CN114948038B - A transcatheter minimally invasive blood vessel automatic anastomosis device - Google Patents

Abstract

The invention provides a device for automatic anastomosis of minimally invasive blood vessels through a catheter, which comprises: the blood vessel stitching instrument comprises a blood vessel stitching instrument, a loading sheath tube component, a protecting sheath tube component and a pushing rod component. A access sheath is provided during vascular surgery to configure an access passage through the wall of a host vessel. The protective sheath component is arranged on the channel sheath in a pluggable manner and is constructed as a protective channel for the access of surgical instruments and transplanted blood vessels. The loading sheath tube component is arranged on the protection sheath tube component in a pluggable manner, and the surgical instrument arranged on the loading sheath tube component is conveyed to the vascular surgery position through the protection channel formed by the protection sheath tube component. The blood vessel stitching instrument can be arranged at the end part of the loading sheath tube assembly in an opening and closing mode and is in transmission connection with the pushing rod assembly, the pushing rod assembly can be arranged on the loading sheath tube assembly in an inserting and pulling mode and drives the blood vessel stitching instrument to carry out stitching operation on the wall of a host blood vessel. The invention can reduce the difficulty of the vascular anastomosis operation and provide safer surgical operation conditions.

Description

A transcatheter minimally invasive blood vessel automatic anastomosis device

technical field

The invention relates to the technical field of surgical blood vessel suturing instruments, in particular to a transcatheter minimally invasive blood vessel automatic anastomosis device.

Background technique

Patients with myocardial ischemia need coronary artery bypass grafting. The general process is to connect a bridging blood vessel to the coronary artery in the epicardium, and then open a hole in the aorta, and connect the bridging blood vessel to the opening on the aorta. , so as to achieve a bypass between the coronary vessels and the aorta. This procedure generally involves cutting or puncturing the aortic vessel wall at the selected anastomotic site or site, and then suturing the bridging vessel around the perforation to establish fluid (blood) communication between the lumens of the two vessels. Due to the high blood pressure and fast flow in the aorta, opening a hole directly on the aorta will lead to massive bleeding. Therefore, in traditional coronary heart bypass grafting, it is necessary to first clamp a part of the aorta with a lateral clamp to isolate the aorta. A small section of aortic tissue with no blood flow is then used to punch a hole in the wall of the aorta in this section and complete the connection to the graft bypass vessel. However, for minimally invasive bypass surgery, the opening on the patient's body is small, the operating space is limited, and the volume of the lateral forceps is relatively large, which is extremely inconvenient and dangerous to use in minimally invasive cardiac surgery, resulting in the aorta. Perforation and anastomosis of grafted bypass vessels become difficult problems. Although there is a great deal of teaching and practice in the field of surgical vascular anastomosis, at least in view of the aforementioned problems associated therewith, there remains a need to develop and practice new instruments and improved methods for use in surgical vascular anastomosis procedures. Therefore, how to develop and practice the use of clampless instruments and methods to perform surgical vascular anastomosis, thereby improving the surgical procedure, has important research significance.

SUMMARY OF THE INVENTION

The invention provides a transcatheter minimally invasive blood vessel automatic anastomosis device, which solves the problems of high operation difficulty and high risk in surgical vascular anastomosis by using clamps to clamp host blood vessels to punch and suture graft bypass blood vessels, and can reduce the difficulty of vascular anastomosis operations , providing safer surgical conditions.

To achieve the above purpose, the present invention provides the following technical solutions:

A transcatheter minimally invasive blood vessel automatic anastomosis device, comprising: a blood vessel stapler, a loading sheath assembly, a protective sheath assembly and a push rod assembly;

Provision of a channel sheath during vascular surgery to be configured as an access channel through the host vessel wall;

The protective sheath tube assembly is releasably disposed on the channel sheath tube, and the protective sheath tube assembly is configured as a protective channel for the entry and exit of surgical instruments and grafted blood vessels;

The loading sheath tube assembly is releasably disposed on the protective sheath tube assembly, and the surgical instrument provided on the loading sheath tube assembly is delivered to the vascular surgery position through the protection channel formed by the protective sheath tube assembly ;

The vascular stapler can be opened and closed on the end of the loading sheath tube assembly, and is drive-connected with the push rod assembly, and the push rod assembly is releasably arranged on the loading sheath tube assembly, And drive the blood vessel stapler to operably suture the host blood vessel wall.

Preferably, it also includes: a suture needle;

The blood vessel stapler is provided with a suture needle, and when the push rod assembly drives the blood vessel stapler to open, the suture needle and the inner wall of the blood vessel are punctured at a set angle, and the blood vessel stapler can be operably controlled. The host vessel wall is sutured;

The suture needle is connected with a flexible suture, one end of the flexible suture is connected with the end of the suture needle, and the other end of the flexible suture is connected with the bypass vessel to be transplanted;

After suturing, the push rod assembly drives the vascular stapler to retract, so that the vascular stapler is received in the protective sheath assembly.

Preferably, the protective sheath tube assembly includes: a protective sheath tube, a first exhaust cap and a first exhaust valve;

The protective sheath is provided with a first guide through hole, and one end of the loading sheath is removably disposed in the protective sheath along the first guide through hole;

An end of one end of the protective sheath is adjustable and sleeved with the first exhaust cap to adjust the tightness of the protective sheath;

The first exhaust cap is provided with the first exhaust valve to discharge residual gas to the protective sheath.

