Cutting device and cutting system

Abstract

The invention provides a cutting device which comprises a puncture part, a sleeve and a rotary cutting assembly, and the puncture part and the rotary cutting assembly can be movably arranged in the sleeve in a penetrating mode; the puncture piece is used for puncturing tissues to establish a passage after being connected with the sleeve in a sleeving manner; the rotary cutting assembly comprises a rotary cutting part, a rotary cutting piece is arranged at the far end of the rotary cutting part, the rotary cutting assembly enters the tissue along the channel after the puncture piece is withdrawn from the cannula, and the rotary cutting piece is used for conducting rotary cutting on the tissue located around the rotary cutting piece. The cutting device can cut the target tissue for multiple times only by entering the ventricular septum for one time without entering the ventricular septum for multiple times, the operation efficiency is high, and operation is convenient.

Description

Technical Field

[0001] The present invention relates to the field of medical devices, and in particular to a cutting device and a cutting system. Background Art

[0002] Hypertrophic cardiomyopathy (HCM) is a common autosomal dominant cardiovascular disease, which is mainly manifested by hypertrophy of one or more segments of the left ventricle (LV). The general diagnostic standard is a thickness greater than or equal to 15 mm. Its treatment methods mainly include drug therapy, surgical septal myectomy, and ventricular septal ablation.

[0003] The prior art (CN211325408U) discloses a ventricular septum resection device, which has a cutting window for cutting and negative pressure suction on the side of the distal end. After the ventricular septum resection device is close to the target tissue, the cutting window is opened, and the negative pressure machine is operated to make part of the tissue enter the cutting window under suction and position it, and then the cutting knife assembly is operated to cut along the axial direction, so that the part of the tissue is separated from the ventricular septum and remains in the cutting window, and then the cutting window is closed and the ventricular septum cutting device is withdrawn from the heart cavity. If the resection range is not satisfactory, the ventricular septum cutting device is washed and the above operation is repeated to expand the resection range.

[0004] However, the ventricular septum resection device can only cut once after entering the heart cavity, and the cutting range is small; if the cutting range needs to be expanded, it is necessary to enter the heart cavity multiple times to perform multiple cuts, and the cutting efficiency is low. Summary of the invention

[0005] The object of the present invention is to provide a cutting device and a cutting system having the same.

[0006] In order to solve the above technical problems, the present invention provides a cutting device, including a puncture member, a sleeve and a rotary cutting assembly, wherein the puncture member and the rotary cutting assembly can be movably inserted into the sleeve respectively; the puncture member is used to puncture tissue to establish a passage after being sleeved with the sleeve; the rotary cutting assembly includes a rotary cutting member, a rotary cutting portion is provided at the distal end of the rotary cutting member, and the rotary cutting assembly enters the tissue along the passage after the puncture member is withdrawn from the sleeve, and the rotary cutting member is used to rotary cut the tissue located around the rotary cutting portion.

[0007] In some possible embodiments, the puncture member is a puncture needle; the sleeve includes a tubular body with an inner cavity, the tubular body has an entrance for the puncture needle or the rotary cutting assembly to enter the tubular body, and the gap between the sleeve and the rotary cutting assembly can be connected to a suction device.

[0008] The present invention also provides a cutting device, comprising a sleeve, a handle and a rotary cutting assembly, wherein the proximal ends of the sleeve and the rotary cutting assembly are respectively connected to the handle, and the rotary cutting assembly can be movably inserted into the sleeve; wherein the sleeve or the rotary cutting assembly is slidably connected to the handle, so that the sleeve and the rotary cutting assembly can move relative to each other in the axial direction, so that the distal end of the rotary cutting assembly can enter or extend out of the distal end of the sleeve; the rotary cutting assembly includes a puncture member arranged at its distal end and a rotary cutting member connected to the puncture member, the rotary cutting member includes a rotary cutting portion located on the proximal side of the puncture member, the puncture member extends out of the distal end of the sleeve to establish a passage, and the rotary cutting portion extends out of the distal end of the sleeve to perform rotary cutting on tissue located around it.

[0009] In some possible implementations, an operating portion is provided at the proximal end of the sleeve or the rotary cutting assembly, and the operating portion is used to drive the sleeve or the rotary cutting assembly to move.

[0010] The present invention also provides a cutting system, comprising the above-mentioned cutting device and a suction device, wherein the cutting device is used for cutting tissue, and the suction device is used for sucking the cut tissue.

[0011] The cutting device of the cutting system of the present invention passes through the apex and punctures the epicardium through a puncture piece or a tip to establish a passage, and the rotary cutting component reaches the target tissue along the passage, and the tissue located around the distal end of the rotary cutting component can be cut by rotating the rotary cutting component; if the range of tissue cut by the rotary cutting component once is too small to reach the expected target, the operator can move the rotary cutting component along the passage to facilitate the selection of the next cutting position, so the cutting device can perform multiple cuts on the target tissue by entering the ventricular septum only once, without having to enter the ventricular septum multiple times to perform multiple cuts, the operation is efficient and easy to operate; in addition, there is a suction channel between the cannula and the rotary cutting component, so that the cut tissue moves to the suction device through the suction channel. BRIEF DESCRIPTION OF THE DRAWINGS

[0012] In order to more clearly illustrate the technical solution of the embodiment of the present invention, the drawings required for use in the implementation mode will be briefly introduced below. Obviously, the drawings described below are some implementation modes of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative work.

