WO2021129058A1 - Interventional locking device - Google Patents

Abstract

An interventional locking device (100), comprising a clamping head (22), a push rod assembly (40), a transmission assembly (60), and an outer sleeve assembly (80). The push rod assembly (40) comprises a push rod (42) disposed outside the clamping head (22), and the clamping head (22) has a fixed axial position and is elastic. In an initial state, a lock pin (300) in which a suture is threaded is received in the clamping head (22), and the part of the clamping head (22) close to the push rod (42) is gradually inclined outward from a proximal end to a distal end; the transmission assembly (60) comprises a threaded transmission member (62) and a flexible inner tube (64) fixedly connected to the threaded transmission member (62), and the threaded transmission member (62) is rotatably connected to the push rod assembly (40); the flexible inner tube (64) rotates to drive the threaded transmission member (62) to rotate, and the rotation of the threaded transmission member (62) drives the push rod assembly (40) to move in the axial direction, so that the push rod (42) pushes the clamping head (22), so as to force the clamping head (22) to compress the lock pin (300) to be deformed and lock the suture threaded in the lock pin (300); the outer sleeve assembly (80) comprises a rigid outer tube (84) sleeved outside the transmission assembly (60) and the flexible inner tube (64), and a plurality of first slot units (840) are arranged in the axial direction on the tube wall of the outer tube (84) to make the outer tube (84) both rigid and flexible.

Description

Interventional locking device Technical field

This application relates to the technical field of medical devices, and in particular to an interventional locking device.

Background technique

In the operation, it is often necessary to knot and fix the sutures. Traditional surgical operations are performed under the condition of open surgery and direct vision, usually by the doctors to manually tie the knots. With the advancement of technology, various minimally invasive and interventional operations have become increasingly common, such as endoscopic surgery and transcatheter interventional surgery. These operations only need to cut a small operating window on the patient's body, thereby extending the endoscope or interventional catheter and other instruments into the patient's body to reach a predetermined location for treatment. In this type of operation, if the suture thread in the patient needs to be knotted or fixed, the operator is usually required to perform the operation outside the patient through the small operating window to knot or fix the suture thread in the patient's body. Fixed, which requires the use of suture locking device.

The existing suture locking device fixes the suture thread inserted in the inner cavity of the lock nail through a lock nail with a hollow inner cavity and a chuck matched with the lock nail to apply pressure to the lock nail to force the lock nail to deform . Due to the need to intervene in the human body, in order to match the physiological anatomical structure of the human body's lumen, the tube body between the chuck and the handle of the suture locking device and the parts provided in the tube body must have a certain degree of flexibility. Generally, the existing suture locking device pushes a flexible part arranged in the tube body and a rigid part fixed on the distal end of the flexible part to the distal end by operating a handle to drive the chuck to compress the locking nail. However, on the one hand, due to the use of direct thrust to lock the suture, the flexible part is easy to bend and break during the transfer of the thrust on the flexible part, the thrust will be greatly lost, and the thrust cannot be effectively transmitted to the flexible part. On the rigid part at the distal end of the component, the chuck cannot effectively compress the locking nail, which cannot ensure that the suture is reliably locked by the locking nail; on the other hand, when the deformation of the locking nail requires a large driving force, the flexible outer tube Insufficient support is not provided, and the flexible part is bent or buckled inside the outer tube, which will affect the shape of the outer tube, causing the outer tube to deform, thereby squeezing the patient's internal blood vessels and tissues, which poses a higher risk.

Application content

The technical problem to be solved by this application is to provide an interventional locking device which has both rigidity and flexibility in view of the defects of the prior art, which can not only reduce thrust loss, ensure that the suture is reliably locked by the locking nail, but also It can make the outer tube have sufficient supporting force.

In order to solve the above-mentioned technical problems, the present application provides an interventional locking device, which includes a chuck, a push rod assembly arranged outside the chuck, a transmission assembly connected to the push rod assembly, and a sleeve attached to the chuck. The chuck, the push rod assembly and the outer jacket assembly of the transmission assembly; the push rod assembly includes a push rod arranged outside the chuck; the axial position of the chuck is fixed and its own elasticity, in the initial state, The chuck contains a lock nail with suture thread in it, and the part of the chuck close to the push rod gradually slopes outward from the proximal end to the distal end; the transmission assembly drives the push rod assembly in the axial direction Move so that the push rod pushes against the chuck, so as to force the chuck to press the lock nail to deform and lock the suture thread inserted in the lock nail; A hard outer tube outside the transmission assembly, and a plurality of first slot units are arranged on the tube wall of the outer tube in an axial direction.

Further, the transmission assembly includes a threaded transmission part and a flexible inner tube fixedly connected to the threaded transmission part, the threaded transmission part is rotatably connected to the push rod assembly; the flexible inner tube rotates to drive the threaded transmission part Rotation, the rotation of the threaded transmission member drives the push rod assembly to move in the axial direction.

The interventional locking device provided by the present application, on the one hand, drives the push rod to move distally relative to the chuck in the axial direction through the rotation of the flexible inner tube and the threaded transmission member, and the push rod slides against the chuck to make The chuck deforms and presses the lock nail to deform to lock the suture thread inserted in the cavity of the lock nail. The rotating torque of the flexible inner tube and the threaded transmission member is transformed into the threaded transmission member to drive the push rod to move axially The axial thrust force is used to drive the push rod to slide in the axial direction to push or loosen the chuck. Because the threaded transmission member is rigid and has a very short length compared with the flexible inner tube, the thrust is not lost and the thrust can be Smooth and effective transmission to the push rod, so that the chuck can effectively press the lock nail to make the lock nail fully deform, and ensure that the suture is reliably locked by the lock nail; on the other hand, because the rigid outer tube wall is along the axis A plurality of first slot units are arranged in a row, so that the outer tube has both rigidity and flexibility. The flexibility enables the outer tube to bend adaptively in the body lumen, and the rigidity enables the outer tube to provide sufficient Supporting force, even if the flexible inner tube drives the threaded transmission member to further bend and fold in the flexible outer tube when it rotates, it will not affect the shape of the outer tube and prevent the outer tube from squeezing the patient's internal blood vessels under the influence of the flexible inner tube And tissues, reducing the risk of surgery.

Description of the drawings

In order to more clearly describe the technical solutions in the embodiments of the present application, the following will briefly introduce the drawings needed in the embodiments. Obviously, the drawings in the following description are only some embodiments of the present application. For those of ordinary skill in the art, without creative work, other obvious variants can be obtained based on these drawings.

Fig. 1 is a schematic diagram of the three-dimensional structure of the interventional locking device provided by the first embodiment of the present application.

Fig. 2 is a cross-sectional view taken along line II-II in Fig. 1.

FIG. 3 is a schematic diagram of the three-dimensional structure of the outer tube in FIG. 1.

Fig. 4 is a schematic side view of the outer tube in Fig. 3.

Figure 5 is a three-dimensional schematic diagram of the second structure of the outer tube;

Figure 6 is a three-dimensional schematic diagram of the third structure of the outer tube;

Fig. 7 is a schematic side view of the outer tube in Fig. 6;

FIG. 8 is a schematic diagram of the three-dimensional structure of the flexible inner tube in FIG. 2.

Fig. 9 is a cross-sectional view of the flexible inner tube in Fig. 8.

Fig. 10 is an enlarged view of part VII in Fig. 2.

FIG. 11 is a schematic diagram of a three-dimensional structure of the locking nail squeezed by the chuck of the interventional locking device provided by the first embodiment of the present application.

Fig. 12 is a cross-sectional view of the lock nail in Fig. 11.

Fig. 13 is a schematic diagram of the structure of the chuck of the interventional locking device in Fig. 10.

