CN116269559A - Medical locking and cutting integrated device - Google Patents

Abstract

The present application provides an integrated medical locking and cutting device, including a base component, a locking nail component, a locking thread component and a thread cutting component. The base component includes a first base body, a support piece and a matching piece; the distal end of the support piece is fixedly connected with the first base body; the matching piece is arranged on the support piece. The locking nail member includes a locking nail main body and a wire pressing piece movably connected with the locking nail main body, and the locking nail main body is detachably arranged in the first base. The thread locking member includes a push rod, the distal end of the push rod is detachably connected to the locking nail body and the two have a self-locking structure that cooperates with each other; the pushing rod moves forward to drive the crimping piece to move relative to the locking nail body to lock the medical lock. wire; the self-locking structure is used to prevent the reverse movement of the push rod under the action of the medical wire. The thread cutting member is slidably connected with the supporting part, and is used for cooperating with the matching part to cut off the medical thread extending from the main body of the locking nail. The medical locking and cutting integrated device integrates the thread locking function and the thread cutting function, and ensures that the medical thread is always locked during the thread cutting operation.

Description

Medical locking and cutting integrated device

technical field

The present application relates to the field of medical devices, in particular to a medical lock-cut integrated device.

Background technique

During the operation, it is often necessary to knot and fix the medical thread (including but not limited to suture thread, repair thread used as artificial chordae, repair thread for edge-to-edge repair of valves, etc.) and cut off the redundant medical thread.

Traditional surgical operations are performed under the condition of direct vision of the surgeon, and the doctor usually knots and fixes it manually, and then cuts off the excess medical thread. With the advancement of technology, various minimally invasive surgery and interventional surgery are becoming more and more common, such as endoscopic surgery, transcatheter interventional surgery, etc. This type of surgery only needs to cut a small operating window on the patient's body, so that the internal Instruments such as a speculum or an interventional catheter are inserted into the patient's body and arrive at the predetermined site for treatment. In this type of operation, the operator is usually required to perform remote operations outside the patient's body through the small operating window to tie knots in the patient's body and cut off redundant medical threads. The existing thread-locking device and thread-cutting device are usually two independent devices. Generally, the thread-locking device is used to intervene in the body first, and the thread-locking device is operated to fix the medical thread with the locking nails, and then the thread-locking device is withdrawn, and then operated A thread cutting device is inserted into the body to cut away excess medical thread. On the one hand, the thread locking device and the thread cutting device enter and leave the patient's body separately, which will lead to complicated operation and long operation time; The locking force of the nail on the medical thread is reduced, and even the medical thread is loosened from the locking nail, and the locking nail falls off, which poses risks to the human body.

Contents of the invention

The purpose of this application is to provide a medical locking and cutting integrated device, which can integrate the thread locking function and the thread cutting function, and ensure that the medical thread is always locked during the thread cutting operation.

The medical locking and cutting integrated device provided by the present application includes: a base component, a locking nail component, a locking thread component and a thread cutting component. The base component includes a first base, a supporting piece and a matching piece, the distal end of the supporting piece is fixedly connected with the first base, and the matching piece is arranged on the supporting piece. The locking nail member includes a locking nail main body and a wire pressing piece that is movably connected with the locking nail main body, and the locking nail main body is detachably arranged in the first base. The thread locking member includes a push rod; the distal end of the push rod is detachably connected to the locking nail body, and the two have a self-locking structure that cooperates with each other; the push rod moves forward to drive the wire pressing member The locking nail body moves to lock the medical wire between the wire pressing member and the locking nail body; the self-locking structure is used to prevent the push rod from moving backward under the action of the medical wire. The thread-cutting member is slidably connected with the supporting part, and the thread-cutting member is used for cooperating with the matching part to cut off the medical thread extending from the locking nail main body.

The medical locking and cutting integrated device provided by the present application connects the locking nail member, the thread locking member and the thread cutting member through the base member, so that the thread locking function and the thread cutting function are integrated, and the instrument The thread locking operation and the thread cutting operation can be completed in one intervention, which can reduce the number of instruments intervening in the body during the operation, simplify the operation process, and save operation time; during the thread cutting operation, the distance of the push rod in the thread locking member end and the self-locking structure on the nail body of the locking nail member can maintain the position where the locking nail member locks the medical thread, ensuring that the medical thread is always in a locked state, thus preventing the medical thread from The locking nail member is loosened, preventing the locking nail member from falling off, and eliminating the risk caused by the locking nail member falling off to the human body.

Description of drawings

In order to illustrate the technical solutions of the embodiments of the present application more clearly, the following will briefly introduce the drawings that are used in the embodiments. Obviously, the drawings in the following description are only some implementations provided by the embodiments of the present application, and those skilled in the art can also obtain other drawings based on these drawings without creative work. .

Fig. 1 is a three-dimensional assembly schematic diagram of a medical locking and cutting integrated device provided by an embodiment of the present application;

Fig. 2 is an axial sectional view of the medical lock-cutting integrated device shown in Fig. 1;

Fig. 3 is a three-dimensional exploded schematic diagram of the medical locking and cutting integrated device shown in Fig. 1;

Fig. 4 is a three-dimensional assembly schematic diagram of a removal sleeve of the medical lock-cutting integrated device shown in Fig. 1;

Fig. 5 is a three-dimensional assembly diagram from another perspective of removing the sleeve of the medical lock-cutting integrated device shown in Fig. 1;

Fig. 6 is a three-dimensional assembly schematic diagram of the base member removal sleeve in the medical lock-cutting integrated device;

Fig. 7 is a schematic axial sectional view of a base member removal sleeve in a medical lock-cutting integrated device;

Fig. 8 is a three-dimensional schematic diagram of the assembly of the supporting part and the matching part in the base member;

