CN114767189A

CN114767189A - Negative pressure continuous stitching instrument under endoscope

Info

Publication number: CN114767189A
Application number: CN202210533392.2A
Authority: CN
Inventors: 朱利勇; 曹耀权; 王国慧; 李伟正; 余芊芊; 王泽阳; 朱晒红
Original assignee: Central South University
Current assignee: Central South University
Priority date: 2022-05-13
Filing date: 2022-05-13
Publication date: 2022-07-22

Abstract

The invention discloses a negative pressure continuous suturing device under an endoscope, comprising a suturing mechanism arranged at the front end of an endoscope tube and used for closing a breach. The control rope is passed through the channel formed in the endoscope tube to the rear end of the endoscope tube. During endoscopy/treatment, the front end of the endoscope is inserted into the patient's body, and the rear end is held in the doctor's hand for manipulation. In the present invention, the suturing mechanism is arranged at the front end of the endoscope tube, and the two are combined into the patient's body as a whole, so as to be able to Perform sutures within the scope of the endoscope's line of sight. And the control rope used to control the action of the robotic arm is passed through the channel in the endoscope tube to the rear end of the endoscope tube, so that the doctor can control the suturing mechanism through it. Compared with the existing suturing device, the present invention combines the endoscope with the suturing mechanism, so that the device not only has the observation function of the endoscope, but also has the additional function of sealing and suturing the breach.

Description

Negative pressure continuous stitching instrument under endoscope

Technical Field

The invention mainly relates to the technical field of medical instruments, in particular to a negative pressure continuous stitching instrument under an endoscope.

Background

With the development of endoscope technology and the rise of natural orifice endoscopic surgery (NOTES), the scope of application is more and more extensive, and the wound needs to be sutured in the treatment process of some endoscope environments, so a suturing device suitable for the endoscope is urgently needed.

Disclosure of Invention

The invention aims to solve the technical problem of overcoming the defects of the prior art and provides a negative pressure continuous stitching instrument under an endoscope.

In order to solve the technical problem, the invention adopts the following technical scheme:

the suturing mechanism comprises a pair of mechanical arms and an operation rope used for controlling the mechanical arms to move alternately to suture the lacerated opening, and the operation rope penetrates through a channel I formed in an endoscope tube to the rear end of the endoscope tube.

The mechanical arms are symmetrically distributed along the channel.

The mechanical arm comprises a front arm and a rear arm which are hinged with each other; the middle part of the forearm is hinged in the endoscope tube by a fastener; the rear end of the rear arm is slidably arranged in the first channel; the rear arm pushes and pulls the front arm to rotate around the fastener along the length direction of the first channel.

The front arm rear end with the back arm front end is articulated, and pin joint slidable mounting is in the spout.

The front arm comprises an arm cylinder, and an opening for penetrating a fastener is formed in the middle of the arm cylinder; the front end of the arm cylinder is provided with an opening, and a front tongue rod is telescopically arranged in the front end opening in a penetrating way; the rear end of the front tongue rod is connected with the arm cylinder through a front spring.

The arm barrel is provided with a rear end opening, a rear tongue rod is telescopically arranged in the rear end opening in a penetrating mode, and the front end of the rear tongue rod is connected with the arm barrel through a rear spring.

The control rope comprises a first rope for controlling the rear arm to move along the length direction of the first channel; the first rope is arranged to be an elastic rope.

The control rope further comprises a second rope used for controlling the front tongue rod to stretch, the second rope is connected with the rear end of the front tongue rod, and the second rope penetrates out of the arm cylinder and then enters the first passage.

The suturing mechanism further comprises a needle groove arranged at the front end of the endoscope tube, and a fracture is formed in the middle of the needle groove; and a sewing needle is arranged in the needle groove and reciprocates to penetrate through the fracture under the alternate control of the two mechanical arms.

The suturing mechanism further comprises a thread coil which is arranged in the endoscope tube and used for supplying threads to the suture needle.

The joint part of the sewing needle and the mechanical arm is formed with a groove which is matched with the shape of the front end of the mechanical arm.

The stitching instrument also comprises a traction mechanism which is arranged in the inner mirror tube and is used for drawing the crevasse peripheral tissues into the operation range of the stitching mechanism.

The traction mechanism comprises a negative pressure tube which can stretch along the length direction of the endoscope tube.

