A combined instrument for vascular connection

Abstract

A combined instrument for vascular connection, comprising an incision component and a blood vessel to be installed. The incision component includes a cylinder body, a sheath cylinder, and a cutter that are sleeved inside in sequence. The cylinder body and the sheath cylinder can slide relative to each other, and the sheath cylinder and the cutter can slide relative to each other. The cutter is used to incise the blood vessel wall of the main blood vessel. The blood vessel to be installed is arranged inside the cylinder body and is sleeved outside the sheath cylinder. The distal end of the blood vessel to be installed is detachably installed on the cylinder body, and the proximal end of the blood vessel to be installed is located at the proximal end of the cylinder body. A clamping member is provided at the proximal end of the blood vessel to be installed. The clamping member includes a first clamping wall and a second clamping wall that are elastically connected; in the initial state, the second clamping wall is clamped on the sheath cylinder, and the synchronous displacement of the sheath cylinder and the cylinder body causes the second clamping wall to cut into the main blood vessel along with the sheath cylinder. The displacement of the sheath cylinder relative to the cylinder body towards the inside of the main blood vessel causes the second clamping wall to disengage from the sheath cylinder, and the second clamping wall that has disengaged from the sheath cylinder elastically rotates to be opposite to the first clamping wall, thereby clamping the blood vessel wall of the main blood vessel.

Description

Technical Field

[0001] The present invention relates to the technical field of medical devices, and particularly to a combined instrument for blood vessel connection. Background Art

[0002] When local lesions occur in arterial or venous blood vessels, a common solution is to establish a bypass blood vessel to bypass the diseased part so as to restore blood supply. Taking the operation of establishing an aortic bypass blood vessel as an example, so far, this operation must be performed using a well-known scalpel to make a longitudinal incision on the side wall of the aorta clamped by a side wall clamp, and the end of the bypass blood vessel is anastomosed to the aortic incision with a surgical needle and suture. This traditional surgical method is complex, requires a high level of the operator, and has a high implementation difficulty. Summary of the Invention

[0003] The purpose of the present invention is to provide a combined instrument for blood vessel connection, which is simpler to use, requires a relatively lower level of the operator, has a lower implementation difficulty, has a shorter operation time, is more conducive to reducing the pain of the patient, and can better ensure safety.

[0004] To solve the above technical problems, the present invention provides a combined instrument for blood vessel connection, including an incision assembly and a blood vessel to be installed. The incision assembly includes a cylinder, a sheath cylinder, and a cutter sleeved inside in sequence. The cylinder and the sheath cylinder can slide relative to each other, and the sheath cylinder and the cutter can slide relative to each other. The cutter is used to cut the blood vessel wall of the main blood vessel. The blood vessel to be installed is also arranged inside the cylinder and is sleeved outside the sheath cylinder. The distal end of the blood vessel to be installed is detachably installed on the cylinder. The proximal end of the blood vessel to be installed is located at the proximal end of the cylinder. The proximal end of the blood vessel to be installed is provided with a clamping member, and the clamping member includes a first clamping wall and a second clamping wall elastically connected. In the initial state, the second clamping wall is clamped on the sheath cylinder. The synchronous displacement of the sheath cylinder and the cylinder enables the second clamping wall to cut into the main blood vessel along with the sheath cylinder. The displacement of the sheath cylinder relative to the cylinder towards the inside of the main blood vessel can make the second clamping wall separated from the sheath cylinder. The second clamping wall separated from the sheath cylinder can elastically rotate to be opposite to the first clamping wall. The first clamping wall and the second clamping wall opposite to each other can clamp the blood vessel wall of the main blood vessel.

[0005] When the combined instrument provided by the present invention is in use, the cutter can be controlled to make an incision in the blood vessel wall of the main blood vessel first; then, the sheath tube and the cylinder body can move into the main blood vessel along with the cutter until the first clamping wall can contact the outer wall of the main blood vessel; then, the sheath tube can be continuously pushed to move relative to the cylinder body into the main blood vessel, so that the second clamping wall can be disengaged from the sheath tube, and the second clamping wall can automatically rebound and flip to be oppositely arranged relative to the first clamping wall, thereby clamping the blood vessel wall of the main blood vessel to complete the docking of the blood vessel to be installed and the main blood vessel.

[0006] Compared with the background art, the combined instrument provided by the present invention is simpler to use, has relatively low requirements for the level of the operator, has a lower implementation difficulty, a shorter operation time, and less surgical trauma, can greatly simplify the surgical procedure, and is beneficial to reducing the pain of the patient.

[0007] More importantly, in the embodiment of the present invention, two components, namely a cutter and a sheath tube, are provided, both of which can move relative to the cylinder body and the cutter and the sheath tube can also move relative to each other; during use, the cutter only needs to make an initial incision in the blood vessel wall of the main blood vessel, and the subsequent actions are all completed by the sheath tube and the cylinder body, which can effectively avoid the situation that the sharp cutter enters the main blood vessel too deeply and penetrates through the main blood vessel, thereby greatly improving the safety of the surgical process.

[0008] Optionally, the outer wall of the sheath tube is provided with a reduced diameter groove extending axially. In the initial state, the second clamping wall is clamped in the reduced diameter groove.

[0009] Optionally, the second clamping wall includes a plurality of partition walls arranged at intervals in the circumferential direction, and the number of the reduced diameter grooves is multiple. In the initial state, each partition wall is correspondingly clamped in the corresponding reduced diameter groove.

[0010] Optionally, the upper end of the reduced diameter groove is further communicated with a receiving groove that does not limit the rotation of the second clamping wall, which is used to receive the second clamping wall and / or a part connecting the first clamping wall and the second clamping wall.

[0011] Optionally, the clamping member is configured with a hemostatic component.

[0012] Optionally, the blood vessel to be installed includes a blood vessel body, a transition connecting member is arranged at the proximal end of the blood vessel body, the transition connecting member includes a cylindrical portion, the cylindrical portion is sleeved and fixed on the inner tube wall of the blood vessel to be installed, a wing plate portion extending radially outward is arranged at the proximal end of the cylindrical portion, and the first clamping wall is connected to the wing plate portion.

[0013] Optionally, the wing plate portion is located radially outside the cylindrical portion and can axially abut against the proximal end of the cylinder body.

[0014] Optionally, the blood vessel to be installed includes a blood vessel body, a first limiting member is provided at the distal end of the blood vessel body, a first adjusting member with adjustable assembly depth is connected to the barrel wall of the cylinder, and the part of the first adjusting member extending into the cylinder can cooperate with the first limiting member to limit the position of the distal end of the blood vessel to be installed within the cylinder.

[0015] Optionally, the blood vessel to be installed includes a blood vessel body, and a docking member is provided at the distal end of the blood vessel body for connecting two blood vessels to be installed.

[0016] Optionally, a second limiting member is provided on the outer wall of the tool, a second adjusting member with adjustable assembly depth is connected to the barrel wall of the sheath cylinder, and the part of the second adjusting member extending into the sheath cylinder can cooperate with the second limiting member to limit the position of the tool within the sheath cylinder.

[0017] Optionally, the sheath cylinder is provided with a first stroke limiting member, the tool is provided with a second limiting member, and when the cooperation between the second adjusting member and the second limiting member is in a released state, the first stroke limiting member is used to cooperate with the second limiting member to limit the size of the tool cutting into the main blood vessel.

[0018] Optionally, a third limiting member is provided on the outer wall of the sheath cylinder, a third adjusting member with adjustable assembly depth is connected to the barrel wall of the cylinder, and the part of the third adjusting member extending into the cylinder can cooperate with the third limiting member to limit the position of the sheath cylinder within the cylinder.

[0019] Optionally, the cylinder is provided with a second stroke limiting member, the sheath cylinder is provided with a second limiting member, and when the cooperation between the third adjusting member and the third limiting member is in a released state, the second stroke limiting member is used to cooperate with the second limiting member to limit the size of the sheath cylinder cutting into the main blood vessel.

[0020] Optionally, the tool includes a tool tip, and a stylet and a cutting edge are provided at the proximal end of the tool.

[0021] Optionally, the tool includes a tubular knife and a rod knife. The tubular knife is sleeved outside the rod knife and can move relative to the rod knife. A plurality of cutting edges are provided at the proximal end of the tubular knife, and a conical needle tip is provided at the proximal end of the rod knife. In addition, a rotatably arranged stop portion is provided on the outer wall of the rod knife. When the rod section of the rod knife provided with the stop portion is located inside the tubular knife, the stop portion is in a retracted state. When the rod section of the rod knife provided with the stop portion is located outside the tubular knife, the stop portion flips to an unfolded state for stopping and recovering the blood vessel wall cut by the tubular knife.

