CN113598863A

CN113598863A - Heart surgery is through left auricle heart outer ring system of pricking of thorax wicresoft

Info

Publication number: CN113598863A
Application number: CN202110900075.5A
Authority: CN
Inventors: 穆纯杰; 马润伟; 潘湘斌; 高雅; 王强; 杨菊先; 宋怡
Original assignee: Fuwai Yunnan Cardiovascular Hospital
Current assignee: Fuwai Yunnan Cardiovascular Hospital
Priority date: 2021-08-06
Filing date: 2021-08-06
Publication date: 2021-11-05

Abstract

The invention relates to the field of medical devices, and specifically discloses a minimally invasive transthoracic cavity extracardiac cerclage system for left atrial appendage in cardiac surgery, comprising a cerclage, a holder I and a holder II; a first end of the cerclage is connected to a The second ends are connected to form a cerclage opening, and a self-locking member for restricting the movement of the second end portion along the enlarging direction of the cerclage opening is provided on the cerclage strap; the holder I includes a housing I, a connecting piece I, a plurality of Claws I and a control handle I, the shell I is tubular and can pass through the cerclage opening of the cerclage strap, and each claw I is connected with the control handle I through the connecting piece I arranged in the shell I, And each jaw I is driven by the control handle I to expand or retract to clamp the left atrial appendage; the gripper II includes a connecting piece II, a plurality of jaws II and a control handle II, and each jaw II is connected to the control handle II through the connecting piece II. The handles II are connected with each other, and each jaw II is driven by the control handle II to expand or retract to clamp the loop tie. The invention facilitates the control of the cerclage position and ensures smooth and efficient cerclage.

Description

Heart surgery is through left auricle heart outer ring system of pricking of thorax wicresoft

Technical Field

The invention relates to the field of medical instruments, in particular to a thoracic minimally invasive left atrial appendage epicardial ligation system for cardiac surgery.

Background

In heart diseases, most patients are associated with atrial fibrillation, the biggest harm of atrial fibrillation is thrombus formation, about 90-100% of the formed thrombus comes from left atrial appendage, and the thrombus shedding can cause major complications such as cerebral infarction, myocardial infarction, organ artery and peripheral artery embolism and the like. At present, the main treatment modes for preventing thrombus generation and falling of patients with atrial fibrillation comprise oral anticoagulation medicine, left atrial appendage endocardial closure, transthoracic left atrial appendage clamping closure, left atrial appendage endocardial closure or epicardial ligation and the like which are performed simultaneously in cardiac surgery.

The problems and disadvantages of the above treatment modalities are: firstly, the oral anticoagulant drug needs to be taken for life, the dosage of the blood coagulation function adjustment drug is checked repeatedly, the bleeding risk exists, and atrial thrombosis still exists after part of patients take the anticoagulant drug orally; secondly, intracardiac occlusion of the left auricle is a treatment mode which is established in recent years, but a femoral vein internal catheter is needed during treatment, a catheter invades a circulatory system, a postoperative patient needs to be braked for a long time, interatrial puncture is needed during the operation, the operation time is long, the puncture risk is high, the occluder is placed in the heart, if the occluder falls off, serious complications can be caused, a huge occluder metal stent is placed in the heart, other long-term complications can be caused, and oral antiplatelet drug treatment is needed after intracardiac occlusion of the left auricle; thirdly, the left auricle is clamped and closed by using an auricle clamp outside the heart of the conventional transthoracic left auricle, and the auricle clamp is large, so that a required operation incision is large (5cm incision), a wound on a patient is large, and postoperative recovery is slow; fourthly, the intracardiac closure or extracardiac ligation of the left auricle is performed simultaneously in the cardiac surgery, the application range to the patient is narrow, and the method is only suitable for the patient with the surgical thoracotomy.