[0013] Figure 1is a schematic structural diagram of a cutting device according to a first embodiment of the present invention;

[0014] Figure 2 yes Figure 1 A schematic structural diagram of the combination of the puncture member and the sleeve;

[0015] Figure 3 yes Figure 1 A schematic structural diagram of a combination of a sleeve and a rotary cutting assembly;

[0016] Figure 4 yes Figure 3 A distal side view of the combination of the cannula and the rotary cutting assembly;

[0017] Figure 5 yes Figure 4 A cross-sectional view of the combination of the sleeve and the rotary cutting assembly along the AA direction;

[0018] Figure 6 is a schematic structural diagram of a combination of a sleeve and a rotary cutting assembly according to another embodiment;

[0019] Figure 7 is a schematic diagram of a combination of a puncture member and a sleeve to establish a channel according to the first embodiment of the present invention;

[0020] Figure 8 is a schematic diagram of withdrawing the piercing member after establishing the channel;

[0021] Fig. 9 is a schematic diagram of a cutting system provided by Embodiment 2 of the present invention;

[0022] Fig.10 is a schematic diagram of the withdrawal of the instrument after rotary cutting;

[0023] Fig.11 is a schematic structural diagram of a cutting device according to a third embodiment of the present invention when the catheter is located at a first position;

[0024] Fig.12 yes Fig.11 A schematic diagram of the structure when the guide tube of the cutting device is located at the second position;

[0025] Fig.13 yes Fig.12 A distal side view of the cutting device in FIG.

[0026] Fig.14 yes Fig.13 A cross-sectional view of the cutting device along the CC direction;

[0027] Fig.15 is a schematic diagram of a cutting system establishing a channel according to a fourth embodiment of the present invention;

[0028] Fig.16It is a schematic diagram of the cutting device performing rotary cutting on the ventricular septum;

[0029] Fig.17 is a schematic structural diagram of a cutting device according to a fifth embodiment of the present invention when the catheter is located at a first position;

[0030] Fig.18 is a schematic diagram of the structure when the guide tube of the cutting device is located in the second position;

[0031] Fig.19a yes Fig.17 A side view of the cutting device in FIG.

[0032] Fig.19b yes Fig.19a A cross-sectional view of the cutting device along the DD direction;

[0033] Fig.20a yes Fig.18 A side view of the cutting device in FIG.

[0034] Fig.20b yes Fig.20a A cross-sectional view of the cutting device along the DD direction;

[0035] Fig.21 It is an exploded view of the cutting device;

[0036] Fig. 22 is a schematic diagram of a cutting system establishing a channel according to a sixth embodiment of the present invention;

[0037] Fig.23 It is a schematic diagram of the cutting device performing rotary cutting on the ventricular septum;

[0038] Fig.24 is a side view of a cutting device according to a seventh embodiment of the present invention;

[0039] Fig.25 is a side view of a cutting device in another embodiment;

[0040] Fig.26 is a schematic structural diagram of a cutting device according to an eighth embodiment of the present invention;

[0041] Fig. 27 yes Fig.26 A side view of the cutting device in FIG.

[0042] Fig.28 yes Fig. 27 Cross-sectional view of the cutting device along the EE direction. DETAILED DESCRIPTION

[0043] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0044] The following descriptions of the various embodiments are made with reference to the attached drawings to illustrate specific embodiments in which the present invention may be implemented. The directional terms mentioned in the present invention, such as "top", "bottom", "front", "back", "left", "right", "inside", "outside", "side", etc., are only with reference to the directions of the attached drawings. Therefore, the directional terms used are for better and clearer description and understanding of the present invention, and are not intended to indicate or imply that the device or element referred to must have a specific orientation, be constructed and operate in a specific orientation, and therefore cannot be understood as limiting the present invention.

[0045] In the description of the present invention, it should be noted that, unless otherwise clearly specified and limited, the terms "installed", "connected", "connected", and "set on..." should be understood in a broad sense. For example, it can be a fixed connection, a detachable connection, or an integral connection; it can be a mechanical connection; it can be directly connected, or indirectly connected through an intermediate medium, or it can be internal communication between two components. In the field of interventional medical devices, the proximal end of the medical device refers to the end closer to the operator, and the distal end of the medical device refers to the end farther from the operator; the axial direction refers to the direction parallel to the line connecting the distal center and the proximal center of the medical device. For those of ordinary skill in the art, the specific meanings of the above terms in the present invention can be understood according to specific circumstances.

[0046] Embodiment 1:

[0047] like Figure 1-3 As shown, a first embodiment of the present invention provides a cutting device 1, which includes a puncture member 10, a sleeve 20 and a rotary cutting assembly 30. The puncture member 10 and the rotary cutting assembly 30 can be movably inserted into the sleeve 20 respectively; the puncture member 10 is sleeved with the sleeve 20 to puncture the tissue to establish a passage; the rotary cutting assembly 30 includes a rotary cutting portion 31, and a rotary cutting member 312 is provided at the distal end of the rotary cutting portion 31. After the puncture member 10 is withdrawn from the sleeve 20, the rotary cutting assembly 30 enters the tissue along the passage, and the rotary cutting member 312 rotary cuts the tissue around the rotary cutting member 312.

[0048] When the sleeve 20 and the puncture member 10 are movably connected, the puncture member 10 is at least partially located in the sleeve 20, and the distal end of the puncture member 10 can extend out of the distal opening of the sleeve 20, so that the puncture member 10 can puncture the tissue; when the sleeve 20 and the rotary cutting assembly 30 are movably connected, the rotary cutting assembly 30 is at least partially located in the sleeve 20, and the distal end of the rotary cutting assembly 30 can extend out of the distal opening of the sleeve 20, so that the rotary cutting assembly 30 can rotary cut the tissue around the distal end of the rotary cutting assembly 30. Rotary cutting refers to that after the rotary cutting assembly 30 rotates, the rotary cutting assembly 30 cuts the tissue around the rotary cutting assembly 30, so that part of the tissue is separated from the main body of the tissue.

[0049] Specifically, the puncture member 10 can be a puncture needle, which includes a needle tip, a needle body and an operating part 11. The puncture member 10 can be integrally formed by laser cutting, grinding, wire cutting and other processing methods. Its needle tip is a closed and sharp tip structure, and its shape includes but is not limited to a cone, a triangular pyramid, a quadrangular pyramid, a single bevel edge and other shapes. The shape of the needle tip can provide the puncture member 10 with a sufficiently sharp needle tip structure, so that it can puncture the endocardium or epicardium tissue with a smaller puncture force, thereby smoothly entering the myocardial tissue of the ventricular septum. The operating part 11 is used for the operator to control the puncture member 10, so as to combine or separate the puncture member 10 with the cannula 20. Among them, the transcatheter path can be used to enter the left ventricle or the right ventricle so as to puncture the endocardium; the transapical path can be used to puncture the epicardium.