Fig. 9, Fig. 10, Fig. 11 are three-dimensional schematic diagrams of different viewing angles of the first base in the base member;

Fig. 12 is a three-dimensional assembly schematic diagram of a perspective view of the locking nail member in the medical lock-cutting integrated device;

Fig. 13 is a three-dimensional assembly schematic diagram of another perspective of the locking nail member in the medical lock-cutting integrated device;

Fig. 14 is a three-dimensional exploded schematic diagram of a locking nail member;

Fig. 15 is a schematic diagram of the locking nail member after the cover plate is removed;

Fig. 16 is a schematic cross-sectional view of the locking nail body in the locking nail member along the axial direction;

Fig. 17 is a three-dimensional schematic diagram of a thread-cutting member in a medical lock-cutting integrated device;

Figure 18 and Figure 19 are schematic diagrams of the process of locking the medical thread by the medical locking and cutting integrated device;

Fig. 20 is a schematic diagram of the tangent line of the medical lock-cutting integrated device;

Figure 21 is a schematic diagram of the separation of the locking nail member from the first base;

Fig. 22 is a schematic perspective view of the locking nail member fixing the medical thread and detaching from the first base.

Detailed ways

The technical solutions in the embodiments of the present application will be clearly and completely described below in conjunction with the drawings in the embodiments of the present application. Apparently, the described implementations are only some of the implementations of this application, not all of them. Based on the implementation manners in this application, all other implementation manners obtained by persons of ordinary skill in the art without making creative efforts belong to the scope of protection of this application.

In addition, the following descriptions of the various embodiments refer to the attached drawings to illustrate specific embodiments that the application can be used to implement. The directional terms mentioned in the present invention, for example, "upper", "lower", "front", "back", "left", "right", "inner", "outer", "side", etc., only is to refer to the direction of the attached drawings. Therefore, the direction terms used are for better and clearer explanation and understanding of the application, rather than indicating or implying that the device or element referred to must have a specific orientation, and must have a specific orientation. construction and operation, therefore, should not be construed as limiting the invention.

Orientation Definition: For clarity of description, the end close to the operator is referred to as the "proximal end" and the end far away from the operator is referred to as the "distal end" during the operation. "Axial" refers to the center of the distal end of the medical device The direction of the line connecting with the center of the proximal end; "radial" refers to the direction perpendicular or approximately perpendicular to the axial direction. "Circumferential" refers to the direction around the axial direction. The above definitions are only for the convenience of expression, and should not be understood as limitations on the present application.

Please refer to FIG. 1 , an embodiment of the present application provides an integrated medical locking and cutting device 100 for locking the medical thread 200 and cutting off the redundant medical thread 200 .

Referring to FIG. 2 , FIG. 3 , FIG. 4 and FIG. 5 , the integrated medical lock cutting device 100 includes a base member 10 , a locking nail member 20 , a thread locking member 30 and a thread cutting member 50 . The locking nail member 20 is detachably provided on the base member 10 . The thread locking member 30 is detachably connected to the locking nail member 20 and used to drive the locking nail member 20 to lock the medical wire 200 . The thread cutting member 50 is slidably connected with the base member 10 , and is used for cutting off the redundant medical thread 200 extending from the locking nail member 20 .

Please refer to FIG. 2 to FIG. 5 , FIG. 6 , FIG. 7 and FIG. 8 , the base member 10 includes a first base body 11 , a supporting part 13 and a matching part 15 . The distal end of the support member 11 is fixedly connected with the first base body 11 . The matching part 15 is disposed on the supporting part 11 .

Please refer to FIG. 2 to FIG. 5 and FIG. 12 to FIG. 14 . The locking nail member 20 includes a locking nail main body 21 and a wire pressing member 23 movably connected with the locking nail main body 21 . The locking nail body 21 is detachably disposed in the first base body 11 .

Please refer to FIGS. 2 to 5 together. The thread locking member 30 includes a push rod 31 , the distal end of the push rod 31 is detachably connected to the locking nail body 21 , and the two have a self-locking structure 210 that cooperates with each other. The push rod 31 moves forward to drive the thread pressing member 23 to move relative to the locking nail main body 21 to lock the medical thread 200 between the thread pressing member 23 and the locking nail main body 21 . The self-locking structure 210 is used to prevent the reverse movement of the push rod 31 under the action of the medical wire 200 . Among them, the forward direction refers to the movement from the proximal end to the distal end, the forward movement refers to the movement from the proximal end to the distal end; the reverse direction refers to the movement from the distal end to the proximal end, and the reverse movement refers to the movement from the distal end to the proximal end. sports. In the subsequent thread cutting process, the medical thread 200 needs to be pulled toward the proximal end, and the pressing member 23 tends to move in the opposite direction driven by the medical thread 200. If the self-locking structure 210 is not provided, the push rod 31 may be pressed by the pressing member. 23 drives the reverse movement, which in turn causes the locking force of the locking nail member 20 on the medical thread 200 to decrease, and even makes the medical thread loose from the locking nail member, causing the locking nail member to fall off; precisely because the self-locking structure 210 is provided, After the push rod 31 moves forward to drive the thread pressing member 23 to move relative to the locking nail body 21 to lock the medical thread 200 between the thread pressing member 23 and the locking nail main body 21, the pulling of the medical thread 200 during thread cutting is not enough. Overcoming the self-locking effect of the self-locking structure 210 , the push rod 31 maintains the locked position of the medical thread 200 and will not reversely move under the action of the medical thread 200 . In this embodiment, the self-locking structure 210 includes an external thread 311 (as shown in FIG. 2 and FIG. 3 ) provided at the distal end of the push rod 31 and a thread provided at the proximal end of the locking nail body 21 and adapted to the external thread. Hole 211 (as shown in Figure 2), that is, the push rod 31 and the locking nail body 21 realize self-locking through the threaded self-locking structure 210; rotating the pushing rod 31 can realize the unlocking between the pushing rod 31 and the locking nail body 21, When the rotation of the push rod 31 is stopped, self-locking is established between the internal and external threads, and the operation is simple and convenient. It can be understood that the self-locking structure 210 is not limited to threaded connection, and the push rod 31 and the locking nail body 21 can also realize self-locking in other ways, for example, in a clamping way and the like.

