WO2020078264A1 - Small lumen anastomat and use method therefor - Google Patents

Abstract

Disclosed are a small lumen anastomat and a use method therefor, wherein same aim at solving the technical problem of anastomosis of an arterial blood vessel and a human body small lumen. The small lumen anastomat structurally comprises: a fixed sleeve (100), a movable sleeve (200) and a lock catch (400), wherein one end of the fixed sleeve (100) is provided with a sleeve shoulder, and the other end of the fixed sleeve (100) is provided with an anastomosis connecting end; the movable sleeve (200) is sleeved on a sleeve wall of the fixed sleeve (100), and is provided with hanging needles (230, 260), and the movable sleeve (200) has the degree of freedom of movement of sliding in a lengthwise direction of the fixed sleeve (100); the length of the movable sleeve (200) satisfies the condition where when the end of the movable sleeve close to the sleeve shoulder is attached to the sleeve shoulder, the anastomosis connecting end is exposed relative to an end face of the other end of the movable sleeve (200); the lock catch (400) is made of an elastic material, has an annular contour and is provided with a locking part, and the shape of an inner hole of the lock catch (400) matches the contour of the anastomosis connecting end; and a sleeve wall face of the fixed sleeve (100) is provided with at least one recessed portion in an inner cavity direction, and the contour of a sleeve cavity of the movable sleeve (200) matches the contour of an outer wall of the fixed sleeve (100). The device can improve the success rate of a surgery and enable the surgery to be safer.

Description

Small lumen anastomotic device and method of use Technical field

The invention relates to the technical field of anastomoses of blood vessels and human small lumens, in particular to a small lumen anastomotic device and a method of using the same.

Background technique

The human body lumen anastomosis technique is a surgical technique that connects the human body into two lumens into one. Vascular suture anastomosis is a kind of vascular anastomosis method that uses sutures to butt suture the broken ends of blood vessels. It is the currently recognized standard method for vascular anastomosis and is the most commonly used vascular anastomosis method in clinical practice. In general, although it is the "gold" standard for vascular anastomosis, it also has the following defects: 1. The suture causes damage to the vascular intima; 2. The suture is exposed to the lumen to interfere with normal blood flow; 3. The anastomotic varus, etc. , Increasing the risk of vascular embolism. 4. The operation is cumbersome and the operation time is long; 5. The skills of doctors are high, and it is difficult to master them in a short time without training. 6. The quality of the operation is easily affected by the psychological and physiological fluctuations of the doctor; 7. The blood vessels are elastic, soft, and stretchable human tissue. It is difficult to locate it by hand suture, and it is difficult to accurately sew with the needle. Therefore, during the operation, problems such as inadequate sutures, too deep or too shallow sutures, too tight or too loose sutures can lead to blood vessel leakage; after the operation, the influence of the suture needle and thread is likely to cause vascular thrombosis; and ultimately cause the failure of the operation . For the anastomosis of vascular mechanical nail rings, the hardware structure shown in Figure 1 is usually used. Two small plastic rings are used. Each small ring has 6 small needles and 6 small holes evenly spaced apart. Pass through the small hole, and lay out 90 degrees and fix it on 6 small needles; the other end of the blood vessel operates in the same way, and then insert the needles and holes of the two needle rings into each other. The effect after anastomosis is usually shown in Figure 2. Although the application of vascular mechanical nail ring anastomosis obviously simplifies the operation and shortens the operation time, it also has the following disadvantages: As shown in Figure 1, the inner diameter of the two plastic rings must be the same, so the diameter of the anastomosis can not be matched. Blood vessels. In actual surgery, many blood vessels have obvious differences. When the blood vessel wall is hung on the small needle, each blood vessel needs to pull the blood vessel six times at a large distance, which makes the operation difficult, the doctor is inconvenient to operate, and easily causes the blood vessel to tear. In addition, when the mechanical nail ring of the above structure is anastomosed to the arterial blood vessel, because the arterial wall is thick and tough, it is not flexible enough to pull a large distance, so the arterial wall cannot be hung on the hanging needle, and the operation fails. Patent No. CN107802308A discloses a vascular anastomotic device and its use method, to make a substantial improvement in the structure of the current suture anastomosis and mechanical nail ring anastomosis, completely solve the mechanical nail ring anastomosis can not be anastomosed diameter The problem of different blood vessels; optimize the operation of vascular anastomosis; promote the standardization of vascular anastomosis. However, it has been found in clinical use that although the above-mentioned vascular stapler can conveniently venous blood vessels, it cannot easily vascular arterial blood vessels. According to the data verification: because the arterial blood vessel wall is thick and tough, and does not have enough elasticity to flip and hang on the hanging needle, the best application of the mechanical staple ring stapler in the prior art is still limited to venous anastomosis. In addition, many small lumens also have the same state as the arterial wall, so it is not possible to reverse the wall well, resulting in anastomosis of the small lumens. Specifically, the small lumen of the human body refers to a human body tissue with a diameter less than 10 mm and a pipe-like shape. In addition to human blood vessels, there are eight main small lumen tissues: bile duct, liver duct, pancreatic duct, bronchus, renal tubule, ureter, vas deferens, and fallopian tube. These small lumens have almost the same wall structure as the arteries. These small lumens also need to be reconnected and anastomosed in the case of damage. However, the existing small luminal anastomosis instruments cannot meet the operation requirements of the above small luminal anastomosis. Need, especially in the inconvenience of the operation of hooking and flipping the wall of the small lumen, so that the doctor is forced to use manual suture during the anastomosis operation. The operation process of manual suturing is time-consuming and labor-intensive, and the operation is difficult. The operation skills of doctors are also too high, so the success rate of surgery is difficult to stabilize at a high value and varies from person to person.

In addition, the vascular stapler in the prior art needs to be clamped and fixed with forceps during the surgical operation, and then the corresponding operation is performed. As a result, the doctor feels that the operation is inconvenient and flexible.

Therefore, to provide a small lumen anastomotic device and a method of using the same to solve the problem of anastomosis of the small lumen of the human body, reduce the damage caused when the small lumen of the human body is anastomosed, and further increase the convenience of anastomosis operation Problems that need to be solved urgently by those skilled in the art.

Summary of the invention

The purpose of the present invention is to provide a small lumen anastomotic device and its use method, in order to solve the technical problem of how to quickly and high-success anastomosis of arterial blood vessels and small lumen of human body.

