CN116077122B - Microvascular anastomat and anastomosis method - Google Patents
Microvascular anastomat and anastomosis methodInfo
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- CN116077122B CN116077122B CN202310181403.XA CN202310181403A CN116077122B CN 116077122 B CN116077122 B CN 116077122B CN 202310181403 A CN202310181403 A CN 202310181403A CN 116077122 B CN116077122 B CN 116077122B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
- A61B2017/1107—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis for blood vessels
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
- A61B2017/1132—End-to-end connections
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Abstract
发明涉及一种微血管吻合器及吻合方法，包括：面对面设置的两个吻合环，多个引线针和夹持钳；吻合环中设有轴向贯通的血管槽孔；两个吻合环中相互靠近的一侧均设有多个插针孔和多个穿针孔，多个插针孔和多个穿针孔沿周向间隔分布，穿针孔为轴向贯穿孔；插针孔的尾端连接有缝合线；夹持钳包括钳子和两个旋转机构，钳子包括两个铰接的钳臂，钳臂与旋转机构连接，两个旋转机构相对于钳臂旋转开合；其中，两个吻合环分别与两个旋转机构连接，两个旋转机构带动两个吻合环旋转开合直至平行，两个钳臂带动两个吻合环相互靠近，两个吻合环中一者的引线针穿插在另一者的穿针孔中。发明轻易的将两个吻合环对齐扣合在一起并且操作方便快捷准确。
This invention relates to a microvascular anastomosis device and method, comprising: two anastomosis rings arranged face-to-face, multiple suture needles, and clamping forceps; each anastomosis ring has an axially penetrating vascular groove; each of the two anastomosis rings has multiple needle insertion holes and multiple needle insertion holes on its adjacent side, the needle insertion holes and needle insertion holes being circumferentially spaced, and the needle insertion holes being axially penetrating holes; a suture is connected to the tail end of each needle insertion hole; the clamping forceps include a forceps and two rotating mechanisms, the forceps including two hinged forceps arms connected to the rotating mechanisms, the two rotating mechanisms rotating and opening relative to the forceps arms; wherein, the two anastomosis rings are respectively connected to the two rotating mechanisms, the two rotating mechanisms driving the two anastomosis rings to rotate and open until they are parallel, the two forceps arms driving the two anastomosis rings to move closer together, and the suture needle of one anastomosis ring being inserted into the needle insertion hole of the other. This invention easily aligns and fastens the two anastomosis rings together and is convenient, quick, and accurate in operation.
Description
Technical Field
The invention relates to the technical field of medical surgical instruments, in particular to a microvascular anastomat and an anastomosis method.
Background
Vascular anastomosis is a necessary procedure in various surgical procedures. Vascular anastomosis generally involves both manual suturing and anastomosis using an anastomotic ring. Regardless of the manner, the key to vascular anastomosis is that the anastomosis should be performed with the intima everted, thereby avoiding contact of the intima with foreign matter that may occur at the vessel interface.
Vascular anastomosis in surgery generally includes both manual suturing and mechanical anastomosis of blood vessels using an anastomotic ring, and is mainly based on the traditional needle and line anastomosis method. The vascular anastomosis by using the suture is a currently accepted standard vascular anastomosis method, and is also the most commonly used vascular anastomosis method in daily clinic.
The manual suturing method is widely used in surgical operations such as operations in various fields of plastic surgery, hepatobiliary surgery, cardiothoracic surgery, urological surgery and the like, and the vascular anastomosis technology is needed after the development of the manual suturing method for more than one hundred years. The manual suturing has the advantages of simple appliance, wide application range and the like, but the suturing skill has higher requirements on doctors, so that the doctors who are skilled in the microsurgery vascular anastomosis technology can achieve the purposes that the microsurgery basic training and experience accumulation are required for at least 3 to 5 years, and even the doctors who are skilled in technology and have long-time operation training can be greatly influenced in various aspects such as physical strength, energy, psychology, emotion and the like due to long operation time (an average operation time is 5 to 8 hours), and operation failure can be caused. In addition, manual suturing of sutures is prone to exposure to procedures that interfere with the normal flow of blood, inversion of the stoma, etc., and increase the risk of thrombosis. The human blood vessel has corresponding elasticity, stretches into tissues, is difficult to accurately position by manual suture, so that the problems of unsmooth suture, too deep or too shallow suture, too tight suture or too loose suture and the like easily occur in the operation, the blood at the joint is leaked, and the thrombus is easily formed and even the operation fails due to the influence of a suture needle and a thread after the operation.
