An intrauterine suture pusher and method of use thereof

Abstract

The present application relates to a kind of intrauterine suture push knot device and its using method, belong to hysteroscope surgical instrument technical field.Push knot device includes stem and head end push knot head, by clamping structure detachable installation in electrotome sleeve channel, replace original surgical electrode station, without independent operating handle, with electrotome handle Synchronous advance;Push knot head protrudes electrotome head end 0-5mm and is located in the field center ±10 ° range, realize whole straight vision push knot, completely solve the " chopsticks effect " of double instrument parallel operation.Push knot device is completely compatible with electrotome original surgical electrode interface, can be replaced with original electrode at any time to restore electrotome / electrocoagulation function, electrotome imaging, flushing and other core functions are not affected.Further set up memory metal universal joint adapts irregular uterine cavity angle, with anti-drop barb's line hole avoids suture to fall, length scale mark push depth, integrated micro cutting knife realizes line cutting integration, self-adapting sealing cap adapts multiple electrotome.

Description

Technical Field

[0001] This invention relates to the field of suture pusher technology, and more specifically, to an intrauterine suture pusher with functions of anti-loosening, angle adjustment, adaptive sealing, and suture cutting, which can be assembled and used with an electrosurgical endoscope to realize intrauterine suture pusher operation under direct vision. Background Technology

[0002] Hysteroscopic intrauterine suturing is a common technique in minimally invasive surgeries such as intrauterine device fixation and closure of intrauterine false passages / diverticula, but current procedures have the following core limitations:

[0003] 1. Existing suture pushers are all instruments independent of the electrosurgical endoscope. They need to be inserted into the uterine cavity simultaneously with the electrosurgical endoscope. The parallel operation of the two produces a "chopstick effect," making it impossible to push the knot under direct vision. According to clinical statistics, the slippage rate of existing intrauterine suture knots is 15%-20%, and the postoperative infection rate is 8%-12%.

[0004] 2. The sutures are prone to coming loose from the hole at the end of the knot, requiring re-threading and extending the operation time;

[0005] 3. The fixed angle of the push-knot head cannot adapt to the suturing position of irregular uterine cavities, and the angle of the electrosurgical endoscope needs to be repeatedly adjusted;

[0006] 4. Without depth markings, the uterine cavity may be damaged due to excessive insertion of the pusher head;

[0007] 5. After pushing the suture knot, additional scissors are needed to cut the suture, increasing the number of times instruments need to be inserted and the risk of infection.

[0008] Existing patent CN222870557U discloses a pusher for hysteroscopy, but it still needs to be inserted in parallel with the electrosurgical endoscope, and the problems of chopstick effect and blind operation have not been solved. The above defects have not been effectively resolved. Summary of the Invention

[0009] The technical problem to be solved by the present invention is to provide an intrauterine suture pusher and its usage method, which addresses the above-mentioned defects of the prior art. In addition to solving the problems of "chopstick effect and blind pusher caused by parallel use of two instruments", the invention further solves the problems of suture detachment, poor angle adaptation, low sealing versatility, inability to judge depth, and the need for additional suture cutting.

[0010] The technical solution adopted by this invention to solve its technical problem is:

[0011] An intrauterine suture pusher is constructed, which can be assembled and used with an electrosurgical endoscope. It includes a rod body and a pusher head disposed at the head end of the rod body. The pusher head has a suture hole for the suture to pass through. The rod body is provided with a snap-fit ​​structure. The tail end of the rod body can be inserted into the cannula channel of the electrosurgical endoscope through the snap-fit ​​structure for installation. The rod body is detachably installed in the cannula channel, occupying the original installation position of the surgical electrode of the electrosurgical endoscope.

[0012] The outer diameter of the rod body matches the outer diameter of the electrosurgical electrode, and the length is configured such that when the snap-fit ​​structure is fixed to the electrosurgical end, the front end of the push-fit head protrudes 0-5mm beyond the lens end of the electrosurgical end and is located within ±10° of the center of the field of view of the electrosurgical end.

[0013] The rod body has no independent operating handle, and its tail end abuts against the handle transmission mechanism of the electrosurgical resection mirror so that it can move forward without deformation as the handle of the electrosurgical resection mirror is pushed.

[0014] The intrauterine suture pusher of the present invention includes a snap-fit ​​structure comprising an insert rod connected to the tail end of the rod body, the insert rod being able to pass through the cannula channel of the electrosurgical endoscope and be inserted into its surgical electrode mounting hole for fixation.

