CN103948404B - Exempt from auxiliary incision anus trocar device - Google Patents

Exempt from auxiliary incision anus trocar device Download PDF

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Publication number
CN103948404B
CN103948404B CN201410168748.2A CN201410168748A CN103948404B CN 103948404 B CN103948404 B CN 103948404B CN 201410168748 A CN201410168748 A CN 201410168748A CN 103948404 B CN103948404 B CN 103948404B
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anus
guiding tube
bonnet
exempt
trocar
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CN103948404A (en
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蔡建春
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Zhongshan Hospital Xiamen University
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Zhongshan Hospital Xiamen University
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/32056Surgical snare instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/04Endoscopic instruments

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

Abstract

Exempt from auxiliary incision anus trocar device, relate to laparoscopically surgical operation assistive device.There is provided one to have abdominal part without cicatrix, farthest reduce postoperative pain, that shortens the advantage such as hospital stays and expense exempts from auxiliary incision anus trocar device.Be provided with trocar sheath, guiding tube, bonnet and apparatus port lid; The tail end band external screw thread of described trocar sheath, trocar sheath is enclosed within outside guiding tube, and be located at the female thread of bonnet and be located at the external thread bolt connection of trocar sheath tail end, the front end of guiding tube is provided with tapering, and the rear end of guiding tube is provided with handgrip; The afterbody of bonnet is provided with instrument hole, the female thread of apparatus port lid and the afterbody external thread bolt connection of bonnet.Left hemicolon under peritoneoscope, rectum resection operation can be completed without stomach wall auxiliary incision, reach the object of Wicresoft, abdominal wound is more attractive in appearance, avoids postoperative incisional hernia, infection of incisional wound, splits, the generation of otch tumor stomach wall plantation etc., can reduce the probability of intestinal tube adhesion simultaneously; Reach without tumorization operation, simple, convenient, safe and reliable.