In order to achieve the above object, on the one hand, the present invention provides a small lumen stapler, including: a fixed sleeve, a movable sleeve and a buckle; one end of the fixed sleeve is provided with a cylindrical shoulder; the other of the fixed sleeve One end is provided with an anastomosed connection end; the movable sleeve is sleeved on the cylinder wall of the fixed sleeve, and a hanging needle is provided on the end away from the cylinder shoulder, and the movable sleeve has a fixed sleeve along the fixed sleeve Freedom of movement for sliding in the length direction of the barrel; the length of the movable sleeve is such that when the end near the shoulder of the barrel is fitted to the shoulder of the barrel, the end of the anastomosing connection end is exposed relative to the other end of the movable sleeve The lock is made of elastic material, the outer shape is ring-shaped and is provided with a locking portion, the inner hole shape of the lock is adapted to the shape of the anastomosis connecting end; characterized in that, the fixing sleeve The barrel wall faces at least one recessed portion in the direction of the inner cavity, and the shape of the movable sleeve barrel cavity matches the shape of the outer wall of the fixed sleeve.

Preferably, a handle is provided on the shoulder of the cylinder.

Preferably, the material of the handle has the flexibility required for bending at any angle and the rigidity required for maintaining the shape after folding after bending.

Preferably, the handle is a metal wire.

Preferably, a protrusion and a pit corresponding to the position of the protrusion are correspondingly provided between the outer wall of the anastomotic connection end and the wall of the inner hole of the lock catch.

Preferably, the lock buckle is made of an elastic material, has a ring shape and is provided with a locking portion, and the shape of the inner hole of the lock buckle is adapted to the shape of the anastomosis connecting end.

Preferably, the cross-sectional shape of the anastomosed connecting end is formed by sequentially connecting a plurality of arcs; the hanging pin on the movable sleeve is tightly connected to the concave portion of the end surface cross-sectional shape at the end face position.

Preferably, the fixed sleeve, the movable sleeve and the lock catch are made of absorbable materials, respectively.

Preferably, at least one of the fixed sleeve, the movable sleeve and the lock catch is made of an absorbable material.

Preferably, the movable sleeve is provided with a guide post; the cylinder shoulder is provided with a guide hole adapted to the guide post structure; after the guide post is inserted into the guide hole, the movable sleeve It has freedom of movement to slide along the length direction of the fixed sleeve.

Preferably, the lock buckle adopts a buckle with an automatic locking effect to achieve a tight connection.

Preferably, the shape of the buckle is alpha-shaped, and one of the two ends of the elastic sheet passes through the socket provided on the other end, and is formed by further bending; when the elastic sheet is bent When both ends are close together, the inner hole of the buckle becomes larger due to the recoverable elastic deformation of the elastic sheet; when the bent two ends of the elastic sheet are not subjected to external force, the inner hole of the buckle The diameter of the hole is reduced to the state before it became larger.

Preferably, the cavity wall of the inner cavity of the fixing sleeve is coated with an adsorption coating.

Preferably, the number of the hanging pins is greater than or equal to one, and the hanging pins are evenly distributed at the end of the movable sleeve away from the shoulder of the cylinder.

Preferably, the number of the hanging pins is four, and the angle formed by two adjacent hanging pins is 90 degrees.

Preferably, the hanging needle includes an inverted hanging needle and a set of fixed hanging needles; the inverted hanging needle is placed on the front surface of the movable sleeve; the fixed fixed needle is placed on the side wall of the movable sleeve.

Preferably, each component of the small-lumen stapler is made of a polymer material.

Preferably, the polymer material is an absorbable polymer material.

On the other hand, the present invention also provides a method of using the small lumen stapler as described above, including the following steps:

S1: Select a small lumen stapler that is suitable for the diameter of the small tube of the human tissue to be connected;

S2: Slide the movable sleeve to the end away from the shoulder of the cylinder;

S3: Identify the small tube to be connected as the first tube and the second tube;

S4: insert the first tube from one end of the fixed sleeve provided with a shoulder, and pass through the other end of the fixed sleeve;

S5: Hanging the end face of the first tube on the hanging pin after turning outward;

S6: Slide the movable sleeve to the shoulder side of the cylinder;

S7: When the inner wall of the connection end of the second tube coincides with the inner wall of the turned-up first tube, attach the lock clip to the anastomosed connection end to which the second tube is connected.

On the other hand, the present invention also provides a method of using the small lumen stapler as described above, including the following steps:

S1: Select a small lumen stapler that is suitable for the diameter of the small tube of the human tissue to be connected;

S2: Slide the movable sleeve to the end away from the shoulder of the cylinder;

S3: Identify the small tube to be connected as the first tube and the second tube;

S4: insert the first tube from one end of the fixed sleeve provided with a shoulder, and pass through the other end of the fixed sleeve;

S5: Bend the handle into a shape required for convenient gripping relative to the current surgical site; the shape can make the small lumen stapler stand upright at the current surgical site, resulting in the movable sleeve being provided with a hanging needle One end faces the current operating doctor;

S6: Hanging the end face of the first tube on the hanging needle after turning over;

S7: Slide the movable sleeve to the side of the cylinder shoulder;

S8: When the inner wall of the connection end of the second tube coincides with the inner wall of the turned-up first tube, attach the locking clip to the anastomosis connection end to which the second tube is connected;

S9: Use scissors to cut the handle from the shoulder of the cylinder; the cut-off part is the fastening connection of the handle on the shoulder of the cylinder.

The beneficial effects of the invention:

The small lumen stapler provided by the present invention can be conveniently applied to arterial blood vessels and human small lumen surgery when used, which breaks through the limitation of the application of the vascular mechanical nail ring anastomosis in the prior art and fills the medical field. A technical gap can make up for the technical defect that the base of the existing vascular anastomotic device is too far away from the blood vessel wall in the structure, so that the lumen wall is not easy to be everted. Further, the concave portion provided on the fixed sleeve and the movable sleeve can accommodate the vascular wall tissue accumulated to the side of the part due to the compression of the propped part during the arterial blood vessel anastomosis, causing the arterial blood vessel to flip During the operation, the operation becomes easier, which can greatly improve the operation efficiency and the success rate of the operation, and greatly reduce the technical risk of the arterial blood vessel and the small lumen being torn during the turning operation. Further, the above structure is very convenient to operate when in use, and only needs to hook the small lumen or arterial blood vessel to complete the anastomosis operation of the two broken tubes at a time. In use, the blood vessel can be reliably valgused by controlling the sliding speed of the movable sleeve The technical effect of the inner wall makes it difficult to tear the hooked lumen wall during the entire operation, resulting in a significant increase in the success rate of surgery. In addition, the setting of the buckle is used to press and seal the lumen in a buckle way, which helps to promote the faster healing of the connected lumen, and makes the connection more firm, greatly reducing the operation of side leakage at the connection risk.

