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).This patent pinprick gets out on needle main body, does 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 distal end is equiped 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 optionally 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; Said syringe needle can be processed (like rustless steel, rather than unmanageable Nitinol) with the metal that is prone to processing, is drilled with aperture on the syringe needle, is used to pass suture; The diameter of the other end of said syringe needle is slightly less than the internal diameter of said needle body, can be assembled to the said acra of said needle body or takes off from said needle body.
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, offer pinprick on the said syringe needle, so that suture therefrom passes and is linked on the said syringe needle.Further, the external diameter at the middle part of said syringe needle is greater than the internal diameter of said needle body, and, have descending tapering transition structure the blunt end from said middle part to said syringe needle; The said distal inner chamber of piped said needle body has the horn mouth structure that enlarges gradually from inside to outside, matches with said tapering transition structure, and when said needle body moved forward, said needle body can push said syringe needle and move forward together; When said needle body moves backward, if the frictional force that said syringe needle is organized or be held fixing, then said syringe needle and the disengaging of said needle body.Said tapering transition structure and said horn mouth structure can be taper seat, or are the curved surface that can coincide each other.
The present invention can be applicable to hard tube formula endoscope or hose type endoscope.
The present invention compared with prior art has the following advantages and effect:
The present invention is simple in structure; Control easy; Controlled being reduced to the motion of the complex space of tissue penetration from curved suture needle of design send pin mechanism that the straight line of needle body and syringe needle is pushed motion, can greatly simplify the overall difficulty of tissue apposition, and the syringe needle of separate type greatly facilitates the enforcement of knotting action.
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 a preferred embodiment of the present invention;
Fig. 4 is the three-dimensional view before syringe needle place embodiment illustrated in fig. 3 begins to puncture;
Fig. 5 is the internal structure sketch map of Fig. 4;
Fig. 6 is that syringe needle place embodiment illustrated in fig. 3 accomplishes the three-dimensional view when puncturing;
Fig. 7 is embodiment illustrated in fig. 3 behind the needle body retraction, the sketch map that syringe needle and needle body break away from;
Fig. 8 is the structural representation of another preferred embodiment of the present invention;
Fig. 9 and Figure 10 are the sectional perspective views that syringe needle embodiment illustrated in fig. 8 is in different visual angles.
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 syringe needle 10 is equipped with in its end; 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.
Referring to Fig. 5, have pinprick on the syringe needle 10, be convenient to suture and therefrom pass and be linked on the syringe needle 10.One end of syringe needle 10 puts the first edge on a knife or a pair of scissors and is the tip, with the puncture tissue; The other end of syringe needle 10 is a blunt end, and diameter is slightly less than the internal diameter of needle body 20, can be assembled on the needle body 20 or from needle body 20 and take off, to cooperate the needs of whole tissue penetration action.The external diameter at syringe needle 10 middle parts is greater than the internal diameter of needle body 20.Can be to have a shoulder between the middle part of syringe needle 10 and the blunt end, also can adopt pyramidal structure,, when needle body 20 moves forward, can push syringe needle 10 and move forward together with the tip engages of needle body 20; When needle body 20 moves backward, if the frictional force that syringe needle 10 is organized or when being held fixedly, will with needle body 20 disengagings.
The propelling movement length of sending pin mechanism 40 can independently control needle body 20 moves the axis direction of needle body 20 needle tubing 30 along the place 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, Fig. 6 and Fig. 7, specifically narrate implementation method of the present invention.
1. as shown in Figure 4, send pin mechanism 40 that needle body 20 is bounced back to place needle tubing 30 inside, another operating theater instruments (for example needle forceps) is filled to needle body 20 tops with syringe needle 10, and suture is attached on the syringe needle 10.With the needle outlet aligning internal organs of place needle tubing 30, the position that tissue needs stitching.
2. send pin mechanism 40 that needle body 20 associating syringe needles 10 are outwards released together.Needle body 20 is independently replied primary circular shape in the process that outwards discharges; Under the help of the blade of syringe needle 10, in tissue, pass with arc track, pass tissue from the opposite side that needs suture location.In this process, because suture is linked to syringe needle 10, suture is also brought to the opposite side that needs stitching, and is as shown in Figure 6.
3. another needle forceps is caught the syringe needle 10 that passes tissue.Send pin mechanism 40 that needle body 20 is bounced back to the outlet of place needle tubing 30, this moment, syringe needle 10 was pulled away from needle body 20, stayed and organized opposite side, and suture is also stayed the same side of syringe needle 10, and is as shown in Figure 7.This moment, needle forceps can be firmly grasped syringe needle 10, and suture was pulled on tissue.So far accomplishing primary structure penetrates.
4. can be filled to syringe needle for 10 times the top of needle body 20 with needle forceps, be returned to state shown in Figure 4, to carry out tissue penetration next time.
In Fig. 3~Fig. 7 of present embodiment, place needle tubing 30 is a straight tube-like.In other embodiments; Like Fig. 8~shown in Figure 10; Place needle tubing 30 ' also can be 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.