阅读说明：本技术 一种内镜下全可视化纤维环缝合器 (Full-visual fibrous ring stitching instrument under endoscope ) 是由 刘光旺 高娟 于 2021-09-17 设计创作，主要内容包括：本发明公开了一种内镜下全可视化纤维环缝合器,包括缝合线和引导装置,所属缝合线包括线体和线栓；所述线体用于牵拉收紧纤维环破口和镜下打结；所述线栓连接于线体的末端,线栓在穿刺针穿透纤维环后留置于纤维环内部；所述线栓为表面带有倒刺的硬质可吸收线棒,受到线体拉力作用时,倒刺自动散开,宽度或最大外径大于原穿刺点直径的部件,使线体收拉时线栓不会从原穿刺点拔出；所述引导装置包括穿刺用的金属导管,用于引导缝合线的线栓进入纤维环内部；穿刺用于推送线栓的金属导管中空,末端为穿刺端,呈尖锐弧形；所述穿刺端尖锐开口,用于引导线栓穿入纤维环内部。该缝合器细长,可在内镜下全可视化操作,结构简洁,设计巧妙,使用方便。(The invention discloses a full-visual fibrous ring stitching instrument under an endoscope, which comprises a stitching line and a guiding device, wherein the stitching line comprises a line body and a line bolt; the wire body is used for drawing and tightening the fiber ring-cut and the under-lens knot; the thread plug is connected to the tail end of the thread body and is left in the fiber ring after the puncture needle penetrates through the fiber ring; the wire bolt is a hard absorbable wire rod with barbs on the surface, when the wire bolt is subjected to the tensile force of the wire body, the barbs automatically scatter, and the width or the maximum outer diameter of the wire bolt is larger than the diameter of the original puncture point, so that the wire bolt cannot be pulled out of the original puncture point when the wire body is pulled; the guiding device comprises a metal catheter for puncture, which is used for guiding the thread plug of the suture thread into the interior of the fibrous ring; the metal conduit for pushing the wire bolt is hollow when punctured, and the tail end of the metal conduit is a puncturing end and is in a sharp arc shape; the puncture end is provided with a sharp opening and is used for guiding the wire bolt to penetrate into the fiber ring. The stitching instrument is long and thin, can be operated in a full-visual mode under an endoscope, and is simple in structure, ingenious in design and convenient to use.)

1. A full visual fibrous ring stitching instrument under an endoscope comprises a stitching line and a guiding device, and is characterized in that the stitching line comprises a line body and a line bolt;

the wire body is used for drawing the fiber ring-opening and knotting;

the thread plug is fixed at one end of the thread body and used for puncturing the surface layer of the fiber ring and then remaining in the fiber ring;

the wire bolt is provided with a component with the width or the maximum outer diameter larger than the diameter of the puncture point under the action of tensile force, so that the wire bolt cannot be pulled out of the puncture point when the wire body is drawn;

the guiding means comprises a metal catheter for guiding a plug of suture into the annulus fibrosus;

the metal conduit is hollow, and the bottom end is a tip end; the tip opening is used for passing a suture;

the metal catheter is slender, the diameter of the metal catheter is 3.5-4.0 mm, the metal catheter is smaller than an instrument channel carried by an endoscope, and full-visualization fibrous ring suture can be realized under the monitoring of the endoscope.

2. The endoscopic full visualization fibrosus loop stapler of claim 1, wherein the wire plug is a rigid rod, and the length of the rigid rod is 2-4 times the diameter.

3. The endoscopic full visualization annular stapler according to claim 1, wherein said peg is a rigid absorbable rod with barbs on a section of its surface.

4. The endoscopic full visualization fiber ring suturing device according to claim 3, wherein the diameter of the barbed wire plug is not smaller than the diameter of the wire body, 2-6 barbs are arranged at the same axial position of the wire, the barbs at the same axial position are uniformly distributed, and barbs are arranged at a plurality of axial positions of the wire.

5. The endoscopic full visualization fiber ring suturing device according to any one of claims 1 to 4, wherein the suture line and the thread plug are made of absorbable materials.