Fig. 14 is a three-dimensional structural diagram of the push rod assembly of the interventional locking device in Fig. 10.

Fig. 15 is a schematic cross-sectional view of the push rod assembly in Fig. 14.

Fig. 16 is a cross-sectional view of the push rod assembly, the transmission assembly and the driving member of the interventional locking device in Fig. 2.

Fig. 17 is an enlarged view of the push rod assembly and part of the transmission assembly in Fig. 16.

FIG. 18 is a schematic diagram of the three-dimensional structure of the handle and the guide rod in FIG. 2.

Fig. 19 is an exploded schematic view of the handle and the guide rod in Fig. 18.

20 is a schematic sectional view of the structure of the handle in FIG. 19.

21 is a perspective view of the assembled structure of the handle, the guide rod, the outer tube, the connecting barrel, the sleeve and the end cover in FIG. 2.

22 is a schematic sectional view of the handle, guide rod, outer tube, connecting piece, sleeve and end cover in FIG. 21.

Figures 23-25 are schematic diagrams of the interventional locking device provided in the first embodiment of the present application used in the tricuspid valve repair process.

Figures 26-28 are schematic diagrams of the process of fixing the suture on the locking nail of the interventional locking device provided by the first embodiment of the present application.

Fig. 29 is a partial enlarged view of the interventional locking device in Fig. 26.

Fig. 30 is a partial enlarged view of the interventional locking device in Fig. 27.

Fig. 31 is a partial enlarged view of the interventional locking device in Fig. 28.

Fig. 32 is an enlarged view of the part XXIX in Fig. 25.

FIG. 33 is a schematic cross-sectional structure diagram of the interventional locking device provided by the second embodiment of the present application.

FIG. 34 is a schematic diagram of the three-dimensional structure of the flexible inner tube of the interventional locking device of FIG. 33.

Fig. 35 is an enlarged view of part XXXIII in Fig. 33.

Fig. 36 is a schematic structural diagram of an interventional locking device provided by a third embodiment of the present application.

Fig. 37 is a schematic diagram of the three-dimensional structure of the flexible inner tube in Fig. 36.

FIG. 38 is a cross-sectional view of the flexible inner tube in FIG. 37. FIG.

FIG. 39 is a schematic diagram of the three-dimensional structure of the flexible inner tube in the interventional locking device provided by the fourth embodiment of the present application.

Fig. 40 is a side view of the flexible inner tube of Fig. 39;

Fig. 41 is an enlarged view of part XLIII in Fig. 40.

Detailed ways

The technical solutions in the embodiments of the present application will be clearly and completely described below in conjunction with the accompanying drawings in the embodiments of the present application. Obviously, the described embodiments are only a part of the embodiments of the present application, rather than all the embodiments. Based on the embodiments in this application, all other embodiments obtained by a person of ordinary skill in the art without creative work shall fall within the protection scope of this application.

In addition, the description of the following embodiments refers to the attached drawings to illustrate specific embodiments that can be implemented in the present application. The directional terms mentioned in this application, for example, "upper", "lower", "front", "rear", "left", "right", "inner", "outer", "side", etc., only It refers to the direction of the attached drawings. Therefore, the direction terms used are for better and clearer description and understanding of this application, rather than indicating or implying that the device or element referred to must have a specific orientation and a specific orientation. The structure and operation cannot therefore be understood as a limitation of this application.

Definition of orientation: For clarity of description, the end close to the operator during the operation is referred to as the "proximal end", and the end far away from the operator is referred to as the "distal"; the axial direction refers to the center and the proximal end of the distal end of the medical device. The direction of the connection between the terminal and the center; the above definition is only for the convenience of presentation, and cannot be understood as a limitation of the application.

1 and 2, the first embodiment of the present application provides an interventional locking device 100, including a chuck 22, a push rod assembly 40 provided outside the chuck 22, and a proximal end connected to the push rod assembly 40 The transmission assembly 60, the drive transmission assembly 60 drives the push rod assembly 40 to move in the axial direction, the sleeve assembly 80 sleeved on the chuck 22, the push rod assembly 40 and the transmission assembly 60, and the sleeve assembly 80 The proximal handle 90. The distal end of the chuck 22 is provided with a gap 25 for placing the locking nail 300, the locking nail 300 is provided with a threading cavity 301 along the axial direction, and the threading cavity 301 is used for threading sutures. The push rod assembly 40 includes a push rod 42 arranged outside the chuck 22; the chuck 22 has a fixed axial position and has elasticity. In the initial state, the chuck 22 contains a lock nail 300 with suture thread in it, and the chuck 22 22 The part close to the push rod 42 gradually slopes outward from the proximal end to the distal end; the transmission assembly 60 includes a threaded transmission part 62 and a flexible inner tube 64 fixedly connected to the threaded transmission part 62, and the threaded transmission part 62 is rotatably connected to the push rod assembly 40; The flexible inner tube 64 rotates to drive the threaded transmission member 62 to rotate. The rotation of the threaded transmission member 62 drives the push rod assembly 40 to move in the axial direction, so that the push rod 42 pushes or loosens the chuck 22 to force the chuck 22 to press the lock nail. 300 deforms to lock the suture thread inserted in the lock pin 300 or release the lock pin 300; the outer jacket assembly 80 includes a hard outer tube 84 and an outer tube 84 sheathed outside the transmission assembly 60 and the flexible inner tube 64 A plurality of first slot units 840 are arranged along the axial direction on the wall of the tube, so that the outer tube 84 has both rigidity and flexibility, and is suitable for the interventional locking process.

The interventional locking device 100 provided by the present application, on the one hand, drives the push rod 42 to move distally relative to the chuck 22 in the axial direction through the rotation of the flexible inner tube 64 and the threaded transmission member 62, and the push rod 42 slides. Push the chuck 22 to deform the chuck 22 and press the lock pin 300 to deform to lock the suture thread inserted in the threading cavity 301 of the lock pin 300. The flexible inner tube 64 and the threaded transmission member 62 rotate The torque is transformed into an axial thrust that the threaded transmission member 62 drives the push rod 42 to move axially to drive the push rod 42 to slide in the axial direction to push or loosen the chuck 22, because the threaded transmission member 62 is rigid , The length is extremely short compared to the flexible inner tube 64, therefore, the thrust is not lost, and the thrust can be smoothly and effectively transmitted to the push rod 42, so that the chuck 22 can effectively compress the lock nail 300 so that the lock nail 300 is fully deformed, and the suture is guaranteed The locking nail 300 is securely locked; on the other hand, because a plurality of first slot units 840 are arranged along the axial direction on the tube wall of the rigid outer tube 84, the outer tube 84 is both rigid and flexible. The outer tube 84 can be bent adaptively in the human body lumen, and the rigidity enables the outer tube 84 to provide sufficient supporting force, even if the flexible inner tube 64 drives the threaded transmission member 62 to rotate, the outer tube 84 is further bent The discount will not affect the shape of the outer tube 84, and prevent the outer tube 84 from squeezing the patient's internal blood vessels and tissues under the influence of the flexible inner tube 64, thereby reducing the risk of surgery. In addition, since the flexible inner tube 64 only rotates without being pushed, the push rod 42 and the chuck 22 will not be caused to swing or shake relative to the flexible inner tube 64, thereby avoiding tearing of the suture point.

Optionally, a plurality of first slot units 840 are arranged uniformly or non-uniformly arranged on the tube wall of the outer tube 84 along the axial direction.

