Microsurgical instrument for anastomosis or suturing of blood vessels and lymphatic vessels

Abstract

The utility model relates to the technical field of microsurgical instruments, in particular to a microsurgical instrument for anastomosis or suturing of blood vessels and lymphatic vessels. Comprising microscopic tweezers, the microscopic tweezers comprise a tweezers handle and two tweezers arms connected with the tweezers handle, the two tweezers arms are used for opening a tube wall, strip-shaped grooves are formed in the opposite sides of the two tweezers arms, and the strip-shaped grooves extend in the length direction of the tweezers arms and penetrate from the head ends of the tweezers arms to the tail ends of the tweezers arms. The microneedle is used for being matched with a pair of microscopic tweezers to achieve suturing. The head end of the microscopic tweezers is a tilting arc-shaped semi-cylinder, a small-diameter semicircular groove penetrates through the center of the tilting arc-shaped semi-cylinder, and a 1 / 8 radian microneedle with a 10-degree back angle needle tip is matched, so that when lymphatic vessel-vein anastomosis is carried out under an ultra-microscopic condition, effective support and protection on a blood vessel wall can be realized, and the operation is simple and convenient. And safe and flexible migration of the suture needle in the blood vessel cavity is ensured, the clinical operation efficiency and success rate are greatly improved, and wide clinical application prospects are achieved.

Description

Technical Field

[0001] This utility model relates to the field of microsurgical instrument technology, specifically a microsurgical instrument for anastomosis or suturing of blood vessels and lymphatic vessels. Background Technology

[0002] Lymphatic-venous anastomosis is mainly used clinically to treat limb lymphedema, neurodegenerative diseases such as Alzheimer's or Parkinson's. This surgery requires operating on small veins and lymphatic vessels with a diameter of only about 0.5 to 1.2 mm under a high-powered microscope, making it extremely difficult.

[0003] In microvascular anastomosis or lymphatic-venous anastomosis, it is necessary to insert, advance, and move the needle through the vessel wall and within the vessel lumen. Because the target vessel wall is extremely thin, even slight carelessness during the procedure can puncture the contralateral vessel wall or damage the inner wall, leading to anastomosis failure. Existing conventional microsurgical instruments (such as ordinary microforceps) are insufficient to provide precise and stable guidance and protection for the suture needle within the narrow vessel lumen; conventional microneedles can only meet general suturing needs and cannot simultaneously ensure flexible movement and safety within the vessel lumen. Therefore, there is an urgent need for a microsurgical instrument that improves the safety and efficiency of lymphatic-venous anastomosis surgery. Utility Model Content

[0004] In view of the above situation and to overcome the defects of the prior art, this utility model provides a microsurgical instrument for anastomosis or suturing of blood vessels and lymphatic vessels, so as to solve the problems involved in the background art.

[0005] To achieve the above objectives, the present invention provides the following technical solution: a microsurgical instrument for anastomosis or suturing of blood vessels or lymphatic vessels, wherein the microforceps includes a handle and a forceps arm connected to the handle, wherein the forceps arm is one or more, and the forceps arm is used to be inserted into the wall of a blood vessel or lymphatic vessel as a guide for a microneedle, wherein a strip-shaped groove is provided on one side of the forceps arm, the strip-shaped groove extending through the tip of the forceps arm and along the length of the forceps arm.

[0006] Furthermore, the tweezers are provided in two parts, including a first tweezers arm and a second tweezers arm;

[0007] A strip-shaped groove is provided on one side of the first or second tweezer arm. The opposite side of the first and second tweezer arms is a plane, and the opposite side is an arc-shaped surface. The strip-shaped groove is located in the plane.

[0008] Furthermore, the tweezers are provided in two parts, including a first tweezers arm and a second tweezers arm;

[0009] Both the first and second tweezer arms have a strip-shaped groove on one side.

