, the other end of the wire outlet 207 is penetrated through the second side wall 2204 of the lock body 22a, which is far away from the entrance of the threading hole 201, and the suture thread can be penetrated through the threading hole 201 and the guiding chute 205 and is penetrated out of the wire outlet 207, and the suture thread part covers the propping platform 225. Specifically, one end of the wire outlet hole 207 is communicated with the sinking groove 206 corresponding to the threading hole 201, and the other end of the wire outlet hole 207 penetrates through the second side wall 2204 of the lock body 22 a; the wire outlet 207 may extend in the radial direction of the lock body 22a or may extend obliquely to the radial direction of the lock body 22a, and the through hole 233 of the push member 23 may not need to penetrate the distal end surface of the push member 23.
When the suture thread 300 is locked by using the suture thread locker in the second embodiment, the threading hole 201 of the proximal self-locking body 22 of the suture thread 300 is threaded into the guiding chute 205 and the sinking chute 206, then the threading hole 207 is threaded out of the threading hole 207; the external connector drives the pusher 23 to screw distally into the connector bore 203 to push the compact 25 distally until the distal portion of the compact 25 is recessed within the sink 206 and the distal face of the compact 25 presses against the suture 300 on the abutment 225 to lock the suture 300 between the compact 25 and the abutment 225.
As shown in fig. 16, the suture locker according to the third embodiment of the present invention has a structure similar to that of the first embodiment, except that: in the third embodiment, the structure of the lock body 22b of the suture shackle is slightly different from that of the lock body 22 in the first embodiment. In the third embodiment, the threading hole 201 extends in the axial direction parallel to the lock body 22b, the threading hole 201 communicates with the slide guide groove 205, the threading hole 201 is located on the side away from the sinking groove 206, and the diameter of the threading hole 201 is smaller than the length of the slide guide groove 205 in the radial direction of the lock body 22b, so that the abutment 225 is formed on the side of the intersection of the inner surface of the threading hole 201 and the inner surface of the slide guide groove 205 near the sinking groove 206. The suture can be locked between the press block 25 and the abutment 225.
As shown in fig. 17, the suture locker according to the fourth embodiment of the present invention has a structure similar to that of the first embodiment, except that: in the fourth embodiment, the lock body 22c of the suture locker and the pushing member 23a are connected in a slightly different manner from the lock body 22 and the pushing member 23 in the first embodiment. In the fourth embodiment, the pushing member 23a is a pushing rod slidably inserted into the connection hole 203, the pushing rod can be clamped in the connection hole 203, and when the pushing rod is clamped in the connection hole 203, the distal end surface of the pushing rod pushes the pressing block 25 against the abutment table 225, so that the suture thread is locked between the abutment table 225 and the pressing block 25. The pushing member 23a is fixedly clamped with the clamping groove through an elastic clamping member between the connecting hole 203 of the lock body 22c, in this embodiment, at least one elastic clamping member 235 is disposed on the outer wall of the pushing member 23a, at least one clamping hole 226 is disposed on the inner surface of the connecting hole 203 of the lock body 22c corresponding to the elastic clamping member 235, and the elastic clamping member 235 is a hemispherical elastic clamping block. The pushing member 23a slides distally along the connecting hole 203, and when the elastic clip 235 is snapped into the clip hole 226, the pushing member 23a pushes the pressing block 25 to press the suture thread 300 on the abutment 225, thereby locking the suture thread 300 between the pressing block 25 and the abutment 225.
Referring to fig. 18 to 26, a suture locker according to a fifth embodiment of the present invention has a similar structure to that of the first embodiment, except that: in the fifth embodiment, the guide chute 220 includes a transverse chute section 221 extending along the axial direction of the lock body 22d and a vertical chute section 223 extending along the radial direction of the lock body 22d, the transverse chute section 221 communicates with the connection hole 203, the vertical chute section 223 communicates with the threading hole 201 near the distal end of the transverse chute section 221, and the vertical chute section 223 forms a lock chute 224 in the lock body 22d after passing through the threading hole 201. Opposite ends of the transverse chute section 221, the vertical chute section 223 and the locking wire slot 224 are respectively penetrated through the first side wall 2203 corresponding to the lock body 22 d. The threading hole 201 extends along the axial direction of the lock body 22d and is parallel to the transverse chute section 221, the proximal end of the threading hole 201 communicates with the connecting hole 203, and the distal end of the threading hole 201 penetrates the distal end face of the lock body 22 d. The locking assembly 21 further comprises a sliding block 26 slidingly accommodated in the transverse chute section 221, the pressing block 25a is slidingly accommodated in the vertical chute section 223, the pushing piece 23 moves along the connecting hole 203 to push the sliding block 26 to slide along the transverse chute section 221, the sliding block 26 pushes the pressing block 25a to slide along the vertical chute section 223 to push against the inner surface of the vertical chute section 223, and the suture line in the threading channel is locked between the pressing block 25a and the inner surface of the vertical chute section 223.