Preferably, the loading sheath assembly includes: a loading sheath, a second exhaust cap and a second exhaust valve;

The loading sheath is provided with a second guide through hole, and one end of the push rod is removably disposed in the loading sheath along the second guide through hole;

An end of one end of the loading sheath is adjustable and sleeved with the second exhaust cap to adjust the tightness of the loading sheath;

The second exhaust cap is provided with the second exhaust valve to discharge residual gas to the loading sheath.

Preferably, the push rod assembly includes: a push rod and a push handle;

One end of the push rod is releasably disposed on the loading sheath, and the other end of the push rod is provided with a push handle.

Preferably, the vascular stapler includes: a puncture needle holder and a needle groove;

The lancet support includes: a first sliding cylinder, a second sliding cylinder and an expansion support; one end of the expansion support is connected with one end of the first sliding cylinder, and the other end of the expansion support is connected to the second sliding cylinder. One end of the sliding cylinder is connected, the first sliding cylinder is sleeved on the end of the push rod, and the second sliding cylinder is slidably arranged in the end of the loading sheath;

A plurality of the needle grooves are arranged around the expansion support, the needle body of the suture needle is inserted into the needle groove, and the needle tip of the suture needle points to the push rod for setting the push handle one end;

When the push rod is pushed forward along the loading sheath, the first sliding cylinder is driven away from the second sliding cylinder, so as to stretch the expansion stent, so that the expansion stent is contracted into a cylindrical structure;

When the push rod drives the first sliding cylinder to pull back in the direction of the second sliding cylinder, the expansion stent is subjected to a pressing force and opens according to a preset structure, so that many Each of the suture needles is uniformly distributed around the periphery of the end of the loading sheath tube.

Preferably, both sides of the first sliding cylinder are provided with first symmetrical through holes, and the first sliding cylinder is connected with the push rod pin shaft through the first symmetrical through holes;

Two sides of the second sliding cylinder are provided with second symmetrical through holes, and the second sliding cylinder is connected with the pin shaft of the end of the loading sheath through the second symmetrical through holes.

Preferably, the end of the push rod is provided with a sliding guide groove, and one end of the pin connecting the second sliding cylinder and the end of the loading sheath penetrates the sliding guide groove, so as to guide the push rod shaft. The sliding displacement and radial movement angle are defined.

Preferably, the expansion stent includes: a first wing frame, a second wing frame and a connecting frame;

The first wing frame and the second wing frame are of the same structure, and the first wing frame and the second wing frame are in a star-shaped structure when the first wing frame and the second wing frame are compressed, and each star triangle corresponds to the frame. The connecting frame is provided on the outer edge, and the first wing frame and the second wing frame are symmetrically connected through the connecting frame;

The first wing frame is connected with the first sliding cylinder, and the first wing frame shrinks into a cylindrical structure along the axial direction of the first sliding cylinder when subjected to tensile force;

The second wing frame is connected with the second sliding cylinder, and the second wing frame shrinks into a cylindrical structure along the axial direction of the second sliding cylinder when subjected to tensile force;

When the push rod drives the first sliding cylinder to slide, it drives the first wing frame and the second wing frame to expand or contract.

Preferably, the first wing frame includes: a first connecting part, a second connecting part and a varicose frame;

A plurality of the first connecting parts are evenly arranged on the circumference of the end of the first sliding cylinder, one end of the first connecting part is connected with the first sliding cylinder, and the other end of the first connecting part is connected with the first sliding cylinder. There are two varicose skeletons connected, and each varicose skeleton is connected with the varicose skeleton connected to the adjacent first connecting part. When the first wing frame is opened, two adjacent first A connecting part forms a rhombus structure with the varicose skeleton;

The second connecting portion is connected at the connection between the two varicose skeletons, and the second connecting portion is used to connect the connecting skeletons;

When the first wing frame is stressed, the first connecting portion and the second connecting portion are bent and deformed.

Preferably, the thickness and/or width of the first connecting portion and the second connecting portion are smaller than the varicose skeleton.

Preferably, the first connecting part and the second connecting part are made of memory metal material.

Preferably, the first wing frame and the second wing frame respectively use 8 of the first connection parts, 8 of the second connection parts and 16 of the varicose frame;

When the first wing frame and the second wing frame are unfolded, an octagonal star structure is formed.

Preferably, the expansion stent is an integral molding structure.

Preferably, the needle groove has a cylindrical structure, and an axial notch is provided on the side wall of the needle groove, and the axial notch is used for the passage of the suture needle and the flexible suture thread in and out.

Preferably, the needle groove is axially arranged on the connecting frame.

Preferably, the side wall of the needle groove is symmetrically provided with long notches, and the two sides of the connecting frame are provided with protrusions. When the needle groove is clamped on the connecting frame, the protrusions are clamped. in the long slot.

Preferably, it also includes: a cutting assembly;

The cutting assembly is releasably disposed on the protective sheath assembly, and is used to cut the anastomosis between the outer wall of the host blood vessel and the bypass vessel to be grafted after the blood vessel stapler enters the host blood vessel.

Preferably, the cutting assembly includes: a cutting catheter, a sleeve and a cutter head;

The cutting conduit is a hollow long tube, the tube sleeve is sleeved on the outer side wall of one end of the cutting guide tube, the cutter head is arranged on the sleeve sleeve, and the tip of the cutter head points to the edge of the cutting conduit. another side.

