Circular endocutter for subpleural ground-glass nodules

Abstract

The present application relates to a kind of circular inner cutting closure for lung subpleural ground glass nodule, comprising: pulling mechanism and cutting ligator, pulling mechanism is installed on cutting ligator, to be cut lung tissue is pulled into cutting ligator by pulling mechanism, and by cutting ligator, first to the cutting lung tissue that is pulled into by pulling mechanism is ligated before cutting is carried out again.Cutting ligator can be expected to complete lung tissue pulling, and combined with cutting ligator, complete removal of lesion, obtain pathological diagnosis, obtain safe cutting edge, and realize the removal of less lung tissue, to reduce the loss of lung function, only using one inner cutting closure can complete operation, further reduce the economic burden of patient, to create more ideal treatment mode for patient, the inner cutting closure is suitable for peripheral type, close to pleura, GGO is mainly early lung cancer.

Description

Technical Field

[0001] This invention relates to the field of subpleural ground-glass nodule cutting technology, specifically to a circular internal cutting closure device for subpleural ground-glass nodules of the lung. Background Technology

[0002] With the widespread use of CT screening, the number of patients with early-stage lung cancer predominantly characterized by ground-glass opacity (GGO) has increased significantly. In some patients, the lesions are located in the subpleural region of the lung, close to the surface of the lung tissue. The pathological histological types of early-stage lung cancer are also gradually changing. Early-stage lung cancer with GGO as the main component is mainly characterized by adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA).

[0003] Currently, surgical resection is the most effective treatment for early-stage lung cancer. Studies on early-stage peripheral small lung cancer (JCOG0804) have found that for GGO lesions with a tumor length ≤2cm and a solid / tumor ratio (CTR) ≤0.25, the 5-year recurrence-free survival (RFS) for patients undergoing sublobar resection (wedge resection, segmentectomy) is 99.7%.

[0004] Currently, thoracoscopic wedge resection, segmentectomy, and electromagnetic navigation microwave ablation can be used, but these treatment methods still face the following problems:

[0005] 1. Surgical procedures remove too much normal lung tissue, resulting in excessive loss of lung function in patients after surgery;

[0006] 2. Electromagnetic navigation microwave ablation has a low pathological positive rate for ground-glass nodules, with reported rates of less than 5% in the literature. Furthermore, the ablation procedure carries risks such as intraoperative pneumothorax, intrathoracic hemorrhage, recurrent hemoptysis, hemoptysis, and fungal cavitation.

[0007] Therefore, there is an urgent need for a surgical procedure that removes less lung tissue, thereby reducing lung function loss, while still completely removing the lesion, obtaining safe surgical margins, and obtaining pathological diagnosis. Summary of the Invention

[0008] The technical problem to be solved by the present invention is to provide a circular internal cutting and closing device for subpleural ground-glass nodules of the lung, so as to overcome the shortcomings of the prior art.

[0009] The technical solution of the present invention to solve the above-mentioned technical problems is as follows: A circular internal cutting closure device for subpleural ground-glass nodules of the lung includes: a traction mechanism and a cutting closure device. The traction mechanism is installed on the cutting closure device to pull the lung tissue to be cut into the cutting closure device, and the cutting closure device first closures the lung tissue to be cut pulled into by the traction mechanism before cutting.

[0010] Based on the above technical solution, the present invention can be further improved as follows.

[0011] Furthermore, the cutting and binding device includes: an outer cylinder and an inner cylinder coaxially placed inside the outer cylinder, the inner cylinder being recessed within the outer cylinder, and the open ends of both the outer and inner cylinders facing downwards; a cover plate fixed to the outer cylinder and the inner cylinder respectively is arranged in the gap between the outer cylinder and the inner cylinder; a hollow sleeve is coaxially fixed to the closed end of the outer cylinder, and an external through hole communicating with the hollow sleeve is opened at the closed end of the outer cylinder; multiple cutting blades are arranged at different heights and positions below the cover plate; a binding strap for binding the lung tissue to be cut is arranged below the lowest cutting blade, the binding strap is movable with the cover plate; a rotating mechanism is fixed on the outer cylinder and the hollow sleeve; the tail end of each cutting blade is fixed to the rotating mechanism, and the rotating mechanism simultaneously drives the tips of multiple cutting blades to rotate towards the axis of the inner cylinder to cut the lung tissue to be cut.