The sliding block 26 is provided with a first inclined guiding and sliding surface 261 facing the side surface of the pressing block 25a, the pressing block 25a is provided with a second inclined guiding and sliding surface 251 facing the side surface of the sliding block 26, and the first guiding and sliding surface 261 is matched with the second guiding and sliding surface 251, namely, the first guiding and sliding surface 261 and the second guiding and sliding surface 251 can be in sliding fit. When the sliding block 26 slides distally along the lateral chute section 221, the first sliding guide surface 261 slidably pushes against the second sliding guide surface 251 to slide the pressing block 25a along the vertical chute section 223.
The included angle between the first sliding guiding surface 261 and the axial direction of the lock body 22d is greater than 0 degrees and less than 90 degrees, preferably, the included angle between the first sliding guiding surface 261 and the axial direction of the lock body 22d is equal to 45 degrees; the included angle between the second sliding guiding surface 251 and the axial direction of the lock body 22d is greater than 0 degrees and less than 90 degrees, and preferably, the included angle between the second sliding guiding surface 251 and the axial direction of the lock body 22d is equal to 45 degrees.
As shown in fig. 23, two opposite threading grooves 253 are formed in two opposite side surfaces of the second sliding guide surface 251 of the pressing block 25a, and two opposite ends of each threading groove 253 respectively penetrate through corresponding side surfaces of the pressing block 25 a. When the pressing block 25a is mounted into the vertical chute section 223 of the lock body 22d, the threading grooves 253 correspond to the threading holes 201, and the threading grooves 253 are used for threading the suture, i.e. the suture bypasses the side of the pressing block 25a facing away from the sliding block 26 through the two threading grooves 253.
When the suture shackle of the fifth embodiment is assembled, the pressing block 25a is inserted into the vertical chute section 223 from one of the first side walls 2203 of the lock body 22d, so that the opposite end surfaces of the pressing block 25a are aligned with the two first side walls 2203 of the lock body 22d, the opposite end surfaces of the pressing block 25a are in interference fit or friction contact with the opposite end surfaces of the vertical chute section 223, the pressing block 25a is positioned at one end far from the locking chute 224, and the threading groove 253 of the pressing block 25a corresponds to the threading hole 201; inserting the slide block 26 into the transverse chute section 221 from one of the first side walls 2203 of the lock body 22d, so that opposite end surfaces of the slide block 26 are aligned with the two first side walls 2203 of the lock body 22d, and the first slide guiding surface 261 of the slide block 26 corresponds to the second slide guiding surface 251 of the pressing block 25 a; the distal end of the pushing member 23 is threaded into the connecting hole 203 until the distal end of the pushing member 23 contacts the slider 26.
Referring to fig. 27 and 28 together, when the suture thread 300 is locked by using the suture thread lock catch in the fifth embodiment, the threading hole 201 of the proximal self-locking body 22d of the suture thread 300 is threaded into the vertical chute section 223 and the connecting hole 203 is threaded out from the through hole 233 of the pushing member 23; the external connector drives the pushing member 23 to rotate in the connecting hole 203 so as to push the sliding block 26 to slide distally, and the first sliding guiding surface 261 pushes the second sliding guiding surface 251 to slide the pressing block 25a along the vertical sliding groove section 223 towards the locking groove 224, so that the pressing block 25a is inserted into the locking groove 224 and drives the suture 300 to bend into a U shape towards the locking groove 224 until the suture 300 is pressed and locked in the locking groove 224. At this time, the suture thread 300 is locked between the side of the pressing block 25a facing away from the slide block 26 and the inner surface of the thread locking groove 224, and the suture thread 300 is threaded into the two thread passing grooves 253 of the pressing block 25 a.