The outer tube 84 uses a laser cutting device to cut a plurality of first slot units 840 arranged in the axial direction on the tube wall of the hard tube. 1 and FIGS. 3 to 7, each first slot unit 840 includes N arc-shaped slots 841 spaced apart from each other in the axial direction and penetrating the wall of the outer tube 84, where N is greater than or equal to 2. Is a positive integer. Each slot 841 in each first slot unit 840 extends along the circumferential direction of the outer tube 84, and two adjacent slots 841 are offset from each other in the circumferential direction of the outer tube 84; the outer tube 84 corresponds to each slot The part 841 has flexibility, and the outer tube 84 has rigidity corresponding to the part between every two adjacent slots 841. The different values of N allow different directions and degrees of bending of the outer tube 84. The larger the value of N, the more bending directions of the outer tube 84 and the more obvious the overall flexibility of the outer tube 84.

In each of the first slot units 840, each slot 841 is an arc-shaped slot extending along the circumferential direction of the outer tube 84, and each slot 841 is not completely opened in the circumferential direction of the outer tube 84 One circle, but all the slots 841 enclose at least one circle in the circumferential direction of the outer tube 84. Since the cut slots 841 make the outer tube 84 flexible, the outer tube 84 can be bent adaptively in the tortuous body lumen. The part of the outer tube 84 that is not penetrated by the slots 841 makes the outer tube 84 It still has a certain rigidity, and the part of the outer tube 84 that is not penetrated by the slot 841 corresponds to the different peripheral parts of the outer tube 84, so that the outer tube 84 has sufficient supporting force to resist the outer tube 84 when the shape of the flexible inner tube 64 changes. Impact. The outer tube 84 may be made of stainless steel, nickel-titanium alloy, cobalt-chromium alloy and other materials. In this embodiment, the outer tube 84 is made by cutting a nickel-titanium alloy tube by a laser cutting device.

Specifically, referring to FIGS. 3 and 4, in the first structure of the outer tube 84, the value of N is 3, that is, each first slot unit 840 includes three arc-shaped slots 841. In each first slot unit 840, three slots 841 are spaced apart from each other along the axial direction of the outer tube 84, and two adjacent slots 841 are staggered in the circumferential direction of the outer tube 84. The arc length of each slot 841 extending in the circumferential direction of the outer tube 84 is greater than or equal to 1/2 of the circumference of the outer tube 84 and less than or equal to 2/3 of the circumference of the outer tube 84; The circumferentially extending arc length of the outer tube 84 is greater than or equal to 1/2 of the circumference of the outer tube 84, which can ensure that the arc length of the slot 841 is not too short, and can ensure that the outer tube 84 has better flexibility; The arc length of the slot 841 extending in the circumferential direction of the outer tube 84 is less than or equal to 2/3 of the circumference of the outer tube 84, which can ensure that the arc length of the slot 841 will not be too long, and can ensure that the outer tube 84 has a better shape.的rigidity. The sum of the arc lengths of all the slots 841 of each first slot unit 840 is greater than or equal to the circumference of the outer tube 84. Each slot 841 in each first slot unit 840 on the outer tube 84 provides the outer tube 84 with a flexible property, and the tube wall of the outer tube 84 is in the physical area between every two adjacent first slots 841 The outer tube 84 is provided with a rigid property, so that the outer tube 84 has both rigidity and flexibility. Preferably, in each first slot unit 840, the arc length of each slot 841 is equal.

Further, in each first slot unit 840, the relative rotation between two adjacent slots 841 is 360/N degrees, that is, between two adjacent slots 841 in each first slot unit 840 The relative rotation angle value of is equal to 360 degrees divided by N. Specifically, for the outer tube 84 shown in FIGS. 3 and 4, each first slot unit 840 includes three slots 841, and the relative rotation angle value between two adjacent slots 841 is 120 degrees.

The slot width of each slot 841 ranges from 0.15 mm to 0.5 mm, and the distance between two adjacent slots 841 ranges from 1 mm to 3.5 mm, so that the outer tube 84 has better flexibility and moderate rigidity. In this embodiment, the width of each slot 841 is 0.3 mm, and the distance between every two adjacent slots 841 is 1.0 mm.

5, the second structure of the outer tube 83, each first slot unit 840 includes 4 slots 841, that is, the N value is 4, the relative rotation angle between two adjacent slots 841 The value is 90 degrees, and the rest of the structure is the same as the first structure of the outer tube 84, and will not be repeated here. It is worth noting that the outer tube 84 of the second structure shown in FIG. 5 has more bending directions than the outer tube 84 of the first structure shown in FIG. 3 and FIG. Better flexibility.

6 and 7, the third structure of the outer tube 83, each first slot unit 840 includes 6 slots 841, that is, the N value is 6, and the gap between two adjacent slots 841 The relative rotation angle value is 60 degrees, and the rest of the structure is the same as the first structure of the outer tube 84, which will not be repeated here. It is worth noting that the outer tube 84 of the third structural form has the most bending direction among the outer tubes 84 of the aforementioned three structural forms, and the overall flexibility of the outer tube 84 is the best.

Of course, the number of slots 841 in each first slot unit 840 can also be set to 2, 5 or more than 6 according to actual needs.

Referring to FIGS. 2 and 8 to 10, the transmission assembly 60 further includes a flexible inner tube 64 fixedly connected to the threaded transmission member 62, and the outer tube 84 is sleeved outside the flexible inner tube 64. The flexible inner tube 64 can be made of stainless steel, nickel titanium alloy, cobalt chromium alloy and other materials. In this embodiment, the flexible inner tube 64 is formed by spirally winding wires. The outer diameter of the flexible inner tube 64 is smaller than the inner diameter of the outer tube 84. The number of silk layers of the flexible inner tube 64 is 2-6 layers. It is 0.25mm～1.2mm, the pitch is 0.25mm～1.5mm, and the gap between the same layer of wire is 0mm～0.15mm. In this embodiment, the wire material of the flexible inner tube 64 is stainless steel wire, and the wall thickness of the flexible inner tube 64 is the thickness of two layers of laminated wire materials. The rotating flexible inner tube 64 can drive the threaded transmission member 62 to move in the axial direction while rotating, so as to drive the push rod 42 to move in the axial direction to push or loosen the chuck 22.

Further, the inner cavity of the flexible inner tube 64 is inserted with a core rod 66 having a certain degree of flexibility. Preferably, the core rod 66 may be made of stainless steel, nickel-titanium alloy, cobalt-chromium alloy and other materials. In this embodiment, the core rod 66 is made of stainless steel, the flexible inner tube 64 and the distal end of the core rod 66 are fixedly connected to the threaded transmission member 62, and the flexible inner tube 64 and the proximal end of the core rod 66 are fixedly connected to the driving member 70; the driving member 70 It can drive the flexible inner tube 64, the core rod 66 and the threaded transmission member 62 to rotate. The arrangement of the core rod 66 not only facilitates the winding of the wire to form the flexible inner tube 64, but also enhances the torsion control when the flexible inner tube 64 and the core rod 66 are rotated.