Currently, those skilled in the art are also trying to perform extracardiac cerclage of the left atrial appendage in a thoracoscopic minimally invasive manner. For example, patent CN103462668B discloses a left atrial appendage ligation device, which comprises an outer sheath tube, an inner sheath tube, a push rod, a lock sleeve and a ligature, wherein the ligature is made into a "jade pendant" shape, every two segments of ligatures are tied, the ligature is threaded in the lock sleeve, and a circular ring is formed at one end of the lock sleeve; when in use, the inner sheath tube is arranged in the outer sheath tube, the luer connector is screwed tightly, the surgical suture is made into a 'jade pendant' ligature, the ligature is arranged on the lock sleeve, the ligature passes through the inner sheath tube, the thread end is exposed outside the luer connector, the exposed thread end is pulled to lead the push rod to pass through the inner sheath tube, the precise screw at the distal end of the push rod is spirally connected with the inner screw hole of the lock sleeve, the ligature is moderately tightened and screwed out for a plurality of times, the ligature is led into the sheath tube through the thoracocentesis, the ring of the ligature is sleeved on the left auricle under the guidance of the thoracoscope, the position of the ligature is adjusted to be at the root part, the push rod is balanced, the ligature is pulled and enters the through hole one by one, until the ligature is tightened, the ligature is clamped in the wire groove and blocked by the step and cannot be loosened slowly, so that the left auricle is ligature is ligatured, the push rod is rotated anticlockwise, the lock sleeve is separated from the push rod, the inner and the outer ligature tube and the sheath tube are cut off, the operation process of the whole device is completed.

However, the inventor of the present invention found in clinical practice that the above-mentioned left atrial appendage ligation device also has some drawbacks: firstly, the cerclage position of the ligature on the left auricle is not easy to control, and the operation fails or the operation time is greatly prolonged due to the influence of body fluid and the influence of the elasticity of the left auricle during cerclage operation; secondly, the metal lock sleeve is retained in the body of the patient together with the ligature, and if the lock sleeve falls off, complications are easily caused, and the use safety is insufficient.

The above technical problems need to be solved.

Disclosure of Invention

In view of the above, the present invention provides a minimally invasive thoracic left atrial appendage epicardial ligation system for cardiac surgery, which facilitates controlling the position of cerclage and ensures smooth and efficient cerclage.

In order to achieve the aim, the invention provides a minimally invasive thoracic cavity-passing left auricle epicardial ligation system for cardiac surgery, which comprises a ligation band, a clamp I and a clamp II;

the first end part and the second end part of the cerclage belt are connected to form a cerclage opening, and the cerclage belt is provided with a self-locking piece for limiting the second end part to move along the enlargement direction of the cerclage opening;

the clamp holder I comprises a shell I, a connecting piece I, a plurality of clamp claws I and a control handle I, wherein the shell I is tubular and can penetrate through a cerclage opening of a cerclage belt, each clamp claw I is connected with the control handle I through the connecting piece I arranged in the shell I, and each clamp claw I is driven by the control handle I to be unfolded or folded so as to clamp a left auricle;

the clamp holder II comprises a connecting piece II, a plurality of clamp claws II and a control handle II, each clamp claw II is connected with the control handle II through the connecting piece II, and each clamp claw II is driven by the control handle II to be unfolded or folded so as to clamp the strapping tape.

As a further improvement of the technical scheme of the invention, the first end of the ring-binding belt is provided with an internal channel and a channel inlet communicated with the internal channel, the internal channel extends to the end face of the first end and is communicated with the outside, the second end of the ring-binding belt extends into the internal channel from the channel inlet and extends out from the end face of the first end, and the self-locking piece is arranged on the inner wall of the internal channel and/or on the outer wall of the second end.

As a further improvement of the technical scheme of the invention, the self-locking piece is barbs I which are distributed on the inner wall of the inner channel and are made of hard materials, and the barbs I protrude towards the axis of the inner channel and protrude towards the end surface of the first end part.

As a further improvement of the technical scheme of the invention, the self-locking piece is barbs II which are distributed on the outer wall of the second end part and are made of hard materials, and the barbs II protrude out of the outer wall of the second end part and face opposite to the direction of the end face of the second end part.

As a further improvement of the technical scheme of the invention, the system also comprises a catheter body, wherein the catheter body is in a straight tube structure and is used for extending to an operation action area, and the catheter body is provided with a first extending inlet for extending the clamp holder I, a second extending inlet for extending the clamp holder II and a third extending inlet for extending the endoscope visual lens.

As a further improvement of the technical scheme of the invention, the shell I extends into the catheter body from the first extending port and then is fixedly connected with the catheter body, and the front end of the shell I extends out from the front end opening of the catheter body; and a gap is reserved between the part of the shell I, which is arranged in the catheter body, and the inner wall of the catheter body.

As a further improvement of the technical scheme of the invention, the system further comprises a shell iii in a transparent tubular structure, a moving channel for the movement of the endoscope visualization lens is formed inside the shell iii, the shell iii extends into the catheter body from the third inlet and then is fixedly connected to the catheter body, and the front end of the shell iii extends to the opening at the front end of the catheter body.