The pushing member 23 in this embodiment is connected to the connecting hole 203 of the lock body 22d by a threaded connection manner, and by controlling the screw thread feeding amount of the pushing member 23, the force of the sliding block 26 pushing the pressing block 25a to press the suture thread 300 in the locking slot 224 can be controlled, so as to control the locking degree of the pressing block 25a to the suture thread 300; secondly, after the pressing block 25a is inserted into the locking wire groove 224, the suture thread 300 positioned in the locking wire groove 224 forms a U-shaped bending effect, and two contact points are shared to squeeze the suture thread 300, so that the locking force of the suture thread lock catch on the suture thread 300 can be improved; thirdly, since the pushing piece 23 is screwed in the lock body 22, the loosening of the pushing piece 23 can be prevented, so that the loosening of the pressing block 25a can be prevented, and the suture 300 is prevented from being separated from the suture clasp 20; in addition, since the width of the threading groove 253 is larger, the suture thread 300 is convenient to disperse, and the overlapping probability of a plurality of suture threads 300 is reduced, so that the contact area between the suture thread 300 and the pressing block 25a is also larger, each suture thread 300 can be extruded, and the locking force of the suture thread lock catch on the locking force is improved.
In other embodiments, the first guiding and sliding surface 261 of the sliding block 26 may be omitted, and only the inclined second guiding and sliding surface 251 is provided on the pressing block 25a, and the distal end of the sliding block 26 slidably pushes against the second guiding and sliding surface 251 to slide the pressing block 25a along the vertical chute section 223.
In other embodiments, the second guiding and sliding surface 251 of the pressing block 25a may be omitted, and only the inclined first guiding and sliding surface 261 may be provided on the sliding block 26, where the first guiding and sliding surface 261 of the sliding block 26 slidably pushes the pressing block 25a to slide the pressing block 25a along the vertical chute section 223.
Referring to fig. 29 and 30, a suture locker according to a sixth embodiment of the present invention has a similar structure to that of the fifth embodiment, except that: in the sixth embodiment, the structure of the lock body 22e of the suture shackle is slightly different from that of the lock body 22d in the fifth embodiment. In the sixth embodiment, a wire outlet hole 227 is formed in the inner surface of the wire locking groove 224 of the lock body 22e on the side away from the threading hole 201, one end of the wire outlet hole 227 is connected to the wire locking groove 224, and the other end of the wire outlet hole 227 penetrates through the second side wall 2204 of the lock body 22a away from the transverse chute section 221. Preferably, the wire outlet hole 227 corresponds to the wire through hole 201. The suture thread is inserted into the thread hole 201 and the thread locking groove 224 and is inserted out of the thread outlet hole 227.
When the suture thread 300 is locked by using the suture thread locker in the sixth embodiment, the threading hole 201 of the proximal self-locking body 22e of the suture thread 300 is threaded into the vertical chute section 223 and the thread locking groove 224 and is threaded out from the thread outlet hole 227; the external connector drives the pushing member 23 to rotate in the connecting hole 203 so as to push the sliding block 26 to slide distally, and the first sliding guiding surface 261 pushes the second sliding guiding surface 251 to slide the pressing block 25a along the vertical sliding groove section 223 towards the locking groove 224, so that the pressing block 25a is inserted into the locking groove 224 and drives the suture 300 to bend towards the locking groove 224 to be L-shaped until the suture 300 is pressed and locked in the locking groove 224. At this time, the suture 300 is pressed at the pressing block 25a and the lock body 22e near the wire outlet hole 201. Specifically, the suture thread 300 is locked between the side of the pressing block 25a facing away from the slide block 26 and the inner surface of the thread locking groove 224, and the suture thread 300 is threaded into the thread groove 253 of the pressing block 25a facing toward the thread hole 201. After the pressing block 25a is inserted into the locking wire groove 224, the suture 300 positioned in the locking wire groove 224 is bent in an L shape, so that a contact point and a stress point of a contact surface are provided for the suture 300, and the locking force of the suture lock catch on the suture 300 can be improved.