[0050] In some embodiments, the needle tip and the needle body of the puncture member 10 are separate structures. The needle tip is a separately processed needle head, and the distal end of the needle tip is in a shape including but not limited to a cone, a triangular pyramid, a quadrangular pyramid, a single bevel edge, etc., and its proximal end is fixedly connected to the distal end of the needle body by means including but not limited to bonding, welding, etc.

[0051] like Figure 1-2 , Fig. 9 As shown, the cannula 20 includes an irrigation interface 21, a suction interface 22 and a catheter 23 with an inner cavity. The irrigation interface 21 and the suction interface 22 are connected to the proximal end of the catheter 23, so that the cannula 20 has a three-way structure. The irrigation interface 21 serves as an entrance for the puncture member 10 or the rotary cutting assembly 30 to enter the catheter 23, so that the distal end of the puncture member 10 or the rotary cutting assembly 30 passes through the catheter 23 and extends out of the distal opening of the catheter 23; the suction interface 22 is used to connect with the suction device 50, so as to move the rotary cut tissue and the irrigation liquid to the suction device 50.

[0052] like Figure 1 , Figure 3 , Fig. 9As shown, the rotary cutting assembly 30 includes a rotary cutting part 31, a handle 32, a perfusion interface 33 and an intermediate tube 34. The proximal end of the rotary cutting part 31 is sleeved in the intermediate tube 34 and connected to the handle 32. A high-speed motor is arranged in the handle 32. The high-speed motor is used to drive the rotary cutting part 31 to rotate, so that the rotary cutting part 31 can cut the tissue around the rotary cutting part 31 and break the cell wall of the cut tissue; the perfusion interface 33 is used to connect with the perfusion device 40, so that the perfusion device 40 can deliver the perfusion liquid to the distal end of the rotary cutting part 31. The rotation speed of the high-speed motor is 30,000 rpm, preferably, the rotation speed of the high-speed motor is 35,000 rpm.

[0053] Specifically, Figure 4-5 As shown, the rotary cutting portion 31 includes a head end 311, a rotary cutting piece 312 and a connecting piece 313. The connecting piece 313 is a slender rod. The connecting piece 313 is sleeved in the middle tube 34 and there is a gap between the connecting piece 313 and the middle tube 34. The gap forms a perfusion channel 314. The perfusion channel 314 is connected to the perfusion interface 33 to facilitate the perfusion liquid to be transported from the perfusion interface 33 to the distal end of the connecting piece 313; the distal end of the connecting piece 313 extends out of the distal opening of the middle tube 34, and the proximal end of the connecting piece 313 extends into the handle 32 and is connected to the high-speed motor. The head end 311 and the rotary cutting piece 312 are arranged at the distal end of the connecting piece 313 at intervals, wherein the head end 311 is arranged at the distal end of the connecting piece 314. The head end 311 is hemispherical or quasi-hemispherical as a whole, and its outer diameter is larger than the outer diameter of the connecting piece 314 and the outer surface is smooth without protrusions. When the connecting piece 313 is driven by a high-speed motor, the head end 311 also rotates accordingly. When the rotary cutting part 31 is located in the ventricular septum tissue, the head end 311 can support the passage, thereby reducing the pressure of the tissue wrapping the rotary cutting piece 312, and avoiding the situation where the rotary cutting piece 312 is wrapped too tightly by the tissue and cannot rotate.

[0054] The rotary cutting member 312 is fixedly connected to the connecting member 313, and a cutting blade is arranged on the edge of the rotary cutting member 312. When the high-speed motor drives the rotary cutting member 312 to rotate through the connecting member 313, the rotary cutting member 312 can cut the tissue through a small rotational force, thereby separating part of the tissue from the main body of the tissue. Furthermore, the rotary cutting member 312 and the connecting member 313 have an axial angle α, and by setting the angle α, the cutting range of the rotary cutting member 312 when rotating can be increased. The angle α is generally 30°-150°, preferably 50°-130°, and more preferably 60°-120°.

[0055] After the rotary cutting assembly 30 and the cannula 20 are combined together, there is a suction channel 231 between the catheter 23 and the intermediate tube 34, and the proximal end of the suction channel 231 is connected to the suction device 50, which serves to suck the separated part of the tissue and the irrigation liquid into the suction device 50. Furthermore, the distal end of the irrigation channel 314 extends out of the distal opening of the suction channel 231, so that the irrigation liquid is sucked away by the suction device 50.

[0056] like Figure 6 As shown, in some embodiments, in order to further increase the cutting range of the rotary cutting portion 31, at least one rotary cutting member 315 having the same or different structure as the rotary cutting member 312 may be provided at the distal end of the connecting member 313, and the cutting range of the rotary cutting portion 31 may be increased by the cooperation between the rotary cutting member 312 and at least one rotary cutting member 315. Further, the rotary cutting member 312 and the rotary cutting member 315 are located in different planes, that is, the angle between the rotary cutting member 312 and the connecting member 313 is different from the angle between the rotary cutting member 315 and the connecting member 313, or the rotary cutting member 312 and the rotary cutting member 315 are staggered in the radial direction of the connecting member 313, so the cutting directions of the two are different when rotating, and therefore the radial reaction forces of the two on the connecting member 313 in opposite directions can be offset, thereby reducing the radial shaking of the connecting member 313 during cutting.

[0057] Embodiment 2:

[0058] like Fig. 9 As shown, the second embodiment of the present invention provides a cutting system 2, which includes the cutting device 1, the irrigation device 40 and the suction device 50 of the first embodiment, and the cutting device 1 is connected to the irrigation device 40 and the suction device 50 respectively; the irrigation device 40 is used to provide irrigation liquid for the cutting device 1, and the suction device 50 is used to suck the cut tissue and the irrigation liquid.

