CN100453053C - Device for ligaturing left atrial appendage and using method thereof - Google Patents
Device for ligaturing left atrial appendage and using method thereof Download PDFInfo
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- CN100453053C CN100453053C CNB2006100603381A CN200610060338A CN100453053C CN 100453053 C CN100453053 C CN 100453053C CN B2006100603381 A CNB2006100603381 A CN B2006100603381A CN 200610060338 A CN200610060338 A CN 200610060338A CN 100453053 C CN100453053 C CN 100453053C
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Abstract
The invention discloses a device for ligaturing left auricle and the utilization method. the device comprises ligaturing line and conveying system: conveying system comprises internal and external sheath tube, the internal part is hollow; the length of internal sheath tube is little longer than that of external sheath tube, the internal sheath tube can be rested in long sheath tube; godet is set on internal sheath tube, and the front part is equipped with circular ring; hat is connected with front part of internal sheath tube. The utilization method comprises following steps: putting internal sheath tube into external sheath tube, keeping one piercing slot on hat is align to ligaturing line; threading the other end of ligaturing line by using godet through internal sheath tube to form loop; looping left auricle with formed loop, tightening ligaturing line to ligature left auricle. The invention is characterized by small injury area, low risk and prevention of stroke.
Description
Technical field
The present invention relates to a kind of device and using method thereof of ligation intracoelomic cavity body, especially relate to a kind of device and using method thereof of ligaturing left atrial appendage.
Background technology
Atrial fibrillation (being called for short atrial fibrillation or AF) is one of very common clinically arrhythmia.Studies show that both at home and abroad: the total incidence that the crowd plants atrial fibrillation is 0.89%.Not only (apoplexy but also claim apoplexy or cerebrovascular accident is one group of unexpected onset to the apoplexy of 16%-21.5%, is the acute cerebrovascular disease of common trait with focal neurological deficit.) thrombosis that caused by atrial fibrillation comes off and cause that the apoplexy that non-valvular heart disease atrial fibrillation causes accounts for the 50%-67.1% of cardiogenic apoplexy case.Apoplexy annual morbidity＞4% of patients with atrial fibrillation; And apoplexy causes that fatality rate and disability rate can reach about 50%.Therefore prevent the atrial fibrillation apoplexy to have the important clinical meaning.
Anticoagulant therapy is the standard method of prevention atrial fibrillation apoplexy complication at present, but there is certain limitation in anticoagulant therapy, as the part patient because have anticoagulant contraindication or relative contraindication and can not anticoagulant, or anticoagulant is subjected to the influence of medicine and food and increases detecting trouble easily, makes some patients can not adhere to anticoagulant therapy for a long time.In addition, anticoagulant therapy itself also has hemorrhage complication, and these make the long-term anticoagulant of patient adhere to that rate reduces, and the effect of anticoagulant therapy performance is limited.Therefore adopting more, the measure of effective and safe prevents the atrial fibrillation apoplexy significant.
Utilize the method for the inaccessible left auricle of internal medicine interventional therapy method also to obtain very great development at present, this kind treatment technology is a kind of good selection for there being severe haemorrhage patient and anticoagulant taboo patient.Left atrial appendage occlusion art commonly used has two kinds: a kind of is to utilize percutaneous left auricle mutual conductance pipe plug to close device (percutaneous left atrial appendage transcatheter occlusion-PLAATO) shutoff left auricle, common as Appriva Medical company; Another kind is to utilize the stifled left auricle that closes of Amplazer interatrial septum shutoff umbrella.Utilize the method for PLAATO device shutoff left auricle little because of its operation wound, the success rate height, advantages such as the thromboembolism incidence rate is low were once enjoying advises order, but its postoperative complication---the hemopericardium incidence rate is higher, at present incidence rate is about 6.9%, thereby also needs further to improve Design of device structure and accumulation surgical experience.And for Amplazer shutoff umbrella, a lot of experts think that it is not is the suitable stifled device that closes of LAA (sealing of percutaneous left auricle), it be not close for LAA is stifled specially designed, but be that the atrium is damaged designed, thereby think if there is not suitable device, still do not carry out left auricle reluctantly and block up and close operation.
Cardiac operation is excised simultaneously or to seal left auricle simple, excision or sealing left auricle when therefore many doctors advocate to need the operation on heart treatment for this type of patient.But for only be the excision or the sealing left auricle the surgery operating wound face very big, should not perform surgical operation.1996 Odell (Ao Daier) etc. reported and, made technology through thoracoscope sealing left auricle prevention atrial fibrillation thromboembolism to have obtained extensive concern through thoracoscope sealing left auricle owing to greatly reduce the wound and the risk of operation.If can further improve the effect of left auricle sealing in this technology, good prospects for application is arranged through thoracoscope sealing left auricle prevention atrial fibrillation thromboembolism.
