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WO2020248807A1 - Instrument de chirurgie endoluminale - Google Patents

Instrument de chirurgie endoluminale Download PDF

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Publication number
WO2020248807A1
WO2020248807A1 PCT/CN2020/092118 CN2020092118W WO2020248807A1 WO 2020248807 A1 WO2020248807 A1 WO 2020248807A1 CN 2020092118 W CN2020092118 W CN 2020092118W WO 2020248807 A1 WO2020248807 A1 WO 2020248807A1
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WO
WIPO (PCT)
Prior art keywords
rod
sleeve
surgical instrument
intracavitary
instrument according
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/CN2020/092118
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English (en)
Chinese (zh)
Inventor
毛张凡
毛航
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of WO2020248807A1 publication Critical patent/WO2020248807A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/0218—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors for minimally invasive surgery

Definitions

  • This application relates to the field of medical devices, and specifically to an intracavity surgical device.
  • laparoscopic surgery generally involves making 3-4 5-12mm incisions B on the body surface A through a puncture cannula C, as shown in Figure 25. Then, the long rod surgical instrument F is extended into the cavity D through the channel of the puncture sleeve C to perform the operation, as shown in FIG. 26.
  • the usual method is to additionally use the puncture sleeve C to perforate and insert the long rod surgical forceps through the puncture sleeve C to pull the tissue or organ in the cavity E is exposed.
  • the long rod surgical forceps occupy the operating space and affect the operation of the surgeon.
  • the increased incision will increase the trauma and pain of the patient, and also increase the scar on the patient's body surface, which affects the appearance.
  • most of the current endoscopic surgical instruments are integrated and cannot be disassembled, so the size of the operation part in the cavity is often limited by the size of the connecting rod.
  • the present application provides an intracavitary surgical instrument, which can reduce the trauma of the patient's body, and at the same time allows the surgical operator to more conveniently perform surgical operations outside the body, reduce the burden on the surgical operator, and thereby increase the success rate of the operation.
  • Operating device including operating part and connecting part
  • the handle is provided with a connecting rod
  • the connecting rod has a tip portion adapted to penetrate into the cavity, and the connecting portion is configured to be fixedly connected to the tip portion of the connecting rod in the cavity;
  • the connecting rod includes a hollow sleeve rod and a core rod movably arranged in the sleeve rod, and the handle is configured to control the core rod to stay in a first position or a second position.
  • the core rod makes the operating device in an open state, and when in the second position, the core rod makes the operating device in a closed state.
  • the operating part includes:
  • a sleeve having an axially penetrating passage, the sleeve including a first end and a second end;
  • the push rod is arranged in the channel of the sleeve and is configured to be able to slide along the axial direction of the channel of the sleeve;
  • the clamp head is configured for controlled opening or closing.
  • the sleeve further includes a boss for restricting the position of the push rod.
  • the putter includes:
  • the first paragraph includes the first end and the second end;
  • the second section is connected to the second end of the first section and can slide along the passage of the sleeve;
  • the first end of the first section of the push rod is connected with the clamp head.
  • the clamp head includes:
  • a transmission mechanism is used to connect the nippers and the push rod, and is configured to drive the nippers to open or close with the movement of the push rod.
  • the transmission mechanism includes:
  • each bending rod including a first end and a second end;
  • each bending rod is connected to the corresponding nipper
  • the second end of each bending rod is connected to one end corresponding to the connecting arm
  • the other end of the connecting arm is connected to the push rod connection.
  • the operating portion further includes a first elastic member, and the first elastic member is arranged between the sleeve and the push rod to keep the push rod moving in the second direction.
  • the connecting portion further includes a connecting mechanism for connecting the operating device and the connecting rod.
  • the handle includes:
  • the connecting rod is partially or completely located in the passage of the grip rod
  • the pressing device is configured to control the axial movement of the core rod.
  • the grip includes:
  • the first rod section includes a first end and a second end
  • the second rod segment includes a first end and a second end
  • the third rod segment includes a first end and a second end
  • the second end of the first rod section is connected with the first end of the second rod section, and the second end of the second rod section is connected with the first end of the third rod section;
  • the sleeve rod is arranged in the channel of the first rod section.
  • the core rod includes a first end and a second end; the sleeve rod includes a first end and a second end; wherein the first end of the core rod is connected to the operating device, and/or The first end of the sleeve rod is connected with the operating device; the second end of the core rod is connected with the pressing device.
  • the pressing device includes:
  • the guide post moves axially along the channel of the grip rod according to the external force received by the button.
  • the guide post includes:
  • Upper tooth column including tooth end and non-tooth end
  • Lower tooth column including tooth end and non-tooth end
  • the second elastic member is used to support between the connecting rod and the grip rod to keep the core rod and the lower tooth column moving in the second direction;
  • the tooth end of the upper tooth column and the tooth end of the lower tooth column are arranged opposite to each other, and can engage in at least one position.
  • the upper tooth column further includes a third elastic member for supporting between the upper tooth column and the grip bar to keep the upper tooth column moving in the second direction.
  • the second end of the core rod is in contact with the guide post, and the core rod is configured to move with the movement of the guide post.
  • the button includes:
  • the first end is arranged in the grip channel and is used to connect with the guide post;
  • the second end is configured to be directly operated by the user.
  • the intracavitary surgical instrument of the embodiment of the present application includes an operating device and a handle, wherein the operating device includes an operating portion and a connecting portion, the handle is provided with a connecting rod, the connecting rod has a tip portion, and the tip portion of the connecting rod is connected to the operating device.