Referring to fig. 31 to 41, a suture locker according to a seventh embodiment of the present invention has a similar structure to that of the first embodiment, except that: in the seventh embodiment, the proximal end of the threading hole 201 is obliquely connected to the guide chute 205 and then penetrates through one of the second side walls 2204 of the lock body 22f, and the side of the guide chute 205 away from the connecting hole 203 penetrates through the threading hole 201 and then forms the slot 228 in the lock body 22 f. The threading hole 201 comprises an inlet section 2011 extending along the axial direction of the lock body 22f from the distal end surface 2201 of the lock body 22f, and a threading section 2013 extending obliquely from the proximal end of the inlet section 2011 towards one side of the guide chute 205 and penetrating through the second side wall 2204 of the lock body 22f away from the inlet section 2011, wherein the threading section 2013 penetrates through the guide chute 205. Opposite ends of the sliding guide groove 205 and the clamping groove 228 are respectively penetrated through the first side wall 2203 corresponding to the lock body 22 f. The locking assembly further comprises a connecting shaft 27 positioned between the pushing piece 23a and the pressing block 25b, and the pushing piece 23a pushes the pressing block 25b to slide along the guide chute 205 through the connecting shaft 27, so that the pressing block 25b pushes the suture thread to be clamped in the thread clamping groove 228.
In this embodiment, the pushing member 23a is a hollow cylindrical pushing rod, and the outer wall of the pushing rod is in threaded connection with the inner wall of the connecting hole 203, specifically, the outer surface of the proximal end of the pushing rod is provided with an external thread 231 matched with the internal thread 2031 of the connecting hole 203. The middle part of the distal end face of the push rod is provided with a hollow round connecting rod 236 along the axial direction of the push rod. The connection rod 236 is provided with a shaft hole 2351 in the axial direction thereof, and the proximal end of the shaft hole 2351 communicates with the through hole 233. The cross section of the shaft hole 2351 is circular, the cross section of the through hole 233 is larger than the cross section of the shaft hole 2351, and a connecting table 2353 is formed at the intersection of the through hole 233 and the shaft hole 2351 in the pushing member 23 a.
The connecting shaft 27 comprises a cylindrical rotating shaft 271, an abutting block 273 arranged at the proximal end of the rotating shaft 271 and a connecting post 275 protruding from the distal end of the rotating shaft 271, wherein the rotating shaft 271 can be rotatably inserted into the shaft hole 2351, the abutting block 273 abuts against the connecting table surface 2353, and the connecting post 275 is connected with the pressing block 25b.
The pressing block 25b is a bar with a rectangular section, a hemispherical notch 255 is formed in the middle of one side of the pressing block 25b facing the wire clamping groove 228, and the notch 255 is used for accommodating a suture. The pressing block 25b is provided with a butt-joint hole 256 along the axial direction of the lock body 22f, and the butt-joint hole 256 corresponds to the notch 255.
When the suture shackle of the seventh embodiment is assembled, the pressing block 25b is inserted into the guide chute 205 from one of the first side walls 2203 of the lock body 22f, so that the opposite end surfaces of the pressing block 25b are aligned with the two first side walls 2203 of the lock body 22f, the notch 255 of the pressing block 25b faces the suture slot 228, and the butt joint hole 256 of the pressing block 25b faces the connection hole 203; inserting the connecting post 275 of the connecting shaft 27 into the through hole 233 from the proximal end of the pushing member 23a until the rotating shaft 271 of the connecting shaft 27 is accommodated in the shaft hole 2351, abutting the connecting table surface 2353 by the abutting block 273, and extending the connecting post 275 out of the shaft hole 2351; the connecting rod 236 of the pushing member 23a is inserted into the connecting hole 203 and the pushing member 23a is screwed into the connecting hole 203, and the connecting post 275 is connected to the abutting hole 256 of the pressing block 25 b. The connection post 275 may be fixedly connected to the docking aperture 256 by riveting, bonding, clamping, welding, or the like. At this time, the connection shaft 27 can rotate relative to the pushing member 23a, and the pushing member 23a rotates in the docking hole 256 to drive the connection shaft 27 to push the pressing block 25b to slide along the guiding chute 205.
Referring to fig. 42 to 44 together, when the suture thread 300 is locked by using the suture thread locker of the seventh embodiment, the proximal end of the suture thread 300 is inserted into the inlet section 2011 and passes through the threading hole 201 and then is threaded out of the threading section 2013; the external connecting piece drives the pushing piece 23a to be screwed into the connecting hole 203, the connecting shaft 27 slides along the guide chute 205 to push the pressing block 25b to slide distally, the pressing block 25b is inserted into the clamping groove 228 and drives the suture 300 to bend into a U shape towards the inside of the clamping groove 228 until the suture 300 is pressed and locked in the clamping groove 228. At this time, the suture thread 300 is clamped and locked between the pressing block 25b and the wire clamping groove 228, specifically, the suture thread 300 is clamped between two opposite side surfaces of the pressing block 25b and corresponding side surfaces of the wire clamping groove 228, and the suture thread 300 is inserted into the notch 255 of the pressing block 25 b.
