CN100475160C - 内窥镜组织缝合装置及其使用方法 - Google Patents
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Abstract
一种内窥镜组织缝合装置,包括:一个用于稳固托住组织部分的真空室,真空室由近端的壁和与之相对的远端的壁定位;工作管道和真空管道与真空室相连通;当通过真空管道在真空室中形成真空时,组织部分被托在真空室中;一根载体针置于距离真空室较近的一端并可以纵向移动进入并穿过真空室,同时一根打孔针置于距离真空室较远的一端并用于接收进入的载体针。一个支撑和释放系统,用于支撑和释放打孔针以在缝合组织部分时起到辅助作用。
Description
相关申请
本申请的在先申请为2004年8月27日提交的临时申请号为60/604,687的美国专利申请,在此将其全文纳入作为参考。
技术领域
本申请涉及一种用于治疗肥胖症及其它此类胃部疾病的内窥镜缝合装置及其使用方法。具体而言,该发明提供了一种用于收集大量胃部组织部分并将之缝合在一起的内窥镜缝合装置。
背景技术
肥胖症是美国同时也是世界上最严重的健康疾病之一,患者不受年龄影响,数以百万计。除了对身体和精神的影响,特别是对年轻人而言,肥胖症使人们更容易患上严重的疾病,包括冠心病、高血脂、高血压和糖尿病。据估计,每年仅肥胖症一项就给美国的健康系统造成三百九十亿美元的支出。
减肥可以通过锻炼增加热量的消耗来实现,也可以通过减少热量的摄入来实现。减少热量摄入可以有很多种方法,包括通过外科方法使用安非他明或去甲肾上腺速化合物之类的食欲抑制剂以减少胃的容量或胃肠道的食物通过时间;或者通过其他方法,如将气囊置入胃部。食欲抑制剂作用于中央神经系统,且可能导致相当大的患病率和副作用。气囊置入也有几个缺点,包括由于爆裂或移位造成的置入失败、肠梗阻(肠腔阻塞)以及要求使用复杂的仪器和/或步骤来保证气囊位于胃内。
过去已经公布了大量的用于治疗肥胖症或胃部相关疾病的专利。例如,1990年2月13日授权给盖仑等人的美国第4899747号专利公开了一种用于治疗肥胖症的方法和仪器。具体的,该仪器是一种置入胃部的柔软的、可浮动的、独立可膨胀的气囊。置入胃部后,气囊膨胀以减少病人的胃部容量。1987年9月22日授权给维纳等人的美国第4694827号专利公开了另一种以气囊为基础的治疗肥胖症的方法。具体的,该气囊膨胀后形成大量的表面光滑的弧面突起,这些突起位于某些特定位置,使气囊能够在某些特定位置与胃壁接触。
1999年2月9日授权给Y.A.艾黎亚斯的美国第5686141号专利公开了一种有大量柔软叶片的内窥镜胃插入物,这些叶片的一端与底座连接,并围绕底座的中轴呈圆周状分布。一可释放的固定器连接叶片的末梢部分,相邻末梢之间间隔很小。
1995年6月13日授权给V.希盖娜的美国第5423872号专利公开了一种涉及根据预设的时间段对胃部连续使用电脉冲来治疗肥胖症的方法。另一项授权给V.希盖娜的专利,即2003年9月2日授权的美国第6615084号专利,公开了另一种对胃小弯,最好是胃小弯的前端或末梢,进行电刺激的技术,对胃小弯的刺激应保持在每分钟2至14次脉冲的频率。
2003年4月9日授权给席尔瓦曼等人的美国第6540789号专利公开了一种涉及在靠近幽门括约肌的壁中置入至少一片插入物以抑制胃部的清空以治疗病态肥胖症的方法。另一个可插入装置的例子是2003年8月26日授权给B.R.波夫亚的美国第6611715号专利。该专利公开了一种使用可插入的铅收集器和外部刺激器进行神经调节以治疗肥胖症和强迫性饮食紊乱。外部刺激器释放电脉冲以刺激迷走神经。外部刺激器包括电源,控制电路,主线圈和控制不同程度治疗的预设程序。
2003年9月30日授权给G.A.洛伊德的美国第6627206号专利公开了一种使用定时释放药物的装置来治疗肥胖症的技术。具体的,大量的空间填充物的量根据病人需要吸收的量来决定,这些物质在病人的身体里共同构成为病人提供治疗效果的结构。
