WO2015058325A1 - Suture puncturing apparatus, suture drawing-in apparatus, tissue piercing stapler and stapling method thereof - Google Patents

Suture puncturing apparatus, suture drawing-in apparatus, tissue piercing stapler and stapling method thereof Download PDF

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Publication number
WO2015058325A1
WO2015058325A1 PCT/CN2013/001407 CN2013001407W WO2015058325A1 WO 2015058325 A1 WO2015058325 A1 WO 2015058325A1 CN 2013001407 W CN2013001407 W CN 2013001407W WO 2015058325 A1 WO2015058325 A1 WO 2015058325A1
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WO
WIPO (PCT)
Prior art keywords
suture
puncture needle
puncture
assembly
head
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PCT/CN2013/001407
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French (fr)
Chinese (zh)
Inventor
孙思予
缪东林
Original Assignee
孙思予
江苏唯德康医疗科技有限公司
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Publication of WO2015058325A1 publication Critical patent/WO2015058325A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0491—Sewing machines for surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0466—Suture bridges
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0409—Instruments for applying suture anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0411—Instruments for removing suture anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0417—T-fasteners
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0464—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B2017/0496—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B2017/06052—Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle

Definitions

  • Stitching puncture device suture folding device, tissue perforating stapler and anastomosis method thereof
  • the invention relates to a suture puncture device, a suture gathering device, a tissue perforating stapler and an anastomosis method thereof, and belongs to the technical field of medical instruments.
  • the technical problem to be solved by the present invention is to overcome the defects of the prior art, and provide a suture puncture device which can conveniently and quickly puncture a suture into a peripheral tissue at a perforation position, thereby facilitating timely suturing of the perforated tissue.
  • a suture puncture device comprising a suture assembly, a puncture needle assembly, an outer tube and a ejector, the puncture needle assembly being axially movably inserted in the outer tube, the suture
  • the assembly comprises a suture fixing head and a suture, one end of the suture is fixed on the suture fixing head, and the other end is passed out of the outer tube.
  • the puncture needle assembly comprises a puncture needle and an outer tube of the puncture needle, and the end of the puncture needle outer tube and the puncture
  • the needle is fixedly connected, the suture fixing head is movably inserted in the puncture needle, and the ejector pin is axially movably inserted into the outer tube of the puncture needle.
  • the ejector pin is moved in the puncture direction, the front end and the suture of the ejector pin The distal end of the fixation head abuts to urge the suture fixation head to move out of the puncture needle in the puncture direction.
  • the suture assembly further includes a recovery line, one end of the recovery line is also fixed on the suture fixing head, and the other end is worn out. Outer tube.
  • the outer end of the outer tube is provided with an outer tube handle, and the end of the external tube of the puncture needle is provided with A puncture needle handle is provided with a protective buckle between the outer tube handle and the piercing needle handle.
  • the ejector end is provided with a ejector handle. Further, in order to facilitate the folding and fixing of the suture, the suture is provided with a movable suture clasp at the end of the suture fixing head.
  • a push tube having a through hole one end of the push tube is fixedly connected to the push head, and the other end is fixedly connected to the push handle, and the suture fixing head is movably mounted in the push head, when the suture assembly is gathered, The suture of the suture assembly passes through the through hole of the suture fastening head and the push tube in turn and then exits the push tube.
  • the perforated tissue is sutured conveniently and quickly under the endoscope.
  • the present invention also provides a tissue perforating stapler comprising the suture puncture device and the suture retracting device.
  • the tissue perforating stapler further includes a suture take-up device having a loop wire and a straight wire fixed together.
  • the invention also provides a method for tissue perforation and anastomosis, the steps of the method are as follows:
  • the puncture method of the single suture assembly is: finding the perforation position of the tissue under direct vision of the endoscope, under the guidance of the endoscope Inserting the puncture device into the body at a certain distance from the edge of the perforation of the tissue, withdrawing the outer tube backward to expose the puncture needle, passing the puncture needle through the tissue wall, pushing the plunger to push the suture fixing head until the suture is fixed The head passes through the tissue wall, and then the suture piercing device is completely evacuated from the suture assembly except the suture assembly, and the suture is connected to the surrounding tissue at the perforation position by the suture fixing head;
  • a method of tightening and securing a suture of a suture assembly is provided.
  • the suture of the suture assembly is tightened and secured by a suture-retracting device: suturing at least one suture assembly
  • the thread passes through the through hole of the suture fastening head and the push tube in turn, and then passes out of the push tube, and then withdraws the components other than the suture fixing head in the suture folding device, and tightens and fixes the suture by the suture fixing head.
  • the suture of the component is provided.
  • the tissue perforation position is found under the direct vision of the endoscope, and under the guidance of the endoscope, the suture puncture device is inserted into the body at a certain distance close to the edge of the perforation position of the tissue, and the outer tube is withdrawn backward to expose the puncture needle. Passing the puncture needle through the tissue wall, pushing the plunger to push the suture fixing head forward until the suture fixing head passes out of the tissue wall, and then completely withdrawing the suture puncture device from the suture assembly except the suture assembly.
  • the suture is connected to the peripheral tissue of the perforation position by the suture fixing head, so that the suture thread can be easily and quickly punctured into the peripheral tissue of the perforation position, and the suture assembly can be further penetrated according to the above-mentioned procedure, and the suture is sutured.
  • the suture of the wire assembly is tightened and fixed, and the peripheral tissue of the perforation position is closed by the traction of the suture to close the perforation position, thereby facilitating the timely suturing of the perforated tissue.