[0012] Furthermore, the cutting blades are arc-shaped, with their cutting edges located on the inner circle, and all the cutting blades are distributed in a circular pattern.

[0013] Furthermore, the rotating mechanism includes: multiple rotating shafts arranged in the gap between the outer cylinder and the inner cylinder, the lower ends of the multiple rotating shafts respectively passing through the cover plate and rotatingly engaging with the cover plate, the lower end of each rotating shaft being fixed to the tail end of a cutting blade, a hollow power rod coaxially arranged inside the hollow sleeve, the lower end of the hollow power rod extending into the outer cylinder through an external through hole, the lower end of the hollow power rod being connected to each rotating shaft via a transmission chain, the upper end of the hollow power rod extending out from the upper end of the hollow sleeve, a handle rotatingly engaging with the upper end of the hollow sleeve being fitted onto the upper end of the hollow sleeve, and a portion of the handle being fixed to the upper end of the hollow power rod.

[0014] Furthermore, the transmission chain includes a driving gear and multiple driven gears. The driving gear is fixed to the lower end of the hollow power rod, and the multiple driven gears are respectively fixed on multiple rotating shafts. Each driven gear meshes with the driving gear.

[0015] Furthermore, the cable ties are toothed cable ties.

[0016] Furthermore, the cover plate, the closed end of the outer cylinder, the lower end of the hollow sleeve, and the upper end of the hollow sleeve are respectively provided with a cloth strap hole. The pulling end of the cable tie passes through the cloth strap hole on the cover plate, the cloth strap hole on the outer cylinder, and the cloth strap hole at the lower end of the hollow sleeve in sequence, and then extends out from the cloth strap hole at the upper end of the hollow sleeve.

[0017] Furthermore, the closed end of the inner cylinder has an inner through hole at the corresponding outer through hole; the pulling mechanism includes: a pulling rod, which is coaxially arranged inside the hollow power rod. The lower end of the pulling rod enters the inner cylinder after passing through the outer through hole and the inner through hole in sequence. The lower end of the pulling rod is provided with multiple hooks. The upper end of the pulling rod extends out from the upper end of the hollow power rod. A fixing frame is provided in a part of the upper end face of the hollow sleeve. The fixing frame is provided with a clamping head for clamping and releasing the pulling rod.

[0018] Furthermore, the clamping head includes: a flap chuck, which is fixed on a fixed frame, and a threaded sleeve is threadedly connected to the flap chuck.

[0019] Furthermore, a detachable pull ring is provided at the upper end of the traction rod.

[0020] The beneficial effects of this invention are: the internal cutting closure device can complete the lung tissue traction as expected, and in conjunction with the cutting closure device, completely remove the lesion, obtain a pathological diagnosis, obtain a safe cutting margin, and remove less lung tissue, thereby reducing lung function loss. The surgery can be completed using only one internal cutting closure device, further reducing the economic burden on patients, thus creating a more ideal treatment method for patients. This internal cutting closure device is suitable for peripheral lung cancer, close to the pleura, and predominantly ground-glass opacity (GGO) type early lung cancer. Attached Figure Description

[0021] Figure 1 This invention describes the structure of a circular internal cutting closure device for subpleural ground-glass nodules in the lungs. Figure 1 ;

[0022] Figure 2 This invention describes the structure of a circular internal cutting closure device for subpleural ground-glass nodules in the lungs. Figure 2 ;

[0023] Figure 3 This invention describes the structure of a circular internal cutting closure device for subpleural ground-glass nodules in the lungs. Figure 3 ;

[0024] Figure 4 This is a cross-sectional view of the circular internal cutting closure device for subpleural ground-glass nodules in the lungs, as described in this invention.

[0025] Figure 5 for Figure 4 A magnified view of a portion of the image.