6. The endoscopic full visualization fiber ring suturing device according to any one of claims 1 to 4, further comprising an endoscopic knot pusher for pushing a knot tied outside the endoscope to the surface of the fiber ring opening through an endoscopic instrument channel and providing a force application point for pulling a wire body to tighten the knot; the knot pusher comprises a push rod and a knot pushing head, the knot pushing head is arc-shaped, the top end of the knot pushing head is provided with a threading hole, and the threading hole is used for a line body to pass through.

7. The endoscopic full visualization fibrosus loop stapler according to any one of claims 1 to 4, further comprising an endoscopic thread cutter including a movable head, a fixed head, a shear plate, a tube body, a pull rod, a pulling portion;

the fixed head is fixed at one end of the pipe body, the fixed head is sheet-shaped, and the movable head is hinged with one end of the pipe body, which is provided with the fixed head; the movable head is hinged with a pull rod, and the pull rod extends into the pipe body;

a pulling part is positioned at one end of the pipe body far away from the fixed head, the pulling part is driven by a handle to rotate, and the pulling part can pull the pull rod to drive the movable head to rotate around a hinge joint of the movable head and the pipe body by rotating;

a shear plate is fixed at the front end of the fixing head far away from the tube body; the front end of the movable head far away from the pipe body is also provided with a shearing plate, and the shearing plate on the movable head can be attached to the inner side surface of the shearing plate on the fixed head when the movable head rotates, so that the wire body is sheared.

8. The endoscopic full visualization fiber ring stapler according to any one of claims 1 to 4, wherein the metal guide tube is hollow and comprises a straight rod part and a bent rod part;

the axis of the curved rod part is an arc line and extends to the straight rod with the linear axis, and the two are communicated with each other through the inner cavity;

the bent rod part is used for expanding the operation range and can suture 2-3 mm of the edge of a fiber ring-opening, the bottom end of the needle head opening of the bent rod part is a needling point, and the distance between the needling point and the axis of the straight rod part is within the range of 3-5 mm.

9. The endoscopic full visualization annular stapler according to any one of claims 1 to 4, further comprising a metal guide rod for pushing the wire plug, wherein the diameter of the metal guide rod is smaller than the inner diameter of the metal guide tube.

10. The endoscopic full visualization annular stapler according to claim 7, wherein the metal guide rod comprises a rod body and a rod handle;

the rod body is a straight rod; the handle part of the rod is larger than the inner diameter of the cavity of the guide rod in a natural state, so that an operator can conveniently hold and push the metal guide rod, the wire bolt can be ejected out of the cavity at the tip of the guide rod after pressure is applied, and the wire bolt is pushed and left in the fibrous ring.

Technical Field

The invention relates to an intervertebral disc fibrous ring suturing device, in particular to an endoscopic minimally invasive suturing device.

Background

The prolapse of intervertebral disc is caused by rupture of the annulus fibrosus due to external force or strain, and protrusion or dissociation of nucleus pulposus from the rupture of the annulus fibrosus inside the intervertebral disc, and compression of nerve and dural sac to cause sciatica. Need extirpating the free nucleus pulposus of protrusion in the operation, but nucleus pulposus excision back annulus fibrosus breach still exists, if can not obtain effective restoration, in the future under the exogenic action, fibril annulus fibrosus breach department still is a weak area, probably rupture again, the nucleus pulposus can be along former breach reextrusion, lead to the relapse, foraminiferous mirror (backbone endoscope) operation is the effective means of treatment disc herniation, the wound is little, it is fast to resume, but, because the internal inside apparatus passageway of backbone endoscope is very narrow, only be 3.5-4.3 millimeters, current suturing tool can only use in open surgery, can't pass through narrow and small backbone endoscope passageway, can not realize the full visual suture of damaged fibrous ring under the mirror.