[0022] Optionally, an accommodation groove extending axially is provided on the outer wall of the rod-shaped cutter, one end of the stop portion is hinged to the proximal end of the accommodation groove, and in the retracted state, the center of gravity of the stop portion is located radially outside the rotation center line of the stop portion.

[0023] Optionally, a fourth limiting member is provided on the outer wall of the rod-shaped cutter, a fourth adjusting member with an adjustable assembly depth is connected to the barrel wall of the barrel-shaped cutter, and the part of the fourth adjusting member extending into the barrel-shaped cutter can cooperate with the fourth limiting member to limit the position of the rod-shaped cutter in the barrel-shaped cutter.

[0024] Optionally, the barrel-shaped cutter is provided with a third stroke limiting member, the rod-shaped cutter is provided with a third limiting member, and when the cooperation between the fourth adjusting member and the fourth limiting member is in a released state, the third stroke limiting member is used to cooperate with the third limiting member to limit the size of the rod-shaped cutter cutting into the main blood vessel.

[0025] Optionally, protective caps are detachably installed at both axial ends of the barrel.

[0026] Optionally, a handle is provided on the outer wall of the barrel. Description of the Drawings

[0027] Figure 1 is a schematic structural diagram of an embodiment of the combined instrument for blood vessel connection provided by the present invention in the initial state;

[0028] Figure 2 is Figure 1 a schematic structural diagram when the rod-shaped cutter is pushed out in

[0029] Figure 3 is Figure 1 a schematic structural diagram when both the rod-shaped cutter and the barrel-shaped cutter are retracted and the second clamping wall is disengaged from the sheath barrel in

[0030] Figure 4 is Figure 3 a partial enlarged view of

[0031] Figure 5 a schematic structural diagram of the sheath barrel;

[0032] Figure 6 a schematic structural diagram of the barrel-shaped cutter;

[0033] Figure 7 a schematic structural diagram of the rod-shaped cutter;

[0034] Figure 8 is a schematic structural diagram of another embodiment of the combined instrument for blood vessel connection provided by the present invention in the initial state;

[0035] Figure 9 isFigure 8 Schematic structural diagram when the tool retracts and the second clamping wall is disengaged from the sheath tube;

[0036] Figure 10 is Figure 8 partial enlarged view of;

[0037] Figure 11 is Figure 8 schematic structural diagram of the tool in;

[0038] Figure 12 is Figure 11 bottom view of;

[0039] Figure 13 schematic structural diagram of the blood vessel to be installed;

[0040] Figure 14 is Figure 13 sectional view in the A-A direction of a specific embodiment of;

[0041] Figure 15 is Figure 13 sectional view in the A-A direction of another specific embodiment of;

[0042] Figure 16 is Figure 13 sectional view in the A-A direction of yet another specific embodiment of.

[0043] Figure 1-16 The reference numerals in are explained as follows:

[0044] 1 Incision assembly, 11 Cylinder body, 111 Third adjustment member, 112 Second stroke limiting member, 12 Tool, 121 Tool tip, 121a Needle, 121b Blade, 122 Cylindrical tool, 122a Second limiting member, 122b Cutting edge, 122c Fourth adjustment member, 122d Second operating head, 123 Rod tool, 123a Needle head, 123b Stopper, 123c Receiving groove, 123d Fourth limiting member, 123e Third operating head, 124 Fourth operating head, 13 First adjustment member, 15 Elastic reset member, 17 Protective cap, 171 Avoidance groove, 172 Insertion slot, 18 Sheath tube, 181 Reduced diameter groove, 182 Accommodation groove, 183 Second adjustment member, 184 First operating head, 185 First stroke limiting member, 186 Third limiting member;

[0045] 2 Blood vessel to be installed, 21 Clamping member, 211 First clamping wall, 212 Second clamping wall, 212a Dividing wall, 213 Connecting portion, 214 Card slot, 215 Hemostasis component, 22 Transition connecting piece, 221 Cylindrical portion, 222 Wing plate portion, 23 First limiting member, 24 Blood vessel body. Specific embodiments

[0046] To enable those skilled in the art to better understand the technical solution of the present invention, the present invention will be further described in detail below with reference to the accompanying drawings and specific embodiments.

[0047] As used herein, "a number of" refers to an indefinite number of multiple, usually more than two; and when "a number of" is used to represent the number of several components, it does not represent the mutual relationship in terms of quantity of these components.

[0048] As used herein, words such as "first", "second", etc. are only for the convenience of describing two or more structures or components with the same or similar structures and / or functions, and do not represent a special limitation on the order and / or importance.

[0049] Please refer to Figure 1 - Figure 16 , Figure 1 , which is a schematic structural view of an embodiment of the combination instrument for blood vessel connection provided by the present invention in an initial state; Figure 2 is Figure 1 a schematic structural view when the middle rod knife is pushed out; Figure 3 is Figure 1 a schematic structural view when both the middle rod knife and the cylinder knife are retracted and the second clamping wall is disengaged from the sheath cylinder; Figure 4 is Figure 3 a partial enlarged view of Figure 5 a schematic structural view of the sheath cylinder; Figure 6 a schematic structural view of the cylinder knife; Figure 7 a schematic structural view of the rod knife; Figure 8 , which is a schematic structural view of another embodiment of the combination instrument for blood vessel connection provided by the present invention in an initial state; Figure 9 is Figure 8 a schematic structural view when the cutting tool is retracted and the second clamping wall is disengaged from the sheath cylinder; Figure 10 is Figure 8 a partial enlarged view of Figure 11 is Figure 8 a schematic structural view of the cutting tool in Figure 12 is Figure 11 a bottom view of Figure 13 a schematic structural view of the blood vessel to be installed; Figure 14 is Figure 13 a sectional view in the A-A direction of a specific embodiment of Figure 15 is Figure 13 a sectional view in the A-A direction of another specific embodiment of Figure 16 is Figure 13 a sectional view in the A-A direction of yet another specific embodiment of

[0050] As described in the background art section, when a local lesion occurs in an arterial or venous blood vessel, a bypass blood vessel needs to be established to bypass the diseased area and thus restore blood supply. For the convenience of distinction and description, the arterial or venous blood vessel with a local lesion can be referred to as the main blood vessel (not shown in the figure). The main blood vessel can be a blood vessel at any part of the operator such as a human body or other animal body, that is, the type of the main blood vessel is not limited herein.

[0051] In this article, the orientation descriptions of "far" and "near" are both referenced based on the position relative to the main blood vessel. For any component, member or structure, the end (part) relatively closer to the main blood vessel during use can be called the proximal end (part), and the end (part) relatively farther from the main blood vessel during use can be called the distal end (part).

[0052] As Figure 1 - Figure 4 shown, the present invention provides a combined instrument for blood vessel connection, specifically referring to the connection between a bypass blood vessel and a main blood vessel. This connection can be to overcome the local lesion obstruction of the main blood vessel or for other diseases. The combined instrument includes an incision assembly 1 and a blood vessel to be installed 2. The blood vessel to be installed 2 can be the whole of the bypass blood vessel or only a part of the bypass blood vessel. For specific details, reference can be made to the description in the following text.

[0053] The incision assembly 11 is used to punch holes and make incisions in the blood vessel wall of the main blood vessel to form an installation position for the bypass blood vessel, and the blood vessel to be installed 2 can be installed in this installation position. The blood vessel to be installed 2 is usually an artificial blood vessel. The structural shape of the blood vessel to be installed 2 is not limited herein either. During specific implementation, those skilled in the art can determine it according to actual needs. For example, in the axial direction of the blood vessel body 24, the blood vessel body 24 can be a blood vessel with a constant area, that is, a blood vessel with the same flow-through area, such as a circular tube with an equal diameter, an elliptical tube with equal dimensions, etc. At this time, the cross-section of the blood vessel body 24 perpendicular to the axial direction can be circular or elliptical; or, in the axial direction of the blood vessel body 24, the blood vessel body 24 can also be a blood vessel with a variable area, that is, the flow-through area can change; or, the blood vessel body 24 can also be a complex structure including several branch blood vessels.

