CN102579087A - Hole puncher for pressure nonstop artery blood vessels - Google Patents

Hole puncher for pressure nonstop artery blood vessels Download PDF

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Publication number
CN102579087A
CN102579087A CN2012100107974A CN201210010797A CN102579087A CN 102579087 A CN102579087 A CN 102579087A CN 2012100107974 A CN2012100107974 A CN 2012100107974A CN 201210010797 A CN201210010797 A CN 201210010797A CN 102579087 A CN102579087 A CN 102579087A
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China
Prior art keywords
sleeve
dowel steel
card punch
internal layer
cutter head
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Granted
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CN2012100107974A
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Chinese (zh)
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CN102579087B (en
Inventor
肖聚亮
高进涛
王国栋
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Tianjin University
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Tianjin University
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Publication of CN102579087A publication Critical patent/CN102579087A/en
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Publication of CN102579087B publication Critical patent/CN102579087B/en
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Abstract

The invention discloses a hole puncher for pressure nonstop artery blood vessels, which comprises a hole puncher body with a sleeve. A dowel bar is sleeved in the sleeve, an inner-layer stent is fixedly sleeved on the outer wall of the sleeve, a cylindrical clamp sleeve is disposed on the lower portion of the inner-layer stent, ring slots are arranged in the clamp sleeve, flexible sealing retainer rings are mounted in the ring slots, and the tail end of the clamp sleeve is connected with a cylindrical shell; the outside of the inner-layer stent is fixedly connected with an outer-layer stent, and a fastening sleeve is disposed on the lower portion of the outer-layer stent and used for fixedly clamping the clamp sleeve; an inverted frustum-shaped opening is arranged at the lower end of the sleeve; the lower end of the dowel bar is fixedly connected with a cutter bit, four lower blades are uniformly distributed at the lower end of the cutter bit, the cutter bit is conical integrally, and a circular upper blade and an annular groove are arranged at the upper end of the cutter bit; the lower end of the cylindrical shell matches with the upper end of the frustum-shaped opening, and a lower port of the frustum-shaped opening matches with the upper blade. The inner-layer stent and the flexible sealing retainer ring stop blood overflowing from an artery after hole punching is finished, and hole punching for the pressure nonstop artery blood vessels is realized.