[0010] On the first tweezer arm, the side closer to the second tweezer arm is a flat surface, and the side farther from the second tweezer arm is an arc-shaped surface, and the strip groove is provided in the flat surface;

[0011] On the second tweezer arm, the side closer to the first tweezer arm is an arc-shaped surface, and the side farther away from the first tweezer arm is a flat surface, with the strip groove located in the flat surface.

[0012] Furthermore, the tweezers arm is provided with a strip-shaped groove, one side of the tweezers arm is a flat surface and the other side is an arc-shaped surface, and the strip-shaped groove is provided in the flat surface;

[0013] Furthermore, the strip groove is semi-cylindrical or semi-frustum shaped.

[0014] Furthermore, the forceps arm gradually thickens from its head to its tail;

[0015] The tip of the tweezers arm has a cut surface perpendicular to the length direction of the tweezers arm.

[0016] Furthermore, the tip of the tweezers arm is provided with an arc-shaped raised structure, with the raised direction facing the side with the strip-shaped groove.

[0017] Furthermore, it also includes microneedles, which are used in conjunction with microforceps to achieve suturing.

[0018] Furthermore, the diameter of the microneedle is smaller than the diameter of the strip groove, allowing the microneedle to advance along the strip groove.

[0019] Furthermore, the microneedles have an arc-shaped structure.

[0020] Furthermore, the tip of the microneedle is provided with a bent portion that is inclined toward the bending direction of the microneedle.

[0021] Furthermore, the method of using microforceps and microneedles is as follows: During the procedure, one arm of the microforceps can be inserted into the blood vessel lumen about 5mm; then, using a microneedle holder, the microneedle is inserted into the lateral wall of the blood vessel and advanced along the groove in the center of the forceps arm; after the needle tip exits the blood vessel opening, the needle tip is held by the forceps or other instruments, and the microneedle pierces one or more severed lymphatic vessels. The needle tip follows the groove of the forceps inserted into the blood vessel lumen to the vicinity of the insertion point, pierces the blood vessel wall, and finally pulls the severed lymphatic vessel into the blood vessel lumen before withdrawing the forceps. The microneedle pierces the blood vessel wall and is knotted for fixation, completing the anastomosis.

[0022] Compared with the prior art, the beneficial effects of this utility model are:

[0023] This invention utilizes the arc-shaped raised structure and strip-shaped groove at the tip of the micro-forceps to allow surgeons to guide the microneedle along the groove during the "locking" needle insertion and intravascular movement. This provides more effective support and guidance for the microneedle, protecting the vessel wall and greatly reducing the risk of puncturing or damaging the vessel wall. Consequently, it improves the safety and success rate of lymphatic-venous anastomosis and reduces the difficulty of the surgical procedure. Attached Figure Description

[0024] Figure 1 This is a three-dimensional structural diagram of the microtweezers according to an embodiment of the present invention;

[0025] Figure 2 This is an enlarged structural diagram of point B on the head of the micro-tweezers in an embodiment of this utility model;

[0026] Figure 3 This is a side view of the head of the micro-tweezers according to an embodiment of the present invention;

[0027] Figure 4 This is a schematic diagram of the AA side section structure of the micro forceps according to an embodiment of the present invention;

[0028] Figure 5 This is a three-dimensional structural diagram of the microneedle according to an embodiment of the present invention;

[0029] Figure 6 This is an enlarged structural diagram of point C of the microneedle head in an embodiment of this utility model;

[0030] Figure 7 This is a schematic diagram of the main view structure of the first forceps arm when the micro forceps of Embodiment 1 of this utility model are placed into the blood vessel.

[0031] Figure 8 This is a left-side view of the structure of the first forceps arm when the micro forceps of Embodiment 1 of this utility model are placed into the blood vessel.