The vascular mechanical anastomosis is a vascular anastomosis method in which a special blood anastomosis device is used for replacing or partially replacing a suture, and is also called a vascular anastomosis ring method, and is generally divided into a sleeve method, a magnetic suction method, an anastomosis clamp method and a needle ring method. The mechanical vascular anastomosis method can well avoid the defects caused by manual suture, but the volume of the vascular anastomosis ring is generally smaller, the precision requirement is high, and the vascular anastomosis ring is not accurate in correspondence during installation, so that the problems of difficult installation and unstable installation are caused. For example, the wheel type anastomotic ring has the advantages of standard, unified and standard operation, no inner membrane wound surface, no anastomotic leakage, no anastomotic stoma stenosis and the like. The multi-needle mandrel stitching instrument is a semi-manual semi-instrument, and although the stitching times of a single needle and a single line are reduced, the manual knotting times after stitching are not reduced, and various defects of manual stitching are not overcome.
Chinese patent CN113069164a discloses that the present invention relates to a detachable reusable microvascular anastomat and a method of using the same. The anastomat comprises two half buckles capable of mutually involuting, wherein the main body of the half buckle is a half cylinder, an axially through half slot is formed in the inner face of the half buckle, involution clamping slots are formed in the slot edges of the half slot, a plurality of tooth-shaped convex edges protruding out of the outer circular surface are arranged at the front section of the half buckle, the tooth-shaped convex edges are outwards divergent from the center, fixing needles or inserting holes are formed in the tooth-shaped convex edges, the tooth-shaped convex edges provided with the fixing needles are distributed at intervals with the tooth-shaped convex edges provided with the inserting holes, the fixing needles extend out of the front end faces of the tooth-shaped convex edges along the axial direction, a triangular hollow with the tip pointing to the root of the tooth-shaped convex edge is formed between two adjacent tooth-shaped convex edges, and an axial hole slot for inserting a suture needle is formed in the tip part of the triangular hollow. The invention can realize eversion anastomosis of the blood vessel, can be removed from the blood vessel after suturing, and reduces the cost and the selling price, thereby reducing the medical expense.
But has the following problems that 1, the anastomat is very small and is not easy to buckle the two anastomat together, so that a fixing needle is difficult to insert into a needle hole on the opposite side, and the use is inconvenient and quick, and 2, the blood vessel is inconvenient to evert after passing through the anastomat.
Disclosure of Invention
Therefore, the invention aims to solve the technical problems that in the prior art, two anastomat are not easy to buckle together, so that a fixing needle is difficult to insert into a pinhole on the opposite side, the use is inconvenient and quick, and the blood vessel is inconvenient to evert after passing through the anastomat.
In order to solve the technical problems, in one aspect, the present invention provides a microvascular anastomat, comprising:
The two anastomotic rings are arranged face to face, and are internally provided with axially through vascular slotted holes, one side of the two anastomotic rings, which is close to each other, is provided with a plurality of pin holes and a plurality of pin penetrating holes, the pin holes and the pin penetrating holes are circumferentially distributed at intervals, and the pin penetrating holes are axial through holes;
a plurality of lead pins connected in pin holes of the two anastomotic rings, and the tail ends of the pin holes are connected with suture lines;
the clamping pliers comprise pliers and two rotating mechanisms, wherein the pliers comprise two hinged pliers arms, the pliers arms are connected with the rotating mechanisms, and the two rotating mechanisms are rotated to open and close relative to the pliers arms;
The two anastomotic rings are respectively connected with the two rotating mechanisms, the two forceps arms are meshed to drive the two anastomotic rings to rotate and open and close until the two anastomotic rings are parallel, the two forceps arms drive the two anastomotic rings to approach each other, and the needle threading of one of the two anastomotic rings is inserted into the needle threading hole of the other anastomotic ring.
In some embodiments of the invention, the anastomotic ring comprises two anastomotic ring halves which are radially apposed to form the anastomotic ring.
In some embodiments of the invention, two anastomotic ring halves are apposed to form a bond line in the anastomotic ring, the bond lines of the two anastomotic rings intersecting;
one of the two anastomotic rings is provided with a through hole, and the other is provided with a fixed needle penetrating through the through hole.
In some embodiments of the invention, a coil groove is arranged at a position outside the needle insertion hole in the anastomotic ring, the coil groove is an annular groove, a suture thread is coiled in the coil groove, and one end of the suture thread is connected with the needle.
In some embodiments of the invention, the anastomotic ring is provided with a slotted hole on one side of the needle penetration hole, and the slotted hole is communicated to the outside of the anastomotic ring.
In some embodiments of the invention, the rotation mechanism includes a connecting rod, a rotating ring, and a thumb wheel;
the two forceps arms are arranged in an X shape and hinged at the intersection of the two forceps arms through a first central shaft, one of the two forceps arms is hinged with the bottom end of the connecting rod through a second central shaft, and the other forceps arm is hinged with the middle part of the connecting rod through a third central shaft;
the thumb wheel is connected to the top end of the clamp arm;
the bottom end of the rotating ring is provided with a cam protruding from the lower surface of the rotating ring, the lower surface of the cam is arc-shaped, and the two ends of the arc-shaped are provided with drop heights along the axial direction of the rotating ring;
the rotating ring is sleeved at the top end of the connecting rod and rotates along the circumferential direction relative to the connecting rod, and the cam of the rotating ring is in contact with the thumb wheel.