Description

A kind of arterial blood pipe racks is pressed and is not stopped defeated card punch
Technical field
The invention belongs to a kind of cardiac operation apparatus, relate generally to a kind of arterial blood pipe racks pressure and do not stop defeated card punch.
Background technology
Bypass operation of coronary artery is as one of main therapeutic modality of coronary heart disease; Be blood vessel or the blood vessel succedaneum of getting patient itself, narrow far-end coronarius and aorta are coupled together, let blood walk around narrow part; Arrive the position of ischemia, improve myocardial blood supply and cardiac function.
No matter be traditional extracorporeal circulation coronary bypass or the bridging under the heart beating situation, surgeon all needs with the continuous or technological vascular anastomosis of carrying out of interrupted suture.Consider surgical field of view depletion of blood and easy to operate, the blood vessel perforate needs proceed step by step under the situation of coronary artery being carried out clamp and blocking-up with sewing up.Clamp can cause the endarterium speckle to come off, and is prone to cause complication such as thrombosis and apoplexy; The blocking-up of artery blood flow also can cause the myocardial ischemia symptom, can cause operative failure when serious; Proceed step by step has increased operating time.
Though existing medical apparatus and instruments can be realized bypass surgery, there are tremulous pulse clamp, blocking-up, perforate and coincide and defective such as do not carry out, blood leaks outside too much simultaneously.Such as number of patent application is 200820029416.6 medium and small arteries card punch, at first need on tremulous pulse, cut an aperture when this utility model is used, and must be under the situation that blood vessel is blocked, to carry out, and forms complication such as thrombosis and apoplexy easily.
Summary of the invention
In order to overcome the above-mentioned deficiency of existing tremulous pulse punching technology; The present invention provides a kind of arterial blood pipe racks pressure that can be implemented in not stop the defeated card punch that punches down; Optimal way has offered a kind of card punch of the simple, convenient punching of arteries efficiently; Punch through this kind mode and to prepare, can improve the success rate of operation for the fast wireless of follow-up grafting vessel coincide.
The present invention solves the arterial blood pipe racks and presses and not stop the technical scheme that the defeated problem of punching down takes and be: provide arterial blood pipe racks of the present invention to press and do not stop defeated card punch; Comprise and be provided with telescopic card punch body; Be set with dowel steel in the said sleeve, wherein, be fixed with the auxiliary stand of forming by internal layer support and outer support on the said telescopic outer wall; Said internal layer support bottom is provided with by left and right sides tubular chuck dimerous; Be equipped with annular groove in each part of said chuck, the flexible sealing back-up ring all is housed in the said annular groove, the end of said chuck is provided with cylindrical outer casing; Said internal layer support external fixation is connected with outer support, and outer support bottom is provided with adapter sleeve, and said chuck is used to be fixedly clamped; Said telescopic lower end is provided with the nozzle that is reverse frustoconic; Said dowel steel lower end is fixedly connected with cutter head, and the lower end of said cutter head is evenly equipped with four following blades, and integral body is conical, the annular groove that the upper end of said cutter head is provided with a circular upper knife edge of circle and is surrounded by said upper knife edge; Wherein said cylindrical outer casing lower end is close to said truncated cone-shaped nozzle upper end, and matches on said cylindrical outer casing lower end and the said truncated cone-shaped nozzle, and said truncated cone-shaped nozzle lower port matches with said upper knife edge.Four following blades that are uniformly distributed with through cutter head of the present invention lower end are high-quality on arterial wall to puncture a cross aperture fast; Allow the terminal cylindrical outer casing of internal layer support to insert in the tremulous pulse with telescopic nozzle; And, dowel steel returns when removing when driving cutter head; Utilize the upper knife edge of cutter head upper end that arterial wall is excised fully, and the arterial wall that downcuts is recovered in the annular groove, avoid falling into tremulous pulse.In addition, after the terminal cylindrical outer casing of internal layer support inserts in the tremulous pulse with telescopic nozzle, keep the shape of perforate,, realize the tapping circumferential seal because the cylindrical outer casing size greater than the blade diameter, makes the tapping arterial wall tightly embrace the terminal cylindrical outer casing of internal layer support; After sleeve was withdrawn from, the Sealing shield ring that is provided with in the internal layer support restored and can stop the blood outflow of overflowing from tremulous pulse, plays the effect of sealing, and the realization zona vascuiosa is pressed and do not stopped the punching of defeated tremulous pulse down.
In technique scheme, preferred said sleeve outer wall is provided with downward first step, is provided with second step in the said internal layer support, and said first step matches with said second step and realizes sleeve and internal layer support location.
For the ease of assembling, internal layer support according to the invention preferably is fixedly connected through keyway with said outer support; Preferably be fixedly connected between said dowel steel lower end and cutter head through screw thread.