Please refer to FIG. 2 to FIG. 5 , FIG. 17 and FIG. 20 , the thread cutting member 50 is slidably connected to the support member 13 . The thread cutting member 50 is used to cooperate with the fitting 15 to cut off the medical thread 200 extending from the staple main body 21 .

Taking the medical thread 200 as an example of repairing the artificial chordae, after the thread cutting is completed, the main body 21 of the locking nail is easy to come out of the first base body 11 under the pull of the beating heart. The pulling direction is toward the distal end, and the force exerted by the medical wire 200 on the wire pressing member 23 is also toward the distal end, which instead makes the locking nail member 20 squeeze the medical wire 200 more tightly.

Specifically, referring to FIG. 9 , FIG. 10 and FIG. 11 , referring to FIG. 3 to FIG. 6 , the first base body 11 includes a first mounting portion 111 and a second mounting portion 113 that are fixedly connected. The first installation part 111 is located at the proximal end of the first base body 11 . The first mounting portion 111 defines a through slot 1111 penetrating in the axial direction for accommodating the supporting member 13 . The proximal end of the first mounting part 111 has a step 1113 for matching with the thread cutting member 50 . In this embodiment, the step 1113 is formed by removing part of material in the radial direction at the proximal end of the first mounting portion 111 . The second mounting portion 113 defines a receiving groove 1131 penetrating in the axial direction for receiving the locking nail main body 21 .

Please refer to FIG. 3 to FIG. 6 , FIG. 7 and FIG. 9 , the supporting member 13 extends along the axial direction. The proximal end of the support member 13 is fixedly connected in the through groove 1111 . The supporting member 13 is provided with a passing channel 131 penetrating in the axial direction and communicating with the receiving groove 1131 for passing the push rod 31 . The through channel 131 communicates with the threaded hole 211 (as shown in FIG. 2 ). The push rod 31 is movably threaded in the threading channel 131 . The passing through channel 131 can provide limit and guide functions for the push rod 31 .

Please refer to FIG. 1 to FIG. 6 , the base member 10 further includes a second base 16 and a sleeve 17 . The second base body 16 is fixed on the proximal end of the support member 13 . The fitting 15 is located between the tangential member 50 and the second base 16 . The sleeve 17 is sheathed on the first base 11 , the tangent member 50 , the fitting 15 and the second base 16 . Both ends of the sleeve 17 are respectively fixedly connected to the first base 11 and the second base 16 . The second base body 16 supports the sleeve 17 together with the first base body 11 . The sleeve 17 is provided with a thread hole 171 for leading out the medical thread 200 extending from the nail main body 21 . The sleeve 17 is roughly cylindrical, and the arrangement of the sleeve 17 improves the consistency and smoothness of the appearance of the medical lock-cutting integrated device 100 , thereby improving the smoothness of the medical lock-cutting integrated device 100 moving in the blood vessel. In this embodiment, referring to Fig. 9 to Fig. 11, the outer contour of the second installation part 113 of the first base body 11 is circular and has a larger diameter for the distal end surface of the sleeve 17 to fit into; the first installation part The outer contour of the distal end of 111 is roughly circular, but the diameter is slightly reduced to match the inner wall of the sleeve 17 . It can be understood that the shape of the sleeve 17 is not limited.

The base member 10 further includes a positioning part 18 , a first positioning hole 151 is formed on the matching part 15 , and a second positioning hole 173 penetrating through a side wall of the sleeve 17 is formed on the sleeve 17 . The positioning part 18 is passed through the first positioning hole 151 and the second positioning hole 173 to fix the matching part 15 and the sleeve 17 together, thereby facilitating the assembly of the base member 10 . In this embodiment, the number of the first positioning holes 151 on the fitting 15 is two, the number of the second positioning holes 173 is two, the number of the positioning parts 18 is two, and the two first positioning holes 151 are matched along the The same diameter of the piece 15 is arranged symmetrically with respect to the axis. It can be understood that the number of positioning elements 18 in the present application is not limited.

The lock nail main body 21 is loosely fitted in the receiving groove 1131 . The gap range between the inner wall of the receiving groove 1131 and the outer wall of the locking nail main body 21 is preferably [0.03, 0.15] millimeter, more preferably [0.06, 0.10] millimeter, so that the locking nail main body 21 is easy to fit into the receiving groove 1131 and Detach from the receiving groove 1131.

Please refer to FIG. 12 , FIG. 13 , and FIG. 14 , referring to FIG. 1 to FIG. 5 , the locking nail body 21 includes a first mounting portion 214 and a second mounting portion 215 . The first mounting portion 214 is located at the proximal end of the locking nail body 21 . In this embodiment, the first mounting portion 214 is substantially in the shape of a circular truncated cone, so that the locking nail main body 21 is easier to disengage from the first base body 11 . The threaded hole 211 (as shown in FIG. 13 ) is provided at the proximal end of the first installation part 214 to realize the detachable connection between the first installation part 214 and the push rod 31 . Compared with the second installation part 215 , the size of the first installation part 214 is reduced in various directions, and "various directions" include radial direction and axial direction.