In some embodiments of the invention, the rotating mechanism further comprises a limit nail and a limit groove, wherein the limit nail is fixed on the outer wall of the connecting rod;
Wherein, the spacing nail is arranged in the spacing groove.
In some embodiments of the invention, the bottom of the rotating ring is provided with an axially extending connecting groove, which communicates with the limiting groove.
In some embodiments of the invention, the top ends of the two rotating mechanisms are connected with rotating clamping parts, the rotating clamping parts are provided with clamping openings, and the inner walls of the clamping openings are provided with protruding clamping tables;
The middle part of the outer wall of the anastomotic ring is provided with a circle of annular groove, the anastomotic ring is positioned in the clamping opening, and the clamping table is clamped in the annular groove.
In some embodiments of the present invention, the pliers further comprise two locking bars, the two locking bars are respectively connected to the inner sides of the two pliers arms, the free ends of the locking bars are respectively provided with teeth, and the teeth of the two locking bars are meshed.
In some embodiments of the invention, the anastomotic ring is made of plastic.
In another aspect, the invention provides a method for anastomosis of a microvascular, comprising the steps of suturing the microvascular by using the microvascular anastomat in the above embodiment, comprising:
The preliminary engagement of the two forceps arms of the forceps drives the two anastomotic rings to rotate along with the two rotating mechanisms until the opposite surfaces of the two anastomotic ring surfaces are parallel;
the two forceps arms of the forceps are continuously meshed to drive the two anastomotic rings to be close to each other until the lead needle of one anastomotic ring is inserted into the needle penetrating hole of the other anastomotic ring.
Compared with the prior art, the technical scheme of the invention has the following advantages:
The two blood vessels respectively pass through the vascular slotted holes of the two anastomotic rings, the broken ends of the blood vessels are turned outwards and are hooked on the lead pins of the anastomotic rings one by one, the two forceps arms drive the two anastomotic rings to rotate along with the two rotating mechanisms until the two anastomotic rings are parallel, then the two forceps arms drive the two anastomotic rings to approach each other until the lead pins of one of the two anastomotic rings are inserted into the needle penetrating holes of the other anastomotic ring, and then the lead pins of one of the two anastomotic rings are pulled out and knotted on the side surface of the other anastomotic ring to finish suturing. According to the application, the two anastomotic rings are aligned and buckled through the engagement of the two clamp arms, so that the two anastomotic rings are easily aligned and buckled together, and the operation is convenient, quick and accurate, thereby further improving the suturing efficiency and the suturing efficiency. Secondly, when the two anastomotic rings are buckled, the two forceps arms drive the two anastomotic rings to rotate along with the two rotating mechanisms until the two anastomotic rings are parallel, so that the front surfaces of the two anastomotic rings are outwards opened in the direction of an operator, the operator can conveniently pass blood vessels through vascular slots of the two anastomotic rings, and can conveniently turn out broken ends of the blood vessels and hook the broken ends of the blood vessels on all lead pins of the anastomotic rings, on one hand, the application is convenient for the operator to use, on the other hand, the axis of the application connects the forceps arms with the anastomotic rings, then passes the blood vessels through vascular slots and turns out the broken ends of the blood vessels on the lead pins, and after ensuring the relative positions of the two anastomotic rings, the vessels are passed through and the broken ends of the blood vessels are turned out on the lead pins, so that the quality and the efficiency of vascular suturing are further ensured on the premise that the two anastomotic rings are easier to align. In addition, the application realizes the change of the included angle between the two anastomotic rings through the rotation of the rotating mechanism, thereby adjusting the included angle between the two anastomotic rings to the maximum through the rotating mechanism when penetrating into a blood vessel, gradually reducing the included angle between the two anastomotic rings until the two anastomotic rings are parallel through the reverse rotating mechanism after penetrating into the blood vessel, and finally, closing the two anastomotic rings to each other by the rotating mechanism for suturing. And thirdly, after the blood vessel broken end is turned outwards, the blood vessel broken end is directly hooked on the lead wire needle, and then the suture of the blood vessel is realized by pulling out the lead wire needle, so that the suture is realized and no other wound is caused to the blood vessel broken end.
Drawings
In order that the invention may be more readily understood, a more particular description of the invention will be rendered by reference to specific embodiments thereof that are illustrated in the appended drawings, in which
Fig. 1 is a three-dimensional schematic view of a microvascular stapler of the invention.
Fig. 2 is a schematic back view of a microvascular stapler of the invention of fig. 1.
Fig. 3 is a schematic view of an anastomotic ring of the microvascular anastomat of fig. 1.
Fig. 4 is an alternative schematic view of a microvascular stapler of the invention of fig. 3.
Fig. 5 is a schematic view of an alternative microvascular stapler of the invention of fig. 3.
Fig. 6 is a schematic view of the structure of a clamping jaw of the microvascular stapler of fig. 1.