Card punch of the present invention has also further improved actuating device, and this actuating device comprises the dowel steel of suit in the sleeve, preferably is made up of epimere dowel steel and hypomere dowel steel two parts, and is fixedly connected through screw thread between two parts; The both sides of sleeve upper end respectively are hinged with a handle; Be hinged with support bar on the said handle; The other end of said support bar is hinged on epimere dowel steel top; The bottom of epimere dowel steel is provided with elastic switch, and the last seam groove that is provided with on the lower surface of elastic switch and the sleeve, the lower surface of seam groove matches and realizes the location of air exercise hole depth down; Said hypomere dowel steel is provided with round ring boss, is provided with the 3rd step in the said sleeve, is set with return spring between this round ring boss and telescopic the 3rd step, and the end of said hypomere dowel steel is fixedly connected through screw thread with said cutter head.Through the distance between last seam groove and the following seam groove, and elastic switch and the lower surface of said up and down seam groove cooperate and drive the location that cutter head that the hypomere dowel steel is connected realizes fighting each other hole depth, and it is more accurate to locate.In addition, preferably through being threaded, cutter head can freely be changed between cutter head and hypomere dowel steel lower end, realizes the hole of opening different size.The present invention also provides a kind of optimal way, and said truncated cone-shaped nozzle inwall is provided with annular baffle, returns when removing at cutter head, upper knife edge is just returned withdraw this annular baffle lower surface to, utilizes stopping of annular baffle, fully fast the excision arterial wall.
Can realize blood vessel not being carried out accomplishing the arteries perforate quickly and easily under the prerequisite of any clamp and blocking-up operation through card punch of the present invention; Simultaneously, the fast wireless that can carry out follow-up grafting vessel through card punch coincide, and can effectively improve the success rate of operation.In addition, through structure optimization, card punch of the present invention rational in infrastructure, simple to operate can be saved operating time greatly.
Description of drawings
Fig. 1 is the 3-D view of card punch of the present invention;
Fig. 2 is the structural representation after card punch of the present invention is installed;
Fig. 3 is the user mode figure of card punch of the present invention;
Fig. 4 is the partial enlarged drawing at A place among Fig. 2;
Fig. 5 is the structural representation of internal layer support;
Fig. 6 is the structural representation of outer support;
The card punch main body structure sketch map that Fig. 7 is made up of sleeve, handle, support bar, dowel steel and cutter head;
Fig. 8 is the telescopic structural representation that is provided with handle;
Fig. 9 is respectively the structural representation of the epimere dowel steel that is provided with elastic switch, hypomere dowel steel, cutter head.
Figure 10 is the enlarged drawing of cutter head among Fig. 9.
Among the figure: 1 cutter head, 2 sleeves, 3 epimere dowel steels, 4 hypomere dowel steels, 5 internal layer supports, 6 outer supports, 7 handles; 8 support bars, 11 times blades, 12 upper knife edges, 13 annular grooves, seam groove on 21,22 times seam grooves, 23 first steps; 24 nozzles, 25 the 3rd steps, 26 annular baffles, 31 elastic switch, 41 round ring boss, 42 return springs, 51 keys; 52 chucks, 53 annular grooves, 54 flexible sealing back-up rings, 55 cylindrical outer casings, 56 second steps, 61 keyways, 62 adapter sleeves.
The specific embodiment
Below in conjunction with accompanying drawing and specific embodiment structure of the present invention is further described as follows:
See also Fig. 1~Figure 10; A kind of arterial blood pipe racks is pressed and is not stopped defeated card punch, comprises the card punch body that is provided with sleeve 2, is set with dowel steel (epimere dowel steel 3 and hypomere dowel steel 4) in the said sleeve 2; Wherein hypomere dowel steel 4 lower ends are connected with cutter head 1; Fixed cover is connected to the auxiliary stand of being made up of internal layer support 5 and outer support 6 on the outer wall of sleeve 2, and wherein internal layer support 5 is provided with key 51, and the bottom is provided with by left and right sides tubular chuck 52 dimerous; Chuck 52 is not open configuration (like Fig. 5) when stressed; Two parts inside of this chuck 52 is equipped with annular groove 53, and flexible sealing back-up ring 54 is installed in the annular groove 53, and the end of said chuck is connected with cylindrical outer casing 55; When the sleeve 2 that wherein comprises when the card punch body inserted internal layer support 5, flexible sealing back-up ring 54 deformed and is close on the sleeve 2, and after the card punch body was withdrawn, flexible sealing back-up ring 54 restored to the original state, and seals.Outer support 6 is provided with keyway 61 (like Fig. 6), during use, cooperates two stands is fixed together (like Fig. 1-3) with key 51 through keyway 61, and outer support 6 bottoms are provided with adapter sleeve 62, and said chuck 52 is used to be fixedly clamped.In addition, the lower end of sleeve 2 is provided with the nozzle 24 that diameter reduces, is reverse frustoconic gradually; Hypomere dowel steel 4 is preferably through the cutter head 1 that is threaded, thereby can change cutter head, opens the hole of different size; Like Fig. 9~shown in Figure 10; The lower end of cutter head 1 is evenly equipped with four following blades 11; And it is conical that integral body is; Be used for the penetration rate of blood tube wall, the annular groove 13 that the upper end of cutter head 1 is provided with a circular upper knife edge 12 of circle and is surrounded by said upper knife edge 12 is respectively applied for the excision arterial wall and deposits the arterial wall that cuts down.The cylindrical outer casing 55 of internal layer support 5 is sleeved on nozzle 24 tops of next-door neighbour's sleeve 2; And match with said truncated cone-shaped nozzle 24 upper ends in said cylindrical outer casing 55 lower ends; Said truncated cone-shaped nozzle 24 lower port match with said upper knife edge 12; Upper knife edge 12 can be returned remove in the nozzle 24, and nozzle 24 is easy to be inserted in the hole that upper knife edge 12 opens; In addition, the size of cylindrical outer casing 55 external diameters according to the present invention the card punch actual size confirm that insert in the tremulous pulsies with sleeve 2 as long as guarantee internal layer support 5 terminal cylindrical outer casings 55, concrete grammar is well known in the art, repeats no more at this.Obviously, the diameter in the hole that the external diameter of cylindrical outer casing 55 is left greater than cutter head 1, the tapping blood vessel wall will tightly be embraced cylindrical outer casing 55, and then realize the circumferential seal of tapping; After arterial wall excises fully; The card punch body is withdrawn, and auxiliary stand is fixed, and flexible sealing back-up ring 54 restores to the original state; The blood that goes out from the tremulous pulse overflow can not overflow under the effect of flexible sealing back-up ring 54, and then accomplishes the zona vascuiosa pressure and do not stop the defeated punching of tremulous pulse down.