  • the connecting rod includes a hollow sleeve rod and a core rod movably arranged in the sleeve rod, and the core rod can be controlled to stay in different positions by operating the handle to open or close the operating device.
  • the operating device is placed in the cavity through the incision, the tip of the connecting rod enters the cavity along the puncture point and fixedly connected with the connecting portion of the operating device, and then the operating portion can be controlled by operating the handle outside the body to achieve the corresponding operation operating.
  • the diameter of the tip of the connecting rod is less than 3mm, and the puncture point does not need to be sutured, which can reduce the trauma of the patient's body.
  • the size of the operating device is not limited by the diameter of the connecting rod, making it easier to perform surgery outside the body operating.
  • Figure 1 is a schematic diagram of the overall structure of an intracavitary surgical instrument according to a first embodiment of the present application
  • FIG. 2 is a schematic diagram of the operation of the intracavitary surgical instrument according to the first embodiment of the present application
  • Fig. 3 is a first schematic diagram of the connection part of the intracavitary surgical instrument according to the first embodiment of the present application;
  • FIG. 4 is a second schematic diagram of the connection part of the intracavitary surgical instrument according to the first embodiment of the present application.
  • Fig. 5 is a third schematic diagram of the connection part of the intracavitary surgical instrument according to the first embodiment of the present application.
  • Fig. 6 is a fourth schematic diagram of the connecting part of the intracavitary surgical instrument according to the first embodiment of the present application.
  • FIG. 7 is a fifth schematic diagram of the connection part of the intracavitary surgical instrument according to the first embodiment of the present application.
  • FIG. 8 is a schematic view of the connection part of the intracavitary surgical instrument according to the first embodiment of the present application, the schematic view of the first limiting member in the second state;
  • FIG. 9 is a schematic view of the connection part of the intracavity surgical instrument according to the first embodiment of the present application, the schematic view of the first limiting member in the first state;
  • FIG. 10 is a schematic diagram of the appearance of the closed state of the operating device of the intracavitary surgical instrument according to the first embodiment of the present application;
  • FIG. 11 is a schematic diagram of the external appearance of the operating device of the intracavitary surgical instrument in the opened state of the first embodiment of the present application;
  • FIG. 12 is a cross-sectional view of the closed state of the operating device of the intracavitary surgical instrument according to the first embodiment of the present application;
  • FIG. 13 is a cross-sectional view of the operating device of the intracavitary surgical instrument in the first embodiment of the present application in an opened state;
  • FIG. 14 is a schematic diagram of the appearance of the handle of the intracavity surgical instrument according to the first embodiment of the present application.
  • 15 is an exploded view of the handle structure of the intracavity surgical instrument according to the first embodiment of the present application.
  • 16 is a cross-sectional view of the handle of the intracavitary surgical instrument according to the first embodiment of the present application.
  • 17 is a schematic diagram of the principle of a pressing device for an intracavity surgical instrument according to the first embodiment of the present application;
  • 19 is a cross-sectional view of the closed state of the operating device of the intracavity surgical instrument according to the second embodiment of the present application.
  • 20 is a cross-sectional view of the operating device of the intracavity surgical instrument in the second embodiment of the present application in an opened state;
  • 21 is a schematic diagram of an opened state of the operating device of an intracavitary surgical instrument according to the third embodiment of the present application.
  • 22 is a schematic diagram of the closed state of the operating device of the intracavitary surgical instrument according to the third embodiment of the present application.
  • FIG. 23 is a partial cross-sectional view 1 of the tip of the connecting rod of the intracavitary surgical device according to the fourth embodiment of the present application;
  • 24 is the second partial cross-sectional view of the tip of the connecting rod of the intracavitary surgical device according to the fourth embodiment of the present application.
  • FIG. 25 is a schematic diagram of the first operation of intracavitary surgery in the prior medical technology related to this application.
  • Fig. 26 is a second schematic diagram of an intracavitary operation in the prior medical technology related to this application.
  • the terms “installed”, “connected”, “connected”, “fixed” and other terms should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or a whole; It can be a mechanical connection or an electrical connection; it can be a direct connection or an indirect connection through an intermediary, and it can be an internal communication between two elements or an interaction relationship between two elements, unless specifically defined otherwise.
  • installed can be a fixed connection, a detachable connection, or a whole
  • It can be a mechanical connection or an electrical connection
  • it can be a direct connection or an indirect connection through an intermediary, and it can be an internal communication between two elements or an interaction relationship between two elements, unless specifically defined otherwise.
  • the specific meanings of the above terms in this application can be understood according to specific circumstances.
  • FIG. 1 is a schematic diagram of an intracavitary surgical instrument according to an embodiment of the present application.
  • Fig. 2 is a schematic diagram of the operation of the intracavity surgical instrument according to the first embodiment of the present application.
  • the intracavitary surgical instrument includes an operating device 1 and a handle 2.
  • the handle 2 is provided with a connecting rod 3, and the connecting rod 3 includes a hollow sleeve rod 31 and movably arranged on the The core rod 32 in the sleeve rod 31 and the connecting rod 3 have a tip.