The pushing member 23a in the embodiment is connected with the connecting hole 203 of the lock body 22f in a threaded manner, and the force of the connecting shaft 27 pushing the pressing block 25b to press the suture thread 300 in the slot 228 can be controlled by controlling the screw feeding amount of the pushing member 23a, so that the tightness of the locking of the pressing block 25b to the suture thread 300 is controlled; secondly, after the pressing block 25b is inserted into the wire clamping groove 228, the suture 300 positioned in the wire clamping groove 228 forms a U-shaped bending effect, and two contact points are shared to squeeze the suture 300, so that the locking force of the suture lock catch on the suture 300 can be improved; again, since the pushing member 23a is screwed into the lock body 22f, the loosening of the pushing member 23a can be prevented, so that the loosening of the pressing block 25b can be prevented, and the suture thread 300 is prevented from being separated from the suture thread lock catch; in addition, because the width of the notch 255 is larger, the suture thread 300 is convenient to disperse, and the overlapping probability of the suture thread 300 is reduced, so that the contact area between the suture thread 300 and the pressing block 25b is also larger, each suture thread 300 can be extruded, and the locking of the suture thread lock catch is improved.
In other embodiments, the connection shaft 27 may be fixed to the pushing member 23a, that is, when the pushing member 23a rotates along the connection hole 203, the connection shaft 27 rotates together with the pushing member 23a, and the connection post 275 of the connection shaft 27 is rotatably connected to the docking hole 256 of the pressing block 25 b. Specifically, the shaft hole 2351 of the pushing member 23a may be a rectangular hole, and the connection post 275 of the connection shaft 27 is a rectangular post fitted in the rectangular hole; or the pushing member 23a and the connecting shaft 27 are integrally formed.
In other embodiments, the connecting shaft 27 is rotatably connected to the pushing member 23a, and the connecting shaft 27 and the pressing block 25b are also rotatably connected, that is, the connecting post 275 of the connecting shaft 27 is rotatably connected to the abutting hole 256 of the pressing block 25 b; the rotation shaft 271 of the connection shaft 27 is rotatably connected to the shaft hole 2351.
Referring to fig. 45 to 50, the use of the suture locking device 100 according to the present invention will be described below with respect to a valve prosthesis for a mitral valve of a heart.
The mitral valve is a unidirectional "valve" between the Left Atrium (LA) and the Left Ventricle (LV), which ensures that blood flows from the left atrium to the left ventricle. The normal healthy mitral valve has a plurality of chordae tendineae, and when the left ventricle is in a diastole state, the leaflets of the mitral valve are in an open state, and blood flows from the left atrium to the left ventricle; when the left ventricle is in a contracted state, chordae tendineae are stretched, the valve leaflets are prevented from being flushed to the atrial side by blood flow, and the valve leaflets of the mitral valve are well closed, so that blood is ensured to flow from the left ventricle to the aorta through the Aortic Valve (AV). Referring to fig. 45, the leaflets of the mitral valve are divided into anterior leaflet 401 and posterior leaflet 403, and if the mitral valve is diseased, when the left ventricle is in a contracted state, the anterior leaflet 401 and the posterior leaflet 403 cannot be restored to a closed state like in a normal state, and the impulsive force of blood flow can further cause the anterior leaflet 401 and the posterior leaflet 403 to drop into the left atrium, resulting in blood reflux.
The seventh embodiment of the present invention provides a suture locking device 100 for use in an edge-to-edge valve repair as follows:
The first step: as shown in fig. 45, first, a plurality of sutures 300 with elastic pads 301 are respectively implanted into the anterior leaflet 401 and the posterior leaflet 403 of the mitral valve, and the point contact between the sutures 300 and the leaflet is converted into the surface contact between the elastic pads 301 and the leaflet, so that the risk of tearing the leaflet can be effectively reduced;
And a second step of: as shown in fig. 46 and 48, a plurality of sutures 300 implanted in the anterior and posterior leaves 401 and 403, respectively, are inserted into the threading channels of the suture locker 100 outside the patient, specifically, the proximal end of each suture 300 is inserted from the inlet section 2011 of the threading hole 201 and is threaded out from the threading section 2013; pushing the distal ends of the mandrel 51 and the push rod 53 into the heart through the apex of the heart, moving the leaflets of the mitral valve closer together, and simultaneously pulling the suture 300; when the valve leaflet is closed to a required degree, the handle 55 drives the distal end of the mandrel 51 to be inserted into the through hole 233 of the pushing piece 23a and rotate relative to the push rod 52 to drive the pushing piece 23a to be screwed into the connecting hole 203 distally, so as to push the connecting shaft 27 to move distally and push the pressing block 25b to move distally, the pressing block 25b is inserted into the wire clamping groove 228 and drives the suture 300 to bend into a U shape towards the wire clamping groove 228, and the suture 300 is extruded and fixed; when the pressing block 25b cannot be moved further, it indicates that the suture locker has locked the suture 300, and at this time, the plurality of sutures 300 are firmly fixed in the suture locker.