Preferably, the cutting catheter is provided with an axial opening for the passage of the suture needle and the flexible suture in and out.

The invention provides a transcatheter minimally invasive blood vessel automatic anastomosis device, wherein a loading sheath is releasably arranged on a protective sheath assembly, the end of the loading sheath assembly is provided with a blood vessel stapler, and the push rod assembly can be pulled out The device is inserted on the loading sheath tube assembly, so as to drive the blood vessel stapler to fit the bypass blood vessel to be grafted on the outer wall of the host blood vessel and perform suture. Solving the problems of difficult operation and high risk in surgical vascular anastomosis using clamps to clamp host blood vessels to punch and suture graft bypass vessels, it can reduce the difficulty of vascular anastomosis and provide safer surgical conditions.

Description of drawings

In order to illustrate the specific embodiments of the present invention more clearly, the accompanying drawings required in the embodiments will be briefly introduced below.

FIG. 1 is a schematic diagram of a transcatheter minimally invasive blood vessel automatic anastomosis device provided by the present invention.

FIG. 2 is a schematic cross-sectional view of FIG. 1 provided by the present invention.

FIG. 3 is a schematic view of the unfolding of an automatic anastomotic device provided by the present invention.

FIG. 4 is a schematic view of the contraction of an automatic anastomotic device provided by the present invention.

FIG. 5 is a schematic structural diagram of a blood vessel stapler provided by an embodiment of the present invention.

FIG. 6 is a schematic diagram of an installation structure of a blood vessel stapler provided by an embodiment of the present invention.

FIG. 7 is a schematic cross-sectional view of FIG. 6 according to an embodiment of the present invention.

FIG. 8 is a schematic structural diagram of a lancet holder provided by an embodiment of the present invention.

FIG. 9 is a schematic structural diagram of an expansion stent provided by an embodiment of the present invention.

FIG. 10 is a schematic diagram of the connection between the expansion stent and the connecting frame provided by the embodiment of the present invention.

FIG. 11 is a schematic front view of a needle groove provided by an embodiment of the present invention.

12 is a schematic top view of a needle groove provided by an embodiment of the present invention.

13 is a schematic cross-sectional view of a vascular stapler provided in an embodiment of the present invention in a contracted state.

FIG. 14 is a partial enlarged view of FIG. 13 provided by an embodiment of the present invention.

FIG. 15 is a schematic diagram of the shrinkage of the lancet support provided by the embodiment of the present invention.

FIG. 16 is a schematic side view of FIG. 15 according to an embodiment of the present invention.

FIG. 17 is a schematic structural diagram of the cutting assembly provided by the present invention.

FIG. 18 is a schematic cross-sectional view of FIG. 17 according to an embodiment of the present invention.

FIG. 19 is a schematic top view of FIG. 17 according to an embodiment of the present invention.

FIG. 20 is a schematic side view of FIG. 17 according to an embodiment of the present invention.

21 is a schematic cross-sectional view of the front end of the cutting catheter provided by the embodiment of the present invention.

Detailed ways

In order to enable those skilled in the art to better understand the solutions of the embodiments of the present invention, the embodiments of the present invention will be further described in detail below with reference to the accompanying drawings and embodiments.

Aiming at the problems of difficult operation and high risk of vascular anastomosis in the current surgical arterial bridging blood vessels using clamps to clamp the host blood vessels to punch and suture the graft bypass blood vessels, the present invention provides a transcatheter minimally invasive blood vessel automatic anastomosis device, which solves the problem of surgical operation. Vascular anastomosis using clamps to clamp the host vessel for perforating and suturing the grafted bypass vessel has the problems of difficult operation and high risk, which can reduce the difficulty of vascular anastomosis and provide safer surgical conditions.

As shown in FIGS. 1 to 21 , a transcatheter minimally invasive blood vessel automatic anastomosis device includes: a blood vessel stapler 100 , a loading sheath assembly 300 , a protective sheath assembly 400 and a push rod assembly 200 . A channel sheath is provided at the time of vascular surgery to configure an access channel through the host vessel wall. The protective sheath assembly 400 is releasably disposed on the channel sheath, and the protective sheath assembly 400 is configured as a protective channel for a surgical instrument and a graft vessel to enter and exit. The loading sheath assembly 300 is releasably disposed on the protective sheath assembly 400, and the surgical instrument provided on the loading sheath assembly is delivered to the blood vessel through the protective channel formed by the protective sheath assembly 400 surgical location. The vascular stapler 100 can be opened and closed at the end of the loading sheath tube assembly, and is drive-connected with the push rod assembly 200, and the push rod assembly 200 is releasably arranged on the loading sheath tube. assembly 300, and drive the blood vessel stapler 100 to operably suture the host blood vessel wall.