[0015] The intrauterine suture pusher of the present invention has at least two clips at the tail end of the rod. The two clips are symmetrically arranged to form a channel through which the inner tube of the electrosurgical manipulator passes, so as to fix the rod and the inner tube of the manipulator. The clips are located on the side of the insertion rod away from the pusher head.

[0016] The intrauterine suture pusher of the present invention includes a snap-fit ​​structure comprising a mounting shaft disposed at the tail end of the rod and perpendicular to each other, wherein the rod is inserted into the fixing groove of the electrosurgical endoscope for mounting surgical electrodes via the mounting shaft.

[0017] The intrauterine suture pusher of the present invention has two elastic plates symmetrically arranged on the rod body. The two elastic plates form a ring shape with an opening, so that the inner tube of the electrosurgical manipulator can be inserted through the opening and fixed with the elastic plate by interference fit.

[0018] The intrauterine suture pusher of the present invention includes an electrosurgical manipulator with a groove for the rod to pass through, and a water-sealing cap at the position corresponding to the groove on the rod, the water-sealing cap cooperating with the groove to form a sealed connection.

[0019] The intrauterine suture pusher of the present invention has a pusher head that is a semi-circular plate-shaped electrocautery ring structure, and the suture hole is located in the middle of the pusher head; the pusher head and the rod body are integrally formed and both are made of medical-grade stainless steel.

[0020] The intrauterine suture pusher of the present invention has a plurality of anti-dislodgement barbs on the inner sidewall of the suture hole that are inclined toward the inside of the pusher head to prevent the suture from falling out of the suture hole.

[0021] The rod is equipped with a shape memory metal universal joint near the head end. The universal joint has a bendability of 0-90°. The outer diameter and stiffness of the main body of the rod are matched with the electrosurgical electrode.

[0022] The outer surface of the rod is provided with length scales distributed along its length direction. The accuracy of the length scale is 1mm, and the zero point of the scale corresponds to the front end of the push head.

[0023] The push-joint head has a micro ceramic cutting blade integrated on the side away from the rod body, and the blade curvature of the cutting blade is adapted to the semi-circular curvature of the push-joint head.

[0024] The intrauterine suture pusher of the present invention has at least two annular sealing lips on the outer wall of the water-sealing cap. The outer diameter of the sealing lip is larger than the inner diameter of the groove, and the sealing lip is made of medical-grade silicone.

[0025] The present invention also provides a method for pushing intrauterine suture knots, using the intrauterine suture knot pusher described in any of the above claims, comprising the following steps:

[0026] S1. Pass the suture thread through the thread hole of the push-knot head and pre-tie it to form a knot;

[0027] S2. Insert the snap-fit ​​structure at the tail end of the rod into the sleeve channel of the electrosurgical endoscope and fix it so that the push head is within the observation range of the electrosurgical endoscope. If the pusher is equipped with a universal joint, adjust the bending angle of the universal joint to match the suturing position.

[0028] S3. Insert the electrosurgical endoscope into the uterine cavity. Under direct vision, operate the handle of the electrosurgical endoscope to push the rod forward. If the pusher has a length scale, determine the insertion depth of the pusher head by the length scale, drive the pusher head to push the knot to the suture position, tighten the knot to complete the fixation. If the pusher has a cutter, cut off the excess suture by the cutter after pushing.

[0029] Compared with the prior art, the beneficial effects of the present invention are as follows:

[0030] 1. Basic effects: The integrated design of the knot pusher and electrosurgical endoscope completely eliminates the chopstick effect and enables direct visualization during the entire knot push process; the knot pusher serves as a temporary consumable to replace the original electrode station, and the core functions of the electrosurgical endoscope, such as optical imaging, illumination, and irrigation / returning, remain unaffected throughout the process. The original surgical electrodes can be replaced at any time to restore the electrosurgical / electrocoagulation function, making it suitable for combined surgical scenarios.

[0031] 2. The anti-loosening barbs can effectively prevent the suture from falling out of the suture hole during the push process. In a test on 20 pig uterine cavity models, the suture push-out rate was 0, and there was no need to re-thread the suture, which effectively shortened the operation time.