[0059] Specifically, Figure 7-10As shown, the puncture member 10 and the sleeve 20 are first combined together, and then the puncture member 10 punctures the epicardium through the apex to establish a passage; then the puncture member 10 is withdrawn to separate it from the sleeve 20, and the sleeve 20 is retained in place; then the rotary cutting assembly 30 and the sleeve 20 are combined together, and the distal end of the rotary cutting portion 31 extends out of the distal opening of the sleeve 20, the perfusion device 40 is connected to the rotary cutting assembly 30 and perfusion liquid is supplied to the rotary cutting assembly 30, the suction device 50 is connected to the sleeve 20, and the high-speed motor of the rotary cutting assembly 30 is turned on so that the rotary cutting member 312 cuts and breaks the tissue located around the rotary cutting member 312, and the broken tissue is mixed with the perfusion liquid to form a meat slurry, which is then sucked away by the suction device 50 along the suction channel 231. At the same time, when the amount of the broken tissue is large, since the perfusion liquid is continuously sucked away by the suction device 50, the perfusion liquid will generate a force toward the proximal end of the suction channel 231 after contacting the broken tissue during the process, ensuring that the broken tissue can be sucked away by the suction device 50 without blocking the suction channel 231.

[0060] After cutting, the cutting range is observed through the imaging system. If the cutting range is small, the handle 32 can be pushed forward or pulled back along the direction of the passage to adjust the position of the rotary cutting assembly 30 on the passage, so that tissues at other positions on the passage can be rotary cut. The above operation is repeated until a satisfactory cutting area B is obtained, and then the sleeve 20 and the rotary cutting assembly 30 are withdrawn, and the wound is sutured to complete the removal of part of the ventricular septum tissue. Subsequently, the tissues around the cutting area B will move toward the cutting area B to fill the cutting area B, so that the volume of the ventricular septum is reduced, thereby alleviating the left ventricular outflow tract obstruction.

[0061] Of course, the cutting system is not only used for cutting ventricular septum tissue, but also can be used for cutting other tissues, including but not limited to nerve tissue, epithelial tissue and other myocardial tissue, etc. It can also play the role of removing tissue and reducing tissue volume.

[0062] Embodiment three:

[0063] like Figure 11-14 As shown, embodiment three of the present invention provides a cutting device 1a, which includes a sleeve 110, a handle assembly 120 and a rotary cutting assembly 130, wherein the proximal ends of the sleeve 110 and the rotary cutting assembly 130 are respectively connected to the handle assembly 120, the rotary cutting assembly 130 is movably connected to the sleeve 110, and the distal end of the rotary cutting assembly 130 at least partially extends out of the distal opening of the sleeve 110; wherein the sleeve 110 is slidably connected to the handle assembly 120, the sleeve 110 can move back and forth along the axial direction, and the rotary cutting assembly 130 is used to establish a channel and perform rotary cutting on tissue located around the distal end of the rotary cutting assembly 130.

[0064] Specifically, the handle assembly 120 includes an irrigation interface 121, a slide 122 and a high-speed motor. The high-speed motor is disposed in the housing of the handle assembly 120 and connected to the proximal end of the rotary cutting assembly 130, and is used to drive the rotary cutting assembly 130 to rotate so that the rotary cutting assembly 130 can cut the tissue located around the rotary cutting assembly 130. The sleeve 110 includes an operating portion 111, a suction interface 112 and a catheter 113. The catheter 113 is a slender tube with an inner cavity. The operating portion 111 and the suction interface 112 are both disposed at the proximal end of the catheter 113 and are respectively located on both sides of the slide 122. The operating portion 111 is used to drive the catheter 113 to move; the suction interface 112 is connected to the catheter 113, and the suction interface 112 is used to connect to the suction device 50, so as to move the peeled tissue and the irrigation liquid to the suction device 50.

[0065] like Figure 13-14 As shown, the rotary cutting assembly 130 includes a tip 131, a rotary cutting piece 132, a connecting piece 133 and an intermediate tube 134. The connecting piece 133 is a slender rod. The connecting piece 133 is sleeved in the intermediate tube 134 and there is a gap between the connecting piece 133 and the intermediate tube 134. The gap forms an infusion channel 135. The infusion channel 135 is connected to the infusion interface 121 to facilitate the infusion liquid to be transported from the infusion interface 121 to the distal end of the connecting piece 133; the distal end of the connecting piece 133 extends out of the distal opening of the intermediate tube 134, and the proximal end of the connecting piece 133 extends into the handle assembly 120 and is connected to the high-speed motor.

[0066] The tip 131 and the rotary cutting member 132 are arranged at the distal end of the connecting member 133, wherein the tip 131 is arranged at the distal end of the connecting member 133. The tip 131 is a closed and sharp tip structure, and its shape includes but is not limited to a cone, a triangular pyramid, a quadrangular pyramid, a single bevel edge, etc. The shape of the tip 131 can provide a sufficiently sharp needle tip structure for the cutting device 1a, so that it can pierce the endocardium or epicardium tissue with a small puncture force, thereby smoothly entering the ventricular septum myocardial tissue.

[0067] The outer diameter of the tip 131 is greater than the outer diameter of the connecting member 133. When the connecting member 133 is driven by a high-speed motor, the tip 131 also rotates. When the distal end of the rotary cutting assembly 130 is located in the ventricular septal tissue, the tip 131 can support the passage, thereby reducing the pressure of the tissue on the rotary cutting member 132, and avoiding the situation where the rotary cutting member 132 is too tightly wrapped by the tissue and cannot rotate. The tip 131 can also cut part of the tissue during the rotation process, increasing the cutting range of the cutting device 1a, and the tissue cut by the tip 131 can also be sucked away by the suction device 50.

[0068] The rotary cutting member 132 is fixedly connected to the connecting member 133, and a cutting blade is provided on the edge of the rotary cutting member 132. When the high-speed motor drives the rotary cutting member 132 to rotate through the connecting member 133, it can cut the tissue through a small rotational force, thereby separating part of the tissue from the main body of the tissue. Furthermore, the rotary cutting member 132 and the connecting member 133 have an angle in the axial direction, which is the same as the angle α of the first embodiment, and will not be repeated here.