Description

Exempt from auxiliary incision anus trocar device
Technical field
The present invention relates to laparoscopically surgical operation assistive device, especially relate to and exempt from auxiliary incision anus trocar device.
Background technology
Laparoscopic surgery is developed to colon, proctectomy gradually from the eighties in 20th century, the advantages such as peritoneoscope knot, operation on rectum is little with its wound, rehabilitation fast, few intercurrent disease, and can obtain the effect identical with conventional therapy, obtains and develops rapidly.Through exploration and the accumulation in more than 20 years, peritoneoscope is assisted Colon and rectum to perform the operation and is gradually improved.Minimally invasive surgery more and more receives the concern of surgeon and patient as one of the important symbol of modern surgery, reduces wound and farthest reservation function is one of development trend of current surgical oncology following under surgical radical treatment principle prerequisite as far as possible.For reducing wound further and reaching better cosmetic result, scholar is had to propose the imagination of " without scar operation ".Within 1994, PeterWilk proposes through natural tract endoscopic surgery technology (naturalorificetransluminalendoscopicsurgery first, NOTES) concept, refer to utilize nature duct (oral cavity, anus, vagina, urethra etc.), soft scope is entered body cavity, puncture hollow organ wall (stomach, colon, vagina, bladder) enters abdominal cavity, completes abdominal visceral browser operation.But as an emerging surgical technic, NOTES is still immature in clinical carrying out, and still needs the practice and exploring of long period.Under the condition still not possessing NOTES operation, making full use of nature tract taking-up specimen can reduce operative incision, more meets the theory of function surgery.Take out specimen through anus, without the need to making auxiliary incision at stomach wall, i.e. taNOSE operation (Transanalnaturalorificespecimenextraction) is a kind of improvement " NOTES " operation.
Summary of the invention
The object of the present invention is to provide one to have abdominal part without cicatrix, farthest reduce postoperative pain, that shortens the advantage such as hospital stays and expense exempts from auxiliary incision anus trocar device.
The present invention is provided with trocar sheath, guiding tube, bonnet and apparatus port lid;
The tail end band external screw thread of described trocar sheath, trocar sheath is enclosed within outside guiding tube, and be located at the female thread of bonnet and be located at the external thread bolt connection of trocar sheath tail end, the front end of guiding tube is provided with tapering, and the rear end of guiding tube is provided with handgrip; The afterbody of bonnet is provided with instrument hole, the female thread of apparatus port lid and the afterbody external thread bolt connection of bonnet.
Described trocar sheath takes out specimen for expanding intestinal tube, to effects such as the mechanical damage of mucosa and muscle, pollution and tumor plantings when preventing from taking out specimen, is convenient to insert anastomat nail seat in art simultaneously.
Described guiding tube is used for when anus sends into rectum, avoiding intestinal wall to damage trocar sheath and reducing the power-assisted that rubs, and guiding tube is enclosed within trocar sheath, and described tapering can be conus portion, and the stage casing of guiding tube is preferably coarctation segment, to reduce frictional resistance when taking out guiding tube.
Described bonnet is used for fixing guiding tube and maintains pneumoperitoneum, and keep intraperitoneal valid function space, the instrument hole set by rear cover back-end can be used for stretching into of operating theater instruments if desired and takes out.
Described apparatus port lid is for safeguarding pneumoperitoneum.
Described handgrip can adopt groove, is convenient to guiding tube in art and takes out in trocar sheath.
The length of described trocar sheath can be 22cm, and external diameter can be 4cm, and internal diameter can be 3.8cm.
The length of described guiding tube can be 28cm, and the diameter that the widest part of conus portion is divided can be 3.7cm, and the diameter of coarctation segment can be 2.5cm, and the diameter of afterbody can be 3.7cm, and wall thickness can be 0.1cm.
The external diameter of described bonnet can be 4cm, and internal diameter can be 3.8cm, and height can be 2cm; The external diameter of instrument hole can be 1.5cm, and internal diameter can be 1.3cm, and height can be 1cm.
The diameter of described apparatus port lid can be 2cm, and height can be 1.2cm.
Total length of the present invention can be 29.2cm.
Outstanding advantages of the present invention is as follows:
1, left hemicolon under peritoneoscope, rectum resection operation can be completed without stomach wall auxiliary incision.
2, without stomach wall auxiliary incision, reach the object of Wicresoft further, abdominal wound is more attractive in appearance.
3, without stomach wall auxiliary incision, avoid postoperative incisional hernia, infection of incisional wound, split, the generation of otch tumor stomach wall plantation etc., the probability of intestinal tube adhesion can be reduced simultaneously;
4, " NOSE " of other modes performs the operation relatively, need not move to outside anus by intestinal tube, reduces unnecessary mesentery and is separated.
5, be expert at when exempting from auxiliary incision left hemicolon, proctectomy can complete taking-up specimen for the anus trocar device of designed, designed, per anum is avoided directly to haul out, the mechanical damage of rectum anal tube mucosa, muscle and intestinal tube are torn and may bring infection thus, specimen is taken out by tubular device, reach without tumorization operation, avoid the harm that tumor cell such as may to plant at the complication.
6, post-operative recovery is fast, and postoperative pain is lighter, and gastrointestinal function recovers fast, and the rehabilitations such as feed, out-of-bed activity are also fast, and body surface is without obvious wound and cicatrix, and trauma of abdomi napwall is less.
7, compared with conventional laparoscopic art formula, the present invention can save hospital stays and hospitalization cost, alleviates patient economy burden.
8, simple, convenient, safe and reliable.
Accompanying drawing explanation
Fig. 1 is the structure composition schematic diagram of the embodiment of the present invention.