[0032] 3. The shape memory metal universal joint allows for adjustable push-button angles, adapting to irregular uterine cavities and reducing the number of adjustments required by the electrosurgical endoscope, thus improving operational efficiency;

[0033] 4. The length scale can indicate the depth of the pusher head in real time, avoiding excessive insertion of the pusher head into the uterine cavity and improving the safety of the operation;

[0034] 5. The integrated micro-cutting blade eliminates the need for additional scissors, reducing the number of times instruments need to enter and exit the uterine cavity and lowering the risk of infection;

[0035] 6. The self-adaptive sealing cap can be adapted to the grooves of different sizes of electrosurgical resection mirrors, making it highly versatile and reliable in sealing performance. Attached Figure Description

[0036] To more clearly illustrate the technical solutions in the embodiments of the present invention or the prior art, the present invention will be further described below in conjunction with the accompanying drawings and embodiments. The drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort:

[0037] Figure 1 This is a three-dimensional structural diagram of the intrauterine suture pusher provided by the present invention, which has the first structure.

[0038] Figure 2 This is the present invention. Figure 1 A three-dimensional structural diagram of the electrosurgical resection section;

[0039] Figure 3 This is the present invention. Figure 1 A three-dimensional structural diagram of the uterine suture pusher;

[0040] Figure 4 This is the present invention. Figure 1 A partial structural diagram of the uterine suture pusher;

[0041] Figure 5 This is a three-dimensional structural diagram of the intrauterine suture pusher provided by the present invention, which has a second structure.

[0042] Figure 6 This is the present invention. Figure 5 A three-dimensional structural diagram of the electrosurgical resection section;

[0043] Figure 7 This is the present invention. Figure 5 A three-dimensional structural diagram of the uterine suture pusher.

[0044] In the diagram: 1. Rod body; 2. Push-joint head; 21. Wire hole; 3. Snap-fit ​​structure; 311. Insert rod; 312. Clamping plate; 313. Opening; 321. Mounting shaft; 322. Elastic plate; 323. Water sealing cap; 4. Electrosurgical cutting mirror; 41. Sleeve channel; 42. Mounting hole; 43. Inner tube of the operator; 44. Fixing groove; 45. Groove. Detailed Implementation

[0045] To make the objectives, technical solutions, and advantages of the embodiments of the present invention clearer, a clear and complete description will be provided below in conjunction with the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only some, not all, of the embodiments of the present invention. All other embodiments obtained by those skilled in the art based on the embodiments of the present invention without creative effort are within the protection scope of the present invention.

[0046] It should be noted that the "occupying the original surgical electrode installation position of the electroresection endoscope" mentioned in this invention refers to the pusher being used as a temporary replaceable consumable, sharing the same tubing channel installation interface with the original surgical electrodes (electroresection ring, electrocoagulation rod, etc.) of the electroresection endoscope. It only temporarily replaces the installation position of the electrodes and does not involve any modification to the main structure of the electroresection endoscope. The core main functions of the electroresection endoscope, such as the optical imaging system, illumination system, and irrigation / return water channel, are not affected throughout the process. The original surgical electrodes can be disassembled and reinstalled back into the tubing channel at any time to restore the electroresection / electrocoagulation function. The replacement process is completely consistent with the replacement process of the original electrodes.

[0047] In the following embodiments, the handle transmission mechanism of the electrosurgical resection mirror is the electrode push rod of the existing electrosurgical resection mirror. After the tail end of the rod is inserted into the sleeve channel, it naturally abuts against the end of the electrode push rod and moves forward synchronously with the movement of the push rod.

[0048] Example 1: Insert-type snap-fit ​​foundation structure

[0049] like Figure 1-4 As shown, the intrauterine suture pusher of this embodiment includes a rod body 1 and a pusher head 2. The rod body 1 is made of medical stainless steel of the same specifications as the electrosurgical electrode, with an outer diameter of 2.5 mm. The rigidity of the main body section (except for the optional universal joint) is completely matched with the electrode. The length configuration is as follows: after the snap-fit ​​structure 3 is fixed to the electrosurgical endpiece 4, the pusher head 2 protrudes 3 mm from the lens end and is located within ±5° of the center of the field of view.

[0050] The snap-fit ​​structure 3 is the insertion rod 311. Its size and locking interface are completely matched with the original surgical electrode mounting holes of commercially available hysteroscopic resection instruments (such as Olympus A22001A and Storz 27040BA). After being inserted into the cannula channel 41 of the resection instrument 4, it snaps into the surgical electrode mounting hole 42 and is locked by the locking knob on the resection instrument. The locking force is tested to be ≥10N, which is completely consistent with the locking requirements of the original electrode. Two clamping pieces 312 are symmetrically arranged at the tail end of the rod body 1. The clamping pieces 312 are located on the side of the insertion rod 311 away from the push head 2, forming a channel through which the inner tube 43 of the resection instrument operator passes. The inner tube 43 is clamped by an interference fit. The clamping force is tested to be ≥5N.

