Reusable near-end anastomosis combined appliance

Abstract

The invention relates to the technical field of medical instruments, in particular to a reusable near-end anastomosis combined appliance which comprises an aorta puncher and a pusher, the aorta puncher comprises a puncher shell and a punching mechanism movably arranged in the puncher shell, the punching mechanism is connected with a reset mechanism, and the reset mechanism is connected with the pusher. The resetting mechanism is used for resetting the punching mechanism after the punching mechanism completes punching; the pusher comprises a pusher shell, a pushing pipe and a pushing mechanism, a sealing assembly is arranged in the pushing pipe, the pushing mechanism comprises a pushing state and a reset state, in the pushing state, the pushing mechanism pushes the sealing assembly in the pushing pipe, and in the reset state, the pushing mechanism recovers to the initial state. According to the reusable near-end anastomosis combined appliance, the aorta hole puncher and the pusher can be repeatedly used for punching and sealing a plurality of coronary artery anastomotic stomas only by replacing the sealing assembly for a patient needing to bypass a plurality of coronary blood vessels, and the operation cost is greatly saved.

Description

Technical Field

[0001] The present invention relates to the technical field of medical devices, and in particular to a reusable proximal anastomosis assembly instrument. Background Art

[0002] In surgical operations, if the arterial defect is small after sharp cutting or debridement, end-to-end anastomosis can be performed directly. End-to-end anastomosis of blood vessels is often performed using a proximal aortic anastomosis device. The proximal aortic anastomosis device mainly includes two parts: an aortic perforator and a sealing component delivery device (the sealing component delivery device includes a loading device, a delivery device, and a sealing component).

[0003] During the use of existing proximal aortic anastomosis instruments, the aortic punch and sealing component delivery device are both disposable tools. For some patients who need multiple coronary artery bypass grafting, in one operation, each coronary artery bypass grafting process requires end-to-end vascular anastomosis. After completing one vascular end-to-end anastomosis, a new aortic punch and sealing component delivery device need to be replaced. Therefore, for patients who need multiple coronary artery bypass grafting, multiple proximal aortic anastomosis instruments are needed to complete one operation, which greatly increases the cost of the operation. Summary of the invention

[0004] The present invention provides a reusable proximal anastomosis combination instrument to solve the defect in the prior art that proximal aortic anastomosis instruments are all disposable tools, which leads to relatively high surgical costs for patients who need multiple coronary artery bypass surgery. The present invention enables the proximal aortic anastomosis instrument to be reused in multiple coronary artery bypass surgery, thereby reducing surgical costs.

[0005] The present invention provides a reusable proximal anastomosis combination instrument, comprising an aortic puncher and a pusher, wherein the aortic puncher is used for punching a hole in the aorta to open an anastomosis, the aortic puncher comprises a puncher shell and a punching mechanism movably arranged in the puncher shell, the punching mechanism is connected with a reset mechanism, and the reset mechanism is used for resetting the punching mechanism after the punching mechanism completes the punching; the pusher is used for placing a sealing component on the anastomosis opened by the aortic puncher to seal the anastomosis, the pusher comprises a pusher shell, a pusher tube penetrating one end of the pusher shell and a pusher mechanism arranged in the pusher shell, the sealing component is arranged in the pusher tube, and the pusher mechanism comprises a pushing state and a reset state, in which the pushing mechanism pushes the sealing component in the pusher tube, and in the reset state, the pushing mechanism restores the initial state.

[0006] A reusable proximal anastomosis assembly instrument provided according to the present invention also includes a crimper, which is used to crimp the sealing assembly into the pushing tube of the pusher.

[0007] The crimper comprises a crimper housing, which is configured as an openable housing, one end of which is provided with a mounting hole for inserting the pusher, and a crimping handle is arranged inside the crimper housing, and the crimping handle is located in the axial direction of the mounting hole.

[0008] According to a reusable proximal anastomosis combination instrument provided by the present invention, the punching mechanism includes a transmission core shaft, a first spring member, a puncture needle and a punching blade, the outer periphery of the transmission core shaft is provided with a protrusion, and the protrusion is clamped in the positioning groove of the inner wall of the punch housing; the first spring member is sleeved on the outer periphery of the transmission core shaft, one end of the first spring member is connected to the inner wall of the punch housing, and the other end is connected to the transmission core shaft; the first spring member stores mechanical energy so that after the protrusion is separated from the positioning groove, the transmission core shaft can move axially and circumferentially under the drive of the first spring member; the puncture needle is fixed to the end face center of one end of the transmission core shaft, and the punching blade is an annular blade, and the punching blade is arranged around the puncture needle.

[0009] According to a reusable proximal anastomosis combination instrument provided by the present invention, a locking plate is movably provided on the punch housing, and a through hole and a locking hole that are interconnected are constructed on the locking plate. The transmission core shaft is passed through the through hole or the locking hole, and a recessed portion is provided on the outer periphery of the transmission core shaft. The through cross-section of the transmission core shaft is adapted to the size of the through hole, and the cross-section of the recessed portion of the transmission core shaft is adapted to the size of the locking hole.

[0010] According to a reusable proximal anastomosis assembly instrument provided by the present invention, a first external thread is arranged on the outer periphery of the end of the punch housing away from the puncture needle, a connecting hole is opened on the end of the transmission core shaft away from the puncture needle, and a first internal thread is arranged on the inner wall of the connecting hole.