[0026] The attached diagram lists the components represented by each number as follows:

[0027] 1. Pulling mechanism, 110. Pulling rod, 120. Hook, 130. Fixing frame, 140. Clamping head, 141. Split chuck, 142. Screw sleeve, 150. Pull ring, 2. Cutting nozzle, 210. Outer cylinder, 211. Outer through hole, 212. Support plate, 220. Inner cylinder, 221. Inner through hole, 230. Cover plate, 240. Hollow sleeve, 250. Cutting blade, 260. Cable tie, 270. Rotating mechanism, 271. Rotating shaft, 272. Hollow power rod, 273. Transmission chain, 2731. Driving gear, 2732. Driven gear, 280. Handle. Detailed Implementation

[0028] The principles and features of the present invention are described below with reference to the accompanying drawings. The examples given are only for explaining the present invention and are not intended to limit the scope of the present invention.

[0029] Example 1

[0030] like Figures 1-5 As shown, a circular internal cutting closure device for subpleural ground-glass nodules (GGOs) in the lung includes: a traction mechanism 1 and a cutting mouthpiece 2. The traction mechanism 1 is installed on the cutting mouthpiece 2. During lung tissue resection surgery, an incision is made at the surgical site, and the circular internal cutting closure device is then inserted into the body through the incision. The traction mechanism 1 is used to pull the lung tissue to be cut into the cutting mouthpiece 2. The cutting mouthpiece 2 then first closes the lung tissue pulled in by the traction mechanism 1 before cutting. After cutting, the circular internal cutting closure device is removed, and the cut lung tissue is also removed along with the circular internal cutting closure device. This internal cutting closure device can complete the lung tissue traction as expected, and in conjunction with the cutting mouthpiece, completely remove the lesion, obtain a pathological diagnosis, obtain a safe resection margin, and achieve the removal of less lung tissue, thereby reducing lung function loss. The surgery can be completed using only one internal cutting closure device, further reducing the economic burden on patients and creating a more ideal treatment method for patients. This internal cutting closure device is suitable for peripheral, near-pleural, predominantly GGO-type early lung cancer.

[0031] Example 2

[0032] like Figures 1-5 As shown, this embodiment is a further improvement on embodiment 1, as detailed below:

[0033] The cutting and binding device 2 includes an outer cylinder 210 and an inner cylinder 220. The inner cylinder 220 is coaxially placed inside the outer cylinder 210. The outer diameter of the outer cylinder 210 is 2cm to 3cm. The inner cylinder 220 is recessed inside the outer cylinder 210, that is, the inner cylinder 220 does not protrude from the open end of the outer cylinder 210. The open ends of both the outer cylinder 210 and the inner cylinder 220 face downwards, that is, the open ends of the outer cylinder 210 and the open ends of the inner cylinder 220 face the same direction. A cover plate 230 is arranged in the gap between the outer cylinder 210 and the inner cylinder 220. The cover plate 230 is annular. The inner ring of the cover plate 230 is fixed to the outer wall of the inner cylinder 220, and the outer ring of the cover plate 230 is fixed to the inner wall of the outer cylinder 210. That is, the cover plate 230 is fixed to both the outer cylinder 210 and the inner cylinder 220.

[0034] A hollow sleeve 240 is arranged outside the closed end of the outer cylinder 210. The hollow sleeve 240 is coaxially fixed to the closed end of the outer cylinder 210. An external through hole 211 communicating with the hollow sleeve 240 is opened at the closed end of the outer cylinder 210. Multiple cutting blades 250 are arranged at different heights and positions below the cover plate 230 to ensure that all subsequent cutting blades 250 do not interfere with each other during rotation. When all cutting blades 250 are arranged, the gap between two adjacent cutting blades 250 is very small. Below the lowest cutting blade 250, a tie 260 is arranged to bind the lung tissue to be cut. The tie 260 and The cover plate 230 is movable and fitted, and the outer cylinder 210 and the hollow sleeve 240 are fixed with a rotating mechanism 270. The tail end of each cutting blade 250 is fixed to the rotating mechanism 270, and the rotating mechanism 270 simultaneously drives the tips of multiple cutting blades 250 to rotate in the direction of the axis of the inner cylinder 220 to cut the lung tissue to be cut. During the rotation of the cutting blade 250, its tip passes through the axis of the inner cylinder 220. When multiple cutting blades 250 rotate under the action of the rotating mechanism 270, the tips of all cutting blades 250 cross in the vertical direction, thereby ensuring that the lung tissue to be cut is cut.