For example: in the prior art, CN205683106U is typically used for puncturing one side of a laceration by using a barb and then puncturing the tissue on the other side of the laceration by using the needlepoint of the barb to guide a suture to suture. However, the operation difficulty is very high, the barb needs to be broken, the barb is completely penetrated out from the inner side of the fibrous ring to guide the suture, the diameter of the barb is larger than the diameter (3.5-4.3 mm) of the channel of the conventional endoscopic instrument, the barb can only be used under the customized large-channel endoscope with the diameter of more than 10 mm, but the large-channel endoscope with the diameter of more than 10 mm does not accord with the original meaning of micro-invasion, and the suture breakage condition during the puncture often occurs when the working end of the suturing instrument is extruded with the endoscope wall during the operation. In addition, the mode that prior art CN107822680B used is to pass the two ends of the suture thread with the bar at the two ends through the two sides of the laceration respectively by using the threading device, then pull out the bar from the laceration, cut off the bar and tie, and this mode has three disadvantages: 1. the length of the suture line must be fixed, and meanwhile, the line must be arranged in the pipeline, assembled and transported, so that the position of the line can be changed, the line bar is easy to be prevented from penetrating out, or the line is scratched by a needle in the penetrating out process, so that the line strength is weakened or broken; 2. the puncture process needs the hollow bar, the push pins for pushing the bar are two, one hollow bar and the other hollow bar pass through the hollow bar, the structure is complex, the cost is high, the assembly requirement of the bar is high, if the bar is clamped in use, the first bar enters the fiber ring, the second bar cannot be normally pushed out, but the suture line is still left in the wire tube of the suture device, the suture line is difficult to cut, and even if the suture line is cut, the first bar is still left in the fiber ring, so that more risks are added to the operation; 3. the line bar is pulled back from the crevasses, on one hand, the line bar is cut off, but the line bar can obstruct the suture sight, on the other hand, the line bar is pulled back from the middle of the crevasses, the suture line can be remained in the crevasses, the healing of the crevasses is slow, and the subsequent recurrence probability is high; 4. the line stick is cylindrical, and the surface is smooth, can't fix in the fibrous ring inside, only is applicable to the fibrous ring below for hollow scene (the line stick remains the hollow zone in the fibrous ring below), but most outstanding cases, fibrous ring and the nucleus pulposus below are an organic whole, the line stick can't anchor the fibrous ring, leads to stitching the failure.

Disclosure of Invention

The embodiment of the application provides a full visual fibrous ring stitching instrument under scope, has solved the problem that the operation degree of difficulty is big among the prior art, and the device structure is complicated, and the trouble possibility is high, and the operation risk is high, has realized easy operation, device simple structure, and is with low costs, the effect that the operation risk is low.

The embodiment of the application provides a full-visualization fiber ring stitching instrument under an endoscope, which comprises a stitching line and a guiding device, wherein the stitching line comprises a line body and a line bolt;

the wire body is used for drawing a crevasse and knotting;

the thread plug is fixed at one end of the thread body and used for puncturing the surface layer of the fiber ring and then remaining in the fiber ring;

the wire bolt is provided with a component with the width or the maximum outer diameter larger than the diameter of the puncture point under the action of tensile force, so that the wire bolt cannot penetrate through the puncture point when the wire body is drawn;

the guiding means comprises a metal catheter for guiding a plug of suture into the annulus fibrosus;

the metal conduit is hollow, and the bottom end is a tip end; the tip is open for passage of sutures.

Furthermore, the wire bolt is a hard rod, and the length of the hard rod is 2-4 times of the diameter.

Further, the wire bolt is a section of hard absorbable wire rod with barbs on the surface.

Furthermore, the diameter of the wire bolt with barbs is not smaller than the diameter of the wire body, 2-6 barbs are arranged at the same axial position of the wire, the barbs at the same axial position are uniformly distributed, and barbs are arranged at a plurality of axial positions of the wire.

Furthermore, the suture line and the line bolt are made of absorbable materials.