Summary of the invention
The device and the using method thereof that the purpose of this invention is to provide a kind of ligaturing left atrial appendage.Can almost completely seal left auricle, improve the probability that stops thrombosis to come off greatly.Be applied to prevent because of the atrial fibrillation apoplexy through the operation of thoracoscope sealing left auricle.Avoid the defective of PLAATO device shutoff art and Amplazer shutoff umbrella simultaneously.
The object of the present invention is achieved like this: a kind of device of ligaturing left atrial appendage, comprise ligature, and be used for ligaturing left atrial appendage; Induction system is used for ligature is pre-formed kink;
And,
Above-mentioned induction system is used for ligature is pre-formed a kink, comprises the epitheca pipe, in the perforation hollow structure is arranged; Interior sheath pipe, in the perforation hollow structure is arranged, length is set slightly is longer than above-mentioned epitheca pipe, and can overlap and tap into above-mentioned epitheca pipe; Seal wire, setting is placed in the above-mentioned interior sheath pipe, and its front end is provided with an annulus, is used to guide above-mentioned ligature; The card medicated cap is provided with above-mentioned interior sheath pipe front end and is connected, and is used for fixing the kink of above-mentioned ligature formation.
Simultaneously,
Above-mentioned ligature is set to insert the biostable material of human body.
Above-mentioned ligature is set to politef or expanded polytetrafluoroethylsealing or polyester material and makes.
Above-mentioned ligature front end is provided with an annulus, and a segment length of close above-mentioned annulus is provided with some nodes greater than the ligature of left auricle outer perimeter.
Distance in above-mentioned some nodes between any two adjacent nodes equals or is a bit larger tham the diameter of above-mentioned ligature.
Above-mentioned interior sheath pipe is provided with one section external screw thread, and above-mentioned epitheca pipe is provided with one section female thread, is used for the two and is threaded.
The above-mentioned interior sheath pipe and the front end of epitheca pipe all are provided with one section step; The rear end is set to handle arrangement, conveniently to rotate and to grip; Above-mentioned external screw thread and female thread are separately positioned on the above-mentioned interior sheath pipe and the handle of epitheca pipe.
Above-mentioned card medicated cap is set to have the cap-like structure of a plurality of grooves, has at least one to be set to connect above-mentioned card medicated cap in above-mentioned a plurality of grooves; Above-mentioned card medicated cap and above-mentioned interior sheath pipe are by screw thread or screwed connection.
A kind of using method of device of ligaturing left atrial appendage comprises the steps:
A) with interior sheath pipe precession epitheca pipe, screwing in the interior sheath pipe in back has a bit of being exposed at outside the epitheca pipe;
B) annulus of ligature front end is put in the sheath pipe be exposed on outer a bit of of epitheca pipe;
C) will block medicated cap and be connected, and keep a through slot on the card medicated cap to aim at simultaneously with ligature with interior sheath pipe;
D) utilize seal wire will not have the other end of the ligature of annulus from interior sheath pipe, to pass, also just pass ligature front end annulus simultaneously, form kink;
E) utilize thoracoscope that the ligature kink is entangled the left auricle root, strain the ligature other end again with tight bundle ligaturing left atrial appendage.
Also comprise step simultaneously:
F) hold ligature and do not have in end of annulus and the reverse rotation sheath pipe with sheath pipe in withdrawing from and epitheca pipe;
G) cut unnecessary ligature.
Realize above-mentioned technical scheme, just can realize purpose of the present invention.Can little wound surface and low-risk effective ligaturing left atrial appendage, prevent that atrial fibrillation from causing that thrombosis comes off and the apoplexy that causes; Avoid the defective of PLAATO device shutoff art and Amplazer shutoff umbrella simultaneously.
Description of drawings
Fig. 1 is a left auricle apparatus for ligating sketch map;
Fig. 2 is the ligature sketch map;
Fig. 3 is a sheath pipe cutaway view;
Fig. 4 is sheath pipe front end partial structurtes sketch maps;
Fig. 5 is card cap sketch map;
Fig. 6 is the view of this device ligaturing left atrial appendage;
Fig. 7 is the block diagram of the method for use device of the present invention.
Specific embodiment
Describe preferred embodiment of the present invention in detail below in conjunction with accompanying drawing,, can clearerly find out and understand advantage of the present invention place by description to preferred embodiment of the present invention.