In addition, in the present embodiment, for ease of assembling, arterial blood pipe racks of the present invention is pressed and is not stopped the defeated preferred dowel steel of card punch and be divided into epimere dowel steel 3 and hypomere dowel steel 4, and between two sections through being threaded; The both sides of sleeve 2 upper ends respectively are hinged with a handle 7 through swivel pin; Be hinged with support bar 8 on the handle 7; The other end of this support bar 8 is movably connected in epimere dowel steel 3 tops through swivel pin; The bottom of this epimere dowel steel 3 is provided with elastic switch 31, and the upper surface of this elastic switch 31 is an inclined-plane, and lower surface is a horizontal plane (like Fig. 9); Said hypomere dowel steel 4 is provided with round ring boss 41, is provided with the 3rd step 25 in the said sleeve 2, and 25 on the 3rd step of this round ring boss 41 and sleeve 2 is set with return spring 42.Through the distance between last seam groove 21 and the following seam groove 22, and elastic switch 31 and the lower surface of said up and down seam groove (21,22) cooperate and drive the location that the cutter head 1 that is connected on the hypomere dowel steel 4 realizes fighting each other hole depth, realizes accurately locating.In addition; Preferably realize through the step of establishing on sleeve 2 and the internal layer support 5 location that sleeve 2 in the present embodiment on the card punch body and internal layer support are 5; Be specially: the outer wall of this sleeve 2 is provided with downward first step 23; In the internal layer support, be provided with second step 56, realize sleeve and internal layer support location on the second step 56 through first step 23 is stuck in.As shown in Figure 4, also adopted a kind of optimal way in the present embodiment, truncated cone-shaped nozzle 24 inwalls are provided with annular baffle 26; When cutter head is removed for 1 time; Make upper knife edge 12 just return the lower surface of withdrawing this annular baffle 26 to, utilize stopping of annular baffle 26, fully fast the excision arterial wall.
Through above-mentioned improvement, make the rational in infrastructure of card punch of the present invention, simple to operate, can save operating time greatly.
Foregoing description only schematically describes the preferred embodiments of the present invention; Be not limited to the above-mentioned specific embodiment; The present invention can also make the concrete conversion of a lot of forms; Like actuating device, also can adopt other actuating devices of prior art well known to those skilled in the art to realize stretching out of cutter heads and return and remove.
Concrete assembly and use below in conjunction with card punch of the present invention further describe the present invention:
1) card punch assembling process:
The bottom chuck 52 of internal layer support 5 is not in open configuration (please refer to Fig. 5) before using.At first flexible sealing back-up ring 54 is fixed in the annular groove 53 of internal layer support 5; With in the keyway 61 on the outer support 6 of key 51 insertions of internal layer support 5 (please refer to Fig. 5 and Fig. 6), the chuck 52 of internal layer support 5 remains closed under the clamping of outer support 6 and is tubular at this moment then; The card punch body is inserted in the internal layer support 5; Through the second step 56 on first step on the sleeve 2 23 and the internal layer support 5 the two is located, and then accomplish the assembling process of card punch, the sketch map after installing please refer to Fig. 2; At this moment; Cutter head 1 does not stretch out, and shown in the partial enlarged drawing of Fig. 4, the upper knife edge 12 of cutter head 1 is near the lower surface of annular baffle 26.
2) card punch is placed the user mode process:
Each parts assembles back (this moment, return spring 42 was in compressive state); Card punch is placed vertical direction; Press elastic switch 31, under the restoring force effect of return spring 42, elastic switch 31 moves downward along sleeve 2 inner surfacies; Hypomere dowel steel 4 drives cutter head 1 and moves downward, and cutter head 1 begins to stretch out; Meanwhile, the support bar 8 that is hinged on epimere dowel steel 3 drives handle 7 and opens, and when the lower surface of elastic switch 31 contacted with the lower surface of following seam groove 22, cutter head 1 stopped to stretch out, and handle 7 stops to open, and this moment, card punch was in user mode, please refer to Fig. 3.
3) punching reaches back the process of removing:
At first utilize four following blades 11 on the cutter head 1 on arterial wall, to puncture a cross osculum; After treating that whole cutter head 1 is cut in the tremulous pulse fully; Draw handle 7 (this moment, return spring 42 was compressed) in, elastic switch 31 moves upward along sleeve 2 inner surfacies, and handle 7 drives epimere dowel steel 3 through support bar 8 and moves upward with hypomere dowel steel 4; And then drive cutter head 1 and do back and remove motion, the circular upper knife edge 12 of cutter head 1 upper end begins to cut arterial wall; When the lower surface of elastic switch 31 contacts with last seam groove 21 lower surfaces; Stop to draw in handle 7, the upper knife edge 12 of cutter head 1 drives arterial wall and abuts against on the annular baffle 26, and with the quick and complete excision of arterial wall; The arterial wall of excision falls in the annular groove 13, and can not fall into tremulous pulse; Draw handle 7 in, when cutter head is removed for 1 time; Auxiliary stand needs radially to advance along tremulous pulse with the card punch body; Terminal cylindrical outer casing 55 until internal layer support 5 inserts in the tremulous pulse; Keep the shape of perforate, the tapping blood vessel wall will tightly be embraced cylindrical outer casing 55, and then realize the circumferential seal of tapping; After treating that arterial wall excises fully; The card punch body is withdrawn, and auxiliary stand is fixed, and the blood that goes out from the tremulous pulse overflow can not overflow under the effect of flexible sealing back-up ring 54; And then accomplish the zona vascuiosa pressure and do not stop the defeated punching of tremulous pulse down, it is ready to coincide for follow-up blood vessel is wireless.