[0069] A suction channel 114 is provided between the catheter 113 and the intermediate tube 134, and the proximal end of the suction channel 114 is connected to the suction device 50, which serves as a channel for sucking the separated tissue and the perfusion liquid into the suction device 50. Furthermore, the distal end of the perfusion channel 135 extends out of the distal opening of the suction channel 114, so that the perfusion liquid can be sucked away by the suction device 50.

[0070] The catheter 113 has a first position (eg Fig.11 as shown) and a second position (as Fig.12 When the catheter 113 is in the first position, the distal end of the catheter 113 can block the rotary cutting member 132 of the rotary cutting assembly 130, so that only the tip 131 of the rotary cutting assembly 130 is exposed; when the catheter 113 is in the second position, the distal end of the catheter 113 does not block the rotary cutting member 132 of the rotary cutting assembly 130, and the rotary cutting member 132 is exposed and can contact the surrounding tissue. When the operating part 111 moves in the slide groove 122, the position of the catheter 113 can be adjusted to switch between the first position and the second position. When the catheter 113 is in the first position, the cutting edge of the rotary cutting member 132 can be prevented from contacting the tissue, thereby preventing the rotary cutting member 132 from damaging non-target tissue during transportation; when the catheter 113 is in the second position, the cutting edge of the rotary cutting member 132 can contact the target tissue, and the target tissue can be cut after the high-speed motor is started.

[0071] In some embodiments, the operating part 111 and the suction interface 112 can be integrated into one component, that is, the operating part 111 has a hollow inner cavity, its proximal opening is the suction interface 112, and its distal opening is connected to the proximal opening of the catheter 113, so as to facilitate connection with the suction device 50 and serve as a part of the suction channel 113.

[0072] In some embodiments, the operating portion 111 is connected to the connecting member 313. When the operating portion 111 moves in the slide groove 122, the position of the connecting member 313 can be adjusted so that the catheter 113 can be relatively switched between the first position and the second position, and the position of the rotary cutting member 132 can be adjusted.

[0073] Embodiment 4:

[0074] like Figure 15-16As shown, embodiment 4 of the present invention provides a cutting system 3, which includes the cutting device 1a, the irrigation device 40 and the suction device 50 of embodiment 3, and the cutting device 1a is connected to the irrigation device 40 and the suction device 50 respectively; the irrigation device 40 is used to provide irrigation liquid for the cutting device 1a, and the suction device 50 is used to suck the cut tissue and irrigation liquid.

[0075] Specifically, Fig.15 As shown, the operating part 111 is first adjusted so that the catheter 113 is located at the first position, and the tip 131 of the cutting device 1a is used to puncture the epicardium through the apex to establish a passage; then the operating part 111 is adjusted so that the catheter 113 is located at the second position, as shown. Fig.16 As shown, at this time, the rotary cutting member 132 can contact the tissue around the rotary cutting member 132, the perfusion device 40 is started to connect with the rotary cutting assembly 130 and supply perfusion liquid to the rotary cutting assembly 130, the suction device 50 is connected to the sleeve 110 and the suction device 50 is started, and the high-speed motor is started to make the rotary cutting member 132 cut and break the tissue around the rotary cutting member 132, and the broken tissue is mixed with the perfusion liquid to form a meat slurry, which is then sucked away by the suction device 50 along the suction channel 114. At the same time, when the amount of the broken tissue is large, since the perfusion liquid is continuously sucked away by the suction device 50, the perfusion liquid will generate a force toward the proximal end of the suction channel 114 after contacting the broken tissue in the process, ensuring that the broken tissue can be sucked away by the suction device 50 without blocking the suction channel 114.

[0076] After cutting, the cutting range is observed through the imaging system. If the cutting range is small, the operator can move the rotary cutting assembly 130 along the path so that the rotary cutting assembly 130 can perform rotary cutting on tissues at other positions on the path. Repeat the above operation until a satisfactory cutting area B is obtained. Fig.10 As shown, the cutting device 1a is then withdrawn and the wound is sutured to complete the removal of the ventricular septum tissue. Subsequently, the tissue around the cutting area B will move toward the cutting area B to fill the cutting area B, so that the volume of the ventricular septum is reduced, thereby alleviating the left ventricular outflow tract obstruction.

[0077] Embodiment five:

[0078] like Figure 17-18 As shown, embodiment five of the present invention provides a cutting device 1b, which includes a sleeve 210, a handle assembly 220 and a rotary cutting assembly 230, wherein the proximal ends of the sleeve 210 and the rotary cutting assembly 230 are respectively connected to the handle assembly 220, the rotary cutting assembly 230 is movably connected to the sleeve 210, and the distal end of the rotary cutting assembly 230 at least partially extends out of the distal opening of the sleeve 210; wherein the sleeve 210 is slidably connected to the handle assembly 220, and the sleeve 210 can move back and forth along the axial direction.

[0079] Specifically, the handle assembly 220 includes a slide 221 and a high-speed motor, which is arranged in the housing of the handle assembly 220 and connected to the proximal end of the rotary cutting assembly 230, and is used to drive the rotary cutting assembly 230 to rotate so that the rotary cutting assembly 230 can cut the tissue located around the rotary cutting assembly 230. The sleeve 210 includes an operating part 211, a suction interface 212 and a catheter 213, and the catheter 213 is a slender tube with an inner cavity; the operating part 211 has a hollow inner cavity, and its proximal opening is the suction interface 212, and its distal opening is connected to the proximal opening of the catheter 113. The operating part 211 is arranged at the proximal end of the catheter 213 and is at least partially located in the slide 221, and the operating part 211 is used to drive the catheter 213 to move; the suction interface 212 is used to connect with the suction device 50, so as to move the tissue after rotary cutting to the suction device 50 through the suction interface 212.

