Controlled from curved suture needle
Technical field
The present invention relates to a kind of operating medical apparatus and instruments that is used for, relate in particular to a kind of structure and method for using that is used for carrying out the suture needle of operation through endoscope.
Background technology
In present widely used wound sew application, the doctor use 3/8ths or 1 pair of wound of the stainless steel suture needle of rigidity of semi arch carry out sew application.Suture needle 1 is as shown in Figure 1, and the semicircle profile of suture needle has axis 2.One end of this tradition rustless steel suture needle 1 molds sharp sharp sword, is convenient to penetrate organ-tissue; The cross section of the other end is shaped to non-round polygon (like triangle), is convenient to effective clamping of needle forceps.It is the polygonal end of non-circle that suture then is connected to the cross section.
Using the sew application of traditional suture needle to be divided into two steps, is respectively the knotting of tissue penetration and suture.As shown in Figure 2, in the tissue penetration action, the doctor need use two needle forceps to cooperatively interact: use one earlier needle forceps clamping suture needle 1, the axis 2 of the semicircle profile of blind stitching pin rotates needle body, begins to penetrate the action of organ-tissue; When suture needle 1 passes from organizing opposite side,, continue to rotate, up to suture needle 1 complete penetrate tissue around the axis 2 of the semicircle profile of this suture needle with other one the bared end of needle forceps clamping suture needle 1.At this moment, because an end of suture needle 1 is connected with suture 3, suture 3 has also penetrated tissue completely.Under such state, the doctor can continue to be used two suture needles and clamp, and realizes follow-up knotting action.
Visible by aforesaid description; The realization of tissue penetration; Need to accomplish a twist operation through the cooperation of two operating theater instruments; Mostly profile at needle forceps is under the situation of an elongated rigidity straight-bar that the action of this tissue penetration is difficult for accurately realizing, thereby makes whole stitching action also all become the difficult point in the various operation techniques.If tissue penetration need carry out with the mode of Wicresoft through the chamber mirror, more increased extra difficulty then for this task; In a lot of Minimally Invasive Surgerys, use the tissue penetration action of traditional suture needle also can't implement.
U.S. patent of invention US5219358; Name is called " Shape memory effect surgical needles (SME surgical sewing needle) "; August 21 1991 applying date; Disclose a kind of surgical operation that adopts marmem to make and used suture needle, it has the low temperature state and the condition of high temperature.At its low temperature state, this suture needle be shaped as thin straight strip, can slip into a straight tube; In its condition of high temperature, the shape of this suture needle becomes preset arc, is used for the stitching of endoscopic surgical.Yet the suture needle of this patent needs cryopreservation before use, and puts into the human intracavity through the apparatus pipeline of endoscope fast, behind the entering human body, makes the reach a high temperature arc of state of suture needle through heating, is used further to operating stitching.In addition, this suture needle still need be used the needle forceps clamping, in the narrow working place of endoscopic surgery, uses inconvenience.
U.S. patent of invention US5573542; Name is called " Endoscopic suture placement tool (endoscope's suture place tool) "; August 17 1994 applying date; Disclose the instrument of a kind of endoscope held suture, its suture needle and drive rod that shape-memory material is processed is bonded together.When this instrument was positioned at the apparatus pipeline of endoscope, its global shape was consistent with the apparatus pipeline; When drive rod when the apparatus pipeline of endoscope stretches out, its end bent becomes hook-shaped, uses as suture needle, the head of this suture needle also is provided with pinprick, is used to be provided with suture, installs or unloads suture and all need could realize by means of the help of other apparatuses.Yet the pinprick of this patent gets out on needle main body, clamping and unclamp suture and be " passive " (have other apparatuses auxiliary), and do not possess the condition that on little external diameter (below the diameter 1mm) needle body, realizes.In addition, this patent apparatus is a rhombus with the pipeline INTERFACE DESIGN, and terminal needle body can not the needle tubing axis rotation around the place.
U.S. patent of invention US6592559, name is called " Hollow, curved; superlastic medical needle (hollow, crooked super-elasticity medical needle) ", and 1999 applyings date December 9 days discloses a kind of hollow needle tubing made from elastic material; Be used for injection; The shape of this needle tubing when unfettered is crooked, but when introducing human body through a co-axial trocar sheath, can in the passage of this trocar sheath, suffer restraints and becomes straight.After this hollow needle tubing stretches out from trocar sheath, reply the curved shape when unfettered again.This invention does not have needle point, and therefore line not with seam does not possess puncture and sew up function.