The endoscope device is used for pushing a knot formed outside an endoscope to the surface of a fiber ring opening through an endoscope instrument channel and providing a force application point for a pulling line body to tighten a knot; the knot pusher comprises a push rod and a knot pushing head, the knot pushing head is arc-shaped, the top end of the knot pushing head is provided with a threading hole, and the threading hole is used for a line body to pass through.

Further, still include the mirror off-line and cut, it includes activity head, fixed head, cuts board, body, pull rod, pulling part.

The fixed head is fixed at one end of the pipe body, the fixed head is sheet-shaped, and the movable head is hinged with one end of the pipe body, which is provided with the fixed head; the movable head is hinged with a pull rod, and the pull rod extends into the pipe body;

a pulling part is positioned at one end of the pipe body far away from the fixed head, the pulling part is driven by a handle to rotate, and the pulling part can pull the pull rod to drive the movable head to rotate around a hinge joint of the movable head and the pipe body by rotating;

a shear plate is fixed at the front end of the fixing head far away from the tube body; the front end of the movable head far away from the pipe body is also provided with a shearing plate, and the shearing plate on the movable head can be attached to the inner side surface of the shearing plate on the fixed head when the movable head rotates, so that the wire body is sheared.

Further, the metal conduit is hollow and comprises a straight rod part and a bent rod part;

the axis of the curved rod part is an arc line and extends to the straight rod with the linear axis, and the two are communicated with each other through the inner cavity;

the bent rod part is used for expanding the operation range and can suture 2-3 mm of the edge of a fiber ring-opening, the bottom end of the needle head opening of the bent rod part is a needling point, and the distance between the needling point and the axis of the straight rod part is within the range of 3-5 mm.

Furthermore, the wire plug pushing device also comprises a metal guide rod for pushing the wire plug, wherein the metal guide rod is used for pushing the wire plug from the guide rod, and the diameter of the metal guide rod is smaller than the inner diameter of the metal guide pipe.

Further, the metal guide rod for pushing the wire bolt comprises a rod body and a rod handle part;

the rod body is a straight rod; the handle part of the rod is larger than the inner diameter of the cavity of the guide rod in a natural state, so that an operator can conveniently hold and push the metal guide rod, and the wire bolt can be pushed out of the cavity at the tip of the guide rod in a proper manner after being pressed, so that the wire bolt is left in the fibrous ring, and the rod body is a straight rod; the handle part of the rod is larger than the inner diameter of the cavity of the guide rod in a natural state, so that an operator can conveniently hold and push the metal guide rod, and the wire bolt can be pushed out of the tube cavity at the tip of the guide rod in a proper manner after pressure is applied, so that the wire bolt is left in the fibrous ring.

One or more technical solutions provided in the embodiments of the present application have at least the following technical effects or advantages: two suture lines with thread bolts are respectively inserted into two sides of a fibrous ring, after a line body outside the fibrous ring is knotted outside a scope, a knot pusher pushes a knot to the surface of the fibrous ring from an endoscope instrument channel, after the knot is tightened, the line body is cut off by a line scissors under the scope, and the redundant line body is taken out, so that minimally invasive suture under an endoscope can be rapidly carried out on a fibrous ring broken opening. The device has the advantages of simple structure, clear steps, convenient operation and obvious effect.

Drawings

FIG. 1 is a schematic structural view of the present invention;

FIG. 2 is a schematic view of a structure of a hard rod at the bottom end of the suture thread;

FIG. 3 is a schematic view of a suturing device with a metal guide rod for pushing a wire bolt;

fig. 4 is a schematic view of the state when suturing.

FIG. 5 is a schematic view of a knot pusher bar;

FIG. 6 is a schematic view of a push button structure;

FIG. 7 is a schematic view of a knotting bar with an internal notch;

FIG. 8 is a schematic view of a knot pushing operation;

FIG. 9 is a schematic view of a knot pushing operation;

FIG. 10 is a schematic view of a wire clipper;

FIG. 11 is a schematic view of the overall structure of the wire clipper;

FIG. 12 is a schematic view of a wire shear full joint;

FIG. 13 is a schematic structural view of a threaded bolt wrapped around the bottom end of a threaded body in a net shape;

FIG. 14 is a schematic view of the position of the threaded rod when it is in a net shape and not fully deployed within the annulus fibrosus;

FIG. 15 is a schematic view of the fully deployed position of the threaded plug in the annulus fibrosus when the plug is in the form of a mesh;

FIG. 16 is a schematic view of the sewing operation when the thread-lock is a ferromagnetic block;

FIG. 17 is a schematic view of the plate shearing position;

FIG. 18 is a schematic view of an intervertebral disc.