Further, the setting of the handle can facilitate the clamping operation of the small lumen stapler during the surgical operation. Attaching to the hanging needle provides great operation convenience, which not only facilitates the doctor to perform anastomosis operation, but also greatly improves the success rate of the operation and saves the operation time consumed during the operation. In addition, because the handle can be easily cut off from the small lumen stapler after use, it will not cause any discomfort to the human body after the operation and will not have any adverse effects on the patient's recovery.

Further, a metal wire made of non-toxic and harmless metal commonly used in the medical field is used as a handle on the small lumen stapler, which has good flexibility and the rigidity necessary to maintain the clamping position of the small lumen stapler. Among them, the excellent plasticity of the metal wire provides great operation convenience for bending it to any shape, and provides more room for high-level doctors to perform surgical operations.

Further, the selection of the anastomosed connecting end whose cross-sectional shape is formed by connecting a plurality of arcs in sequence can provide great convenience for the turning of the small lumen and the arterial blood vessel; the end surface of the sliding sleeve is arranged on two adjacent circles The hanging needle at the inter-arc junction can be closer to the anastomotic small lumen and arterial blood vessel, and the flipping and hooking operation will become easier; further, after the flipping operation, the small lumen wall or the arterial blood vessel wall is affected The part of the backlog will be stored in the natural trench formed between the two adjacent arcs, resulting in the flat shape of the inverted small lumen wall or the arterial blood vessel wall forming a cylindrical shape, which is easy to form a solid with the other end of the lumen end surface A flat fit. In addition, the fixed sleeve with the above structure and the movable sleeve with a matching shape also have the technical advantages of simple shape, convenient processing and easy mass production, and saving manufacturing cost.

Further, the fixed sleeve, the movable sleeve and the buckle made of an absorbable material can be slowly absorbed by the human tissue following the recovery of the human body after the anastomosis operation, and the foreign body at the lumen can be completely eliminated.

Further, the guide column structure provided between the movable sleeve and the shoulder of the cylinder can improve the sliding stability of the movable sleeve when sliding relative to the fixed sleeve, and reduce the risk of the tube wall being torn during the anastomosis operation. Prevent the anastomotic tubule or arterial blood vessel from being twisted at the connection site during the anastomosis operation.

Further, the present invention uses a buckle with an automatic locking effect to achieve the fastening connection of the lock buckle, which helps to achieve the technical effect of quickly tightening the blood vessel. Only the lock buckle can be engaged in the operation to achieve the above technical purpose. The operation is more simple and convenient.

Further, the present invention can obtain further convenience by adopting one of the two ends of the elastic sheet through the socket provided on the other end and further bending the character α-shaped buckle formed as the fixing form of the buckle The technical effect of surgical operation, only need to put the lock on the arterial blood vessel to be connected in advance, and after the anastomosis of the arterial blood vessel is completed, the diameter of the inner hole of the lock can be expanded by clamping both ends after bending the elastic sheet The technical effect is that when the lock is sleeved on the anastomotic connection end that has completed the vascular anastomosis connection, the arterial blood vessel connection can be stabilized in a socketed manner by releasing the clamping of the two ends after the bending of the opposite sheet Technical effect.

Further, the adsorption coating applied on the inner wall of the fixed sleeve lumen can firmly absorb the outer wall of the lumen on the inner wall after the small lumen or artery blood vessel passes through the fixed sleeve lumen, resulting in the small lumen or artery The cross-section of the blood vessel is consistent with the cross-sectional shape of the anastomotic connection end, which provides great operation convenience for the tube wall to be stably held on the hanging needle of the movable sleeve.

Further, the corresponding protrusions and recesses between the outer wall of the anastomotic connection end and the inner wall of the lock buckle help to increase the contact area between the small lumen and the anastomotic connection end, which can be promoted when the lock is locked The technical effect of tighter lumen connection.

Further, based on the advantages of the surgical operation brought by the above structure of the present invention, the number of hanging needles can be further reduced to one, which further reduces the damage to the blood vessel wall caused by the vascular anastomosis operation, and can greatly reduce the blood vessel wall Surgery risk of being torn. Compared with the prior art vascular mechanical stapler anastomosis method which needs to be attached to the blood vessel wall at least 12 times, the small lumen stapler of the present invention only needs to be attached to the blood vessel wall 3 times during the entire surgical operation, and the related technical operation difficulty It is greatly reduced, and the use of the above-mentioned small-lumen stapler of the present invention can greatly reduce the time spent in the surgical operation, and can promote the surgical success rate to be greatly improved.

In addition, the use of the method of using the small lumen stapler further provided by the present invention can more conveniently solve the technical problem of how to staple the small lumen and arterial blood vessels, optimize the necessary surgical operations required for the anastomosis operation, and greatly increase The convenience of the anastomosis operation reduces the time spent on the key steps of the anastomosis operation, and can reduce the surgical risk of tearing the tube wall, improve the success rate of the operation, and make the anastomosis operation safer and more effective.