As shown in FIGS. 2 and 10, the threaded transmission member 62 is rotatably connected with the outer casing assembly 80, and the rotation of the threaded transmission member 62 relative to the outer casing assembly 80 can drive the push rod 42 to move in the axial direction. Specifically, the outer sleeve assembly 80 further includes a connecting barrel 82, a sleeve 86 sleeved on the chuck 22 and the push rod assembly 40 and fixedly connected to the distal end of the connecting barrel 82, and an end cap 88 covering the distal end of the sleeve 86 . The distal end of the outer tube 84 is fixedly connected to the proximal end of the connecting cylinder 82, the proximal end of the outer tube 84 is fixedly connected to the distal end of the handle 90, the inner cavity of the outer tube 84 communicates with the inner cavity of the connecting cylinder 82, and the connecting cylinder 82 is connected to the The threaded transmission member 62 is screwed. The sleeve 86 houses the chuck 22 and the push rod assembly 40, and the chuck 22 is fixedly connected to the sleeve 86 so that the axial position of the chuck 22 is fixed. The threaded transmission member 62 is rotatably inserted into the connecting barrel 82. Specifically, the threaded transmission member 62 and the connecting barrel 82 are driven by threaded cooperation. In this embodiment, the inner peripheral surface of the connecting cylinder 82 is provided with internal threads, the threaded transmission member 62 is a transmission screw that fits the internal threads, and the distal end of the threaded transmission member 62 is fixedly connected with a connecting member 67, and the connecting member 67 rotates. Connected to the push rod assembly 40, the threaded transmission member 62 rotates and moves axially simultaneously to drive the push rod assembly 40 to move in the axial direction. In this embodiment, the internal thread of the connecting barrel 82 is a triangular thread, and the driving screw rod is provided with a triangular thread that matches the internal thread of the connecting barrel 82. Of course, the internal thread of the connecting barrel 82 and the external thread on the driving screw rod may also be a sawtooth thread, a rectangular thread, a trapezoidal thread, and the like.

10 and 26 to 31, the sleeve 86 is a hollow tube, the proximal end of the sleeve 86 is provided with a snap ring groove around its inner cavity, and the distal end of the connecting cylinder 82 is fixedly connected to the card of the sleeve 86 Adapter ring groove; the sleeve 86 has a snap ring protruding to the distal end around its inner cavity, and the snap ring is used to fix the connection end cover 88. A threading groove 860 is provided on the peripheral wall of the sleeve 86 near the chuck 22, and the threading groove 860 is used for threading the suture thread through the lock nail 300.

The distal end of the end cap 88 is provided with a suture inlet 880 communicating with the inner cavity of the sleeve 86, and the locking nail 300 can be inserted into the inner cavity of the sleeve 86 through the suture inlet 880. Specifically, the end cover 88 includes a circular cover plate 881 and an annular connecting plate 883 arranged on the periphery of the cover plate 881. The connecting plate 883 is connected to the distal end of the sleeve 86. The suture inlet 880 is axially opened on the cover plate 881. Central.

Referring to FIGS. 11 and 12, the threading cavity 301 of the locking nail 300 penetrates through opposite ends of the locking nail 300 in the axial direction, and the threading chamber 301 is used for receiving and passing the suture thread. The lock nail 300 can be compressed when subjected to mechanical external force to fix the suture thread in the threading cavity 301 of the lock nail 300. The locking nail 300 can be in various shapes, for example, cylindrical, prismatic, elliptical, etc., as long as it has a threading cavity 301 for accommodating sutures. In this embodiment, the locking nail 300 adopts a hollow cylindrical shape to reduce the pressing resistance and avoid scratching the human tissue. The outer wall of the distal end of the locking nail 300 is radially protruded with an annular round table 303. The proximal and distal edges of the outer peripheral surface of the round table 303 are both chamfered to avoid scratching the internal tissues of the patient's body. Preferably, the outer circumference of the round table 303 Both the proximal and distal edges of the face are rounded. There is a smooth transition between the distal opening of the threading cavity 301 of the locking nail 300 and the distal surface of the locking nail 300, so as to avoid cutting sutures at the connection between the two or scratching the internal tissue of the patient. The lock nail 300 is made of biocompatible materials such as stainless steel, pure titanium, nickel-titanium, and cobalt-chromium alloy, and is preferably made of pure titanium or stainless steel.

In other embodiments, in order to improve the connection force between the pin 300 and the suture after being crimped, at least a pair of interlocking structures may be provided in the threading cavity 301 of the locking nail 300, for example, the threading cavity 301 is opposite to each other. Two positions are respectively provided with a raised lock table and a concave lock hole. When the lock pin 300 is subjected to an external pressing force and begins to deform, the raised lock table is pressed into the concave lock hole. The nail 300 continues to deform, and the lock platform and the key hole are deformed at the same time until they cannot be separated. At this time, the suture is firmly fixed in the threading cavity 301 of the lock nail 300.

In order to improve the connection force between the pressed lock nail 300 and the suture thread, an anti-skid structure can also be provided on the inner peripheral surface of the threading cavity 301, such as anti-skid patterns or rough treatment on the inner peripheral surface of the threading cavity 301 After the lock nail 300 is deformed by the external pressing force, the friction between the suture thread and the inner peripheral surface of the threading cavity 301 increases, so that the suture thread is more firmly fixed in the threading cavity 301 of the lock nail 300.

Please refer to FIGS. 10 and 13 together. The chuck 22 includes a first chuck 221 and a second chuck 223 that are integrally formed and disposed opposite to each other, and a gap 25 is formed between the first chuck 221 and the second chuck 223. When the driving member 70 drives the threaded transmission member 62 to rotate, because the position of the connecting cylinder 82 is fixed, the threaded transmission member 62 moves axially while rotating and pushes the push rod 42 to move in the axial direction, that is, the rotation of the threaded transmission member 62 is transformed into The axial movement of the push rod 42 makes the push rod 42 abut against the first chuck 221 and the second chuck 223 of the push chuck 22, and the first chuck 221 and the second chuck 223 can squeeze the lock nail 300, The locking nail 300 is deformed to lock the suture.

In this embodiment, the first chuck 221 and the second chuck 223 are integrally formed of a rigid material with elasticity. When the push rod 42 moves toward the proximal end in the axial direction to slide against the first chuck 221 , The first chuck 221 is elastically deformed toward the second chuck 223 to squeeze the lock nail 300. The proximal end of the chuck 22 is closed and a pin 24 perpendicular to the axial direction passes through the proximal end of the chuck 22. The opposite ends of the pin 24 are both fixed to the sleeve 86. Specifically, the pin 24 is inserted into the proximal end of the gap 25, and the opposite ends of the pin 24 are respectively fixedly connected to the sleeve 86; the sleeve 86 defines two opposite connecting holes along its radial direction, and the opposite ends of the pin 24 are respectively The pin 24 is fixedly inserted into the two connecting holes, and the pin 24 positions the chuck 22 to prevent the chuck 22 from moving in the axial direction.

As shown in FIG. 13, the first chuck 221 and the second chuck 223 are arranged opposite to each other at intervals, and the proximal ends of the two are connected to each other. A gap 25 is enclosed between the first chuck 221 and the second chuck 223. The gap 25 is adjacent to the connection of the first chuck 221 and the second chuck 223 with a pin hole 2211, and the pin 24 is inserted into the pin hole 2211 Preferably, the central angle corresponding to the pin hole 2211 is greater than 180 degrees to prevent the chuck 22 from moving axially toward the proximal end or the distal end. The side of the first chuck 221 facing away from the second chuck 223 is provided with an inclined sliding guide surface 2213. The sliding guide surface 2213 is located at the distal end of the first chuck 221 and extends obliquely toward the side away from the gap 25. Specifically, the distal end of the first chuck 221 is provided with a protrusion protruding into the gap 25, and the side of the protrusion facing the second chuck 223 is provided with a first clamping tooth 2215. Specifically, the first clamping tooth 2215 is located in the first The chuck 221 faces the distal end of the side surface of the second chuck 223, and the first chuck teeth 2215 include a plurality of tooth grooves, and each tooth groove extends in a direction substantially perpendicular to the axial direction.