  • Figure 2 is an enlarged view of a portion A of Figure 1;
  • Figure 3 is a schematic structural view of the suturing and folding device of the present invention.
  • Figure 4 is an enlarged view of a portion B of Figure 3;
  • Figure 5 is a schematic view showing the structure of a suture assembly with a suture buckle
  • Figure 6 is an enlarged view of a portion C of Figure 5;
  • Figure 7 is a schematic structural view of a suture take-up device of the present invention.
  • Figure 8 is a flow chart of the method of tissue perforation and anastomosis of the present invention.
  • Figure 9 is a second flow chart of the method for perforating anastomosis of tissue of the present invention.
  • FIG. 10 is a third flowchart of the method for perforating anastomosis of tissue of the present invention.
  • FIG 11 is a fourth flowchart of the method of tissue perforation and anastomosis of the present invention.
  • Figure 12 is a fifth flowchart of the method for perforating anastomosis of tissue of the present invention.
  • Figure 13 is an enlarged view of a portion K of Figure 12;
  • Figure 14 is a sixth flowchart of the method for perforating anastomosis of tissue of the present invention.
  • 50 is a perforated tissue.
  • a suture puncture device comprising a suture assembly, a puncture needle assembly, an outer tube 3 and a plunger 10, the needle assembly being axially movably inserted into the outer tube 3
  • the suture assembly includes a suture fixing head 1 and a suture 6 having one end fixed to the suture fixing head 1 and the other end penetrating the outer tube 3, the puncture needle assembly including the puncture needle 2 and the puncture needle outer tube 4
  • the tip end of the outer tube 4 of the puncture needle is fixedly connected with the puncture needle 2, and the suture fixing head 1 is movably inserted into the puncture needle 2, and the plunger 10 is axially movably inserted into the outer tube 4 of the puncture needle.
  • the suture puncture device of this structure can easily and quickly puncture the suture into the peripheral tissue of the perforation position, thereby facilitating the suturing of the perforation tissue in time.
  • the suture assembly further includes a recovery line 7, and one end of the recovery line 7 is also fixed on the suture fixing head 1. The other end passes through the outer tube 3.
  • the outer end of the outer tube 3 is provided with an outer tube handle 5, and the end of the outer tube 4 of the puncture needle a puncture needle handle 9 is provided, .
  • the top end of the jack 10 is provided with a jack handle 1 1 .
  • the suture 6 is provided with an active suture clasp 16 at the end of the suture fixing head 1.
  • the suture fixing head 1 may be a straight short rod shape or an elastic circular shape or an elastic spring shape, but is not limited thereto.
  • a suture folding device for grasping a suture assembly in the suture puncture device that has been pierced into a tissue surrounding the perforation position includes a suture fastening head 15, a push head 12, and a push handle. 14 and a push tube 13 having a through hole, one end of the push tube 13 is fixedly connected to the push head 12, and the other end is fixedly connected to the push handle 14, and the suture fixing head 15 is movably mounted in the push head 12, when the stitching is closed
  • the suture 6 of the suture assembly passes through the through-hole of the suture fastening head 15 and the push tube 13 in turn and then exits the push tube 13.
  • a tissue perforating stapler comprising the suture puncture device and the suture gathering device. It can concentrate on the advantages of the puncture device and the suture folding device, and it is convenient and quick to suture the perforated tissue under the endoscope.
  • the tissue piercing stapler further includes a suture take-up having a loop wire 17 and a straight wire 18 fixed together.
  • the suture taker can be used to pass the suture assembly well through the suture folding device.
  • the suture puncture device uses the suture puncture device to puncture at least one suture assembly into the peripheral tissue at the perforation position: wherein the puncture method of the single suture assembly is: finding the perforation position of the tissue under direct vision of the endoscope, under the guidance of the endoscope
  • the suture device is inserted into the body at a certain distance from the edge of the tissue perforation position, and the outer tube 3 is withdrawn backward to expose the puncture needle 2, the puncture needle 2 is passed through the tissue wall, and the plunger 10 is pushed forward to eject the suture fixing head.
  • step c) the suture 6 of the suture assembly is tightened and secured by the suture folding device: the suture 6 of the suture assembly is sequentially passed through the through-hole of the suture fastening head 15 and the push tube 13 Pushing the tube 13 and then withdrawing the components other than the suture fixing head 15 in the suture folding device, and tightening and fixing the suture 6 of the suture assembly by the suture fixing head 15, the suture fixing head 15 sets can be Through the suture buckle 16, the suture fastening head 15 is firmly fixed, so that the perforated tissue is closed by the traction of the suture, of course, not limited thereto.
  • the recovery line 7 is retained in the human body. After the tissue is healed, if it is determined that the suture fixing head 1 is to be taken out as needed, the foreign body pliers are used to pull the recovery line 7, and the suture fixing head 1 is slowly withdrawn along the original path.

Abstract

Disclosed are a suture puncturing apparatus, a suture drawing-in apparatus, a tissue piercing stapler and a stapling method thereof. The suture puncturing apparatus comprises a suture thread assembly, a puncture needle assembly, an outer tube (3) and an ejector pin (10), wherein the puncture needle assembly can be axially inserted into the outer tube (3) in a movable manner; the suture thread assembly comprises a suture thread fixing head (1) and a suture thread (6), with one end of the suture thread (6) fixed on the suture thread fixing head (1), and the other end passing through and out of the outer tube (3); the puncture needle assembly comprises a puncture needle head (2) and a puncture needle outer tube (4), wherein the head end of the puncture needle outer tube (4) is fixedly connected to the puncture needle head (2); the suture thread fixing head (1) can be movably inserted into the puncture needle head (2); and the ejector pin (10) can be axially inserted into the puncture needle outer tube (4) in a movable manner. When the ejector pin (10) is pushed to move in the direction of puncturing, the front end of the ejector pin (10) abuts the tail end of the suture thread fixing head (1) so as to push the suture thread fixing head (1) to move in the direction of puncturing and release the puncture needle head (2). The suture puncturing apparatus can conveniently and quickly puncture a suture thread in tissue surrounding a piercing location, thereby aiding in suturing the pierced tissue in a timely manner.