[0011] The reset mechanism comprises a reset handle and a reset auxiliary nut, wherein the reset auxiliary nut is provided with a second internal thread and a third internal thread, the end of the reset handle is provided with a second external thread, and the outer peripheral surface of the reset handle is provided with a third external thread.

[0012] The first internal thread is used to cooperate with the second external thread to form a first screw-on portion, the second internal thread is used to cooperate with the first external thread to form a second screw-on portion, and the third internal thread is used to cooperate with the third external thread to form a third screw-on portion. The first screw-on portion and the second screw-on portion have the same rotation direction, and the rotation direction is opposite to that of the third screw-on portion.

[0013] According to a reusable proximal anastomosis assembly device provided by the present invention, the pushing mechanism comprises a pushing shaft, a second spring member, a locking member, a guide rail sleeve, a pressure rod and a pushing handle, the first end of the pushing shaft is passed through the pushing tube; the second spring member is sleeved on the pushing shaft, one end of the second spring member is connected to the inner wall of the pusher housing, and the other end is connected to the pushing shaft; the locking member is rotatably sleeved on the second end of the pushing shaft, and a plurality of strip-shaped protrusions are distributed at intervals along the circumferential direction on the outer periphery of the locking member, and the end of the strip-shaped protrusion away from the pushing shaft is constructed as an inclined surface; the guide rail sleeve is fixed Fixed on the inner wall of the pusher housing, a plurality of guide rail grooves matching the strip-shaped protrusions are distributed circumferentially inside the guide rail sleeve, and the end of the protrusion formed between two adjacent guide rail grooves is constructed as an inclined surface matching the end face of the strip protrusion; the first end of the pressure rod is constructed with a sharp tooth protrusion along the circumferential direction, and the sharp tooth protrusion is used to match the inclined surface end of the strip protrusion so that the locking member rotates under the squeezing of the pressure rod; a plurality of guide blocks matching the guide rail grooves are distributed circumferentially on the outer circumferential surface of the pressure rod; the pushing handle is connected to the second end of the pressure rod.

[0014] According to a reusable proximal anastomosis assembly instrument provided by the present invention, a positioning hole is provided on the push tube, and a spring pin which cooperates with the positioning hole is passed through the pusher housing, so that the push tube can be detachably connected to the pusher housing.

[0015] The push tube is provided with a marking line, and the marking line is aligned with the positioning hole along the axial direction of the push tube.

[0016] According to a reusable proximal anastomosis combination instrument provided by the present invention, the crimper shell includes a base plate and an upper shell detachably connected to the base plate, the base plate and the upper shell constitute an inner cavity of the crimper shell, the mounting hole is formed at one end of the inner cavity of the crimper shell, and curling operation ports are respectively formed on both sides of the inner cavity of the crimper shell away from the mounting hole, which are used to operate the curling handle at the curling operation port.

[0017] According to a reusable proximal anastomosis combination instrument provided by the present invention, the curling handle includes an elastic tensioning portion fixed on the center line of the base plate and extrusion portions respectively connected to both ends of the elastic tensioning portion, the two extrusion portions are symmetrically arranged along the center line of the base plate, and are respectively located at the two curling operation ports, so that a curling operation area is formed between the two extrusion portions, and arc-surface extrusion blocks are relatively arranged on the sides of the two extrusion portions facing the curling operation area.

[0018] According to a reusable proximal anastomosis assembly instrument provided by the present invention, the outer circumferential surfaces of the aortic puncher and the pusher are detachably provided with anti-splash protective covers, the anti-splash protective covers are transparent acrylic discs, and the anti-splash protective covers are provided with a hydrophobic coating.

[0019] The reusable proximal anastomosis assembly instrument provided by the present invention mainly includes an aortic puncher for punching a hole in the aorta to open an anastomosis and a pusher for placing a sealing component on the anastomosis, wherein the aortic puncher and the pusher are both reusable surgical instruments, and the aortic puncher realizes the punching of the aorta through a punching mechanism, and after the punching is completed, the punching mechanism is reset by a reset mechanism so as to punch the hole next time. The pusher can send the sealing component in the push tube into the anastomosis through the push mechanism, and after the sealing component is pushed, the push mechanism can be reset to restore the initial state for the next use. This reusable proximal anastomosis assembly instrument of the present invention can be used for patients who need multiple coronary artery bypass grafting. Only the sealing component needs to be replaced to reuse the aortic puncher and the pusher to perform punching and sealing of multiple bridge vessel anastomoses, which greatly saves surgical costs. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] In order to more clearly illustrate the technical solutions in the present invention or the prior art, the following briefly introduces the drawings required for use in the embodiments or the description of the prior art. Obviously, the drawings described below are some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative work.

[0021] Figure 1 The figure is a schematic diagram of the axial structure of the aortic puncher provided by the present invention.

[0022] Figure 2 The figure is a schematic diagram of the explosion structure of the aortic puncher provided by the present invention.

[0023] Figure 3 It is a structural schematic diagram of the transmission mandrel provided by the present invention.

[0024] Figure 4 It is a schematic diagram of the internal structure of the punch housing provided by the present invention.

[0025] Figure 5 It is a structural schematic diagram of the locking plate provided by the present invention.

[0026] Figure 6 It is a schematic diagram of the installation structure of the reset mechanism provided by the present invention.

[0027] Figure 7 It is a schematic diagram of the resetting principle of the resetting mechanism provided by the present invention.