[0051] The push-knot head 2 is a semi-circular plate structure with a thickness of 0.3 mm and a suture hole 21 with a diameter of 1.0 mm, which is suitable for 2-0 to 4-0 sutures. The push-knot head 2 is integrally formed with the rod body 1. The inner side of the suture hole 21 is provided with anti-loosening barbs with a height of 0.2 mm and a spacing of 0.7 mm. When the suture moves outward, it is stuck by the barbs. After testing on 20 cases of pig uterine cavity models, the suture push-loosening rate was 0.

[0052] The tail end of the rod 1 abuts against the electrode push rod of the electrosurgical resection mirror 4. The transmission stroke and push feel are ≤0.3mm different from the original electrode. When operating the electrosurgical resection mirror handle, the push rod drives the rod 1 forward synchronously. There is no independent operating handle.

[0053] Compatibility test: The plug-in type pusher was continuously replaced 15 times on the same Olympus A22001A electrocautery mirror (switching back and forth between the pusher and the original electrocautery ring). The imaging resolution of the electrocautery mirror, the electrode pushing feel, and the electrocautery energy output were no different from the original. There was no wear or scratches on the sleeve channel, and the average replacement time was 18 seconds.

[0054] Example 2: Structure with universal joint and integrated functions

[0055] like Figure 5-7 As shown, the pusher in this embodiment adopts a mounting shaft 321 type snap-fit ​​structure. The mounting shaft 321 is vertically set at the tail end of the rod body 1. Its size is fully compatible with the fixing groove 44 of mainstream brand electrosurgical resection mirrors such as Storz and Olympus. It is inserted into the fixing groove 44 of the electrosurgical resection mirror 4 for fixation. Two elastic plates 322 are symmetrically arranged on the rod body 1 to form an annular structure with an opening 313. The inner tube 43 of the operator is snapped into the annular structure through the opening 313 and fixed with the elastic plate 322 by interference fit.

[0056] The operator of the electrosurgical resectoscope 4 has a groove 45, and a water-sealing cap 323 is provided at the corresponding position of the rod 1. The water-sealing cap 323 has two layers of sealing lips 3231 on the outside. The outer diameter is 0.2mm larger than the inner diameter of the groove 45. It is made of medical silicone material and is interference-fitted with the groove 45. It has been tested and found to have no leakage under 0.12MPa water pressure.

[0057] The rod 1 has a nickel-titanium shape memory metal universal joint 12 near the head end, which can be bent from 0-90° and maintain the angle. The outer surface is covered with a medical silicone protective cover to prevent debris from falling off. The outer surface of the rod 1 is laser-engraved with length scale 11 with an accuracy of 1mm. The zero point corresponds to the front end of the push head 2. The side of the push head 2 integrates a zirconia ceramic cutting blade. The blade curvature is adapted to the push head 2. The hardness reaches HRA88, which can easily cut the suture.

[0058] Functional recovery test: If temporary electrocoagulation hemostasis is required during surgery, simply loosen the locking knob of the fixation slot 44, pull out the pusher, and insert the original electrocoagulation rod to restore the electrocoagulation function. No adjustment of any parameters of the electroresection scope is required. The irrigation flow rate and field of view of the electroresection scope are normal throughout the process, and the single-trip replacement time is ≤20s.

[0059] Example 3: Miniature knot pusher adapted to a small-diameter electrosurgical resection mirror

[0060] The outer diameter of the rod 1 is 1.8mm, which is perfectly matched with the outer diameter of the surgical electrode of the 3Fr fine-diameter electrosurgical endoscope. The rigidity of the main body is consistent with that of the fine-diameter electrode. The push-joint head 2 is a semi-circular plate structure with a thickness of 0.2mm. The wire hole 21 has a diameter of 0.5mm and is suitable for 4-0 to 5-0 specification fine sutures. The snap-fit ​​structure 3 is a miniature insert 311 with a diameter of 1.2mm, which matches the specification of the surgical electrode mounting hole 42 of the fine-diameter electrosurgical endoscope. After insertion, it is locked by the micro locking knob of the electrosurgical endoscope, and the locking force is ≥8N.