In the figure, a metal catheter 100, a straight shaft portion 110, a bent shaft portion 120, a needle opening 121;

suture 200, wire body 210, wire bolt 220, barb 221;

a metal guide rod 300, a rod body 310, a compression part 320;

a knot pushing rod 400, a knot pushing head 410, a threading hole 411 and an inner notch 412;

the wire cutter 500, the movable head 510, the fixed head 520, the cut plate 530, the tube 540, the pull rod 550 and the pulling part 560.

Detailed Description

To facilitate an understanding of the invention, the invention will now be described more fully with reference to the accompanying drawings. Preferred embodiments of the present invention are shown in the drawings. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete.

It will be understood that when an element is referred to as being "secured to" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. The terms "vertical," "horizontal," "left," "right," and the like as used herein are for illustrative purposes only and do not represent the only embodiments.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used herein in the description of the invention is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.

The existing suture device is too complex in structure, and the operation risk is very high once a fault occurs. The existing sewing technical thought is along with the traditional sewing process, namely, a crevasse is sewn by a continuous thread, and the thought causes the designed sewing device to be difficult to use, complex in operation, complex in structure, high in cost and high in risk. The present invention divides the suturing process into two lines to complete. 1-18, sutures are prevented from being pulled out by a suture with a plug capable of anchoring inside the full layer of the annulus, and the laceration is sutured by pulling and tying two sutures anchored on both sides of the laceration.

Example one

As shown in fig. 1, 2 and 4, an endoscopic full visualization fiber ring stitching instrument comprises a stitching wire 200 and a guiding device, wherein the stitching wire 200 comprises a wire body 210 and a wire bolt 220;

the wire body 210 is used for pulling a laceration and knotting; the thread body is a common suture thread, and certainly, the thread body cannot be removed after the endoscopic operation, so that the thread body is preferably an absorbable thread.

The thread bolt 220 is fixed at one end of the thread body 210, and the thread bolt 220 is used for puncturing the fiber ring and then remaining in the fiber ring; the wire bolt 220 is made of medical material absorbable by human body;

the thread bolt is provided with an agnail and is automatically anchored in the fiber ring after being subjected to the action of tensile force, and the width or the maximum outer diameter of the thread bolt is larger than the diameter of the puncture point, so that the thread bolt cannot be pulled out of the puncture point when the wire body is drawn; the purpose of the wire plug is to provide the pull wire with fixing and force points when traction force is applied to the two sides of the laceration, so that the fiber rings on the two sides of the laceration can be tightly closed after the wire body 210 is pulled and knotted, and the healing in one period is facilitated.

The guiding device comprises a metal catheter 100 for puncturing and pushing the thread plug, and is used for guiding the thread plug of the suture thread into the fibrous ring;

the metal conduit 100 for pushing the wire plug is punctured to be hollow, and the bottom end is a tip end; the tip is open for passage of sutures. The metal guide tube for pushing the wire bolt is required to be punctured to enter the crevasse from an instrument channel of the endoscope, and the length and the outer diameter are proper.

When the novel suture needle is used, a suture thread can be preset in the metal catheter 100 for pushing the suture needle, the tip of the metal catheter 100 is used for puncturing the whole layer of an annulus fibrosus, at the moment, if the suture thread is hard, the suture thread can bear axial pressure, the cutting deformation is not large, the suture needle can directly enter the annulus fibrosus through the tip opening of the metal catheter 100, and the maximum outer diameter of the suture needle is not larger than the diameter of the tip opening.

