Tubular knot-tying device

Abstract

Disclosed in the present invention is a tubular knotting device, which comprises a hollow operating member and a suture thread penetrating through the operating member. One end of the suture thread is wound around an outer surface of the operating member to form a pre-tied knot and a knotting thread segment located between the operating member and the pre-tied knot. When the tubular knotting device is not in use, the knotting thread segment abuts against the outer surface of the operating member in a length direction.

Description

FIELD OF INVENTION

[0001] The present invention relates to a knot-tying device for suturing, and more particularly to a tubular knot-tying device. BACKGROUND OF THE INVENTION

[0002] With the continuous advancement of modern medical technology, surgical procedures have increasingly been required to be performed with small incisions or by minimally invasive approaches. Such approaches not only facilitate rapid and effective wound recovery, but also help reduce and improve postoperative scarring. In the prior art, when a surgeon intends to suture a wound, a suture needle carrying a thread is typically held by hand to stitch and draw together tissues on both sides of the wound, and a fixed knot is then formed to secure the end of the thread.

[0003] However, in the foregoing prior art, the formation of the fixed knot relies on the surgeon manually wrapping and tying the thread by hand. The knot-tying process is complicated, and in current minimally invasive surgical procedures, factors such as the location of the wound or limited operative space often hinder the hand movements required to wrap the thread, thereby resulting in poor knot quality. If multiple fixed knots are formed at the wound one by one using the above-described knot-tying approach, not only is the overall procedure time-consuming and inefficient, but improper tying of the fixed knots may also cause the wound to reopen, adversely affecting the recovery of the patient. SUMMARY OF THE INVENTION

[0004] To overcome the drawbacks of conventional knotting techniques in surgical wound closure, which require repeatedly forming multiple fixed knots along the wound and result in prolonged and inefficient surgical time and potentially compromising patient recovery due to insufficiently secured knots, the present invention provides a tubular knotting device, including an operation member having a distal end and a proximal end defined at opposite ends along a longitudinal direction, and a hollow through-hole extending through the operation member along the longitudinal direction, and a distal opening and a proximal opening formed at the distal end and at the proximal end of the operation member respectively, and a suture threaded through the hollow through-hole, at least a portion of the suture protruding from the distal opening and being wound around an outer surface of the operation member to form a pre-tied knot, and a knotting segment positioned between the distal opening and the pre-tied knot, and at least a portion of the suture protruding from the proximal end includes an operation structure, and a maximum outer diameter of the operation structure is larger than the diameter of the hollow through-hole.

[0005] Wherein, when the tubular knot-tying device is not in use, the knotting segment abuts against the outer surface of the operation member along the longitudinal direction, and when the tubular knot-tying device is to be used, the pre-tied knot slides toward the distal end of the operation member, such that the knotting segment is separated from the outer surface and together with the outer surface forms a threading gap.

[0006] Wherein, the operation member comprises a small-diameter portion adjacent to the proximal end, and the suture is movably passable through a diameter defined by the small-diameter portion within the hollow through-hole.

[0007] Wherein, the suture forms a stopper structure at the distal end of the smalldiameter portion, the stopper structure being movable within the hollow through-hole, and a stopper diameter defined by the stopper structure being greater than the diameter defined by the small-diameter portion.

[0008] Wherein, when the tubular knot-tying device is not in use, the operation structure abuts against the proximal opening.

[0009] Wherein, the operation member adjacent to the distal end on the outer surface includes an indicator mark, and when the tubular knot-tying device is to be used, the pre-tied knot is displaced to the indicator mark.

[0010] Wherein, the distance between the indicator mark and the distal opening is between 1.5 and 3 mm.

[0011] When the tubular knot-tying device is not in use, the interface formed by the contact between the knotting segment and the outer surface along the longitudinal direction generates a static friction force, which can simultaneously prevent the operation structure from disengaging from the proximal opening, thus establishing a structural balance between the operation member and the suture when the tubular knottying device is not in use.

[0012] When the tubular knot-tying device is to be used, the pre-knot is slid toward the distal end of the operation member. At this time, the knotting segment separates from the outer surface, and together with the outer surface forms the threading gap. At this moment, the static friction generated at the interface where the knotting segment contacts the outer surface disappears, completing the pre-use preparation of the tubular knot-tying device.