  • the doctor when performing intracavitary surgery, the doctor opens a puncture hole B on the patient's body surface A as needed, and then inserts a puncture sleeve C corresponding to the size of the puncture hole B into the puncture hole B to form a surgical instrument Then put the operating device 1 into the cavity D through the puncture cannula C; the user holds the handle 2 and pierces the tip of the connecting rod 3 into the cavity D through other positions on the patient's body surface A; The connecting rod 3 is fixedly connected with the operating device 1 through the puncture hole B to operate in the cavity D; then, the user can control the operating device 1 through the handle 2 outside the body to perform corresponding surgical operations on the tissue or organ E in the cavity.
  • the operating device 1 includes an operating part 11 and a connecting part 12.
  • the operating device 1 may be an instrument suitable for intracavitary surgery, such as a medical holder, medical scissors, and the like.
  • FIGS 3-7 are schematic diagrams of the connecting portion of this embodiment.
  • the connecting portion 12 has a connecting mechanism 121, and the connecting mechanism 121 includes a fixing groove 122.
  • the fixing groove 122 is provided with a first limiting member 122 a for fixing the connecting rod 3.
  • the first end of the sleeve rod 31 is provided with a second limiting member 33 that cooperates with the first limiting member 122a.
  • the connecting portion 12 is made of high-strength and high-hardness materials such as alloy steel, which can increase the strength of the operating device 1, and can also be processed into a small-sized structure to meet the needs of use.
  • Fig. 3 is a first schematic diagram of the connecting portion of the first embodiment of the present application.
  • the first limiting member 122 a includes at least one circular spring coil, which is embedded in the fixing groove 122.
  • the inner diameter of the circular spring coil in the natural state is smaller than the outer diameter of the sleeve rod 31, and the natural state refers to the state of the circular spring coil without any external force.
  • the second limiting member 33 is configured as a locking groove 331 and a guide groove 332 that are matched with the circular spring coil.
  • the clamping groove 331 and the guiding groove 332 are sequentially arranged from the first end of the sleeve rod 31 to the second end of the sleeve rod 31, wherein the depth of the clamping groove 331 is smaller than the guide groove 332.
  • the circular spring ring is squeezed into the slot 331. Due to the small accommodating space of the slot 331, the circular spring ring is deformed.
  • the cross section becomes approximately elliptical, and the long axis of the ellipse forms an angle with the insertion direction of the sleeve rod 31.
  • the angle between the long axis of the elliptical section of the circular spring coil and the sleeve rod will increase, thereby increasing the movement of the sleeve rod 31 Resistance, it is difficult to pull out the sleeve rod 31.
  • the sleeve rod 31 can be inserted into the fixing groove 122 in the first direction. Due to the insertion direction, the long axis of the cross section of the circular spring coil is elliptical.
  • the angle between it and the sleeve rod becomes smaller, so that the resistance on the sleeve rod 31 to move is smaller, and the circular spring ring can easily enter the guide groove 332. Because the guide groove 332 has a larger space, the The circular spring ring returns to its natural state. At this time, when the connecting rod 3 is pulled out, the circular spring ring is squeezed and deformed when it enters the slot 331 again. At this time, the long axis of the oval cross section of the circular spring ring is clamped between the sleeve rod 31 The angle gradually decreases with the movement of the sleeve rod 31 in the second direction. Since the resistance on the sleeve rod 31 is small, the sleeve rod 31 can be easily pulled out of the fixing groove 122 to realize the connection between the connecting rod 3 and the operating device 1. Separate.
  • the first limiting member 122a may be configured as an internal thread
  • the second limiting member 33 of the sleeve rod 31 is configured as an external thread matching the internal thread.
  • the sleeve rod 31 enters the cavity through the puncture point and is fixedly connected with the connecting portion 12 through threads.
  • the first limiting member 122a may be configured as an elastic buckle
  • the second limiting member 33 of the sleeve rod 31 is configured to match the elastic buckle.
  • the buckle slot After the sleeve rod 31 enters the cavity through the puncture point, it is fixedly connected with the connecting portion 12 through a buckle and a buckle groove. After use, the user can use tools such as medical scissors or medical forceps to cut the connecting rod 3 so as to realize the separation of the handle 2 and the operating device 1.
  • the first limiting member 122 a may be configured as an elastic claw, which is embedded in the end of the fixing groove 122.
  • the second limiting member 33 is configured as a card slot. After the sleeve rod 31 enters the cavity through the puncture point, the claw moves at the first end of the sleeve rod 31 according to its own elasticity. When it moves to the slot, it returns to its natural state (not affected by any The state of external force) is fixedly connected to the card slot. After use, the user can use tools such as medical scissors or medical forceps to cut the connecting rod 3 so as to realize the separation of the handle 2 and the operating device 1.
  • the first limiting member 122a may be configured as a movable buckle, the first limiting member 122a is fixedly connected to the fixing groove 122 through the fourth elastic member 122c, and the fixing groove 122 is provided with a limiting groove 122b for accommodating the first limiting member 122a in the longitudinal direction. Due to the elasticity of the fourth elastic member 122c, the first limiting member 122a can move in the limiting groove 122b.
  • a through hole is provided on the movable buckle, and a fixed buckle is provided in the through hole for fixing the sleeve rod 31.
  • the second limiting member 33 is configured as a card slot 331.
  • three second limiting members 33 are provided in the circumferential direction of the sleeve rod 31, so that the connecting rod 3 can be fixed to the connecting portion 12 in three positions, and at the same time, it can be better
  • those skilled in the art can also set any number of slots 331 as needed.