2003年3月18日授权给伊姆兰等人的美国第6535764号专利公开了一种诊断和治疗胃紊乱的装置和方法。该装置置于病人的胃中并由一缝合装置固定。该装置既可以是用来感应胃部或胃部环境参数的感应器,也可以是治疗传送装置。在一具体实施例中,该装置提供胃部电刺激,其中刺激电极由缝合装置固定在胃壁上。一个电子单位包含一个该装置的电子电路且该装置可通过编程来回应感应到的信息或信号。该装置由内窥镜输送系统通过食道送入胃中并附着在胃壁上。然后,内窥镜仪器与该装置和缝合装置连接并协助决定胃壁上上的最佳附着点。
2004年6月29日授权给盖伊茨的美国第6755869号专利公开了一种假体,该假体由以生物可吸收的细丝为材料的多孔织物构成,一端开口,呈扁圆形,大小超过食道裂孔和出胃口。该假体用于限制胃中存放的食物的量并对底部施加压力,以制造一种满腹的感觉。
另一个治疗肥胖症和其它此类胃部疾病的装置包括一根围着病人的胃部外壁以减小内部容量的有弹性的带子。因而病人可以在摄取更少食物的情况下获得满腹的感觉,并在相对较短的时间内减掉相当大的重量。
另一个治疗肥胖症和其它此类胃部疾病的装置是使用内窥镜缝合装置将病人的胃内组织缝合在一起1992年1月14日授权给米尔斯等人的美国第5080663号专利,1998年8月11日授权给斯维恩等人的美国第5792153号专利,2003年11月6日公开的申请人为甘布尔等人的公开号为2003/0208209的美国专利申请,以及2004年12月2日公开的申请人为甘布尔等人的公开号为2004/103189的国际专利申请,各自公开了不同类型的内窥镜缝合装置。
内窥镜缝合装置的使用不会给病人造成外部切口,而是通过内窥镜仪器进行外部控制。缝合装置通常包括一个缝合或压订装置以配合一个柔软的内窥镜使用,虽然也可以配合坚硬的内窥镜使用。
举例来说,要将胃部组织的某些部分缝合在一起,缝合装置,如缝合囊,应附着在内窥镜视镜的末端,通过食道插入并在食道下端以下的胃部组织中形成大量的缝线。第一缝线透过胃部组织到达食道的一侧,而第二缝线使用同一根缝合线,紧靠第一缝线。收紧两根缝线使直接相对的被封合的胃部组织紧贴。
缝合完成后,将内窥镜从病人体内取出,缝合线向病人体外伸出,其自由端系着一个绳结。使用位于内窥镜末梢的导针器将绳结向下压至缝合处。重复几次缝合和打结的步骤。在绳结和缝合数量足够后,使用可通过内窥镜操作的断针器将缝合线从靠近组织一端的切断。
总体说来,米尔斯等人的663号专利和斯维恩等人的153号专利公开了一种位于内窥镜末端并用其将缝合线穿透胃部组织的缝合装置。该缝合装置包括一根可在第一位置(针位于胃外)和第二位置(针穿透胃部组织)之间移动的空心针,和一个附在线上并置于针内的载线器。缝合装置也包括一个实体,该实体定义了一个空腔。在该空腔中,胃部组织被吸力吸住,针也在这里进行第一和第二位置之间的移动。
对常规内窥镜缝合装置如何操作的更具体或更明确的说明将以斯维恩等人的153号专利为范例。关于斯维恩等人的153号专利如何工作的说明也有助于理解与本发明的区别,下面将详细叙述。
附图1-3是斯维恩的153号专利公开的常规内窥镜缝合装置。
附图1展示了可弯曲的内窥镜1的末端,其上附有缝合装置2。内窥镜1有一观察管道(未显示),末端有一棱镜。内窥镜1还有一工作管道3和一吸力管道4,吸力管道4的近端与一真空源(未显示)相连接。
缝合装置2包括一与吸力管道4相连的管5,其中有大量的穿孔6。穿孔6与缝合装置2形成的向上开口的真空室7相连。
空心针8置于工作管道3中,其有斜面的间断伸入缝合装置2。针8穿过管9,针8的尾部附有一柔软的线绕电缆10。中央金属丝11完全伸入电缆10并可以纵向移动。金属丝11可在管9中纵向移动并且附图一所示的位置,金属丝11的前端伸入管9的后端。
载线器或金属牌12(附图1A)置于管9中,可滑动也可释放。金属牌12是空心的并有一透壁的孔13。线14的一端穿过孔13后固定于金属牌12,并由一足够大的绳结15系住,以防止从金属牌12中滑落。