[0032] Figure 9 This is a schematic diagram of the main view structure of the second forceps arm being inserted into the blood vessel during the use of the micro forceps in Embodiment 1 of this utility model;

[0033] Figure 10 This is a left-side view of the structure of the second forceps arm inserted into the blood vessel during the use of the micro forceps in Embodiment 1 of this utility model;

[0034] Figure 11 This is a schematic diagram of the main structure of the micro forceps used in Embodiment 2 of this utility model when inserted into a blood vessel;

[0035] Figure 12 This is a schematic diagram of the left side of the structure of the micro forceps used in Embodiment 2 of this utility model when inserted into a blood vessel;

[0036] Figure 13This is a schematic diagram of the main structure of the micro forceps used in Embodiment 3 of this utility model when inserted into a blood vessel;

[0037] Figure 14 This is a schematic diagram of the left-hand structure of the micro forceps used in Embodiment 3 of this utility model when inserted into a blood vessel;

[0038] In the picture:

[0039] 1. Tweezer handle; 2. Tweezer arm; 21. Plane; 22. Arc-shaped surface; 23. Cut surface; 24. Arc-shaped raised structure; 25. Strip groove; 3. Microneedle; 31. Bending part. Detailed Implementation

[0040] The technical solutions of the present utility model will be clearly and completely described below with reference to the accompanying drawings of the embodiments of the present utility model. Obviously, the described embodiments are only some embodiments of the present utility model, and not all embodiments. All other embodiments obtained by those skilled in the art based on the embodiments of the present utility model without creative effort are within the protection scope of the present utility model.

[0041] Example 1:

[0042] Depend on Figure 1-4 As shown, a microsurgical instrument for anastomosis or suturing of blood vessels and lymphatic vessels includes microforceps. The microforceps can be made of medical-grade stainless steel or titanium alloy, which possess high-temperature and high-pressure sterilization resistance, as well as good elasticity and toughness. The microforceps include a handle 1 and two forceps arms 2 connected to the handle 1. The closure and coaxiality of the two forceps arms 2 meet the requirements of microsurgical manipulation. There are two forceps arms 2, including a first forceps arm and a second forceps arm. On the first forceps arm, the side closer to the second forceps arm is a flat surface 21, and the side farther from the second forceps arm is an arc-shaped surface 22. On the second forceps arm, the side closer to the first forceps arm is an arc-shaped surface 22, and the side farther from the first forceps arm is a flat surface 21. The forceps arms 2 can open the vessel wall, providing sufficient space for the passage of microneedles.

[0043] The forceps arm 2 has a semi-frustum-shaped tip that gradually thickens from the tip to the end, with a diameter of approximately 0.3 mm at the very front and approximately 0.5 mm at the very back. The tip has a cut surface 23 perpendicular to the length of the forceps arm 2. The tip also has a smoothly transitioning, arc-shaped raised structure 24, approximately 2 cm in length. When the forceps are inserted into the blood vessel lumen for approximately 5 mm, the vessel can be moderately "lifted" or opened, providing greater space and visibility for needle insertion and traction operations; it also provides some support and protection for the vessel wall.

[0044] A strip-shaped groove 25 is provided on one side of the center line of the upper plane 21 of the first and second forceps arms. The upward direction of the arc-shaped raised structure 24 faces the side where the strip-shaped groove 25 is provided. The strip-shaped groove 25 extends from the head end of the forceps arm 2 to the tail end, along the length of the forceps arm 2. The strip-shaped groove 25 is semi-cylindrical or semi-truncated. The diameter of the strip-shaped groove 25 is 0.2mm. The strip-shaped groove 25 forms a "guide rail" to help the microneedle advance along the strip-shaped groove 25, obtain stable guidance in the blood vessel lumen, and better support the blood vessel wall. This makes the needle insertion and movement process more stable and controllable, and avoids scratching or puncturing the blood vessel wall as much as possible. The surgeon can complete the "locking method" and subsequent suturing operations more quickly, reducing the probability of rework or failure.

[0045] The micro-forceps of this application have a chamfered design, and all parts are rounded and flat without sharpness, so they will not cut blood vessels.