Claims (5)

1. an arterial blood pipe racks is pressed and is not stopped defeated card punch, comprises being provided with telescopic card punch body, is set with dowel steel in the said sleeve; It is characterized in that; Be fixed with the auxiliary stand of being made up of internal layer support and outer support on the said telescopic outer wall, said internal layer support bottom is provided with by left and right sides tubular chuck dimerous, is equipped with annular groove in each part of said chuck; The flexible sealing back-up ring is housed in the said annular groove, and the end of said chuck is provided with cylindrical outer casing; Said internal layer support is connected with outer support outward, and said outer support bottom is provided with adapter sleeve, and said chuck is used to be fixedly clamped; Said telescopic lower end is provided with the nozzle of reverse frustoconic; Said dowel steel lower end is fixedly connected with cutter head, and the lower end of said cutter head is evenly equipped with four following blades, and integral body is conical, the annular groove that the upper end of said cutter head is provided with a circular upper knife edge of circle and is surrounded by said upper knife edge; Wherein said cylindrical outer casing lower end is close to said truncated cone-shaped nozzle upper end, and matches on said cylindrical outer casing lower end and the said truncated cone-shaped nozzle, and said truncated cone-shaped nozzle lower port matches with said upper knife edge.
2. arterial blood pipe racks according to claim 1 is pressed and is not stopped defeated card punch; It is characterized in that; Described dowel steel is made up of interconnective epimere dowel steel and hypomere dowel steel; The both sides of said sleeve upper end respectively are hinged with a handle, are hinged with support bar on the said handle, and the other end of said support bar is hinged on epimere dowel steel top; The bottom of epimere dowel steel is provided with elastic switch, and the last seam groove that is provided with on the lower surface of elastic switch and the sleeve, the lower surface of seam groove matches and realizes the location of air exercise hole depth down; Said hypomere dowel steel is provided with round ring boss, is provided with the 3rd step in the said sleeve, is set with return spring between said round ring boss and sleeve the 3rd step.
3. arterial blood pipe racks according to claim 1 is pressed and is not stopped defeated card punch, it is characterized in that said truncated cone-shaped nozzle inwall is provided with annular baffle.
4. arterial blood pipe racks according to claim 1 is pressed and is not stopped defeated card punch; It is characterized in that; Said telescopic outer wall is provided with downward first step, is provided with second step in the said internal layer support, and said first step matches with said second step and realizes sleeve and internal layer support location.
5. arterial blood pipe racks according to claim 1 is pressed and is not stopped defeated card punch, it is characterized in that, is fixedly connected through screw thread between described dowel steel lower end and cutter head.
CN2012100107974A 2012-01-13 2012-01-13 Hole puncher for pressure nonstop artery blood vessels Active CN102579087B (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107951515A (en) * 2016-10-14 2018-04-24 美联实业有限公司 Aortic punches
CN111419469A (en) * 2020-04-16 2020-07-17 中国医学科学院阜外医院 Cutting device for aortic surgery
CN112842476A (en) * 2020-12-31 2021-05-28 河南科技大学第一附属医院 Aorta blood vessel puncher capable of stably punching