Therefore, those skilled in the art is devoted to develop a kind of suture needle easy to use, is used for endoscopic surgery.
Summary of the invention
Because the above-mentioned defective of prior art, technical problem to be solved by this invention provides a kind of suture needle easy to use, is used for endoscopic surgery
For realizing above-mentioned purpose, the invention provides a kind of controlled certainly curved suture needle, be used for operation through endoscope's implementation, comprise syringe needle, needle body, place needle tubing and send pin mechanism; Wherein, said needle body is a tubulose, and inside is equipped with said syringe needle; Said needle body integral body again is arranged in the needle tubing of said place; Said place needle tubing has hollow lumen, and at least one end is the rigid tubular end, and the other end and the said pin mechanism that send are fixedly connected; One end of said needle body is an acra, and said acra is first shape of the circular arc of molding in advance when unfettered; The other end of said needle body links to each other with the said pin mechanism that send; Under the said propelling movement of sending pin mechanism; Said needle body moves with respect to said place needle tubing and rotates, and makes the said acra of said needle body can be accommodated within the said rigid tubular end of said place needle tubing or with required deflection angle and is exposed to outside the said rigid tubular end of said place needle tubing; Wherein, in the time of within said acra is accommodated in said rigid tubular end, said acra suffers restraints, and becomes and said hollow lumen corresponding to second shape of said place needle tubing at said rigid tubular end place; One end of said syringe needle is provided with the sword limit, and being used to puncture needs the tissue of suture site; The other end of said syringe needle links to each other with the said pin mechanism that send, and under the said propelling movement of sending pin mechanism, said syringe needle moves with respect to said needle body, makes said syringe needle to hold with a firm grip or unclamps suture.
Preferably, described controlled from curved suture needle, the said acra of said at least needle body is processed by the elastomeric material with strong restoring force.Further, said elastomeric material with strong restoring force is a Nitinol.
Preferably, in the described controlled certainly curved suture needle, the said rigid tubular end of said place needle tubing is a straight tube-like, and said second shape is straight basically.Perhaps, in the described controlled certainly curved suture needle, the said rigid tubular end of said place needle tubing is a bent tube form, and said second is shaped as bending.In addition, the global shape of place needle tubing except the rigid tubular end also can be linear or shaped form.
Preferably; Described controlled in curved suture needle; Said syringe needle is two halves in tip punishment at least; Be separated position under the no external force effect, comprise at least: the first jag end, first linking part that links to each other with the said first jag end, the second jag end and second linking part that links to each other with the said second jag end; Wherein said first linking part and said second linking part are the thin elastic rod shape, and the external diameter after both close up is slightly less than the internal diameter of said needle body; External diameter after said first jag end and the said second jag end close up is greater than the internal diameter of said needle body; Said first linking part links to each other with the said pin mechanism that send with said second linking part; When said when sending pin mechanism to strain said first linking part and said second linking part; Said syringe needle moves to said needle body direction; Make the tube wall of said needle body oppress said first linking part and said second linking part, thereby said jag end first jag end and the said second jag end close up, and are in closure state until said syringe needle.Further, at least one in said first jag end and the said second jag end is provided with breach, and when said syringe needle was in said separated position, said breach was open, for holding with a firm grip or unclamping suture; When said syringe needle was in said closure state, said breach sealing was for the clamping suture.Further, can be equipped with breach on said first jag end and the said second jag end, this two breach is oppositely arranged, and makes when said syringe needle is in said closure state, said breach sealing.Said syringe needle can be symmetrical structure, wherein, and said first jag end and said second jag end symmetry, said first linking part and said second linking part symmetry.Said syringe needle also can be unsymmetric structure.
The present invention is fit to be applied to hard tube formula endoscope or hose type endoscope.