The side of the second chuck 223 facing the first chuck 221 is provided with a second clamping tooth 2235 adjacent to the distal end. Specifically, the second clamping tooth 2235 is located at the side of the second chuck 223 facing the gap 25 adjacent to the distal end, The second clamping tooth 2235 includes a plurality of tooth grooves, and the extending direction of each tooth groove of the second clamping tooth 2235 is the same as the extending direction of the tooth groove of the first clamping tooth 2215. When the first chuck 221 and the second chuck 223 are close to each other, the first chuck teeth 2215 of the first chuck 221 and the second chuck teeth 2235 of the second chuck 223 are misaligned and can mesh with each other. Therefore, the first chuck The head 221 is elastically deformed to move closer to the second clamping head 223, and the first clamping teeth 2215 and the second clamping teeth 2235 squeeze the lock nail 300 placed in the gap 25 into a shape having a curvature. The proximal end of the side surface of the second chuck 223 facing away from the first chuck 221 is provided with a sliding guide surface 2236 parallel to the axial direction. Specifically, the sliding guide surface 2236 is provided with a threading hole 2237 communicating with the gap 25. The threading hole 2237 is adjacent to the proximal end of the second clamping tooth 2235, so that the suture after passing through the lock nail 300 can pass through the threading hole 2237. A positioning block 2233 protrudes from the distal end of the second chuck 223 facing away from the side of the first chuck 221, the proximal surface of the positioning block 2233 is close to the threading hole 2237, and the proximal surface of the positioning block 2233 is a tangent surface 2238.

In other embodiments, the proximal surface of the positioning block 2233 is provided with a tangent groove, and the tangent groove penetrates two opposite sides of the second chuck 223 in a direction perpendicular to the axial direction.

Please refer to Figure 10, Figure 14-15 and Figure 26-Figure 31, the push rod assembly 40 also includes a base 44 coaxial with the threaded transmission member 62 and a cutting blade 46 fixedly connected to the base 44, a push rod 42 is fixedly connected to the base 44 and extends in the axial direction; the connecting member 67 rotates to connect to the base 44, and an axial limiting structure is provided between the connecting member 67 and the base 44. The thread cutting blade 46 is arranged opposite to the push rod 42 at intervals, and the thread cutting blade 46 can slide against the sliding guide surface 2236 in the axial direction. The base 44 is slidably received in the sleeve 86 in the axial direction. The base 44 is slidably received in the sleeve 86 in the axial direction, and the push rod 42 is slidably abutted against the sliding surface 2213 of the first chuck 221 in the axial direction. In this embodiment, the base 44 is a cylindrical rod, and the tangent blade 46 is fixedly connected to the base 44 on the opposite side of the push rod 42. A stepped hole 440 is formed in the middle of the base 44 along the axial direction. The opposite ends of the stepped hole 440 respectively penetrate the proximal and distal surfaces of the base 44. The stepped hole 440 includes a large hole 441 located at the distal end of the base 44 and The small hole 443 at the distal end of the base 44; the base 44 forms a stepped surface 445 between the large hole 441 and the small hole 443. The outer peripheral wall of the base 44 is respectively provided with fixing grooves 446 on opposite sides of the step hole 440, and the proximal end of the push rod 42 and the proximal end of the cutting blade 46 are respectively fixed to the two fixing grooves 446.

The end of the push rod 42 facing the tangent blade 46 away from the base 44 is provided with an arc-shaped sliding surface 420, and the sliding surface 420 is used to slidably abut the sliding surface 2213 of the first chuck 221. The distal end of the push rod 42 is provided with a push block 421 protruding inward, and the push block 421 is used to press the lock nail 300 to deform when the chuck 22 is pushed. Specifically, the end of the push rod 42 away from the base 44 faces the tangent blade 46. A pushing block 421 is protrudingly provided on one side, the sliding surface 420 is arranged on the side of the pushing block 421 facing the thread cutting blade 46, and the distal end of the thread cutting blade 46 is provided with a knife edge 461. In this embodiment, the outer surface of the push rod 42 is coplanar with the outer surface of the base 44; the outer surface of the tangent blade 46 is coplanar with the outer surface of the base 44. When the chuck 22 is elastically deformed and the locking nail 300 is deformed to lock the suture, the thread cutting blade 46 slides relative to the sliding surface 2236 of the chuck 22 until the blade 461 is pressed against the cutting surface 2238 to cut the thread. The suture through the threading hole 2237.

Please refer to FIGS. 2 and 16-17 together, the connecting member 67 is connected between the distal end of the threaded transmission member 62 and the push rod assembly 40; the threaded transmission member 62 includes a transmission screw rod 621 located at the distal end and is arranged on the transmission At the proximal end of the connecting portion 623 of the screw rod 621, the driving screw rod 621 is screwed to the internal thread of the connecting barrel 82. A positioning hole 624 is formed in the middle of the distal end surface of the transmission screw 621 in the axial direction, a connecting hole 626 is formed in the proximal end surface of the connecting portion 623, and the distal end of the flexible inner tube 64 is fixedly connected to the connecting hole 626 of the threaded transmission member 62. The proximal end of the flexible inner tube 64 is fixedly connected to the driving member 70, and the driving member 70 is used to drive the flexible inner tube 64 and the threaded transmission member 62 to rotate.

In this embodiment, the connecting member 67 is a connecting nail. The connecting member 67 includes a small hole 443 inserted into the stepped hole 440 and a connecting rod 672 inserted in the positioning hole 624, and is arranged at the distal end of the connecting rod 672 and is accommodated in the stepped hole. The stop 674 in the large hole 441 of 440. The connecting rod 672 is fixedly connected to the positioning hole 624, the connecting rod 672 is rotatably inserted into the small hole 443, the stopper 674 is rotatably received in the large hole 441, and the stopper 674 is stopped by the step surface 445. The axial limiting structure between the connecting member 67 and the base 44 refers to the stepped hole 440 and the stop 674. The drive screw 621 rotates and moves in the axial direction to drive the connecting member 67 to rotate in the stepped hole 440. At the same time, the distal end of the drive screw 621 pushes the push rod assembly 40 and moves toward the distal end in the axial direction, or the stop 674 pulls and pushes. The rod assembly 40 moves toward the proximal end in the axial direction.

In other embodiments, the threaded transmission member 62 is also a transmission screw rod, but the threaded transmission member 62 is directly screwed to the base 44 (not shown), and the axial position of the threaded transmission member 62 relative to the sleeve 86 is fixed. The transmission member 62 only rotates to drive the push rod assembly 40 to move in the axial direction. Specifically, between the threaded transmission member 62 and the proximal end of the sleeve 86, a device that restricts the axial movement of the threaded transmission member 62 but allows the threaded transmission member 62 to rotate may be provided. Limiting structures, such as matching grooves and flanges.

As shown in FIGS. 2 and 16, the driving member 70 is connected to the proximal end of the transmission assembly 60. Specifically, the driving member 70 is a rotating member rotatably disposed at the proximal end of the handle 90, the flexible inner tube 64 and the core rod 66 The proximal end is fixedly connected to the driving member 70. A rotating shaft 72 is protruded from the middle of the distal surface of the driver 70 along the axial direction, and an annular flange 74 is provided on the edge of the distal surface of the driver 70 in the axial direction. The extension length of the rotating shaft 72 is greater than the extension length of the flange 74 , An annular receiving groove 75 is enclosed between the rotating shaft 72 and the flange 74. A through hole 76 is formed in the middle of the driving member 70 along the axial direction. The through hole 76 is located in the middle of the rotating shaft 72. The through hole 76 is used to pass through the flexible inner tube 64 and the proximal end of the core rod 66. The proximal surface of the driving member 70 is provided with a positioning hole 77 around the through hole 76. A positioning block 78 is fixed in the positioning hole 77. The proximal end of the flexible inner tube 64 and the core rod 66 passes through the through hole 76 and is fixedly connected to the positioning block. 78. The positioning block 78 is preferably a square block, and the rotation of the driving member 70 drives the flexible inner tube 64 and the core rod 66 to rotate together through the positioning block 78. The outer wall of the driving member 70 is provided with an anti-skid mechanism 79, and the anti-skid mechanism 79 is held by hand to facilitate rotating the driving member 70.