Description

缝合穿刺装置、 缝合收拢装置、 组织穿孔吻合器及其吻合方法 技术领域  Stitching puncture device, suture folding device, tissue perforating stapler and anastomosis method thereof
本发明涉及一种缝合穿刺装置、 缝合收拢装置、 组织穿孔吻合器及其吻合方法， 属 于医疗器械技术领域。  The invention relates to a suture puncture device, a suture gathering device, a tissue perforating stapler and an anastomosis method thereof, and belongs to the technical field of medical instruments.
背景技术 Background technique
目前， 随着消化内镜下手术的普遍开展， 特别是在内镜下进行组织剥离、 组织切除 和组织间吻合、 切口造痿等手术的开展， 常常会遇到组织的意外穿孔或主动造口， 组织 穿孔后的补救特别重要， 但目前没有合适的器械能方便快速的在内镜下将缝合线穿剌进 组织穿孔位置处并将穿孔组织缝合。  At present, with the widespread development of digestive endoscopic surgery, especially under the endoscope, tissue dissection, tissue resection and inter-tissue anastomosis, incision and ostomy, often encounter unexpected perforation or active stoma Remediation of tissue perforation is particularly important, but there is currently no suitable instrument for facilitating rapid endoscopic insertion of the suture into the tissue perforation site and suturing the perforated tissue.
发明内容 Summary of the invention
本发明所要解决的技术问题是克服现有技术的缺陷， 提供一种缝合穿刺装置， 它能 够方便、 快捷地将缝合线穿刺进穿孔位置的周边组织， 从而有利于及时缝合穿孔组织。  The technical problem to be solved by the present invention is to overcome the defects of the prior art, and provide a suture puncture device which can conveniently and quickly puncture a suture into a peripheral tissue at a perforation position, thereby facilitating timely suturing of the perforated tissue.
为了解决上述技术问题， 本发明的技术方案是： 一种缝合穿刺装置， 它包括缝合线 组件、 穿刺针组件、 外管和顶杆， 穿刺针组件可轴向移动地插装在外管内， 缝合线组件 包括缝合线固定头和缝合线， 缝合线的一端固定在缝合线固定头上， 另一端穿出外管， 穿刺针组件包括穿刺针头和穿刺针外管， 穿刺针外管的头端与穿刺针头固定连接， 缝合 线固定头可移动地插装在穿刺针头内， 顶杆可轴向移动地插装在穿刺针外管内， 当推动 顶杆向穿刺方向移动时， 顶杆的前端与缝合线固定头的尾端相抵接以便推动缝合线固定 头向穿刺方向移动脱离出穿刺针头。  In order to solve the above technical problem, the technical solution of the present invention is: a suture puncture device comprising a suture assembly, a puncture needle assembly, an outer tube and a ejector, the puncture needle assembly being axially movably inserted in the outer tube, the suture The assembly comprises a suture fixing head and a suture, one end of the suture is fixed on the suture fixing head, and the other end is passed out of the outer tube. The puncture needle assembly comprises a puncture needle and an outer tube of the puncture needle, and the end of the puncture needle outer tube and the puncture The needle is fixedly connected, the suture fixing head is movably inserted in the puncture needle, and the ejector pin is axially movably inserted into the outer tube of the puncture needle. When the ejector pin is moved in the puncture direction, the front end and the suture of the ejector pin The distal end of the fixation head abuts to urge the suture fixation head to move out of the puncture needle in the puncture direction.
进一歩为了能够在穿孔组织愈合后及时回收缝合线组件， 避免发生手术后遗症的问 题， 缝合线组件还包括回收线， 所述的回收线的一端也固定在缝合线固定头上， 另一端 穿出外管。  In order to be able to recover the suture assembly in time after the perforated tissue is healed, to avoid the problem of surgical sequelae, the suture assembly further includes a recovery line, one end of the recovery line is also fixed on the suture fixing head, and the other end is worn out. Outer tube.
进一步为了防止在手术过程中 ώ于穿刺针组件的误移动， 从而不利于手术进行的问 题， 所述的外管的尾端设置有外管手柄， 所述的穿刺针外管的尾端设置有穿刺针手柄， 外管手柄和穿剌针手柄之间设置有保护扣。  Further, in order to prevent the erroneous movement of the puncture needle assembly during the operation, which is disadvantageous for the operation, the outer end of the outer tube is provided with an outer tube handle, and the end of the external tube of the puncture needle is provided with A puncture needle handle is provided with a protective buckle between the outer tube handle and the piercing needle handle.
进一歩为了方便操作者能够很好地操作顶杆， 所述的顶杆的尾端设置有顶杆手柄。 进一歩为了方便缝合线的收拢固定， 所述的缝合线上在连接缝合线固定头的端部设 置有活动的缝合线卡扣。  Further, in order to facilitate the operator to operate the ram well, the ejector end is provided with a ejector handle. Further, in order to facilitate the folding and fixing of the suture, the suture is provided with a movable suture clasp at the end of the suture fixing head.