[0013] When the tubular knot-tying device is to be used, the indicator mark serves to guide the pre-tied knot to be moved to the position of the indicator mark, so as to ensure that the pre-tied knot can be adjusted to a preferred operating position. This avoids situations in which the pre-tied knot is too far from the distal end of the operation member, making it difficult to disengage the pre-tied knot from the operation member, or in which the pre-tied knot is too close to the distal end of the operation member, thus being prone to unintended premature slipping off the operation member due to accidental contact.

[0014] The provision of the sliding section helps to reduce a reaction force generated when, after the pulling force applied in the direction of the suture needle disappears, the pre-tied knot disengages from the operation member toward the distal end due to a pulling force of the suture toward the proximal end, thus preventing the reaction force from affecting the suture site and causing secondary injury to the suture site or even suture failure.

[0015] The tubular knot-tying device provided by the present invention has a simple structure, which is not only easy to manufacture but also allows miniaturization. In addition, it overcomes the problem in conventional surgical suturing techniques where knots of different sutures are prone to loosening, making it suitable for use in minimally invasive surgeries such as laparoscopy or Da Vinci robotic surgeries. BRIEF DESCRIPTION OF THE DRAWINGS

[0016] Figure 1A is a schematic diagram of a first state of a preferred embodiment of the present invention; Figure 1B is a schematic diagram of a second state of a preferred embodiment of the present invention; Figure 2 is an exploded view of a preferred embodiment of the present invention; Figures 3A to 3D are step diagrams illustrating the usage state of a preferred embodiment of the present invention; Figure 4 is a partially enlarged view of a second preferred embodiment of the present invention; Figure 5 is a perspective sectional view of a third preferred embodiment of the present invention; Figure 6 is a partially enlarged view of a fourth preferred embodiment of the present invention; Figure 7 is a partially enlarged view of a fifth preferred embodiment of the present invention; Figure 8A is a partially enlarged view of a sixth preferred embodiment of the present invention; Figure 8B is a partially enlarged view of a seventh preferred embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0017] With reference to Figures 1A to 2, a preferred embodiment of the tubular knot-tying device provided by the present invention includes an operation member 10 and a suture 20. The operation member 10 is defined at its two ends along the longitudinal direction as a distal end 11 and a proximal end 12, and includes a hollow through-hole 13 extending along the longitudinal direction of the operation member 10, such that the operation member 10 forms a distal opening 131 at the distal end 11 and a proximal opening 132 at the proximal end 12. In one embodiment, the distance between the distal opening 131 and the proximal opening 132 is at least 9 mm.

[0018] In another embodiment, the operation member 10 is made of a material having hardness, such as a metal material or a high-hardness polyethylene (PE) or polyether ether ketone (PEEK).

[0019] In embodiments corresponding to Figures 6 to 8, at least a portion of the operation member 10 adjacent to the distal end 11 has deformability. The deformability can be achieved either through the use of a flexible material or a deformable structure.

[0020] The flexible material is preferably selected from thermoplastic elastomer (TPE), polyvinyl chloride (PVC), polytetrafluoroethylene (PTFE), or thermoplastic polyurethane (TPU).

[0021] The deformable structure can be achieved through structural design. For example, the operation member 10 may be formed as a tubular member woven from multiple metal wires 16, with gaps between adjacent metal wires 16. When the operation member 10 is subjected to radial pressure, an adjustable outer diameter effect is produced.

[0022] Alternatively, the operation member 10 may be configured through both structural design and material selection to possess both strength and deformability. For example, at least a portion of the tubular wall of the operation member 10 at the distal end 11 may be provided with a cut 17, such that when the tubular wall of the operation member 10 is subjected to radial pressure, an adjustable outer diameter effect is produced.

[0023] Preferably, the operation member 10 may be of a multi-layered design. For example, the inner layer is made of a flexible material, while the outer layer comprises a woven structure of multiple metal wires 16. The overall structural strength of the operation member 10 can be adjusted by the number of metal wires 16, while avoiding interference from the gaps between the metal wires 16 during operation.