The second mounting portion 215 of the locking nail body 21 is in clearance fit with the inner wall of the receiving groove 1131 (as shown in FIG. 2 ). There is also a mutually compatible anti-rotation structure between the first base body 11 and the second installation part 215. The anti-rotation structure is used to prevent the lock nail body 21 from rotating relative to the first base body 11, and then the medical lock-cutting integrated device 100 can be used as a lock. During wire operation, the nail main body 21 does not rotate, and the push rod 31 rotates and moves axially relative to the nail main body 21 .

In this embodiment, the anti-rotation structure between the first base body 11 and the second mounting portion 215 is at least a pair of planes that cooperate with each other. Specifically: the first base body 11 is provided with two opposite planes on the inner wall of the receiving groove 1131 . The second mounting portion 215 of the locking nail body 21 includes a first outer surface 2151 (as shown in FIG. 13 ), a second outer surface 2152 (as shown in FIG. 13 ), and a third outer surface 2153 (as shown in FIG. shown) and the fourth outer surface 2154 (shown in FIG. 12 ). The first outer surface 2151 is opposite to the third outer surface 2153 , and the second outer surface 2152 is opposite to the fourth outer surface 2154 . The first outer surface 2151 and the third surface 2153 are arc surfaces, and the second outer surface 2152 and the fourth outer surface 2154 are planes. The second outer surface 2152 is engaged with one plane in the receiving groove 1131 of the first base body 11 for non-rotational fit, and the fourth outer surface 2154 is engaged with another plane for non-rotational fit in the receiving groove 1131 of the first base body 11 . In other words, the anti-rotation structure between the first base body 11 and the second mounting portion 215 is two pairs of planes that cooperate with each other. It can be understood that the present application does not limit the first outer surface 2151 and the third surface 2153 to arc surfaces, and does not limit the second outer surface 2152 and the fourth outer surface 2154 to be planes. The anti-rotation fit of the inner wall is sufficient. It can be understood that the anti-rotation structure 216 may also include, but is not limited to, protrusions and grooves extending in the axial direction and adapted to each other.

The locking nail main body 21 has an accommodating cavity 217 for accommodating the crimping member 23 . The receiving chamber 217 extends from the first mounting portion 215 to the second mounting portion 215 . The accommodating cavity 217 runs through the distal end of the second installation part 215 away from the first installation part 214 , that is, the distal opening of the locking nail body 21 , so as to facilitate the assembly and disassembly of the wire crimping part 23 and the locking nail body 21 . The inner wall of the receiving cavity 217 is provided with a crimping groove 2171 . The crimping groove 2171 has a bottom wall 2173 . When the push rod 31 moves in the forward direction, the wire pressing member 23 is driven to gradually approach the bottom wall 2173 until the gap between the wire pressing member 23 and the bottom wall 2173 is smaller than the diameter of the medical thread 200, so as to lock the wire pressing member 23 and the bottom wall 2173. Medical wire 200 between walls 2173.

The locking nail body 21 further includes a guide portion 218 disposed on a side wall of the receiving chamber 217 . The wire pressing member 23 is movably connected with the guide part 218 and can move along the guide part 218 . The guide portion 218 is used to guide the movement of the wire crimping member 23 relative to the locking nail main body 21 . The guide portion 218 gradually approaches the bottom wall 2173 from its proximal end to its distal end. The guiding portion 218 includes a first guiding portion 2181 and a second guiding portion 2183 . The first guiding portion 2181 is located at the proximal end of the guiding portion 218 , the first guiding portion 2181 is inclined relative to the axial direction of the locking nail body 21 , and the second guiding portion 2183 extends along the axial direction of the locking nail body 21 .

The locking nail body 21 also includes a wire outlet hole 219 communicating with the accommodating cavity 217 . The wire outlet hole 219 extends from the first surface 2151 of the second mounting portion 215 to the first mounting portion 214 , and the wire outlet hole 219 is used for leading the medical wire 200 out of the receiving cavity 217 . The outlet hole 219 is arranged obliquely relative to the axial direction. The ratio range between the length of the wire outlet hole 219 and the length of the locking nail main body 21 is preferably [1/3, 1/2], and the ratio range between the width of the wire outlet hole 219 and the maximum width of the locking nail main body 21 is preferably [ 1/3, 1], so that the outlet hole 219 is set to reduce the weight of the locking nail main body 21 to the greatest extent, reduce the volume of the locking nail main body 21, and reduce the impact on human tissue after the locking nail member 20 of the medical thread 200 is released. Impact.

The crimping member 23 is movably accommodated in the accommodating cavity 217 and is movably connected with the guide portion 218 . In this embodiment, the crimping member 23 includes a crimping portion 231 and a connecting portion 233 that are fixedly connected. The crimping part 231 can be pressed onto the bottom wall 2173 of the crimping groove 2171 . The outer diameter of the crimping portion 231 is larger than the outer diameter of the connecting portion 233 . The connecting portion 233 can roll in the guiding portion 231 , and the crimping portion 231 is coaxially arranged with the connecting portion 233 . Please refer to FIG. 15 and FIG. 16 together. Let the axial direction of the lock nail body 21 be the first direction, and the extension direction of the central axis of the crimping member 23 be the second direction, which is perpendicular to the first direction and the second direction. is the third direction, the width of the crimping portion 231 in the second direction is set as W1, the width of the crimping groove 217 in the second direction is set as W2, the diameter of the crimping portion 231 is set as D1, and the distal end of the guide portion 218 is along the The height of the third direction is set to H2, the maximum distance between the far end of the guide part 218 and the bottom wall 2173 at the far end of the wire crimping groove 2171 is set to H1, and the diameter of the medical wire 200 is set to D2, it is necessary to set:

W2>W1, and

0≤H1-H2/2-D1/2≤D2.