As a further improvement of the technical solution of the present invention, the first and third insertion ports are respectively provided on the upper and lower side walls of the catheter body, and the second insertion port is provided in the rear end opening portion of the catheter body.

As a further improvement of the technical scheme, the control handle I is of a pressing block structure, the jaw I is of an L-shaped plate structure, and the connecting piece I is of a pull rod or inhaul cable structure and is longer than the shell I; the rear end of each clamp claw I is connected to a sliding block, the front end of each connecting piece I is connected to the sliding block, the rear end of each connecting piece I extends out of the opening at the rear end of the shell I and is fixedly connected to the control handle I, and a return spring is arranged between the control handle I and the shell I; the sliding block can slide along the inner hole of the shell I under the pushing and pulling action of the connecting piece I, and the sliding block drives the clamp claw I to gradually extend into the inner hole of the shell I and gradually furl in the moving process towards the rear end of the inner hole of the shell I.

As a further improvement to the technical scheme of the invention, the clamp II further comprises a shell II with a straight tube structure; the connecting piece II is of a pull rod structure and is arranged in the shell II; the clamp claw II comprises an upper claw and a lower claw, the upper claw and the lower claw are connected to the shell II in a crossed and rotating mode through rotating shafts, the rear end of the clamp claw II and the front ends of the two connecting rods form a plane four-rod telescopic structure through two first connecting pins respectively, and the rear ends of the two connecting rods are connected with the front end of the connecting piece II through second connecting pins; the control handle II comprises a fixed handle and a movable handle rotationally connected with the fixed handle, the front end of the fixed handle is fixedly connected to the rear end of the shell II, and the front end of the movable handle is fixedly connected to the rear end of the connecting piece II.

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

the invention provides a cardiac surgery thoracic cavity minimally invasive left auricle external ligation system, which is characterized in that when the system is used, a first end part and a second end part of a ligation band are connected to form a ligation opening, the ligation opening is sleeved outside a shell I, then the shell I of a clamp I is stretched into a patient body through a thoracic cavity incision under the assistance of an endoscope system, when the position of a left auricle is reached, a jaw I is operated through a control handle I to be unfolded and folded properly to clamp the left auricle, then a clamp II is operated, the jaw II is used for pushing a ring to the root of the left auricle and sleeving the ligation opening outside the root of the left auricle, then the grasping part of the jaw II is changed to be the second end part of the ligation band, backward pulling force is applied to the second end part to shrink the ligation opening, and therefore the ligation operation of the left auricle is completed gradually; through the guide of holder I and to the centre gripping location of left auricle to and the remote operation of holder II, can be accurate the definite left auricle root that is located of bundling area, and can prevent to take place not hard up at the cerclage in-process, thereby reach the effect of being convenient for control cerclage position, guaranteed smooth, the high-efficient going on of cerclage.

The heart disease treatment device is simple in structure, convenient to use, suitable for popularization and application, has a positive technical effect on treating heart diseases, meets social requirements, and has high practicability.

Drawings

FIG. 1 is a schematic structural view of the present invention;

FIG. 2 is a schematic structural view of the cerclage strap of the present invention;

FIG. 3 is a schematic view of the structure of the holder I of the present invention;

FIG. 4 is a schematic structural view of a second clamp of the present invention;

fig. 5 is an enlarged schematic view at a in fig. 4.

Detailed Description

In order to make the technical solutions of the present invention better understood, the following detailed description of the present invention is provided with reference to the accompanying drawings and specific embodiments; of course, the drawings are simplified schematic diagrams and non-exclusive product structure diagrams, and the proportional sizes of the drawings do not limit the patented products.

Examples

As shown in fig. 1 to 5: the embodiment provides a cardiac surgery transthoracic minimally invasive left atrial appendage epicardium external ligature system, which comprises a ligature belt 1, a clamp I and a clamp II. The cerclage belt 1 is used for cerclage a left auricle, the clamp I is used for conveying the cerclage belt 1 and positioning the cerclage position, and the clamp II is used for remotely controlling the cerclage belt 1; the system is a cerclage operation performed through the thoracic cavity, and the operation process needs to be performed under the assistance of the existing endoscope system. In the following description, the "front end" is the end that is closer to the operating area when in use, and the "rear end" is the end that is farther from the operating area when in use.