[0054] Specifically, the incision assembly 1 includes a cylinder 11, a sheath 18, and a cutter 12 that are nested in sequence. That is, the sheath 18 can be nested inside the cylinder 11, the cutter 12 can be nested inside the sheath 18, and the cylinder 11 and the sheath 18 can slide relative to each other, and the cutter 12 and the sheath 18 can also slide relative to each other. The blood vessel 2 to be installed is also arranged inside the cylinder 11 and is sleeved outside the sheath 18. The distal end of the blood vessel 2 to be installed is detachably installed on the cylinder 11, the proximal end of the blood vessel 2 to be installed is located at the proximal end of the cylinder 11, and a clamping member 21 is further provided at the proximal end of the blood vessel 2 to be installed. The clamping member 21 includes a first clamping wall 211 and a second clamping wall 212 that are elastically connected. In the initial state, the second clamping wall 212 is clamped on the sheath 18. In this way, when the sheath 18 and the cylinder 11 synchronously cut into the main blood vessel, the second clamping wall 212 can cut into the main blood vessel together with the sheath 18. When the sheath 18 displaces towards the inside of the main blood vessel relative to the cylinder 11, the second clamping wall 212 can be separated from the cutter 12 and the second clamping wall 212 separated from the sheath 18 can elastically flip to be oppositely arranged with the first clamping wall 211. At this time, a clamping groove can be formed between the first clamping wall 211 and the second clamping wall 212 to clamp the blood vessel wall of the main blood vessel.

[0055] When the combined instrument provided by the present invention is used, the cutter 12 can be first controlled to cut an incision in the blood vessel wall of the main blood vessel. Then, the sheath 18 and the cylinder 11 can displace into the main blood vessel along with the cutter 12 until the first clamping wall 211 can contact the outer wall of the main blood vessel. Then, the sheath 18 can be continuously pushed to displace towards the inside of the main blood vessel relative to the cylinder 11 so that the second clamping wall 212 can be separated from the sheath 18, and the second clamping wall 212 can automatically rebound and flip to be oppositely arranged with the first clamping wall 211, thereby clamping the blood vessel wall of the main blood vessel to complete the docking of the blood vessel 2 to be installed with the main blood vessel.

[0056] Compared with the background technology, the combined instrument provided by the present invention is simpler to use, has relatively low requirements for the level of the operator, has a lower implementation difficulty, a shorter operation time, and less surgical trauma. It can greatly simplify the surgical procedure and is beneficial to reducing the pain of the patient.

[0057] More importantly, in the embodiment of the present invention, two components, namely the cutter 12 and the sheath 18, are provided that can both displace relative to the cylinder 11 and the cutter 12 and the sheath 18 can also displace relative to each other. When in use, the cutter 12 only needs to complete the initial incision in the blood vessel wall of the main blood vessel, and the subsequent actions are all completed by the sheath 18 and the cylinder 11, which can effectively avoid the situation that the sharp cutter 12 enters the main blood vessel too deep and penetrates the main blood vessel, thereby greatly improving the safety of the surgical process.

[0058] Here, the embodiments of the present invention do not limit the structure of the tool 12, as long as the technical purpose of making an incision on the blood vessel wall of the main blood vessel can be achieved.

[0059] In the first embodiment, the tool 12 can be a rotary cutting tool. Specifically, as Figure 6 , Figure 7 shown, in this embodiment, the tool 12 can include a cylindrical cutter 122 and a rod cutter 123. The cylindrical cutter 122 refers to a cutting component in the shape of a cylinder; the cylindrical cutter 122 can be sleeved outside the rod cutter 123 and can move relative to the rod cutter 123. Here, the movement includes axial displacement and circumferential rotation; several cutting edges 122b can be provided at the proximal end of the cylindrical cutter 122, and a conical needle 123a can be provided at the proximal end of the rod cutter 123 so that the rod cutter 123 can penetrate into the blood vessel wall of the main blood vessel; a rotatable stop portion 123b can also be provided on the outer wall of the rod cutter 123.

[0060] Combined with Figure 1 , when the rod section of the rod cutter 123 provided with the stop portion 123b is located inside the cylindrical cutter 122, blocked by the cylindrical cutter 122, the stop portion 123b can be in a retracted state, that is, the stop portion 123b can be integrally abutted against the outer wall of the rod cutter 123. Combined with Figure 2 and Figure 4 , when the rod section of the rod cutter 123 provided with the stop portion 123b is located outside the cylindrical cutter 122, the stop portion 123b can be flipped to the unfolded state for blocking and recovering the cut blood vessel wall by the cylindrical cutter 122.

[0061] In the initial state, the stop portion 123b of the rod cutter 123 is in a retracted state. When in use, the rod cutter 123 can be first pushed into the main blood vessel. After entering the main blood vessel, the limit of the stop portion 123b by the cylindrical cutter 122 is released, and the stop portion 123b can be flipped to the unfolded state; then, a force can be applied to the rod cutter 123 along the direction of pulling out the rod cutter 123 (this force can be manually applied by the operator or automatically applied by the elastic reset member 15 in the embodiment of the drawing) until the stop portion 123b can be tightly attached to the inner tube wall of the main blood vessel; then, the cylindrical cutter 122 can be operated to rotate to integrally cut the blood vessel wall. Since this part of the blood vessel wall is fixed on the rod cutter 123 by the stop portion 123b, it can prevent this part of the blood vessel wall from escaping with the blood flow and blocking the blood vessel.

[0062] In the embodiments of the present invention, it is preferably to provide an elastic reset member 15 to implement the automatic reset of the rod cutter 123 and the automatic tight attachment of the stop portion 123b in the unfolded state to the inner tube wall of the main blood vessel, so as to simplify the operation.

[0063] The type of the above elastic reset member 15 is not limited herein. It can be various forms of elastic components such as springs, elastic blocks, and tension ropes, as long as the corresponding functions can be achieved. Taking a spring as an example, the elastic reset member 15 can be sleeved outside the rod cutter 123, and its two ends can act on the rod cutter 123 (or a component connected to the rod cutter 123) and the cylinder cutter 122 (or a component connected to the cylinder cutter 122) respectively. When the rod cutter 123 moves towards the inside of the main blood vessel relative to the cylinder cutter 122, the elastic deformation accumulated by the elastic reset member 15 can increase. Thus, when the operating force on the rod cutter 123 by the operator is released, the elastic deformation accumulated by the elastic reset member 15 can be released to drive the rod cutter 123 to reset; the aforementioned elastic deformation can be a compressive deformation or a tensile deformation, which is specifically related to the installation position of the elastic reset member 15, etc.

[0064] In the initial state, the proximal end portion of the rod cutter 123 can have a part protruding from the cylinder cutter 122, or can be entirely retracted inside the cylinder cutter 122, which does not affect the operation of the rod cutter 123. Similarly, in the initial state, the proximal end portion of the cylinder cutter 122 can have a part protruding from the cylinder body 11, or can be entirely retracted inside the cylinder body 11, which also does not affect the operation of the cylinder cutter 122.

[0065] When operating the rod cutter 123, if the rod segment provided with the stop portion 123b is separated from the cylinder cutter 122 before entering the main blood vessel, the stop portion 123b can be flipped to the unfolded state first; during the process of this part of the rod segment entering the main blood vessel, the blood vessel wall will act on the stop portion 123b to force the stop portion 123b to re-abut against the outer wall of the rod cutter 123 so as not to affect the rod cutter 123 from cutting into the main blood vessel; after this part of the rod segment completely enters the main blood vessel, the stop portion 123b can be flipped to the unfolded state again.

[0066] Please continue to refer to Figure 7 , a receiving groove 123c extending axially can be provided on the outer wall of the rod cutter 123, and one end of the stop portion 123b can be hinged to the proximal end of the receiving groove 123c, and in the retracted state, the center of gravity of the stop portion 123b can be located radially outside the rotation center line of the stop portion 123b. Thus, when there is no external force acting on the stop portion 123b, the stop portion 123b can be flipped to the unfolded state under its own gravity; and when inside the main blood vessel, considering the impact of blood flow on the stop portion 123b, when the part of the rod cutter 123 provided with the stop portion 123b is inserted into the main blood vessel, the rod cutter 123 can be operated to rotate so as to rotate the stop portion 123b facing the blood flow to a position away from the blood flow, so that each stop portion 123b can be relatively easily unfolded.