空心头16,定义了室20,位于缝合装置2的末端。壁17位于室20和空腔7之间,其上形成了孔18。孔18的直径大于针8的直径,两者在一条直线上。针8和孔18之间的间隙必须足够小以防止胃部组织挤入孔18而塞住针8。附图1也显示了病人的组织部分19,上面已经形成了缝合线。
在操作中,吸力通过管5的穿孔6先作用于吸力管道4再作用于真空室7。如附图2所示,胃部组织19的U形部分19a被吸入真空室7中。通过向远端伸长电缆10和针8,针8受到推力穿透U形组织部分19a。当针8完全穿透U形组织部分19a折叠的两层后,针8的斜面端穿越壁17伸入空心头16中的室20。电缆10中可滑动的金属丝11向远端移动,将金属牌12退出管9进入室20。金属牌12翻转,与孔18不再在一条线上。而被室20接纳。
金属丝11然后向近端缩回,电缆10也跟着缩回,从而从U形组织部分19a中收回针8。吸力消失,U形组织部分19a从真空室7中脱落。
如附图3所示,脱落的组织上有穿透形成U形组织19a的两层的缝合线14。缝合线14的一端连接着金属牌12,金属牌12则继续留在室20中而缝合线14的另一端则穿过病人的食道到达体外。最后,内窥镜1和缝合装置2退出病人体外。此时,由于金属牌12被向近端拖动并拉出体外,线14也从U形组织部分19a中被部分拉出。由于线14的两端都已在体外,将其打结并通过内窥镜推至缝合处并用内窥镜绳结推动器将其割断。
米尔斯等人的663号专利,以及甘布尔等人的公开号为209和189的申请,与斯维恩的153号专利一样,在其公开的内窥镜缝合装置中,缝合线在缝合胃部组织折叠层之前都是留在真空室的中部。每一种方法都表现出一些特定问题。例如,上述每个专利中,当缝合线穿过胃部组织折叠层后,缝合线就不在处于紧张状态,从而可能影响此后的缝合工作。另外,每个常规缝合装置的真空管道都位于各自真空室的底部或底层,这导致被吸入真空室的胃部组织会形成凹陷,从而使胃部组织不能稳固的保持在真空室中。
更进一步来说,由于这些常规装置要求在使用单线装置完成缝合后要将装置从病人体内退出,从而会产生一个问题。使用这样的装置耗费时间,步骤繁琐,而且由于多重插管或食道穿孔可能会给病人带来风险。而且,病人也被要求长时间处于麻醉状态。
发明内容
本发明提供了一个内窥镜胃部组织的缝合装置,能够通过在病人胃部插入一个末端带有缝合装置的内窥镜,收集大量胃组织部分。为能够确定适当的缝合位置,缝合装置可以被固定在任何合适的内窥镜末端,并且是可以拆卸下来的。缝合装置包括一个可以容纳部分胃部组织的组织真空室,可以穿过真空室的互相套叠的载体针和打孔针,以及与缝合线相连、防止缝合线脱离缝合装置的金属箍。
本发明有一个特点,缝合装置应固定于一柔软的内窥镜的末端,内窥镜可软可硬。内窥镜有一条工作管道和一条与真空源相连的真空管道。理想状态下,真空管道由缝合装置的内部管道构成,其末端位于真空室内。
在一具体实施例中,第一或载体针位于工作管道内,其顶端中空并具有斜面,指向真空室。载体针的具有斜面的顶端被设计成用于接收被置于内窥镜末端并与真空室相对或远离的支撑室内的相对较短的第二或打孔针。打孔针上也有与载体针上具有斜面的顶端相对应的具有斜面的顶端,两个顶端可以对接。
本发明提供了一个支撑通道,与工作室同轴。据此,开始运作时,载体针运动出真空室进入支撑通道。在真空室底面的垂直方向上,支撑通道的正上方有一个释放通道。在一个具体实施例中,释放通道中有一个支撑装置,该支撑装置包括一个可滚动键,其外表呈凸起状,还有一个狭槽性构件,该构件中有一个用来容纳滚动键支点的下垂狭槽以及一个偏置构件。
该具体实施例中的偏置构件包括一个由第一和第二支撑支柱滑动支持的圆柱体,支撑支柱内形成孔隙以容纳该滑动的圆柱体。在该圆柱体上一直与支撑支柱接触的位置上有一个突出的阻挡物。一个弹性圈螺旋缠绕着该圆柱体,以便该弹性圈的一端一直与阻挡物接触,而其另一端一直与内窥镜末端的支撑支柱接触。
本发明有一个特点,即内窥镜组织缝合装置利用一种使用了缝合线的组织固定装置,减少了缝合或修复内部组织所要求的插管数量。
本发明的另一个特点是内窥镜组织缝合装置易于制作和使用。
本发明的另一个特点是组织缝合装置具有纵向灵活性,将其置于内窥镜末端时易于在自然体腔内操控。