[0061] The length configuration is as follows: after the snap-fit ​​fixation, the push-joint head 2 protrudes 2mm from the end of the electrosurgical resectoscope, located within ±8° of the center of the field of view, with no obstruction of the field of view. This embodiment does not include a universal joint (the rigidity of the small-diameter rod is sufficient for conventional pushing requirements), nor does it integrate a cutting blade (the small-diameter structure lacks sufficient installation space). The suture hole 21 has anti-loosening barbs with a height of 0.1mm and a spacing of 1mm. The outer surface of the rod 1 has length markings 11 with an accuracy of 1mm. Testing showed that this embodiment is compatible with the Storz 27040KA small-diameter electrosurgical resectoscope, providing clear imaging after installation. In a test involving 20 cases of porcine stenotic uterine cavity models, all 20 cases were successfully operated on, with a suture slippage rate of 0% and no uterine cavity damage.

[0062] Example 4: Reusable and detachable push-head type pusher

[0063] This embodiment is designed for the reusable medical device needs of primary hospitals. The head of the rod 1 is provided with an M1.2 external thread interface, and the push-joint head 2 is provided with an internal thread. The two are detachably connected. The push-joint head 2 can be replaced with a structure with anti-detachment barbs, a cutting blade 23, or no additional functions, depending on the needs. The rod 1 is made of medical stainless steel that can be sterilized by high temperature and high pressure. It can withstand high temperature sterilization of 134℃ for 30 minutes and can be reused ≥50 times.

[0064] The snap-fit ​​structure 3 is a mounting shaft type 321. The rod body 1 is symmetrically provided with elastic plates 322, forming a ring structure with an opening 313, which is interference fit with the inner tube 43 of the operator. The rod body 1 is provided with a detachable memory metal universal joint 12 near the head end. The universal joint 12 is a sleeve structure, which is sleeved on the outside of the rod body 1 and can be replaced with different specifications of bending angle. The outer surface of the rod body 1 is provided with length scale 11, and the water sealing cap 323 is provided with two layers of sealing lips 3231, which are adapted to the groove 45 of the conventional electrosurgical endoscope.

[0065] After testing, the pusher in this embodiment showed no deformation of the rod 1 after 10 high-temperature sterilizations, the locking force of the snap-fit ​​structure 3 was still ≥10N, and the threaded connection was not loose. It was tested in 20 cases of pig uterine cavity models and was reused 10 times without failure. The operation time was not significantly different from that of the disposable pusher.

[0066] Example 5: A pusher with a central flushing channel

[0067] This embodiment is designed for clinical scenarios involving intrauterine bleeding and obscured vision during suturing. The structure is similar to... Figure 7 Similarly, rod 1 is a hollow tubular structure. Rod 1 has a 0.8mm diameter irrigation channel at its center and a Luer interface at its tail end for connecting a uterine irrigation fluid bag; the push-knot head 2 has two side holes that connect to the central irrigation channel, allowing simultaneous irrigation of the surgical field when pushing the suture knot; the snap-fit ​​structure 3 is a type of insert rod 311, which is hollow and connects to the central channel of rod 1 to ensure irrigation fluid flow.

[0068] The outer diameter of the rod 1 is 2.5mm, which matches the outer diameter of the conventional electrosurgical electrode. The rigidity of the main body is consistent with that of the electrode. A hollow shape memory metal universal joint 12 is provided at the proximal end, which can be bent from 0 to 90°. The central channel of the universal joint 12 is connected to the channel of the rod 1. The push head 2 is equipped with anti-detachment barbs and a micro ceramic cutting blade. The outer surface is marked with length scale 11. The water sealing cap 323 and the groove 45 are matched to seal. The sealing performance meets the requirement of no leakage under 0.1MPa water pressure during rinsing.

[0069] Tests showed that the flushing flow rate in this embodiment can reach 50 ml / min. In a simulated bleeding scenario using 20 pig uterine models, the field of vision remained clear without the need to remove the pusher. All 20 operations were successfully completed without any operational errors caused by unclear field of vision.

[0070] Example 6: Magnetic snap-fit ​​structure pusher

[0071] This embodiment is a specific implementation of the magnetic snap-fit ​​structure in the alternative claims, adapted to portable electrosurgical resection mirrors without mechanical locking structures.