[0028] Figure 8 It is a schematic diagram of the axial structure of the pusher provided by the present invention.

[0029] Fig. 9 It is a schematic diagram of the explosion structure of the pusher provided by the present invention.

[0030] Fig.10 It is a structural schematic diagram of the guide rail sleeve provided by the present invention.

[0031] Fig.11 It is a structural schematic diagram of the pressure rod provided by the present invention.

[0032] Fig.12 It is a structural schematic diagram of the locking member provided by the present invention.

[0033] Fig.13 It is a schematic diagram of the axial structure of the crimper provided by the present invention.

[0034] Fig.14 It is a schematic diagram of the matching structure of the crimper and the pusher provided by the present invention.

[0035] Fig.15 It is a schematic diagram of the explosion structure of the crimper provided by the present invention.

[0036] Fig.16 It is a schematic diagram of the axial structure of the curling handle provided by the present invention.

[0037] Figure numerals: 1. aortic puncher; 11. puncher housing; 111. positioning groove; 12. punching mechanism; 121. transmission mandrel; 1211. raised portion; 1212. recessed portion; 1213. connecting hole; 122. first spring member; 123. puncture needle; 124. punching blade; 125. locking plate; 1251. through hole; 1252. locking hole; 13. reset mechanism; 131. reset handle; 132. reset auxiliary nut; 133. first screw connection; 134. second screw connection; 135. third screw connection; 2. pusher; 21. Pusher housing; 22. Pusher tube; 221. Positioning hole; 222. Marking line; 23. Pusher mechanism; 231. Pusher shaft; 232. Second spring member; 233. Locking member; 234. Guide sleeve; 235. Pressure rod; 236. Pusher handle; 24. Spring pin; 3. Sealing assembly; 4. Crimper; 41. Crimper housing; 411. Bottom plate; 412. Upper shell; 42. Mounting hole; 43. Crimping handle; 431. Elastic tensioning portion; 432. Extrusion portion; 433. Arc extrusion block; 44. Crimping operation port; 5. Splash-proof protective cover. DETAILED DESCRIPTION

[0038] In order to make the purpose, technical solution and advantages of the present invention clearer, the technical solution of the present invention will be clearly and completely described below in conjunction with the drawings of the present invention. Obviously, the described embodiments are 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.

[0039] In the description of the embodiments of the present invention, it should be noted that the terms "center", "longitudinal", "lateral", "up", "down", "front", "back", "left", "right", "vertical", "horizontal", "top", "bottom", "inside" and "outside" etc., indicating orientations or positional relationships, are based on the orientations or positional relationships shown in the accompanying drawings, and are only for the convenience of describing the embodiments of the present invention and simplifying the description, and do not indicate or imply that the referred device or element must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as a limitation on the embodiments of the present invention.

[0040] In the description of the embodiments of the present invention, it should be noted that, unless otherwise clearly specified and limited, the terms "connected" and "connection" 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 directly connected or indirectly connected through an intermediate medium. For ordinary technicians in this field, the specific meanings of the above terms in the embodiments of the present invention can be understood according to specific circumstances.

[0041] In the embodiments of the present invention, unless otherwise clearly specified and limited, the first feature being "above" or "below" the second feature may mean that the first and second features are in direct contact, or the first and second features are in indirect contact through an intermediate medium. Moreover, the first feature being "above", "above" and "above" the second feature may mean that the first feature is directly above or obliquely above the second feature, or simply means that the first feature is higher in level than the second feature. The first feature being "below", "below" and "below" the second feature may mean that the first feature is directly below or obliquely below the second feature, or simply means that the first feature is lower in level than the second feature.

[0042] In the description of this specification, the description with reference to the terms "one embodiment", "some embodiments", "example", "specific example", or "some examples" etc. means that the specific features, structures, materials or characteristics described in conjunction with the embodiment or example are included in at least one embodiment or example of the embodiment of the present invention. In this specification, the schematic representations of the above terms do not necessarily refer to the same embodiment or example. Moreover, the specific features, structures, materials or characteristics described may be combined in any one or more embodiments or examples in a suitable manner. In addition, those skilled in the art may combine and combine the different embodiments or examples described in this specification and the features of the different embodiments or examples, without contradiction.

[0043] Combine the following Figures 1 to 16 The specific structure and working principle of the reusable proximal anastomosis assembly instrument of the present invention are described.

[0044] One embodiment of the present invention provides a reusable proximal anastomosis assembly instrument, comprising: Figure 1 The aortic punch 1 and Figure 8 The pusher 2 shown in the figure and the aortic punch 1 are used to punch a hole in the aorta to open an anastomosis. Figure 2 As shown, the aortic perforator 1 comprises a perforator housing 11 and a perforating mechanism 12 movably arranged in the perforator housing 11, the perforating mechanism 12 is connected to a resetting mechanism 13, and the resetting mechanism 13 is used to reset the perforating mechanism 12 after the perforating mechanism 12 completes the perforation; the pusher 2 is used to place the sealing assembly 3 on the anastomosis opened by the aortic perforator 1 to seal the anastomosis, see Fig. 9 As shown, the pusher 2 includes a pusher housing 21, a pusher tube 22 passing through one end of the pusher housing 21, and a pusher mechanism 23 arranged in the pusher housing 21. A sealing component 3 is arranged in the pusher tube 22. The pusher mechanism 23 includes a push state and a reset state. In the push state, the pusher mechanism 23 pushes the sealing component 3 in the pusher tube 22. In the reset state, the pusher mechanism 23 returns to the initial state.