First end 11 and the second end 12 of cerclage area 1 link to each other and form cerclage mouth 13, just be equipped with on the cerclage area 1 and be used for restricting second end 12 along the cerclage mouth 13 from the locking piece that enlarges the direction and remove. The ring-tying belt 1 can be made of polyester materials, and the first end part 11 and the second end part 12 are two ends of the belt body; the banding strap 1 is in a long belt shape under the condition that two ends are not connected, a banding opening 13 of a closed structure is formed after the two ends are connected, and the banding opening 13 can be continuously reduced or enlarged along with the relative movement of the first end part 11 and the second end part 12; the self-locking element limits the direction of relative movement of the first end portion 11 and the second end portion 12, thereby preventing the cinch 13 from expanding, i.e. the cinch 13 can only be continuously reduced during use.

The clamp holder I comprises a shell I21, a connecting piece I22, a plurality of clamp claws I23 and a control handle I24, wherein the shell I21 is tubular and can penetrate through a cerclage opening 13 of a cerclage belt 1, each clamp claw I23 is connected with the control handle I24 through the connecting piece I22 arranged in the shell I21, and each clamp claw I23 is driven by the control handle I24 to be unfolded or folded so as to clamp a left auricle. Control handle I24 and claw I23 are located the rear end of holder I, front end respectively, and during the operation, control handle I24 is located the human body outward, and it is controlled claw I23 through connecting piece I22.

The clamp holder II comprises a connecting piece II 32, a plurality of claws II 33 and a control handle II 34, each claw II 33 is connected with the control handle II 34 through the connecting piece II 32, and each claw II 33 is driven by the control handle II 34 to be unfolded or folded so as to clamp the banding strap 1. The control handle II 34 and the jaw II 33 are respectively positioned at the rear end and the front end of the clamp holder II, during operation, the control handle II 34 is positioned outside a human body, and the control handle II 32 controls the jaw II 33.

When the ring-tying band is used, the first end part 11 and the second end part 12 of the ring-tying band 1 are connected to form a ring-tying port 13, the ring-tying port 13 is sleeved outside the shell I21, then the shell I21 of the clamp I is inserted into a patient body through a chest incision under the assistance of an endoscope system, when the position of a left auricle is reached, the control handle I24 is used for operating the clamp claw I23 to be properly unfolded and folded so as to clamp the left auricle, at the moment, the clamp II is operated, the ring-tying band 1 is pushed to the root part of the left auricle by using the clamp claw II 33, the ring-tying port 13 is sleeved outside the root part of the left auricle, then the grasping part of the clamp claw II 33 is changed to be the second end part 12 of the ring-tying band 1, backward pulling force is applied to the second end part 12 so as to shrink the ring-tying port 13, and accordingly the ring-tying operation of the left auricle is gradually completed; through the guide of holder I and to the centre gripping location of left auricle to and the remote operation of holder II, can be with ribbon 1 accurate positioning in left auricle root, and can prevent to take place not hard up at the cerclage in-process, thereby reach the effect of being convenient for control cerclage position, guaranteed the smooth, high-efficient of cerclage and gone on.

In this embodiment, the first end 11 of the ring tie 1 is provided with an internal channel 15 and a channel inlet 16 communicated with the internal channel 15, the internal channel 15 extends to the end surface of the first end 11 and is communicated with the outside, and the second end 12 of the ring tie 1 extends into the internal channel 15 from the channel inlet 16 and extends out from the end surface of the first end 11; the self-locking element may be disposed only on the inner wall of the inner passage 15 or on the outer wall of the second end portion 12, or may be disposed on both the inner wall of the inner passage 15 and the outer wall of the second end portion 12. As shown in FIG. 2, the left end of the ring-tie 1 is the first end 11 thereof, and the right end thereof is the second end 12 thereof. Through the setting of interior passageway 15, first end 11 and second end 12 of ligature 1 can form the structure of connecting certainly, promptly when using, through bending second end 12 and moving towards first end 11, second end 12 gets into interior passageway 15 and finally wears out interior passageway 15 from passageway entry 16, under the effect of self-locking piece, second end 12 once get into interior passageway 15 then can't the reverse movement, consequently can effectively prevent not hard up of ligature 1 self.