  • the through hole of the first limiting member 122a is coaxial with the fixing groove 122 so that the sleeve rod 3 passes through the through hole
  • the buckle in the through hole It is matched with the slot 331 to fix the sleeve rod 31.
  • the first limiting member 122a When the first limiting member 122a is in the second state in the fixing groove 122, the distance between the central axis of the through hole of the first limiting member 122a and the central axis of the fixing groove 122 is relatively large, and the sleeve rod 31 cannot pass through at this time
  • the through hole is shown in FIG. 8.
  • the central axis of the through hole of the first limiting member 122a coincides with or approximately coincides with the central axis of the fixing groove 122, and the sleeve rod 31 can pass through Through the through hole, as shown in FIG. 9.
  • the connecting rod 3 When the connecting rod 3 needs to be pulled out, again use tools such as medical pliers to press the first limiting member 122a, that is, the movable buckle, from the outside of the operating device 1, so that the connecting rod 3 passes through the through hole of the first limiting member 122a. Thus, the connecting rod 3 is separated from the operating device 1.
  • tools such as medical pliers to press the first limiting member 122a, that is, the movable buckle
  • the operating portion 11 is a traction clip. Doctors can choose different traction clips according to different target tissues. Such as lung clamp, stomach clamp, intestinal clamp, liver clamp, tendon clamp, blood vessel clamp, etc.
  • the operating part 11 includes a sleeve 13, a push rod 14, a first elastic member 111 and a pliers head 15.
  • the sleeve 13 has an axially penetrating channel, and the middle of the sleeve 13 has a boss in the circumferential direction. 131.
  • the push rod 14 includes a first section and a second section, and the diameter of the second section is larger than the diameter of the first section.
  • the first elastic member 111 is a first spring
  • the first spring is sleeved on the first section of the push rod 14, the first section of the push rod 14 and the passage of the first spring from the second end of the sleeve 13
  • the opening is installed to enter, so that the first spring is supported between the boss 131 and the shoulder connecting the second section and the first section of the push rod 14, so that the push rod 14 maintains the movement tendency in the second direction.
  • the clamp head 15 includes a nipper 151 and a transmission mechanism 152.
  • the transmission mechanism 152 includes two bending rods 152a and two connecting arms 152b, and the first end of each bending rod 152a passes through the corresponding nipper 151
  • the pin is connected, and the second end of the bent rod 152a is connected to one end of the corresponding connecting arm 152b by a pin.
  • the angle at the bend of each bending rod 152a is greater than 90° and less than 180°, that is, an obtuse angle, so that the opening angle of the clamp head 15 is maintained in a suitable range.
  • the two bending rods 152a are connected with the first end of the sleeve 13 through a pin at the bending position.
  • one pin is used to connect the two bending rods 152a and the two positions on the first end of the sleeve 13 to make the bending rod 152a can rotate around a fixed connection point.
  • the other ends of the two connecting arms 152b are connected to the first section of the push rod 14 by a pin.
  • Those skilled in the art can also choose other forms of rotational connection, for example, bolt connection.
  • the length of the bent rod 152a is adapted to the length of the connecting arm 152b, so that the clamp head 15 can obtain a suitable opening angle and the overall size of the clamp head 15 can be reduced.
  • the solution of the embodiment of the present application is only a preferred choice, and those skilled in the art can also set different structures of traction clips or other instruments suitable for surgical operations according to specific conditions.
  • the user can make the core rod 32 move correspondingly in the axial direction by controlling the handle 2.
  • the push rod 14 In the natural state (no external force), the push rod 14 is in the initial position, the angle between the two connecting arms 152b is small, the distance between the two connecting points of the bent rod 152a and the connecting arm 152b is the shortest, and the clamp head 15 closure.
  • the core rod 32 is controlled to move in the first direction, the first end of the core rod 32 pushes the push rod 14 to move in the first direction, which increases the angle between the two connecting arms 152b.
  • the position of the bend is fixed relative to the sleeve 13, the distance between the two joints of the bending rod 152a and the connecting arm 152b is correspondingly increased, the opening angle of the pliers 15 increases, and the core rod 32 moves in the first direction The distance corresponds to the opening angle of the clamp head 15.
  • the first spring is compressed.
  • the core rod 32 stops moving it stays in the first position.
  • the force exerted by the core rod 32 and the reaction force of the spring are in a balanced state, so that the push rod 14 stays near the first position, and the pliers 15 maintains a The open state.
  • the first spring recovers from the compressed state to the initial state, pushing the push rod 14 to move in the second direction, so that the two connecting arms 152b
  • the angle between the two bending rods 152a is fixed relative to the sleeve 13 at the bending position, and the distance between the two connecting points of the bending rod 152a and the connecting arm 152b is also reduced accordingly.
  • the opening angle of 15 becomes smaller, so that the two nippers 151 can clamp the tissue or organ in the cavity to be clamped.
  • the user can pull the handle in the second direction, so that the clamp head 15 drives the clamped intracavitary tissues and organs to leave the original position, so that the surgical field of vision can be well exposed.
  • a clamping device or the like is used near the body surface to connect with the handle 2.
  • the intracavity surgical instrument is fixed, so that the user's hand can be freed to perform other surgical operations.
  • the handle 2 includes a grip rod 21, a connecting rod 3 and a pressing device 22.
  • the grip rod 21 is used to accommodate the pressing device 22 and the connecting rod 3 with three rod sections, including a first rod section 211, a second rod section 212, and a third rod section 213.