Fig. 2 is the structure composition schematic diagram of embodiment of the present invention trocar sheath.
Fig. 3 is the structure composition schematic diagram of embodiment of the present invention guiding tube.
Fig. 4 is the structure composition schematic diagram of embodiment of the present invention bonnet.
Fig. 5 is the structure composition schematic diagram of embodiment of the present invention apparatus port lid.
Detailed description of the invention
Following examples will the present invention is further illustrated by reference to the accompanying drawings.
See Fig. 1 ~ 5, the embodiment of the present invention is provided with trocar sheath 1, guiding tube 2, bonnet 3 and apparatus port lid 4.
The tail end band external screw thread 11 of described trocar sheath 1, trocar sheath 1 is enclosed within outside guiding tube 2, and the female thread 31 being located at bonnet 3 is spirally connected with the external screw thread 11 being located at trocar sheath 1 tail end, and the front end of guiding tube 2 is provided with tapering 21, and the rear end of guiding tube 2 is provided with handgrip 22; The afterbody of bonnet 3 is provided with instrument hole 32, and the female thread 41 of apparatus port lid 4 is spirally connected with the afterbody external screw thread 31 of bonnet 3.
Described trocar sheath 1 is mainly used in expanding intestinal tube and takes out specimen, to effects such as the mechanical damage of mucosa and muscle, pollution and tumor plantings when preventing from taking out specimen, is convenient to insert anastomat nail seat in art simultaneously.
Described guiding tube 2 for avoiding intestinal wall to damage trocar sheath 1 and reducing the power-assisted that rubs when anus sends into rectum, and guiding tube 2 is enclosed within trocar sheath 1, and described tapering is conus portion, and guiding tube 2 stage casing is coarctation segment, to reduce frictional resistance when taking out guiding tube 2.
Described bonnet 3 is for fixing guiding tube 2 and maintain pneumoperitoneum, keeps intraperitoneal valid function space, instrument hole 32 the stretching into and taking out for operating theater instruments set by bonnet 3 rear end.
Described apparatus port lid 4 is for safeguarding pneumoperitoneum.
Described handgrip 22 adopts groove, is convenient to guiding tube 2 and takes out from anal orifice.
The length of described trocar sheath 1 is 22cm, and external diameter is 4cm, and internal diameter is 3.8cm.
The length of described guiding tube 2 is 28cm, and the diameter that the widest part of conus portion is divided is 3.7cm, and the diameter of coarctation segment is 2.5cm, and the diameter of afterbody is 3.7cm, and wall thickness is 0.1cm.
The external diameter of described bonnet 3 is 4cm, and internal diameter is 3.8cm, and height is 2cm; The external diameter of instrument hole 32 is 1.5cm, and internal diameter is 1.3cm, and height is 1cm.
The diameter of described apparatus port lid 4 is 2cm, and height is 1.2cm.
Total length of the present invention is 29.2cm.
Trocar sheath 1 is main function components of the present invention, plays expansion of intestinal canal, takes out specimen, to effects such as the mechanical damage of mucosa and muscle, pollution and tumor plantings when preventing from taking out specimen.Facilitate in art simultaneously and insert anastomat nail seat, complete intestinal wall and coincide.
The stage casing of guiding tube 2 adopts constriction structure, can reduce in art frictional resistance when taking out guiding tube 2.The conical structure of described guiding tube 2 front end can make apparatus avoid when entering rectum damaging intestinal wall, can reduce frictional resistance again.When arriving target intestinal tube, bonnet 3 can be opened, taking out guiding tube 2, then shutting bonnet 3, prevent CO2 gas from losing.
The afterbody external thread part of described bonnet 3 plays maintenance pneumoperitoneum, keeps the effect in intraperitoneal valid function space.Open apparatus port lid 4, can stretch into apparatus assisting operation, the inner thread structure of apparatus port lid 4 combines with bonnet 3, plays the effect jointly safeguarding pneumoperitoneum, when carrying out anus instrumentation, can open apparatus port lid 4.
Below provide operational approach of the present invention and process:
A: be separated left hemicolon mesentery, vascular root folder closes and cuts off arteriovenous under mesentery, and cleans vascular root lymphoid tissue, free left hemicolon, rectum epimere and mesentery thereof, and purging zone draining lymph tissue.Expand anus after sterilization, assemble the present invention, be coated with paraffin oil, send into anus.
B: arrive pre-dialysis place of far-end intestinal tube, open bonnet 3, takes out guiding tube 2.
C: directly send into circular staplers nail seat to tumor near-end intestinal tube (or in tumor upper and lower intestinal wall holing feeding respectively) through the present invention.
D: cover bonnet 3, cuts off colon above closed tumor with intracavity cutting closer.
E: after the intestinal tube that nakedization is coincide in advance, ultrasound knife cuts off intestinal tube in tumor far-end holostrome.
F: open bonnet 3, pulls out tumor place intestinal tube through the present invention.
G: take out the present invention.
H: ultrasound knife cuts near-end intestinal canal anastomosis place one aperture, pull-out circular staplers nail seat head, again uses the intracavity cutting closer closed distal intestinal tube broken ends of fractured bone (about 1cm), takes out the broken ends of fractured bone through laparoscope penetration hole.
I: per anum inserts circular staplers fuselage, row end to end anastomosis.
J: coincide.
Applicable elements of the present invention: colorectal carcinoma diameter should not be too large, otherwise not easily from anus haul out swollen thing (it is generally acknowledged tumor invading rectum week footpath >1/2 or blocked, mesorectum especially plumpness, longest diameter of tumor >4cm, have the patient of infringement to use to tub wall and surrounding tissue).
Technical scheme of the present invention proposes under the inspiration of laparoscopic surgery for colorectal neoplasm development trend, notes concept, take out specimen through the present invention and coincide, exempt from auxiliary incision formula peritoneoscope left hemicolon, proctectomy, specimen is taken out through anus, without the need to separately making otch at stomach wall, i.e. taNOSE operation (Transanalnaturalorificespecimenextraction) is a kind of improvement " NOTES " operation.