Specifically, during the vascular transplantation operation, firstly, the host blood vessel is punctured through the channel sheath, the loading sheath assembly sends the vessel stapler to the operating position through the protective channel formed by the protective sheath assembly, and the push rod assembly is driven and arranged on the loading sheath. The vascular stapler on the assembly penetrates the outer wall of the host blood vessel and enters the host blood vessel. The vascular stapler is operably controlled for expansion, penetration, suturing or retraction by the push rod assembly. After suturing, the push rod assembly drives the blood vessel stapler to retract, so that the blood vessel stapler is accommodated in the protective sheath tube assembly along with the loading sheath tube assembly. After the puncture of the blood vessel, due to the extensibility and tension of the outer wall of the blood vessel, the blood flow of the blood vessel is very small, and at the same time, the outer wall of the blood vessel is attached to the protective sheath assembly, and the blood will not overflow to the outside. Moreover, the vascular stapler is directly sent into the host blood vessel, and the vascular stapler is operated from the inside to the outside through the push rod assembly, which can solve the problem of surgical vascular anastomosis using clamps to clamp the host blood vessel for punching and suturing the graft bypass vessel, which is difficult and difficult to operate. The problem of high risk can reduce the difficulty of vascular anastomosis and provide safer surgical conditions.

As shown in FIG. 5 and FIG. 6 , the device further includes: a suture needle 500; the blood vessel stapler 100 is provided with a suture needle 500, and when the push rod assembly drives the blood vessel stapler to open, the suture needle is The vessel is punctured at a set angle with the inner wall of the blood vessel, and the vessel suturing device can be operably controlled to sew the host vessel wall. The suture needle 500 is connected with a flexible suture thread 700, one end of the flexible suture thread 700 is connected with the end of the suture needle 500, and the other end of the flexible suture thread 700 is connected with the bypass vessel to be transplanted. After suturing, the push rod assembly drives the vascular stapler to retract, so that the vascular stapler is received in the protective sheath assembly.

In practical applications, when the vascular stapler is opened, the needle tip of the suture needle is aligned with the inner wall of the host blood vessel, and when the push rod assembly is pulled, the vascular stapler is driven to pull back, so that the suture needle penetrates the blood vessel wall. The suture needle is removed from the vascular stapler, and the suture operation is performed. After suturing, the push rod assembly drives the vascular stapler to shrink, and pulls back the loading sheath, so that the vascular stapler is accommodated in the protective sheath assembly, and then withdrawn from the protective sheath. The device enables the suture needle to be punctured from the inside of the host blood vessel to the outside during the blood vessel suturing operation, which can reduce the difficulty of suturing and reduce the risk of surgical operation.

As shown in FIGS. 1 to 5 , the push rod assembly 200 includes a push rod 201 and a push handle 202 . One end of the push rod 201 is detachably disposed on the loading sheath 301 , and the other end of the push rod 201 is provided with a push handle 202 .

As shown in FIGS. 1 to 4 , the loading sheath assembly 300 includes a loading sheath 301 , a second exhaust cap 303 and a second exhaust valve 302 . The loading sheath 301 is provided with a second guide through hole, and one end of the push rod 201 is detachably provided in the loading sheath 301 along the second guide through hole. An end of one end of the loading sheath 301 is adjustably sleeved with the second exhaust cap 303 to adjust the air pressure in the loading sheath. The second exhaust cap 303 is provided with the second exhaust valve 302 to perform pressure relief adjustment on the loading sheath.

Further, as shown in FIGS. 1 to 4 , the protective sheath tube assembly 400 includes: a protective sheath tube 401 , a first exhaust cap 403 and a first exhaust valve 402 . The protective sheath 401 is provided with a first guide through hole, and one end of the loading sheath 301 is removably disposed in the protective sheath 401 along the first guide through hole. An end of one end of the protective sheath 401 is adjustably sleeved with the first exhaust cap 403 to adjust the air pressure in the protective sheath. The first exhaust cap 403 is provided with the first exhaust valve 402 to perform pressure relief adjustment on the protective sheath.

Specifically, the loading sheath is removably provided in the protective sheath, and the push rod is removably provided in the loading sheath. The blood vessel stapler is openably and closably disposed at the end of the loading sheath and is drive-connected with the push rod. The blood vessel stapler is used for operatively connecting the graft bypass blood vessel to the host blood vessel for suture. The blood vessel stapler is provided with a suture needle, and after the blood vessel stapler passes through the anastomosis hole, the push rod drives the blood vessel stapler to open, so that the suture needle and the inner wall of the blood vessel form a set angle puncture, and then operably control the vessel stapler to fit the bypass vessel to be grafted on the outer wall of the host vessel to perform suturing. After suturing, the push rod drives the vascular stapler to retract, so that the vascular stapler is accommodated in the loading sheath.

Further, as shown in FIG. 5 , the suture needle 500 is connected with a flexible suture thread 700, and one end of the flexible suture thread 700 is connected to the end of the suture needle 500 through the second guide through hole. The other end of the suture 700 is connected to the bypass vessel to be transplanted.