[0024] With reference to Figure 5, in one embodiment provided by the present invention, the operation member 10 includes, at a position adjacent to the proximal end 12, a small-diameter portion 121, wherein the small-diameter portion 121 defines a diameter within the hollow through-hole 13 that is smaller than the diameter of the hollow through-hole 13.

[0025] Wherein, the small-diameter portion 121 may be formed by postprocessing or the like, by forming a recessed groove in a surface of the operation member 10 adjacent to the proximal end 12 and facing toward the hollow through-hole 13, or by protrudingly forming the small-diameter portion 121 on an inner surface of the operation member 10 adjacent to the proximal end 12.

[0026] The suture 20 is threaded through the hollow through-hole 13 and is movably passable through the diameter defined by the small-diameter portion 121. Two ends of the suture 20 respectively protrude from the distal opening 131 and the proximal opening 132 of the operation member 10. At least a portion of the suture 20 protruding from the distal opening 131 is wound around an outer surface 15 of the operation member 10 to form a pre-tied knot 21, and a knotting segment 22 is formed between the distal opening 131 and the pre-tied knot 21. Wherein, depending on the position of the pre-tied knot 21 relative to the outer surface 15 of the operation member 10, the presence or absence of a threading gap 221 between the pre-tied knot 21, the knotting segment 22, and the operation member 10 is determined.

[0027] For example, when the knotting segment 22 abuts against the outer surface 15 of the operation member 10 along the longitudinal direction, no gap is formed between the pre-tied knot 21, the knotting segment 22, and the operation member 10.

[0028] Preferably, the pre-tied knot 21 is preferably spaced at least 9 mm from the distal opening 131.

[0029] Alternatively, when the distance between the pre-tied knot 21 and the distal opening 131 is less than that of the knotting segment 22, a threading gap 221 is formed between the pre-tied knot 21, the knotting segment 22, and the operation member 10.

[0030] Preferably, the threading gap 221 defines a threading diameter of at least 2 millimeters (mm), making the threading gap 221 more easily identifiable during minimally invasive surgery.

[0031] With reference to Figure 3A, in one embodiment, the suture 20 at the pretied knot 21 extending toward the distal end 11 has a suture end 23 that may optionally be connected to a suture needle A, for the purpose of suturing and securing a suture site W.

[0032] At least a portion of the suture 20 protruding from the proximal opening 132 includes an operation structure 24, wherein the maximum outer diameter of the operation structure 24 is greater than the diameter of the small-diameter portion 121, and the operation structure 24 is retained at the proximal end 12 of the small-diameter portion 121 to prevent the suture 20 from undesirably moving toward the distal end 11 relative to the operation member 10 within the hollow through-hole 13, and to assist in moving the suture 20 toward the proximal end 12 relative to the operation member 10 during use.

[0033] Further, at the proximal opening 132 at the end of the small-diameter portion 121 at the proximal end 12, the operation member 10 clamps a stopper knot 241 to simultaneously achieve storage and fixation of the operation structure 24, preventing unnecessary pulling or slipping.

[0034] The operation structure 24 may be a globular stopper knot 241 formed by tying the suture 20, and preferably, the diameter of the stopper knot 241 is greater than the diameter of the hollow through-hole 13, such that the operation structure 24 is blocked by the stopper knot 241 from entering or passing through the hollow through-hole 13. In this way, during use, the stopper knot 241 can be directly pulled to move the suture 20 relative to the operation member 10.

[0035] In the present embodiment, the operation structure 24 includes the stopper knot 241 and a pulling loop 242. Any segment of the suture 20 extending toward the proximal end 12 is bent to form a loop, and the end of the suture 20 extending toward the proximal end 12 is tied with at least a portion of the suture 20 to form the globular stopper knot 241, and at least a portion of the looped suture 20 together with the stopper knot 241 jointly form the pulling loop 242. Accordingly, during use, the operation structure 24 can be engaged with the pulling loop 242 by an instrument or the like, thereby enabling the suture 20 to be pulled to move relative to the operation member 10, improving convenience and accuracy during operation and preventing slipping during pulling.