[0067] In addition to relying on its own weight, a torsion spring can also be sleeved on the rotating shaft of the stop portion 123b. In the retracted state, the torsion spring can store elastic force. In this way, when the external force disappears or weakens, the elastic force of the torsion spring can be released to drive the stop portion 123b to rotate to the deployed state.

[0068] In the deployed state, the stop portion 123b can abut against the inner wall of the receiving groove 123c to present a state that is substantially perpendicular to the central axis of the rod cutter 123. In fact, the stop portion 123b and the central axis of the rod cutter 123 can also present a non-90-degree angle, as long as reliable stopping and recovery of the cut blood vessel wall can be ensured. From Figure 7 a perspective, the stop portion 123b can basically present a horizontal state.

[0069] In the second embodiment, the cutter 12 can be an inserted cutter. Specifically, as Figure 8 - Figure 12 shown, the cutter head 121 can include an equal-dimension segment and a tapered segment. Here, the equal-dimension segment refers to the part where the shape and size of the cross-section perpendicular to the axial direction do not change in the axial direction; the tapered segment is closer to the main blood vessel relative to the equal-dimension segment, and a thorn 121a can be provided at the vertex position of the tapered segment. When making an incision, the thorn 121a can first pierce into the blood vessel wall of the main blood vessel to position the cutter 12.

[0070] In the initial state, the equal-dimension segment (the lower end of the equal-dimension segment, which is also the large-diameter end of the tapered segment) can be located at the outer front end of the cylinder 11; in this way, when the incision assembly 1 is pushed as a whole towards the main blood vessel for cutting, the equal-dimension segment can cut into the incision of the main blood vessel, and there is no need to perform a separate pushing operation on the cutter 12. Of course, in the initial state, the cutter 12 can also be entirely retracted inside the cylinder 11. At this time, a separate push on the cutter 12 is still required to make an incision with the cutter 12.

[0071] It should be noted that in addition to the structure of the cutter head 121 shown in the drawings, the cutter head 121 can also adopt other structural forms, as long as the relevant requirements such as the shape and size of the incision can be met. For example, the cutter head 121 can be entirely bullet-shaped, etc.

[0072] The cutter head 121 can be provided with a cutting edge 121b for cutting the blood vessel wall of the main blood vessel. The structural form and quantity of the cutting edge 121b are not limited herein. During specific implementation, those skilled in the art can set them according to actual needs.

[0073] In the embodiment of the drawings, as Figure 8 - Figure 11As shown, the blade 121b may have a blade portion with an arcuate contour line to enhance the cutting force; the extending direction of the blade 121b may be generally linear, and the arranging direction of the blade may be generally in the radial direction; the number of the blades 121b may be multiple and may be arranged at intervals in the circumferential direction; the projection of each blade 121b in the cross-section perpendicular to the axial direction is the first projection, and the projection of the equal-size segment in the cross-section perpendicular to the axial direction is the second projection. The first projections are all within the range of the second projections, that is, each blade 121b does not protrude from the outer wall surface of the equal-size segment to avoid over-cutting the main blood vessel.

[0074] Different from the first embodiment, in this embodiment, the blood vessel wall is not cut off as a whole, but is squeezed between the first clamping wall 211 and the second clamping wall 212. That is to say, the blood vessel wall between the first clamping wall 211 and the second clamping wall 212 is a double-layer blood vessel wall.

[0075] Moreover, in the second embodiment, since it is a cutting scheme of direct insertion and cutting without rotation, there can be more choices for the shape of the cutter head 121. Reference can also be made here Figure 14 - Figure 15 that there is also a matching relationship between the cross-section of the cutter head 121 perpendicular to the axial direction and the cross-section of the blood vessel body 24 of the blood vessel 2 to be installed: when the cross-section of the blood vessel body 24 perpendicular to the axial direction is oval, the cross-section of the cutter head 121 perpendicular to the axial direction can also be a matching oval; when the cross-section of the blood vessel body 24 perpendicular to the axial direction is circular, the cross-section of the cutter head 121 perpendicular to the axial direction can also be a matching circle.

[0076] It should be noted that the above two exemplary matching relationships are actually both based on the situation where the cutter head 121 cuts into the blood vessel wall of the main blood vessel perpendicular to it. When the cutter head 121 cuts into the blood vessel wall of the main blood vessel obliquely, even if the cross-section of the cutter head 121 perpendicular to the axial direction is circular, an oval incision can still be formed.

[0077] The sheath tube 18 is provided with a clamping structure capable of clamping the second clamping wall 212. This clamping structure can be an independent component and can then be installed on the sheath tube 18 by conventional mechanical connection methods. Or, it can also be a structure formed by the sheath tube 18 itself. The specific form of this clamping structure can be various as long as it can meet the usage requirements.

[0078] In the scheme of the drawings, as Figure 5 shown and in combination with Figure 1 - Figure 4 , the outer wall of the sheath tube 18 may be provided with a reduced-diameter groove 181 extending in the axial direction. Here, the reduced-diameter groove 181 refers to a structure with a small groove opening size and a large groove inner size, such as a dovetail groove, a T-shaped groove, an L-shaped groove, etc.; in the initial state, the second clamping wall 212 can be clamped in the reduced-diameter groove 181, and the groove wall of the reduced-diameter groove 181 can prevent the automatic flipping of the second clamping wall 212.

[0079] In the above solution, since the necking groove 181 is provided on the outer wall of the sheath tube 18, the overall shape of the necking groove 181 is actually also related to the shape of the outer wall of the sheath tube 18. If the part of the sheath tube 18 where the necking groove 181 is provided is an equal-dimension part, the extending direction of the necking groove 181 is generally parallel to the central axis of the sheath tube 18. In the initial state, the second clamping wall 212 and the first clamping wall 211 can be approximately at an angle of 90 degrees (as Figure 4 shown); if the part of the sheath tube 18 where the necking groove 181 is provided is a tapered part, the extending direction of the necking groove 181 can be at an angle greater than 90 degrees with the central axis of the sheath tube 18; or, the necking groove 181 can also be partially located in the equal-dimension part of the sheath tube 18 and partially located in the tapered part of the sheath tube 18.

[0080] Preferably, in the embodiment of the present invention, the entire necking groove 181 can be provided in the equal-dimension part. In this way, when the sheath tube 18 is advanced into the main blood vessel, the clamping structure between the second clamping wall 212 and the necking groove 181 will not form damping, and the advancement of the sheath tube 18 can be smoother.

[0081] Furthermore, the upper end of the necking groove 181 is also communicated with a receiving groove 182 that does not limit the rotation of the second clamping wall 212, which is used to receive the part connecting the first clamping wall 211 and the second clamping wall 212 (hereinafter referred to as the connecting part 213) and / or the second clamping wall 212. In this way, other parts of the clamping member 21 except the first clamping wall 211 can be restricted within the sheath tube 18, which can reduce the influence of the clamping member 21 on the insertion of the sheath tube 18 into the main blood vessel to ensure the shape of the incision on the blood vessel wall of the main blood vessel.

[0082] Again, as Figure 13 shown, the clamping member 21 can also include a connecting part 213 connecting the first clamping wall 211 and the second clamping wall 212; with this structure, when the second clamping wall 212 is separated from the sheath tube 18, the cross-section of the clamping member 21 along the axial direction can be approximately a U shape with an opening facing outward. Of course, the above-mentioned connecting part 213 can also be absent, that is, the second clamping wall 212 and the first clamping wall 211 can also be directly connected; with this structure, when the second clamping wall 212 is separated from the sheath tube 18, the cross-section of the clamping member 21 along the axial direction can be approximately a V shape with an opening facing outward.

[0083] The material of the clamping member 21 can specifically be a shape memory alloy, or it can also be other materials that can meet the usage requirements.

[0084] Combined with Figure 13 - Figure 16, the second clamping wall 212 may include a plurality of partition walls 212a arranged at circumferential intervals. In this way, the second clamping wall 212 can be flipped relatively easily; these partition walls 212a may or may not be connected to each other. Correspondingly, the number of the necking grooves 181 may also be multiple. In the initial state, each partition wall 212a can be clamped in the corresponding necking groove 181 one by one. The number of the partition walls 212a and the necking grooves 181 is not limited herein.

[0085] The structural form of each partition wall 212a is not limited herein. In specific implementation, those skilled in the art can set it according to actual needs. The surfaces of the partition walls 212a can be passivated to reduce the cutting ability of each partition wall 212a, and thus, to a large extent, avoid damage to the blood vessel wall of the main blood vessel when each partition wall 212a contacts the blood vessel wall of the main blood vessel.