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5893369A (en) * 1997-02-24 1999-04-13 Lemole; Gerald M. Procedure for bypassing an occlusion in a blood vessel
US20030065343A1 (en) * 2001-09-28 2003-04-03 Yencho Stephen A. Access port system for anastomosis
US20070043387A1 (en) * 1999-05-18 2007-02-22 Cardica, Inc. Surgical method for treating a vessel wall
CN201200451Y (en) * 2008-06-14 2009-03-04 包军胜 Perforator for middle and small arterial vessels
DE102009059078A1 (en) * 2009-12-18 2011-06-22 Geister Medizintechnik GmbH, 78532 Surgical punch for instrument set for intervention to blood vessel for establishing anastomosis e.g. end-to-side anastomosis, has punching tool with cutting edge, and punching surface with corner

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5893369A (en) * 1997-02-24 1999-04-13 Lemole; Gerald M. Procedure for bypassing an occlusion in a blood vessel
US20070043387A1 (en) * 1999-05-18 2007-02-22 Cardica, Inc. Surgical method for treating a vessel wall
US20030065343A1 (en) * 2001-09-28 2003-04-03 Yencho Stephen A. Access port system for anastomosis
CN201200451Y (en) * 2008-06-14 2009-03-04 包军胜 Perforator for middle and small arterial vessels
DE102009059078A1 (en) * 2009-12-18 2011-06-22 Geister Medizintechnik GmbH, 78532 Surgical punch for instrument set for intervention to blood vessel for establishing anastomosis e.g. end-to-side anastomosis, has punching tool with cutting edge, and punching surface with corner

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107951515A (en) * 2016-10-14 2018-04-24 美联实业有限公司 Aortic punches
CN111419469A (en) * 2020-04-16 2020-07-17 中国医学科学院阜外医院 Cutting device for aortic surgery
CN112842476A (en) * 2020-12-31 2021-05-28 河南科技大学第一附属医院 Aorta blood vessel puncher capable of stably punching
CN112842476B (en) * 2020-12-31 2022-03-22 河南科技大学第一附属医院 Aorta blood vessel puncher capable of stably punching

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