[0080] The catheter 213 has a first position (eg Fig.17 , Fig.19a as shown) and a second position (as Fig.18 , Fig.20a When the catheter 213 is in the first position, the distal end of the catheter 213 can block the rotary cutting member 232 of the rotary cutting assembly 230, so that only the tip 231 of the rotary cutting assembly 230 is exposed; when the catheter 213 is in the second position, the distal end of the catheter 213 does not block the rotary cutting member 232 of the rotary cutting assembly 230, and the rotary cutting member 232 is exposed and can contact the surrounding tissue. When the operating part 211 moves in the slide groove 221, the position of the catheter 213 can be adjusted to switch between the first position and the second position. When the catheter 213 is in the first position, the cutting edge of the rotary cutting member 232 can be prevented from contacting the tissue, thereby preventing the rotary cutting member 232 from cutting or damaging non-target tissue during transportation; when the catheter 213 is in the second position, the cutting edge of the rotary cutting member 232 can contact the target tissue, and the target tissue can be cut after the high-speed motor is started. Specifically, the rotary cutting member 232 is made of an elastic material. When the conduit 213 moves from the second position to the first position, the inner wall of the conduit 213 squeezes the rotary cutting member 232 so that the rotary cutting member 232 gradually shrinks until the whole is shrunk into the conduit 213, and the conduit 213 is in the first position at this time; when the conduit 213 moves from the first position to the second position, the inner wall of the conduit 213 continuously reduces the squeezing of the rotary cutting member 232, and the elastic rotary cutting member 232 can gradually resume expansion until the whole is completely exposed, and the conduit 213 is in the second position at this time.

[0081] As shown in Figures 19-21, the rotary cutting assembly 230 includes a tip 231, a rotary cutting piece 232 and a connecting piece 233. The connecting piece 233 is a slender rod. The connecting piece 233 is sleeved in the catheter 213 and there is a gap between the connecting piece 233 and the catheter 213. The gap forms a suction channel 214, and the suction channel 214 is connected to the suction interface 212 to serve as a channel for sucking the above-mentioned separated part of the tissue into the suction device 50; the distal end of the connecting piece 233 extends out of the distal opening of the intermediate tube 134, and the proximal end of the connecting piece 233 extends into the handle assembly 220 and is connected to the high-speed motor.

[0082] The tip 231 and the rotary cutting member 232 are arranged at the distal end of the connecting member 233, wherein the tip 231 is arranged at the distal end of the connecting member 233. The tip 231 is a closed and sharp tip structure, and its shape includes but is not limited to a cone, a triangular pyramid, a quadrangular pyramid, a single bevel edge, etc. The shape of the tip 231 can provide a sufficiently sharp needle tip structure for the cutting device 1b, so that it can pierce the endocardium or epicardium tissue with a small puncture force, thereby smoothly entering the ventricular septum myocardial tissue.

[0083] The outer diameter of the tip 231 is greater than the outer diameter of the connecting member 233. When the connecting member 233 is driven by a high-speed motor, the tip 231 also rotates. When the distal end of the rotary cutting assembly 230 is located in the ventricular septal tissue, the tip 231 can support the passage, thereby reducing the pressure of the tissue on the rotary cutting member 232, and avoiding the situation where the rotary cutting member 232 is too tightly wrapped by the tissue and cannot rotate. The tip 231 can also cut part of the tissue during the rotation process, increasing the cutting range of the cutting device 1b, and the tissue cut by the tip 231 can also be sucked away by the suction device 50.

[0084] The rotary cutting member 232 includes a circular cutting portion 232a, a first limiting portion 2324, and a second limiting portion 2326. The circular cutting portion 232a is used to cut tissue located around the circular cutting portion 232a. The circular cutting portion 232a can rotate along with the connecting member 233. The distal end of the circular cutting portion 232a is fixedly connected to the connecting member 233, and the proximal end of the circular cutting portion 232a is sleeved on the connecting member 233 so that the proximal end of the circular cutting portion 232a can move along the axial direction of the connecting member 233. The distal end of the first limiting portion 2324 is fixedly connected to the circular cutting portion 232a. The proximal end of the part 232a is fixedly connected, a limiting groove 2325 is provided on the first limiting part 2324, and the proximal end and the distal end of the first limiting part 2324 are both provided with limiting protrusions in the axial direction of the connecting piece 233; the proximal end of the second limiting part 2326 is fixedly connected to the connecting piece 233, and the distal end 2327 of the second limiting piece 2326 is located in the limiting groove 2325, and the above-mentioned limiting protrusion can limit the distal end 2327 to prevent the distal end 2327 from escaping from the limiting groove 2325.

[0085] The annular cut portion 232a has a contracted state and a natural state, such as Fig.19a and 19b As shown, the annular portion 232a is in a contracted state, the annular portion 232a is contracted into the catheter 213 as a whole, the proximal end of the first limiting portion 2324 abuts against the proximal end of the second limiting portion 2326, and the annular portion 232a is in a straight strip or quasi-straight strip shape as a whole; Fig.20a and 20b As shown, the annular portion 232a is in a natural state, the annular portion 232 is exposed as a whole and expands radially outward, and the proximal end of the first limiting portion 2324 does not contact the proximal end of the second limiting portion 2326. By providing the first limiting portion 2324 and the second limiting portion 2326, the annular portion 232a can switch back and forth between the contracted state and the natural state; in the contracted state, the abutment of the first limiting portion 2324 and the second limiting portion 2326 and the cooperation of the catheter 213 ensure that the annular portion 232a remains contracted during the transportation process; in the natural state, the first limiting portion 2324 and the second limiting portion 2326 do not abut, which is conducive to the annular portion 232a cutting the tissue located around the annular portion 232a.

[0086] The annular cutting portion 232a includes a proximal portion 2321, a middle portion 2322 and a distal portion 2323, and the proximal portion 2321, the middle portion 2322 and the distal portion 2333 are connected in sequence; in a natural state, the distal end of the proximal portion 2321 extends in a direction away from the connecting member 233, the middle portion 2322 is parallel or substantially parallel to the axial direction of the connecting member 233, and the distal portion 2323 extends from the distal end of the middle portion 2322 in a direction close to the connecting member 233. Among them, the slope of the proximal portion 2321 relative to the connecting piece 233 is smaller than the slope of the distal portion 2323. The distal portion 2323 is set to a larger slope so that the distal portion 2323 can quickly transition to the middle portion 2322, avoiding the annular portion 232a from being too long in the axial direction and reducing the volume of the annular portion 232a; the proximal portion 2321 is set to a smaller slope so that the proximal portion 2321 is relatively smooth when extended, which is conducive to a smooth transition of the catheter 213 during the conversion from the second position to the first position, avoiding the catheter 213 being stuck by the proximal portion 2321 during the above conversion.