[0045] It can be understood that the reusable proximal anastomosis assembly instrument of the present embodiment mainly includes an aortic puncher 1 for punching a hole in the aorta to open an anastomosis and a pusher 2 for placing a sealing component 3 at the anastomosis, wherein the aortic puncher 1 and the pusher 2 are both reusable surgical instruments, and the aortic puncher 1 realizes the punching of the aorta through a punching mechanism 12, and after the punching is completed, the punching mechanism 12 is reset by a reset mechanism 13 so as to perform the punching next time. The pusher 2 can deliver the sealing component 3 in the push tube 22 into the anastomosis through a push mechanism 23, and after the sealing component 3 is pushed, the push mechanism 23 can be reset to restore the initial state so as to be used next time. The reusable proximal anastomosis assembly instrument of the present embodiment can be used for patients who need multiple coronary artery bypass grafting, and only the sealing component 3 needs to be replaced to reuse the aortic puncher 1 and the pusher 2 to perform the punching and sealing of multiple bridge vessel anastomoses, which greatly saves the cost of surgery.

[0046] In some embodiments of the reusable proximal anastomosis assembly instrument of the present invention, the assembly instrument further comprises: Fig.13 The crimper 4 shown is used to crimp the sealing assembly 3 into the push tube 22 of the pusher 2. Specifically, the crimper 4 includes a crimper housing 41, which is configured as an openable housing, and a mounting hole 42 for inserting the pusher 2 is opened at one end of the crimper housing 41, and a crimping handle 43 is arranged inside the crimper housing 41, and the crimping handle 43 is located in the axial direction of the mounting hole 42.

[0047] It is understandable that the crimper 4 of this embodiment can crimp the sealing component 3 and then send it into the push tube 22 of the pusher 2, so that the pusher 2 can place the sealing component 3 at the anastomosis to achieve sealing. It should be understood that the sealing component 3 used in the present invention includes a metal opening rod that can be rolled and folded and a sealing umbrella connected to both ends of the metal opening rod. After the metal opening rod is opened, the sealing umbrella is opened to achieve the occlusion of the anastomosis. The sealing component 3 is an existing device, and its structure can be seen in Fig.14 , and no detailed description is given here.

[0048] In some specific embodiments of the reusable proximal anastomosis assembly of the present invention, the punching mechanism 12 includes a transmission mandrel 121, a first spring member 122, a puncture needle 123 and a punching blade 124, see Figure 3 As shown, the outer periphery of the transmission core shaft 121 is provided with a protrusion 1211, and the protrusion 1211 is clamped in the positioning groove 111 on the inner wall of the punch housing 11 (see Figure 4As shown); the first spring member 122 is sleeved on the outer circumference of the transmission core shaft 121, one end of the first spring member 122 is connected to the inner wall of the punch housing 11, and the other end is connected to the transmission core shaft 121; the first spring member 122 stores mechanical energy so that after the protrusion 1211 is separated from the positioning groove 111, the transmission core shaft 121 can move axially and circumferentially under the drive of the first spring member 122; the puncture needle 123 is fixed to the end face center of one end of the transmission core shaft 121, and the punching blade 124 is an annular blade, and the punching blade 124 is arranged around the puncture needle 123.

[0049] It can be understood that in the punching mechanism 12 of this embodiment, in the initial state, the transmission mandrel 121 is engaged with the positioning groove 111 on the inner wall of the punch housing 11 through the protrusion 1211 arranged on the periphery, and the transmission mandrel 121 is positioned. The first spring member 122 on the transmission mandrel 121 has obtained a certain torque through reverse rotation, and is in a state of increasing diameter and shortening length. When using the aortic puncher 1 for punching, after finding the punching position, the puncture needle 123 at the end of the transmission mandrel 121 is inserted into the aorta and positioned at the expected anastomotic position; then, the circumferential position of the transmission mandrel 121 is adjusted so that the protrusion 1211 of the transmission mandrel 121 is disengaged from the positioning groove 111 on the inner wall of the punch housing 11, and the transmission mandrel 121 is free from the restriction of the punch housing 11. The torque in the first spring member 122 is released, and the driving mandrel 121 rotates together with the first spring member 122 and moves axially, and the punching blade 124 at the end of the driving mandrel 121 rotates downward to cut the aorta to achieve anastomotic perforation.

[0050] In some specific examples, a locking plate 125 is movably provided on the punch housing 11, see Figure 5As shown, the locking plate 125 is constructed with a through hole 1251 and a locking hole 1252 that are interconnected, the transmission spindle 121 is inserted into the through hole 1251 or the locking hole 1252, a recessed portion 1212 is provided on the periphery of the transmission spindle 121, the through cross section of the transmission spindle 121 is adapted to the size of the through hole 1251, and the cross section of the recessed portion 1212 of the transmission spindle 121 is adapted to the size of the locking hole 1252. It can be understood that the locking plate 125 in this example is used to positionally lock the transmission spindle 121. In the initial state, the locking plate 125 and the transmission spindle 121 are in a locked state, the transmission spindle 121 is inserted into the locking plate 125, and the recessed portion 1212 of the transmission spindle 121 is engaged with the locking hole 1252 on the locking plate 125, and the transmission spindle 121 cannot rotate. When punching is required, the locking plate 125 is pulled outward on the punch housing 11 so that the recessed portion 1212 of the transmission spindle 121 is located in the through hole 1251 on the locking plate 125. Since the inner diameter of the through hole 1251 is larger than the size of the recessed portion 1212 of the transmission spindle 121, the locking plate 125 can no longer lock the transmission spindle 121. When the raised portion 1211 on the outer periphery of the transmission spindle 121 is disengaged from the positioning groove 111, the transmission spindle 121 can move axially and circumferentially under the drive of the first spring member 122.