Specifically, the protective sheath adopts a tubular structure, the first guide through hole is a circular through hole, the size of the vascular stapler and the loading sheath is smaller than that of the first guide through hole, and can be pulled back and forth along the first guide through hole. . During vascular transplantation, the puncture device punctures the outer wall of the host blood vessel through the first guide through hole in the protective sheath, and after the puncture hole is formed, the loading sheath and the vascular stapler slide along the first guide and pass through the puncture hole into the host's blood vessels. The push rod pushes the vascular stapler to open, so that the suture needle is at a certain angle with the inner wall of the blood vessel, wherein the needle of the suture needle points to the inner wall of the host blood vessel, and then pulls the vascular stapler, so that the suture needle penetrates the inner wall of the host blood vessel, and the operator pulls the suture needle, Stress the suture and pull the bypass vessel to be transplanted to slide along the first guide through hole of the protective sheath, so that the connecting mask of the bypass vessel to be transplanted surrounds the puncture hole and fits the host vessel, and then passes through the puncture hole. Suture needle for suture. After suturing, the push rod pushes the vascular stapler to contract, so that the vascular kiss protector is accommodated in the protective sheath, and then moved out of the body, and then the protective sheath is removed to complete the anastomosis operation. The device can solve the problems of difficult operation and high risk in surgical vascular anastomosis by using clamps to clamp host blood vessels to punch holes and suture graft bypass vessels, reduce the difficulty of vascular anastomosis and provide safer surgical conditions.

In one embodiment, as shown in FIGS. 5 to 10 , the vascular stapler 100 includes: a lancet holder 110 and a needle slot 120 . The lancet holder 110 includes: a first sliding cylinder 111 , a second sliding cylinder 112 and an expansion bracket 113 ; one end of the expansion bracket 113 is connected to one end of the first sliding cylinder 111 , and the expansion bracket 113 is The other end is connected to one end of the second sliding cylinder 112, the first sliding cylinder 111 is sleeved on the end of the push rod 201, and the second sliding cylinder 112 is slidably arranged on the loading rod 201. inside the end of the sheath 301 .

A plurality of the needle grooves are arranged around the expansion bracket 113 , the needle body of the suture needle 500 is inserted into the needle groove 120 , and the needle tip of the suture needle 500 is directed to the push rod 201 . one end of the push handle.

When the push rod 201 is pushed forward along the loading sheath 301 , the first sliding cylinder 111 is driven away from the second sliding cylinder 112 to stretch the expansion stent 113 and make the expansion stent 113 The shrinkage is cylindrical.

When the push rod 201 drives the first sliding cylinder 111 to pull back in the direction of the second sliding cylinder 112 , the expansion stent 113 is subjected to a pressing force and expands according to a preset structure, so that the stent 113 arranged in the expansion The plurality of suture needles 500 on the bracket 113 are uniformly distributed around the periphery of the end of the loading sheath 301 in a ring shape.

Further, first symmetric through holes 114 are provided on both sides of the first sliding cylinder 111 , and the first sliding cylinder 111 is pin-connected to the push rod 201 through the first symmetric through holes 114 .

Two sides of the second sliding cylinder 112 are provided with second symmetrical through holes 115 , and the second sliding cylinder 112 is pin-connected to the end of the loading sheath 301 through the second symmetrical through holes 115 .

Further, the end of the push rod 201 is provided with a sliding guide groove 205, and one end of the pin connecting the second sliding cylinder 112 with the end of the loading sheath 301 penetrates the sliding guide groove 205, so that the The axial sliding displacement and radial movement angle of the push rod are limited.

In practical applications, as shown in FIGS. 6 to 8 , when the lancet holder is in the open state, the first and second slidable cylinders 111 and 112 at both ends of the lancet holder 110 are respectively provided with a first symmetrical through hole 114 and a second symmetrical through hole 114 . The through hole 115 and the front end of the push rod 201 are provided with a sliding guide groove 205 , and the length m of the sliding guide groove is greater than the distance required for the lancet holder to be retracted. The front end of the lancet holder 110 and the front end of the push rod 201 are fixed (riveted, welded, glued, etc.) together through the first pin shaft 203 and the shaft sleeve. The inner side of the rear end of the lancet holder is matched with the sliding guide groove 205 of the push rod 201 through the second pin shaft 204, and the outer side is fixed with the front end of the transfer sheath. By moving the push rod 201, the lancet holder 110 can be expanded and contracted, and the second pin shaft 204 can also prevent the lancet holder 110 from being deformed from rotation.

As shown in FIGS. 5-9 , the expansion stent 113 includes: a first wing frame 1131 , a second wing frame 1132 and a connecting frame 1133 . The first wing frame 1131 and the second wing frame 1132 are of the same structure. When the first wing frame 1131 and the second wing frame 1132 are compressed, they form a star-shaped structure. The connecting frame 1133 is disposed on the outer edge of the triangular corresponding frame, and the first wing frame 1131 and the second wing frame 1132 are symmetrically connected through the connecting frame 1133 . The first wing frame 1131 is connected to the first sliding cylinder 111 , and the first wing frame 1131 shrinks into a cylindrical structure along the axial direction of the first sliding cylinder 111 when being stretched. The second wing frame 1132 is connected to the second sliding cylinder 112 , and the second wing frame 1132 shrinks into a cylindrical structure along the axial direction of the second sliding cylinder 112 when being stretched. When the push rod 201 drives the first sliding cylinder 111 to slide, the first wing frame 1131 and the second wing frame 1132 are driven to expand or contract.

As shown in FIGS. 7-8 , in the expanded state of the lancet stent, the first sliding cylinder 111 and the second sliding cylinder 112 at both ends are connected to the expansion stent 113 in the middle, forming a whole. The two sides of the expansion stent 113 in the middle are formed by connecting multiple groups of diamond structures, which makes the stent have stable radial support force.