BRIEF DESCRIPTION

Figure 1 is a schematic diagram of the structure of a vascular mechanical nail ring in the prior art;

2 is a schematic view of the use state after the anastomotic connection of the vascular mechanical nail ring in FIG. 1;

3 is an exploded view of the structure of a specific embodiment of a small lumen stapler provided by the present invention;

Figure 4 is a diagram of the state of use of the small lumen stapler;

5 is a schematic structural view of the fixed sleeve in FIG. 3;

6 is a schematic structural view of the movable sleeve in FIG. 3;

7 is a schematic structural view of the handle in FIG. 3;

8 is a schematic diagram of the structure of the lock in FIG. 3;

9 is a structural state diagram of the movable sleeve in the final position of FIG. 3;

10 is a state diagram of the final state structure of the small lumen stapler of FIG. 3 (vessels not shown);

11 is a schematic diagram of the position and status between the initial movable sleeve and the fixed sleeve of the surgical operation;

12 is a schematic view of the position of the first small lumen after the broken end passes through the fixed sleeve during the surgical operation;

13 is a schematic view of the position of the hanging end of the first small lumen after the end face of the end of the first small lumen is turned over during the surgical operation;

14 is a schematic diagram of the effect of 180-degree valgus at the end of the broken end of the first small lumen during the surgical operation;

15 is a schematic diagram of a state where a broken end of a first small lumen and a broken end of a second small lumen are to be connected during a surgical operation;

16 is a schematic diagram of the connection state after the second small lumen broken end and the first small lumen broken end are sleeved in the operation operation;

17 is a schematic view of the connection state of the locking clip on the outer wall of the broken end of the second small lumen during the surgical operation;

18 is a schematic diagram of a specific structure of a fixed sleeve portion of a vascular anastomotic device in the prior art;

FIG. 19 is a schematic diagram of the specific structure of the fixed sleeve portion of the small lumen stapler of this application;

20 is a schematic diagram of the hanging needle spacing dimension in the state of use of a vascular stapler with a diameter of 2 mm in the prior art;

21 is a schematic diagram of the hanging pin spacing dimension in the application state of a small tube stapler with a diameter of 2 mm in this application;

22 is a schematic structural diagram of a lock catch in Example 2 of this application;

23 is a schematic diagram of the improved structure of the lock in FIG. 22;

24 is a schematic diagram of another improved structure of the lock in FIG. 22;

FIG. 25 is a schematic diagram of another improved structure of the lock catch in FIG. 22.

detailed description

Hereinafter, embodiments of the present invention will be described in detail. Examples of the embodiments are shown in the drawings, in which the same or similar reference numerals indicate the same or similar elements or elements having the same or similar functions. The embodiments described below with reference to the drawings are exemplary, and are intended to explain the present invention, and should not be construed as limiting the present invention.

Example 1:

Please refer to FIG. 3, which is an exploded view of the structure of a specific embodiment of the small lumen stapler provided by the present invention, which can easily solve the problem of the small lumen and arterial blood vessel anastomosis Less damage, and promote the standardization of human small lumen and arterial vascular anastomosis operations, increase the convenience of anastomosis operation, reduce the difficulty of doctor surgery and training time.

In the above specific embodiment, the small lumen stapler provided by the present invention has a long column shape as a whole, and the column-shaped axial cross section resembles a petal shape. It consists of 4 parts to form a small lumen anastomosis system. The four parts are fixed sleeve 100, movable sleeve 200, handle 300, and latch 400. All four parts can be made of non-absorbable or absorbable materials. Among them, the fixed sleeve 100 is hollow, the outer section of the front end resembles a petal shape, the rear end has a convex block, and there is a guide hole 110 (see FIG. 5); the inner hole shape of the movable sleeve 200 and the outer section shape of the front end of the fixed sleeve 100 Matching, the front end face has an inverted hanging pin 230 (see Figure 6), which is located in the depression of the petal shape, which makes the wall hanging distance shorter, thereby completing the thick and tough lumen that cannot be completed by the original vascular stapler Wall hanging action; there is also a hanging pin on its side for hanging the other end of the lumen, and a guide rod near its edge; the guide rod on the movable sleeve is inserted into the guide hole of the fixed sleeve and can slide back and forth ; The handle is thin rod-shaped, with a hand-held handle at the tail, the thin rod is soft and can be bent freely, its head is connected with the fixed sleeve; when the lock is locked, the shape of the inner hole and the outer section of the front end of the fixed sleeve The shape matches, and when the lock is opened, it can be expanded into a strip shape. The buckle is used to axially and radially lock the lumen connected together so that the two will not be displaced from each other.

It should be noted that the outer shape of the cylindrical axial section of the fixed sleeve is not limited to the petal shape shown in the figure. To meet the design needs, it is made into a structure with at least one recessed portion, which is also claimed in this application. . Specifically, the petal-shaped shape described above may be preferably formed by connecting a plurality of arcs in sequence; on the cross-section, the chords formed by the two ends of the arcs together form a polygon. Preferably, the hanging pin on the movable sleeve is tightly connected at the position of the end surface with the concave part of the cross-sectional shape of the end surface. It is also preferable that the above-mentioned polygonal outline is further provided as a regular polygon.

The initial state when this solution is implemented is shown in FIG. 3, the movable sleeve 200 slides over the fixed sleeve 100, through the 110 hole in the fixed sleeve 100 shown in FIG. 5 and the movable sleeve 200 shown in FIG. The guide rod of 210 cooperates, so that the movable sleeve 200 is limited to the fixed sleeve 100 and can only slide back and forth; the handle 300 passes through the end of the rod 330 shown in FIG. 7 and the 140 hole on the fixed sleeve 100 shown in FIG. 5 Tight fit to connect together.

When in use, first bend the handle into a shape suitable for placing the stapler at the surgical site of the small lumen according to the position of the small lumen, and then use the handle to send the stapler to the small end of the small lumen; cut the small end of the lumen Pass through the inner hole channel composed of the fixed sleeve and the movable sleeve; place the handle in a suitable position so that the front end of the movable sleeve with the needle is vertically upward, which is convenient for the doctor to hang the broken end of the small lumen on the movable sleeve Hang the needle on the end of the tube; let the movable sleeve retract, so that the small lumen will be turned 180 degrees, reverse the sleeve on the outer wall of the fixed sleeve, and then put the other broken end of the small lumen on it and hang it Hang the needle on the side of the movable sleeve; finally put the lock on the outer wall of the small lumen and lock it. Thus the anastomosis of the lumen is completed.