And a third step of: as shown in fig. 47 and 49, the push rod 53 and the mandrel 51 are retracted, the connection between the mandrel 51 and the pushing member 23a is released, the connection between the push rod 53 and the lock body 22f is released, the suture lock catch is released from the distal opening of the push rod 53, and the handle 55 is retracted to withdraw the mandrel 51 and the push rod 53 from the body;
Fourth step: the appropriate suture length is adjusted, the excess suture is trimmed, the suture clasp 20 and the remaining suture remain in the patient, and at this time the anterior leaflet 401 and posterior leaflet 403 of the mitral valve are pulled toward each other by the plurality of sutures to form a "double-hole structure" with two apertures G, completing the edge-to-edge repair.
It will be appreciated that after suture 300 is adjusted to the appropriate length, as shown in fig. 50, the excess suture 300 may not be trimmed, but rather the ends of all sutures 300 may be directly secured to the apex, papillary muscles or ventricular wall. The ends of the suture 300 may be secured by conventional shims or patches, or by suture knot means, specifically by threading the ends of the suture 300 through the cardiac incision and into the other suture catch 20, pushing the mandrel 51 and push rod 53 distally until they reach the vicinity of the outer surface of the heart, locking the suture 300, and then cutting off the excess suture 300, at which time one suture catch 20 forms a "double-hole structure" within the heart under the leaflets, leaving the other suture catch 20 on the outer surface of the heart to secure the ends of the suture 300.
It will be appreciated that the above description is given by way of example only of a suture clasp and suture locking device for use in a mitral valve repair procedure, and that the suture clasp and suture locking device of the present invention may be used for locking and securing sutures in other surgical procedures. The foregoing is a description of embodiments of the present invention, and it should be noted that, for those skilled in the art, modifications and variations can be made without departing from the principles of the embodiments of the present invention, and such modifications and variations are also considered to be within the scope of the present invention.
Claims (18)
1. The suture lock catch is characterized by comprising a lock body and a locking assembly movably connected in the lock body, wherein the lock body is provided with a threading channel for threading a suture thread, the locking assembly comprises a pushing piece and a pressing block, and the pushing piece pushes the pressing block to extrude the suture thread threaded in the threading channel so as to lock the suture thread in the suture lock catch;
The threading channel comprises a threading hole which is positioned at the far end of the lock body and penetrates through the far end face of the lock body, and a connecting hole which is positioned at the near end of the lock body and penetrates through the near end face of the lock body, a guide chute is arranged between the threading hole and the connecting hole of the lock body, the guide chute is communicated with the threading hole and the connecting hole, and the pressing block is slidingly accommodated in the guide chute;
The guide chute comprises a transverse chute section extending along the axial direction of the lock body and a vertical chute section extending along the radial direction of the lock body, the transverse chute section is communicated with the connecting hole, the vertical chute section is communicated with the far end close to the transverse chute section and the threading hole, and a locking slot is formed in the lock body after the vertical chute section passes through the threading hole;
the suture thread is locked between the press block and the inner surface of the vertical chute section.
2. The suture shackle of claim 1, wherein the pushing member moves in a proximal to distal direction of the lock body to push the compact against the suture.
3. The suture shackle of claim 1, wherein one end of the threading channel extends through a distal face of the lock body and the other end of the threading channel extends through a proximal face or side wall of the lock body.
4. A suture catch according to any one of claims 1-3 wherein the pushing member moves along the attachment aperture to urge the compact to slide along the guide chute until the compact abuts a suture threaded in the threading channel.
5. The suture shackle of claim 4, wherein the guide channel extends from a proximal end to a distal end along an axial direction of the lock body, opposite ends of the guide channel respectively passing through sidewalls of the lock body.