In this embodiment, the self-locking piece can be the barb I14 a that adopts hard material to make that distributes in inside passageway 15 inner wall, barb I14 a projects and the terminal surface of protruding to first end 11 towards the axis of inside passageway 15. The barb I14 a can be made of metal material, and the protruding tail end of the barb I14 a is of a tip structure; in FIG. 2, the barbs I14 a project inwardly and simultaneously to the left; the barbs I14 a are uniformly distributed on the inner wall of the inner passage 15, so that they are not exposed to the outside, and the use safety is high.

In this embodiment, the self-locking element can also be the barb II 14b that adopts hard material to make that distributes in second tip 12 outer wall, barb II 14b protrusion in second tip 12 outer wall and its orientation is opposite with the direction of second tip 12 terminal surface. The barb II 14b and the barb I14 a can be arranged at the same time or alternatively. The barb II 14b can be made of metal material, and the protruding tail end of the barb II is of a tip structure; in FIG. 2, the barb II 14b is inwardly and simultaneously projecting to the left; barbs II 14b are uniformly distributed on the outer wall of the second end portion 12 and can be fixed in an embedding mode, and processing and manufacturing are facilitated.

In this embodiment, the system further includes a catheter body 4, the catheter body 4 is in a straight tube structure and is used for extending to the operation action region, and the catheter body 4 is provided with a first extending port 41 for extending the holder i, a second extending port 42 for extending the holder ii, and a third extending port 43 for extending the endoscope visualization lens (not shown in the figure). The both ends opening of pipe body 4, the front end extends operation effect region during the use, the rear end is located outside the human body, and holder I, holder II and the visual camera lens of chamber mirror all stretch into in the human body through pipe body 4, and it provides accurate route for the removal of holder I and holder II, and the smooth of being convenient for perform the operation prevents to cause the damage to other tissues.

In this embodiment, the housing i 21 extends into the catheter body 4 from the first inlet 41 and is fixedly connected to the catheter body 4, and the front end of the housing i 21 extends out from the front end opening of the catheter body 4; and a gap is reserved between the part of the shell I21 arranged in the catheter body 4 and the inner wall of the catheter body 4. By adopting the structure, the clamp I moves along with the catheter body 4, so that the operation efficiency can be improved; the gap is convenient for sleeving the banding band 1 outside the shell I21.

In this embodiment, the system further includes a housing iii 51 in a transparent tubular structure, a moving channel 52 for moving the endoscope visualization lens is formed inside the housing iii 51, the housing iii 51 is fixedly connected to the catheter body 4 after extending into the catheter body 4 from the third extending port 43, and a front end of the housing iii 51 extends to an opening at a front end of the catheter body 4. The shell III 51 can be made of transparent plastic, for example, so that an operator can observe the real-time conditions of the catheter body 4, the clamp I and the clamp II through the endoscope visual lens conveniently. A gap can be formed between the shell III 51 and the inner wall of the catheter body 4, and the cerclage belt 1 can also be sleeved outside the shell III 51 when in use.

In the present embodiment, the first inlet port 41 and the third inlet port 43 are provided on the upper side wall and the lower side wall of the catheter body 4, respectively, and the second inlet port 42 is provided in the rear end opening of the catheter body 4. "Up" and "down" are based on the directions shown in FIG. 1; at the moment, the shell I21 and the shell III 51 are both of bent tube structures, the angle of the bent position is an obtuse angle, and the part of the bent position in the catheter body 4 is parallel to the axis of the catheter body 4; by adopting the structure, the pipe diameter of the catheter body 4 can be effectively reduced, the mutual interference of instruments during operation is avoided, and the smooth operation is ensured.

In the embodiment, the control handle I24 is of a pressing block structure, the jaw I23 is of an L-shaped plate structure, and the connecting piece I22 is of a pull rod or inhaul cable structure and the length of the connecting piece I22 is larger than that of the shell I21; the rear end of each jaw I23 is connected to a sliding block 25, the front end of the connecting piece I22 is connected to the sliding block 25, the rear end of the connecting piece I22 extends out of the rear end opening of the shell I21 and is fixedly connected to a control handle I24, and a return spring 26 is arranged between the control handle I24 and the shell I21; the sliding block 25 can slide along the inner hole of the shell I21 under the pushing and pulling action of the connecting piece I22, and the sliding block 25 drives the clamp claw I23 to gradually extend into the inner hole of the shell I21 and gradually contract in the process of moving towards the rear end of the inner hole of the shell I21.