In one embodiment, as shown in FIG. 9 , the first wing frame 1131 includes: a first connecting portion 11311 , a second connecting portion 11312 and a varicose frame 11313 . A plurality of the first connecting parts 11311 are evenly arranged on the circumference of the end of the first sliding cylinder 111, one end of the first connecting parts 11311 is connected with the first sliding cylinder 111, and the first connection The other end of the portion 11311 is connected with two varicose frames 11313, each of the varicose frames 11313 is connected to the varicose frame 11313 connected to the adjacent first connecting portion 11311, and the first wing frame When the 1131 is opened, two adjacent first connecting portions 11311 and the varicose skeleton 11313 form a diamond-shaped structure. The second connecting portion 11312 is connected at the connection between the two varicose frames 11313 , and the second connecting portion 11312 is used to connect the connecting frame 1133 . When the first wing frame 1131 is stressed, the first connecting portion 11311 and the second connecting portion 11312 are bent and deformed.

Further, as shown in FIG. 10 , the thickness and/or width of the first connecting portion 11311 and the second connecting portion 11312 are smaller than those of the flexural frame 11313, so that when the first wing frame is subjected to a compressive force, The first connecting portion and the second connecting portion are first bent and deformed, and then opened according to a preset structure. Correspondingly, when the first wing frame is stretched, the first connecting portion and the second connecting portion return to their original state, so that the first wing frame is accommodated into a cylindrical structure.

Further, the first connecting part and the second connecting part are made of memory metal material.

Further, the first wing frame and the second wing frame respectively use 8 of the first connection parts, 8 of the second connection parts and 16 of the varicose skeletons. When the first wing frame and the second wing frame are unfolded, an octagonal star structure is formed.

Further, the lancet holder is an integral molding structure. In practical applications, the lancet support can be integrally formed with a tubular material, and has a cylindrical structure when it is contracted, and a star structure when it is expanded.

Further, as shown in FIG. 3 and FIG. 13 , in order to protect the blood vessel stapler from touching the inner wall of the blood vessel and causing damage to the blood vessel, a soft rubber head 600 can be provided at the end of the blood vessel stapler, and the soft rubber head is arranged on the first The end of the sliding cylinder 111 can be fixed by bonding.

As shown in FIGS. 11 and 12 , the needle slot 120 has a cylindrical structure, and the side wall of the needle slot 120 is provided with an axial gap 123 , and the axial gap 123 is used for the suture needle and the flexible suture Line in and out of the operating channel.

Further, the needle groove 120 is axially arranged on the connecting frame 1133 .

In one embodiment, the side wall of the needle slot 120 is symmetrically provided with long slots 121, and the two sides of the connecting frame are provided with protrusions. When the needle slot 120 is clamped on the connecting frame 1133 , the protrusion is clamped in the long slot 121 .

In practical application, the lower part of the needle groove 120 is provided with two long notches 121 . The protrusions on both sides of the connecting frame 1133 of the expansion stent in the middle are matched with the long notch, so that the needle groove 120 and the puncture needle support 110 are snap-fastened together. Of course, other methods can also be used for connection, such as welding or plugging.

The upper part of the needle tube is provided with an axial notch 123, and the axial notch 123 can make the needle groove 120 have a certain elasticity. The suture needle 500 and the suture thread 700 can be stably connected in the needle groove 120 through the axial gap 123, and are also easy to be pulled out and inserted. The back of the needle tube is provided with an open groove 122, the open groove 122 makes the back of the needle groove 120 have elasticity, which can facilitate extrusion deformation and prevent the puncture needle from being displaced or dislodged from the back of the needle tube.

Further, the device further includes: a cutting assembly; the cutting assembly is releasably disposed on the protective sheath assembly, and is used for bypassing the outer wall of the host blood vessel and the to-be-grafted blood vessel after the blood vessel stapler enters the host blood vessel. The anastomotic part of the blood vessel is cut open.

As shown in FIGS. 17-21 , the cutting assembly includes: a cutting catheter 800 , a sleeve 810 and a cutter head 900 . The cutting catheter 800 is a long hollow tube, a sleeve 810 is sleeved on the outer side wall of one end of the cutting catheter 800, the cutter head 900 is arranged on the sleeve 810, and the cutter head 900 The tip points to the other end of the cutting catheter.

During a blood vessel transplantation operation, one end of the cutting catheter 800 penetrates the channel sheath to send the cutter head into the host blood vessel, and after the wall of the bypass vessel to be transplanted is attached to the inner wall of the host blood vessel, the cutting is pulled back. A catheter, which drives the cutter head to pierce the wall of the host blood vessel from the inside out, and rotates the cutting catheter, so that the cutter head cuts a circular hole on the wall of the host blood vessel isolated by the bypass blood vessel to be transplanted as a bleeding hole of the host blood vessel, Then, the bypass vessel to be grafted is connected to the bleeding hole on the host vessel wall through a flexible suture.

Specifically, the cutting catheter is a long hollow tube, and the grafted blood vessel and the flexible suture are passed through the cutting catheter. After cutting the catheter, the flexible suture, and the bypass blood vessel to be transplanted together from the channel sheath into the host blood vessel, the channel sheath is withdrawn from the host blood vessel. The cutting catheter moves the cutter head into the host vessel wall while the remainder remains outside the host vessel wall. Tightening the flexible suture drives the wall of the blood vessel to be transplanted to fit with the inner wall of the host blood vessel to achieve hemostasis and isolation. The cutting catheter is pulled back, and the tip of the cutter head at the end of the cutting catheter pierces the host vessel wall from the inside to the outside. Rotate the cutting catheter, so that the cutter head cuts a round hole in the host blood vessel wall isolated by the grafted blood vessel as a bleeding hole of the host blood vessel. At this time, the cutting assembly is removed, and the grafted blood vessel is connected to the host blood vessel wall by knotting a flexible suture. round hole.