[0086] Different from the second clamping wall 212, the first clamping wall 211 can be annular. In this way, after the clamping is completed, the first clamping wall 211 can cover the incision of the main blood vessel. In fact, the first clamping wall 211 can also adopt a structure similar to that of the second clamping wall 212, which does not affect the connection between the clamping member 21 and the blood vessel wall of the main blood vessel.

[0087] Furthermore, the clamping member 21 can also be configured with a hemostatic component 215 to minimize bleeding. The above-mentioned hemostatic component 215 refers to a component used for hemostasis in the medical field, such as a medical hemostatic felt, etc. It can be attached to the side of the first clamping wall 211 opposite to the second clamping wall 212. In this way, after the blood vessel 2 to be installed is docked with the main blood vessel, the hemostatic felt can be located outside the main blood vessel and press the incision tightly.

[0088] The blood vessel 2 to be installed may include a blood vessel body 24, and the aforementioned clamping member 21 is arranged at the proximal end of the blood vessel body 24. There can be many choices for the specific installation method as long as the reliable connection between the clamping member 21 and the blood vessel body 24 can be ensured.

[0089] Combined Figure 13 , a transition connecting member 22 can be provided at the proximal end of the blood vessel 2 to be installed. The transition connecting member 22 may include a cylindrical portion 221. The cylindrical portion 221 can be sleeved and fixed on the inner pipe wall of the blood vessel 2 to be installed. The specific fixing method can be interference fit or bonding; a wing plate portion 222 extending radially outward can be provided at the proximal end of the cylindrical portion 221, and the first clamping wall 211 can be connected to the wing plate portion 222. The connection method can be bonding, welding, etc., which is also related to the materials of the clamping member 21 and the transition connecting member 22 to a certain extent.

[0090] Preferably, the above-mentioned wing plate portion 222 can also serve as the first limiting member of the proximal end of the blood vessel body 24 and the cylinder 11, and is used to limit the relative position of the proximal end of the blood vessel body 24 and the cylinder 11. Specifically, in the initial state, the wing plate portion 222 can abut against the proximal end of the cylinder 11 along the axial direction, and further can limit the proximal end of the blood vessel body 24 at a position substantially consistent with the proximal end of the cylinder 11. The first clamping wall 211 connected to the wing plate portion 222 can be flush with the proximal end of the cylinder 11, or can also protrude appropriately from the proximal end of the cylinder 11, so that when the cylinder 11 is operated to approach the main blood vessel, the first clamping wall 211 can contact the blood vessel wall of the main blood vessel. It should be noted that if a hemostatic component 215 is provided on the first clamping wall 211, actually it is this hemostatic component that contacts the blood vessel wall of the main blood vessel. At this time, it only needs to ensure that the hemostatic component 215 protrudes appropriately from the proximal end of the cylinder 11 or is flush with the proximal end of the cylinder 11.

[0091] The structural form of the wing plate portion 222 can be various as long as the corresponding technical effects can be achieved. For example, the wing plate portion 222 can be a complete annular plate member, or the wing plate portion 222 can include a plurality of sub-plate members arranged at intervals in the circumferential direction, and each sub-plate member can be connected to the cylindrical portion 221.

[0092] As mentioned above, the distal end of the blood vessel 2 to be installed is detachably installed in the cylinder 11. In actual application, before the clamping member 21 is clamped with the main blood vessel, the distal end of the blood vessel 2 to be installed and the cylinder 11 can be in a connected state to maintain the installation state of the blood vessel 2 to be installed in the cylinder 11. After the clamping member 21 is clamped with the main blood vessel, the connection state between the distal end of the blood vessel 2 to be installed and the cylinder 11 can be released. At this time, the tool 12, the cylinder 11 and the blood vessel 2 to be installed can be controlled to be separated.

[0093] There can be many choices for this detachable connection method as long as the corresponding technical requirements can be met.

[0094] In the scheme of the drawings, as Figure 1 、 Figure 13 shown, the distal end of the blood vessel 2 to be installed can be provided with a first limiting member 23, and the cylinder wall of the cylinder 11 is connected with a first adjusting member 13 with an adjustable assembly depth; the assembly depth here refers to the insertion dimension along the radial direction of the cylinder 11. The part of the first adjusting member 13 extending into the cylinder 11 can be axially matched with the first limiting member 23 to limit the position of the distal end of the blood vessel 2 to be installed in the cylinder 11, and when it is necessary to release the limiting cooperation between the two, only the assembly depth of the first adjusting member 13 needs to be adjusted.

[0095] Specifically, the first adjusting member 13 may be a structural member such as a screw that is adjusted by screwing to adjust the assembly depth, or the first adjusting member 13 may also be a structural member such as a spring pin that is adjusted by plugging and unplugging to adjust the assembly depth.

[0096] The establishment of a bypass blood vessel requires forming two connection points with the main blood vessel, while the combined instrument provided by the present invention can only complete the establishment of one connection point at a time. Thus, when establishing a bypass blood vessel, two blood vessels to be installed 2 need to be respectively arranged at both ends of the diseased part of the main blood vessel; then, these two blood vessels to be installed 2 can be docked, and the establishment of the bypass blood vessel can be completed.

[0097] Therefore, a docking member also needs to be provided on the blood vessel to be installed 2, and specifically, the docking member may be arranged at the distal end of the blood vessel body 24.

[0098] To simplify the structure, the docking member and the aforementioned first limiting member 23 may be the same member, that is to say, in addition to being able to cooperate with the first adjusting member 13 to limit the axial displacement of the blood vessel to be installed 2 relative to the cylinder 11, the first limiting member 23 can also be used for the docking of the two blood vessels to be installed 2. Specifically, the first limiting member 23 may be a buckle, and the two blood vessels to be installed 2 can be connected through the buckle.

[0099] Furthermore, as Figure 1 、 Figure 3 shown, a second limiting member 122a may be provided on the outer wall of the cutting tool 12, and a second adjusting member 183 with an adjustable assembly depth is also connected to the cylinder wall of the sheath cylinder 18. The structural form of the second adjusting member may be similar to that of the aforementioned first adjusting member 13; similarly, the part of the second adjusting member 183 extending into the sheath cylinder 18 can cooperate with the second limiting member 122a to limit the position of the cutting tool 12 in the sheath cylinder 18. The installation position of the second limiting member 122a on the cutting tool 12 is not limited herein. In the attached drawing embodiments, as Figure 1 、 Figure 3 shown, the second limiting member 122a may be located at the distal end of the cutting tool 12.

[0100] With such a setting, when the limiting cooperation between the second adjusting member 183 and the second limiting member 122a is not released, the cutting tool 12 cannot displace relative to the sheath cylinder 18, which can facilitate the overall operation of the incision assembly 1 and can avoid accidental touching of the cutting tool 12; when the limiting cooperation between the second adjusting member 183 and the second limiting member 122a is released, the cutting tool 12 can displace relative to the sheath cylinder 18 to facilitate the individual operation of the cutting tool 12.

[0101] The second limiting member 122a may be a positioning groove extending radially on the tool 12, or the second limiting member 122a may also be an annular groove provided on the outer wall of the tool 12 for cooperating with the second adjusting member 183 to position the tool 12; this is specifically related to the structure of the tool 12 as well. The specific structure of the second adjusting member 183 may refer to the aforementioned first adjusting member 13 and will not be elaborated here.

[0102] In the foregoing description, the embodiments of the present invention provide two forms of tools. For the tool 12 involved in the first embodiment, it may include a cylindrical tool 122 and a rod tool 123, and the cylindrical tool 122 may be externally sleeved on the rod tool 123. The above-mentioned two limiting members 122a may be configured on the cylindrical tool 122. Since the limiting required for the cylindrical tool 122 includes not only axial displacement limitation but also circumferential rotation limitation, the second limiting member 122a required for the cylindrical tool 122 may be in the form of the aforementioned positioning holes.

[0103] The second limiting member 122a and the cylindrical tool 122 may be an integral structure. Or, the second limiting member 122a may also be an independent component and then assembled with the cylindrical tool 122. In the embodiment of the drawings, the distal end of the cylindrical tool 122 may be provided with a second operating head 122d, and the above-mentioned second limiting member 122a may be provided on the second operating head 122d.

[0104] For the tool 12 involved in the second embodiment, as Figure 8 and Figure 9 shown, the second limiting member 122a may be formed on the fourth operating head 124 at the distal end of the tool 12.

