Vascular anastomosis auxiliary device operated by one person

Abstract

A vascular anastomosis auxiliary device operated by a single person belongs to the technical field of medical instruments and comprises a medical supporting plate, a rectangular wire clamping plate, a vascular supporting column, a supporting column pull ring, pull columns, an elastic pull rope and a pull hook, the rectangular wire clamping plate is placed on the medical supporting plate, the vascular supporting column is located in the rectangular wire clamping plate, the pull columns are fixed on two sides of the middle of the vascular supporting column, and the elastic pull rope is fixed on the pull columns. A supporting column pull ring is fixed to the outer end of the pull column, and a pull hook is hooked to the supporting column pull ring and fixed to the rectangular wire clamping plate through an elastic pull rope. A plurality of wire clamping grooves are formed in the upper surfaces of the rectangular wire clamping plates corresponding to the two ends of the blood vessel supporting column, and semi-annular blood vessel containing grooves are formed in the lower portions of the rectangular wire clamping plates with the wire clamping grooves. The device can replace an assistant, stably assists in pulling and exposing microvessels, lymphatic vessels and nerve broken ends, realizes intracavity support and suture separation and arrangement, and is suitable for single-person vascular and nerve anastomosis operation; the operation difficulty of operators is reduced, and the operation efficiency and the operation success rate are improved.

Description

Technical Field

[0001] The invention belongs to the technical field of medical devices, and in particular relates to a single-person-operated vascular anastomosis auxiliary device. Background Art

[0002] The microsurgical anastomosis technology of small and medium-caliber blood vessels, lymphatic vessels, and nerves is widely used in departments such as hand microsurgery, trauma surgery, vascular surgery, plastic surgery, cardiovascular bypass surgery, and lymphatic surgery. It is a core but advanced technology. In principle, during the operation, an assistant is required to cooperate in pulling up the outer membrane of the anastomosed blood vessels and nerves or suturing the sutures at the knotted part first to help expose the broken ends. On the one hand, it is convenient for the surgeon to insert the needle at the appropriate position, leave the sutures, and then tie the knot to make the broken ends even and well aligned. On the other hand, it avoids blockage of the posterior wall after suturing, especially thin-walled veins and lymphatic vessels, which are easily adhered and closed due to effusion and bleeding, making it difficult to expose them. Repeated operations can easily damage blood vessels and cause postoperative thrombosis. Junior doctors usually need a longer learning curve and a tempered mentality to assist in the operation. They are often unskilled in operation, nervous and prolonged. High-intensity concentration leads to hand tremors, distraction, adhesion of sutures to surrounding tissues, etc., which often cause artificial suture tissue tearing during traction suture-assisted exposure. In mild cases, the microvascular nerves need to be re-trimmed and sutured. In severe cases, defects may be caused, requiring transplantation and anastomosis, increasing trauma and even leading to operation failure. It can be said that "a miss is a thousand miles away". Therefore, in many cases, junior doctors do not receive long-term, repeated guidance and assistance from experienced senior doctors, lack practice opportunities, grow slowly, and even many doctors choose to give up learning this technology. At the same time, when there is a shortage of staff in emergency and grassroots hospitals, senior doctors have to operate alone, but assisted traction exposure is extremely difficult because there are no special auxiliary instruments, which prolongs the operation time, consumes the doctor's energy, increases the risk, and even forces many patients who can be treated with limb preservation to undergo amputation, resulting in lifelong disability.

[0003] Although the existing anastomosis device makes the vascular anastomosis operation simple and fast, it requires the blood vessel ends to be folded over. It is more feasible and effective for veins with larger calibers and thinner walls, but it is still not suitable for anastomosis of arterial degeneration, thickening, stiffness, plaque formation, and smaller caliber blood vessels, lymphatic vessels and nerves. It is also expensive and not suitable for widespread use. There are also publicly available microscopic instruments for intracavitary support and suture separation, but they have single functions, unreasonable designs and poor practicality. Summary of the invention

[0004] The present invention aims at the problems existing in the background technology and provides a single-person vascular anastomosis auxiliary device. The present invention can replace assistants, stably assist in pulling and exposing microvessels, lymphatic vessels, and nerve stumps, and can measure the inner diameter of the pipeline at the same time, realize intracavitary support and suture separation and arrangement, which is suitable for single-person vascular and nerve anastomosis operations; it is also suitable for low-level doctors to practice single-person microanastomosis operations, reduce the difficulty of the operator's operation, improve the efficiency of the operation, increase the success rate of the operation, and facilitate the promotion of high-level technical standardization; it can also be used as one of the auxiliary instruments for microsurgical robot surgery.