[0035] In addition, multiple support plates 212 are provided on the inner wall of the outer cylinder 210 below the cover plate 230. The multiple support plates 212 limit and guide the cable tie 260, which facilitates the completion of the cable tie 260 binding.

[0036] Example 3

[0037] like Figure 2 As shown, this embodiment is a further improvement on embodiment 2, as detailed below:

[0038] The cutting blade 250 is arc-shaped, and the cutting edge of the cutting blade 250 is located on the inner circle. All cutting blades 250 are distributed in a circle. The number of cutting blades 250 can be two or three, depending on the product size.

[0039] Example 4

[0040] like Figure 4 , Figure 5 As shown, this embodiment is a further improvement on embodiment 2 or 3, as detailed below:

[0041] The rotating mechanism 270 includes: a plurality of rotating shafts 271 arranged in the gap between the outer cylinder 210 and the inner cylinder 220, the rotation axis of the rotating shafts 271 being parallel to the axis of the inner cylinder 220; the lower ends of the plurality of rotating shafts 271 respectively passing through the cover plate 230 and rotatably engaging with the cover plate 230; the lower end of each rotating shaft 271 is fixed to the tail end of a cutting blade 250, i.e., the number of rotating shafts 271 is the same as the number of cutting blades 250; and a hollow power rod 272 is coaxially arranged inside the hollow sleeve 240, the lower end of the hollow power rod 272 extending into the outer cylinder 210 through the outer through hole 211; the lower end of the hollow power rod 272 is connected to each rotating shaft 271 via a transmission chain 273; the hollow power rod 272... The upper end of 2 extends from the upper end of the hollow sleeve 240. A handle 280 is fitted onto the upper end of the hollow sleeve 240 and rotates in coordination with it. The axis of rotation of the handle 280 around the hollow sleeve 240 is coaxial with the axis of rotation of the hollow sleeve 240. A portion of the handle 280 is fixed to the upper end of the hollow power rod 272. Rotating the handle 280 will drive the hollow power rod 272 to rotate. The rotating hollow power rod 272 will drive each rotating shaft 271 to rotate via the transmission chain 273, thereby causing the cutting blades 250 fixed to the rotating shafts 271 to rotate. During the rotation of the blade tips of the multiple cutting blades 250 towards the axis of the inner cylinder 220, they will cooperate to cut the lung tissue to be cut.

[0042] Example 5

[0043] like Figure 5 As shown, this embodiment is a further improvement on embodiment 4, as detailed below:

[0044] The transmission chain 273 includes a drive gear 2731 and multiple driven gears 2732. The drive gear 2731 is fixed to the lower end of the hollow power rod 272, while the multiple driven gears 2732 are respectively fixed on multiple rotating shafts 271. Each driven gear 2732 meshes with the drive gear 2731. When the hollow power rod 272 rotates, the drive gear 2731 will rotate. Since the driven gears 2732 mesh with the drive gear 2731, the driven gears 2732 will be driven to rotate by the drive gear 2731. When the driven gears 2732 rotate, the rotating shafts 271 will also rotate. Preferably, the size of the drive gear 2731 is larger than the size of the driven gears 2732 to ensure that the driven gears 2732 can rotate multiple times when the drive gear 2731 rotates one revolution, thereby reducing the rotation angle of the handle 280.

[0045] Example 6

[0046] like Figure 2 , Figure 5 As shown, this embodiment is a further improvement on any one of embodiments 2 to 5, as detailed below:

[0047] Cable tie 260 uses a toothed cable tie, which can better bind the knots by taking advantage of the characteristic that the toothed cable tie cannot be loosened, thus providing higher safety. Cable tie 260 is made of biocompatible materials.