[0105] For a subject such as a human body or other animal body, the inner diameter of the main blood vessel is relatively small. Even for the aortic blood vessel, its inner diameter is in the centimeter range. Therefore, when operating the tool 12 to make an incision in the blood vessel wall of the main blood vessel, it is necessary to pay attention to avoiding the tool 12 piercing through the blood vessel wall on the other side and causing additional damage to the main blood vessel.

[0106] In specific practice, the above situation can be controlled by the fine operation of the operator. At this time, auxiliary judgment structures such as scale lines may also be provided on the sheath tube 18 to prompt the operator of the displacement distance of the tool 12.

[0107] In addition, a first stroke limiting member 185 may also be provided in the sheath tube 18, and the tool 12 may be provided with a second limiting member. When the cooperation between the second adjusting member 183 and the second limiting member 122a is in a released state, the first stroke limiting member 185 can cooperate with the second limiting member to limit the size of the tool 12 cutting into the main blood vessel, and thus can preferably avoid the tool 12 penetrating the main blood vessel.

[0108] The above-mentioned first stroke limiting member 185 can be an independent component, and then can be installed in the sheath tube 18 through mechanical connection means such as threaded connection, welding, clamping, bonding, etc. In combination with Figure 3 , the first stroke limiting member 185 can be the inner wall of the first operating head 184, and the first operating head 184 can be installed on the sheath tube 18.

[0109] Alternatively, the above-mentioned first stroke limiting member 185 and the sheath tube 18 can also be an integral structure. For example, the first stroke limiting member 185 can be a limiting boss formed by the inner wall of the sheath tube 18 protruding radially inward. In this way, the advancement amount of the tool 12 can also be limited. And in this implementation manner, there can also be many choices for the structural form of the first stroke limiting member 185; for example, it can be annular, or it can also be a single or multiple bumps arranged at intervals in the circumferential direction on the inner wall of the cylinder body 11.

[0110] For the tool 12 involved in the first implementation manner, it can include a barrel cutter 122 and a rod cutter 123, and the second limiting component can be a second operating head 122d arranged at the distal end of the barrel cutter 122. For the tool 12 involved in the second implementation manner, the second limiting component can be a fourth operating head 124 arranged at the distal end of the tool 12.

[0111] Similar to the structural design between the tool 12 and the sheath tube 18, for the tool 12 in the first implementation manner, a relative movement limiting structure and a stroke limiting structure can also be provided between the rod cutter 123 and the barrel cutter 122.

[0112] Specifically, a fourth limiting member 123d can be provided on the outer wall of the rod cutter 123, and a fourth adjusting member 122c with an adjustable assembly depth can be connected to the barrel wall of the barrel cutter 122. The structure of the fourth adjusting member 122c can refer to the aforementioned first adjusting member 13; the part of the fourth adjusting member 122c extending into the barrel cutter 122 can cooperate with the fourth limiting member 123d to limit the position of the rod cutter 123 in the barrel cutter 122.

[0113] With such a setting, when the limiting cooperation between the fourth adjusting member 122c and the fourth limiting member 123d is not released, the rod cutter 123 cannot displace relative to the barrel cutter 122, and accidental actuation of the rod cutter 123 can be avoided; when the limiting cooperation between the fourth adjusting member 122c and the fourth limiting member 123d is released, the rod cutter 123 can displace relative to the barrel cutter 122 so as to perform a separate operation on the rod cutter 123.

[0114] The fourth limiting member 123d and the rod cutter 123 may be an integral structure. Alternatively, the fourth limiting member 123d may also be an independent component and then assembled with the rod cutter 123. In the embodiment of the drawings, the distal end portion of the rod cutter 123 may be provided with a third operating head 123e, and the above-mentioned fourth limiting member 123d may be disposed on the third operating head 123e.

[0115] Further, the barrel cutter 122 may further be provided with a third stroke limiting member, and the rod cutter 123 may be provided with a third limiting member. When the cooperation between the fourth adjusting member 122c and the fourth limiting member 123d is in a released state, the third stroke limiting member is used to cooperate with the third limiting member to limit the size of the rod cutter cutting into the main blood vessel.

[0116] The second limiting member of the rod cutter 123 may be a third operating head 123e provided at the distal end portion of the rod cutter 123. The third stroke limiting member may be arranged with reference to the aforementioned first stroke limiting member 185 and the second stroke limiting member 112. In fact, when an elastic reset member 15 is disposed between the rod cutter 123 and the barrel cutter 122, the elastic reset member 15 may also serve as the third stroke limiting member to limit the relative displacement distance between the rod cutter 123 and the barrel cutter 122.

[0117] Further, a similar relative movement limiting structure and stroke limiting structure may also be provided between the sheath tube 18 and the barrel 11.

[0118] As Figure 2 、 Figure 3 shown, the outer wall of the sheath tube 18 may be provided with a third limiting member 186, and the barrel wall of the barrel 11 is connected with a third adjusting member 111 with an adjustable assembly depth. The portion of the third adjusting member 111 extending into the barrel 11 can cooperate with the third limiting member 186 to limit the position of the sheath tube 18 in the barrel 11.

[0119] With such a setting, when the limiting cooperation between the third adjusting member 111 and the third limiting member 186 is not released, the sheath tube 18 cannot be displaced relative to the barrel 11, and accidental touching of the sheath tube 18 can be avoided; when the limiting cooperation between the third adjusting member 111 and the third limiting member 186 is released, the sheath tube 18 can be displaced relative to the barrel 11 for separate operation of the sheath tube 18.

[0120] The third limiting member 186 and the sheath tube 18 may be an integral structure. Alternatively, the third limiting member 186 may also be an independent component and then assembled with the sheath tube 18. In the embodiment of the drawings, the distal end portion of the sheath tube 18 may be provided with a first operating head 184, and the above-mentioned third limiting member 186 may be disposed on the first operating head 184.

[0121] The cylinder body 11 may be provided with a second stroke limiting member 112, and the sheath cylinder 18 may be provided with a second limiting member. When the cooperation between the third adjusting member 111 and the third limiting member 186 is in a released state, the second stroke limiting member 112 is used to cooperate with the second limiting member to limit the size of the sheath cylinder 18 cutting into the main blood vessel, thereby better avoiding the situation that the sheath cylinder 18 cuts into the main blood vessel too deeply. The second limiting member may be a boss structure formed by the inner wall of the cylinder body 11.

[0122] Protective caps 17 are detachably installed at both axial ends of the cylinder body 11. This detachable connection method can be a threaded connection or an interference fit to a certain extent, etc. During use, the protective caps 17 at both ends of the cylinder body 11 can be removed first. The protective caps 17 can be made of transparent materials or non-transparent materials.

[0123] The protective cap 17 can be directly sleeved and installed on the cylinder body 11, or alternatively, a slot 172 can be provided at the end of the cylinder body 11, and then the protective cap 17 can be inserted into the slot 172.

[0124] Combined Figure 1 , if the protective cap 17 extends to be able to cover the second adjusting member 183 and the third adjusting member 111, the second adjusting member 183 and the third adjusting member 111 will interfere with the installation of the protective cap 17. At this time, an avoidance groove 171 can be provided on the protective cap 17 to avoid the second adjusting member 183 and the third adjusting member 111.

[0125] Furthermore, a handle 14 can also be provided on the outer wall surface of the cylinder body 11 to facilitate the operation of the combined instrument provided by the embodiment of the present invention.

[0126] The embodiment of the present invention does not limit the assembly process of the above-mentioned combined instrument. During actual assembly, it can be assembled in various orders as long as the final product can meet the usage requirements. The following gives an exemplary assembly step of the embodiment of the present invention.