Specifically, the doctor holds the grip portion 310 in FIG. 7 in hand, and bends the rod portion 320 in FIG. 7 to arbitrarily place the stapler at a suitable surgical site near the lumen; a broken end of the small lumen is shown in the figure. The 130 petal-shaped inner hole of the fixing sleeve shown in 5 penetrates from back to front. The inner wall of the inner hole will adsorb the outer wall of the small blood vessel on the inner wall due to the adsorption coating, so that the cross section of the small blood vessel is also petal-shaped, which is beneficial to Later flip operation. When the broken end of the small lumen passes through the 240 surface of the movable sleeve 200 shown in FIG. 6 at an appropriate distance, use the handle 300 to rotate the stapler so that the 240 surface of the movable sleeve 200 faces the doctor vertically upwards, which is convenient for the broken end Wall hanging operation; use tweezers to clamp the broken end wall of the small lumen clockwise and hang it on all the flipping hanging pins 230 on the movable sleeve 200 shown in FIG. 6. The broken tissue will be automatically accommodated in the 250 groove. Using the handle 300 to rotate the stapler, the stapler is returned to the initial state as shown in FIG. 4. Since 220 shown in FIG. 6 is a petal-shaped inner hole and is larger than the petal-shaped outer contour of the fixed sleeve 160 in FIG. 5, pushing the 240 surface on the movable sleeve 200 with tweezers can retract the movable sleeve 200 to that shown in FIG. 9 Shows the termination state; at this time, the small lumen has completed 180 degrees of valgus. Use tweezers to spread the other end of the small lumen, and put it on the inner wall of the end of the small lumen. And hang the wall of the tube on the set pin 260 shown in FIG. 6; the two ends of the lumen are set together. Align the 410 inner hole of the lock 400 shown in FIG. 8 with the 120 concave outer wall of the fixing sleeve 100 shown in FIG. 5, and insert the 430 middle slotted convex lock into the 420 inner hole to complete the lock of the lock, the small tube Cavity anastomosis is completed. The state after completion is shown in Figure 10.

It should be noted that the installation method of the above-mentioned inverted hanging pin 230 is that, except that the root part is partially bent and is firmly connected to the end surface of the movable sleeve, the length direction of the needle body and the sleeve sleeve of the movable sleeve are always kept perpendicular, and the improved hanging The needle structure can be more firmly connected to the outer wall of the lumen than before the improvement, and the lumen is not easy to slip off after being connected, which can greatly improve the success rate and operation efficiency of the anastomosis operation. In addition, the setting method of the sleeve pin 260 is that the length direction of the needle body is kept parallel to the sleeve sleeve connection direction of the movable sleeve, and the needle tip faces the fixed sleeve, except that the root is partially bent and fastened to the end surface of the movable sleeve direction. The setting purpose of the set hanging needle 260 is to connect another lumen sleeved on the anastomotic connection end. In the prior art, when anastomosis operation is performed, another lumen is usually sleeved on the anastomosis connection end and the anastomosis site is connected and fixed by means of a lock; however, in actual operation, the above steps often need to be repeated many times to connect successfully. The specific reason is that the lumen after socketing is easy to slip off from the anastomotic connection end, or it is prone to misalignment and twisting during the locking operation. The setting of the fixed hanging needle 260 can better solve the above technical problems, can greatly improve the operation success rate of the anastomosis operation, and can greatly improve the doctor's operation efficiency and shorten the operation time.

Further, the set of fixed hanging pins 260 is fixedly arranged on the side wall of the movable sleeve, and is used to hook another lumen sleeved on the anastomosed connection end; when actually set, the fixed hanging pins 260 and the movable sleeve are set The angle of the sliding direction of the barrel can be flexibly adjusted from 0 degrees to 90 degrees as needed. In addition, the above-mentioned flipping hanging pin 230 is fixed on the front end surface of the movable sleeve, and is used to hang the inner wall of the flipping lumen; in actual installation, the angle between the flipping hanging pin 230 and the sliding direction of the movable sleeve can also be 0 Flexible adjustment between degrees and 90 degrees.

Further, in order to achieve the technical effect of further firmly hooking the pipe wall, the above-mentioned inverted hanging pin 230 and the set hanging pin 260 can also be provided with barbs similar to the barb structure on the fish hook in the prior art, because The structure of setting the barb on the hanging needle is based on the prior art, so the relevant structural details will not be further illustrated and described here.

The technical effects that can be achieved after using the above structure are as follows:

1. All small lumen can be anastomosed (vascular [artery + vein], bile duct, liver duct, pancreatic duct, bronchus, renal tubule, ureter, vas deferens, fallopian tube). It solves the problem that the previous scheme can only anastomosing venous blood vessels.

2. Not only anastomoses small lumens of the same diameter, but also anastomoses small lumens of different diameters, the scope of surgery is wider.

3. The petal-shaped design of the fixed sleeve makes it easier and safer to hang the wall of the small lumen and avoid the risk of tearing the wall of the tube.

4. The arbitrary bending design of the handle increases the flexibility of operation and makes the operation easier.

To further explain the use method of the above-mentioned small-lumen anastomotic device of the present invention, the use method of the small-lumen anastomotic instrument will be described with reference to FIGS. 11 to 17.

This technical solution is carried out according to the following steps in actual use

According to the diameter of the small lumen, choose the appropriate model of small lumen stapler.

First, the position of a broken end of the small lumen is straightened without twisting, and then the small lumen anastomotic instrument is placed so that its relative position with the small lumen is consistent with that shown in Figure 11.

Using tweezers, make the small end of the lumen pass through the inner holes of the fixed sleeve 100 and the movable sleeve 200, and extend the end of the small end of the small lumen to the outside of the movable sleeve 200 with the needle surface, as shown in Figure 10 The location shown. And check to make sure that the small lumen is not twisted in the hole.

Turn the stapler over so that the face on the movable sleeve 200 equipped with the hanging needle faces the doctor, which facilitates the operation of hanging the wall at the broken end. Observe the positions of the four flipped hanging needles on the movable sleeve 200, use tweezers to pull the outer edge of the broken end surface to the nearest hanging needle, and finally hang the outer edge of the end surface on the hanging needle, repeat the same action until the Hang the broken end edge of the small lumen on the four hanging pins, as shown in Figure 13.

Using forceps, the movable sleeve 200 is retracted to the end position, as shown in FIG. 14. At this time, the end of the blood vessel has achieved 180 degree valgus.

Pull the other end of the small lumen to the stapler, and make the two ends as coaxial as possible and as close as possible, as shown in Figure 15.

Use tweezers to pull the outer edge of the other broken end of the small lumen and hang it on the two sets of hanging pins on the side wall of the movable sleeve 200, and reach the position shown in FIG. 16. And check to ensure that there is no relative twisting of the two broken ends.

Put the lock 400 on the outer wall of the small lumen and close the lock with tweezers to complete the anastomosis of the small lumen. The final anastomotic state is shown in Figure 17.