[0072] The end of the rod 1 is embedded with a neodymium iron boron permanent magnet with a diameter of 3mm and a magnetic force of ≥5N. The end of the sleeve channel 41 of the electrosurgical resection mirror 4 is provided with an iron adsorption plate. After the rod 1 is inserted into the sleeve channel 41, the permanent magnet attracts the iron plate to fix it. The rod 1 is also provided with an elastic positioning pin. After insertion, it is locked into the positioning groove of the sleeve channel 41 to prevent the rod 1 from rotating. No locking knob needs to be turned. The average installation time is 13 seconds.

[0073] The push-joint head 2 is a semi-circular plate structure with a thickness of 0.3mm. The wire hole 21 has a diameter of 1.0mm and is equipped with anti-detachment barbs with a height of 0.2mm and a spacing of 0.7mm (not shown). The near end is equipped with a memory metal universal joint 12, and the outer surface is equipped with length scale 11. The push-joint head 2 integrates a micro ceramic cutting blade (not shown). The water sealing cap 323 is equipped with two layers of sealing lips 3231 and is adapted to the groove 45 of a conventional electric cutting mirror.

[0074] Tests showed that the magnetic fixation force was ≥5N, meeting the requirements for intraoperative procedures. The procedure was tested on 20 pig uterine models, with no cases of detachment. The installation process is more convenient than the insert-type method.

[0075] Example of intrauterine suture push-knot method:

[0076] Using any of the above-described intrauterine suture pushers, the operation steps include the following two clinical scenarios:

[0077] Scenario 1: Pure intrauterine suturing surgery (no electrocautery required, such as intrauterine device fixation, diverticulum suturing)

[0078] S1. Pass the 3-0 medical suture through the thread hole 21 of the push-knot head 2 and pre-tie it to form a knot;

[0079] S2. Insert the snap-fit ​​structure 3 at the end of the rod 1 into the sleeve channel 41 of the electrosurgical resectoscope 4 and fix it. Confirm that the push head 2 is located within ±10° of the center of the field of view of the electrosurgical resectoscope 4. If the pusher is equipped with a universal joint 12, manually bend the universal joint 12 to the angle that matches the suturing position.

[0080] S3. Insert the electrosurgical endoscope 4 into the uterine cavity. Under direct vision, operate the handle of the electrosurgical endoscope to push the rod 1 forward. If the knot pusher has a length scale 11, determine the insertion depth of the knot pusher head 2 by the scale, drive the knot pusher head 2 to push the knot to the suture position, tighten the knot to complete the fixation. If the knot pusher has a cutting blade, push the rod 1 to make the cutting blade cut off the excess suture.

[0081] Scenario 2: Combined surgery involving electrocautery / electrocoagulation followed by suturing

[0082] S1. First, install the original surgical electrode of the electroresection scope into the cannula channel 41 to complete the electroresection of the lesion and the electrocoagulation of the bleeding point.

[0083] S2. Loosen the electrode locking structure, pull out the original electrode, and install the pusher according to step S2 in scenario one to complete the suture pusher operation.

[0084] S3. If electrocutting is required again, loosen the pusher clamping structure 3, pull out the pusher, and reinstall the original electrode to restore the electrocutting function.

[0085] The pusher of this invention, combined with the Olympus A22001A hysteroscopic resection device, was used in 20 cases of uterine cavity surgery on a pig model. Among them, 12 cases were combined surgeries of "electrosurgical resection of lesions + suturing and hemostasis". On average, the pusher and the original electrode were changed 2.3 times per surgery, with a single change time of 18±2 seconds. The imaging clarity, electrosurgical energy output, and irrigation flow rate of the resection device were no different from those of the original device. There was no wear or leakage in the cannula channel. The test results showed that the suture push-off rate was 0% and the suture slippage rate was 0%. The operation time was shortened by 47% compared with the traditional pusher.

[0086] The snap-fit ​​structure of the present invention can also be a snap-fit ​​type, magnetic type, threaded type or other detachable fixing structure; the anti-detachment barb can be made of medical plastic material; the universal joint can be made of flexible polymer material; the sealing lip of the water-sealing cap can be set as 1 layer or 3 layers; the shape of the push-joint head can be adjusted to arc shape or hook shape according to the requirements, all of which are within the protection scope of the present invention.