[0046] The microforceps of this application provide support and protection for blood vessels. The semi-circular frustum-shaped ends of the forceps arms protect the vessel wall, preventing puncture. The strip-shaped grooves 25 help protect the vessel arms and reduce friction on the inner wall when the needle tip moves within the lumen. The arc-shaped raised structure 24 of the microforceps "opens" the blood vessel, allowing the surgeon to see the needle entry point more clearly under a high-powered microscope. The strip-shaped grooves 25 allow the microneedle to "fit" the grooves as it moves forward, improving the stability of needle entry and the "locking" technique.

[0047] like Figure 7-10 The diagram shows the first or second arm of a microforceps inserted into a blood vessel, with the arrows indicating the direction and angle of the microneedle insertion.

[0048] Example 2:

[0049] The similarities between this embodiment and Embodiment 1 will not be repeated here. The differences are as follows:

[0050] The forceps arm 2 has two parts, including a first forceps arm and a second forceps arm; one side of the first forceps arm or the second forceps arm has a strip-shaped groove 25, the opposite side of the first forceps arm and the second forceps arm is a plane 21, and the opposite side is an arc-shaped surface 22, and the strip-shaped groove 25 is located in the plane 21 of the first forceps arm or the second forceps arm. In use, one forceps arm with the strip-shaped groove 25 is inserted into the blood vessel.

[0051] For example Figure 11-12 The diagram shows a micro-forceps arm with a groove 25 inserted into a blood vessel, where the arrows indicate the insertion direction and angle of the microneedle.

[0052] Example 3:

[0053] The similarities between this embodiment and Embodiment 1 will not be repeated here. The differences are as follows:

[0054] The tweezers arm 2 is provided with a strip-shaped groove 25. One side of the tweezers arm 2 is a plane 21 and the other side is an arc-shaped surface 23. The strip-shaped groove 25 is located in the plane.

[0055] like Figure 13-14 The diagram shows the arms of a microforceps inserted into a blood vessel, with the arrows indicating the direction and angle of the microneedle insertion.

[0056] Example 4:

[0057] The similarities between this embodiment and Embodiment 1 will not be repeated here. The differences are as follows:

[0058] like Figure 5-6 The device also includes a microneedle 3, made of stainless steel or alloy steel, which is used in conjunction with microforceps to perform suturing. The diameter of the microneedle is approximately 80 μm, smaller than the diameter of the strip groove 25, allowing the microneedle to advance along the strip groove 25. The microneedle 3 has an arc-shaped structure, specifically a 1 / 8 arc shape, with an arc length of approximately 4 mm, matching a 10-gauge suture approximately 10 cm long. The microneedle tip has a bent portion 31 inclined towards the bending direction of the microneedle. The bent portion is located approximately 1 mm from the needle tip, with an inclination angle of 10°, to ensure that the needle tip can advance along the strip groove 25 while minimizing scratching of the vessel wall when moving within the blood vessel. This design allows the needle to penetrate the vessel wall without causing unnecessary damage to the inner wall of the vessel.

[0059] This application can be applied to deep neck lymphatic vessel-vein anastomosis, lymphatic vessel-vein anastomosis for limb lymphedema, and other ultramicrosurgical procedures that require anastomosis or suturing of blood vessels with a diameter of approximately 0.5–1.2 mm.

[0060] The surgical method combining microforceps and microneedles described in this application is as follows:

[0061] I. Preoperative preparation

[0062] Routinely assess the patient's cardiopulmonary function, coagulation function, complete blood count, and relevant imaging findings (such as neck ultrasound, ICG fluorescein lymphangiography, etc.). Determine the course and diameter of the deep cervical lymphatic vessels and jugular vein to be anastomosed. Prepare anastomosis materials such as microforceps, a high-powered microscope (20-30x or higher), microneedles, and 11-0 / 10-0 sutures.

[0063] General anesthesia or a combination of general and local anesthesia is generally used to ensure that the patient is painless and stress-free during the operation. The patient is placed in a supine position with their head turned slightly to one side and tilted back to expose the neck appropriately, which facilitates the exposure of the cervical lymphatic vessels and veins.