[0005] A single-person operated vascular anastomosis auxiliary device includes a medical support plate, a rectangular clamping plate, a vascular support column, a support column pull ring, a pull column, an elastic pull rope and a pull hook. The rectangular clamping plate is placed on the medical support plate, the vascular support column is located in the rectangular clamping plate, and the pull columns are fixed on both sides of the middle of the vascular support column. The support column pull ring is fixed on the outer end of each pull column, and the pull hook is hooked on the support column pull ring. The pull hook is fixed together with the elastic pull rope, and the elastic pull rope is fixed on the rectangular clamping plate; a plurality of clamping grooves are provided on the upper surface of the rectangular clamping plates corresponding to the two ends of the vascular support column, and a semi-circular vascular placement groove is provided on the lower part of the rectangular clamping plate with the clamping grooves.

[0006] The upper surface of the rectangular clamping plate at the fixed end of the elastic drawstring is provided with a plurality of elastic drawstring fixing grooves, in which the elastic drawstring is clamped. During operation, the elastic drawstring can be fixed in any of the elastic drawstring fixing grooves to adapt to the position of the blood vessel support column.

[0007] The blood vessel support columns are of several different diameters to accommodate blood vessels of different diameters.

[0008] The medical support plate is a medical stainless steel support plate.

[0009] Both sides of the rectangular clamping plate with the semi-circular blood vessel placement groove are inclined outwards by 45 degrees, so that the vertical field of vision is clear and the surgical operation is convenient.

[0010] The pulling column is a steel wire which passes through the blood vessel support column to form pulling columns located on both sides of the blood vessel support column. Both ends of the steel wire are bent to form support column pulling rings.

[0011] The rectangular clamping plate and the blood vessel support column are made of silica gel.

[0012] The blood vessel supporting column is a cylinder.

[0013] Beneficial effects of the present invention: The present invention can replace assistants, stably assist in pulling and exposing microvessels, lymphatic vessels, and nerve stumps, and can measure the inner diameter of the pipeline at the same time, realize intracavitary support and suture separation and arrangement, and is suitable for single-person vascular and nerve anastomosis operations; it is also suitable for low-level doctors to practice single-person microanastomosis operations, reducing the operator's operating difficulties, improving surgical efficiency, increasing the success rate of the operation, and facilitating the promotion of high-level technical standardization; it can also be used as one of the auxiliary instruments for microsurgical robot surgery operations. BRIEF DESCRIPTION OF THE DRAWINGS

[0014] Figure 1 It is a three-dimensional schematic diagram of a first embodiment of the present invention; Figure 2 is a perspective schematic diagram of a second embodiment of the present invention; Figure 3 It is a schematic diagram of the operation of the first embodiment of the present invention; Figure 4 FIG. 2 is a schematic diagram of the operation of the second embodiment of the present invention. DETAILED DESCRIPTION

[0015] See also Figure 1 As shown, the first embodiment of the present invention is a single-person operated vascular anastomosis auxiliary device, including a medical support plate 1, a rectangular clamping plate 2, a vascular support column 3, a support column pull ring 4, a pull column 5, an elastic pull rope 6 and a hook 7. The rectangular clamping plate 2 is placed on the medical support plate 1, and the vascular support column 3 is located in the rectangular clamping plate 2. Pulling columns 5 are fixed on both sides of the middle of the vascular support column 3. The outer end of each pull column 5 is fixed to the support column pull ring 4, and the hook 7 is hooked on the support column pull ring 4. The hook 7 is fixed together with the elastic pull rope 6, and the elastic pull rope 6 is fixed on the rectangular clamping plate 2; a plurality of clamping grooves 21 are provided on the upper surface of the rectangular clamping plate 2 corresponding to the two ends of the vascular support column 3, and a semi-annular vascular placement groove 22 is provided at the lower part of the rectangular clamping plate 2 with the clamping grooves 21.