FIG. 7 is a schematic illustration of the operation of one microvascular anastomosis method of the invention of FIG. 1.
Fig. 8 is a schematic representation of the operation of an anastomosis ring in one of the microvascular anastomosis methods of the invention of fig. 1.
The reference numerals of the specification show that 100 parts of the anastomotic ring, 100a parts of the first anastomotic ring, 100b parts of the second anastomotic ring, 110 parts of the vascular groove, 120 parts of the needle insertion hole, 130 parts of the needle insertion hole, 140 parts of the anastomotic ring, 141 parts of the bonding wire, 141a parts of the first bonding wire, 141b parts of the second bonding wire, 141c parts of the third bonding wire, 141d parts of the fourth bonding wire, 150 parts of the through hole, 160 parts of the fixed needle, 161 parts of the bulge, 170 parts of the communicating groove, 180 parts of the disc line groove, 190 parts of the groove-shaped hole;
200. A wire needle;
300. a suture;
400. Clamping pliers 410, pliers arms 411, first central shaft 412, second central shaft 413, third central shaft 420, connecting rod 421, sliding chute 430, rotary ring 431, cam 431a, first end 431b, second end 432, connecting groove 440, thumb wheel 450, limit nail 460, limit groove 470, locking rod 471, tooth;
500. a rotary clamping part, 510, a clamping opening, 511, a clamping table, 512 and an annular groove;
600. and (5) blood vessels.
Detailed Description
The invention will be further described in connection with the accompanying drawings and specific examples which are set forth so that those skilled in the art will better understand the invention and will be able to practice it, but the examples are not intended to be limiting of the invention.
Referring to fig. 1-2, the invention provides a microvascular anastomat, comprising:
The two anastomotic rings 100 are arranged face to face, the anastomotic rings 100 are internally provided with axially through vascular slotted holes 110, and the vascular slotted holes 110 are circular holes, one side of the two anastomotic rings 100, which is close to each other, is provided with a plurality of pin holes 120 and a plurality of pin penetrating holes 130, the pin holes 120 and the pin penetrating holes 130 are circumferentially distributed at intervals, and the pin penetrating holes 130 are axially through holes;
A plurality of lead pins 200 connected to pin holes 120 of two anastomotic rings 100 and pulled out from pin holes 120, and a suture thread 300 is connected to the tail end of pin hole 120;
the clamping pliers 400 comprise pliers and two rotating mechanisms, wherein the pliers comprise two hinged pliers arms 410, the pliers arms 410 are connected with the rotating mechanisms, and the two rotating mechanisms are rotated to open and close relative to the pliers arms 410;
Wherein, the two anastomotic rings 100 are respectively connected with the two rotating mechanisms, the two forceps arms 410 are meshed to drive the two anastomotic rings 100 to rotate and open and close until the two anastomotic rings 100 are parallel, the two forceps arms 410 drive the two anastomotic rings 100 to approach each other, and the needle 200 of one anastomotic ring 100 is inserted into the needle penetrating hole 130 of the other anastomotic ring 100. For convenience of description, two anastomotic rings 100 are referred to as a first anastomotic ring 100a and a second anastomotic ring 100b, respectively, the needle-threading holes 130 of the first anastomotic ring 100a and the needle-threading holes 130 of the second anastomotic ring 100b are arranged opposite to each other in the axial direction, the needle-threading holes 200 of the first anastomotic ring 100a and the needle-threading holes 200 of the second anastomotic ring 100b are arranged in a staggered manner in the circumferential direction, and the needle-threading holes 130 of the first anastomotic ring 100a and the needle-threading holes 130 of the second anastomotic ring 100b are arranged in a staggered manner in the circumferential direction.