为了用于很好地收拢已穿刺进穿孔位置周边组织的上述该缝合穿刺装置中的缝合 一 ， Used for well stitching the suture device described above in the suture device that has been pierced into the perforation site One,
和具有通孔的推送管， 推送管的一端与推送头固定连接， 另一端与推送手柄固定连接， 所述的缝合线卡固头可移动地安装在推送头内， 当收拢缝合线组件时， 缝合线组件的缝 合线依次穿过缝合线卡固头和推送管的通孔后穿出推送管。 And a push tube having a through hole, one end of the push tube is fixedly connected to the push head, and the other end is fixedly connected to the push handle, and the suture fixing head is movably mounted in the push head, when the suture assembly is gathered, The suture of the suture assembly passes through the through hole of the suture fastening head and the push tube in turn and then exits the push tube.
为了能够集中缝合穿刺装置和缝合收拢装置的优势， 方便并快捷地在内镜下将穿孔 组织缝合， 本发明还提供了一种组织穿孔吻合器， 它包括该缝合穿刺装置以及该缝合收 拢装置。  In order to be able to concentrate the suture device and the suture folding device, the perforated tissue is sutured conveniently and quickly under the endoscope. The present invention also provides a tissue perforating stapler comprising the suture puncture device and the suture retracting device.
进一歩为了能够将缝合线组件很好地穿过缝合收拢装置， 组织穿孔吻合器还包括缝 合线取出器， 该缝合线取出器具有固定在一起的环形丝和直丝。  Further, in order to be able to pass the suture assembly well through the suture folding device, the tissue perforating stapler further includes a suture take-up device having a loop wire and a straight wire fixed together.
本发明还提供了一种组织穿孔吻合方法， 该方法的歩骤如下：  The invention also provides a method for tissue perforation and anastomosis, the steps of the method are as follows:
a) 提供一缝合穿刺装置；  a) providing a suture puncture device;
b )采用该缝合穿刺装置将至少一根缝合线组件穿刺进穿孔位置的周边组织： 其中， 单根缝合线组件的穿刺方法为： 在内镜直视下找到组织穿孔位置， 在内镜引导下， 将缝 合穿刺装置进入体内靠近组织穿孔位置边缘的一定距离， 向后撤回外管使其露出穿刺针 头， 将穿刺针头穿过组织壁， 向前推动顶杆顶出缝合线固定头直至缝合线固定头穿出组 织壁， 再将缝合穿刺装置除缝合线组件外的其他部件完全撤离出缝合线组件， 此时缝合 线通过缝合线固定头与穿孔位置的周边组织相连；  b) using the suture puncture device to puncture at least one suture assembly into the peripheral tissue at the perforation position: wherein the puncture method of the single suture assembly is: finding the perforation position of the tissue under direct vision of the endoscope, under the guidance of the endoscope Inserting the puncture device into the body at a certain distance from the edge of the perforation of the tissue, withdrawing the outer tube backward to expose the puncture needle, passing the puncture needle through the tissue wall, pushing the plunger to push the suture fixing head until the suture is fixed The head passes through the tissue wall, and then the suture piercing device is completely evacuated from the suture assembly except the suture assembly, and the suture is connected to the surrounding tissue at the perforation position by the suture fixing head;
c ) 将缝合线组件的缝合线收紧并固定， 通过缝合线的牵引将穿孔位置的周边组织 合拢， 使穿孔位置封闭。  c) tighten and fix the suture of the suture assembly, and close the peripheral tissue at the perforation position by the traction of the suture to close the perforation position.
进一歩提供了一种收紧并固定缝合线组件的缝合线的方法， 在歩骤 c ) 中， 通过缝 合收拢装置收紧并固定缝合线组件的缝合线： 将至少一根缝合线组件的缝合线依次穿过 缝合线卡固头和推送管的通孔后穿出推送管， 然后撤离缝合收拢装置中除缝合线卡固头 以外的其他部件， 通过缝合线卡固头收紧并固定缝合线组件的缝合线。  Further, a method of tightening and securing a suture of a suture assembly is provided. In step c), the suture of the suture assembly is tightened and secured by a suture-retracting device: suturing at least one suture assembly The thread passes through the through hole of the suture fastening head and the push tube in turn, and then passes out of the push tube, and then withdraws the components other than the suture fixing head in the suture folding device, and tightens and fixes the suture by the suture fixing head. The suture of the component.
采用了上述技术方案后， 在内镜直视下找到组织穿孔位置， 在内镜引导下， 将缝合 穿刺装置进入体内靠近组织穿孔位置边缘的一定距离， 向后撤回外管使其露出穿刺针 头， 将穿刺针头穿过组织壁， 向前推动顶杆顶出缝合线固定头直至缝合线固定头穿出组 织壁， 再将缝合穿刺装置除缝合线组件外的其他部件完全撤离出缝合线组件， 此时缝合 线通过缝合线固定头与穿孔位置的周边组织相连， 这样就方便、 快捷地将缝合线穿刺进 穿孔位置的周边组织， 可以再按照上述歩骤再穿入几根缝合线组件， 将缝合线组件的缝 合线收紧并固定， 通过缝合线的牵引将穿孔位置的周边组织合拢， 使穿孔位置封闭， 从 而有利于及时缝合穿孔组织。  After adopting the above technical solution, the tissue perforation position is found under the direct vision of the endoscope, and under the guidance of the endoscope, the suture puncture device is inserted into the body at a certain distance close to the edge of the perforation position of the tissue, and the outer tube is withdrawn backward to expose the puncture needle. Passing the puncture needle through the tissue wall, pushing the plunger to push the suture fixing head forward until the suture fixing head passes out of the tissue wall, and then completely withdrawing the suture puncture device from the suture assembly except the suture assembly. The suture is connected to the peripheral tissue of the perforation position by the suture fixing head, so that the suture thread can be easily and quickly punctured into the peripheral tissue of the perforation position, and the suture assembly can be further penetrated according to the above-mentioned procedure, and the suture is sutured. The suture of the wire assembly is tightened and fixed, and the peripheral tissue of the perforation position is closed by the traction of the suture to close the perforation position, thereby facilitating the timely suturing of the perforated tissue.