[0016] See also Figure 2 As shown, it is the second embodiment of the present invention. The difference between the second embodiment and the first embodiment is that a plurality of elastic draw rope fixing grooves 23 are provided on the upper surface of the rectangular clamping plate 2 at the fixed end of the elastic draw rope 6, and the elastic draw rope 6 is clamped in the elastic draw rope fixing grooves 23. During operation, the elastic draw rope 6 can choose any elastic draw rope fixing groove 23 for fixing to adapt to the position of the vascular support column 3.

[0017] The blood vessel support columns 3 are provided in a plurality of different diameters to accommodate blood vessels of different diameters.

[0018] The medical support plate 1 is a medical stainless steel support plate.

[0019] Both sides of the rectangular clamping plate 2 with the semi-circular blood vessel placement groove 22 are inclined outward by 45 degrees, so that the vertical field of view is clear and the surgical operation is convenient.

[0020] The pulling column 5 is a steel wire, which passes through the blood vessel support column 3 to form the pulling columns 5 located on both sides of the blood vessel support column 3 , and the two ends of the steel wire are bent into the support column pulling ring 4 .

[0021] The rectangular clamping plate 2 and the blood vessel support column 3 are made of silicone.

[0022] The blood vessel support column 3 is a cylinder.

[0023] The operation process of the present invention: like Figure 3 and Figure 4 As shown, the vascular support column 3 made of silicone material has a certain deformation ability, which is convenient for insertion into the vascular cavity and can stably support, so that the front and rear vascular walls are separated, and the rear wall of the blood vessel 9 is prevented from being sutured together when the front wall of the blood vessel 9 is sutured, resulting in stenosis or occlusion of the blood vessel 9 cavity; the diameter and length of the vascular support column 3 are designed according to the diameter of the blood vessel 9 to be inserted. When the diameter of the blood vessel 9 is below 2mm, because of the limited caliber, the needle insertion site is also relatively close to the blood vessel stump, and the vascular support column 3 should not and does not need to be inserted into the lumen of the blood vessel 9 too long. The length of the vascular support column 3 is set to 1mm, and the diameter of the vascular support column 3 can be selected from 0.3mm, 0.5mm, 0.8mm, 1.0mm, 1.2mm, 1.5mm, 1.8mm and 2.0mm according to the situation; When the diameter of the blood vessel 9 is greater than 2 mm, especially greater than 4 mm, the length of the blood vessel support column 3 is set to 2 mm, that is, the blood vessel support column 3 needs to be inserted 2 mm into the lumen of the blood vessel 9 to achieve stable support. The diameter of the blood vessel support column 3 can be selected from 2.5 mm, 2.8 mm, 3.0 mm, 3.5 mm and 4.0 mm according to actual conditions.

[0024] The diameter of the vascular support column 3 can be used to measure the inner diameter of a tiny pipe. When in use, which vascular support column 3 has a diameter that can be smoothly inserted into the lumen of the blood vessel 9, while the diameter of the adjacent vascular support column 3 cannot be inserted, then the measured inner diameter of the blood vessel 9 is the middle value of the diameters of the two vascular support columns 3, but the accuracy is affected by the difference in the diameters of the selected vascular support columns 3. In principle, it can be designed that the diameter of the vascular support column 3 differs by 0.2mm and the measured accuracy is 0.1mm, but such high accuracy is not required in most cases during actual use; in addition, because the current limit of the caliber of the blood vessels 9 and lymphatic vessels that can be anastomosed by surgeons is 0.2mm, and the caliber of the blood vessels that need to be anastomosed in most conventional microsurgery operations is 0.5mm or more, therefore, the minimum diameter of the vascular support column 3 is designed to be 0.3mm.