Specifically, two blood vessels 600 of the present application respectively pass through the vascular slots 110 of two anastomotic rings 100, and the cut ends of the blood vessels 600 are turned outwards and hooked on the respective needles 200 of the anastomotic rings 100 one by one, the two forceps arms 410 drive the two anastomotic rings 100 to rotate along with the two rotating mechanisms until parallel, then the two forceps arms 410 drive the two anastomotic rings 100 to approach each other until the needles 200 of one of the two anastomotic rings 100 are inserted into the needle holes 130 of the other, and then the needles 200 of one of the two anastomotic rings 100 are pulled out and knotted on the side of the other to complete suturing. The two anastomotic rings 100 of the present application are aligned and fastened by the engagement of the two clamp arms 410, so that the two anastomotic rings 100 are easily aligned and fastened together, and the operation is convenient, fast and accurate, thereby further improving the suturing efficiency and the suturing efficiency. Secondly, when the two anastomotic rings 100 are buckled, the two forceps arms 410 drive the two anastomotic rings 100 to rotate along with the two rotating mechanisms until the two anastomotic rings 100 are parallel, so that the front surfaces of the two anastomotic rings 100 are outwards expanded towards the direction of an operator, the operator can conveniently pass the blood vessel 600 through the vascular slotted holes 110 of the two anastomotic rings 100, and can conveniently outwards turn over the broken ends of the blood vessel 600 and hook the broken ends on the lead needles 200 of the anastomotic rings 100, on the one hand, the application is convenient for the operator to use, on the other hand, the forceps arms 410 are connected with the anastomotic rings 100 along the axis, then the blood vessel 600 passes through the vascular slotted holes 110 and outwards turns over the broken ends of the blood vessel 600 to hook the lead needles 200, and on the premise that the two anastomotic rings 100 are easier to align, the quality and the efficiency of the suturing of the blood vessel 600 are further ensured. In addition, the present application realizes the change of the included angle between the two anastomotic rings 100 by the rotation of the rotation mechanism, so that the included angle between the two anastomotic rings 100 is adjusted to the maximum by the rotation of the rotation mechanism when penetrating into the blood vessel 600, the opposite rotation of the rotation mechanism gradually reduces the included angle between the two anastomotic rings 100 until the two anastomotic rings are parallel after penetrating into the blood vessel 600, and finally the rotation of the rotation mechanism enables the two anastomotic rings 100 to approach each other for suturing. Again, the broken end of the blood vessel 600 in the present application is directly hooked on the needle 200 after being turned out, and then the suture of the blood vessel 600 is achieved by pulling out the needle 200, and the suture is achieved without causing additional wound to the broken end of the blood vessel 600.
Referring to fig. 3, further, anastomosis ring 100 includes two anastomosis ring halves 140, and anastomosis ring 100 is formed by radially apposing two anastomosis ring halves 140. Two anastomotic ring halves 140 are each provided with half a vascular slot 110.
Specifically, anastomosis ring 100 in the present embodiment is formed by the apposition of two anastomosis ring halves 140, which facilitate threading of blood vessel 600 through vessel slots 110.
With continued reference to fig. 3, further, two anastomotic ring halves 140 are apposed to form a bond line 141 in anastomotic ring 100, the bond lines 141 of two anastomotic rings 100 intersecting, e.g., the bond lines 141 of two anastomotic rings 100 intersecting in a cross shape;
One of the two anastomotic rings 100 is provided with a through hole 150 and the other is provided with a fixation needle 160 penetrating through hole 150.
Specifically, the joining lines 141 of the two anastomotic rings 100 in this embodiment intersect and the relative fixed connection of the two anastomotic rings 100 is achieved by the passage of the fixation needle 160 of one of the two anastomotic ring halves 140 through the passage hole 150 of the other. Simple structure is convenient for each other fixed and each other the separation.
Referring to fig. 4, in some possible embodiments, two anastomotic ring halves 140 of the present embodiment are apposed to form two joining lines 141 in anastomotic ring 100, the joining lines 141 of the two anastomotic rings 100 being arranged in a circumferentially offset relationship with each other, e.g., two anastomotic ring halves 140 of a first anastomotic ring 100a form a first joining line 141a and a second joining line 141b, and two anastomotic ring halves 140 of a second anastomotic ring 100b form a third joining line 141c and a fourth joining line 141d, the first joining line 141a, the second joining line 141b, the third joining line 141c and the fourth joining line 141d being arranged in a circumferentially offset relationship with each other. This prevents vessel 600 from being radially stressed by anastomosis ring 100, thereby preventing vessel 600 from being damaged by external forces.
One of the two anastomotic ring halves 140 is provided with a through hole 150 and the other is provided with a fixation needle 160 penetrating through the hole 150.
Referring to fig. 5, further, the front end of the fixing needle 160 is provided with a tapered head.
In particular, the tapered head facilitates penetration of the fixation needle 160 into the pass-through hole 150.
With continued reference to fig. 5, further, the forward end of the needle 200 is provided with a tapered head.
In particular, the tapered head facilitates penetration of the needle 200 into the needle penetration aperture 130.
With continued reference to fig. 5, further, the forward end of the stationary needle 160 is provided with a tapered head. The front end of the needle 200 is provided with a conical head.
With continued reference to fig. 5, further, the securing needle 160 is provided with a projection 161 protruding from its outer wall, the projection 161 being in interference fit with the through hole 150.
Specifically, in this embodiment, the fixing needle 160 is provided with the protrusion 161, the outer diameter of the other part of the fixing needle 160 is smaller than the inner diameter of the through hole 150, and the outer diameter of the protrusion 161 is larger than the inner diameter of the through hole 150, so that the fixing needle 160 can penetrate into the through hole 150, and the protrusion 161 is in interference fit with the through hole 150 after the fixing needle 160 penetrates through the through hole 150, so that the two anastomotic rings 100 can be prevented from influencing the suturing due to the axial movement in the suturing process.
With continued reference to fig. 5, further, the fixation needle 160 is spaced a greater distance from the center of the vascular slot 110 than the guide wire 200 is spaced from the center of the vascular slot 110. That is, the fixing needle 160 is disposed at the outer ring compared to the lead needle 200.