本发明的另一个特点是提供了连接组织的方法,通过同时抓住至少两个区域的组织,将组织固定装置传送过这些区域的组织,从而达到连接组织的目的。
本发明的附加优点和新特征将在接下来的说明书中部分阐明。在本行业的技术熟练者亲自检验或实践学习本发明后,这些优点和新特征将更加明显。
附图说明
本发明的上述和其它特点将通过以下的说明更加清楚。请参见下面的附图:
附图1至3显示了常规内窥镜缝合装置操作时的连续步骤;
附图4是本发明的具体实施例的一个缝合装置的示意图,其载体针处于缩回位置;
附图4A是一根独立的打孔针的状态图;
附图5是与本发明的具体实施例一致的载体针处于略微伸展状态的示意图;
附图6是与本发明的具体实施例一致的载体针置于打孔针中的示意图;
附图7是与本发明的具体实施例一致的载体针和打孔针处于缩回状态的示意图;
附图8是与本发明的具体实施例一致的U形胃部组织被吸入真空室和真空管道的示意图;
附图9是与本发明的具体实施例一致的载体针和打孔针刺穿U形胃部组织的示意图;
附图10是与本发明的具体实施例一致的被缝合的胃部组织被缝合线穿透且载体针和打孔针回归原位的示意图;
附图11至16展示了使用本发明所公开的内窥镜组织缝合装置进行胃部组织缝合的示范性步骤。
具体实施方式:
本发明提供了一个内窥镜胃部组织的缝合装置,能够通过在病人胃部插入一个末端带有缝合装置的内窥镜,收集大量胃组织部分。为能够确定适当的缝合位置,缝合装置可以被固定在任何合适的内窥镜末端,并且是可以拆卸下来的。缝合装置包括一个可以容纳部分胃部组织的组织真空室,可以穿过真空室的互相套叠的载体针和打孔针,以及与缝合线相连、防止缝合线脱离缝合装置的金属箍。
附图4显示了一个可弯曲的内窥镜的末端100,其上附有根据本发明制作的缝合装置110。内窥镜100上有一个观察管道未标出,一直通到内窥镜100末端表面上的镜头未标出。观察管道和镜头都是内窥镜中常见的基本组成部分。
内窥镜100上还有一个工作管道115以及一个真空管道120,其中真空管道120的近端120a与一个真空源未显示相通。虽然真空管道120可以是一个延伸到内窥镜外面的单独管道,而不是目前所显示的一个内部管道,因为将在下文中表述的原因,真空管道120作为一个内部管道并且其末端直通到真空室130近端垂直立面上如图4所示,是更好的方案。
作为演示范例,如附图4所示,一个顶端为斜面141的第一或载体针140,伸向真空室,并被置于工作管道115之中。载体针140的顶端斜面141是中空的,用来容纳装在相对于载体针140的真空室130对面或末端的内窥镜末端100上、相对较短的第二或打孔针150。打孔针150顶端也呈斜面151,与载体针140的顶端斜面141相对应,用来接纳载体针140的顶端斜面141。打孔针150通过一个支撑结构170被托在位于内窥镜末端100的支撑管道160上。
附图4A是附图4中所示打孔针150的放大图,包括一个孔隙152和一个V形凹153。孔隙152用来容纳缝合处或其中的缝合线180,其中孔隙152的直径大于缝合处180的直径。在缝合线180的末端设有一个金属箍或其他固定装置154,其尺寸大于孔隙152的直径,从而金属箍或其他固定装置154不能从孔隙152通过。在使用缝合装置的整个手术过程中,打孔针150将缝合线180及金属箍牢牢固定。如图4所示,V形凹153被设计用来与例如一个可转动的滚动键171咬合,并且咬合可以松开。
本发明中包括一个支撑和释放系统。如附图4中的示范说明,一个支撑管道160与工作室115同轴。工作室115末端115a有一个孔隙116直接与支撑管道160近端160a的孔隙161相对。因此,载体针140在被激活时可穿透并最终穿过真空室130,进入支撑管道160。
一个释放管道190直接位于支撑管道160的上方,相对于真空室130底面的正交或垂直方向。释放管道190的末端190a上有一个孔隙191,在与支撑管道160孔隙161相邻的对应位置。但是,如附图4所示,释放管道190的纵向长度大于支撑管道的纵向长度,具体原因将要下文中说明。