附图说明 P ； DRAWINGS P ;
图 2为图 1的 A部放大图；  Figure 2 is an enlarged view of a portion A of Figure 1;
图 3为本发明的缝合收拢装置的结构示意图；  Figure 3 is a schematic structural view of the suturing and folding device of the present invention;
图 4为图 3的 B部放大图；  Figure 4 is an enlarged view of a portion B of Figure 3;
图 5为带缝合线卡扣的缝合线组件的结构示意图；  Figure 5 is a schematic view showing the structure of a suture assembly with a suture buckle;
图 6为图 5的 C部放大图；  Figure 6 is an enlarged view of a portion C of Figure 5;
图 7为本发明的缝合线取出器的结构示意图；  Figure 7 is a schematic structural view of a suture take-up device of the present invention;
图 8为本发明的组织穿孔吻合方法的流程图之一；  Figure 8 is a flow chart of the method of tissue perforation and anastomosis of the present invention;
图 9为本发明的组织穿孔吻合方法的流程图之二；  Figure 9 is a second flow chart of the method for perforating anastomosis of tissue of the present invention;
图 10为本发明的组织穿孔吻合方法的流程图之三；  Figure 10 is a third flowchart of the method for perforating anastomosis of tissue of the present invention;
图 11为本发明的组织穿孔吻合方法的流程图之四；  Figure 11 is a fourth flowchart of the method of tissue perforation and anastomosis of the present invention;
图 12为本发明的组织穿孔吻合方法的流程图之五；  Figure 12 is a fifth flowchart of the method for perforating anastomosis of tissue of the present invention;
图 13为图 12的 K部放大图；  Figure 13 is an enlarged view of a portion K of Figure 12;
图 14为本发明的组织穿孔吻合方法的流程图之六；  Figure 14 is a sixth flowchart of the method for perforating anastomosis of tissue of the present invention;
其中： 50为穿孔组织。  Where: 50 is a perforated tissue.
具体实施方式 detailed description
为了使本发明的内容更容易被清楚地理解， 下面根据具体实施例并结合附图， 对本 发明作进一歩详细的说明。  In order to make the content of the present invention more comprehensible, the present invention will be described in detail below with reference to the accompanying drawings.
如图 1、 2、 5、 6所示， 一种缝合穿刺装置， 它包括缝合线组件、 穿刺针组件、 外 管 3和顶杆 10, 穿刺针组件可轴向移动地插装在外管 3内，缝合线组件包括缝合线固定 头 1和缝合线 6， 缝合线 6的一端固定在缝合线固定头 1上， 另一端穿出外管 3， 穿刺 针组件包括穿刺针头 2和穿刺针外管 4， 穿刺针外管 4的头端与穿刺针头 2固定连接， 缝合线固定头 1可移动地插装在穿刺针头 2内， 顶杆 10可轴向移动地插装在穿刺针外 管 4内， 当推动顶杆 10向穿刺方向移动时， 顶杆 10的前端与缝合线固定头 1的尾端相 抵接以便推动缝合线固定头 1 向穿刺方向移动脱离出穿刺针头 2。 这种结构的缝合穿刺 装置能够很方便、 快捷地将缝合线穿刺进穿孔位置的周边组织， 从而有利于及时缝合穿 孔组织。  As shown in Figures 1, 2, 5 and 6, a suture puncture device comprising a suture assembly, a puncture needle assembly, an outer tube 3 and a plunger 10, the needle assembly being axially movably inserted into the outer tube 3 The suture assembly includes a suture fixing head 1 and a suture 6 having one end fixed to the suture fixing head 1 and the other end penetrating the outer tube 3, the puncture needle assembly including the puncture needle 2 and the puncture needle outer tube 4 The tip end of the outer tube 4 of the puncture needle is fixedly connected with the puncture needle 2, and the suture fixing head 1 is movably inserted into the puncture needle 2, and the plunger 10 is axially movably inserted into the outer tube 4 of the puncture needle. When the push rod 10 is moved in the puncture direction, the front end of the jack 10 abuts against the tail end of the suture fixing head 1 to push the suture fixing head 1 to move out of the puncture needle 2 in the puncture direction. The suture puncture device of this structure can easily and quickly puncture the suture into the peripheral tissue of the perforation position, thereby facilitating the suturing of the perforation tissue in time.
为了能够在穿孔组织愈合后及时回收缝合线组件， 避免发生手术后遗症的问题， 如 图 5所示， 缝合线组件还包括回收线 7， 回收线 7的一端也固定在缝合线固定头 1上， 另一端穿出外管 3。  In order to recover the suture assembly in time after the perforated tissue is healed, to avoid the problem of surgical sequelae, as shown in FIG. 5, the suture assembly further includes a recovery line 7, and one end of the recovery line 7 is also fixed on the suture fixing head 1. The other end passes through the outer tube 3.
为了防止在手术过程中 ώ于穿刺针组件的误移动， 从而不利于手术进行的问题， 如 图 1所示， 外管 3的尾端设置有外管手柄 5， 穿刺针外管 4的尾端设置有穿刺针手柄 9， 。 In order to prevent the erroneous movement of the puncture needle assembly during the operation, which is disadvantageous to the operation of the operation, as shown in Fig. 1, the outer end of the outer tube 3 is provided with an outer tube handle 5, and the end of the outer tube 4 of the puncture needle a puncture needle handle 9 is provided, .