And a second channel is formed on the inner lens tube, and the negative pressure tube is telescopically arranged in the second channel in a penetrating way.

Compared with the prior art, the invention has the advantages that:

when the endoscope is used for examination and treatment, the front end of the endoscope is inserted into the body of a patient, and the rear end of the endoscope is held in the hand of a doctor for operation. And an operation rope for operating the mechanical arm to move penetrates through a first channel in the endoscope tube to the rear end of the endoscope tube so that a doctor can operate the suturing mechanism through the operation rope. Compared with the existing suture device, the invention combines the endoscope and the suture mechanism, so that the device not only has the observation function of the endoscope, but also has the function of closing and suturing the lacerations.

Drawings

FIG. 1 is a schematic view of a suturing process of the stapler (state one);

FIG. 2 is a schematic view of the suturing process of the suturing device (state two);

FIG. 3 is a schematic view of the suturing process of the suturing device (state three);

FIG. 4 is a schematic view of the suturing process of the stapler (state four);

FIG. 5 is a schematic view of the suturing process of the stapler (state five);

FIG. 6 is a schematic structural view of the forearm;

FIG. 7 is a schematic view of the construction of the needle.

The reference numerals in the figures denote: 1. an endoscope tube; 11. a first channel; 12. a second channel; 2. a suturing mechanism; 21. a mechanical arm; 211. a forearm; 2111. an arm cylinder; 2112. opening a hole; 2113. a front tongue bar; 2114. a rear tongue bar; 2115. a front spring; 2116. a rear spring; 212. a rear arm; 213. a fastener; 214. a hinge point; 22. sewing; 221. a groove; 23. a control rope; 231. a first rope; 232. a second rope; 24. a chute; 25. a needle groove; 251. breaking off; 26. coiling the wire; 3. a traction mechanism; 31. a negative pressure tube.

Detailed Description

The invention will be described in further detail below with reference to the drawings and specific examples.

As shown in fig. 1 to 7, in the present embodiment, the endoscope includes a suturing mechanism 2 disposed at the front end of the endoscope tube 1 for closing the laceration, the suturing mechanism 2 includes a pair of mechanical arms 21 and a control rope 23 for controlling the mechanical arms 21 to alternately move a needle 22 to suture the laceration, and the control rope 23 passes through a first channel 11 formed in the endoscope tube 1 to the rear end of the endoscope tube 1. When the endoscope is used for examination and treatment, the front end of the endoscope is inserted into the body of a patient, and the back end of the endoscope is held in the hand of a doctor for operation. And a control rope 23 for controlling the mechanical arm 21 to act penetrates to the rear end of the inner lens tube 1 through a passage I11 in the inner lens tube 1 so that a doctor can control the suturing mechanism 2 through the control rope. Compared with the existing suture device, the invention combines the endoscope and the suture mechanism, so that the device not only has the observation function of the endoscope, but also has the function of closing and suturing the lacerations.

In this embodiment, the robotic arms 21 are symmetrically distributed along the first channel 11. The mechanical arm 21 comprises a front arm 211 and a rear arm 212 articulated to each other; the middle part of the front arm 211 is hinged in the endoscope tube 1 by a fastener 213; the rear end of the rear arm 212 is slidably arranged in the first channel 11; rear arm 212 pushes and pulls front arm 211 along the length of first channel 11 to rotate about fastener 213. The front arm 211 is hinged at its rear end to the front end of the rear arm 212, and the hinge point 214 is slidably mounted to the slide groove 24. The front arm 211 comprises an arm cylinder 2111, and an opening 2112 for penetrating the fastener 213 is formed in the middle of the arm cylinder 2111; the front end of the arm tube 2111 is opened, and a front tongue bar 2113 is telescopically arranged in the front end opening; the rear end of the front tongue bar 2113 is connected to the arm cylinder 2111 via a front spring 2115. The arm tube 2111 is opened at the rear end, a rear tongue bar 2114 is telescopically arranged in the rear end opening, and the front end of the rear tongue bar 2114 is connected with the arm tube 2111 through a rear spring 2116. The control rope 23 comprises a first rope 231 for controlling the rear arm 212 to move along the length direction of the first channel 11; the first cord 231 is configured as an elastic cord. The control rope 23 further comprises a second rope 232 for controlling the front tongue bar 2113 to stretch, the second rope 232 is connected with the rear end of the front tongue bar 2113, and the second rope 232 penetrates out of the arm cylinder 2111 and enters the first passage 11. The suturing mechanism 2 also comprises a needle groove 25 arranged at the front end of the endoscope tube 1, and a fracture 251 is formed in the middle of the needle groove 25; a needle 22 is arranged in the needle groove 25, and the needle 22 passes through the fracture 251 in a reciprocating mode under the alternate operation of the two mechanical arms 21. The stapler further comprises a traction mechanism 3 which is arranged in the endoscope tube 1 and is used for drawing the crevasse peripheral tissues into the operation range of the suturing mechanism 2. The traction mechanism 3 includes a negative pressure tube 31 which can be extended and contracted in the longitudinal direction of the endoscope tube 1. The inner lens tube 1 is formed with a second channel 12, and the negative pressure tube 31 is telescopically arranged in the second channel 12 in a penetrating way.