Fig. 1 shows left auricle apparatus for ligating of the present invention, mainly form by ligature 1, epitheca pipe 2, interior sheath pipe 3, seal wire 4 and card medicated cap 5, wherein ligature 1 is used for the ligaturing left atrial appendage opening, and induction system then can make ligature be pre-formed a kink.A lot of brief summary points 6 are arranged on the ligature 1, and screw thread 9 can be fixedly connected on card medicated cap 5 on the epitheca pipe 2.Wherein the effect of screw thread 9 also can be threaded alternative with the external screw thread of interior sheath pipe front end by the female thread of card medicated cap setting.The front end of seal wire 4 has an annulus, is placed in the interior sheath pipe 3.
For being placed on for a long time in the human body, ligature is the biostable material of human implantable preferably, makes as politef, expanded polytetrafluoroethylsealing or polyester material etc.
Fig. 2 is the structural representation of ligature 1, its front end has a small circle ring 7 and a lot of brief summary point 6, annulus 7 effects are when an end that does not have annulus 7 of ligature 1 passes from annulus 7, can form a kink, when kink entangles the left auricle root of wanting ligation, just can tighten up ligature 1 with tight bundle ligaturing left atrial appendage.Owing to there is node 6, thereby ligature 1 can not get loose after being locked.Slide for fear of being stuck in two ligatures 1 between the neighborhood of nodes 6, the distance of any two neighborhood of nodes is moderate, be preferably the diameter that equals or be slightly larger than ligature 1, so just can avoid ligature 1 between two nodes 6, to slide, prevent that ligation is not firm.The ligature segment length that will guarantee node 6 simultaneously will be equal to, or greater than the left auricle outer perimeter, so that make that annulus 7 can be stuck in node 6 places when ligature 1 tightened up.
Fig. 3 is inside and outside sheath pipe cutaway view, wherein interior sheath pipe 3 and epitheca pipe 2 all are that front end has one section step, end has the structure of handle, there is matching thread at two handle places, 3 precessions of sheath pipe or back-out epitheca pipe 2 in can making, and interior sheath pipe 3 will be longer than epitheca pipe 2 slightly, and sheath pipe 3 its front end when precession can expose sub-fraction from epitheca pipe 2 front ends in guaranteeing, is used for putting in advance the small circle ring 7 of ligature 1 front end.
Inside and outside sheath pipe front end partial structurtes sketch map as shown in Figure 4.
Fig. 5 is the structural representation of card medicated cap.Card medicated cap 5 is the structures with a plurality of grooves, and one of them groove connects.When the annulus 7 of ligature 1 front end entangles the interior sheath tube portion that exposes, will block medicated cap 5 this moment and buckle, and allow ligature 1 pass through through slot 8.On sheath pipe 3 front ends, can avoid annulus 7 to come off on the one hand in card medicated cap 5 is buckled in securely by screw thread or screw thread 9, can prevent that on the other hand card medicated cap 5 is fallen in the human body in the operation process.
As Fig. 6, show the state after the left auricle ligation.
As Fig. 7, use the method for device of the present invention, at first be step s10, with interior sheath pipe precession epitheca pipe,, make the interior sheath pipe in screw-in back have a bit of stretching out to be exposed at outside the epitheca pipe because the sheath length of tube is longer than the epitheca pipe in being provided with; Next is step s12, the sheath pipe exposed on a bit of outside the epitheca pipe in the annulus of ligature front end put, on the ligature of one section left auricle outer perimeter of close annulus some nodes are set on the ligature, and the distance between any two neighborhood of nodes equals or is slightly larger than the diameter of ligature; Being step s14 once more, will blocking medicated cap and be connected with interior sheath pipe, can be to be threaded, and also can be by connections such as screw threads, comes off to prevent annulus, and notes allowing the through slot on the card medicated cap aim at ligature; Next step is step s16, utilizes seal wire ligature not to be had an end of annulus pass from interior sheath pipe, has so also just passed the annulus of sheath pipe front end in being enclosed within, and has formed kink; At next step is step s18, open three holes at chest, one is used for device of the present invention is put into, one is used for tweezers and enters, one is used for thoracoscope and enters to observe, and by thoracoscope the ligature kink is enclosed within the root of left auricle then, and tightens up ligature with tight bundle left auricle, lock owing to ligature can be stuck in two little nodes on the ligature, thus ligation left auricle; Be step s20 then, tighten up ligature after, sheath pipe handle in the reverse rotation withdraws from inside and outside sheath pipe; Be step s22 at last, cut unnecessary ligature, finish the process of whole use device of the present invention.
Here it is to be noted: those of ordinary skill in the art can make various suitable distortion or replacement on basis of the present invention, but all these distortion or replacement all should belong to protection scope of the present invention.