Specifically, the distance between the fixing needle 160 of the present embodiment and the center of the vascular slot 110 is greater than the distance between the guide needle 200 and the center of the vascular slot 110, so that the broken end of the blood vessel 600 is directly hooked on the guide needle 200 after everting, and the broken end of the blood vessel 600 is not hooked on the fixing needle 160, thereby reducing the damage of the broken end of the blood vessel 600.
With continued reference to fig. 5, further, one side of insertion hole 120 of anastomosis ring 100 is provided with a communication slot 170 communicating with insertion hole 120, and needle 200 of anastomosis ring 100 is interference fit with insertion hole 120.
Specifically, in this embodiment, communication groove 170 is provided on anastomosis ring 100, and the provision of communication groove 170 facilitates pulling needle 200 out of needle insertion hole 120 for suturing.
With continued reference to fig. 5, further, a wire groove 180 is provided at a position of the anastomotic ring 100 outside the needle insertion hole 120, the wire groove 180 is an annular groove 512, the wire groove 180 is communicated with the needle insertion hole 120 through a communication groove 170, a suture 300 is provided in the wire groove 180, and one end of the suture 300 is connected with the needle 200.
Specifically, the present embodiment provides the wire coiling groove 180, so that the suture 300 can be coiled in the wire coiling groove 180 in advance and one end of the suture is directly connected to the wire leading needle 200, and the operator does not need to perform the operation when using the suture, thereby being more convenient and faster to use.
With continued reference to fig. 5, further, anastomosis ring 100 is provided with a slotted aperture referenced 190 on a side thereof located at needle aperture 130, slot aperture referenced 190 communicating outside anastomosis ring 100.
In particular, the present embodiment provides a slot-type hole 190 to facilitate tying a knot with the other end of the suture 300 positioned in the wire slot 180 after pulling one end of the suture 300 connected to the needle 200 out of the slot-type hole 190 after suturing the blood vessel 600.
Referring to fig. 1, 2 and 6, further, the rotation mechanism includes a connection rod 420, a rotation ring 430 and a dial wheel 440;
The two forceps arms 410 of the forceps are arranged in an X shape, and are hinged at the intersection of the two forceps arms 410 through a first central shaft 411, the central shaft is a pin shaft, one of the two forceps arms 410 positioned on the same side of the first central shaft 411 is hinged with the bottom end of the connecting rod 420 through a second central shaft 412, the other one of the two forceps arms is hinged with the middle part of the connecting rod 420 through a third central shaft 413, the connecting rod 420 is provided with a sliding groove 421 extending along the axial direction of the connecting rod, and the third central shaft 413 slides back and forth in the sliding groove 421;
The thumb wheel 440 is connected to the top end of the jawarms 410;
The bottom end of the rotating ring 430 is provided with a cam 431 protruding from the lower surface thereof, the lower surface of the cam 431 is arc-shaped, and both ends of the arc have a drop, i.e., a position difference, in the axial direction of the rotating ring 430, which are respectively referred to as a first end 431a and a second end 431b for convenience of the following description, the first end 431a being axially adjacent to the anastomosis ring 100 with respect to the second end 431 b.
The rotating ring 430 is sleeved on the top end of the connecting rod 420 and rotates along the circumferential direction relative to the connecting rod 420, and the cam 431 of the rotating ring 430 contacts with the thumb wheel 440.
Specifically, in this embodiment, the two jawarms 410 are engaged to move the third central shaft 413 in the sliding groove 421, so as to drive the cam 431 to move from the second end 431b to the first end 431a to engage the lower surface of the rotating ring 430, so as to drive the anastomotic ring 100 to rotate around the connecting rod 420 along with the rotating ring 430, and when the third central shaft 413 slides to the top end of the sliding groove 421, the two anastomotic rings 100 are parallel. The two jawarms 410 are then continued to be engaged, at which time the two anastomotic rings 100 are brought toward one another to suture the vessel 600. Thus, the embodiment is more convenient to operate, and the suturing quality and efficiency are high.
With continued reference to fig. 1,2 and 6, further, the rotating mechanism further includes a limit pin 450 and a limit groove 460, wherein the limit pin 450 is fixed on the outer wall of the connecting rod 420, and the limit groove 460 penetrates through the wall body of the rotating ring 430 along the circumferential direction of the rotating ring 430;
Wherein the spacing pin 450 is positioned in the spacing groove 460.
Specifically, the present embodiment provides the limiting nail 450 and the limiting groove 460, and the limiting nail 450 is located in the limiting groove 460, so that the cooperation of the limiting nail 450 and the limiting groove 460 provides a guiding function for the rotation of the rotating ring 430 on one hand, and limits the axial movement of the rotating ring 430 in the rotating process on the other hand.
With continued reference to fig. 1, 2 and 6, further, the bottom of the rotating ring 430 is provided with an axially extending connecting groove 432, and the connecting groove 432 communicates with the limiting groove 460.