In the process of moving from the first state to the second state (namely, fig. 1 to 2), a doctor firstly pushes the negative pressure tube 31 forwards at the rear end of the inner lens tube 1 to enable the front end opening of the negative pressure tube to be attached to any side tissue of the lacerated opening, and the lacerated opening tissue is connected with the negative pressure tube under the action of negative pressure; at this time, the negative pressure tube 31 is pulled backward to drive the one-side crevasse tissue into the middle port 251 of the needle groove 25 and is kept in the position. Then, the doctor pushes the first rope 231 at the rear end of the endoscope tube 1, the rear end of the first rope 231 is hinged with the two rear arms 212, and then the rear end of the rear arm 212 is pushed to move forwards in the first channel 11; because the front end of the rear arm 212 is slidably mounted in the chute 24, and the opening of the chute 24 is vertically arranged, the front end of the rear arm 212 moves outwards along the chute 24 under the action of thrust; because the front end of the rear arm 212 is hinged with the rear end of the front arm 211, the rear end of the front arm 211 synchronously moves outwards along the sliding groove 24 under the driving of the rear arm 212; the middle part of the front arm 211 is fixed by a fastener 213, and the front end rotates inwards around the fastener 213 under the pushing of the rear end. The sliding groove 24 and the needle groove 25 are arranged in parallel, the front arm 211 is changed from oblique to vertical in the rotating process, and the front and rear tongue rods retract into the arm barrel 2111 simultaneously due to the fact that the two ends of the front arm 211 are pressed; the front end of the front tongue 2113 of the upper forearm 211 always pushes the needle 22 in the needle groove 25 forward, and the front tongue 2113 rotates clockwise to generate a downward pushing force on the needle 22, and the needle 22 moves downward by the pushing force and the lower end thereof enters the notch 251.

In the process of moving from the second state to the third state (i.e. fig. 2 to 3), the physician continues to push the first rope 231 at the rear end of the endoscope tube 1, so as to drive the front end of the rear arm 212 to move outwards along the sliding slot 24, and under the action of the rear arm 212, the front end of the front arm 211 continues to rotate inwards around the fastening member 213. The lower end of the needle 22 pierces the crevasse tissue in the fracture 251 and passes through the fracture 251 into the lower needle groove 25 by pushing on the front end of the front tongue 2113 of the upper forearm 211. During the period, the doctor firstly pulls the second rope 232 for controlling the lower front tongue bar 2113 to retract the front tongue bar 2113 into the arm cylinder 2111, and when the lower end of the suture needle 22 moves to the front end opening of the lower arm cylinder 2111, the second rope 232 for controlling the lower front tongue bar 2113 is loosened to enable the front tongue bar 2113 to protrude and push the suture needle 22 to form connection; then, pulling the second rope 232 for operating the upper front tongue bar 2113 retracts the front tongue bar 2113 into the arm cylinder 2111, i.e. the upper front tongue bar 2113 is separated from the needle 22, so as to realize one alternation of the operation of the upper and lower mechanical arms 21 on the needle 22.