6. The suture shackle of claim 4, wherein the pushing member is a pushing shaft, the pushing shaft being threadedly engaged with the connecting hole, the pushing shaft being axially provided with a through hole, the proximal end of the suture passing through the through hole.
7. The suture shackle of claim 1, wherein the locking assembly further comprises a slider slidingly received in the transverse chute section, the compact is slidingly received in the vertical chute section, the pusher moves along the connecting hole to push the slider to slide along the transverse chute section, and the slider pushes the compact to slide along the vertical chute section to be inserted into the suture slot and to drive the suture to bend into a U-shape toward the suture slot to lock the suture in the suture slot.
8. The suture clasp of claim 7, wherein said slider is provided with a sloped first guide slide surface facing a side of said compact and/or said compact is provided with a sloped second guide slide surface facing a side of said slider, said first guide slide surface slidably pushing said compact sliding or said slider slidably pushing said compact sliding along said second guide slide surface.
9. The suture clasp of claim 8, wherein said first sliding guide surface slidingly engages said second sliding guide surface.
10. The suture clasp of claim 8, wherein said first sliding guide surface is at an angle greater than 0 degrees and less than 90 degrees to the axis of the attachment hole; the included angle between the second sliding guide surface and the axial lead of the connecting hole is more than 0 degrees and less than 90 degrees.
11. The suture shackle of claim 10, wherein the angle between the first sliding guide surface and the axis of the connecting hole and the angle between the second sliding guide surface and the axis of the connecting hole are both 45 degrees.
12. The suture shackle of claim 7, wherein two opposite sides of the compact are in interference fit or friction contact with two opposite sides of the vertical chute section, two opposite sides of the compact are respectively provided with a threading slot corresponding to the threading hole, and the suture passes through two threading slots to bypass the side of the compact facing away from the sliding block.
13. The suture shackle of claim 7, wherein a wire outlet is formed in a side, facing the side surface of the pressing block, away from the threading hole, of the vertical chute section, one end of the wire outlet is communicated with the vertical chute section, the other end of the wire outlet penetrates through the side wall of the lock body, the suture extends out of the wire outlet after penetrating through the threading hole and the vertical chute section, and the pressing block is inserted into the wire locking groove to enable the suture in the wire locking groove to form an L-shaped bend.
14. The suture shackle of claim 4, wherein the proximal end of the threading hole is connected to the guide chute and then penetrates through the sidewall of the lock body, one side of the guide chute away from the connecting hole penetrates through the threading hole and then forms a wire clamping groove in the lock body, the suture is threaded in the threading hole, the locking assembly further comprises a connecting shaft positioned between the pushing member and the pressing block, the pushing member pushes the pressing block to slide along the guide chute towards the distal end through the connecting shaft, the pressing block is inserted into the wire clamping groove and drives the suture to bend into a U shape towards the inside of the wire clamping groove, and the suture is extruded and locked in the wire clamping groove.
15. The suture shackle of claim 14, wherein the outer wall of the pushing member is in threaded connection with the inner wall of the connecting hole, the connecting shaft is rotatably connected to the pushing member and/or the pressing block, and the pushing member is screwed into the distal end of the lock body to drive the connecting shaft to push the pressing block against the pressing block to be inserted into the wire clamping groove.
16. The suture shackle of claim 14, wherein a side of the compact facing the wire clamping groove is provided with a notch, the suture is threaded into the notch, and the suture is clamped between opposite sides of the compact and corresponding sides of the wire clamping groove when the compact is inserted into the wire clamping groove.
17. A suture knot device comprising the suture catch of any one of claims 1-16, and a catch pushing mechanism; the lock catch pushing mechanism comprises a mandrel, a push rod movably sleeved outside the mandrel and a handle connected with the proximal end of the push rod, and the suture line lock catch is accommodated in the distal end of the push rod and is detachably connected with the distal end of the mandrel; the handle drives the push rod to move relative to the mandrel.