  • the second end of the first rod section 211 and the second rod The first end of the section 212 is connected, and the second end of the second rod section 212 is connected to the first end of the third rod section 213.
  • the grip rod 21 is divided into three rod sections to facilitate assembly.
  • those skilled in the art can design any number and shape of rod segments according to specific needs.
  • connection between the rod sections of the grip rod adopts threaded connection or snap connection, and those skilled in the art can also adopt other connection methods suitable for stable connection.
  • the first rod section 211, the second rod section 212 and the third rod section 213 of the grip rod 21 are connected in sequence, they form a whole with an axially through channel. This channel is used to accommodate the pressing device and 22 connecting rod 3.
  • the connecting rod 3 includes a sleeve rod 31 and a core rod 32.
  • the sleeve rod 31 is fixedly connected in the channel at the first end of the first rod section 211, the length of the core rod 32 is greater than the length of the sleeve rod 31, the sleeve rod 31 is hollow, and the core rod 32 can slide axially in the sleeve rod 31.
  • the first end of the core rod 32 has a tip portion, which is suitable for puncturing operation and facilitates the connecting rod to penetrate the human body.
  • the second end of the core rod 32 is provided with a base 321 whose diameter is larger than the inner diameter of the sleeve rod 31. The end of the base 321 is connected to the pressing device 22.
  • the arrangement of the base 321 can increase the contact area between the core rod 32 and the pressing device 22, so that it can be more stably moved along the axial direction of the sleeve rod 31 by the force transmitted by the pressing device 22, and prevent the core rod 32 from being caused by uneven force. Break off.
  • the pressing device 22 includes a button 221 and a guide post 222, and the guide post 222 includes an upper tooth post 223, a lower tooth post 224 and a second elastic member 225.
  • the second elastic member 225 is sleeved on the core rod 32 and supported between the base 321 at the second end of the core rod 32 and the boss in the first rod section of the grip rod to keep the core rod 32 and the pressing device 22 in the second direction Sports trends.
  • the second elastic member 225 is a second spring
  • the upper tooth column 223 includes a third elastic member 226, and the third elastic member 226 is a third spring. As shown in FIG.
  • three protruding guide rails 227 are fixed and evenly distributed in the inner circumferential direction of the first rod section of the grip rod, and the first end of each guide rail 227 is a tooth column 223 on the inclined surface.
  • Three rail grooves corresponding to the guide rail 227 are evenly distributed in the circumferential direction of the tooth end, and three teeth are evenly distributed in the tooth end of the upper tooth column 223 in the circumferential direction.
  • the tooth end of the lower tooth column 224 is evenly distributed with three guide rail grooves corresponding to the guide rail 227 in the circumferential direction, and the tooth end of the lower tooth column 224 is evenly distributed with three teeth in the circumferential direction.
  • the rail grooves of the upper tooth column 223 and the rail grooves of the lower tooth column 224 have different distribution positions on the teeth.
  • the tooth end of the upper tooth column 223 can mesh with the tooth end of the lower tooth column 224, and the inclined surface of the first end of the guide rail 227 can also mesh with the tooth end of the lower tooth column 224.
  • the third spring is sleeved on the upper shank 223 and supported between the upper shank 223 and the second end of the guide rail 227 in the grip rod 21 to keep the upper shank 223 moving in the second direction.
  • the button 221 is connected to the non-tooth end of the upper tooth column 223.
  • the pressing device 22 When the pressing device 22 is in a natural state (in a state without any external force), the first end of the guide rail 227 is in the guide groove of the lower shank 224, and the second end of the guide rail 227 is in the guide groove of the upper shank 223.
  • the tooth end of 223 is partially meshed with the tooth end of the lower tooth column 224.
  • the upper shank 223 also moves in the first direction along the guide rail 227, pushing the lower shank 224 to move in the first direction along the guide rail 227 until the upper shank 223 and the lower
  • the meshing surface of the tooth column 224 is in the same plane as the inclined surface of the first end of the guide rail 227, that is, the first end of the guide rail 227 is away from the guide groove of the lower tooth column 224.
  • the core rod 32 moves in the first direction to the first position Nearby, the traction clip is opened while the second spring and the third spring are compressed.
  • the core rod 32 moves in the first direction to increase the opening angle of the traction clip and release the clamped tissue or organ.
  • the second spring and the third The spring compresses and stores elastic potential energy.
  • the meshing surface of the upper tooth column 223 and the lower tooth column 224 is in the same plane as the inclined surface of the first end of the guide rail 227, the external force applied to the button 221 is reduced or removed, and the lower tooth column 224 is moved toward the second
  • the force of the third direction moves in the second direction along the meshing surface until the first end of the guide rail 227 enters the guide groove of the lower shank 224.
  • the third spring exerts a force in the second direction on the upper shank 223.
  • the upper tooth column 223 is moved in the second direction along the guide rail 227 to near the second position. During this process, the core rod 32 moves a certain distance in the second direction, and the opening angle of the traction clip is reduced until it is completely closed, that is, the pressing device 22 Return to its natural state.
  • the pressing device includes a button 221, a guide post 222 and a motor.
  • the guide post 222 has threads in the circumferential direction, a corresponding threaded section and a corresponding limit device are arranged on the channel wall of the grip rod 21, and the shaft of the motor is connected with the guide post 222 to drive the guide post 22 to rotate.
  • the motor housing is slidably connected with the grip rod 21.