[0025] The two ends of the pulling column 5 are support column pulling rings 4 with an inner diameter of 0.5mm and made of steel wire with a diameter of about 0.25mm; the support column pulling rings 4 at both ends are the anchor positions for the sutures 8 that are tied with two knots at the 3 o'clock and 9 o'clock positions of the clock that are first sutured during the micro-anastomosis process to fix the auxiliary traction. During use, two stitches are sutured at the 3 o'clock and 9 o'clock positions of the clock of the blood vessel 9 or nerve respectively. When tying the knot, about 2cm of the thread tail on one side of the seamless needle is left. After the knot is tied on the blood vessel or nerve wall, the suture needle is passed through the support column pulling ring 4, and then tied with the reserved thread tail to fix it, and then a thread loop knot is tied outside the support column pulling ring 4 for standby use; considering that the actual operation is more delicate and the surgical field of view is limited, it is necessary to suture the anterior wall of the blood vessel first, and then turn 180° to suture the posterior wall of the blood vessel. During this process, try to maintain the clock In order to ensure stable traction of the suture 8 at the 3 o'clock and 9 o'clock positions, the diameter and length of the pulling column 5 are also designed according to the grouping of the anastomotic tube and nerve diameter. When the required anastomotic tube and nerve diameter is less than 3mm, the pulling column 5 diameter is designed to be 0.3mm, and the length is designed to be 5mm, and the length of the pulling column 5 does not include the supporting column pulling rings 4 at both ends; when the required anastomotic tube and nerve diameter is greater than 3mm, the pulling column 5 diameter is designed to be 0.5mm, and the length is designed to be 10mm, and the length of the pulling column 5 does not include the supporting column pulling rings 4 at both ends; at the same time, considering that the supporting column pulling ring 4 is close to the outer wall of the micro-channel or the nerve, and the suture 8 is insufficient to maintain good traction, the pull hook 7 connected to the supporting column pulling ring 4 through the rectangular clamping plate 2 and the elastic pull rope 6 can be connected to strengthen or adjust the traction.

[0026] The rectangular clamping plate 2 is located on the medical support plate 1. The wall thickness of the rectangular clamping plate 2 is 1mm and the height is 2mm. The medical support plate 1 is 1mm wide and 0.3mm thick. The semi-circular blood vessel placement groove 22 can straddle the blood vessels or nerves 9 to be anastomosed. The clamping grooves 21 on the rectangular clamping plate 2 are 6-8 cracks with a width of 0.2mm and a depth of 1mm, which can be marked with contrasting color columns. Because when the interrupted suture method is conventionally used, as the stitches are sutured one by one, the residual space becomes smaller and smaller, and it is impossible to confirm To ensure accurate needle insertion and removal during subsequent suturing and to avoid mistakenly suturing the other side wall during suturing one side wall, this may occur even with the lumen support of the vascular support column 3. Therefore, first insert the needle at the midpoint of the 3 o'clock and 9 o'clock positions, that is, the 12 o'clock position, either single-point or horizontal mattress-style. The horizontal mattress-style is recommended, including the 3 o'clock, 9 o'clock and 6 o'clock positions of the posterior wall to ensure sufficient eversion. Do not tie a knot on the suture 8 first, and then continue to insert the suture at 3 o'clock, 12 o'clock, 9 o'clock, and 12 o'clock positions. About 3-4 sutures 8 are arranged between the point positions according to the situation. Before each needle insertion, the sutures 8 used in the previous insertion and withdrawal are placed one by one in the left-right symmetrical clamping grooves 21 to ensure that there is no crossing or entanglement between the sutures 8. At the same time, the clamping grooves 21 can fix the sutures 8 without damaging the sutures 8, but the length can be adjusted by pulling with a microscopic instrument, which is convenient for subsequent knotting and fixing; after the sutures 8 are arranged, the horizontal mattress-like sutures 8 at the 12 o'clock position of the clock are first tightened and knotted, and then the other sutures 8 of the intermittent single-needle sutures on one side are knotted in turn, and finally the front wall suture is successfully completed; then the draw hook 7 is removed from the support column pull ring 4, and then the draw column 5 is turned 180° clockwise, and then the draw hook 7 is connected to the support column pull ring 4, and then the elastic draw rope 6 is adjusted, and the elastic draw rope fixing groove 23 can maintain a good exposure of the back wall. During the operation of turning over the blood vessel 9, the rectangular clamping plate 2 basically does not need to be active, and the method of inserting the suture 8 in the back wall is the same as that of the front wall.