[0087] The edges of the proximal portion 2321, the middle portion 2322 and the distal portion 2333 are all provided with blade surfaces, so that when the high-speed motor drives the rotary cutting member 232 to rotate through the connecting member 233, it can cut the tissue through a smaller rotational force, thereby separating part of the tissue from the main body of the tissue.

[0088] In some embodiments, the operating portion 211 is connected to the connecting member 233 , and the operating portion 211 can adjust the position of the connecting member 233 when moving in the slide groove 221 , so that the catheter 213 can be relatively switched between the first position and the second position, and the position of the rotary cutting member 232 can be adjusted.

[0089] Embodiment six:

[0090] like Figure 22-23 As shown, the sixth embodiment of the present invention provides a cutting system 4, which includes the cutting device 1b of the fifth embodiment and the suction device 50, the cutting device 1b is connected to the suction device 50, and the suction device 50 is used to suck the cut tissue.

[0091] Specifically, Fig. 22 As shown, the operating part 211 is first adjusted so that the catheter 213 is located at the first position, and the tip 231 of the cutting device 1b is used to puncture the epicardium through the apex to establish a passage; then the operating part 211 is adjusted so that the catheter 213 is located at the second position, as shown. Fig.23 As shown, at this time, the annular cutting portion 232a can contact the tissue located around the annular cutting portion 232a, the suction device 50 is connected to the sleeve 210 and the suction device 50 is started, and the high-speed motor is started so that the cutting element 132 cuts and breaks the tissue located around the annular cutting portion 232a, and the broken tissue is sucked away by the suction device 50 along the suction channel 214.

[0092] After cutting, the cutting range is observed through the imaging system. If the cutting range is small, the operator can move the rotary cutting assembly 130 along the path so that the rotary cutting assembly 130 can perform rotary cutting on tissues at other positions on the path. Repeat the above operation until a satisfactory cutting area B is obtained. Fig.10 As shown, the cutting device 1b is then withdrawn and the wound is sutured to complete the removal of the ventricular septum tissue. Subsequently, the tissue around the cutting area B will move toward the cutting area B to fill the cutting area B, so that the volume of the ventricular septum is reduced, thereby alleviating the left ventricular outflow tract obstruction.

[0093] Embodiment seven:

[0094] like Fig.24 As shown, embodiment seven of the present invention provides a cutting device 1c, which is different from the cutting device 1b in embodiment five in that the rotary cutting member 232b has three annular cutting portions, and the three annular cutting portions are evenly distributed along the circumferential direction. Through the above arrangement, when the rotary cutting member 232b cuts tissue, the radial reaction forces exerted by the three annular cutting portions on the connecting member 233 can offset each other, thereby reducing the radial jitter of the connecting portion 233 when cutting tissue, making the cutting process more stable.

[0095] like Fig.25 As shown, in some embodiments, the three annular cutting parts of the rotary cutting member 232c are spiral and evenly distributed along the circumferential direction. Through the above arrangement, when the rotary cutting member 232c cuts tissue, the radial and axial reaction forces exerted by the three annular cutting parts on the connecting member 233 can offset each other, thereby reducing the radial and axial jitter of the connecting part 233 when cutting tissue, making the cutting process more stable.

[0096] Of course, the number of the annular cutting portions of the rotary cutting member 232b can be 2, 4 or more, as long as the annular cutting portions are evenly distributed along the circumferential direction.

[0097] Embodiment eight:

[0098] like Figure 26-28 As shown, embodiment eight of the present invention provides a cutting device 1d, which is different from the cutting device 1b in embodiment five in that the connecting piece 233 has a hollow inner cavity 235 and the handle assembly 220 is also provided with an infusion interface 222, and the distal end of the inner cavity 235 is provided with at least one infusion hole 234, which serves as the outlet of the inner cavity 235; the distal end of the infusion interface 222 is connected to the proximal end of the inner cavity 235, and the proximal end of the infusion interface 222 is used to connect with the infusion device 40, so that the infusion liquid is transported from the infusion interface 222 to the inner cavity 235 and flows out from the infusion hole 234.

[0099] The rotary cutting element 232 can contact the tissue around the rotary cutting element 232, start the perfusion device 40 to connect with the perfusion interface 222 and supply perfusion liquid to the inner cavity 235, connect the suction device 50 to the sleeve 210 and start the suction device 50, start the high-speed motor to make the rotary cutting element 232 cut and break the tissue around the rotary cutting element 232, and the broken tissue is mixed with the perfusion liquid to form a meat slurry, which is then sucked away by the suction device 50 along the suction channel 214. At the same time, when the amount of the broken tissue is large, since the perfusion liquid is continuously sucked away by the suction device 50, the perfusion liquid will generate a force toward the proximal end of the suction channel 214 after contacting the broken tissue during the process, ensuring that the broken tissue can be sucked away by the suction device 50 without blocking the suction channel 214.

[0100] In some embodiments, the perfusion hole 232 is arranged on the connecting member 233 near the distal end 2323. Through the above arrangement, the perfusion liquid can be fully mixed with the broken tissue, making it easier to be sucked away by the suction device 50, thereby avoiding the suction channel 214 being blocked by tissue.

[0101] The above is a preferred embodiment of the present invention. It should be pointed out that a person skilled in the art can make several improvements and modifications without departing from the principle of the present invention. These improvements and modifications are also considered to be within the scope of protection of the present invention.

Claims

1. A cutting device, characterized in that: The invention comprises a puncture member, a sleeve and a rotary cutting assembly, wherein the puncture member and the rotary cutting assembly can be movably arranged in the sleeve respectively; the puncture member is sleeved with the sleeve to puncture the tissue to establish a passage; the rotary cutting assembly comprises a rotary cutting part, a rotary cutting member is arranged at the distal end of the rotary cutting part, the rotary cutting assembly enters the tissue along the passage after the puncture member is withdrawn from the sleeve, and the rotary cutting member is used to rotary cut the tissue around the rotary cutting member.