Please refer to Figures 1 to 2 and 18 to 20 together, the driving member 70 is rotatably connected to the proximal end of the handle 90, the handle 90 is provided with a through slot 910 in the axial direction, and the flexible inner tube 64 and the proximal end of the mandrel 66 penetrate The through slot 910 is fixedly connected to the driving member 70. The handle 90 includes a housing 91 and a guide rod 96 fixedly inserted into the housing 91, and the guide rod 96 is used for positioning the flexible inner tube 64. In this embodiment, the cross section of the housing 91 is a polygonal rod-shaped structure. The proximal surface of the housing 91 defines a rotating hole 93 around the through slot 910. The rotating hole 93 is used to rotatably connect the distal end of the driving member 70. Specifically, the rotating shaft 72 of the driving member 70 is rotatably inserted into the rotating hole 93. The distal end of the handle 90 is provided with a positioning hole 95 around the through groove 910, the guide rod 96 is inserted into the positioning hole 95, the guide rod 96 is provided with a guide groove 962 along the axial direction, and the proximal end of the flexible inner tube 64 can be movably received In the guide groove 962, the proximal end of the flexible inner tube 64 is prevented from kinking and warping when rotating. A cover plate 964 is provided at the distal end of the guide rod 96. A connecting tube 966 is protruding from the middle of the distal surface of the cover plate 964. The guide groove 962 passes through the cover plate 964 and communicates with the inner cavity of the connecting tube 966. The proximal end of the flexible inner tube 64 passes through the connecting tube 966, the guide groove 962, and the inner cavity of the connecting tube 966. The through slot 910 is then connected to the driving member 70; the proximal end of the outer tube 84 is fixedly connected to the connecting tube 966. The proximal end of the outer peripheral wall of the guide rod 96 is provided with at least one fixing hole 967, and the outer peripheral wall of the housing 91 is provided with a connecting hole 913 communicating with the positioning hole 95. When the guide rod 96 is inserted into the positioning hole 95, the cover plate 964 covers On the distal end of the housing 91, the fixing hole 967 of the guide rod 96 corresponds to the connecting hole 913 of the housing 91, and the locking rod is inserted into the connecting hole 913 and the fixing hole 967, so that the guide rod 96 and the housing 91 are fixedly connected. In other embodiments, the cross section of the housing 91 may also be a circular, elliptical, rectangular or irregular rod-shaped structure.

21 and 22, the handle 90 is provided with at least one length scale 915 along the axial direction adjacent to the driving member 70, and the at least one length scale 915 is used to display the displacement amount of the driving member 70 along the axial direction. Specifically, the proximal end of the outer peripheral surface of the housing 91 is provided with a plurality of length scales 915, and the plurality of length scales 915 are arranged in a circle along the circumferential direction of the housing 91 to facilitate the observation of the displacement of the driving member 70 in the axial direction. When the distal surface of the flange 74 of the driving member 70 is directly opposite to the 0 on the length scale 915, the first chuck 221 and the second head 223 of the chuck 22 are in a fully opened state, and the push rod 42 does not align with the chuck. 22 applies an axial thrust; when the driving member 70 rotates and moves in the axial direction until the distal end of the flange 74 is in direct alignment with a certain scale value on the length scale 915, such as 5, the push rod 42 pushes against the chuck 22 , The first chuck 221 and the second head 223 of the chuck 22 squeeze the lock nail 300 to deform to fix the suture thread passing through the lock nail 300. The above-mentioned certain scale value refers to the scale value for the first chuck 221 and the second head 223 to squeeze the lock nail 300 to deform so that the lock nail 300 can firmly fix the suture thread. The certain scale value can be set by itself according to actual needs. The driving member 70 rotates to drive the flexible inner tube 64 and the threaded transmission member 62 to rotate. The threaded transmission member 62 is screwed to the internal thread of the connecting barrel 82, and the connecting barrel 82 is fixed in the axial position. Therefore, the threaded transmission member 62 is Rotate and move in the axial direction at the same time, so that the push rod 42, the flexible inner tube 64 and the driving member 70 move axially accordingly. When the driving member 70 moves in the axial direction until the distal end of the flange 74 is directly facing the certain scale value At this time, the chuck 22 has pressed the lock pin 300 to deform to fix the suture thread inserted in the lock pin 300, and the rotation of the driving member 70 can be stopped at this time. The outer peripheral surface of the handle 90 is provided with an anti-skid mechanism 917, which is convenient to hold.

Please refer to Figure 1, Figure 2, Figure 10, and Figure 19-22 together. When assembling the locking device 100, insert the guide rod 96 into the positioning hole 95 of the handle 90 so that the guide groove 962 is facing the through groove 910. And the fixing hole 967 is facing the connecting hole 913, the locking rod is inserted into the connecting hole 913 and the fixing hole 967; the rotating shaft 72 of the driving member 70 is rotatably inserted into the rotating hole 93 of the handle 90; the flexible inner tube 64 and the core rod After the proximal end of 66 passes through the connecting tube 966, the guide groove 962, the through groove 910 and the through hole 76 in sequence, it is fixed in the positioning hole 77 of the driving member 70 by the positioning block 78; the flexible inner tube 64 and the distal end of the mandrel 66 The end is fixed to the connecting hole 626 of the threaded transmission member 62, the outer tube 84 is sleeved outside the threaded transmission member 62 and the flexible inner tube 64, and the proximal end of the outer tube 84 is fixedly connected to the connecting tube 966 of the guide rod 96; After the drive screw 621 of the transmission member 62 is screwed to the internal thread of the connecting barrel 82, the distal end of the outer tube 84 is fixedly connected to the proximal end of the sleeve 86 through the connecting barrel 82; the push rod assembly 40 is placed on the connecting barrel 82 The proximal end of the push rod assembly 40 faces the distal end of the connecting cylinder 82, and the connecting rod 672 of the connecting member 67 is inserted into the step hole 440 of the base 44 and then fixedly connected to the positioning hole of the threaded transmission member 62 624; fix the chuck 22 at the distal end of the sleeve 86 so that the threading hole 2237 of the second chuck 223 faces the threading groove 860 of the sleeve 86, and the opposite ends of the pin 24 are respectively fixed to the sleeve 86 The sleeve 86 is sleeved outside the push rod assembly 40, and the proximal end of the sleeve 86 is fixedly connected to the distal end of the connecting barrel 82, so that the chuck 22 is located between the push rod 42 and the cutting blade 46, and the push rod 42 is in contact The first chuck 221, the cutting edge 461 of the tangent blade 46 is facing the tangent surface 2238; and then the end cap 88 is covered on the distal end of the sleeve 86, so that the proximal end of the end cap 88 is fixedly connected to the distal end of the sleeve 86. The suture entrance 880 of the cover 88 can be directly opposite to the gap 25.

Please refer to Figs. 23 to 32. The following takes a tricuspid valve repair operation as an example to illustrate the use process of the interventional locking device 100 provided in the present application.