[0036] In one embodiment, the operation structure 24 may be presented in various forms as required. For example, the operation structure 24 may be formed by coupling or binding the suture 20 to a blocking member, wherein the blocking member may be a bar or a flexible loop. Any structure that is effective to prevent the suture 20 from unexpectedly moving toward the distal end 11 relative to the operation member 10 within the hollow through-hole 13 and assists in moving the suture 20 toward the proximal end 12 relative to the operation member 10 during use, is encompassed within the scope of the present application.

[0037] Further, the suture 20 forms a stopper structure 25 at the distal end 11 of the small-diameter portion 121. The stopper structure 25 is movable within the hollow through-hole 13, and a stopper diameter defined by the stopper structure 25 is greater than the diameter defined by the small-diameter portion 121. Accordingly, the movement of the suture 20 toward the proximal end 12 within the hollow through-hole 13 is limited by the small-diameter portion 121 and the stopper structure 25, thus preventing the suture 20 from disengaging from the operation member 10.

[0038] The stopper structure 25 may be, in the same manner as the operation structure 24, a globular stopper knot 241 formed by tying the suture 20.

[0039] With reference to Figures 3A to 3D and Figure 6, in one embodiment where the operation member 10 is made of a flexible material, the distance between the pre-tied knot 21 and the distal opening 131 is less than that of the knotting segment 22 to form the threading gap 221 between the pre-tied knot 21, the knotting segment 22, and the operation member 10. When the tubular knot-tying device is to be used, an operator positions the distal end 11 of the operation member 10 at an intended suture site W, and uses the suture needle A to guide the suture end 23 through the suture site W, subsequently passing the suture needle A together with the suture end 23 through the threading gap 221.

[0040] Next, the operator pulls the operation structure 24 of the suture 20 away from the operation member 10. At this time, the suture 20 is pulled as a whole toward the proximal end 12, causing the knotting segment 22 at the distal opening 131 to enter the hollow through-hole 13 and move toward the proximal end 12 within the hollow through-hole 13. This results in the threading gap 221 gradually narrowing until the remaining portion of the knotting segment 22 protruding from the distal opening 131 abuts against the outer surface 15 of the operation member 10 (as shown in Figure 3C).

[0041] Next, the operation structure 24 is continuously pulled away from the operation member 10. Since the operation member 10 has deformability, the pre-tied knot 21 further moves toward the distal end 11 along the pulling direction and tightens around the operation member 10, until the pre-tied knot 21 disengages from the distal end 11 of the operation member 10. It should be noted that, as the pre-tied knot 21 moves, the outer diameter of the operation member 10 corresponding to the pre-tied knot 21 changes synchronously; that is, after the pre-tied knot 21 moves away, the outer diameter of the operation member 10 returns to its original state. In this manner, it can be ensured that, when the pre-tied knot 21 moves toward the distal end 12, the outer diameter of the operation member 10 located at the proximal side 11 of the pre-tied knot 21 is greater than the outer diameter of the operation member 10 at the position corresponding to the pre-tied knot 21, thus preventing the pre-tied knot 21 from moving toward the proximal end 12.

[0042] In one embodiment as shown in Figure 7, differing from the foregoing embodiments, the operation member 10 is formed by weaving multiple metal wires 16, when the pre-tied knot 21 moves toward the distal end 11 along the pulling direction and tightens around the operation member 10, adjacent metal wires 16 move toward each other, thus reducing the gaps therebetween, so as to assist the pre-tied knot 21 in disengaging from the distal end 11 of the operation member 10.

[0043] In one embodiment as shown in Figure 8, differing from the foregoing embodiments, at least a portion of the tubular wall of the operation member 10 at the distal end 11 is provided with a cut 17, when the pre-tied knot 21 moves toward the distal end 11 along the pulling direction and tightens around the operation member 10 while passing the cut 17, the tubular walls of the operation member 10 on both sides of the cut 17 move toward each other, thus reducing the gap of the cut 17 and producing an adjustable outer diameter effect, so as to assist the pre-tied knot 21 in disengaging from the distal end 11 of the operation member 10.