The wire crimping member 23 further includes a limiting portion 235 fixed on the connecting portion 233 for preventing the connecting portion 233 from detaching from the guiding portion 18 . In this embodiment, the guide part 18 is a guide groove that runs through the main body 21 of the locking nail, the connecting part 233 passes through the guiding groove, the limiting part 235 is located outside the main body 21 of the locking nail, and the diameter of the limiting part 235 is greater than the opening height of the guiding groove . In this embodiment, the guiding portion 18 is defined on the second surface 2152 and the fourth surface 2154 . In other embodiments, the guide part 18 can be a guide rail provided on the inner wall of the accommodation chamber 217, the connecting part 233 can be accommodated in the accommodation chamber 217 and can roll along the guide rail, and the limiting part 235 can be omitted.

The locking nail member 20 further includes an end cap 25 fixedly disposed on the distal end of the second installation portion 215 to close the distal end of the locking nail body 21 . The end cap 25 is also used to limit the movement of the wire pressing member 23 on the guide portion 218 to prevent the wire pressing member 23 from detaching from the locking nail body 21 . The main body 21 of the locking nail and the end cover 25 are arranged separately to facilitate the assembly and disassembly of the crimping member 23 . The end cap 25 is provided with a wire inlet hole 251 for passing the medical wire 200 into the receiving cavity 217 . Let the axial length of the locking nail main body 21 be L1, set the proximal end length of the distal end of the support member 13 inserted into the first base body 11 as L2, the axial length of the first base body 11 is L, and the end cap 25 is along the locking nail main body 21. The axial length of is L3, and the following condition L=L1+L2+L3 is satisfied.

Since the locking nail member 20 (including the locking nail main body 21, the crimping part 23 and the end cover 25) is finally implanted in the human body, the material of the locking nail member 20 includes but is not limited to stainless steel, pure titanium, nickel titanium, cobalt chromium alloy Biocompatible materials such as pure titanium and stainless steel are preferred.

Please refer to FIG. 2 to FIG. 7 , with reference to FIG. 18 to FIG. 20 , the push rod 31 of the locking thread member 30 is movably threaded in the threading channel 131 . When the push rod 31 rotates so that the push rod 31 moves axially toward the distal end (i.e. forward direction) synchronously, push the wire crimping member 23 to move from the proximal end to the distal end along the guide portion 218 (i.e. forward movement), gradually Press the medical thread 200 tightly in the thread-crimping part 231 and the thread-crimping groove 2171 of the thread-crimping part 23, and then move the thread-cutting member 50 to the proximal end in the axial direction, cut off the excess medical thread 200 on the fitting 15, and cut the thread During the process, due to the self-locking effect of the external thread on the push rod 31 and the threaded hole 211 of the locking nail body 21, the distal end of the push rod 31 continues to push the wire pressing member 23, preventing the wire pressing member 23 from moving to the proximal end, so that There is always a minimum gap between the crimping portion 231 of the crimping member 23 and the bottom wall 2173 of the crimping groove 2171 to compress the medical thread 200, even if the medical thread 200 is pulled towards the proximal end or other external force during the operation, it can Prevent the medical thread 200 from loosening and ensure reliable locking.

The locking wire member 30 also includes a locking wire inner core 33 fixedly connected with the proximal end of the push rod 31 . The lock wire inner core 33 is used to drive the push rod 31 to rotate and move axially. The locking wire inner core 33 is a flexible body with anti-torsion support force, preferably a flexible body such as a laser cut tube, a spring, a stainless steel wire, and a multi-layer solid mandrel. In this embodiment, the locking wire inner core 33 is made of stainless steel wire. The push rod 31 can be driven to rotate and move by driving the lock wire inner core 33 to rotate. Rotate the thread locking inner core 33 in a preset direction, and the thread locking inner core 33 drives the push rod 31 to move forward toward the distal end, and the push rod 31 can drive the thread pressing member 23 to move relative to the locking nail body 21 . After the thread cutting is completed, the locking thread inner core 33 is rotated in the opposite direction, and the locking thread inner core 33 drives the push rod 31 to make a reverse movement toward the proximal end, and the distal end of the push rod 31 is separated from the locking nail body 21 .

Please refer to FIG. 2 to FIG. 5 again, and in conjunction with FIG. 17 and FIG. 20 , the thread cutting member 50 includes a knife seat 51 , a blade 53 and a driving member 55 . The knife seat 51 is used to carry the blade 53 , and the driving member 55 is used to drive the blade 53 to move.

The knife seat 51 is located between the first base body 11 and the fitting part 15 . The knife seat 51 is slidably sleeved on the support member 13 so as to be able to move along the support member 13 . The knife seat 51 is provided with a mounting groove 511 for mounting the blade 53 . The knife seat 51 further includes a third installation portion 512 and a fourth installation portion 514 . The fourth installation portion 514 protrudes from the distal surface of the third installation portion 512 along the axial direction. The proximal end of the third mounting portion 512 is provided with a through hole 5120 for passing through the support member 13 . The third installation portion 512 is connected to the support member 13 in a non-rotational manner. Preferably, please refer to FIG. 17 and FIG. 8 , the support member 13 includes two opposite planes 135 and two oppositely arranged arc surfaces 137 , the contour of the piercing hole 5120 is adapted to the shape of the support member 13 , and prevents The knife seat 51 rotates relative to the support member 13 .

The fourth mounting portion 514 is covered on the step 1113 and can slide along the axial direction of the first base 11 . The step 1113 is used to provide support for the knife seat 51 and at the same time provide a guide for the axial movement of the knife seat 51 , which is beneficial to improve the stability of the movement of the knife seat 51 . In addition, the shape of the step 1113 and the fourth mounting part 514 are complementary and compatible, and the two share the radial space and the axial space, thereby reducing the overall radial dimension and axial length of the distal end of the integrated medical lock cutting device 100 , which is beneficial to reduce the volume and weight of the integrated medical lock-cut device 100 .