The end face of the rear end of the shell I21 is provided with a radially extending stop block which can be used as a part pulled by fingers of an operator when in use, so that the operator can press the control handle I24 conveniently; the return spring 26 is of a pressure spring structure, and in a natural state, the return spring 26 generates backward pulling force on the connecting piece I22, so that the sliding block 25 and the claws I23 move into an inner pore channel of the shell I21; the jaw I23 can be of an elastic plate structure, the jaw I23 is fixedly connected to the sliding block 25, and is contacted with the front end of the shell I21 in the moving process of the jaw I23 and gradually folded by the reactive force applied to the front end of the shell I21; of course, the jaw I23 and the sliding block 25 can be connected in a rotating manner, and in this case, an elastic member needs to be arranged between the jaw I23 and the sliding block 25.

The connecting piece I22 can be a pull rod or a pull cable structure and is used for driving the sliding block 25 to reciprocate; under the condition that casing I21 is the bent tube structure, preferred adoption sectional type body of rod structure is taken to connecting piece I22, and it includes the first body of rod, the second body of rod and the third body of rod that connect gradually from back to front, and wherein the second body of rod is flexible and crooked structure to correspond with the bending of casing I21, and also can adapt to the bending of casing I21 in the removal process, the first body of rod is rigid structure with the third body of rod, the first body of rod is connected with sliding block 25, the third body of rod is connected with control handle I24.

In this embodiment, the second gripper further comprises a second shell 31 with a straight tube structure; the connecting piece II 32 is of a pull rod structure and is arranged in the shell II 31; the second jaw 33 comprises an upper jaw 33a and a lower jaw 33b, the upper jaw 33a and the lower jaw 33b are connected to the second shell 31 in a crossed and rotating mode through a rotating shaft 34, the rear ends of the second jaw 33 and the front ends of two connecting rods 35 form a plane four-bar telescopic structure through two first connecting pins 36, and the rear ends of the two connecting rods are connected with the front end of the second connecting piece 32 through a second connecting pin 37; the control handle II 34 comprises a fixed handle 34a and a movable handle 34b which is rotatably connected with the fixed handle 34a, the front end of the fixed handle 34a is fixedly connected with the rear end of the shell II 31, and the front end of the movable handle 34b is fixedly connected with the rear end of the connecting piece II 32.

The connecting piece II 32 is integrally of a rigid rod structure; the claw II 33 extends out of the front end of the shell II 31; the rotating shaft 34 is rotatably connected to the inner wall of the shell II 31; the upper claw 33a and the lower claw 33b are connected to form an X-shaped structure; by pressing the movable handle 34b, the connecting piece II 32 can be driven to reciprocate along the axial direction of the shell II 31, so that the upper claw 33a and the lower claw 33b are driven to approach or separate from each other through the planar four-bar telescopic structure, and the clamping effect is achieved. An elastic reset piece can be arranged between the movable handle 34b and the fixed handle 34a, so that the upper claw 33a and the lower claw 33b are kept away in a natural state; the lower ends of the movable handle 34b and the fixed handle 34a can be provided with finger rings for the operation of the operator.

Finally, the principle and embodiments of the present invention have been described by using specific examples, and the above description of the examples is only for the purpose of helping understanding the core idea of the present invention, and the present invention may be modified and modified without departing from the principle of the present invention, and the modified and modified examples also fall within the protection scope of the present invention, for example, the clamp I and the clamp II may be medical forceps of other structures in the prior art, as long as the functions can be realized.

Claims

1. a cardiac surgery minimally invasive left atrial appendage extracardiac cerclage system through the thoracic cavity, is characterized in that: comprise cerclage, holder I and holder II;

The first end of the cerclage is connected to the second end to form a cerclage opening, and the cerclage is provided with a self-locking member for restricting the movement of the second end along the expansion direction of the cerclage;

The gripper I includes a housing I, a connecting piece I, a plurality of jaws I and a control handle I, the housing I is tubular and can be passed through the cerclage opening of the cerclage, and each jaw I are connected with the control handle I through the connecting piece I provided in the housing I, and each of the jaws I is driven by the control handle I to expand or retract to clamp the left atrial appendage;

The gripper II includes a connecting piece II, a plurality of jaws II and a control handle II, each of the jaws II is connected with the control handle II through the connecting piece II, and each of the jaws II is connected by the control handle II. The drive unfolds or folds to hold the loop tie.