[0044] In another embodiment, when the tubular knot-tying device is not in use, the operation structure 24 abuts against or is clamped at the proximal opening 132 of the operation member 10. The knotting segment 22 abuts against the outer surface 15 of the operation member 10 along the longitudinal direction; in this state, no gap is formed among the pre-tied knot 21, the knotting line segment 22, and the operation member 10.

[0045] In another embodiment, when the tubular knot-tying device is not in use, the operation structure 24 abuts against or is held within the proximal opening 132 of the operation member 10. The knotting segment 22 abuts against the outer surface 15 of the operation member 10 along the longitudinal direction, such that no gap is formed between the pre-tied knot 21, the knotting segment 22, and the operation member 10. It is noteworthy that the other end of the suture 20 simultaneously maintains a structural relationship in which the knotting segment 22 abuts the outer surface 15 of the operation member 10 along the longitudinal direction. At this time, the interface formed by the contact between the knotting segment 22 and the outer surface 15 along the longitudinal direction generates a static friction force, which can simultaneously prevent the operation structure 24 from disengaging from the proximal opening 132, thus establishing a structural balance between the operation member 10 and the suture 20 when the tubular knot-tying device is not in use (as shown in Figure 1A).

[0046] When the tubular knot-tying device is to be used, the pre-knot 21 is slid toward the distal end 11 of the operation member 10. At this time, the knotting segment 22 separates from the outer surface 15, and together with the outer surface 15 forms the threading gap 221 (as shown in Figure 1B). At this moment, the static friction generated at the interface where the knotting segment 22 contacts the outer surface 15 disappears, completing the pre-use preparation of the tubular knot-tying device.

[0047] In one embodiment, when the tubular knot-tying device is not in use, the proximal opening 132 and the distal end opening 131 are preferably spaced at least 6 mm apart. In this way, when the tubular knot-tying device is to be used, the threading gap 221 formed by sliding the pre-knot 21 toward the distal end 11 of the operation member 10 will have a size more suitable for subsequent operational steps.

[0048] Furthermore, to allow the pre-knot 21 to be stably retained on the operation member 10, the pre-knot 21 should not experience displacement or detachment when positioned at a resting location on the operation member 10. Preferably, the difference between the outer diameter of the operation member 10 corresponding to the resting location of the pre-knot 21 and the outer diameter of the operation member 10 corresponding to the proximal opening 132 and / or the distal end opening 131 is less than 10%.

[0049] Wherein, the resting location includes a first resting location on the operation member 10 near the proximal opening 132 when the tubular knot-tying device is not in use, and a second resting location on the operation member 10 near the distal opening 131 or at the position of the indicator mark 151 when the tubular knot-tying device is in a pre-use state.

[0050] Further, the difference between the outer diameter of the operation member 10 at the first resting location and the outer diameter of the operation member 10 at the second resting location is preferably less than 1%.

[0051] Next, with reference to Figures 3A to 3D, when the tubular knot-tying device is in use, an operator positions the distal end 11 of the operation member 10 at an intended suture site W, and uses the suture needle A to guide the suture end 23 through the suture site W, subsequently passing the suture needle A together with the suture end 23 through the threading gap 221.

[0052] Next, the operator pulls the operation structure 24 of the suture 20 away from the operation member 10. At this time, the suture 20 as a whole is pulled to move toward the proximal end 12, causing the knotting segment 22 to enter the hollow through-hole 13 via the distal opening 131 and move toward the proximal end 12 within the hollow through-hole 13, thus resulting in the threading gap 221 gradually narrowing until the remaining portion of the knotting segment 22 protruding from the distal opening 131 abuts against the outer surface 15 of the operation member 10 (as shown in Figure 3C). It is noteworthy that, at this moment, the suture end 23 passing through the threading gap 221 is simultaneously restricted by the knotting segment 22 and abuts against the outer surface 15 of the operation member 10.

[0053] Next, the operator continues to pull, causing the suture 20 to continue moving toward the proximal end 12. At this time, the pre-tied knot 21 moves along the pulling direction toward the distal opening 131 until it disengages from the operation member 10 (as shown in Figure 3D). When the pre-tied knot 21 disengages from the operation member 10, the suture end 23 is simultaneously tightened, forming a secured surgical knot.