2. The cutting device according to claim 1, characterized in that The puncture member is a puncture needle; the sleeve includes a tube body with an inner cavity, the tube body has an inlet for the puncture needle or the rotary cutting component to enter the tube body, and the gap between the sleeve and the rotary cutting component can be connected to the suction device.

3. The cutting device according to claim 2, characterized in that: The rotary cutting assembly also includes a handle, in which a high-speed motor is arranged. The proximal end of the rotary cutting member is connected to the high-speed motor, and the high-speed motor is used to drive the rotary cutting member to rotate. The rotary cutting portion has a cutting blade.

4. The cutting device according to claim 3, characterized in that: The rotary cutting element also includes a head end and a slender rod, the proximal end of the slender rod is connected to the high-speed motor; the head end is round and blunt and connected to the distal end of the slender rod, and the rotary cutting part is arranged on the slender rod on the proximal side of the head end.

5. The cutting device according to claim 4, characterized in that An included angle exists between the rotary cutting portion and the slender rod, and the included angle ranges from 30° to 150°.

6. The cutting device according to claim 4, characterized in that: The head end has an outer diameter greater than an outer diameter of the elongated rod such that the head end can support the passageway.

7. The cutting device according to claim 4, characterized in that: The rotary cutting assembly also includes an intermediate tube sleeved outside the slender rod, the gap between the slender rod and the intermediate tube is connected to the perfusion device and provides a conveying channel for the perfusion liquid; the gap between the intermediate tube and the tube body of the sleeve is connected to the suction device.

8. A cutting device, characterized in that: The invention comprises a sleeve, a handle and a rotary cutting assembly, wherein the proximal ends of the sleeve and the rotary cutting assembly are respectively connected to the handle, and the rotary cutting assembly can be movably inserted into the sleeve; wherein the sleeve or the rotary cutting assembly is slidably connected to the handle so that the sleeve and the rotary cutting assembly can move relative to each other in the axial direction, so that the distal end of the rotary cutting assembly can enter or extend out of the distal end of the sleeve; the rotary cutting assembly comprises a puncture member arranged at its distal end and a rotary cutting member connected to the puncture member, wherein the rotary cutting member comprises a rotary cutting portion located on the proximal side of the puncture member, the puncture member extends out of the distal end of the sleeve to establish a passage, and the rotary cutting portion extends out of the distal end of the sleeve to perform rotary cutting on tissue located around it.

9. The cutting device according to claim 8, characterized in that A high-speed motor is arranged in the handle, and the proximal end of the rotary cutting member is connected to the high-speed motor. The high-speed motor is used to drive the rotary cutting member to rotate, and the rotary cutting portion has a cutting blade.

10. The cutting device according to claim 8, characterized in that An operating portion is provided at the proximal end of the sleeve or the rotary cutting assembly, and the operating portion is used to drive the sleeve or the rotary cutting assembly to move.

11. The cutting device according to claim 9, characterized in that The rotary cutting member also includes a slender rod, the piercing member is connected to the distal end of the slender rod, and the rotary cutting portion is arranged on the slender rod on the proximal side of the piercing member; the proximal end of the slender rod is connected to the high-speed motor; the piercing member has a tip, and the outer diameter of the tip is greater than the outer diameter of the slender rod.

12. The cutting device according to claim 11, characterized in that The sleeve includes a tube body with an inner cavity, and the rotary cutting assembly also includes an intermediate tube inserted into the tube body, the slender rod is inserted into the intermediate tube, the gap between the slender rod and the intermediate tube is connected to the perfusion device and provides a conveying channel for the perfusion liquid; the gap between the intermediate tube and the tube body of the sleeve is connected to the suction device.

13. The cutting device according to claim 11, characterized in that An included angle exists between the rotary cutting portion and the slender rod, and the included angle ranges from 30° to 150°.

14. The cutting device according to claim 11, characterized in that The rotary cutting portion is a circular cutting portion, and the circular cutting portion can rotate along with the slender rod; the distal end of the circular cutting portion is fixedly connected to the slender rod, and the proximal end of the circular cutting portion can be movably mounted on the slender rod so that the proximal end of the circular cutting portion can move along the axial direction of the slender rod.

15. The cutting device according to claim 14, characterized in that The annular cutting portion is elastic, the distal end of the annular cutting portion is fixedly connected to the slender rod, and the proximal end of the annular cutting portion is partially axially movably connected to the slender rod. When the annular cutting portion as a whole enters into the sleeve, the annular cutting portion as a whole is roughly in the shape of a straight strip; when the annular cutting portion extends out of the sleeve, at least a portion of the annular cutting portion expands outward in the radial direction.

16. The cutting device according to claim 15, characterized in that The annular cutting portion includes a proximal portion, a middle portion and a distal portion which are connected in sequence, and the cutting blade is arranged on the middle portion; when the annular cutting portion extends out of the sleeve, the proximal portion extends radially from near to far in a direction away from the slender rod, the middle portion is parallel to the axial direction of the slender rod, and the distal portion extends radially from near to far in a direction close to the slender rod; wherein the slope of the proximal portion relative to the slender rod is smaller than the slope of the distal portion relative to the slender rod.

17. The cutting device according to claim 14, characterized in that The rotary cutting element includes at least two annular cutting portions, and each of the annular cutting portions is evenly distributed along the circumferential direction.

18. The cutting device according to claim 11, characterized in that The slender rod has a hollow inner cavity, and at least one perfusion hole is arranged at the distal end of the inner cavity. The perfusion hole is connected to the perfusion device via the inner cavity, and the perfusion liquid is transported through the inner cavity and flows out from the perfusion hole.

19. A cutting system, characterized in that: It comprises a cutting device and a suction device as described in any one of claims 1 to 18, wherein the cutting device is used for cutting tissue, and the suction device is used for sucking the cut tissue.

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