Specifically, this embodiment provides a connection slot 432 in communication with the limiting slot 460 such that the rotary ring 430 of the present anastomotic ring 100 is separated from the connecting rod 420 prior to use, the anastomotic ring 100 is first mounted on the rotary ring 430 and then the rotary ring 430 is mounted on the connecting rod 420 during use, such that the rotary ring 430 and the anastomotic ring 100 connected to the rotary ring 430 are disposable products and the forceps and the connecting rod 420 connected to the forceps are reusable parts. Because of the relatively small area of anastomosis ring 100, if an operator installs anastomosis ring 100 on rotary ring 430 in the field, it is not easy to install and the efficiency of the procedure is reduced. In this embodiment, the anastomotic ring 100 is mounted on the rotating ring 430 in advance, and when in use, the connecting groove 432 of the rotating ring 430 is sleeved on the limiting nail 450, and then the rotating ring 430 is pulled downwards and then the rotating ring 430 is rotated, so that the limiting nail 450 is clamped in the limiting groove 460. Is convenient for operators to use quickly.
With continued reference to fig. 1,2 and 6, further, the top ends of the two rotating mechanisms are connected with a rotating clamping part 500, the rotating clamping part 500 is provided with a clamping opening 510, and the inner wall of the clamping opening 510 is provided with a protruding clamping platform 511;
A ring-shaped groove 512 is arranged in the middle of the outer wall of the anastomotic ring 100, the anastomotic ring 100 is positioned in the clamping opening 510, and the clamping table 511 is clamped in the ring-shaped groove 512.
Specifically, this embodiment uses the cooperation of the snap-on abutment 511 and the annular groove 512 to connect the anastomotic ring 100 to the rotation mechanism, and to detach the anastomotic ring 100 from the blood vessel 600 after suturing the blood vessel 600, thereby avoiding the anastomotic ring 100 from remaining on the blood vessel 600.
With continued reference to fig. 1, 2 and 6, the pliers further comprise two locking bars 470, wherein the two locking bars 470 are respectively connected to the inner sides of the two pliers arms 410, the free ends of the locking bars 470 are respectively provided with teeth 471, and the teeth 471 of the two locking bars 470 are engaged.
Specifically, the locking lever 470 in this embodiment is configured to enable the two jawarms 410 to form a pulling force therebetween, so as to avoid excessive opening and closing of the two jawarms 410, which affects the normal use of the rotating mechanism.
Further, anastomosis ring 100 is formed from plastic. For example, anastomosis ring 100 may be of PEEK, polytetrafluoroethylene, nylon or the like.
In some possible embodiments, anastomosis ring 100 may be formed from metal. For example, the material of anastomosis ring 100 may be titanium alloy or 316L stainless steel, or the like.
Referring to fig. 7 to 8, the invention provides a method for anastomosis of a microvascular 600, and the microvascular anastomosis device in the above embodiment is used for suturing the microvascular, which comprises the following specific steps:
The initial engagement of the two arms 410 of the pliers drives the two anastomotic rings 100 to rotate with the two rotating mechanisms until the two anastomotic rings 100 are parallel face to face;
the two arms 410 of the forceps continue to engage bringing the two anastomotic rings 100 closer together until the needle 200 of one of the two anastomotic rings 100 is inserted into the needle-passing hole 130 of the other.
With continued reference to fig. 7-8, further, the anastomotic ring 100, the rotary clamping part 500 and the rotary ring 430 connected together are mounted at the end of the connecting rod 420;
the broken ends of the blood vessel 600 are turned outwards along the blood vessel slot 110 passing through the blood vessel 600 to be sutured, and are hooked on the lead pins 200 of the anastomotic ring 100 one by one, so as to complete the eversion operation of the inner membrane of the blood vessel 600;
repeating the above steps, hooking the other broken end of the blood vessel 600 to another anastomosis ring 100 of the same type;
Engaging the two forceps arms 410 such that the two anastomotic rings 100 are first closed and then moved closer to each other, inserting the lead 200 of one of the two anastomotic rings 100 with the progressive approach into the needle-threading hole 130 of the other, and then removing the forceps to knot the suture 300, thereby achieving suturing;
The clamping pliers are assembled to release the two pliers arms 410 so that the two anastomotic rings 100 are separated, then the two anastomotic rings 100 are respectively taken off from the two rotary clamping parts 500, and then each anastomotic ring 100 is split into two anastomotic semi-rings 140, so that the anastomotic rings 100 are detached from the blood vessel 600, and the eversion anastomosis operation of the blood vessel 600 is completed.
It is apparent that the above examples are given by way of illustration only and are not limiting of the embodiments. Other variations and modifications of the present invention will be apparent to those of ordinary skill in the art in light of the foregoing description. It is not necessary here nor is it exhaustive of all embodiments. And obvious changes and modifications which are extended therefrom are still within the scope of the invention.