In order to further clarify why this application can conveniently solve the technical problem of how to anastomose small lumens, the anastomotic operation effect of the existing anastomotic device and this application is compared as follows:

Because arterial vessels or similar luminal tissues have significantly thicker walls than venous vessels, and tissue elasticity is significantly reduced. Therefore, there is no problem in anastomosing venous blood vessels with the stapler in Figure 1, but it is not possible to anastomosing arterial blood vessels. Because the wall of the arterial tube cannot be pulled so far in a straight line during the operation of hanging the needle. Therefore, the present invention improves the stapler in the previous invention.

18 is a schematic diagram of the specific structure of the fixed sleeve part of the vascular anastomotic device in the prior art. As can be seen from the figure, the inner diameter of the anastomotic device is 2mm. Now we perform anastomosis of the 2mm lumen. If you see, the linear distance between the two opposite hanging needles is 3.6mm; as can be seen from Figure 19, the same is the stapler with an inner diameter of 2mm. If the lumen of 2mm is also anastomosed, the two opposite hanging needles The linear distance is 2.5mm. In the current scheme, the straight-line distance between the two hanging pins is only 70% of the original scheme. In this way, the lumen wall will easily hang on the hanging needle.

The reason why the minimum distance between the two hanging pins in FIG. 18 is 3.6mm is because the fixing sleeve of the small lumen stapler provided in the prior art is a plastic structure, and a wall thickness structure of at least 0.3mm is required, otherwise the fixing sleeve The barrel does not have enough strength to maintain its shape; in addition, the minimum distance between the fixed sleeve and the movable sleeve is 0.1 mm, otherwise the movable sleeve cannot slide on the fixed sleeve; Finally, the hanging pin is made of metal and is away from the inner wall of the movable sleeve A minimum distance of 0.4mm is also required, otherwise the hanging needle cannot be firmly fixed in its position. In summary: 2+ (0.3 + 0.1 + 0.4) x2 = 3.6, so 3.6mm is its minimum straight-line distance.

In the case where these basic structural dimensions are unchanged, the linear distance of the two hanging needles on the movable sleeve can be shortened to 2.5mm due to the contraction of the four positions of the fixed sleeve, so that the arteries and similar tissue lumens The wall can be easily hung on the hanging pin. And at the same time, as shown in FIG. 20, if the lumen wall is hung on four hanging needles in the prior art, the length of the lumen expansion is 4x2.6 = 10.4mm. As shown in FIG. 21, in this application, the lumen wall is hung on four hanging needles, and the length of the lumen expansion is 4x1.8 = 7.2mm, which greatly reduces the extent of the expansion of the tube wall.

Example 2:

The structure of the small lumen stapler provided in this embodiment can be summarized as follows: a fixed sleeve, a movable sleeve, and a latch; one end of the fixed sleeve is provided with a shoulder; the other end of the fixed sleeve An anastomotic connection end is provided; the movable sleeve is sleeved on the cylinder wall of the fixed sleeve, and a hanging needle is provided at an end away from the cylinder shoulder, the movable sleeve has a along the fixed sleeve Freedom of movement in the longitudinal direction; when the length of the movable sleeve is close to the end of the sleeve and the sleeve, the anastomotic connection end is exposed relative to the end of the movable sleeve; The lock buckle is made of an elastic material, has a ring shape and is provided with a locking portion, and the shape of the inner hole of the lock buckle is adapted to the shape of the anastomotic connection end; the cylinder wall of the fixing sleeve faces inward At least one recess is provided in the direction of the cavity, and the shape of the movable sleeve barrel is adapted to the shape of the outer wall of the fixed sleeve.

It should be noted that since the relevant details in the above structure have been fully illustrated in Embodiment 1, the relevant repetitive technical content in this embodiment will not be further illustrated and described in detail.

The small lumen stapler provided by the present invention can be conveniently applied to arterial blood vessels and human small lumen surgery when used, which breaks through the limitation of the application of the vascular mechanical nail ring anastomosis in the prior art and fills the medical field. A technical gap can make up for the technical defect that the base of the existing vascular anastomotic device is too far away from the blood vessel wall in the structure, so that the lumen wall is not easy to be everted. Further, the concave portion provided on the fixed sleeve and the movable sleeve can accommodate the vascular wall tissue accumulated to the side of the part due to the compression of the propped part during the arterial blood vessel anastomosis, causing the arterial blood vessel to flip During the operation, the operation becomes easier, which can greatly improve the operation efficiency and the success rate of the operation, and greatly reduce the technical risk of the arterial blood vessel and the small lumen being torn during the turning operation. Further, the above structure is very convenient to operate when in use, and only needs to hook the small lumen or arterial blood vessel to complete the anastomosis operation of the two broken tubes at a time. In use, the blood vessel can be reliably valgused by controlling the sliding speed of the movable sleeve The technical effect of the inner wall makes it difficult to tear the hooked blood vessel during the entire operation, resulting in a significant increase in the success rate of surgery. In addition, the setting of the buckle is used to press and seal the lumen in a buckle way, which helps to promote the faster healing of the connected lumen, and makes the connection more firm, greatly reducing the operation of side leakage at the connection risk.

Preferably, in one of the preferred technical solutions of this embodiment, a handle is connected to the barrel shoulder; the material of the handle has the flexibility required for bending at any angle and maintains the current shape after bending Required rigidity. The setting of the handle can facilitate the clamping operation of the small lumen stapler in the surgical operation. If the small lumen anastomosis operation can directly face the operating doctor toward the end surface of the lumen during the operation, the wall of the lumen can be flipped and hooked on the hook The needle provides great operation convenience, which not only facilitates the doctor to perform anastomosis operation, but also greatly improves the success rate of the operation and saves the operation time consumed during the operation. In addition, because the handle can be easily cut off from the small lumen stapler after use, it will not cause any discomfort to the human body after the operation and will not have any adverse effects on the patient's recovery.

Preferably, in one of the preferred technical solutions of this embodiment, the handle is a metal wire. The metal wire made of non-toxic and harmless metal commonly used in the medical field is used as a handle on the small lumen stapler, which has good flexibility and the rigidity necessary to maintain the clamping position of the small lumen stapler. Among them, the excellent plasticity of the metal wire provides great operation convenience for bending it to any shape, and provides more room for high-level doctors to perform surgical operations.

Preferably, in one of the preferred technical solutions of this embodiment, a protrusion and a recess corresponding to the position of the protrusion are correspondingly provided between the outer wall of the anastomotic connection end and the hole wall of the inner hole of the lock catch.