[0051] After the punching of the aortic anastomosis is completed by the punching mechanism 12 of the aortic puncher 1, the punching mechanism 12 needs to be reset by the reset mechanism 13. In some embodiments of the reusable proximal anastomosis assembly instrument of the present invention, a first external thread is provided on the outer periphery of the end of the punch housing 11 away from the puncture needle 123, a connecting hole 1213 is provided on the end of the transmission core shaft 121 away from the puncture needle 123, and a first internal thread is provided on the inner wall of the connecting hole 1213. The reset mechanism 13 includes a reset handle 131 and a reset auxiliary nut 132, a second internal thread and a third internal thread are provided inside the reset auxiliary nut 132, a second external thread is provided on the end of the reset handle 131, and a third external thread is provided on the outer peripheral surface of the reset handle 131. See Figure 6 As shown, the first internal thread is used to cooperate with the second external thread to form a first screw-on portion 133, the second internal thread is used to cooperate with the first external thread to form a second screw-on portion 134, and the third internal thread is used to cooperate with the third external thread to form a third screw-on portion 135. The first screw-on portion 133 and the second screw-on portion 134 have the same rotation direction, and the rotation direction is opposite to that of the third screw-on portion 135.

[0052] It is understandable that after the first punching is completed, when it is necessary to punch again, the punching mechanism 12 needs to be reset for reuse. Figure 6 and Figure 7As shown, in the first step, the reset handle 131 and the reset auxiliary nut 132 are assembled, and the third internal thread of the reset auxiliary nut 132 cooperates with the third external thread of the reset handle 131 to form a third screw-on portion 135, so that the reset auxiliary nut 132 is screwed counterclockwise to the upper part of the reset handle 131; in the second step, the second internal thread of the reset auxiliary nut 132 is cooperated with the first external thread of the punch housing 11 to form a second screw-on portion 134, and the reset auxiliary nut 132 is screwed clockwise to the threaded connection part of the punch housing 11; in the third step, the reset handle 131 is rotated clockwise to make it screw-on with the transmission spindle 121, that is, the first internal thread is used to cooperate with the second external thread to form a first screw-on portion 133; in the fourth step, the reset handle 131 is continued to be rotated clockwise, and at the same time, it is slightly pulled up. At this time, due to the reset auxiliary nut 132 The end of the punch housing 11 is fixed, and under the action of the third screw connection 135, the reset handle 131 moves outward relative to the reset auxiliary nut 132. At the same time, in the process of rotating the reset handle 131, the transmission spindle 121 will be driven by the reset handle 131 to rotate and rise at a fixed pitch, so that the first spring member 122 is restored to the punch state; the fifth step, when the external thread of the reset handle 131 is screwed out of the internal thread of the reset auxiliary nut 132, the transmission spindle 121 is gently pulled to the right position so that the protrusion 1211 on the transmission spindle 121 is just stuck in the positioning groove 111, and the locking plate 125 is pushed to lock the transmission spindle 121; the sixth step, the reset auxiliary nut 132 is rotated counterclockwise to screw it out of the punch housing 11, and the reset handle 131 is rotated counterclockwise to screw it out of the transmission spindle 121. At this point, the punching mechanism 12 is reset, and the first spring member 122 completes the torque energy storage again, and can be prepared for the next punching.

[0053] Furthermore, a destroy button is also provided on the punch housing 11. After the last punching is completed and the punching operation is no longer continued, in order to avoid cross-use of the device, the destroy button on the punch housing 11 can be pressed to destroy the product function at one time. During normal operation, the destroy button is on the outside of the transmission mandrel 121, and the transmission mandrel 121 can move up and down normally. When the destroy button is pressed, the destroy button moves inward and is in the up and down movement path of the transmission mandrel 121. At this time, the transmission mandrel 121 cannot be reset and fixed, and the aortic punch 1 cannot work normally, realizing the self-destruction function.

[0054] In other embodiments of the reusable proximal anastomosis assembly instrument of the present invention, Figure 8 and Fig. 9As shown, the pushing mechanism 23 includes a pushing shaft 231, a second spring member 232, a locking member 233, a guide rail sleeve 234, a pressure rod 235 and a pushing handle 236. The first end of the pushing shaft 231 is inserted into the pushing tube 22; the second spring member 232 is sleeved on the pushing shaft 231, one end of the second spring member 232 is connected to the inner wall of the pusher housing 21, and the other end is connected to the pushing shaft 231; the locking member 233 is rotatably sleeved on the second end of the pushing shaft 231, and a plurality of strip-shaped protrusions are distributed at intervals along the circumferential direction on the outer periphery of the locking member 233, and the end of the strip-shaped protrusion away from the pushing shaft 231 is constructed as an inclined surface; the guide rail sleeve 234 is fixed to the inner wall of the pusher housing 21, and a plurality of guide rail grooves matching the strip-shaped protrusions are distributed circumferentially inside the guide rail sleeve 234, and the end of the protrusion formed between two adjacent guide rail grooves is constructed as an inclined surface matching the end face of the strip-shaped protrusion; the first end of the pressure rod 235 is constructed with a sharp tooth protrusion along the circumferential direction, and the sharp tooth protrusion is used to match the inclined surface end of the strip-shaped protrusion so that the locking member 233 rotates under the squeezing of the pressure rod 235; a plurality of guide blocks matching the guide rail grooves are distributed circumferentially on the outer peripheral surface of the pressure rod 235; the pushing handle 236 is connected to the second end of the pressure rod 235.