In the process of moving from the third state to the fourth state (namely, fig. 3 to 4), a doctor firstly pushes the negative pressure tube 31 forwards at the rear end of the endoscope tube 1 to enable the front end opening of the negative pressure tube to be attached to the tissue on the other side of the lacerated opening, and the lacerated opening tissue is connected with the negative pressure tube under the action of negative pressure; at this time, the negative pressure tube 31 is pulled backwards to drive the side crevasse tissue to enter the middle port 251 of the needle groove 25 and keep the position immovable; at this point, the tissue penetrated by needle 22 remains in fracture 251 under the pull of the suture. Then, the doctor pulls the first rope 231 at the rear end of the endoscope tube 1, the rear end of the first rope 231 is hinged with the two rear arms 212, and then the rear end of the rear arm 212 is pulled to move backwards in the first channel 11; because the front end of the rear arm 212 is slidably mounted in the chute 24, and the opening of the chute 24 is vertically arranged, the front end of the rear arm 212 moves inwards along the chute 24 under the action of pulling force; because the front end of the rear arm 212 is hinged with the rear end of the front arm 211, the rear end of the front arm 211 synchronously moves inwards along the sliding groove 24 under the driving of the rear arm 212; the middle part of the front arm 211 is fixed by a fastener 213, and the front end rotates outwards around the fastener 213 to be vertical to the chute 24 under the pulling of the rear end. The sliding groove 24 and the needle groove 25 are arranged in parallel, the front arm 211 is changed from oblique to vertical in the rotating process, and the front and rear tongue rods retract into the arm barrel 2111 at the same time due to the fact that the two ends of the front arm 211 are pressed; the front end of the front tongue 2113 of the lower forearm 211 always pushes the needle 22 in the needle groove 25 forward, and the front tongue 2113, when rotating in the reverse direction, exerts an upward pushing force on the needle 22, by which the needle 22 moves upward and its upper end enters the fracture 251.

In the process of moving from the fourth state to the fifth state (i.e. fig. 4 to 5), the physician first pushes the first rope 231 at the rear end of the endoscope tube 1, and then drives the front end of the rear arm 212 to move outwards along the sliding slot 24, and under the action of the rear arm 212, the front end of the front arm 211 rotates inwards around the fastening member 213. The upper end of the needle 22 pierces the double-walled laceration tissue in the fracture 251 and passes through the fracture 251 into the upper needle groove 25 by the pushing action of the front end of the front tongue 2113 of the lower forearm 211. During the period, the doctor firstly pulls the second rope 232 for operating the upper front tongue bar 2113 to retract the front tongue bar 2113 into the arm cylinder 2111, and when the upper end of the suture needle 22 moves to the front end opening of the upper arm cylinder 2111, the second rope 232 for operating the upper front tongue bar 2113 is loosened to enable the front tongue bar 2113 to protrude and push the suture needle 22 to form connection; then, pulling the second rope 232 for operating the lower front tongue bar 2113 retracts the front tongue bar 2113 into the arm cylinder 2111, i.e. the lower front tongue bar 2113 is separated from the needle 22, so that the upper and lower mechanical arms 21 can operate the needle 22 alternately again.

After the fifth state, the endoscope tube 1 is moved in the direction of the laceration, and the above-described operations are repeated so as to perform sequential suturing in the direction of the laceration.

In this embodiment, the suturing mechanism 2 further includes a thread roll 26 disposed inside the endoscope tube 1 for supplying thread to the needle 22. Since the coil 26 is disposed in the distal end of the endoscope tube 1 so as to be as close to the needle 22 as possible and the suture drawn from the coil 26 is fixed to the needle 22, the loose needle drawn from the coil 26 is short because the coil 26 is close to the needle 22, and the probability of entanglement with other structures can be reduced.

In this embodiment, a groove 221 is formed in the joint portion between the needle 22 and the arm 21, and the groove 221 is adapted to the shape of the tip of the arm 21. The needle 22 is connected to the robot arm 21 in such a manner that the front tongue 2113 pushes the needle 22 into the needle groove 25 and drives the needle 22 to move by friction. In the process, in order to improve the fit between the needle 22 and the front tongue 2113, the joint between the needle 22 and the arm 21 is formed in a groove shape so that the front tongue 2113 protrudes thereinto to increase friction.

Although the present invention has been described with reference to the preferred embodiments, it is not intended to be limited thereto. Those skilled in the art can make numerous possible variations and modifications to the present invention, or modify equivalent embodiments to equivalent variations, without departing from the scope of the invention, using the teachings disclosed above. Therefore, any simple modification, equivalent change and modification made to the above embodiments according to the technical essence of the present invention shall fall within the protection scope of the technical solution of the present invention, unless the technical essence of the present invention departs from the content of the technical solution of the present invention.