Claims (8)
1, a kind of device of ligaturing left atrial appendage comprises ligature, is used for ligaturing left atrial appendage; Induction system is used for ligature is pre-formed kink;
Described induction system is used for ligature is pre-formed kink, comprises the epitheca pipe, in the perforation hollow structure is arranged; Interior sheath pipe, in the perforation hollow structure is arranged, length is set slightly is longer than described epitheca pipe, can overlap and tap into described epitheca pipe; Seal wire, setting are placed in the described interior sheath pipe, and its front end is provided with an annulus, is used to guide described ligature; The card medicated cap, setting is connected with described interior sheath pipe front end, is used for fixing the kink that described ligature forms.
2, the device of a kind of ligaturing left atrial appendage according to claim 1 is characterized in that described ligature is set to insert the biostable material of human body.
3, the device of a kind of ligaturing left atrial appendage according to claim 1 and 2 is characterized in that described ligature is set to politef or expanded polytetrafluoroethylsealing or polyester material and makes.
4, the device of a kind of ligaturing left atrial appendage according to claim 1 and 2 is characterized in that described ligature front end is provided with another annulus, and a segment length of close this another annulus is provided with some nodes greater than the ligature of left auricle outer perimeter.
5, the device of a kind of ligaturing left atrial appendage according to claim 4 is characterized in that the distance between any two adjacent nodes in described some nodes equals or be a bit larger tham the diameter of described ligature.
6, the device of a kind of ligaturing left atrial appendage according to claim 1 is characterized in that described interior sheath pipe is provided with one section external screw thread, and described epitheca pipe is provided with one section female thread, is used for the two and is threaded.
7,, it is characterized in that the front end of described interior sheath pipe and epitheca pipe all is provided with one section step according to the device of claim 1 or 6 described a kind of ligaturing left atrial appendages; The rear end is set to handle arrangement, conveniently to rotate and to grip; Described external screw thread and female thread are separately positioned on the handle of described interior sheath pipe and epitheca pipe.
8, the device of a kind of ligaturing left atrial appendage according to claim 1 is characterized in that described card medicated cap is set to have the cap-like structure of a plurality of grooves, has at least one to be set to connect described card medicated cap in described a plurality of grooves; Described card medicated cap and described interior sheath pipe are by screw thread or screwed connection.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB2006100603381A CN100453053C (en) | 2006-04-21 | 2006-04-21 | Device for ligaturing left atrial appendage and using method thereof |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB2006100603381A CN100453053C (en) | 2006-04-21 | 2006-04-21 | Device for ligaturing left atrial appendage and using method thereof |
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| Publication Number | Publication Date |
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| CN101057789A CN101057789A (en) | 2007-10-24 |
| CN100453053C true CN100453053C (en) | 2009-01-21 |
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| CNB2006100603381A Active CN100453053C (en) | 2006-04-21 | 2006-04-21 | Device for ligaturing left atrial appendage and using method thereof |
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Families Citing this family (10)
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| CN103300904B (en) * | 2013-06-19 | 2015-07-22 | 孔祥清 | Assistant intracardiac positioning device for ligaturing and closing left aurcle through epicardium at lower part |
| CN103462668B (en) * | 2013-09-13 | 2018-03-23 | 徐州亚太科技有限公司 | A kind of left auricle ligation device |
| JP6332998B2 (en) * | 2014-02-28 | 2018-05-30 | オリンパス株式会社 | Atrial ligation instrument |
| CN104939887B (en) * | 2014-03-28 | 2019-03-26 | 上海微创电生理医疗科技有限公司 | Pericardium endoscope, lasso trick device and heart left auricle of heart closed system |
| JP6345465B2 (en) * | 2014-03-31 | 2018-06-20 | オリンパス株式会社 | Atrial ligation instrument |
| CN104116574A (en) * | 2014-07-04 | 2014-10-29 | 先健科技(深圳)有限公司 | Plug and plugging device |
| CN104546039A (en) * | 2014-12-19 | 2015-04-29 | 山东博达医疗用品有限公司 | Endoscope loop line device for minimally invasive surgery |
| CN106137292B (en) * | 2015-04-10 | 2019-02-22 | 上海市同济医院 | A kind of device for left auricle of heart ligation operation |
| CN110786975B (en) * | 2018-08-03 | 2022-07-05 | 先健科技(深圳)有限公司 | Handle assembly of conveyor, conveyor and conveying system |
| CN115462856B (en) * | 2022-09-06 | 2023-04-25 | 南京鼓楼医院 | Left auricle ligator |
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| EP0628286B1 (en) * | 1993-06-07 | 1999-09-08 | Ethicon, Inc. | Endoscopic suturing device |
| JPH07328023A (en) * | 1994-06-14 | 1995-12-19 | Yuichi Matsuzawa | Ligating method for surgical suture and forceps body for surgical suture |
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| CN101057789A (en) | 2007-10-24 |
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