The blade 53 is fixedly received in the installation groove 511 . After the assembly is completed, there is a gap 530 (as shown in FIG. 2 ) between the blade 53 and the support member 13, so that the medical thread 200 (as shown in FIGS. 1 , 4 and 5 ) of the self-locking nail body 21 can pass through and be positioned at Below the blade 53. The blade 53 has a cutting edge 531 . Referring to FIG. 4 , the fitting 15 also has a tangent surface 153 disposed opposite to the cutting edge 531 , and the cutting edge 531 cooperates with the tangential surface 153 to cut off the medical thread 200 extending from the wire outlet hole 219 of the locking nail body 21 . During the thread cutting process of the thread cutting member 50 , the thread cutting surface 153 is used to provide abutment for the medical thread 200 so as to facilitate cutting of the medical thread 200 by the cutting edge 531 . In this embodiment, the tangent plane 153 is a plane. It can be understood that the tangent surface 153 may also be a curved surface.

The driving member 55 is fixedly connected with the knife seat 51 to drive the knife seat 51 to move along the support member 13 toward the fitting 15, so that the blade 53 cooperates with the fitting 15 to cut off the medical wire 200 extending from the outlet hole 219 of the locking nail main body 21. The driving member 55 includes a connecting rod 551 , a guiding member 553 and a tangential inner core 555 . The connecting rod 551 is fixedly connected between the guide member 553 and the third mounting portion 512 of the knife seat 51 . The tangent inner core 555 is fixedly connected with the guide member 553 for driving the connecting rod 551 , the guide member 553 and the knife seat 51 to move axially.

More specifically, a connection hole 5121 is provided at the proximal end of the third mounting portion 512 of the knife seat 51 . The connecting rod 551 is fixedly connected with the connecting hole 5121 to realize the fixed connection between the connecting rod 551 and the knife seat 51 . A guide hole 155 is also provided on the fitting 15, and the connecting rod 551 passes through the guide hole 155 (as shown in FIG. 8 ). In this embodiment, the guide hole 155 is approximately a half-waist hole, and the guide hole 155 passes through the peripheral wall of the matching part 15 . The inner wall of the guide hole 155 guides the movement of the connecting rod 551 relative to the support member 13 . The connecting rod 551 is a rigid body with a certain length, preferably a rigid body such as a stainless steel tube or a stainless steel rod, and a stainless steel rod is selected in this embodiment. In this embodiment, the number of connecting rods 551 is two, and the support member 13 is located between the two connecting rods 551. The two connecting rods 551 are arranged symmetrically with respect to the central axis of the supporting member 13, so as to improve the movement of the tool holder 51 relative to the supporting member 13. of stability. It can be understood that the present application does not limit the number of connecting rods 551 .

The guide piece 553 is slidably sleeved on the support piece 13 , and the guide piece 553 is fixedly connected with the proximal end of the connecting rod 551 . The guide member 553 is used to guide the movement of the knife seat 51 . The guide piece 553 is located between the fitting piece 15 and the second base body 16 . Please also refer to Fig. 2, in this way, the part between the first base body 11 and the matching part 15 of the supporting part 13 is used as the guide rail for the tool holder 51 to move axially, and the part of the supporting part 13 located between the matching part 15 and the second part The part between the two bases 16 is used as a guide rail for the axial movement of the guide member 553 . The guide member 553 is also provided with a perforated hole 5531 adapted to the shape of the support member 13 to ensure anti-rotation and guiding functions. The shape of the guide 553 includes but is not limited to a circle, an ellipse, and the like.

The tangential inner core 555 is fixedly connected to the proximal end of the guide 553 . The matching part 15 is located between the knife seat 51 and the guide part 553 . The tangential inner core 555 is a flexible body with anti-torsion support force, preferably a flexible body such as a laser-cut tube, a spring, a stainless steel wire, and a multi-layer solid mandrel. In this embodiment, stainless steel wire is used. The tangent inner core 555 applies an axial driving force to the guide member 553 , and the guide member 553 drives the connecting rod 551 to move in the axial direction to drive the knife seat 51 and the blade 53 to move.

The locking and cutting integrated device 100 provided in the embodiment of the present application connects the locking nail member 20, the thread locking member 30, and the thread cutting member 50 through the base member 10, so that the thread locking function and the thread cutting function are integrated into one, and the instrument can intervene at one time. The thread locking operation and the thread cutting operation can be completed, which can reduce the number of instruments intervening in the body during the operation, simplify the operation process, and save operation time; The self-locking structure 210 on the locking nail main body 21 of the component 20 can keep the position where the locking nail member 20 locks the medical thread 200 to ensure that the medical thread 200 is always in a locked state, thus preventing the medical thread 200 from locking the nail member 20 Loosening in the center prevents the locking nail member 20 from falling off, and eliminates the risk caused by the locking nail member 20 falling off to the human body.

The mitral valve is a one-way "valve" between the left atrium (abbreviation: LA) and the left ventricle (abbreviation: LV), which can ensure blood flow from the left atrium to the left ventricle. A normal, healthy mitral valve has multiple chordae. The leaflets of the mitral valve are divided into anterior leaflet and posterior leaflet. When the left ventricle is in a diastolic state, the two are in an open state, and blood flows from the left atrium to the left ventricle; when the left ventricle is in a systolic state, the chordae are stretched to ensure The valve leaflets will not be rushed to the atrium side by the blood flow, and the front and rear leaflets are well closed, thereby ensuring that blood flows from the left ventricle to the aorta through the aortic valve (abbreviation: AV). If the chordal tendon ruptures in the mitral valve, when the left ventricle is in a contraction state, the mitral valve cannot return to a fully closed state as in the normal state, but insufficiency occurs, and the momentum of the blood flow will further cause the leaflet to protrude into the left The atrium, causing blood backflow.