支撑结构170位于释放管道190中,并且包含有一个可以转动的滚动键171,其外表呈凸起状,还有一个狭槽性构件172,该构件中有一个用来容纳滚动键171支点一端的下垂狭槽172a以及一个偏置构件173。偏置构件173中包括一个圆柱体174,由第一个175和第二个176支撑支柱支撑其滑动。支撑支柱175176中含有孔隙,以容纳在其中滑动的圆柱体174。
圆柱体174上还有一个突出的阻挡物177,可以使圆柱体不断地在支撑支柱175176之间滑动。一个偏置构件,例如且仅以此为例,一个弹性圈178,螺旋状缠绕在圆柱体174上,从而弹性圈178的第一端不停与从圆柱体174上突出来的阻挡物接触,而弹性圈的第二端与内窥镜末端100的第二个支撑支柱176接合。打孔针150中的V形凹153、滚动键171、孔隙161以及狭槽构件172,共同构成了一个再装系统,使缝合装置110为下一次缝合做好准备。
附图4-10将说明对合或缝合装置110如何通过图4和4A中演示的装置将胃部相邻的组织缝合起来。
参见附图4和4A,本发明中的缝合装置110可附在一个可弯的或不可弯的内窥镜一端100。载体针140在工作管道115内保持第一位置。在保持第一位置期间,支撑结构170中的滚动键171,通过与打孔针中的V形凹153咬合,将打孔针150置于支撑通道160内。同时,缝合线180从打孔针150的孔隙152中穿过,由金属箍154将其固定在打孔针中。并且圆柱体174的第一端与滚动键171脱离,或不与之接合。
接下来,如附图5所示,载体针140被激活,其顶端斜面141进入真空室130。与此同时,打孔针150继续被滚动键171控制在支撑管道160中。随后,圆柱体174继续与滚动键171保持脱离,或不与之接触。
在完全穿过真空室130后,载体针140的顶端斜面141进入打孔针150并与其接合,见附图6。随后,相互套叠的载体针140和打孔针150开始回缩,载体针140和打孔针向工作管道115回缩,滚动键171转动并滑动着与打孔针150的V形凹153脱离。在载体针140和打孔针150刚开始回缩时,滚动键171开始上行至狭槽构件172,在此,滚动键171的凸起表面与圆柱体174的一端相触。
根据附图4中的演示说明,滚动键的凸起表面将圆柱体174推向内窥镜100的最远端即向附图6中的右边方向。随着圆柱体174被越推越远即向附图6中的右边方向,圆柱体外表面的阻挡物177与弹性圈178的第一端接触,而弹性圈178的第二端则压向支撑支柱176。滚动键171的凸起表面对圆柱体174的不停推动导致弹性圈178在移动的阻挡物177和支撑支柱176之间挤压。圆柱体174的最远端伸入释放管道190的最远端,并超出了支持管道160的最远端。参见附图7。
一旦套叠的载体针140和打孔针150回缩到工作管道115之中,真空源图中未显示即被打开,通过真空管道120在真空室130中产生真空压力。附近的胃部组织因此被吸入真空室130和真空管道的末端120b,通过真空压力,部分胃部组织在真空室130中形成了U形200。见附图8所示。同时,偏置构件或弹性圈178继续使阻挡物倾斜,使入离开内窥镜的末端110,其中的圆柱体174被向释放管道190的孔隙190a处推动。
当套叠的载体针140和打孔针150被激活或经过真空室向内窥镜末端100的支撑管道160回推时,套叠的载体针140和打孔针150会穿透U形组织200。如附图9所示,缝合线180被打孔针150的针尖在由U形组织200中缝出的一个长条部分。如在上文中解释的,缝合线180被附着在其一端的金属箍154牢牢地固定在打孔针150上。
一旦打孔针150进入支撑管道160,载体针140就与打孔针分开,回缩到工作管道115中。而后,由于载体针140不再套叠在打孔针150中,载体针的外表面不再阻挡滚动键171进入打孔针150中的V形凹153。因此,滚动键171的狭槽构件172向下滑落,滚动键171的上部落入或伸进支撑管道160中,进而滚动键171与打孔针150上的V形凹153接触,将打孔针150固定在管道160中。