Claims (9)
1. A microvascular anastomat is characterized by comprising:
The two anastomotic rings are arranged face to face, and are internally provided with axially through vascular slotted holes, one side of each anastomotic ring, which is close to the other side of each anastomotic ring, is provided with a plurality of pin holes and a plurality of pin penetrating holes, the pin penetrating holes and the pin penetrating holes are circumferentially distributed at intervals, and the pin penetrating holes are axially through holes;
the plurality of lead pins are connected in pin holes of the two anastomotic rings, and the tail ends of the pin holes are connected with suture lines;
The clamping pliers comprise pliers and two rotating mechanisms, wherein the pliers comprise two hinged pliers arms, the pliers arms are connected with the rotating mechanisms, and the two rotating mechanisms are rotated to open and close relative to the pliers arms;
The two anastomotic rings are respectively connected with the two rotating mechanisms, the two forceps arms are meshed to drive the two anastomotic rings to rotate and open until the two anastomotic rings are parallel, the two forceps arms drive the two anastomotic rings to approach each other, and a lead needle of one of the two anastomotic rings is inserted into a needle penetrating hole of the other anastomotic ring;
The rotating mechanism comprises a connecting rod, a rotating ring and a thumb wheel;
the two forceps arms are arranged in an X shape and hinged at the intersection of the two forceps arms through a first central shaft, one of the two forceps arms is hinged with the bottom end of the connecting rod through a second central shaft, and the other forceps arm is hinged with the middle part of the connecting rod through a third central shaft;
the dial wheel is connected to the top end of the clamp arm;
the bottom end of the rotating ring is provided with a cam protruding out of the lower surface of the rotating ring, the lower surface of the cam is arc-shaped, and two ends of the arc-shaped are provided with drop heights along the axial direction of the rotating ring;
The rotary ring is sleeved at the top end of the connecting rod and rotates along the circumferential direction relative to the connecting rod, and the cam of the rotary ring is in contact with the thumb wheel.
2. The microvascular stapler of claim 1, wherein the anastomotic ring comprises two anastomotic ring halves that are radially apposed to form the anastomotic ring.
3. The microvascular stapler of claim 2, wherein the two anastomotic ring halves are apposed to form a bond line in the anastomotic ring, the bond lines of the two anastomotic rings intersecting;
one of the two anastomotic rings is provided with a through hole, and the other is provided with a fixing needle penetrating through the through hole.
4. The microvascular anastomat of claim 1, wherein a coil groove is arranged at the position outside the needle insertion hole in the anastomotic ring, the coil groove is an annular groove, a suture thread is coiled in the coil groove, and one end of the suture thread is connected with the lead needle.
5. The microvascular anastomat of any one of claims 1 to 4, wherein a groove-shaped hole is formed in one side of the needle-threading hole in the anastomotic ring, and the groove-shaped hole is communicated to the outside of the anastomotic ring.
6. The microvascular anastomat of claim 1, wherein the rotating mechanism further comprises a limit nail and a limit groove, wherein the limit nail is fixed on the outer wall of the connecting rod;
wherein, the spacing nail is located in the spacing groove.
7. The microvascular anastomat of claim 6, wherein the bottom of the rotating ring is provided with an axially extending connecting groove, and the connecting groove is communicated with the limiting groove.
8. The microvascular anastomat according to any one of claims 6 to 7, wherein the top ends of the two rotating mechanisms are connected with a rotating clamping part, the rotating clamping part is provided with a clamping opening, and the inner wall of the clamping opening is provided with a convex clamping table;
the middle part of the outer wall of the anastomotic ring is provided with a ring-shaped groove, the anastomotic ring is positioned in the clamping opening, and the clamping table is clamped in the ring-shaped groove.
9. The microvascular anastomat of claim 1, wherein said anastomotic ring is made of plastic.
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| CN213697048U (en) * | 2020-05-07 | 2021-07-16 | 华融科创生物科技（天津）有限公司 | Novel microvascular anastomosis device |
| CN114145799A (en) * | 2022-01-04 | 2022-03-08 | 郭志勇 | Vascular occlusion anastomosis device |
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| JP2609079B2 (en) * | 1995-01-06 | 1997-05-14 | 瑞穂医科工業株式会社 | Vascular anastomosis forceps |
| US20050038454A1 (en) * | 1998-05-29 | 2005-02-17 | By-Pass, Inc. | Anastomotic delivery system |
| KR101001625B1 (en) * | 2008-08-13 | 2010-12-17 | (주)트리플씨메디칼 | Gear type coronary anastomosis device |
| WO2012161627A1 (en) * | 2011-05-23 | 2012-11-29 | Prozeo Vascular Implant Ab | A device, a tool means, a kit and a method for anastomosis |
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| CN213697048U (en) * | 2020-05-07 | 2021-07-16 | 华融科创生物科技（天津）有限公司 | Novel microvascular anastomosis device |
| CN114145799A (en) * | 2022-01-04 | 2022-03-08 | 郭志勇 | Vascular occlusion anastomosis device |
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