[0054] Wherein, during the continuous pulling of the operation structure 24, the suture needle A can be pulled at the same time. At this time, the suture 20 generates tension toward both ends, centered on the portion of the suture 20 passing through the suture site W, until the remaining portion of the knotting segment 22 protruding from the distal opening 131 abuts against the outer surface 15 of the operation member 10. Then, the suture needle A is released. At this time, when the pulling force applied in the direction of the suture needle A suddenly disappears, the pre-tied knot 21 can move away from the operation member 10 toward the distal end 11 according to the pulling force of the suture 20 toward the proximal end 12.

[0055] Notably, when the pre-tied knot 21 disengages from the operation member 10 to form the surgical knot, the operator further cuts the suture 20 of the surgical knot relative to the suture site W, so as to remove the remaining suture 20 and the operation member 10. At this time, regardless of whether the suture 20 has already formed the surgical knot by the pre-tied knot 21 or has already been displaced away from the operation structure 24 relative to the operation member 10, there is essentially no longer any engagement or contact relationship between the suture 20 and the operation member 10. As a result, the operation member 10 is easily separated from the cut suture 20, and if the operation member 10 accidentally falls into the body, this may easily cause the operator to spend additional time searching for it, and may even give rise to surgical risks.

[0056] Through the arrangement of the small-diameter portion 121 and the stopper structure 25 in the present embodiment, it can be ensured that the suture 20 is restricted in movement by the stopper structure 25 and the small-diameter portion 121, and that the suture 20 maintains a structural engagement relationship with the operation member 10. Accordingly, after the suture 20 is cut, the operator only needs to grasp the remaining suture 20 to ensure that the suture 20 together with the operation member 10 are removed simultaneously, thus reducing operational risks and enhancing safety and convenience.

[0057] Further with reference to Figure 4, the outer surface 15 of the operation member 10 adjacent to the distal end 11 includes an indicator mark 151. When the tubular knot-tying device is to be used, the indicator mark 151 serves to guide the pre tied knot 21 to be moved to the position of the indicator mark 151, so as to ensure that the pre-tied knot 21 can be adjusted to a preferred operating position. This avoids situations in which the pre-tied knot 21 is too far from the distal end 11 of the operation member 10, making it difficult to disengage the pre-tied knot 21 from the operation member 10, or in which the pre-tied knot 21 is too close to the distal end 11 of the operation member 10, thus being prone to unintended premature slipping off the operation member 10 due to accidental contact.

[0058] Preferably, the distance between the indicator mark 151 and the distal opening 131 of the operation member 10 is preferably between 1.5 mm and 3 mm.

[0059] Further, the operation member 10 forms a sliding section 152 between the indicator mark 151 and the distal opening 131. A surface structure or an outer tube diameter of the sliding section 152 is at least partially different from a surface structure or an outer tube diameter of the operation member 10 located at the proximal end 11. The provision of the sliding section 152 helps to reduce a reaction force generated when, after the pulling force applied in the direction of the suture needle A disappears, the pretied knot 21 disengages from the operation member 10 toward the distal end 12 due to a pulling force of the suture 20 toward the proximal end 11, thus preventing the reaction force from affecting the suture site W and causing secondary injury to the suture site W or even suture failure.

[0060] In addition, the provision of the sliding section 152 can also help to reduce the static friction and / or dynamic friction generated by the suture 20 and the knotting segment 22 simultaneously abutting against the outer surface 15 of the operation member 10.

[0061] Preferably, the indicator mark 151 is arranged adjacent to the sliding section 152.

[0062] In one embodiment, the surface structure of the sliding section 152 includes a smooth surface, which facilitates the pre-tied knot 21 to slide along the sliding section 152 and disengage.

[0063] In another embodiment, the outer diameter of the sliding section 152 tapers toward the distal end 11, such that the sliding section 152 as a whole forms a conical shape.