The following takes mitral valve chordae repair as an example, that is, the medical thread is used as an artificial chordae repair thread, to describe the use process of the medical locking cut integrated device 100 provided in this embodiment in the chordae tendon repair.

Step 1: first implant one or more medical wires 200 into the anterior leaflet or posterior leaflet of the mitral valve.

Step 2: Put the medical thread 200 on the valve leaflet through the anchoring part of the anchoring device outside the patient's body, send the anchoring part into the left ventricle and anchor the anchoring part in the anterior papillary muscle or posterior papillary muscle or on the ventricular wall;

Step 3: Put the medical thread 200 on the valve leaflet into the locking nail member 20 of the medical locking and cutting integrated device 100 outside the patient's body, and pass the medical thread 200 through the thread outlet hole 219 on the locking nail main body 21 and the sleeve 17 Pass through the wire hole 171 on the top, as shown in Figure 1.

Step 4: Following the guidance of the medical thread 200, push the distal end of the medical locking cut integrated device 100 into the left atrium of the heart through the femoral vein and the atrial septum, and move towards the anterior papillary muscle or posterior papillary muscle of the left ventricle, while pulling The medical thread 200 until the distal end of the medical lock cutting integrated device 100 reaches a predetermined position in the left ventricle.

Step 5: Adjust the tightness of the medical threads 200 respectively, and at the same time determine the state of the lightest mitral valve regurgitation through ultrasound. When this state is reached, stop adjusting and maintain the tightness of each medical thread 200 . Please refer to FIG. 18 , at this moment, the wire crimping member 23 is located at the proximal end of the locking nail main body 21 . Rotate the thread-locking member 30 to drive the push rod 31 to move axially and distally against the thread-pressing member 23 to continuously press the medical thread 200 into the thread-pressing groove 2171 of the locking nail body 21 (as shown in FIG. 14 ). When the wire pressing member 23 moves to the position limited by the end cap 25 , the medical wire 200 is pressed against the locking nail main body 21 by the wire pressing member 23 , as shown in FIG. 19 .

Step 6: After compressing the medical thread 200, apply axial tension on the tangent inner core 555, and the tangent member 50 moves from the distal end to the proximal end under the guidance of the support member 13, and put the excess medical thread 200 on the fitting 15 on the tangent plane 153, as shown in Figure 20. Specifically, during the thread cutting process, the edge 531 of the blade 53 presses against the tangent surface 153, and the tangent surface 153 provides support for the medical thread 200, and provides a force point for the edge 531 of the blade 53, so that the medical thread 200 is easy to be cut; Simultaneously, because the cutting edge 531 of the blade 53 and the tangent surface 153 are pressed against each other, there will not be an interlaced relationship similar to that of scissors, so there is no abnormal line extrusion between the blade 53 and the tangent surface 153 situation, to ensure that the entire medical locking and cutting integrated device 100 can be withdrawn smoothly later, and to avoid the risk of pulling organs and tissues due to thread extrusion. During the thread cutting process of the thread cutting member 50 , due to the self-locking structure 210 , the thread pressing member 23 is still kept at the position where the medical thread 200 is locked without loosening.

After thread cutting is completed, rotate the thread-locking member 30 (the push rod 31 and the thread-locking inner core 33) to drive the thread-locking member 30 to move axially to the proximal end, and the distal end of the push rod 31 and the locking nail body 21 of the locking nail member 20 Separated, since the proximal end of the locking nail main body 21 has a frustum-shaped structure, the locking nail member 20 is easily released from the first base body 11 under the force of the beating heart, as shown in FIG. 21 .

Step 7: Withdraw the base member 10, thread-locking member 30, thread-cutting member 50, and redundant medical thread 200 of the medical lock-cutting integrated device 100 out of the patient's body, and the nail-locking member 20 remains in the patient's body. At this time, the nail-locking member 20 Fix the medical thread 200 (as shown in FIG. 22 ) to the anterior papillary muscle or posterior papillary muscle or the wall of the ventricle, and the chord tendon is reconstructed.

It can be understood that the medical thread 200 can also be a suture thread, a repair thread for edge-to-edge repair of a valve, etc. The medical lock cutting integrated device 100 provided by this application can also be applied to tissue suture and valve edge-to-edge repair Wait, lock and cut off the medical thread 200 .

The above are some implementations of the present application. It should be pointed out that for those of ordinary skill in the art, without departing from the principle of the present application, some improvements and modifications can also be made, and these improvements and modifications are also considered as the present invention. The scope of protection applied for.

Claims (17)

1. A medical locking and cutting integrated device, comprising:

the base body component comprises a first base body, a supporting piece and a matching piece, wherein the distal end of the supporting piece is fixedly connected with the first base body, and the matching piece is arranged on the supporting piece;

the locking pin component comprises a locking pin main body and a pressing line piece movably connected with the locking pin main body, and the locking pin main body is detachably arranged in the first base body;

a lockwire member including a push rod; the distal end of the push rod is detachably connected with the locking nail main body, and the distal end of the push rod and the locking nail main body are provided with self-locking structures which are matched with each other; the push rod moves forward to drive the pressing wire piece to move relative to the locking nail main body so as to lock a medical wire between the pressing wire piece and the locking nail main body; the self-locking structure is used for preventing the push rod from moving reversely under the action of the medical line; and

and a cutting member slidably coupled to the support member, the cutting member being adapted to cooperate with the mating member to cut the medical wire extending from the staple body.