The present invention compared with prior art has the following advantages and effect:
But folding syringe needle of the present invention is held with a firm grip and the action of unclamping suture is " initiatively " action, does not need other apparatuses auxiliary.But and should folding syringe needle can be arranged on the less needle body of diameter (can less than 1mm), still can realize holding with a firm grip and unclamping suture.Apparatus pipeline of the present invention interface is circular, and when rotating around axis when sending pin mechanism, terminal needle body can be realized the rotation of the needle tubing axis around the place, so the present invention is Duoed a controllable degrees of freedom than the rhombus apparatus pipeline interface of prior art.The present invention is simple in structure, controls easyly, and controlled being reduced to the motion of the complex space of tissue penetration from curved suture needle of design sent pin mechanism that the straight line of needle body and syringe needle is pushed to move, can greatly simplify the overall difficulty of tissue apposition.
Below will combine accompanying drawing that the technique effect of design of the present invention, concrete structure and generation is described further, to understand the object of the invention, characteristic and effect fully.
Description of drawings
Fig. 1 is the rigid joint needle construction sketch map of prior art;
Fig. 2 is the motion sketch map that tissue penetration is implemented in the rigidity suture needle of prior art;
Fig. 3 is the structural representation of first preferred embodiment of the present invention;
Fig. 4 to Fig. 7 is the step sketch map of first preferred embodiment of the present invention when implementing tissue penetration motion;
Fig. 8 and Fig. 9 are the partial structurtes sketch maps of second preferred embodiment of the present invention;
Figure 10 is the structural representation of the 3rd preferred embodiment of the present invention;
Figure 11 is a partial structurtes sketch map embodiment illustrated in fig. 10.
The specific embodiment
The essential meaning of using suture needle to carry out tissue penetration is that suture is penetrated wound (or other need suture) both sides, makes follow-up suture knotting to continue.The present invention a kind ofly can accurately control the suture needle of autonomous serpentine track and send pin mechanism through designing, and greatly simplifies the complexity of tissue penetration action, thereby reduces the overall difficulty of sewing up action.
As shown in Figure 3, first preferred embodiment of the present invention is by syringe needle 10, needle body 20, place needle tubing 30 and send pin mechanism 40 to form.
Tubulose needle body 20 is processed by the elastomeric material with strong restoring force, and inside is installed with syringe needle 10, and needle body 20 integral body again is through in the place needle tubing 30; Send the propelling movement control of pin mechanism 40, can realize the action of tissue penetration easily.Tubulose needle body 20 is set at circular arc through Technology for Heating Processing with its end (near needle end) original-shape.
Mainly by the decision of two factors, a factor is the Young's modulus of this elastomeric material to the restoring force of elastomeric material after distortion, and under the certain situation of deflection, Young's modulus is big more, and deformation-recovery power is just big more; Another factor is the regime of elastic deformation of this elastomeric material, size that just can regressive deflection, and under the certain situation of Young's modulus, regime of elastic deformation is big more, and deformation-recovery power is also big more.
The Nitinol of certain proportioning, Young's modulus is about stainless 1/3rd about 70GPa; And elastic deformation scope (elastic strain) can reach 6%, is about stainless 60 times; In the elastic deformation scope, the Nitinol needle body can produce the restoring force that number decuples the rustless steel needle body of same size.
Place needle tubing 30 is a rigidity, and its internal diameter is slightly larger than needle body 20 external diameters.The shape of place needle tubing 30 can be linear type or arc line type.Drive down when tubulose needle body 20 is sending pin mechanism 40, bounce back to place needle tubing 30 fully when inner, needle body 20 is understood the shape that be constrained to the place needle tubing by place needle tubing 30; In the time of beyond tubulose needle body 20 is pushed to place needle tubing 30,20 of tubulose needle bodies independently revert back to original-shape.
As shown in Figure 4, syringe needle 10 is dimidiation therefrom, is the nature separated position under the no external force effect, thereby has jag end 11,12 and linking part 15,16.Linking part 15 and 16 is the thin elastic rod shape, and the external diameter after it closes up is slightly less than the internal diameter of tubulose needle body 20.When thin rod shape linking part 15 and 16 is tightened up, when in tubulose needle body 20, moving, the tube wall of needle body 20 can nature compressing jag end, makes syringe needle jag end 11,12 closures.11,12 liang of side grindings of syringe needle jag end have the sword limit, to make things convenient for tissue penetration.The relative part of jag end 11,12 is provided with pinprick, closes up back portability suture.External diameter after syringe needle jag end 11 and 12 closes up is greater than the internal diameter of tubulose needle body 20.Utilize the relative position of syringe needle 10 with respect to tubulose needle body 20, the folding of the syringe needle 10 of this jag of may command, thus can clamp or unclamp suture, to cooperate the needs of whole tissue penetration action.