为了方便操作者能够很好地操作顶杆 10， 如图 1所示， 顶杆 10的尾端设置有顶杆 手柄 1 1。  In order to facilitate the operator to operate the jack 10 well, as shown in Fig. 1, the top end of the jack 10 is provided with a jack handle 1 1 .
为了方便缝合线 6的收拢固定， 缝合线 6上在连接缝合线固定头 1的端部设置有活 动的缝合线卡扣 16。  In order to facilitate the folding and fixing of the suture 6, the suture 6 is provided with an active suture clasp 16 at the end of the suture fixing head 1.
缝合线固定头 1可以为直型短棒形或弹性圆形或弹性弹簧形， 但不限于此。  The suture fixing head 1 may be a straight short rod shape or an elastic circular shape or an elastic spring shape, but is not limited thereto.
如图 3、 4所示， 一种缝合收拢装置， 用于收拢已穿刺进穿孔位置周边组织的该缝 合穿刺装置中的缝合线组件， 它包括缝合线卡固头 15、 推送头 12、 推送手柄 14和具有 通孔的推送管 13， 推送管 13的一端与推送头 12固定连接， 另一端与推送手柄 14固定 连接， 缝合线卡固头 15可移动地安装在推送头 12内， 当收拢缝合线组件时， 缝合线组 件的缝合线 6依次穿过缝合线卡固头 15和推送管 13的通孔后穿出推送管 13。  As shown in Figures 3 and 4, a suture folding device for grasping a suture assembly in the suture puncture device that has been pierced into a tissue surrounding the perforation position includes a suture fastening head 15, a push head 12, and a push handle. 14 and a push tube 13 having a through hole, one end of the push tube 13 is fixedly connected to the push head 12, and the other end is fixedly connected to the push handle 14, and the suture fixing head 15 is movably mounted in the push head 12, when the stitching is closed In the case of the wire assembly, the suture 6 of the suture assembly passes through the through-hole of the suture fastening head 15 and the push tube 13 in turn and then exits the push tube 13.
一种组织穿孔吻合器， 它包括该缝合穿刺装置以及该缝合收拢装置。 它能够集中缝 合穿刺装置和缝合收拢装置的优势， 方便并快捷地在内镜下将穿孔组织缝合。  A tissue perforating stapler comprising the suture puncture device and the suture gathering device. It can concentrate on the advantages of the puncture device and the suture folding device, and it is convenient and quick to suture the perforated tissue under the endoscope.
如图 7所示， 组织穿孔吻合器还包括缝合线取出器， 该缝合线取出器具有固定在一 起的环形丝 17和直丝 18。 可以利用该缝合线取出器将缝合线组件很好地穿过缝合收拢 装置。  As shown in Fig. 7, the tissue piercing stapler further includes a suture take-up having a loop wire 17 and a straight wire 18 fixed together. The suture taker can be used to pass the suture assembly well through the suture folding device.
如图 8-14所示， 一种组织穿孔吻合方法， 该方法的步骤如下：  As shown in Figure 8-14, a method of tissue perforation and anastomosis, the steps of the method are as follows:
a) 提供一缝合穿刺装置；  a) providing a suture puncture device;
b )采用该缝合穿刺装置将至少一根缝合线组件穿刺进穿孔位置的周边组织： 其中， 单根缝合线组件的穿刺方法为： 在内镜直视下找到组织穿孔位置， 在内镜引导下， 将缝 合穿刺装置进入体内靠近组织穿孔位置边缘的一定距离， 向后撤回外管 3使其露出穿刺 针头 2，将穿刺针头 2穿过组织壁， 向前推动顶杆 10顶出缝合线固定头 1直至缝合线固 定头 1穿出组织壁， 再将缝合穿刺装置除缝合线组件外的其他部件完全撤离出缝合线组 件， 此时缝合线 6通过缝合线固定头 1与穿孔位置的周边组织相连；  b) using the suture puncture device to puncture at least one suture assembly into the peripheral tissue at the perforation position: wherein the puncture method of the single suture assembly is: finding the perforation position of the tissue under direct vision of the endoscope, under the guidance of the endoscope The suture device is inserted into the body at a certain distance from the edge of the tissue perforation position, and the outer tube 3 is withdrawn backward to expose the puncture needle 2, the puncture needle 2 is passed through the tissue wall, and the plunger 10 is pushed forward to eject the suture fixing head. 1 until the suture fixing head 1 passes out of the tissue wall, and then the suture puncture device is completely evacuated from the suture assembly except the suture assembly, at which time the suture 6 is connected to the peripheral tissue of the perforation position by the suture fixing head 1. ;
c ) 将缝合线组件的缝合线 6收紧并固定， 通过缝合线 6的牵引将穿孔位置的周边 组织合拢， 使穿孔位置封闭。  c) The suture 6 of the suture assembly is tightened and fixed, and the peripheral tissue at the perforation position is closed by the traction of the suture 6 to close the perforation position.