In addition, the thread plug can be loaded with medicines which are helpful for wound healing and infection prevention, such as growth factors, antibiotics and the like. The drug loading mode can be that the drug is directly and physically embedded on the surface of the wire bolt, or growth factors or antibiotics which can be slowly released are added in the wire bolt processing.

In the second embodiment, as shown in fig. 2, the wire bolt 210 is a hard rod with a length 2-4 times the diameter. The structure of the line bolt has many possible realization modes, when the line bolt is a hard rod, the line body is fixedly connected with the middle part of the hard rod, after the line bolt enters the fiber ring, when the line bolt is pulled outwards, the hard rod can be transversely arranged at the deep hollow part of the punctured fiber ring, and therefore the line body is prevented from moving outwards.

In the third embodiment, as shown in fig. 1, the thread plug 210 is a section of thread with barbs.

The diameter of the line with barbs is not smaller than the diameter of the line body, 2-6 barbs are arranged in the same axial position of the line, the barbs in the same axial position are uniformly distributed, barbs are arranged in a plurality of axial positions of the line, and the barbs in adjacent axial positions are arranged in a staggered mode in the circumferential direction. This approach further facilitates penetration into the annulus fibrosus. In this way the diameter of the part of the wire bolt other than the barbs is preferably larger than the part of the wire body.

In a fourth embodiment, as shown in fig. 1 and 3, the metal conduit 100 includes a straight rod portion 110 and a bent rod portion 120;

the axis of the curved part 120 is an arc line and is fixed at the bottom end of the straight rod 110, the axis of which is a straight line, and the two are communicated with each other through a hollow cavity;

the curved rod part 120 is used for expanding the operation range, the bottom end of the needle head opening 121 of the curved rod part 120 is a needling point, and the distance between the needling point and the axis of the straight rod part 110 is within the range of 3-5 mm. The main function of the curved portion 120 is to expand the operation range, and the opening diameter of the bottom opening of the curved portion is larger, so that the wire bolt can conveniently penetrate out.

In the fifth embodiment, as shown in fig. 3, the wire-pushing device further comprises a metal guide rod 300 for pushing the wire plug, wherein the metal guide rod 300 for pushing the wire plug is used for pushing the wire plug, and the diameter of the metal guide rod 300 for pushing the wire plug is smaller than the inner diameter of the cavity of the metal conduit 100 for puncturing the wire plug.

The metal guide rod 300 for pushing the wire bolt comprises a rod body 310 and a rod handle 320;

the rod body 310 is a straight rod; the handle part 320 is not smaller than the inner diameter of the cavity of the metal conduit 100 for pushing the wire bolt by puncturing in a natural state, so that an operator can conveniently hold and push the metal guide rod, the metal guide rod for pushing the wire bolt is a thin rod, and the metal guide rod of the straight rod part can push the wire bolt out of the metal conduit 100 along the trend after the handle part is pressed, so that the wire bolt is left in the fibrous ring.

EXAMPLE six

As shown in fig. 13-15, the wire bolt 220 is unfolded into a circle, a rectangle or a polygon with more than four sides, the unfolded area is 0.5-1 square centimeter, and the wire body 210 is fixed with the center of the wire bolt;

the wire plug 220 is manufactured as follows; the wire bolt is unfolded into a net shape and is woven by the same material as the wire body 210;

firstly, soaking the suppository in physiological saline liquid containing slow-release nutritional factors;

step two, folding the wire bolt 220 in half comprises turning the wire bolt towards the bottom end of the wire body 210, and then turning the wire bolt into a rod shape towards one direction (clockwise or anticlockwise); or one side of the wire bolt 220 is firstly rolled inwards to the side far away from the wire body 210, then the opposite side is folded inwards, and then the rolled side is wrapped into a rod shape, as shown in fig. 2;

step three; the plug 220 is vacuum freeze dried to set the plug 220.

Like this, the line bolt 220 can contain more growth factors, and liquid dilution can expand down after getting into the fibrous ring simultaneously, forms the location of more stable line body, is favorable to in the subsequent knot pulling breach, avoids the line bolt 220 to be pulled out the fibrous ring.