Claims

1. Continuous ware of sewing up of negative pressure under scope, its characterized in that: including setting up in endoscope pipe (1) front end, being used for sealing the sewing mechanism (2) of breach, sewing mechanism (2) include a pair of arm (21) and be used for controlling arm (21) alternate movement seam needle (22) sew up the controlling rope (23) of breach, control rope (23) and wear to the rear end of endoscope pipe (1) through passageway (11) of shaping in endoscope pipe (1).

2. The continuous endoscopic negative pressure stapler according to claim 1, wherein: the mechanical arms (21) are symmetrically distributed along the first channel (11).

3. The continuous endoscopic negative pressure stapler according to claim 2, wherein: the mechanical arm (21) comprises a front arm (211) and a rear arm (212) which are mutually hinged; the middle part of the front arm (211) is hinged in the endoscope tube (1) by a fastener (213); the rear end of the rear arm (212) is slidably arranged in the first channel (11); the rear arm (212) pushes and pulls the front arm (211) to rotate around the fastener (213) along the length direction of the first channel (11).

4. The continuous endoscopic negative pressure stapler according to claim 3, wherein: the rear end of the front arm (211) is hinged with the front end of the rear arm (212), and a hinge point (214) is slidably mounted on the sliding groove (24).

5. The continuous endoscopic negative pressure stapler according to claim 3, wherein: the front arm (211) comprises an arm cylinder (2111), and an opening hole (2112) for penetrating a fastener (213) is formed in the middle of the arm cylinder (2111); the front end of the arm tube (2111) is provided with an opening, and a front tongue bar (2113) is arranged in the front end opening in a telescopic and penetrating way; the rear end of the front tongue rod (2113) is connected with the arm cylinder (2111) through a front spring (2115).

6. The continuous endoscopic negative pressure stapler according to claim 5, wherein: the rear end opening of the arm tube (2111) is provided with a rear tongue bar (2114) in the rear end opening in a telescopic and penetrating manner, and the front end of the rear tongue bar (2114) is connected with the arm tube (2111) through a rear spring (2116).

7. The endoscopic negative pressure continuous suturing device according to claim 5, wherein: the control rope (23) comprises a first rope (231) for controlling the rear arm (212) to move along the length direction of the first channel (11); the first rope (231) is arranged as an elastic rope.

8. The endoscopic negative pressure continuous suturing device according to claim 5, wherein: the control rope (23) further comprises a second rope (232) used for controlling the front tongue rod (2113) to stretch, the second rope (232) is connected with the rear end of the front tongue rod (2113), and the second rope (232) penetrates out of the arm cylinder (2111) and then enters the first channel (11).

9. The endoscopic negative pressure continuous suturing device according to claim 1, wherein: the suturing mechanism (2) further comprises a needle groove (25) arranged at the front end of the endoscope tube (1), and a fracture (251) is formed in the middle of the needle groove (25); a sewing needle (22) is arranged in the needle groove (25), and the sewing needle (22) passes through the fracture (251) in a reciprocating mode under the alternate control of the two mechanical arms (21).

10. The endoscopic negative pressure continuous suturing device according to claim 1, wherein: the suturing mechanism (2) further comprises a thread coil (26) which is arranged in the endoscope tube (1) and used for supplying thread for the suture needle (22).

11. The endoscopic negative pressure continuous suturing device according to claim 1, wherein: a groove (221) is formed in the joint part of the sewing needle (22) and the mechanical arm (21), and the groove (221) is matched with the shape of the front end of the mechanical arm (21).

12. The continuous endoscopic negative pressure stapler according to any one of claims 1 to 11, wherein: the suturing device also comprises a traction mechanism (3) which is arranged in the endoscope tube (1) and used for drawing the crevasse peripheral tissues into the operation range of the suturing mechanism (2).

13. The endoscopic negative pressure continuous suturing device according to claim 12, wherein: the traction mechanism (3) comprises a negative pressure tube (31) which can stretch along the length direction of the endoscope tube (1).

14. The endoscopic negative pressure continuous suturing device according to claim 13, wherein: the endoscope is characterized in that a second channel (12) is formed in the endoscope tube (1), and a negative pressure tube (31) is arranged in the second channel (12) in a penetrating mode in a telescopic mode.