The tricuspid valve is a one-way "valve" between the right atrium (abbreviation: RA) and the right ventricle (abbreviation: RV), which can ensure blood flow from the right atrium to the right ventricle. A normal healthy tricuspid valve has multiple chordae. The leaflets of the tricuspid valve are divided into anterior leaflets, posterior leaflets and septal leaflets. When the right ventricle is in a diastolic state, the three are in an open state, and blood flows from the right atrium to the right ventricle; when the right ventricle is in a contracted state, the chordae tendons are pulled Extend to ensure that the valve leaflets will not be rushed to the atrium side by blood flow, and the anterior leaflets, posterior leaflets and septal leaflets are closed well, thus ensuring that blood flows from the right ventricle to the pulmonary artery through the pulmonary valve (referred to as PV). If the tricuspid valve is diseased, when the right ventricle is in a contracted state, the tricuspid valve cannot return to a fully closed state as in the normal state, but insufficiency occurs. The impulse of blood flow will further cause the valve leaflets to fall into the right atrium, causing Reflux of blood. For tricuspid regurgitation, an interventional method can be used to implant sutures into each leaflet, and then use the locking device in this application to lock the sutures and threads on each leaflet together to implement edge-to-edge repair. The specific process is as follows:

Step 1: As shown in Figure 23, firstly, one or more sutures 500 with elastic spacers 501 are implanted into the anterior, posterior and septal leaflets of the tricuspid valve of the patient. The point contact between the leaflets is converted into the surface contact between the elastic gasket 501 and the leaflets, which can effectively reduce the risk of leaflet tearing;

Step 2: As shown in Figure 24, Figure 26 and Figure 29, the multiple sutures 500 on the three valve leaflets are inserted into the threading cavity 301 of the lock nail 300 outside the patient's body, and the sutures 500 are placed at the proximal end Pass through the threading cavity 301 of the lock nail 300, the gap 25 between the first chuck 221 and the second chuck 223, and the threading hole 2237 in turn, and pass through the threading groove 860 of the sleeve 86;

Step 3: Push the distal end of the interventional locking device 100 into the right atrium of the heart through the femoral vein with the aid of a bending sheath (not shown), move it closer to the leaflets of the tricuspid valve, and pull the suture 500 at the same time until The distal end of the locking device 100 reaches a predetermined position in the right atrium;

Step 4: Adjust the tightness of the sutures 500 of the front, back, and septal leaflets respectively, and determine the lightest state of tricuspid regurgitation through ultrasound. When this state is reached, stop the adjustment and maintain the three sets of sutures The tightness of the line 500, that is, maintaining the relative position between the anterior, posterior and septal leaflets of the tricuspid valve;

Step 5: As shown in Figures 27 and 30, the driving member 70 on the handle 90 is rotated. The rotation of the driving member 70 drives the flexible inner tube 64 and the threaded transmission member 62 to rotate. The threaded transmission member 62 is screwed to the connecting cylinder 82 The inner thread of the connecting cylinder 82 is fixed in the axial position. Therefore, the threaded transmission member 62 rotates the same and moves in the axial direction, thereby driving the driving member 70, the flexible inner tube 64 and the threaded transmission member 62 to rotate along the axis Moving toward the distal end, the threaded transmission member 62 moves toward the distal end in the axial direction against the push rod assembly 40, the push rod 42 moves distally relative to the chuck 22, and the sliding surface 420 of the push rod 42 continues to squeeze the chuck 22 The upper sliding surface 2213 makes the first chuck 221 of the chuck 22 move closer to the second chuck 223, and the first clamping teeth 2215 and the second clamping teeth 2235 press and hold the lock nail 300 contained in the gap 25 until The locking nail 300 is deformed to lock the three sets of sutures 500 in the locking nail 300 together. At the same time, the cutting edge 461 of the thread cutting blade 46 is pressed against the tangent surface 2238 of the second chuck 223, and the thread cutting blade 46 smoothly cuts the locking nail 300 Three sets of sutures 500 on the proximal side, and then these three sets of redundant sutures 500 are drawn out of the patient's body;

Step 6: As shown in Figure 25, Figure 28, Figure 31 and Figure 32, the drive member 70 on the drive handle 90 rotates in the reverse direction, and the reverse rotation of the drive member 70 drives the flexible inner tube 64 and the threaded drive member 62 to reverse direction. Rotate to make the driving member 70, the flexible inner tube 64 and the threaded transmission member 62 move toward the proximal end in the axial direction. The threaded transmission member 62 pulls the push rod assembly 40 through the connecting member 67 to move toward the proximal end in the axial direction; In the process of moving proximally in the axial direction, the sliding surface 420 of the push rod 42 continuously releases the squeezing force from the sliding guide surface 2213 on the chuck 22 until the chuck 22 rebounds to the initial position by its own elastic force. The deformed locking nail 300 is released from the gap 25 of the chuck 22 and the distal end of the outer cover assembly 80, and is separated from the locking device 100;

Step 7: Withdraw the distal end of the locking device 100 out of the patient's body, and the locking nail 300 is left in the patient's body. At this time, the locking nail 300 will fix the three sets of sutures 500 through the anterior, posterior and septal leaves together , The anterior, posterior and septal leaflets of the tricuspid valve are repaired.

It is understandable that the above-mentioned interventional locking device is only used for an interventional tricuspid valve repair process as an example to illustrate its use process. The interventional locking device of the present application can also be used in other interventional surgical procedures. Locking and fixing of sutures.

The interventional locking device 100 of the present application is particularly suitable for the following scenarios, such as:

Interventional mitral valve repair surgery through the path of femoral vein-right atrium-atrial septum-left atrium-mitral valve;

Interventional mitral valve repair surgery through the path of femoral artery-aortic arch-aortic valve-left ventricle-mitral valve;

Interventional mitral valve repair surgery was performed through the path of jugular vein-right atrium-atrial septum-left atrium-mitral valve.

It is also suitable for the following scenarios: interventional tricuspid valve repair surgery through the jugular vein-right atrium-tricuspid valve path. By means of minimally invasive intervention, the interventional locking device 100 is operated outside the patient's body to fix the suture 500 implanted on the valve leaflet with the locking nail 300.

In other embodiments, the push rod assembly 40 and the sleeve 86 are connected by an axially extending guide groove and a guide bar to ensure that the push rod assembly 40 only slides in the axial direction in the sleeve 86 without rotating; Specifically, the outer wall of the push rod 42 is provided with a guide bar extending in the axial direction, and the inner peripheral surface of the sleeve 86 is provided with a guide groove corresponding to the guide bar; or the outer wall of the push rod 42 is provided with a guide groove extending in the axial direction, the sleeve 86 A guide bar corresponding to the guide groove is provided on the inner peripheral surface of the guide bar, and the guide bar can slide axially in the guide groove.

Referring to FIGS. 33 to 35, the structure of the interventional locking device provided by the second embodiment of the present application is similar to the structure of the first embodiment, except that the structure of the flexible inner tube 64a in the second embodiment is similar to that of the first embodiment. The structure of the flexible inner tube 64 in the first embodiment is different. Specifically, in this embodiment, the flexible inner tube 64a has a similar structure to the outer tube 84, and a laser cutting device is also used to cut a plurality of second slot units 641 on the tube wall of the rigid tube to obtain flexibility.

Specifically, each second slot unit 641 includes M slots 642 spaced apart from each other in the axial direction and penetrating the tube wall of the flexible inner tube 64a. M is a positive integer greater than or equal to 2, and the flexible inner tube 64a corresponds to The part of each slot 642 has flexibility, which corresponds to the rigidity of the part between every two adjacent slots 642. In this embodiment, the value of M is 4. In other embodiments, the value of M can also be 2, 3, 5, 6, etc. The larger the value of M, the better the flexibility of the flexible inner tube 64a. As for the structure of each slot 642, the relationship between two adjacent slots 642, etc., are consistent with the corresponding structure and relationship on the outer tube 84, and will not be repeated here.