[0055] It is understandable that after the aortic puncher 1 is used to complete the punching of the anastomosis, the sealing component 3 is inserted through the pusher 2 to seal the anastomosis. In this embodiment, after the anastomosis is formed, the pusher 2 with the sealing component 3 inserted is held and aimed at the anastomosis at a certain angle, the finger pressing the anastomosis is removed, and the push handle 236 is pressed forward, and the sealing component 3 in the push tube 22 can be sent into the anastomosis through the push shaft 231. The sealing component 3 separated from the push tube 22 will be subjected to the tension of its own elastic components and reopened in the aorta, and will be close to the aortic wall under the blood pressure in the aorta, forming a sealing area for anastomosis of the target blood vessel.

[0056] It should be understood that in this embodiment, by pressing the push handle 236 forward, the sealing assembly 3 in the push tube 22 can be sent into the anastomotic opening through the push shaft 231. Fig.10 , Fig.11 and Fig.12 As shown, the push handle 236 is pressed, and the push handle 236 acts on the pressure rod 235. The circumferentially distributed guide blocks of the pressure rod 235 move in the guide grooves in the guide sleeve 234. The circumferentially constructed sharp teeth at the first end of the pressure rod 235 act on the multiple strip protrusion inclined surfaces on the periphery of the locking member 233, so that the locking member 233 rotates. The strip protrusion of the locking member 233 cooperates with the inclined surface at the end of the protrusion formed between the two guide grooves of the guide sleeve 234, so that the locking member 233 moves forward, pushes the push shaft 231 and compresses the second spring member 232. The push shaft 231 pushes the sealing component 3 in the push tube 22, and the sealing component 3 is sent from the push tube 22 into the anastomotic opening.

[0057] After the sealing assembly 3 is inserted into the anastomotic opening, the push handle 236 is pressed again. Fig.10 , Fig.11 and Fig.12 As shown, the pushing handle 236 acts on the pressure rod 235, and the sharp tooth protrusion constructed along the circumferential direction at the first end of the pressure rod 235 continues to act on the multiple strip protrusion inclined surfaces on the outer periphery of the locking member 233, so that the locking member 233 rotates, and the strip protrusion of the locking member 233 enters the guide rail groove in the guide rail sleeve 234. Under the resetting action of the second spring member 232, the pushing shaft 231, the locking member 233 and the pressure rod 235 are pushed back to realize the resetting of the pushing mechanism 23. At this time, the sealing assembly 3 can be placed in the pushing tube 22 again, so that the next time the pusher 2 is used to push the sealing assembly 3 to seal the anastomosis.

[0058] In some examples, a positioning hole 221 is provided on the push tube 22, and a spring pin 24 is provided on the pusher housing 21 to cooperate with the positioning hole 221, so that the push tube 22 can be detachably connected to the pusher housing 21. A marking line 222 is provided on the push tube 22, and the marking line 222 is aligned with the positioning hole 221 along the axial direction of the push tube 22. It can be understood that in this example, the push tube 22 can be pulled out from the push mechanism 23, and the sealing assembly 3 is curled into the push tube 22 to form a new set of sealing parts, and the new set of sealing parts is inserted into the push mechanism 23. During the insertion process, the marking line 222 on the push tube 22 is aligned with the spring pin 24 on the pusher housing 21, until the spring pin 24 is engaged with the positioning hole 221 on the push tube 22, and the reset installation of the push mechanism 23 is completed.

[0059] In other embodiments of the reusable proximal anastomosis assembly device of the present invention, see Fig.15 As shown, the curler housing 41 includes a base plate 411 and an upper shell 412 detachably connected to the base plate 411, an inner cavity of the curler housing 41 is formed between the base plate 411 and the upper shell 412, a mounting hole 42 is formed at one end of the inner cavity of the curler housing 41, and curling operation ports 44 are respectively formed on both sides of the inner cavity of the curler housing 41 away from the mounting hole 42, which are used to operate the curling handle 43 at the curling operation port 44.

[0060] Understandably, see Fig.14As shown, the sealing assembly 3 is in the push tube 22 before curling (the metal expansion rod is retracted in the tube, and the blocking umbrella is opened outside), and the pusher 2 is pre-installed in the crimper 4. The two sides of the curling handle 43 are pressed inward from the curling operation ports 44 on both sides of the crimper 4, and the blocking umbrella of the sealing assembly 3 is curled through the curling handle 43. The curling handle 43 is kept pressed, so that the pusher 2 moves in the installation hole 42 toward the inner cavity of the crimper housing 41, so that the curled blocking umbrella of the sealing assembly 3 is placed in the push tube 22 of the pusher 2, and a new round of installation of the sealing assembly 3 in the pusher 2 is completed.