此时,真空源被关闭,已缝合的U形组织200从真空室130中收回,缝合线180通过真空室,如附图10所示。
通过附图11-16中的示范步骤可以更清楚地看到,缝合装置110此时将被移至胃的其他部分,附图4-10所示范的上述步骤将重新开始。
现将本发明中的缝合装置110在肥胖症外科手术中的应用作一说明,以便更好地帮助理解本发明可以应用的多种方式。但这一说明仅为举例,并不意在限制本发明的范围或本发明在应用过程中的各种其他步骤。
首先,病人被麻醉,并倾斜躺在工作台如外科手术台上。用一根导线将缝合装置110放入病人胃和食管的连接处,然后取出导线。
肥胖症外科手术一般是在病人的胃部进行。一般说来,人体的胃有一个前门,一个后门,以及两者之间的较大的胃大弯,在手术中,胃大弯需被一缝合物封闭住,该缝合物最好是一个不会被吸收的细绳,从靠近十二指肠腔体的一端缝合到胃底。如附图11所示,每隔一个点缝一次,相邻缝线点之间应相隔10厘米左右。
此类手术最好通过内窥镜100进行,并且在其末端装上一个缝合装置110。如附图11所示,内窥镜100及缝合装置110通过食管插入病人的胃部。缝合装置100被固定在多个相隔的点上,在此使用本装置结合附图4-10所示采用上述方法将U形胃部组织200缝合在一起。
如附图11-15所示,在间隔各点的胃部组织随后被缝了起来,形成了附图16中所显示的被修正后的胃部形状,其中胃部容量较手术前大大减小,因为胃的前壁和后壁被放到了一起。例如,据估计,使用这一方法经过大约一个小时的手术,胃镜面积可减小约50%到60%。
第一针被缝在离胃和食管连接处约两厘米的胃底部背面附图11。然后将缝合装置在同一面沿胃部角度移动10-12厘米,然后按附图4-10显示的并在以上讨论的步骤缝下一针。附图12。为了保持缝合线180在胃部内有足够的长度,将缝合装置从胃壁上移开,向幽门方向移动附图13,然后将缝合装置110向胃部和食管联接处上移,在第二针前面,朝向胃的后壁附图14,结合附图4-10所示并按上文中讨论的步骤缝下一针。
随后的缝合应在左右两边交替向上缝合,每针相隔1到1.5厘米,一直缝到与第一针位置相对、距胃部与食管连接处两厘米左右的位置。缝合线180的两端随后汇合附图15,因而胃底空间及胃体随之减小附图16。
缝合完成之后,将缝合装置110从病人体内取出,并且将缝合线180的两端扎在一起,打结或用一个合适的固定装置例如能进行生物降解的胃部夹子或钳子将其固位后将其放回病人的胃中,并将多余的缝合线去除。[0078]整个过程将使用静脉注射麻醉,术后无需卧床,病人在手术完成后6个小时即可进流食。
以上是对本发明目前实施方法的介绍,今后可能会对此作各种修改。本申请的权利要求意欲涵盖符合本发明的精神实质并在本发明范围之内的所有未来发生的此等修改。
例如,以上所述的支撑装置170只是对可以用来将打孔针周期性地支撑在支撑管道160内的结构组件的一个示例。使用任何已有的或今后开发出来的系统来执行这一功能,均将属于在本发明的范围之内。例如,可通过摩擦、重力、磁力、电磁力、螺线管构件及类似装置将打孔针150托在支撑管道160内。此外,只要有合适的方式能帮助滚动键171及打孔针150的V形凹153周期性地接触和脱离,滚动键171的凸起表面,支撑支柱175176,以及圆柱体174、阻挡物177及弹性圈178均可被略去。
Claims (16)
1.一个内窥镜组织缝合装置,由以下部分组成:
装置主体,有第一端部分和第二端部分;
装置主体内有一真空室,用于容纳被收集到其中的人体组织,真空室位于装置的第一端部分和第二端部分之间;
与真空室相连通的真空线,用于将真空室抽至真空状态;
一个可在装置主体的第一端部分中伸缩,并能穿过真空室到达装置主体的第二端部分的载体针;
能与装置主体的第二端接触,在此套叠载体针的打孔针;以及
一个支撑和释放系统,可在装置主体的第二端部分内周期性地支撑打孔针,并且
其中打孔针与缝合线结合;并且
带有缝合线的打孔针在载体针被收入打孔针后,穿过真空室。
2.根据权利要求1所述的缝合装置,其中载体针和打孔针顶端均为斜面,且打孔针是中空的。