Referring to FIGS. 36 to 38, the structure of the interventional locking device provided by the third embodiment of the present application is similar to that of the first embodiment, except that the structure of the flexible inner tube 64d in the third embodiment is similar to that of the first embodiment. The structure of the flexible inner tube 64 in the first embodiment is slightly different. Specifically, the flexible inner tube 64d is a hollow tubular flexible tube body that is spirally wound from multiple strands and has a certain torsion resistance. The parameters of the hollow tubular flexible pipe body: the number of wire groups is 3-6 groups, the wire diameter is 0.3mm-0.75mm, the thread pitch is 0.3mm-0.8mm, and the wire gap is 0mm-0.15mm. The hollow tube is flexible The opposite ends of the pipe body are respectively provided with metal sleeves 645, and the metal sleeve 645 can be directly welded to the opposite ends of the hollow tubular flexible pipe body by using equipment. In this embodiment, 6 sets of wires are selected to be tightly wound to form a hollow flexible inner tube 64d. The flexible inner tube 64d of this structure is more flexible, and the weight of the device can be moderately reduced under the condition of ensuring sufficient torsion resistance. The proximal end of the flexible inner tube 64d passes through the through hole 76 and is fixedly connected to the positioning block 78, and the distal end of the flexible inner tube 64d passes through the outer tube 84 and is fixed to the proximal end of the threaded transmission member 62.

Referring to FIGS. 39 to 41, the structure of the interventional locking device provided by the fourth embodiment of the present application is similar to the structure of the first embodiment, except that the structure of the flexible inner tube 64e in the fourth embodiment is similar to that of the first embodiment. The structure of the flexible inner tube 64 in the first embodiment is different. Specifically, the flexible inner tube 64e in this embodiment includes a plurality of hinged cylinders 646, and two adjacent hinged cylinders 646 are nested and connected. The barrel 646 is connected to a flexible inner tube 64e, which can be bent toward two opposite sides of the nesting site. The proximal end of the flexible inner tube 64e passes through the through hole 76 and is fixedly connected to the positioning block 78, and the distal end of the flexible inner tube 64e passes through the outer tube 84 and is fixed to the proximal end of the threaded transmission member 62.

Specifically, one end of each hinge cylinder 646 is protruded with two opposite embedding pieces 6461, and the opposite end of each hinge cylinder 646 is provided with two opposite connection ports 6463. Among the two adjacent hinged cylinders 64, the two embedding pieces 6461 of one hinged cylinder 646 are respectively nested in the two connecting ports 6463 of the other hinged cylinder 646, and the two adjacent hinged cylinders 64 are located between the hinged parts. There are axial gaps on both sides of the spool to facilitate bending of the flexible inner tube 64e. The connecting port 6463 of each hinged cylinder 646 is substantially a C-shaped opening, and the embedding piece 6461 of each hinged cylinder 646 is a circular-like convex piece nested in the corresponding connecting port 6463.

The above is the implementation of the embodiments 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 embodiments of the present application, several improvements and modifications can be made, and these improvements and modifications are also Treated as the scope of protection of this application.

Claims (16)

An interventional locking device, which is characterized by comprising a chuck, a push rod assembly arranged outside the chuck, a transmission assembly connected to the push rod assembly, and sleeves on the chuck and the push rod Assembly and the outer jacket assembly of the transmission assembly; the push rod assembly includes a push rod arranged outside the chuck; the axial position of the chuck is fixed and its own elasticity, in the initial state, the chuck is contained The lock nail with suture thread is inserted, the part of the chuck close to the push rod is gradually inclined outward from the proximal end to the distal end; the transmission assembly drives the push rod assembly to move in the axial direction, so that the The push rod pushes against the chuck to force the chuck to press the lock nail to deform and lock the suture thread inserted in the lock nail; the outer cover assembly includes a rigid body sleeved outside the transmission assembly A plurality of first slot units are arranged along the axial direction on the outer tube of the outer tube. The interventional locking device according to claim 1, wherein the plurality of first slot units are arranged uniformly or non-uniformly arranged on the tube wall of the outer tube along the axial direction. The interventional locking device according to claim 1, wherein each of the first slot units includes N arc-shaped slots spaced apart from each other in the axial direction and penetrating the wall of the outer tube , N is a positive integer greater than or equal to 2. In each of the first slot units, each of the slots extends along the circumferential direction of the outer tube, and two adjacent slots are in the outer The circumferential direction of the tubes are misaligned with each other. The interventional locking device according to claim 3, wherein, in each of the first slot units, the arc lengths of each of the slots are equal, and all of the first slot units have the same arc length. The slot encloses at least one circle in the circumferential direction of the outer tube. The interventional locking device according to claim 4, wherein in each of the first slot units, two adjacent slots rotate 360/N degrees relative to each other. The interventional locking device according to claim 5, wherein N is 2, 3, 4, 5, or 6, and in each of the first slot units, one of two adjacent slots is Correspondingly rotate 180 degrees, 120 degrees, 90 degrees, 72 degrees or 60 degrees relative to each other. The interventional locking device according to claim 4, wherein the arc length of each slot extending in the circumferential direction of the outer tube is greater than or equal to 1/2 of the circumference of the outer tube, Less than or equal to 2/3 of the circumference of the outer tube. The interventional locking device according to claim 3, wherein the slot width of each of the slots ranges from 0.15 mm to 0.5 mm, and the distance between every two adjacent slots ranges from 1 mm to 1 mm. 3.5 mm. The interventional locking device according to any one of claims 1-8, wherein the outer sleeve assembly further comprises a sleeve fixedly connected to the distal end of the outer tube, and the clamp is placed in the sleeve. The head and the push rod assembly, and the chuck is fixedly connected to the sleeve. The interventional locking device according to claim 9, wherein the transmission assembly comprises a threaded transmission part and a flexible inner tube fixedly connected to the threaded transmission part, and the threaded transmission part is rotatably connected to the push rod assembly The flexible inner tube rotates to drive the threaded transmission member to rotate, and the rotation of the threaded transmission member drives the push rod assembly to move in the axial direction. The interventional locking device according to claim 10, wherein the threaded transmission member is a transmission screw rod; the threaded transmission member is fixedly connected to a connecting member, and the connecting member is rotatably connected to the push rod assembly, The threaded transmission member rotates synchronously and moves in the axial direction to drive the push rod assembly to move in the axial direction; or the threaded transmission member is directly screwed to the push rod assembly, and the threaded transmission member only rotates to drive the push rod assembly. The rod assembly moves in the axial direction. The interventional locking device according to claim 10, further comprising a driving member for driving the flexible inner tube and the threaded transmission member to rotate, and the driving member is fixedly connected to the proximal end of the flexible inner tube. The interventional locking device according to claim 12, further comprising a handle, the driving member is rotatably arranged at the proximal end of the handle, the handle is provided with a through groove in the axial direction, and the flexible The proximal end of the inner tube passes through the through slot and is fixedly connected to the driving member. The interventional locking device according to claim 13, wherein the proximal surface of the handle is provided with a rotating hole around the through slot, and the distal end of the driving member is provided with a rotating insert to be connected to the rotating The axis of rotation in the hole. The interventional locking device according to claim 14, wherein a guide rod is fixedly inserted into the handle, the guide rod is provided with a guide groove along the axial direction, and the proximal end of the flexible inner tube is movably It is contained in the guide groove, and the proximal end of the outer tube is fixedly connected to the distal end of the guide rod. The interventional locking device according to claim 11, wherein the push rod assembly further comprises a base coaxial with the threaded transmission member, and the push rod is fixedly connected to the base and extends along the axis. Extend toward the base; the connecting member is rotated to connect the base, and an axial limiting structure is provided between the connecting member and the base; or the threaded transmission member is directly screwed to the base, and The axial position of the threaded transmission member relative to the sleeve is fixed.

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