[0064] The tubular knot-tying device provided by the present invention has a simple structure, which is not only easy to manufacture but also allows miniaturization. In addition, it overcomes the problem in conventional surgical suturing techniques where knots of different sutures are prone to loosening, making it suitable for use in minimally invasive surgeries such as laparoscopy or Da Vinci robotic surgeries.

Claims

1. A tubular knot-tying device, comprising:an operation member having a distal end and a proximal end defined at opposite ends along a longitudinal direction, and a hollow through-hole extending through the operation member along the longitudinal direction, and a distal opening and a proximal opening formed at the distal end and at the proximal end of the operation member respectively; anda suture threaded through the hollow through-hole, at least a portion of the suture protruding from the distal opening and being wound around an outer surface of the operation member to form a pre-tied knot, and a knotting segment positioned between the distal opening and the pre-tied knot, wherein, when the tubular knot-tying device is not in use, the knotting segment abuts against the outer surface of the operation member along the longitudinal direction, and when the tubular knot-tying device is to be used, the pre-tied knot slides toward the distal end of the operation member, such that the knotting segment is separated from the outer surface and together with the outer surface forms a threading gap,the operation member further comprising a small-diameter portion adjacent to the proximal end, the suture being movably passable through a diameter defined by the small-diameter portion within the hollow through-hole,the suture further forming a stopper structure at the distal end of the small-diameter portion, the stopper structure being movable within the hollow through-hole, and a stopper diameter defined by the stopper structure being greater than the diameter defined by the small-diameter portion.2024453466   28 Jul 20262. The tubular knot-tying device according to claim 1, wherein at least a portion of the suture protruding from the proximal opening comprises an operation structure, a maximum outer diameter of the operation structure is greater than the diameter defined by the small-diameter portion, and the operation structure is retained at a proximal side of the small-diameter portion to prevent the suture from undesirably moving toward the distal end relative to the operation member within the hollow through-hole and to assist in moving the suture toward the proximal end relative to the operation member during use.

3. The tubular knot-tying device according to claim 1, wherein the operation member adjacent to the distal end on the outer surface comprises an indicator mark, and when the tubular knot-tying device is to be used, the pre-tied knot is displaced to the indicator mark.

4. The tubular knot-tying device according to claim 3, wherein the distance between the indicator mark and the distal opening is between 1.5 and 3 mm.

5. The tubular knot-tying device according to claim 1, wherein the difference between the outer diameter of the operation member corresponding to the proximal opening and / or the distal opening and the outer diameter of the operation member corresponding to a resting location of the pre-tied knot is less than 10%.2024453466   28 Jul 20266. The tubular knot-tying device according to claim 1, wherein a distance between the distal opening and the proximal opening is at least 6 mm.

7. The tubular knot-tying device according to claim 1, wherein the pre-tied knot is movable on the operation member between a first resting location adjacent to the proximal opening and a second resting location adjacent to the distal opening, and when the pre-tied knot is positioned at the second resting location, the knotting segment and the outer surface jointly form a threading gap.

8. The tubular knot-tying device according to claim 7, wherein a threading diameter defined by the threading gap is at least 2 mm.

9. The tubular knot-tying device according to claim 1, wherein at least a portion of the suture protruding from the proximal end comprises an operation structure, and when the tubular knot-tying device is not in use, the operation structure is positioned adjacent to the proximal opening.

10. The tubular knot-tying device according to claim 1, wherein at least a portion of the operation member adjacent to the distal end has deformability.2024453466   28 Jul 202611. The tubular knot-tying device according to claim 10, wherein the operation member is made of a flexible material, the flexible material being preferably selected from a thermoplastic elastomer (TPE), polyvinyl chloride (PVC), polytetrafluoroethylene (PTFE), or thermoplastic polyurethane (TPU).

12. The tubular knot-tying device according to claim 10, wherein the operation member is formed from a tubular material woven from multiple metal wires, and a gap is present between the adjacent metal wires.

13. The tubular knot-tying device according to claim 10, wherein at least a portion of a tubular wall of the operation member near the distal end is provided with a cut.

14. The tubular knot-tying device according to claim 10, wherein the operation member comprises an inner layer made of a flexible material and an outer layer formed of multiple woven metal wires.

Images