[0064] A small oblique incision of about 4 cm is usually made in the third or fourth cervical lymph node regions (the lower third of the anterior border of the sternocleidomastoid muscle). The branches of the external or internal jugular vein are identified, and the deep cervical lymphatic vessels and lymph nodes are carefully located using indocyanine green (ICG) fluorescence imaging or under a magnifying glass. The target vein is selected and a segment of about 1-2 cm is dissected; for lymphatic vessels, a segment of 0.5-1 cm can be dissected to facilitate subsequent anastomosis.

[0065] II. Operation of Microtweezers

[0066] Preparation before insertion into the blood vessel lumen: Under 20-30x magnification of a microscope, gently retract the surrounding tissue with regular small forceps or other blunt instruments, taking care not to damage thin-walled lymphatic vessels and veins. Ensure the anastomosis (or detachment point) is centered in the field of view.

[0067] Gently insert the curved, upturned structure 24 at the tip of one arm 2 of the microforceps into the target blood vessel or lymphatic vessel lumen, about 3-5 mm, slightly spreading the vessel wall. During insertion, the curved, upturned structure 24 can gently "push up" the vessel wall, allowing for better exposure of the lumen of the blood vessel or lymphatic vessel;

[0068] If slight traction of the blood vessel is required, the modified forceps can be used in conjunction with another ordinary micro forceps: the modified forceps are placed inside the blood vessel lumen to open and protect it, while the other forceps are used outside the blood vessel to pull or adjust the angle of the blood vessel, making it easier for suture needles to enter and exit from different directions.

[0069] III. Microneedling Operation

[0070] Use a microneedle holder (or a small needle holder of equivalent size) to hold the rear third of the arc-shaped structure of the microneedle 3, avoiding directly pinching the needle tip or back corner to prevent deformation. When inserting the needle, try to keep the back corner of the needle tip facing "down" or "away" from the blood vessel wall, so as to make full use of the cooperation between the 10° back corner and the strip groove.

[0071] The microneedle 3 is inserted into the outer wall of the blood vessel (or lymphatic vessel). After the needle tip enters the blood vessel lumen, it naturally adheres to the strip groove 25 at the end of the forceps arm 2. The needle tip is kept in "fitting" with the strip groove 25 as it moves forward, reducing the needle tip from moving randomly inside the blood vessel wall.

[0072] When the needle tip has advanced to the appropriate position in the lumen, the needle holder can be rotated slightly to change the direction of the needle tip, piercing the other side of the blood vessel or a suitable point to complete the "lasso".

[0073] If it is necessary to pull the lymphatic vessels, the needle tip can be passed through the walls of several severed lymphatic vessels on one side, and the lymphatic vessels can be looped around and pulled into the venous cavity.

[0074] After the "lasso" is completed, rotate the needle tip slightly, pierce the vein wall or return it to the outside, and withdraw the needle.

[0075] The suture can be tied outside the blood vessel, or continuous suture or interrupted suture can be used according to the surgical design. When pulling out the needle tip, ensure that no excess blood vessel wall or lymphatic vessel wall is accidentally entangled. If necessary, a modified micro forceps can be used to reopen the blood vessel lumen to clearly observe the suture point.

[0076] Example 3:

[0077] This embodiment includes the micro-tweezers of Embodiment 1 and the microneedles of Embodiment 2.

[0078] The application steps of microforceps and microneedles in the treatment of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease through modified deep cervical lymphatic-venous anastomosis:

[0079] I. Locate and expose the anastomosis

[0080] A small incision is made to expose the deep cervical lymphatic vessels and the internal / external jugular veins. Lymphatic vessel function and course are determined under ICG fluorescence imaging. The target vein is then transected.

[0081] 2. Insert microforceps into the vein cavity

[0082] Gently slide the arc-shaped lifting structure 24 at the end of the forceps arm 2 into the vein lumen about 3-5mm to lift the blood vessel wall;

[0083] Using a micro needle holder, insert the micro needle 3 from the outside of the vein → into the venous cavity → along the groove 25 of the modified micro forceps → and then continuously puncture the walls of multiple unilateral lymphatic vessels to form a combination of numerous lymphatic vessels.