Claims

1. An intrauterine suture pusher, which can be assembled and used with an electrosurgical unit, characterized in that, The device includes a rod body and a push-knot head disposed at the head end of the rod body. The push-knot head has a suture hole for sutures to pass through. The rod body is provided with a snap-fit ​​structure. The tail end of the rod body can be inserted into the cannula channel of the electrosurgical endoscope through the snap-fit ​​structure for installation. The rod body is detachably installed in the cannula channel, occupying the original installation position of the surgical electrode of the electrosurgical endoscope. The outer diameter of the rod body matches the outer diameter of the electrosurgical electrode, and the length is configured such that when the snap-fit ​​structure is fixed to the electrosurgical end, the front end of the push-fit head protrudes 0-5mm beyond the lens end of the electrosurgical end and is located within ±10° of the center of the field of view of the electrosurgical end. The rod body has no independent operating handle, and its tail end abuts against the handle transmission mechanism of the electrosurgical resection mirror so that it can move forward without deformation as the handle of the electrosurgical resection mirror is pushed.

2. The intrauterine suture pusher according to claim 1, characterized in that, The snap-fit ​​structure includes a plug connected to the tail end of the rod, which can pass through the cannula channel of the electrosurgical endoscope and be inserted into its surgical electrode mounting hole for fixation.

3. The intrauterine suture pusher according to claim 2, characterized in that, The tail end of the rod is provided with at least two clips, which are symmetrically arranged to form a channel through which the inner tube of the electrosurgical resection device passes, so as to fix the rod and the inner tube of the device. The clips are located on the side of the insertion rod away from the push head.

4. The intrauterine suture pusher according to claim 1, characterized in that, The snap-fit ​​structure includes a mounting shaft located at the tail end of the rod and perpendicular to each other, through which the rod is inserted into the fixing slot of the electrosurgical endoscope for mounting surgical electrodes.

5. The intrauterine suture pusher according to claim 4, characterized in that, The rod body is symmetrically provided with two elastic plates, which form a ring shape with an opening, so that the inner tube of the electrosurgical resection device can enter through the opening and be fixed with the elastic plate by interference fit.

6. The intrauterine suture pusher according to claim 5, characterized in that, The operator of the electrosurgical resection mirror has a groove for the rod to pass through. A water-sealing cap is provided at the position of the rod corresponding to the groove, and the water-sealing cap cooperates with the groove to form a sealed connection.

7. The intrauterine suture pusher according to any one of claims 1-6, characterized in that, The pusher head is a semi-circular plate-shaped electric cutting ring structure, and the wire hole is located in the middle of the pusher head; the pusher head and the rod body are integrally formed, and both are made of medical-grade stainless steel.

8. The intrauterine suture pusher according to claim 7, characterized in that, The inner wall of the suture hole is provided with multiple anti-loosening barbs that are inclined toward the inside of the push-knot head to prevent the suture from falling out of the suture hole; The rod is equipped with a shape memory metal universal joint near the head end. The universal joint has a bendability of 0-90°. The outer diameter and stiffness of the main body of the rod are matched with the electrosurgical electrode. The outer surface of the rod is provided with length scales distributed along its length direction. The accuracy of the length scale is 1mm, and the zero point of the scale corresponds to the front end of the push head. The push-joint head has a micro ceramic cutting blade integrated on the side away from the rod body, and the blade curvature of the cutting blade is adapted to the semi-circular curvature of the push-joint head.

9. The intrauterine suture pusher according to claim 6, characterized in that, The outer wall of the water-sealing cap is provided with at least two layers of annular sealing lips. The outer diameter of the sealing lip is larger than the inner diameter of the groove. The sealing lip is made of medical-grade silicone.

10. A method for intrauterine suture knot pushing, characterized in that, The intrauterine suture pusher according to any one of claims 1-9 includes the following steps: S1. Pass the suture thread through the thread hole of the push-knot head and pre-tie it to form a knot; S2. Insert the snap-fit ​​structure at the tail end of the rod into the sleeve channel of the electrosurgical endoscope and fix it so that the push head is within the observation range of the electrosurgical endoscope. If the pusher is equipped with a universal joint, adjust the bending angle of the universal joint to match the suturing position. S3. Insert the electrosurgical endoscope into the uterine cavity. Under direct vision, operate the handle of the electrosurgical endoscope to push the rod forward. If the pusher has a length scale, determine the insertion depth of the pusher head by the length scale, drive the pusher head to push the knot to the suture position, tighten the knot to complete the fixation. If the pusher has a cutter, cut off the excess suture by the cutter after pushing.

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