[0027] In this embodiment, the elastic drawstring fixing groove 23 is three cracks with a width of 0.3mm and a depth of 1mm, similar to the clamping groove 21, and is marked with a contrasting color column. The elastic drawstring 6 is a medium elastic silicone tube with a diameter of 0.5mm and a length of 3cm. The front section carries a 3 / 4 arc 0.3mm diameter hook 7, which is convenient for connecting with the support column pull ring 4 to adjust the pulling effect, especially after the front wall suture is turned over, the suture 8 of the back wall is arranged and before the knots are tied in sequence, because the support column pull ring 4 needs to be cut off at this time. The sutures 8 at 3 o'clock and 9 o'clock on the clock remove the vascular support column 3 from the blood vessel 9 cavity, which makes the original 3 o'clock and 9 o'clock positions on the clock lose their traction and support function. In the subsequent knotting process of the sutures 8 on the back wall, it may cause unclear display and wrong knot position, resulting in poor patency of the pipeline. At this time, the 3 o'clock and 9 o'clock positions on the clock can be used to tie and fix the support column pull ring 4, and then the spare wire loop pre-installed outside the support column pull ring 4 can be connected with the hook 7, and the elastic pull rope 6 can be embedded in the elastic pull rope fixing groove 23 to play a pulling and revealing role. Because the elastic pull rope 6 and the elastic pull rope fixing groove 23 both have a certain elasticity, the elastic pull rope 6 with a slightly thicker diameter can be pulled and embedded in the elastic pull rope fixing groove 23 to maintain effective traction by relying on friction, and it is convenient for disassembly and assembly, saving time.

Claims

1. A single-operator vascular anastomosis auxiliary device, characterized in that: The invention comprises a medical support plate (1), a rectangular clamping plate (2), a blood vessel support column (3), a support column pull ring (4), a pull column (5), an elastic pull rope (6) and a pull hook (7). The rectangular clamping plate (2) is placed on the medical support plate (1), the blood vessel support column (3) is located in the rectangular clamping plate (2), the pull columns (5) are fixed on both sides of the middle of the blood vessel support column (3), the outer end of each pull column (5) is fixed to the support column pull ring (4), the pull hook (7) is hooked on the support column pull ring (4), the pull hook (7) and the elastic pull rope (6) are fixed together, and the elastic pull rope (6) is fixed on the rectangular clamping plate (2); a plurality of clamping grooves (21) are opened on the upper surface of the rectangular clamping plate (2) corresponding to the two ends of the blood vessel support column (3), and a semi-circular blood vessel placement groove (22) is opened on the lower part of the rectangular clamping plate (2) having the clamping grooves (21).

2. A single-operator vascular anastomosis assisting device according to claim 1, characterized in that: A plurality of elastic drawstring fixing grooves (23) are provided on the upper surface of the rectangular clamping plate (2) at the fixing end of the elastic drawstring (6), and the elastic drawstring (6) is clamped in the elastic drawstring fixing grooves (23).

3. The single-operated vascular anastomosis auxiliary device according to claim 1, characterized in that: The medical support plate (1) is a medical stainless steel support plate.

4. The single-operated vascular anastomosis auxiliary device according to claim 1, characterized in that: Both side edges of the rectangular clamping plate (2) having the annular blood vessel placement groove (22) are inclined outwards at 45 degrees.

5. The single-operated vascular anastomosis auxiliary device according to claim 1, characterized in that: The pulling column (5) is a steel wire which passes through the blood vessel support column (3) to form pulling columns (5) located on both sides of the blood vessel support column (3), and both ends of the steel wire are bent to form support column pulling rings (4).

6. The single-operated vascular anastomosis auxiliary device according to claim 1, characterized in that: The rectangular clamping plate (2) and the blood vessel support column (3) are made of silicone.

7. The single-operated vascular anastomosis auxiliary device according to claim 1, characterized in that: The blood vessel support column (3) is a cylinder.

8. The single-operated vascular anastomosis auxiliary device according to claim 1, characterized in that: When the diameter of the blood vessel (9) is less than 2 mm, the length of the blood vessel support column (3) is 1 mm, and the diameter of the blood vessel support column (3) is 0.3 mm, 0.5 mm, 0.8 mm, 1.0 mm, 1.2 mm, 1.5 mm, 1.8 mm or 2.0 mm; when the diameter of the blood vessel (9) is greater than 2 mm, the length of the blood vessel support column (3) is 2 mm, and the diameter of the blood vessel support column (3) is 2.5 mm, 2.8 mm, 3.0 mm, 3.5 mm or 4.0 mm.

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