Send propelling movement length that pin mechanism 40 can distinguish independent control tubulose needle body 20 and deflection angle and syringe needle 10 relative position with respect to tubulose needle body 20.
When sending the propelling movement length of pin mechanism 40 control needle bodies 20, the axis direction of needle body 20 needle tubing 30 along the place is moved or the axis of needle tubing 30 rotates around the place.Needle body 20 can be accommodated in the place needle tubing 30 along the mobile acra of needle body 20 that makes of the axis direction of place needle tubing 30, or is exposed to outside the outlet of place needle tubing 30.The axis of needle body 20 needle tubing 30 around the place rotates the acra that can make needle body 20 and is exposed to the outlet of place needle tubing 30 with required deflection angle, aims at the tissue that will sew up more easily.
Below in conjunction with Fig. 4 to Fig. 7, specifically narrate operational approach of the present invention.
1. send pin mechanism 40 earlier syringe needle 10 to be pushed away tubulose needle body 20, the jag end 11,12 of syringe needle 10 freely separates under the internal stress effect, and is as shown in Figure 4.At this moment, can suture be put to the open interior of syringe needle 10 by another operating theater instruments (for example needle forceps).
2. send pin mechanism 40 that syringe needle 10 is tightened up to tubulose needle body 20 inboards, the tube wall of needle body 20 draws the jag end 11,12 of syringe needle 10 in, and suture is held with a firm grip naturally, and is as shown in Figure 5.This moment is with the needle outlet aligning internal organs of place needle tubing 30, the position that tissue needs stitching.
3. send pin mechanism 40 with tubulose needle body 20 associating syringe needles 10 together, the needle outlet of needle tubing 30 is outwards released from the place.Needle body 20 is independently replied primary circular shape in the process that outwards discharges, under the help of syringe needle 10, in tissue, pass with arc track, passes tissue from the opposite side that needs suture location.In this process, because suture is clamped by syringe needle 10, suture is also brought to the opposite side that needs stitching, and is as shown in Figure 6.
4. send pin mechanism 40 that syringe needle 10 is pushed away needle body 20, syringe needle 10 natural jags unclamp suture, and are as shown in Figure 7.Another needle forceps is firmly grasped suture, and suture was pulled on tissue.
5. send pin mechanism 40 to tighten up syringe needle 10, syringe needle 10 returns to state shown in Figure 6 (this moment, suture broke away from).The needle outlet that send pin mechanism 40 again syringe needle 10 and needle body 20 together to be bounced back to place needle tubing 30, state as shown in Figure 5.So far accomplishing primary structure penetrates.
Fig. 8 and Fig. 9 show second preferred embodiment of the present invention.The difference of the present embodiment and first embodiment is that two parts of syringe needle 10 ' jag are asymmetric, wherein on the jag end 11 ' pinprick is not set, and only depending on the pinprick that is provided with on the jag end 12 is the portability suture, realizes the object of the invention.
In other embodiments, the linking part of syringe needle also can be asymmetric, as long as syringe needle jag end is separately closed up, can make it to carry suture, realizes the object of the invention.
In other embodiments, syringe needle also can be divided into three, four even more jag ends that as petal, separates, as long as can make the jag end separately; To unclamp suture; The jag end is closed up, realize tissue penetration, can realize the object of the invention with the suture of holding with a firm grip.
Figure 10 and Figure 11 show the 3rd present embodiment of the present invention.The difference of the present embodiment and first embodiment is that place needle tubing 30 ' is a syphon shape; When the acra of needle body 20 is incorporated in the place needle tubing 30 ' of syphon shape; Receive the constraint of place needle tubing 30 ' hollow lumen, the acra of needle body 20 will correspondingly become the bending consistent with the hollow lumen of place needle tubing 30 '.
More than describe preferred embodiment of the present invention in detail.The ordinary skill that should be appreciated that this area need not creative work and just can design according to the present invention make many modifications and variation.Therefore, all technical staff in the art all should be in the determined protection domain by claims under this invention's idea on the basis of existing technology through the available technical scheme of logical analysis, reasoning, or a limited experiment.