EXAMPLE seven

As shown in the drawing, the two sutures 200 inserted into the annulus fibrosus are finally aligned and fixed by tying a knot, but the operation is very difficult when the operation is performed under an endoscope (spinal endoscope). Therefore, an under-mirror knot pusher 400 is added for pushing a knot tied outside the endoscope to the fiber ring opening and providing a point of application for pulling, aligning and positioning the wound; the knot pusher 400 comprises a knot pusher 410, the top end of the knot pusher 410 is provided with a threading hole 411, and the threading hole 411 is used for a thread 210 to pass through.

When the medical suture is used, one thread body 210 penetrates through the threading hole 411, the knot pushing head 410 extends into an endoscope (spinal endoscope), the tied knot is pushed to the position of the broken opening, the thread body 210 is pulled, the broken opening is aligned, the second knot is tied in the same operation, the two threads can be fixed, and the wound is aligned and positioned.

The end face of the contact wire body 210 of the knot pushing head 410 can be provided with an arc surface 412 for pushing the knot, so that the contact surface is reduced, the force is more concentrated, and the knot is made more firmly.

Example eight

As shown in fig. 10 to 12, in order to cut off an unnecessary wire after finishing the operation, a wire cutter 500 for use under an endoscope (spinal endoscope) is provided, which includes a movable head 510, a fixed head 520, a cut plate 530, a tube 540, a pull rod 550, and a pulling unit 560.

The fixed head 520 is fixed at one end of the tube 540, the fixed head 520 is sheet-shaped, and the movable head 510 is hinged with one end of the tube 540 with the fixed head 520; the movable head 510 is hinged with a pull rod 550, and the pull rod 550 extends into the tube body 540;

a pulling part 560 is positioned at one end of the tube body 540 far away from the fixed head 520, the pulling part 560 is driven by the handle to rotate, and the pulling part 560 rotates to pull the pull rod 520 to drive the movable head 510 to rotate around a hinge point of the movable head 510 and the tube body 540;

a shear plate 530 is fixed at the front end of the fixing head 520 far away from the tube body 540; the front end of the movable head 510, which is far away from the tube body 540, is also provided with a shear plate 530, and the shear plate 530 on the movable head 510 can be attached to the inner side surface of the shear plate 530 on the fixed head 520 when the movable head 510 rotates, so that the wire body 210 is sheared.

The pulling part 560 may be two wheels or a rod, the pull rod passes through a gap between the two wheels or rods, the two wheels or the roller are abutted against the pull rod, and when one handle is rotated to rotate one wheel or the roller, the pull rod 550 can be pulled, so as to achieve the purpose of rotating the movable head 510.

The shear plate 530 is provided to be able to shear at a suitable position when the wire body 210 is drawn to intersect the surface of the annulus.

Example nine

Still another suturing method is shown in fig. 16, in which the wire bolt 220 is a ferromagnetic block (which may be made of steel, iron, etc., preferably spherical); after the stem 100 is guided into the annulus fibrosus, the magnetic suction rod 600 is extended into the annulus fibrosus from the laceration;

the magnetic attraction rod 600 comprises an outer rod 610, an inner rod 620 and a magnet 630;

the outer rod 610 is a non-magnetic rod with an arc-shaped bottom end, and can be a plastic rod;

the inner rod 620 is a magnetic conductive metal rod and is positioned in the outer rod 610, and the bottom end of the inner rod 620 extends out of the bottom end of the outer rod 610 to form a magnetic conductive metal tip;

the magnet 630 is positioned at the top end of the outer rod 610 and contacts the inner rod 620, so that the metal tip at the bottom end of the inner rod 620 can attract the wire bolt 220;

the bottom end of the rod body 310 is provided with a magnet for attracting the wire bolt 220 and pulling out the wire bolt from the metal conduit 100 which is punctured for pushing the wire bolt;

after being pulled out, the knot can be tied by using the knot pushing rod 400 in the seventh embodiment.

The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.