[0127] For Figure 1 - Figure 7 the assembly process of the first embodiment shown is described as follows:

[0128] Step S101, install the blood vessel 2 to be installed into the cylinder body 11, and axially abut the wing plate portion 222 against the proximal end of the cylinder body 11, then straighten the blood vessel 2 to be installed, and cooperate the first adjusting member 13 with the first limiting member 23 to limit the position of the distal end of the blood vessel 2 to be installed;

[0129] Step S102: Slide the sheath tube 18 over the blood vessel 2 to be installed from bottom to top, and adjust the installation position of the sheath tube 18 so that the second clamping wall 212 can be clamped and assembled in the necking groove 181 of the sheath tube 18. Then install the first operating head 184 and the third adjusting member 111 so that the third adjusting member 111 can cooperate with the third limiting member 186 to limit the relative position between the sheath tube 18 and the cylinder body 11;

[0130] Step S103: Slide the barrel cutter 122 over the sheath tube 18 from bottom to top, then install the second operating head 122d and the second adjusting member 183 so that the second adjusting member 183 can cooperate with the second limiting member 122a to limit the relative position between the barrel cutter 122 and the sheath tube 18;

[0131] Step S104: Slide the rod cutter 123 over the barrel cutter 122 from top to bottom, then install the elastic reset member 15 and the third operating head 123e, and then install the fourth adjusting member 122c so that the fourth adjusting member 122c can cooperate with the fourth limiting member 123d to limit the relative position between the rod cutter 123 and the barrel cutter 122;

[0132] Step S105: Install protective caps 17 at both axial ends of the cylinder body 11.

[0133] For the combined instrument involved in the first embodiment, the following embodiments of the present invention can also briefly describe its operating steps.

[0134] Step S11: Remove the protective caps 17 at the proximal end and the distal end of the cylinder body 11, and operate the handle 14 to make the cylinder body 11 close to the blood vessel wall of the main blood vessel;

[0135] It should be noted that the direction in which the cutter 12 cuts into the main blood vessel can be vertical cutting or inclined cutting, and both of these two schemes are optional choices.

[0136] Step S12: Release the limiting cooperation between the fourth adjusting member 122c and the fourth limiting member 123d, and then operate the rod cutter 123 to cut into the main blood vessel through the third operating head 123e. The stop portion 123b of the rod cutter 123 can be turned over to the unfolded state in the main blood vessel, and then under the action of the elastic reset member 15, the stop portion 123b can be closely attached to the inner tube wall of the main blood vessel;

[0137] In this step, the displacement of the rod cutter 123 is guided by the barrel cutter 122.

[0138] Step S13: Release the limiting cooperation between the second adjusting member 183 and the second limiting member 122a, and then rotate and press down the second operating head 122d to operate the barrel cutter 122 to make an incision on the blood vessel wall of the main blood vessel. The cut blood vessel wall can be collected by the rod cutter 123;

[0139] At this time, it is possible to first displace the rod cutter 123 relative to the cylinder cutter 122 in a direction away from the main blood vessel, or a unified retraction operation of the rod cutter 123 and the cylinder cutter 122 can be performed subsequently.

[0140] Step S14, the operating sheath tube 18 and the cylinder body 11 are displaced together along the cylinder cutter 122 into the main blood vessel. The sheath tube 18 can be inserted into the main blood vessel until the hemostatic component 215 of the clamping member 21 contacts the outer wall of the blood vessel of the main blood vessel.

[0141] At this time, the rod cutter 123 and the cylinder cutter 122 can be displaced relative to each other in a direction away from the main blood vessel.

[0142] Step S15, the limiting fit between the third adjusting member 111 and the third limiting member 186 is released, and then the first operating head 184 is pressed down to displace the sheath tube 18 relative to the cylinder body 11 into the main blood vessel until the clamping of the second clamping wall 212 with the sheath tube 18 is released, and the second clamping wall 212 rotates to be oppositely arranged with the first clamping wall 211, thereby clamping the blood vessel wall of the main blood vessel.

[0143] In this process, the first stroke limiting member 185 is used to limit the advancement amount of the cutter 12.

[0144] Step S16, the axial limiting fit between the first adjusting member 13 and the first limiting member 23 is released, and the incision assembly 1 is slowly displaced in a direction away from the main blood vessel. When the blood vessel to be installed 2 is exposed outside the cylinder body 11, the blood vessel to be installed 2 is clamped with a hemostatic forceps to prevent blood from flowing out, and then, the cylinder body 11 and the cutter 12 are completely pulled out.

[0145] Step S17, Steps S11 - S16 are repeated to connect another blood vessel to be installed 2 at the other end of the diseased part of the main blood vessel.

[0146] Step S18, after fully discharging the gas in the two blood vessels to be installed 2 and making the blood in the blood vessel to be installed 2 flow to the distal end of the corresponding blood vessel to be installed 2, the two blood vessels to be installed 2 are quickly docked by using the first limiting member 23 to complete the establishment of the bypass blood vessel.

[0147] For Figure 8 - Figure 12 In the second embodiment shown, its assembly process is basically similar to the above Steps S101 - S105, and the main difference is that the assembly schemes of the cylinder cutter 122 and the rod cutter 123 in Steps S103 and S104 are integrated into the same step. Thus, the assembly process of the second embodiment can be as follows:

[0148] Step S201, the same as Step S101 described above;

[0149] Step S202 is the same as the aforementioned step S102;

[0150] In step S203, the tool 12 is sleeved inside the sheath tube 18 from bottom to top, and then the fourth operating head 124 is installed, and the second adjusting member 183 is installed so that the second adjusting member 183 can cooperate with the second limiting member 122a to limit the relative position of the tool 12 relative to the sheath tube 18;

[0151] Step S204 is the same as step S105.

[0152] Regarding the combined instrument involved in the second embodiment, the following embodiments of the present invention can also briefly describe its operating steps.

[0153] In step S21, the protective caps 17 at the proximal end and the distal end of the cylinder 11 are removed, and the operating handle 14 is operated to make the incision assembly 1 close to the blood vessel wall of the main blood vessel;

[0154] It should be noted that the tool 12 can cut into the main blood vessel vertically or obliquely, and both of these two schemes are optional choices that can be adopted.

[0155] In addition, when directly driving the incision assembly 1 close to the main blood vessel, if the proximal end of the tool 12 itself protrudes from the sheath tube 18 by a sufficient length, the tool 12 can be directly inserted into the main blood vessel, and the tool 12 can already form an incision of a suitable size in the main blood vessel. If the proximal end of the tool 12 itself does not protrude from the sheath tube 18, or the protruding part of the proximal end of the tool 12 from the sheath tube 18 is relatively short and is not sufficient to enable the tool 12 to cut into the main blood vessel in place and form an incision of a suitable size in the main blood vessel, then the following step S22 can be executed.

[0156] In step S22, the limiting cooperation between the second adjusting member 183 and the second limiting member 122a is released, and the fourth operating head 124 is pressed down to drive the tool 12 to cut into a suitable position in the main blood vessel and form an incision of a suitable size in the main blood vessel;

[0157] In step S23, the sheath tube 18 and the cylinder 11 are operated to displace together along the barrel cutter 122 into the main blood vessel, and the sheath tube 18 can be inserted into the main blood vessel until the hemostatic part 215 of the clamping member 21 contacts the outer wall of the blood vessel of the main blood vessel;

[0158] In step S24, the limiting cooperation between the third adjusting member 111 and the third limiting member 186 is released, and then the first operating head 184 is pressed down to operate the sheath tube 18 to displace relative to the cylinder 11 into the main blood vessel until the second clamping wall 212 is disengaged from the clamping of the sheath tube 18, and the second clamping wall 212 rotates to be opposite to the first clamping wall 211, thereby clamping the blood vessel wall of the main blood vessel;

[0159] In this process, the first stroke limiting member 185 is used to limit the advancement amount of the tool 12.

[0160] Step S25: Release the axial limiting fit between the first adjusting member 13 and the first limiting member 23, and slowly displace the incision assembly 1 away from the main blood vessel. When the blood vessel 2 to be installed is exposed outside the cylinder 11, clamp the blood vessel 2 to be installed with a hemostatic forceps to prevent blood from flowing out, and then completely pull out the cylinder 11 and the tool 12.

[0161] Step S26: Repeat steps S21 - S25 to connect another blood vessel 2 to be installed at the other end of the diseased part of the main blood vessel.

[0162] Step S27: Fully discharge the gas in the two blood vessels 2 to be installed, and when the blood in the blood vessel 2 to be installed flows to the distal end of the corresponding blood vessel 2 to be installed, quickly dock the two blood vessels 2 to be installed with the first limiting member 23 to complete the establishment of the bypass blood vessel.

[0163] It should be noted that the combined instrument provided by the present invention can be used under open - chest conditions or for minimally invasive interventional surgery. That is to say, the implementation scenario of the combined instrument provided by the present invention is not limited. In addition, the materials used for each component in the combined instrument provided by the present invention are all medical functional materials that are harmless to human tissues and blood, so as to avoid the resistance between the material itself and the patient.