  • a guide groove is provided in the channel of the grip rod 21, and a guide block is provided at a corresponding position on the motor housing, so that the motor can slide along the guide groove.
  • the button 221 is electrically connected to the motor, and can control the motor to rotate forward and reverse.
  • the button 221 controls the motor to rotate in one direction
  • the guide post rotates in the first direction along the corresponding thread on the channel of the grip rod 21, and the core rod 32 also moves in the first direction and finally stays near the first position.
  • the operating device 1 is in an open state.
  • the button 221 controls the motor to rotate in another direction
  • the guide post rotates in the second direction along the corresponding thread on the channel of the grip rod 21, and the core rod 32 also moves in the second direction and finally stays in the second position.
  • the operating device 1 is in a closed state.
  • the outer diameter of the connecting rod 3 is generally less than 3mm, and it enters the cavity through the puncture point. After being pulled out, due to the autocontraction function of muscle and skin, wounds less than 3mm will stop bleeding quickly, and the puncture wound does not need to be sutured , Using a nearly non-invasive method to reduce the damage to the patient's body.
  • the diameter of the sleeve rod 31 can be set to 2.5 mm, 2 mm, and 1.5 mm, which can meet the requirements of different operations and facilitate processing. Of course, those skilled in the art can also design the diameter of the connecting rod 3 as required.
  • a frosted surface is provided in the middle section of the sleeve rod 31.
  • the middle section means that the first end of the sleeve rod 31 is provided with a number of frosted surfaces of predetermined length along the length direction.
  • the middle section may also be a frosted rod with a predetermined length provided between the first end and the second end of the sleeve rod 31, and the two ends are respectively used to connect the first end and the second end.
  • the outer surface of the frosted rod is frosted, and its outer diameter and inner diameter are the same as those of the tip portion, and the frosted rod is coaxial with the first end and the second end of the sleeve rod 31.
  • the predetermined length can be set to 1 cm, and the specific length can be set according to different operations or different patients.
  • the scrub can increase the friction between the connecting rod 3 and the cavity wall, and at the same time increase the airtightness of the contact point between the connecting rod 3 and the cavity wall, so as to avoid air leakage during abdominal surgery and affect the operation.
  • the intracavitary surgical instrument of this embodiment includes an operating device and a handle, wherein the operating device includes an operating portion and a connecting portion, the handle is provided with a connecting rod, the connecting rod has a tip, and the tip of the connecting rod is connected to the operating device.
  • the connecting rod includes a hollow sleeve rod and a core rod movably arranged in the sleeve rod, and the core rod can be controlled to stay in different positions by operating the handle to open or close the operating device.
  • the operating device is placed in the cavity through the incision, the tip of the connecting rod enters the cavity along the puncture point and fixedly connected with the connecting portion of the operating device, and then the operating portion can be controlled by operating the handle outside the body to achieve the corresponding operation operating.
  • the diameter of the connecting rod is less than 3mm, and the puncture point does not need to be sutured, which can reduce the trauma of the patient's body.
  • the size of the operating device is not limited by the diameter of the connecting rod, making it easier to perform surgical operations outside the body.
  • the doctor when performing intracavitary surgery, the doctor opens a puncture hole B on the patient's body surface A as needed, and then inserts a puncture sleeve C corresponding to the size of the puncture hole B into the puncture hole B to form a surgical instrument Then put the operating device 1 into the cavity D through the puncture cannula C; the user holds the handle 2 and pierces the tip of the connecting rod 3 into the cavity D through other positions on the patient's body surface A; The connecting rod 3 is fixedly connected with the operating device 1 through the puncture hole B to operate in the cavity D; then, the user can control the operating device 1 through the handle 2 outside the body to perform corresponding surgical operations on the tissue or organ E in the cavity.
  • the operating device 1 includes an operating part 11 and a connecting part 12.
  • the operating device 1 may be an instrument suitable for intracavitary surgery, such as a medical holder, medical scissors, and the like.
  • the operating portion 11 is a traction clip. Doctors can choose different traction clips according to different target tissues. Such as lung clamp, stomach clamp, intestinal clamp, liver clamp, tendon clamp, blood vessel clamp, etc.
  • the traction clamp includes a sleeve 13, a push rod 14, a first elastic member 111 and a pliers head 15.
  • the sleeve 13 has an axially penetrating channel.
  • the push rod 14 includes a first section and a second section, and the diameter of the second section is larger than the diameter of the first section.
  • the inner surface of the sleeve 13 and the outer surface of the second section of the push rod 14 are smooth and sized, so that the push rod 14 can slide axially in the passage of the sleeve 13 smoothly.
  • the sleeve 13 also includes an end cap 132, which is arranged at the second end of the sleeve 13. A part of the end cap 132 is located in the passage of the sleeve 13, and the center of the end cap 132 has a hole that can accommodate the connecting rod 3. There is an annular groove at one end of the end cover 132 in the passage of the sleeve 12.
  • the first elastic member 111 is a first spring.
  • One end of the first spring is fixed in the annular groove of the end cover 132, and the other end is connected to the push rod 14 so that the push rod 14 keeps moving in the second direction. trend.
  • the end cover 132 can also be provided with a spring energy storage seal, so that the connection between the end cover 132 and the sleeve 13, and the connection between the end cover 132 and the sleeve rod 31 is more stable and can be more stable.
  • the coaxiality between the connecting rod 3 and the sleeve 13 and the push rod 14 is well ensured.