[0048] Example 7

[0049] like Figure 1 , Figure 2 , Figure 3 As shown, this embodiment is a further improvement on any one of embodiments 2 to 6, as detailed below:

[0050] The cover plate 230 has a cloth strap hole, the closed end of the outer cylinder 210 has a cloth strap hole, the lower end of the hollow sleeve 240 has a cloth strap hole, and the upper end of the hollow sleeve 240 has a cloth strap hole. The pulling end of the cable tie 260 passes through the cloth strap hole on the cover plate 230, the cloth strap hole on the outer cylinder 210, and the cloth strap hole at the lower end of the hollow sleeve 240 in sequence, and then extends out from the cloth strap hole at the upper end of the hollow sleeve 240. Most of the pulling end of the cable tie 260 is located inside the hollow sleeve 240 and the outer cylinder 210. Pulling the pulling end of the cable tie 260 is safer and less likely to damage other tissues of the patient.

[0051] Example 8

[0052] like Figure 5 As shown, this embodiment is a further improvement on any one of embodiments 2 to 6, as detailed below:

[0053] The closed end of the inner cylinder 220 has an inner through hole 221 at the corresponding outer through hole 211; the pulling mechanism 1 includes: a pulling rod 110, which is coaxially arranged inside the hollow power rod 272. The lower end of the pulling rod 110 enters the inner cylinder 220 after passing through the outer through hole 211 and the inner through hole 221 in sequence. The lower end of the pulling rod 110 is provided with multiple hooks 120. The upper end of the pulling rod 110 extends from the upper end of the hollow power rod 272. A fixing frame 130 is provided in a portion of the upper end face of the hollow sleeve 240. The fixing frame 130 is provided with a clamping head 140 for clamping and releasing the pulling rod 110. The installation position of the fixing frame 130 does not affect the hand. When the handle 280 rotates within a predetermined angle range, the tips of the multiple cutting blades 250 can rotate towards the axis of the inner cylinder 220 and cooperate to cut the lung tissue to be cut. When the traction mechanism 1 is in use, the doctor first releases the traction rod 110 through the clamping head 140, and then manually controls the traction rod 110 to move into the patient's body so that the hook 120 at the lower end of the traction rod 110 hooks the lung tissue to be cut. Then, the doctor lifts the traction rod 110 upward so that the lung tissue to be cut is pulled into the inner cylinder 220 of the cutting nozzle 2. Finally, the traction rod 110 is clamped by the clamping head 140.

[0054] Example 9

[0055] like Figure 1 , Figure 2 , Figure 3 As shown, this embodiment is a further improvement on embodiment 8, as detailed below:

[0056] The clamping head 140 includes a flap 141, which is fixed on the fixing frame 130. A threaded sleeve 142 is threaded onto the flap 141. A pull rod 110 passes through the flap 141. By rotating the threaded sleeve 142, the flap 141 can clamp and release the pull rod 110. The operation is convenient and the stability is good.

[0057] In addition, the upper end of the traction rod 110 is equipped with a detachable pull ring 150, which makes it easy for doctors to use this as a force point to pull the traction rod 110 to prevent slippage.

[0058] Although embodiments of the present invention have been shown and described above, it is understood that the above embodiments are exemplary and should not be construed as limiting the present invention. Those skilled in the art can make changes, modifications, substitutions and variations to the above embodiments within the scope of the present invention.