在歩骤 c ) 中， 通过缝合收拢装置收紧并固定缝合线组件的缝合线 6: 将缝合线组 件的缝合线 6依次穿过缝合线卡固头 15和推送管 13的通孔后穿出推送管 13，然后撤离 缝合收拢装置中除缝合线卡固头 15以外的其他部件， 通过缝合线卡固头 15收紧并固定 缝合线组件的缝合线 6 , 可以将缝合线卡固头 15套过缝合线卡扣 16， 将缝合线卡固头 15牢牢固定住， 这样就通过缝合线的牵引将穿孔组织合拢住， 当然不限于此。  In step c), the suture 6 of the suture assembly is tightened and secured by the suture folding device: the suture 6 of the suture assembly is sequentially passed through the through-hole of the suture fastening head 15 and the push tube 13 Pushing the tube 13 and then withdrawing the components other than the suture fixing head 15 in the suture folding device, and tightening and fixing the suture 6 of the suture assembly by the suture fixing head 15, the suture fixing head 15 sets can be Through the suture buckle 16, the suture fastening head 15 is firmly fixed, so that the perforated tissue is closed by the traction of the suture, of course, not limited thereto.
后续手术过程可以用同样的方法根据需要继续缝合。 。 Subsequent surgical procedures can be continued in the same way as needed. .
将回收线 7保留在人体内， 待组织愈合后， 根据需要确定要取出体内的缝合线固定 头 1时， 用异物钳拉动回收线 7， 慢慢将缝合线固定头 1沿原路撤出。  The recovery line 7 is retained in the human body. After the tissue is healed, if it is determined that the suture fixing head 1 is to be taken out as needed, the foreign body pliers are used to pull the recovery line 7, and the suture fixing head 1 is slowly withdrawn along the original path.
以上所述的具体实施例， 对本发明解决的技术问题、 技术方案和有益效果进行了进 一歩详细说明， 所应理解的是， 以上所述仅为本发明的具体实施例而己， 并不用于限制 本发明， 凡在本发明的精神和原则之内， 所做的任何修改、 等同替换、 改进等， 均应包 含在本发明的保护范围之内。  The specific embodiments described above provide a detailed description of the technical problems, technical solutions and beneficial effects of the present invention. It should be understood that the above description is only specific embodiments of the present invention and is not used for All modifications, equivalents, improvements, etc., made within the spirit and scope of the invention are intended to be included within the scope of the invention.

Claims

1、 一种缝合穿刺装置， 其特征在于： 它包括缝合线组件、 穿刺针组件、 外管 （3) 和顶杆 （10)， 穿刺针组件可轴向移动地插装在外管 （3) 内， 缝合线组件包括缝合线固 定头 （1) 和缝合线 （6)， 缝合线 （6) 的一端固定在缝合线固定头 （1) 上， 另一端穿 出外管 （3)， 穿刺针组件包括穿刺针头 （2) 和穿刺针外管 （4)， 穿刺针外管 （4) 的头 端与穿刺针头 （2) 固定连接， 缝合线固定头 （1) 可移动地插装在穿刺针头 （2) 内， 顶杆 （10) 可轴向移动地插装在穿刺针外管 （4) 内， 当推动顶杆 （10) 向穿刺方向移 动时， 顶杆（10)的前端与缝合线固定头（1)的尾端相抵接以便推动缝合线固定头（1) 向穿刺方向移动脱离出穿刺针头 （2)。 1. A suture and puncture device, characterized in that: it includes a suture assembly, a puncture needle assembly, an outer tube (3) and a push rod (10), and the puncture needle assembly is axially movably inserted into the outer tube (3) , The suture assembly includes a suture fixing head (1) and a suture (6). One end of the suture (6) is fixed on the suture fixing head (1), and the other end passes through the outer tube (3). The puncture needle assembly It includes a puncture needle (2) and a puncture needle outer tube (4). The head end of the puncture needle outer tube (4) is fixedly connected to the puncture needle (2). The suture fixing head (1) is movably inserted into the puncture needle (4). 2), the ejector rod (10) is axially movably inserted into the puncture needle outer tube (4). When the ejector rod (10) is pushed to move in the puncture direction, the front end of the ejector rod (10) is fixed to the suture. The tail end of the head (1) is in contact with each other so as to push the suture fixing head (1) to move in the puncture direction and disengage from the puncture needle (2).
2、 根据权利要求 1 所述的缝合穿刺装置， 其特征在于： 所述的缝合线组件还包括 回收线 （7)， 所述的回收线 （7) 的一端也固定在缝合线固定头 （1) 上， 另一端穿出外 管 （3)。 2. The suture puncture device according to claim 1, characterized in that: the suture assembly further includes a recovery line (7), and one end of the recovery line (7) is also fixed on the suture fixing head (1 ), and the other end passes through the outer tube (3).
3、 根据权利要求 1所述的缝合穿刺装置， 其特征在于： 所述的外管 （3) 的尾端设 置有外管手柄 （5)， 所述的穿刺针外管 （4) 的尾端设置有穿刺针手柄 （9)， 外管手柄 3. The suture puncture device according to claim 1, characterized in that: the tail end of the outer tube (3) is provided with an outer tube handle (5), and the tail end of the outer tube (4) of the puncture needle Provided with a puncture needle handle (9) and an outer tube handle
(5) 和穿刺针手柄 (9) 之间设置有保护扣 （8)。 There is a protective buckle (8) between (5) and the puncture needle handle (9).
4、 根据权利要求 1 所述的缝合穿刺装置， 其特征在于： 所述的顶杆 （10) 的尾端 设置有顶杆手柄 （11)。 4. The suture and puncture device according to claim 1, characterized in that: the tail end of the ejector rod (10) is provided with an ejector rod handle (11).
5、 根据权利要求 1所述的缝合穿刺装置， 其特征在于： 所述的缝合线 （6) 上在连 接缝合线固定头 （1) 的端部设置有活动的缝合线卡扣 （16)。 5. The suture puncture device according to claim 1, characterized in that: the suture (6) is provided with a movable suture buckle (16) at the end connected to the suture fixing head (1).