[0164] The above is only the preferred embodiment of the present invention. It should be pointed out that for those of ordinary skill in the art, without departing from the principle of the present invention, several improvements and refinements can be made, and these improvements and refinements should also be regarded as the protection scope of the present invention.

Claims

1. A combined instrument for vascular connection, characterized in that, it includes an incision component (1) and a blood vessel to be installed (2). The incision component (1) includes a cylinder (11), a sheath cylinder (18) and a cutter (12) which are sleeved inside in sequence. The cylinder (11) and the sheath cylinder (18) can slide relative to each other, and the sheath cylinder (18) and the cutter (12) can slide relative to each other. The cutter (12) is used to cut an incision in the blood vessel wall of the main blood vessel. The blood vessel to be installed (2) is also arranged inside the cylinder (11) and is sleeved outside the sheath cylinder (18). The distal end of the blood vessel to be installed (2) is detachably installed on the cylinder (11), and the proximal end of the blood vessel to be installed (2) is located at the proximal end of the cylinder (11). A clamping member (21) is provided at the proximal end of the blood vessel to be installed (2). The clamping member (21) includes a first clamping wall (211) and a second clamping wall (212) which are elastically connected; In the initial state, the second clamping wall (212) is clamped on the sheath cylinder (18). The synchronous displacement of the sheath cylinder (18) and the cylinder (11) enables the second clamping wall (212) to cut into the main blood vessel along with the sheath cylinder (18). The displacement of the sheath cylinder (18) relative to the cylinder (11) towards the inside of the main blood vessel can cause the second clamping wall (212) to be disengaged from the sheath cylinder (18). The second clamping wall (212) disengaged from the sheath cylinder (18) can elastically rotate to be arranged opposite to the first clamping wall (211). The first clamping wall (211) and the second clamping wall (212) arranged opposite to each other can clamp the blood vessel wall of the main blood vessel.

2. The combined instrument for vascular connection according to claim 1, characterized in that, a necking groove (181) extending axially is provided on the outer wall of the sheath cylinder (18). In the initial state, the second clamping wall (212) is clamped in the necking groove (181).

3. The combined instrument for vascular connection according to claim 2, characterized in that, the second clamping wall (212) includes a plurality of sub-walls (212a) arranged at intervals in the circumferential direction. The number of the necking grooves (181) is multiple. In the initial state, each of the sub-walls (212a) is clamped in the corresponding necking groove (181) one by one.

4. The combined instrument for vascular connection according to claim 2, characterized in that, a receiving groove (182) that does not limit the rotation of the second clamping wall (212) is further communicated with the upper end of the necking groove (181) and is used to accommodate the second clamping wall (212) and / or the part connecting the first clamping wall (211) and the second clamping wall (212).

5. The combined instrument for vascular connection according to claim 1, characterized in that, the clamping member (21) is configured with a hemostatic component (215).

6. The combined instrument for vascular connection according to any one of claims 1-5, characterized in that, The vascular graft (2) to be installed includes a vascular graft body (24), a transition connecting member (22) is provided at the proximal end of the vascular graft body (24), the transition connecting member (22) includes a cylindrical portion (221), the cylindrical portion (221) is sleeved and fixed on the inner tube wall of the vascular graft (2), a wing plate portion (222) extending radially outward is provided at the proximal end of the cylindrical portion (221), and the first clamping wall (211) is connected to the wing plate portion (222).

7. The combined instrument for vascular connection according to claim 6, wherein, the wing plate portion (222) is located radially outside the cylindrical portion (221) and can axially abut against the proximal end of the cylinder body (11).

8. The combined instrument for vascular connection according to any one of claims 1-5, wherein, the vascular graft (2) to be installed includes a vascular graft body (24), a first limiting member (23) is provided at the distal end of the vascular graft body (24), a first adjusting member (13) with adjustable assembly depth is connected to the tube wall of the cylinder body (11), and the part of the first adjusting member (13) extending into the cylinder body (11) can cooperate with the first limiting member (23) to limit the position of the distal end of the vascular graft (2) in the cylinder body (11).

9. The combined instrument for vascular connection according to any one of claims 1-5, wherein, the vascular graft (2) to be installed includes a vascular graft body (24), a docking member is provided at the distal end of the vascular graft body (24) for connecting two vascular grafts (2) to be installed.

10. The combined instrument for vascular connection according to any one of claims 1-5, wherein, a second limiting member (122a) is provided on the outer wall of the cutter (12), a second adjusting member (183) with adjustable assembly depth is connected to the tube wall of the sheath cylinder (18), and the part of the second adjusting member (183) extending into the sheath cylinder (18) can cooperate with the second limiting member (122a) to limit the position of the cutter (12) in the sheath cylinder (18).

11. The combined instrument for vascular connection according to claim 10, wherein, the sheath cylinder (18) is provided with a first stroke limiting member (185), the cutter (12) is provided with a second limiting part, and when the cooperation between the second adjusting member (183) and the second limiting member (122a) is in a released state, the first stroke limiting member (185) is used to cooperate with the second limiting part to limit the size of the cutter (12) cutting into the main blood vessel.

12. The combined instrument for vascular connection according to any one of claims 1-5, wherein, The outer wall of the sheath tube (18) is provided with a third limiting member (186), and the barrel wall of the barrel body (11) is connected with a third adjusting member (111) with an adjustable assembly depth. The part of the third adjusting member (111) extending into the barrel body (11) can cooperate with the third limiting member (186) to limit the position of the sheath tube (18) in the barrel body (11).

13. The combined instrument for blood vessel connection according to claim 12, wherein, the barrel body (11) is provided with a second stroke limiting member (112), the sheath tube (18) is provided with a second limiting part. When the cooperation between the third adjusting member (111) and the third limiting member (186) is in a released state, the second stroke limiting member (112) is used to cooperate with the second limiting part to limit the size of the sheath tube (18) cutting into the main blood vessel.

14. The combined instrument for blood vessel connection according to any one of claims 1-5, wherein, the cutter (12) includes a cutter head (121), and a puncture needle (121a) and a cutting edge (121b) are provided at the proximal end of the cutter head (121).

15. The combined instrument for blood vessel connection according to any one of claims 1-5, wherein, the cutter (12) includes a cylindrical cutter (122) and a rod cutter (123). The cylindrical cutter (122) is sleeved outside the rod cutter (123) and can move relative to the rod cutter (123). A plurality of cutting edges (122b) are provided at the proximal end of the cylindrical cutter (122). A conical needle head (123a) is provided at the proximal end of the rod cutter (123), and a rotatably arranged stop portion (123b) is further provided on the outer wall of the rod cutter (123); When the rod section of the rod cutter (123) provided with the stop portion (123b) is located inside the cylindrical cutter (122), the stop portion (123b) is in a retracted state. When the rod section of the rod cutter (123) provided with the stop portion (123b) is located outside the cylindrical cutter (122), the stop portion (123b) flips to an unfolded state for stopping and recycling the blood vessel wall cut by the cylindrical cutter (122).

16. The combined instrument for blood vessel connection according to claim 15, wherein, an axially extending receiving groove (123c) is provided on the outer wall of the rod cutter (123). One end of the stop portion (123b) is hinged to the proximal end of the receiving groove (123c), and when in the retracted state, the center of gravity of the stop portion (123b) is located radially outside the rotation center line of the stop portion (123b).

17. The combined instrument for blood vessel connection according to claim 15, wherein, The outer wall of the rod cutter (123) is provided with a fourth limiting member (123d), and the barrel wall of the barrel cutter (122) is connected with a fourth adjusting member (122c) for adjusting the assembly depth. The part of the fourth adjusting member (122c) extending into the barrel cutter (122) can cooperate with the fourth limiting member (123d) to limit the position of the rod cutter (123) in the barrel cutter (122).

18. The combined instrument for blood vessel connection according to claim 17, wherein, the barrel cutter (122) is provided with a third stroke limiting member, the rod cutter (123) is provided with a third limiting member. When the cooperation between the fourth adjusting member and the fourth limiting member is in a released state, the third stroke limiting member is used to cooperate with the third limiting member to limit the size of the rod cutter (123) cutting into the main blood vessel.

19. The combined instrument for blood vessel connection according to any one of claims 1-5, wherein, protective caps (17) are detachably installed at both axial ends of the cylinder body (11).

20. The combined instrument for blood vessel connection according to any one of claims 1-5, wherein, a handle (14) is arranged on the outer wall of the cylinder body (11).

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