18. The suture tying device of claim 17, wherein the lock body is removably coupled to a push rod, the push member being removably coupled to the push rod, the push rod driving the push member to move distally to push the compact relative to the lock body until the compact moves to compress a suture threaded in the threading channel, the suture being locked between the compact and the lock body.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201910366557.XA CN111839626B (en) | 2019-04-30 | 2019-04-30 | Suture knot locking device with improved locking mode and suture knot locking device |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201910366557.XA CN111839626B (en) | 2019-04-30 | 2019-04-30 | Suture knot locking device with improved locking mode and suture knot locking device |
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| CN111839626A CN111839626A (en) | 2020-10-30 |
| CN111839626B true CN111839626B (en) | 2024-08-09 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| WO2022068202A1 (en) * | 2020-09-30 | 2022-04-07 | 杭州德晋医疗科技有限公司 | Medical lock catch and medical locking device |
| CN112674819B (en) * | 2021-01-15 | 2022-04-19 | 上海汇禾医疗科技有限公司 | Suture auxiliary operation instrument and operation method thereof |
| CN116269559A (en) * | 2021-12-21 | 2023-06-23 | 杭州德晋医疗科技有限公司 | Medical locking and cutting integrated device |
| CN114886613A (en) * | 2022-05-06 | 2022-08-12 | 上海以心医疗器械有限公司 | Wire locking device |
| CN115399821B (en) * | 2022-06-27 | 2025-07-22 | 瀚芯医疗科技(深圳)有限公司 | Lock knot device and handle control system |
| CN119055406B (en) * | 2023-05-30 | 2025-11-14 | 杭州德晋医疗科技有限公司 | Locking assembly |
| CN119632727B (en) * | 2023-09-15 | 2025-09-19 | 杭州德晋医疗科技有限公司 | Lock holding device |
| CN119632726B (en) * | 2023-09-15 | 2025-09-19 | 杭州德晋医疗科技有限公司 | System for deploying cardiac anchors |
| CN119632728B (en) * | 2023-09-15 | 2025-09-19 | 杭州德晋医疗科技有限公司 | Anchor assembly |
| CN120284537B (en) * | 2025-06-13 | 2025-08-12 | 科瑞迈吉(苏州)医疗科技有限公司 | A thread-cutting-free locking device and valve ring repair system |
Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN210612172U (en) * | 2019-04-30 | 2020-05-26 | 杭州德晋医疗科技有限公司 | Suture locking device with improved locking mode and suture lock catch thereof |
Family Cites Families (13)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CA2125733A1 (en) * | 1993-06-15 | 1994-12-16 | William J. Zwaskis | Biocompatible suture knot clip |
| US5324308A (en) * | 1993-10-28 | 1994-06-28 | Javin Pierce | Suture anchor |
| US7993368B2 (en) * | 2003-03-13 | 2011-08-09 | C.R. Bard, Inc. | Suture clips, delivery devices and methods |
| US20050245932A1 (en) * | 2004-04-16 | 2005-11-03 | Fanton Gary S | Apparatus and methods for securing tissue to bone |
| US20060282081A1 (en) * | 2004-04-16 | 2006-12-14 | Fanton Gary S | Apparatus and method for securing tissue to bone with a suture |
| EP1799123B1 (en) * | 2004-09-28 | 2015-05-06 | Surgical Solutions, LLC | Suture anchor |
| US7875056B2 (en) * | 2005-07-22 | 2011-01-25 | Anpa Medical, Inc. | Wedge operated retainer device and methods |
| AU2007227351A1 (en) * | 2006-03-22 | 2007-09-27 | C2M Medical, Inc. | Suture passer devices and uses thereof |
| WO2007140309A2 (en) * | 2006-05-25 | 2007-12-06 | Mitralign, Inc. | Lockers for surgical tensioning members and methods of using the same to secure surgical tensioning members |
| US20110004242A1 (en) * | 2009-07-01 | 2011-01-06 | Stchur Robert P | Knotless suture fixation device and method |
| US9226742B2 (en) * | 2012-01-27 | 2016-01-05 | Arthrocare Corporation | Restricted wedge suture anchor and method for soft tissue repair |
| KR20160011381A (en) * | 2014-07-22 | 2016-02-01 | (주) 타우피엔유메디칼 | apparatus and method for fixing the cerclage wire in Mitral cerclage coronary sinus annuloplasty |
| EP2985001B1 (en) * | 2014-08-11 | 2017-04-19 | Biedermann Technologies GmbH & Co. KG | Polyaxial bone anchoring device |
-
2019
- 2019-04-30 CN CN201910366557.XA patent/CN111839626B/en active Active
Patent Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN210612172U (en) * | 2019-04-30 | 2020-05-26 | 杭州德晋医疗科技有限公司 | Suture locking device with improved locking mode and suture lock catch thereof |
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