  • the clamp head 15 includes a nipper 151 and a transmission mechanism 152.
  • the structure of the transmission mechanism 152 is similar to that of the first embodiment, and will not be repeated here.
  • the user can make the core rod 32 move correspondingly in the axial direction by controlling the handle 2.
  • the push rod 14 is in the initial position, the angle between the two connecting arms 152b is small, and the angle between the two connecting points of the bent rod 152a and the connecting arm 152b The shortest distance, the clamp head 15 is closed.
  • the core rod 32 is controlled to move in the first direction, the first end of the core rod 32 pushes the push rod 14 to move in the first direction, which increases the angle between the two connecting arms 152b.
  • the first spring recovers from the stretched state to the natural state, pulling the push rod 14 to move in the second direction, so that one of the two connecting arms 152b
  • the angle between the two bending rods 152a is fixed relative to the sleeve 13 at the bending position, and the distance between the two joints of the bending rod 152a and the connecting arm 152b is also reduced correspondingly.
  • the opening angle becomes smaller, so that the two nippers 151 clamp the tissue or organ in the cavity that needs to be clamped.
  • the user can pull the handle in the second direction, so that the clamp head 15 drives the clamped intracavitary tissues and organs to leave the original position, so that the surgical field of vision can be well exposed.
  • the connecting mechanism 121 of the connecting portion 12 is provided on the end cover 132.
  • the structures of the connecting portion 12, the pliers head 15 and the handle 2 are similar to the corresponding structures of the first embodiment, and will not be repeated here.
  • FIG. 21 is a schematic diagram of the open state of the operating device of the intracavitary surgical device of this embodiment
  • FIG. 22 is a schematic diagram of the closed state of the operating device of the intracavitary surgical device of this embodiment.
  • the intracavitary surgical device of this embodiment has basically the same structure as the intracavitary surgical device of the first or second embodiment, with the only difference being:
  • the push rod 14 in the natural state (no external force), the push rod 14 is in the initial position, the angle between the two connecting arms 152b is small, and the angle between the two connecting points of the bent rod 152a and the connecting arm 152b is small.
  • the distance is the shortest, and the clamp head 15 is in an open state.
  • the core rod 32 is controlled to move in the first direction, the first end of the core rod 32 pushes the push rod 14 to move in the first direction, which increases the angle between the two connecting arms 152b.
  • the position of the bend is fixed relative to the sleeve 13, the distance between the two joints of the bending rod 152a and the connecting arm 152b is correspondingly increased, and the opening angle of the pliers head 15 is reduced.
  • the first spring drives the push rod 14 to move in the second direction, thereby reducing the angle between the two connecting arms 152b.
  • the bending rod 152a is fixed relative to the sleeve 13 at the bending position, the distance between the two joints of the bending rod 152a and the connecting arm 152b is also reduced correspondingly, and the opening angle of the clamp head 15 is increased, thereby releasing the Clamped cavity tissue or organ.
  • the pressing device 22 includes a button 221 and a guide post 222, and the guide post 222 includes an upper tooth post 223, a lower tooth post 224 and a second elastic member 225.
  • the second elastic member 225 is sleeved on the core rod 32 and supported between the base 321 at the second end of the core rod 32 and the boss in the first rod section of the grip rod to keep the core rod 32 and the pressing device 22 in the second direction Sports trends.
  • the second elastic member 225 is a second spring
  • the upper tooth column 223 includes a third elastic member 226, and the third elastic member 226 is a third spring. As shown in FIG.
  • three protruding guide rails 227 are fixed and evenly distributed in the inner circumferential direction of the first rod section of the grip rod, and the first end of each guide rail 227 is a tooth column 223 on the inclined surface.
  • Three rail grooves corresponding to the guide rail 227 are evenly distributed in the circumferential direction of the tooth end, and three teeth are evenly distributed in the tooth end of the upper tooth column 223 in the circumferential direction.
  • the tooth end of the lower tooth column 224 is evenly distributed with three guide rail grooves corresponding to the guide rail 227 in the circumferential direction, and the tooth end of the lower tooth column 224 is evenly distributed with three teeth in the circumferential direction.
  • the rail grooves of the upper tooth column 223 and the rail grooves of the lower tooth column 224 have different distribution positions on the teeth.
  • the tooth end of the upper tooth column 223 can mesh with the tooth end of the lower tooth column 224, and the inclined surface of the first end of the guide rail 227 can also mesh with the tooth end of the lower tooth column 224.
  • the third spring is sleeved on the upper shank 223 and supported between the upper shank 223 and the second end of the guide rail 227 in the grip rod 21 to keep the upper shank 223 moving in the second direction.
  • the button 221 is connected to the non-tooth end of the upper tooth column 223.
  • the pressing device 22 When the pressing device 22 is in a natural state (in a state without any external force), the first end of the guide rail 227 is in the guide groove of the lower shank 224, and the second end of the guide rail 227 is in the guide groove of the upper shank 223.
  • the tooth end of 223 is partially meshed with the tooth end of the lower tooth column 224.
  • the upper shank 223 also moves in the first direction along the guide rail 227, pushing the lower shank 224 to move in the first direction along the guide rail 227 until the upper shank 223 and the lower
  • the meshing surface of the tooth column 224 is in the same plane as the inclined surface of the first end of the guide rail 227, that is, the first end of the guide rail 227 is away from the guide groove of the lower tooth column 224.