2. The medical lock-cutting integrated device of claim 1, wherein the tangential member comprises a blade holder, a blade, and a driver; the tool apron is sleeved on the supporting piece in a sliding way between the first base body and the matching piece; the blade is fixedly arranged on the blade holder; the driving piece is fixedly connected with the tool apron, so that the tool apron is driven to move along the supporting piece towards the matching piece, and the blade and the matching piece are matched to cut off the medical wire extending from the locking nail main body.

3. The medical lock-cutting integrated device according to claim 2, wherein the tool holder is provided with a mounting groove, the blade is fixedly accommodated in the mounting groove, a gap is formed between the blade and the supporting member, the blade is provided with a cutting edge, the matching member is provided with a tangential surface opposite to the cutting edge, and the cutting edge is matched with the tangential surface for cutting off a medical line extending from the lock pin main body.

4. The medical lock-cut integrated device of claim 2, wherein the first base comprises a first mounting portion and a second mounting portion fixedly connected; the first mounting part is positioned at the proximal end of the first base body, and the proximal end of the first mounting part is provided with a step; the tool apron comprises a third installation part and a fourth installation part, the fourth installation part is axially arranged on the far end surface of the third installation part in a protruding mode, and the fourth installation part is arranged on the step in a covering mode and can axially slide along the first base body.

5. The medical lock-cutting integrated device according to claim 4, wherein the tool holder is provided with a mounting groove, and the mounting groove extends from the proximal end surface of the third mounting part to the fourth mounting part; the blade is fixedly accommodated in the mounting groove, and a gap is reserved between the blade and the supporting piece.

6. The medical lock-cutting integrated device according to claim 4, wherein the second mounting portion is provided with a receiving groove penetrating along the axial direction, and the lock pin main body is in clearance fit in the receiving groove; the first mounting part is provided with a through groove penetrating along the axial direction, and the proximal end of the supporting piece is fixedly connected in the through groove; the support piece is internally provided with a penetrating channel which penetrates through the support piece along the axial direction and is communicated with the accommodating groove, and the push rod movably penetrates through the penetrating channel.

7. The medical lock-cutting integrated device according to claim 2, wherein the driving member comprises a connecting rod, a guiding member and a tangent inner core, the connecting rod is fixedly connected with the proximal end of the tool apron, a guiding hole is arranged on the matching member, and the connecting rod passes through the guiding hole; the guide piece is sleeved on the support piece in a sliding way, the guide piece is fixedly connected with the proximal end of the connecting rod, and the tangent inner core is fixedly connected with the proximal end of the guide piece; the mating element is located between the tool holder and the guide element.

8. The medical lock-cut integrated device of claim 2, wherein the base member further comprises a second base and a sleeve, the second base being secured to the proximal end of the support, the mating element being located between the tool holder and the second base; the sleeve is sleeved outside the first base body, the tool apron, the matching piece and the second base body, and two ends of the sleeve are respectively and fixedly connected with the first base body and the second base body; the sleeve is provided with a wire passing hole for guiding out the medical wire extending out of the locking nail main body.

9. The medical lock-cut integrated device of claim 1, wherein the locking wire member further comprises a locking wire inner core, the locking wire inner core being a flexible body, the locking wire inner core being fixedly connected to the proximal end of the push rod.

10. The medical lock-cutting integrated device of claim 1, wherein the self-locking structure comprises an external thread provided at a distal end of the push rod and a threaded hole provided at a proximal end of the locking pin body and adapted to the external thread;

the support piece is internally provided with a penetrating channel penetrating through the support piece along the axial direction, the penetrating channel is communicated with the threaded hole, and the push rod movably penetrates through the penetrating channel.

11. The medical lock-cutting integrated device according to any one of claims 1 to 10, wherein the lock pin body has a receiving cavity, and the wire pressing member is movably received in the receiving cavity; the locking pin main body comprises a first mounting part and a second mounting part, and the first mounting part is positioned at the proximal end of the locking pin main body; the first mounting portion is reduced in size in each direction as compared to the second mounting portion.

12. The medical lock-cut integrated device of claim 11, wherein the first base is in clearance fit with the second mounting portion of the locking pin body, and the first base and the second mounting portion are provided with mutually-adapted rotation-stopping structures.

13. The medical lock and cut integrated device of claim 11, wherein the lock pin body further comprises a wire outlet hole in communication with the receiving cavity, the wire outlet hole extending from the second mounting portion to the first mounting portion, the wire outlet hole for guiding the medical wire out of the receiving cavity.

14. The medical lock-cut integrated device according to claim 13, wherein a ratio between a length of the wire-outlet hole and a length of the lock pin main body ranges from [1/3,1/2]; the ratio between the width of the wire outlet hole and the maximum width of the locking pin main body is in the range of [1/3,1].

15. The medical lock-cut integrated device according to claim 11, wherein the inner wall of the receiving cavity is provided with a wire-pressing groove, the wire-pressing groove having a bottom wall; when the push rod moves forward, the pressing line piece is driven to gradually approach the bottom wall until a gap between the pressing line piece and the bottom wall is smaller than the diameter of the medical line, so that the medical line between the pressing line piece and the bottom wall is locked.

16. The medical lock and cutting integrated device according to claim 15, wherein the lock pin main body further comprises a guide portion provided on a side wall of the accommodating chamber, the wire pressing member is movably connected with and moves along the guide portion, and the guide portion gradually approaches the bottom wall from a proximal end thereof to a distal end thereof.

17. The medical lock and cut integrated device according to claim 11, wherein the locking pin member further comprises an end cap, the end cap being fixedly capped at a distal end of the locking pin body, the end cap being provided with a wire-in hole for penetrating the medical wire into the receiving cavity.

Images