Claims

1. A circular endo-cutting closure device for pulmonary subpleural ground-glass nodule, characterized in that, The application relates to a cutting and bundling device for lung tissue, which comprises a pulling mechanism (1) and a cutting and bundling device (2), wherein the pulling mechanism (1) is installed on the cutting and bundling device (2) to pull lung tissue to be cut into the cutting and bundling device (2) and cut the lung tissue to be cut after bundling by the cutting and bundling device (2); the cutting and bundling device (2) comprises an outer cylinder (210) and an inner cylinder (220) coaxially arranged in the outer cylinder (210), the inner cylinder (220) is arranged in the outer cylinder (210) in a retracted mode, and the opening ends of the outer cylinder (210) and the inner cylinder (220) are downward; a cover plate (230) is arranged in the gap between the outer cylinder (210) and the inner cylinder (220) and fixed with the outer cylinder (210) and the inner cylinder (220); a hollow sleeve (240) is coaxially fixed to the closed end of the outer cylinder (210), an outer through hole (211) is formed in the closed end of the outer cylinder (210) and communicated with the hollow sleeve (240), a plurality of cutting knives (250) are arranged at different heights and different positions below the cover plate (230), a binding belt (260) for bundling lung tissue to be cut is arranged below the lowermost cutting knife (250), the binding belt (260) is movably connected with the cover plate (230), a rotating mechanism (270) is fixed to the outer cylinder (210) and the hollow sleeve (240), the tail ends of the cutting knives (250) are respectively fixed to the rotating mechanism (270), and the rotating mechanism (270) simultaneously drives the rotating of the tip ends of the cutting knives (250) towards the axial direction of the inner cylinder (220) to cut the lung tissue to be cut. The rotating mechanism (270) comprises a plurality of rotating shafts (271) arranged in the gap between the outer cylinder (210) and the inner cylinder (220), the lower ends of the rotating shafts (271) respectively penetrate through the cover plate (230) and movably connected with the cover plate (230), the lower ends of the rotating shafts (271) are respectively fixed to the tail ends of the cutting knives (250), a hollow power rod (272) is coaxially arranged in the hollow sleeve (240), the lower end of the hollow power rod (272) extends into the outer cylinder (210) through the outer through hole (211), the lower end of the hollow power rod (272) is connected with the rotating shafts (271) through a transmission chain (273), the upper end of the hollow power rod (272) extends out of the upper end of the hollow sleeve (240), the upper end of the hollow sleeve (240) is sleeved with a handle (280) movably connected with the hollow sleeve (240), and the handle (280) is fixed to the upper end of the hollow power rod (272) in a partial region. The cutting knives (250) are in arc shapes, and the cutting edges of the cutting knives (250) are on the inner circles, and all the cutting knives (250) are circularly distributed.

2. A circular endocutter for subpleural ground-glass nodules according to claim 1, characterized in that, ​ 3. A circular endocutter for subpleural ground-glass nodules according to claim 1, wherein, The transmission chain (273) comprises a driving gear (2731) and a plurality of driven gears (2732), the driving gear (2731) is fixed to the lower end of the hollow power rod (272), and the plurality of driven gears (2732) are respectively fixed to the plurality of rotating shafts (271), each driven gear (2732) is engaged with the driving gear (2731).

4. The circular endocutter for subpleural ground-glass nodules according to claim 1, wherein, The cable tie (260) is a toothed cable tie.

5. The circular endocutter for subpleural ground-glass nodules according to any one of claims 1-4, characterized in that, The cover plate (230), the closed end of the outer cylinder (210), the lower end of the hollow sleeve (240), and the upper end of the hollow sleeve (240) are respectively provided with a belt hole, and the pulling end of the cable tie (260) is sequentially pulled through the belt holes on the cover plate (230), the outer cylinder (210), the lower end of the hollow sleeve (240), and the upper end of the hollow sleeve (240).

6. The circular endocutter for subpleural ground-glass nodules according to any one of claims 1-4, characterized in that, The closed end of the inner cylinder (220) is provided with an inner through hole (221) at the corresponding outer through hole (211); the pulling mechanism (1) comprises a pulling rod (110), the pulling rod (110) is coaxially arranged in the hollow power rod (272), the lower end of the pulling rod (110) is sequentially passed through the outer through hole (211) and the inner through hole (221) and then enters the inner cylinder (220), the lower end of the pulling rod (110) is provided with a plurality of hooks (120), the upper end of the pulling rod (110) is pulled out from the upper end of the hollow power rod (272), the upper end face of the hollow sleeve (240) is provided with a fixing frame (130), and the fixing frame (130) is provided with a clamping head (140) for clamping and loosening the pulling rod (110).

7. A circular endocutter for subpleural ground-glass nodules according to claim 6, characterized in that, The clamping head (140) comprises a petal-shaped collet (141), the petal-shaped collet (141) is fixed to the fixing frame (130), and the petal-shaped collet (141) is threadedly connected with a sleeve (142).

8. A circular endocutter for subpleural ground-glass nodules according to claim 6, wherein, The upper end of the pulling rod (110) is provided with a detachable pull ring (150).

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