[0061] Specifically, see Fig.16 As shown, the curling handle 43 includes an elastic tensioning portion 431 fixed on the center line of the base plate 411 and an extrusion portion 432 respectively connected to both ends of the elastic tensioning portion 431. The two extrusion portions 432 are symmetrically arranged along the center line of the base plate 411 and are respectively located at the two curling operation ports 44 so that a curling operation area is formed between the two extrusion portions 432. Arc extrusion blocks 433 are relatively arranged on the sides of the two extrusion portions 432 facing the curling operation area.

[0062] It is understandable that after the sealing umbrella of the sealing component 3 is curled for the first time, when the sealing umbrella of the second set of sealing component 3 needs to be curled, the upper shell 412 of the curler 4 needs to be disassembled from the bottom plate 411 and placed in the reset pusher 2, and the upper shell 412 needs to be covered again to perform the curling operation. The metal opening rod of the sealing component 3 is folded and placed in the push tube 22 of the pusher 2. The sealing umbrella of the sealing component 3 is located in the curling operation area between the two extrusion parts 432 of the curling handle 43. After the two extrusion parts 432 are pressed, the two opposite arc extrusion blocks 433 squeeze and curl the sealing umbrella of the sealing component 3, and then enter the push tube 22 when the pusher 2 moves forward, completing the curling installation of the sealing component 3 in the pusher 2.

[0063] Based on the structures of the above-mentioned embodiments and examples, in other embodiments of the reusable proximal anastomosis combination instrument of the present invention, a splash-proof protective cover 5 can be detachably provided on the outer peripheral surfaces of the aortic puncher 1 and the pusher 2. The splash-proof protective cover 5 is a transparent acrylic disc, and a hydrophobic coating is provided on the splash-proof protective cover 5.

[0064] It can be understood that the splash protection cover 5 can make the splashed blood flow down quickly along the surface of the splash protection cover 5 without forming any droplets to block the field of vision. Figure 1 As shown, a splash shield 5 is vertically installed on the outer peripheral surface of the aortic puncher 1 near the punching end. During the punching process of the aortic puncher 1, a small amount of blood will splash out. At this time, the splash shield 5 can prevent the sprayed blood from splashing onto the operator's face or body to cause occupational exposure risks. Similarly, see Figure 8 As shown, the push tube 22 of the pusher 2 is detachably connected to the splash protection cover 5 at a certain angle, which is used to prevent blood from splashing when pushing the sealing assembly 3. The arrangement of the splash protection cover 5 of this embodiment effectively prevents blood from splashing during the aortic puncture and the placement of the sealing assembly, and protects the operator's safety to a great extent, avoids exposure risks, and ensures a clear surgical field of view.

[0065] Finally, it should be noted that the above embodiments are only used to illustrate the technical solutions of the present invention, rather than to limit it. Although the present invention has been described in detail with reference to the aforementioned embodiments, those skilled in the art should understand that they can still modify the technical solutions described in the aforementioned embodiments, or make equivalent replacements for some of the technical features therein. However, these modifications or replacements do not deviate the essence of the corresponding technical solutions from the spirit and scope of the technical solutions of the embodiments of the present invention.

Claims

1. A reusable proximal anastomosis assembly, characterized in that: include: An aortic puncher (1) is used for punching a hole in the aorta to create an anastomosis. The aortic puncher (1) comprises a puncher housing (11) and a punching mechanism (12) movably arranged in the puncher housing (11). The punching mechanism (12) is connected to a reset mechanism (13). The reset mechanism (13) is used to reset the punching mechanism (12) after the punching mechanism (12) completes the punching. A pusher (2) is used to place a sealing component (3) on the anastomosis opened by the aortic perforator (1) to seal the anastomosis. The pusher (2) comprises a pusher housing (21), a pusher tube (22) passing through one end of the pusher housing (21), and a push mechanism (23) arranged in the pusher housing (21). The pusher tube (22) is provided with the sealing component (3). The push mechanism (23) comprises a push state and a reset state. In the push state, the push mechanism (23) pushes the sealing component (3) in the pusher tube (22). In the reset state, the push mechanism (23) returns to an initial state.

2. The reusable proximal anastomosis assembly according to claim 1, characterized in that: It also includes a crimper (4), the crimper (4) being used to crimp the sealing assembly (3) into a push tube (22) of the pusher (2); The crimper (4) comprises a crimper housing (41), the crimper housing (41) being configured as an openable housing, one end of the crimper housing (41) being provided with a mounting hole (42) for inserting the pusher (2), a crimping handle (43) being arranged inside the crimper housing (41), the crimping handle (43) being located in the axial direction of the mounting hole (42).

3. The reusable proximal anastomosis assembly according to claim 1, characterized in that: The punching mechanism (12) comprises: A transmission mandrel (121), wherein a protrusion (1211) is provided on the outer periphery of the transmission mandrel (121), and the protrusion (1211) is snap-fitted into a positioning groove (111) on the inner wall of the punch housing (11); a first spring member (122), the first spring member (122) being sleeved on the outer circumference of the transmission core shaft (121), one end of the first spring member (122) being connected to the inner wall of the punch housing (11), and the other end being connected to the transmission core shaft (121); the first spring member (122) storing mechanical energy so that after the protrusion (1211) is separated from the positioning groove (111), the transmission core shaft (121) can move in the axial direction and the circumferential direction under the drive of the first spring member (122); A puncture needle (123) and a punching blade (124), wherein the puncture needle (123) is fixed to the center of the end surface of one end of the transmission core shaft (121), and the punching blade (124) is an annular blade, and the punching blade (124) is arranged around the puncture needle (123).