Further, the cutting catheter 800 is provided with an axial opening for the passage of the suture needle and the flexible suture in and out.

In practical applications, the cutting catheter is composed of a catheter 800 , a sleeve 810 and a pin 820 . The cutting catheter is integrally provided with an axial opening of A°, including both the catheter and the front-end sleeve having an opening of A°.

A boss 811 is provided at the place where the cutting knife is installed on the pipe sleeve, and a slot 901 is provided at the handle of the cutter head 900 . Through the cooperation of the boss 811 with the slot 901, the cutting knife and the sleeve are snapped together.

The sleeve 810 and the catheter 800 are provided with a through hole, and the pin 820 is fixed at the through hole, so that the position of the sleeve and the catheter is fixed. At the same time, the cutting blade is provided with a bidirectional blade 902, which can realize bidirectional cutting.

It can be seen that the present invention provides a transcatheter minimally invasive blood vessel automatic anastomosis device. A loading sheath is set in the protective sheath, the end of the loading sheath is provided with a vascular stapler, and a push rod is releasably arranged on the loading sheath. inside the sheath to drive the blood vessel stapler to open or contract, so that the suture needle provided on the blood vessel stapler is punctured and sutured at a set angle to the inner wall of the blood vessel. Solving the problems of difficult operation and high risk in surgical vascular anastomosis using clamps to clamp host blood vessels to punch and suture graft bypass vessels, it can reduce the difficulty of vascular anastomosis and provide safer surgical conditions.

The structure, features and effects of the present invention have been described in detail above according to the embodiments shown in the drawings. The above descriptions are only the preferred embodiments of the present invention, but the scope of the present invention is not limited by the drawings. Changes made to the concept of the present invention, or modifications to equivalent embodiments with equivalent changes, shall fall within the protection scope of the present invention as long as they do not exceed the spirit covered by the description and drawings.

Claims (11)

1. A transcatheter minimally invasive vascular automatic anastomosis device, comprising: the device comprises a blood vessel stitching instrument, a loading sheath tube assembly, a protecting sheath tube assembly, a stitching needle and a push rod assembly;

providing a access sheath during a vascular procedure to construct an access passage through a wall of a host vessel;

the protective sheath assembly is arranged on the channel sheath in a pluggable manner, and is constructed as a protective channel for the entry and exit of surgical instruments and transplanted blood vessels;

the loading sheath tube assembly is arranged on the protection sheath tube assembly in a pluggable manner, and a surgical instrument arranged at the end part of the loading sheath tube is conveyed to a vascular surgery position through a protection path formed by the protection sheath tube assembly;

the vessel stitching instrument is openably and closably arranged at the end part of the loading sheath tube assembly and is in transmission connection with the pushing rod assembly, and the pushing rod assembly is arranged on the loading sheath tube assembly in a pluggable way and drives the vessel stitching instrument to operatively stitch the vessel wall of the host;

the blood vessel stitching instrument is provided with a stitching needle, when the pushing rod assembly drives the blood vessel stitching instrument to open, the stitching needle is punctured at a set angle with the inner wall of the blood vessel, and the blood vessel stitching instrument is controlled to carry out stitching operation on the wall of the blood vessel of a host in an operable manner;

the suture needle is connected with a flexible suture line, one end of the flexible suture line is connected with the end part of the suture needle, and the other end of the flexible suture line is connected with a bypass blood vessel to be transplanted;

after suturing, the pushing rod assembly drives the vascular suturing device to retract so that the vascular suturing device is received in the protective sheath assembly;

the push rod assembly includes: a push rod and a push handle;

one end of the pushing rod is arranged on the loading sheath tube in a pluggable manner, and the other end of the pushing rod is provided with a pushing handle;

the loading sheath assembly comprises: the loading sheath, the second exhaust cap and the second exhaust valve;

a second guide through hole is formed in the loading sheath tube, and one end of the push rod is arranged in the loading sheath tube along the second guide through hole in a pluggable manner;

the end part of one end of the loading sheath tube is adjustably sleeved with the second exhaust cap so as to adjust the tightness of the loading sheath tube;

the second exhaust cap is provided with the second exhaust valve so as to discharge residual gas to the loading sheath pipe;

the protective sheath assembly comprises: the protective sheath pipe, the first exhaust cap and the first exhaust valve;

a first guide through hole is formed in the protection sheath tube, and one end of the loading sheath tube is arranged in the protection sheath tube along the first guide through hole in a pluggable manner;

the end part of one end of the protective sheath tube is adjustably sleeved with the first exhaust cap so as to adjust the tightness of the protective sheath tube;

the first exhaust valve is arranged on the first exhaust cap to exhaust residual gas of the protective sheath pipe;

the blood vessel stitching instrument comprises: a needle holder and a needle slot;