Preferably, in one of the preferred technical solutions of this embodiment, the lock buckle is made of an elastic material, has a ring shape and is provided with a lock portion, and the shape of the inner hole of the lock buckle is The shape is suitable.

Preferably, in one of the preferred technical solutions of this embodiment, at least one of the fixed sleeve, the movable sleeve and the lock catch is made of an absorbable material. After the anastomosis operation, the fixed sleeve, the movable sleeve and the lock buckle made of the absorbable material can be slowly absorbed by the human tissue with the recovery of the human body, and can completely eliminate the foreign body at the lumen.

Preferably, in one of the preferred technical solutions of this embodiment, as shown in FIG. 6, the hanging pin includes a flip hanging pin 230 and a set hanging pin 260; the length direction of the flip hanging pin 230 and the activity The sliding direction of the sleeve is perpendicular; the length direction of the set fixed hanging needle 260 is parallel to the sliding direction of the movable sleeve, and the needle tip of the set fixed hanging needle is disposed facing the fixed sleeve.

Preferably, in one of the preferred technical solutions of this embodiment, a guide post is provided on the movable sleeve; a guide hole adapted to the structure of the guide post is provided on the shoulder of the barrel; the guide post After being inserted into the guide hole, the movable sleeve has freedom of movement to slide along the length direction of the fixed sleeve. The guide column structure provided between the movable sleeve and the shoulder of the sleeve can improve the sliding stability of the movable sleeve when sliding relative to the fixed sleeve, reduce the risk of the tube wall being torn during the anastomosis operation, and also prevent the anastomosis operation At the time of being anastomosed, the tubules or arteries are twisted at the connection site.

Preferably, in one of the preferred technical solutions of this embodiment, the lock buckle adopts a buckle with an automatic locking effect to achieve a tight connection. As shown in FIG. 22, the lock 400 uses a cylindrical plug spring 401, and a through hole 402 adapted to the diameter of the cylindrical plug spring 401 to achieve automatic locking; wherein, the cylindrical plug spring 401 is composed of two pieces containing semicircular mesa-shaped protrusions The elastic piece is composed of a pair of cylindrical springs 401 inserted into the through hole 402, and the cylindrical spring 401 is inserted into the through hole to restore the original degree of freedom of deformation. After the 401 is inserted into the through hole, the cylindrical insertion spring 401 is prevented from being pulled out from the through hole 402, thereby achieving the technical effect of automatic locking. As shown in FIG. 23, the lock 400 uses a cylindrical insert 403, and a slot 404 adapted to the cylindrical insert 403 to achieve automatic locking; wherein, the cylindrical insert 403 includes a cylindrical insert tongue and a thickness For the connecting piece smaller than the diameter of the cylindrical tongue, because the cylindrical insert 403 is pulled out of the slot 404, the elastic force required to overcome the deformation of the sidewall of the slot 404 needs to be overcome, so the cylindrical insert 403 is pressed into the slot 404 during use Both can automatically lock the lock 400. As shown in FIG. 24, the lock buckle 400 adopts a tab 405 provided with protrusions, and a socket 406 adapted to the shape of the tab 405 to achieve automatic locking; wherein, the direction of insertion of the tab 405 and the lock The opening and closing direction of the buckle 400 is perpendicular, which has the technical effect that it is not easy to accidentally open after locking; in this embodiment, the number of tabs is two, but not limited to two, and a lock with any number of tabs to meet the needs of the setting All buckles 400 should fall within the protection scope of the present invention. The invention realizes the fastening connection of the lock by adopting a buckle with an automatic locking effect, which helps to achieve the technical effect of quickly fastening the blood vessel. Only the lock can be engaged during the operation to achieve the above technical purpose, and the operation is more Simple and convenient.

Preferably, as shown in FIG. 25, in one of the preferred technical solutions of this embodiment, the shape of the buckle is a character α-shaped, and one end 407 of the two ends of the elastic sheet passes through the insert provided on the other end 408 The hole 409 is formed after further bending; when the bent ends (407 and 408) of the elastic sheet are forced together, the inner hole of the lock 400 is restored due to the elastic deformation of the elastic sheet Becomes larger; when the bent ends (407 and 408) of the elastic sheet are not subjected to external force, the inner diameter of the inner hole of the lock catch shrinks to the state before it becomes larger, which can be used to complete the anastomotic connection The blood vessels are tightened. In actual production, the width of the elastic sheet is adapted to the length of the matching connecting end.

The invention adopts a character α-shaped buckle formed by bending one end of the two ends of the elastic sheet through the other end and formed by further bending as a fixed form of the lock buckle, which can achieve further convenience for surgical operation Technical effect, only need to put the buckle on the blood vessel to be connected in advance, and after the anastomosis operation of the blood vessel section is completed, the technical effect of expanding the diameter of the inner hole of the buckle can be achieved by clamping the bent ends of the elastic sheet. When the lock is sleeved on the anastomotic connection end which has completed the anastomotic connection of the blood vessel, the technical effect of stabilizing the blood vessel connection in the manner of the sleeve can be achieved by releasing the clamping of the two ends after the bending of the opposite sheet.

Preferably, in one of the preferred technical solutions of this embodiment, the cavity wall of the lumen of the fixed sleeve is coated with an adsorption coating, and the arrangement of the adsorption coating will adsorb the outer wall of the blood vessel on it, so that the blood vessel cross-section is Round to facilitate the subsequent flip operation. It should be noted that the material of the adsorption coating is the prior art, so its detailed composition and related coating process will not be further illustrated and described here.

Preferably, in one of the preferred technical solutions of this embodiment, by further adopting the filling sleeve in the prior art, it is also possible to solve the technical problem of anastomosis of small lumens with different tube diameters.

In this embodiment, the operation method of the small lumen stapler without a handle is as follows:

S1: Select a small lumen stapler that is suitable for the diameter of the small tube of the human tissue to be connected;

S2: Slide the movable sleeve to the end away from the shoulder of the cylinder;

S3: Identify the small tube to be connected as the first tube and the second tube;

S4: insert the first tube from one end of the fixed sleeve provided with a shoulder, and pass through the other end of the fixed sleeve;

S5: Hanging the end face of the first tube on the hanging pin after turning outward;

S6: Slide the movable sleeve to the shoulder side of the cylinder;

S7: When the inner wall of the connection end of the second tube coincides with the inner wall of the turned-up first tube, attach the lock clip to the anastomosed connection end to which the second tube is connected.