4. The reusable proximal anastomosis assembly according to claim 3, characterized in that: A locking plate (125) is movably provided on the punch housing (11); a through hole (1251) and a locking hole (1252) are formed on the locking plate (125), the transmission spindle (121) is provided in the through hole (1251) or the locking hole (1252); a recessed portion (1212) is provided on the outer periphery of the transmission spindle (121); the through cross section of the transmission spindle (121) is adapted to the size of the through hole (1251); and the cross section of the recessed portion (1212) of the transmission spindle (121) is adapted to the size of the locking hole (1252).

5. The reusable proximal anastomosis assembly according to claim 4, characterized in that: A first external thread is provided on the outer periphery of the end of the punch housing (11) away from the puncture needle (123); a connecting hole (1213) is provided on the end of the transmission core shaft (121) away from the puncture needle (123); and a first internal thread is provided on the inner wall of the connecting hole (1213); The reset mechanism (13) comprises a reset handle (131) and a reset auxiliary nut (132); a second internal thread and a third internal thread are arranged inside the reset auxiliary nut (132); a second external thread is arranged at the end of the reset handle (131); and a third external thread is arranged on the outer peripheral surface of the reset handle (131); The first internal thread is used to cooperate with the second external thread to form a first screw-on portion (133), the second internal thread is used to cooperate with the first external thread to form a second screw-on portion (134), and the third internal thread is used to cooperate with the third external thread to form a third screw-on portion (135). The first screw-on portion (133) and the second screw-on portion (134) have the same rotation direction, and the rotation direction is opposite to that of the third screw-on portion (135).

6. The reusable proximal anastomosis assembly according to claim 1, characterized in that: The pushing mechanism (23) comprises: A pushing shaft (231), wherein a first end portion of the pushing shaft (231) is inserted into the pushing tube (22); A second spring member (232), the second spring member (232) being sleeved on the pushing shaft (231), one end of the second spring member (232) being connected to the inner wall of the pusher housing (21), and the other end of the second spring member (232) being connected to the pushing shaft (231); A locking member (233), the locking member (233) being rotatably mounted on the second end of the pushing shaft (231), the outer periphery of the locking member (233) being provided with a plurality of strip-shaped protrusions spaced apart in the circumferential direction, the end of the strip-shaped protrusion away from the pushing shaft (231) being constructed as an inclined surface; A guide rail sleeve (234), the guide rail sleeve (234) being fixed to the inner wall of the pusher housing (21), the guide rail sleeve (234) having a plurality of guide rail grooves arranged at intervals along the circumferential direction inside the guide rail sleeve (234) and matching with the strip-shaped protrusions, and an end portion of a protrusion formed between two adjacent guide rail grooves being constructed as an inclined surface matching with an end face of the strip-shaped protrusion; A pressure rod (235), wherein a first end portion of the pressure rod (235) is provided with a sharp tooth protrusion along the circumferential direction, the sharp tooth protrusion being used to cooperate with the inclined surface end portion of the strip-shaped protrusion so that the locking member (233) rotates under the pressure of the pressure rod (235); a plurality of guide blocks cooperating with the guide rail groove are distributed at intervals along the circumferential direction on the outer circumferential surface of the pressure rod (235); A pushing handle (236), the pushing handle (236) being connected to the second end of the pressing rod (235).

7. The reusable proximal anastomosis assembly according to claim 6, characterized in that: The push tube (22) is provided with a positioning hole (221), and the pusher housing (21) is provided with a spring pin (24) that cooperates with the positioning hole (221), so that the push tube (22) can be detachably connected to the pusher housing (21); The push tube (22) is provided with a marking line (222), and the marking line (222) is aligned with the positioning hole (221) along the axial direction of the push tube (22).

8. The reusable proximal anastomosis assembly according to claim 2, characterized in that: The curling tool housing (41) comprises a bottom plate (411) and an upper shell (412) detachably connected to the bottom plate (411); an inner cavity of the curling tool housing (41) is formed between the bottom plate (411) and the upper shell (412); the mounting hole (42) is formed at one end of the inner cavity of the curling tool housing (41); curling operation ports (44) are respectively formed on both sides of the inner cavity of the curling tool housing (41) away from the mounting hole (42), for operating the curling handle (43) at the curling operation port (44).

9. The reusable proximal anastomosis assembly according to claim 8, characterized in that: The curling handle (43) comprises an elastic tensioning portion (431) fixed on the center line of the base plate (411) and extrusion portions (432) respectively connected to two ends of the elastic tensioning portion (431), the two extrusion portions (432) being symmetrically arranged along the center line of the base plate (411) and respectively located at the two curling operation ports (44) so ​​that a curling operation area is formed between the two extrusion portions (432), and arc-surface extrusion blocks (433) are relatively arranged on the sides of the two extrusion portions (432) facing the curling operation area.

10. The reusable proximal anastomosis assembly according to any one of claims 1 to 9, characterized in that: The outer circumferential surfaces of the aortic puncher (1) and the pusher (2) are both detachably provided with a splash-proof protective cover (5), the splash-proof protective cover (5) being a transparent acrylic disc, and a hydrophobic coating is provided on the splash-proof protective cover (5).

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