6、 一种缝合收拢装置， 用于收拢己穿刺进穿孔位置周边组织的如权利要求 1 至 5 中任一项所述的缝合穿刺装置中的缝合线组件，其特征在于：它包括缝合线卡固头（15)、 推送头 （12)、 推送手柄 （14) 和具有通孔的推送管 （13)， 推送管 （13) 的一端与推送 头 （12) 固定连接， 另一端与推送手柄 （14) 固定连接， 所述的缝合线卡固头 （15) 可 移动地安装在推送头 （12) 内， 当收拢缝合线组件时， 缝合线组件的缝合线 （6) 依次 穿过缝合线卡固头 （15) 和推送管 （13) 的通孔后穿出推送管 （13)。 6. A suture gathering device used to gather the suture assembly in the suture puncture device according to any one of claims 1 to 5 that has been punctured into the surrounding tissue of the perforation site, characterized in that: it includes a suture card The solid head (15), the push head (12), the push handle (14) and the push pipe (13) with a through hole. One end of the push pipe (13) is fixedly connected to the push head (12), and the other end is connected to the push handle (13). 14) Fixed connection, the suture clamping head (15) is movably installed in the push head (12), when the suture assembly is gathered, the sutures (6) of the suture assembly pass through the suture clamp in turn After inserting the through hole of the fixing head (15) and the push pipe (13), pass out the push pipe (13).
7、 一种组织穿孔吻合器， 其特征在于： 它包括如权利要求 1至 5中任一项所述的 缝合穿刺装置以及如权利要求 6所述的缝合收拢装置。 7. A tissue perforation stapler, characterized in that: it includes the suture puncture device according to any one of claims 1 to 5 and the suture gathering device according to claim 6.
8、 根据权利要求 7所述的组织穿孔吻合器， 其特征在于： 它还包括缝合线取出器， 该缝合线取出器具有固定在一起的环形丝 （17) 和直丝 （18)。 8. The tissue perforation stapler according to claim 7, characterized in that: it also includes a suture extractor having annular wires (17) and straight wires (18) fixed together.
9、 一种组织穿孔吻合方法， 其特征在于该方法的歩骤如下： 9. A tissue perforation anastomosis method, characterized in that the steps of the method are as follows:
a) 提供一如权利要求 1至 5任一项所述的缝合穿刺装置； wo 2 8^ &合穿刺装置将至少一根缝合线组件穿刺进穿孔位^！^^ ^ 中，' 单根缝合线组件的穿刺方法为： 在内镜直视下找到组织穿孔位置， 在内镜引导下， 将缝 合穿刺装置进入体内靠近组织穿孔位置边缘的一定距离， 向后撤回外管 （3) 使其露出 穿刺针头 （2)， 将穿刺针头 （2) 穿过组织壁， 向前推动顶杆 （10) 顶出缝合线固定头 (1) 直至缝合线固定头 （1) 穿出组织壁， 再将缝合穿刺装置除缝合线组件外的其他部 件完全撤离出缝合线组件， 此时缝合线 （6) 通过缝合线固定头 （1) 与穿孔位置的周边 组织相连； a) Provide a suture puncture device as described in any one of claims 1 to 5; wo 2 8 ^&Combined puncture device punctures at least one suture component into the puncture site^! ^^ ^, 'The puncture method of a single suture component is: Find the tissue perforation position under direct vision of the endoscope, and under the guidance of the endoscope, insert the suture puncture device into the body at a certain distance close to the edge of the tissue perforation position, and move backward Withdraw the outer tube (3) to expose the puncture needle (2), pass the puncture needle (2) through the tissue wall, push the push rod (10) forward, and push out the suture fixing head (1) until the suture fixing head (1 ) penetrate the tissue wall, and then completely evacuate the other components of the suture puncture device except the suture assembly from the suture assembly. At this time, the suture (6) is connected to the surrounding tissue at the perforation position through the suture fixing head (1);
c) 将缝合线组件的缝合线 （6) 收紧并固定， 通过缝合线 （6) 的牵引将穿孔位置 的周边组织合拢， 使穿孔位置封闭。 c) Tighten and fix the suture thread (6) of the suture thread component, and use the traction of the suture thread (6) to close the surrounding tissue at the perforation site to seal the perforation site.
10、 根据权利要求 9所述的组织穿孔吻合方法， 其特征在于： 在歩骤 c) 中， 通过 如权利要求 6所述的缝合收拢装置收紧并固定缝合线组件的缝合线（6): 将缝合线组件 的缝合线（6)依次穿过缝合线卡固头（15)和推送管（13) 的通孔后穿出推送管（13)， 然后撤离缝合收拢装置中除缝合线卡固头（15)以外的其他部件，通过缝合线卡固头（15) 收紧并固定缝合线组件的缝合线 （6)。 10. The tissue perforation anastomosis method according to claim 9, characterized in that: in step c), the suture thread (6) of the suture thread assembly is tightened and fixed by the suture tightening device according to claim 6: Pass the suture thread (6) of the suture thread assembly through the through holes of the suture thread clamping head (15) and the push tube (13) in sequence, then pass through the push tube (13), and then evacuate the suture gathering device to remove the suture thread clamp. Other parts other than the head (15), tighten and fix the suture (6) of the suture assembly through the suture clamping head (15).
PCT/CN2013/001407 2013-10-23 2013-11-18 Suture puncturing apparatus, suture drawing-in apparatus, tissue piercing stapler and stapling method thereof WO2015058325A1 (en)

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