It should be noted that the steps S1 to S3 in the above steps are in no particular order, and the actual operation can be made according to operating habits.

In this embodiment, the operation method of the small lumen stapler provided with a handle is as follows:

S1: Select a small lumen stapler that is suitable for the diameter of the small tube of the human tissue to be connected;

S2: Slide the movable sleeve to the end away from the shoulder of the cylinder;

S3: Identify the small tube to be connected as the first tube and the second tube;

S4: insert the first tube from one end of the fixed sleeve provided with a shoulder, and pass through the other end of the fixed sleeve;

S5: Bend the handle into a shape required for convenient gripping relative to the current surgical site; the shape can make the small lumen stapler stand upright at the current surgical site, resulting in the movable sleeve being provided with a hanging needle One end faces the current operating doctor;

S6: Hanging the end face of the first tube on the hanging needle after turning over;

S7: Slide the movable sleeve to the side of the cylinder shoulder;

S8: When the inner wall of the connection end of the second tube coincides with the inner wall of the turned-up first tube, attach the locking clip to the anastomosis connection end to which the second tube is connected;

S9: Use scissors to cut the handle from the shoulder of the cylinder; the cut-off part is the fastening connection of the handle on the shoulder of the cylinder.

It should be noted that the above step S5 improves the operation posture taken by the existing anastomosis operation when attaching the tube wall to the hanging needle, enabling the small lumen stapler to face the operating doctor in an upright posture during the operation, and then attaching the tube wall The operation provides great convenience. After using the above operation methods, the success rate of the anastomosis operation can be greatly improved.

The use of the small lumen anastomotic device further provided by the present invention can more conveniently solve the technical problem of anastomosis of small lumens and arteries, optimize the necessary surgical operations required for the anastomosis operation, and greatly increase the anastomosis operation The convenience of the operation reduces the time spent on the key steps of the anastomosis operation, and can reduce the surgical risk of tearing the tube wall, improve the success rate of the operation, and make the anastomosis operation safer and more effective.

It should be noted that the steps S1 to S4 in the above steps are in no particular order, and the actual operation can be made according to operation habits.

The above embodiments are only preferred embodiments of the present invention. In the technical field, any changes and improvements based on the technical solutions of the present invention should not be excluded from the protection scope of the present invention.

Claims (10)

A small lumen anastomat includes a fixed sleeve, a movable sleeve and a buckle; one end of the fixed sleeve is provided with a cylindrical shoulder; the other end of the fixed sleeve is provided with an anastomotic connection end; the movable The sleeve is sleeved on the wall of the fixed sleeve, and a hanging pin is provided at an end away from the shoulder of the sleeve, the movable sleeve has a freedom of movement to slide along the length direction of the fixed sleeve; The length of the movable sleeve is such that when the end close to the shoulder of the sleeve fits with the shoulder of the sleeve, the end face of the anastomosed connection end is exposed relative to the other end of the movable sleeve; the lock is made of an elastic material , The shape is ring-shaped and is provided with a locking portion, the shape of the inner hole of the lock is adapted to the shape of the anastomosis connecting end; characterized in that, the cylinder wall of the fixing sleeve is provided with at least one in the direction of the inner cavity At a depression, the shape of the movable sleeve barrel is adapted to the shape of the outer wall of the fixed sleeve. The small lumen stapler according to claim 1, wherein a handle is provided on the shoulder of the barrel. The small lumen stapler according to claim 2, characterized in that the material of the handle has the flexibility required for bending at any angle and the rigidity required for maintaining the outer shape after bending. The small lumen stapler according to claim 3, wherein the handle is a metal wire. The small lumen anastomotic device according to claim 1, characterized in that the cross-sectional shape of the anastomotic connection end is formed by sequentially connecting a plurality of arcs; the hanging needle on the movable sleeve is at the position of the end face , And tightly connect with the concave part of the end section. The small lumen stapler according to claim 1, wherein at least one of the fixed sleeve, the movable sleeve and the lock catch is made of an absorbable material. The small lumen stapler according to claim 1, characterized in that a guide post is provided on the movable sleeve; a guide hole adapted to the structure of the guide post is provided on the shoulder of the barrel; After the guide post is inserted into the guide hole, the movable sleeve has freedom of movement to slide along the length direction of the fixed sleeve. The small lumen stapler according to claim 1, characterized in that, the hanging needle comprises an inverted hanging needle and a sleeve fixed hanging needle; the inverted hanging needle is placed on the front end surface of the movable sleeve; the sleeve fixed hanging The needle is placed on the side wall of the movable sleeve. A method for using a small lumen stapler according to any one of claims 1 to 8, characterized in that it includes the following steps: S1: Select a small lumen stapler that is suitable for the diameter of the small tube of the human tissue to be connected; S2: Slide the movable sleeve to the end away from the shoulder of the cylinder; S3: Identify the small tube to be connected as the first tube and the second tube; S4: insert the first tube from one end of the fixed sleeve provided with a shoulder, and pass through the other end of the fixed sleeve; S5: Hanging the end face of the first tube on the hanging pin after turning outward; S6: Slide the movable sleeve to the shoulder side of the cylinder; S7: When the inner wall of the connection end of the second tube coincides with the inner wall of the turned-up first tube, attach the lock clip to the anastomosed connection end to which the second tube is connected. A method for using a small lumen stapler according to any one of claims 2 to 4, characterized in that it includes the following steps: S1: Select a small lumen stapler that is suitable for the diameter of the small tube of the human tissue to be connected; S2: Slide the movable sleeve to the end away from the shoulder of the cylinder; S3: Identify the small tube to be connected as the first tube and the second tube; S4: insert the first tube from one end of the fixed sleeve provided with a shoulder, and pass through the other end of the fixed sleeve; S5: Bend the handle into a shape required for convenient gripping relative to the current surgical site; the shape can make the small lumen stapler stand upright at the current surgical site, resulting in the movable sleeve being provided with a hanging needle One end faces the current operating doctor; S6: Hanging the end face of the first tube on the hanging needle after turning over; S7: Slide the movable sleeve to the side of the cylinder shoulder; S8: When the inner wall of the connection end of the second tube coincides with the inner wall of the turned-up first tube, attach the locking clip to the anastomosis connection end to which the second tube is connected; S9: Use scissors to cut the handle from the shoulder of the cylinder; the cut-off part is the fastening connection of the handle on the shoulder of the cylinder.

Images