Claims (9)

1. exempt from auxiliary incision anus trocar device, it is characterized in that being provided with trocar sheath, guiding tube, bonnet and apparatus port lid;
The tail end band external screw thread of described trocar sheath, trocar sheath is enclosed within outside guiding tube, and be located at the female thread of bonnet and be located at the external thread bolt connection of trocar sheath tail end, the front end of guiding tube is provided with tapering, and the rear end of guiding tube is provided with handgrip; The afterbody of bonnet is provided with instrument hole, the female thread of apparatus port lid and the afterbody external thread bolt connection of bonnet;
The stage casing of described guiding tube is coarctation segment.
2. exempt from auxiliary incision anus trocar device as claimed in claim 1, it is characterized in that described tapering is conus portion.
3. exempt from auxiliary incision anus trocar device as claimed in claim 1, it is characterized in that described handgrip adopts groove.
4. exempt from auxiliary incision anus trocar device as claimed in claim 1, it is characterized in that the length of described trocar sheath is 22cm, external diameter is 4cm, and internal diameter is 3.8cm.
5. exempt from auxiliary incision anus trocar device as claimed in claim 1, it is characterized in that the length of described guiding tube is 28cm.
6. exempt from auxiliary incision anus trocar device as claimed in claim 2, it is characterized in that the diameter that the widest part of described conus portion is divided is 3.7cm, the diameter of coarctation segment is 2.5cm, and the diameter of afterbody is 3.7cm, and wall thickness is 0.1cm.
7. exempt from auxiliary incision anus trocar device as claimed in claim 1, it is characterized in that the external diameter of described bonnet is 4cm, internal diameter is 3.8cm, and height is 2cm.
8. exempt from auxiliary incision anus trocar device as claimed in claim 1, it is characterized in that the external diameter of described instrument hole is 1.5cm, internal diameter is 1.3cm, and height is 1cm.
9. exempt from auxiliary incision anus trocar device as claimed in claim 1, it is characterized in that the diameter of described apparatus port lid is 2cm, height is 1.2cm.
CN201410168748.2A 2014-04-24 2014-04-24 Exempt from auxiliary incision anus trocar device Active CN103948404B (en)

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Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104706388B (en) * 2015-03-19 2017-06-06 厦门大学附属中山医院 One kind exempts from auxiliary incision right hemicolon sample per anum and takes out trocar device
CN104721945A (en) * 2015-04-13 2015-06-24 广西昌鑫科技有限公司 Disposable gynecology vagina examination expander and use method thereof
CN105476709B (en) * 2016-01-15 2017-09-12 宿迁市第一人民医院 A kind of rectum turns up assistive device
CN108567477A (en) * 2017-03-13 2018-09-25 潘凯 Sample device is taken through natural cavity
CN108158616A (en) * 2018-01-08 2018-06-15 浙江大学 The gas that tumor specimen is taken out used in the postoperative per anum of Colon and rectum fills formula lane device
CN108986621B (en) * 2018-10-12 2023-06-30 北京大学人民医院 Simulation trainer for anorectal NOTES endoscopic surgery

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US7597688B1 (en) * 2004-12-27 2009-10-06 Masson Marcos V Cannula apparatus with inflatable seal and adjustable length
CN101919726A (en) * 2002-07-31 2010-12-22 机能医疗干预公司 Orifice introducer device
CN203263449U (en) * 2013-05-21 2013-11-06 高志刚 Transanal minimally invasive surgery pathway set
CN203802511U (en) * 2014-04-24 2014-09-03 厦门大学附属中山医院 Auxiliary-incision-free anus cannula device

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Patent Citations (4)

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Publication number Priority date Publication date Assignee Title
CN101919726A (en) * 2002-07-31 2010-12-22 机能医疗干预公司 Orifice introducer device
US7597688B1 (en) * 2004-12-27 2009-10-06 Masson Marcos V Cannula apparatus with inflatable seal and adjustable length
CN203263449U (en) * 2013-05-21 2013-11-06 高志刚 Transanal minimally invasive surgery pathway set
CN203802511U (en) * 2014-04-24 2014-09-03 厦门大学附属中山医院 Auxiliary-incision-free anus cannula device

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