  • the core rod 32 moves in the first direction to the second position In the vicinity, the opening angle of the traction clip is reduced, while the second spring and the third spring are compressed.
  • the core rod 32 moves in the first direction, and the second spring and the third spring are compressed.
  • the meshing surface of the upper tooth column 223 and the lower tooth column 224 is in the same plane as the inclined surface of the first end of the guide rail 227, the external force applied to the button 221 is reduced or removed, and the lower tooth column 224 is moved toward the second
  • the force of the third direction moves in the second direction along the meshing surface until the first end of the guide rail 227 enters the guide groove of the lower shank 224.
  • the third spring exerts a force in the second direction on the upper shank 223.
  • the upper tooth column 223 is moved along the guide rail 227 in the second direction to the vicinity of the first position.
  • the core rod 32 moves a certain distance in the second direction, and the opening angle of the traction clip increases to release the clamped cavity
  • the tissue or organ, that is, the pressing device 22, returns to its natural state.
  • the pressing device includes a button 221, a guide post 222 and a motor.
  • the guide post 222 has threads in the circumferential direction, a corresponding threaded section and a corresponding limit device are arranged on the channel wall of the grip rod 21, and the shaft of the motor is connected with the guide post 222 to drive the guide post 22 to rotate.
  • the motor housing is slidably connected with the grip rod 21.
  • a guide groove is provided in the channel of the grip rod 21, and a guide block is provided at a corresponding position on the motor housing, so that the motor can slide along the guide groove.
  • the button 221 is electrically connected to the motor, and can control the motor to rotate forward and reverse.
  • the button 221 controls the motor to rotate in one direction
  • the guide post rotates in the first direction along the corresponding thread on the channel of the grip rod 21, and the core rod 32 also moves in the first direction and finally stays near the second position.
  • the operating device 1 is in a closed state.
  • the button 221 controls the motor to rotate in another direction
  • the guide post rotates in the second direction along the corresponding thread on the channel of the grip rod 21, and the core rod 32 also moves in the second direction and finally stays in the first position.
  • the operating device 1 is in an open state.
  • the structures of the sleeve 13, the push rod 14, the connecting portion 12, and the handle 2 are similar to the corresponding structures in the first or second embodiment, and will not be repeated here.
  • FIG. 23 is a partial cross-sectional view of the tip of the connecting rod of the intracavitary surgical device of this embodiment
  • FIG. 24 is a partial cross-sectional view of the tip of the connecting rod of the intracavitary surgical device of this embodiment.
  • the connecting rod 3 has a tip portion, and the tip portion of the connecting rod 3 is provided on the sleeve rod 31.
  • the tip portion of the sleeve rod 31 is used for puncture, and the first end of the core rod 32 is relatively flat, and has a larger contact area with the push rod 14, which can push the push rod 14 more smoothly and make the operation of the operating part 11 smoother.
  • the sleeve rod 31 and the core rod 32 can also be provided with tip portions, so that the connecting rod 3 can still be worn when the tip of one of the sleeve rod 31 or the core rod 32 is worn. Can perform puncture operations.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un instrument de chirurgie endoluminale, comprenant un dispositif d'actionnement (1) et une poignée (2). Le dispositif d'actionnement (1) comprend une partie d'actionnement (11) et une partie de liaison (12). La poignée (2) est pourvue d'une tige de liaison (3), la tige de liaison (3) comporte une partie pointe et la partie pointe de la tige de liaison (3) est reliée au dispositif d'actionnement (1). La tige de liaison (3) comprend une tige creuse de manchon (31) et une tige centrale (32) disposée de manière mobile dans la tige de manchon (31), la tige centrale (32) pouvant être commandée pour rester dans différentes positions au moyen de l'actionnement de la poignée (2), de façon à permettre l'ouverture ou la fermeture du dispositif d'actionnement (1). Pendant une opération, le dispositif d'actionnement (1) est placé dans une lumière (D) à travers une incision (B), la partie pointe de la tige de liaison (3) pénètre ensuite dans la lumière (D) le long d'un point de perforation et est reliée fixement à la partie de liaison (12) du dispositif d'actionnement (1), la poignée (2) étant ensuite actionnée in vitro, de façon à pouvoir la commander la partie d'actionnement (11) pour mettre en œuvre une opération chirurgicale correspondante. Le diamètre de la partie pointe de la tige de liaison (3) est inférieur à 3 mm, si bien que le point de perforation ne nécessite pas de suture, ce qui réduit une lésion du corps d'un patient. De plus, comme le dispositif d'actionnement (1) peut être détaché de la poignée (2), la taille du dispositif d'actionnement (1) n'est pas limitée par le diamètre de la tige de liaison (3), si bien qu'il est possible d'effectuer plus commodément l'opération chirurgicale in vitro.
PCT/CN2020/092118 2019-06-14 2020-05-25 Instrument de chirurgie endoluminale Ceased WO2020248807A1 (fr)

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CN201910517911.4 2019-06-14

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CN111493952A (zh) * 2020-05-29 2020-08-07 北京市富乐科技开发有限公司 一种椎体间撑开组件和椎体间撑开器
CN112603396B (zh) * 2020-12-22 2024-12-27 南微医学科技股份有限公司 一种组织牵引装置及组织牵引装置的使用方法
CN114699143A (zh) * 2022-03-17 2022-07-05 广东海恺普新型医药包装材料有限公司 一种定位导丝推送装置及包括其的软组织定位装置
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