[0084] Insert the micro forceps into the blood vessel about 3-5mm from the broken end of the vessel. Use the micro needle holder to insert the special micro needle 3 into the vein through the groove of the modified forceps from the vein opening, and then pierce the blood vessel wall on the opposite side of the previous insertion point before withdrawing the needle.

[0085] Tie a loose knot and secure the lymphatic vessel.

[0086] Although embodiments of the present invention have been shown and described, it will be understood by those skilled in the art that various changes, modifications, substitutions and alterations can be made to these embodiments without departing from the principles and spirit of the present invention, the scope of which is defined by the appended claims and their equivalents.

Claims

1. A microsurgical instrument for anastomosis or suturing of blood vessels, lymphatic vessels, comprising a microforceps, said microforceps comprising a forceps handle, forceps arms connected to the forceps handle, characterized in that: The forceps arm is provided with one or more. The forceps arm is used to insert into the wall of a blood vessel or lymphatic vessel as a guide for the microneedle. A strip groove is provided on one side of the forceps arm. The strip groove extends through the tip of the forceps arm and extends along the length of the forceps arm.

2. The microsurgical instrument for blood vessel, lymphatic vessel anastomosis or suturing according to claim 1, characterized in that: The tweezers have two arms, including a first tweezers arm and a second tweezers arm; A strip-shaped groove is provided on one side of the first or second tweezer arm. The opposite side of the first and second tweezer arms is a plane, and the opposite side is an arc-shaped surface. The strip-shaped groove is located in the plane.

3. The microsurgical instrument for blood vessel, lymphatic vessel anastomosis or suturing according to claim 1, characterized in that: The tweezers have two arms, including a first tweezers arm and a second tweezers arm; Both the first and second tweezer arms have a strip-shaped groove on one side. On the first tweezer arm, the side closer to the second tweezer arm is a flat surface, and the side farther from the second tweezer arm is an arc-shaped surface, and the strip groove is provided in the flat surface; On the second tweezer arm, the side closer to the first tweezer arm is an arc-shaped surface, and the side farther away from the first tweezer arm is a flat surface, with the strip groove located in the flat surface.

4. The microsurgical instrument for blood vessel, lymphatic vessel anastomosis or suturing according to claim 1, characterized in that: The tweezers arm is provided with a strip-shaped groove. One side of the tweezers arm is a flat surface, and the other side is an arc-shaped surface. The strip-shaped groove is located in the flat surface.

5. The microsurgical instrument for blood vessel, lymphatic vessel anastomosis or suturing according to claim 1, characterized in that: The groove is semi-cylindrical or semi-platform.

6. The microsurgical instrument for blood vessel, lymphatic vessel anastomosis or suturing according to claim 1, characterized in that: The forceps arm gradually thickens from the head to the tail; The tip of the tweezers arm has a cut surface perpendicular to the length direction of the tweezers arm.

7. The microsurgical instrument for blood vessel, lymphatic vessel anastomosis or suturing according to any one of claims 2-4, characterized in that: The tip of the tweezers arm has an arc-shaped raised structure, with the raised direction facing the side with the strip-shaped groove.

8. The microsurgical instrument for blood vessel, lymphatic vessel anastomosis or suturing according to claim 1, characterized in that: It also includes microneedles, which are used in conjunction with microforceps to perform suturing.

9. The microsurgical instrument for blood vessel, lymphatic vessel anastomosis or suturing according to claim 7, characterized in that: The diameter of the microneedle is smaller than the diameter of the strip groove, allowing the microneedle to advance along the strip groove.

10. The microsurgical instrument for blood vessel, lymphatic vessel anastomosis or suturing according to claim 7, characterized in that: The microneedles have an arc-shaped structure; The microneedle has a bent portion at its tip that is inclined toward the bending direction of the microneedle.

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