2. a kind of cardiac surgery perthoracic minimally invasive left atrial appendage extracardiac cerclage system according to claim 1, is characterized in that:

The first end of the cerclage is provided with an inner channel and a channel inlet communicated with the inner channel, the inner channel extends to the end face of the first end and communicates with the outside world, and the second end of the cerclage is The part protrudes into the inner channel from the channel inlet and protrudes from the end face of the first end part, and the self-locking part is provided on the inner wall of the inner channel and/or on the outer wall of the second end part.

3. a kind of cardiac surgery minimally invasive left atrial appendage extracardiac cerclage system through thoracic cavity according to claim 2, is characterized in that:

The self-locking element is a barb I made of hard material distributed on the inner wall of the inner channel, and the barb I protrudes toward the axis of the inner channel and toward the end face of the first end portion.

4. a kind of cardiac surgery minimally invasive left atrial appendage extracardiac cerclage system through thoracic cavity according to claim 2, is characterized in that:

The self-locking member is a barb II made of hard material distributed on the outer wall of the second end portion, the barb II protruding from the outer wall of the second end portion and its orientation is opposite to the direction of the end face of the second end portion .

5. a kind of cardiac surgery minimally invasive left atrial appendage extracardiac cerclage system through thoracic cavity according to any one of claims 1 to 4, is characterized in that:

The system also includes a catheter body, the catheter body is in a straight tube structure and is used to extend to the operation area, and the catheter body is provided with a first extension port for the holder I to extend into, for clamping A second extending port into which the device II extends and a third extending port for the endoscopic visualization lens to extend into.

6. a kind of cardiac surgery minimally invasive left atrial appendage epicardial cerclage system through thoracic cavity according to claim 5, is characterized in that:

The casing I extends into the conduit body from the first extension port and is fixedly connected to the conduit body, and the front end of the casing I protrudes from the front end opening of the conduit body; and the casing I is placed in the conduit body. There is a gap between the portion and the inner wall of the catheter.

7. a kind of cardiac surgery minimally invasive left atrial appendage extracardiac cerclage system through thoracic cavity according to claim 5, is characterized in that:

The system also includes a casing III with a transparent tubular structure, a moving channel for the movement of the endoscopic visualization lens is formed inside the casing III, and the casing III extends into the catheter body from the third protruding port and is fixedly connected to the The catheter body, and the front end of the casing III extends to the front end opening of the catheter body.

8. a kind of cardiac surgery minimally invasive left atrial appendage epicardial cerclage system through thoracic cavity according to claim 5, is characterized in that:

The first extending port and the third extending port are respectively provided on the upper side wall and the lower side wall of the duct body, and the second extending port is provided on the rear end opening of the duct body.

9. a kind of cardiac surgery minimally invasive left atrial appendage epicardial cerclage system through thoracic cavity according to claim 5, is characterized in that:

The control handle I is a pressing block structure, the jaw I is an "L"-shaped plate structure, the connecting piece I is a pull rod or a cable structure and its length is greater than the length of the housing I; each of the jaws I The rear end of the connector I is connected to a sliding block, the front end of the connecting piece I is connected to the sliding block, and the rear end protrudes from the rear end opening of the housing I and is fixedly connected to the control handle I, and the control handle I is connected to the control handle I. A return spring is arranged between the casings I; the sliding block can slide along the inner hole of the casing I under the push-pull action of the connecting piece I, and the sliding block moves toward the rear end of the inner hole of the casing I during the process The middle driving jaw I gradually extends into the inner hole of the shell I and gradually closes.

10. A cardiac surgery minimally invasive left atrial appendage epicardial cerclage system through the thoracic cavity according to claim 5, is characterized in that:

The gripper II also includes a casing II with a straight tube structure; the connecting piece II is a tie rod structure and is arranged in the casing II; the jaws II include an upper claw and a lower claw, the upper claw and the lower claw The claws are cross-rotatedly connected to the housing II through the rotating shaft. The rear ends of the jaws II and the front ends of the two connecting rods respectively form a plane four-bar telescopic structure through two first connecting pins. The rear ends of the two connecting rods The front end of the connecting piece II is connected with the second connecting pin; the control handle II includes a fixed handle and a movable handle rotatably connected with the fixed handle, the front end of the fixed handle is fixedly connected to the rear end of the housing II, and the movable handle is The front end of the handle is fixedly connected to the rear end of the connecting piece II.