the lancet holder comprises: the expansion bracket comprises a first sliding barrel, a second sliding barrel and an expansion bracket; one end of the expansion bracket is connected with one end of the first sliding barrel, the other end of the expansion bracket is connected with one end of the second sliding barrel, the first sliding barrel is sleeved at the end of the pushing rod, and the second sliding barrel is slidably arranged in the end of the loading sheath tube;

the needle grooves are arranged on the expansion bracket in a surrounding manner, the needle body part of the suture needle is inserted into the needle grooves, and the needle tip part of the suture needle points to one end of the push rod, which is provided with the push handle;

when the pushing rod is pushed forwards along the loading sheath tube, the first sliding barrel is driven to be away from the second sliding barrel so as to stretch the expanded stent, and the expanded stent is contracted into a cylindrical structure;

when the pushing rod drives the first sliding barrel to pull back towards the second sliding barrel, the expansion bracket is extruded and opened according to a preset structure, so that the plurality of suture needles arranged on the expansion bracket are uniformly distributed on the periphery of the end part of the loading sheath pipe in an annular shape;

two sides of the first sliding barrel are provided with first symmetrical through holes, and the first sliding barrel is connected with the push rod through the first symmetrical through holes in a pin shaft manner;

second symmetrical through holes are formed in two sides of the second sliding barrel, and the second sliding barrel is connected with the end part of the loading sheath pipe through a pin shaft through the second symmetrical through holes;

the end part of the pushing rod is provided with a sliding guide groove, and one end of a pin shaft, connected with the end part of the loading sheath tube, of the second sliding cylinder penetrates through the sliding guide groove so as to limit the axial sliding displacement and the radial movable angle of the pushing rod;

the expanding stent comprises: the wing frame comprises a first wing frame, a second wing frame and a connecting framework;

the first wing frame and the second wing frame are of the same structure, the first wing frame and the second wing frame are in a star-shaped structure when subjected to extrusion force, the connecting framework is arranged on the outer edge of the framework corresponding to each star triangle, and the first wing frame and the second wing frame are symmetrically connected through the connecting framework;

the first wing frame is connected with the first sliding barrel, and the first wing frame contracts into a barrel-shaped structure along the axial direction of the first sliding barrel when being pulled;

the second wing frame is connected with the second sliding cylinder, and the second wing frame is contracted into a cylindrical structure along the axial direction of the second sliding cylinder when being subjected to tensile force;

when the pushing rod drives the first sliding cylinder to slide, the first wing frame and the second wing frame are driven to expand or contract;

the first wing frame includes: the first connecting part, the second connecting part and the varicose framework are arranged;

the first connecting parts are uniformly arranged on the circumference of the end part of the first sliding barrel, one end of each first connecting part is connected with the first sliding barrel, the other end of each first connecting part is connected with two curved framework, each curved framework is connected with the curved framework connected with the adjacent first connecting part, and when the first wing frame is unfolded, the adjacent two first connecting parts and the curved frameworks form a diamond structure;

the second connecting part is connected to the joint of the two curved frameworks and is used for connecting the connecting frameworks;

when the first wing frame is stressed, the first connecting part and the second connecting part are subjected to bending deformation.

2. The device according to claim 1, wherein the first and second connection portions have a thickness and/or width smaller than the varicose frame.

3. The automatic transcatheter minimally invasive vascular anastomosis device according to claim 2, wherein said first connection portion and said second connection portion are made of a memory metal material.

4. The automated transcatheter minimally invasive vascular anastomosis device according to claim 3, wherein said first and second limbs employ 8 of said first connectors, 8 of said second connectors, and 16 of said curved scaffolds, respectively;

the first wing frame and the second wing frame are in an octagonal star structure when being opened.

5. The device for automatic anastomosis of transcatheter minimally invasive blood vessels according to claim 4, wherein the stent is of an integrally formed structure.

6. The automatic transcatheter minimally invasive vascular anastomosis device according to claim 5, wherein the needle slot is of a cylindrical structure, and the side wall of the needle slot is provided with an axial slit for passing the suture needle and the flexible suture thread in and out of the operation channel.

7. The automatic transcatheter minimally invasive vascular anastomosis device according to claim 6, wherein said needle slot is axially disposed on said connection scaffold.

8. The automatic transcatheter minimally invasive vascular anastomosis device according to claim 7, wherein the side walls of the needle groove are symmetrically provided with long notches, the two sides of the connecting framework are provided with protrusions, and when the needle groove is clamped on the connecting framework, the protrusions are clamped in the long notches.

9. The automatic transcatheter minimally invasive vascular anastomosis device according to claim 1, further comprising: a cutting assembly;

the cutting assembly is arranged on the protective sheath assembly in a pluggable manner and is used for cutting the opening of the anastomotic part of the outer wall of the host blood vessel and the bypass blood vessel to be transplanted after the blood vessel stitching instrument enters the host blood vessel.

10. The automated transcatheter minimally invasive vascular anastomosis device according to claim 9, wherein said cutting assembly comprises: cutting the guide pipe, the pipe sleeve and the cutter head;

the cutting guide pipe is a hollow long pipe, the pipe sleeve is sleeved on the outer side wall of one end of the cutting guide pipe, the cutter head is arranged on the pipe sleeve, and the cutter point of the cutter head points to the other end of the cutting guide pipe.

11. The automated transcatheter minimally invasive vascular anastomosis device according to claim 10, wherein said cutting catheter is provided with an axial opening for access to said suture needle and said flexible suture.

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