3.根据权利要求1所述的缝合装置,其中有一个支撑和释放系统,由以下部分组成:
一个支撑管道,可在其中托住打孔针,并可以松开打孔针;
一个释放管道,其中包括一个支撑结构。
4.根据权利要求3所述的缝合装置,其中释放通道的纵向长度大于支撑管道的纵向长度。
5.根据权利要求3所述的缝合装置,其中支撑结构由以下部分组成:
一个有支点一端的滚动键;
一个狭槽性构件,该构件中有一个用来容纳滚动键支点一端的下垂狭槽;以及
一个偏置构件。
6.根据权利要求5所述的缝合装置,其中打孔针又包括:
为防止打孔针滑出支撑管道而用来容纳滚动键的V形凹;
一个缝线孔隙。
7.根据权利要求6所述的缝合装置,其中缝合线从打孔针的缝线孔隙中穿过。
8.根据权利要求7所述的缝合装置,又包含以下部分:
附于缝合线松开的一端的金属箍,其尺寸大于缝合线孔隙,以防止缝合线从打孔针中脱落。
9.根据权利要求第8项所述的缝合装置,其中偏置构件由以下部分组成:
一个圆柱体,上面有阻挡物,伸出圆柱体的外表面;
至少一个支撑支柱,中间是一个贯穿的孔洞,圆柱体可以在其中纵向运动;
一个缠绕在圆柱体外表面的环圈。
10.根据权利要求9所述的缝合装置,其中环圈的第一端与阻挡物接合,第二端与所述支撑柱柱接合。
11.根据权利要求10所述的缝合装置,其中滚动键表面有凸起,该凸起在滚动键随着打孔针被送出支撑管道、载体针缩回工作管道而纵向向上滑动时,将圆柱体推向装置的末端,圆柱体上的环圈在阻挡物和所述支撑柱之间被压缩。
12.一个内窥镜组织缝合装置包括:
将人体组织收集到设施内部的组织收集装置,组织收集装置有第一端和第二端,其中第二端与第一端位置相对;
向组织收集装置提供真空压力的真空装置;
可在组织收集装置上纵向推进的载体针;
可将载体针纳入的打孔针;
支撑和释放打孔针的支撑和释放系统,支撑和释放系统与组织收集装置相连通,其中,缝合线附入打孔针。
13.根据权利要求12所述的缝合装置,其中组织收集装置经由组织收集装置第一端上形成的孔隙与真空装置相连通。
14.根据权利要求13所述的缝合装置,其中载体针置于组织收集装置的第一端,打孔针置于组织收集装置的第二端。
15.根据权利要求14所述的缝合装置,其中支撑和释放系统置于组织收集装置的第二端。
16.根据权利要求12所述的缝合装置,其中载体针和打孔针是同轴的。
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JP2006061689A (ja) | 2006-03-09 |
AU2005203208A1 (en) | 2006-03-16 |
US20120215235A1 (en) | 2012-08-23 |
US20060047289A1 (en) | 2006-03-02 |
MXPA05008127A (es) | 2006-03-01 |
EP1629780A1 (en) | 2006-03-01 |
AR055686A1 (es) | 2007-09-05 |
DE602005009450D1 (de) | 2008-10-16 |
RU2005124159A (ru) | 2007-02-10 |
US8172857B2 (en) | 2012-05-08 |
CA2513774A1 (en) | 2006-02-27 |
CN1853577A (zh) | 2006-11-01 |
US9149270B2 (en) | 2015-10-06 |
EP1629780B1 (en) | 2008-09-03 |
BRPI0503152A (pt) | 2006-04-11 |
ATE406844T1 (de) | 2008-09-15 |
BRPI0503152B1 (pt) | 2016-12-13 |
CA2513774C (en) | 2014-01-14 |
KR20060048961A (ko) | 2006-05-18 |
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