JPS6141445A - Surgical instrument for enlarging edge of wound - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION [Technical Field] The present invention relates to a surgical instrument for widening the edges of a wound, and more particularly to at least one valve for application to the edge of the wound;
a pedestal, each of the bulbs having a shovel-shaped central portion and a protruding edge substantially perpendicular thereto, the pedestal supporting the end of the bulb opposite the protruding edge; It relates to a surgical instrument that unfolds.

[Prior art]

Instruments of this type with a shovel-like valve are used, for example, to widen the edges of a wound in order to have free access to the surgical area.

In the case of this type of device, for example, the base is equipped with only one valve, and in order to widen the opposite wound edges, two valves, which can be fixed on the base at different distances from each other, are provided. The valve is often fixed to a stand.

According to French Patent Publication No. 69'0530, a surgical instrument is known which has a plurality of integrally molded valves. These valves are mounted on a pedestal so that they can be moved in adjustment directions perpendicular to each other. The first adjustment direction makes it possible to widen the edges of the wound, and the second direction adapts the table to the size of the body part to be operated on, so that the body part is placed on the table with the valve. Be surrounded. This structure has the disadvantage that the reach area of the individual valves does not change.

Depending on the respective plug-in, different valve lengths must be selected. The length of the bulb is related to, for example, the location of the area to be operated on or the thickness of the tissue to be restrained. Surgical widening instruments of this type therefore usually include a set of valves of different lengths, which are connected to a platform as desired. Not only is this wasteful in purchasing and managing, but it also often requires determining during surgery what size valve is needed; must be replaced. This is tedious and a waste of time.

[Purpose of the invention]

SUMMARY OF THE INVENTION The object of the invention is to improve a surgical instrument belonging to the above-mentioned technical field so that a single valve can be used to insert the surgical instrument even at different depths of the wound margins. .

[Summary of the invention]

This object is achieved according to the invention in a surgical instrument of the type mentioned at the outset.

That is, the central part contains two parts movable relative to each other, one of which is held on a stand and the other supports a projecting edge, and the different lengths of the central part formed by the two parts and the corresponding fixing the two parts to each other in relative positions on the mount such that different distances between the protruding edges and the platform result; This arrangement therefore allows the valve to be trimmed to an effective length so that it can be quickly adapted to each case without having to replace the valve.

It is advantageous if the two parts of the central part lie flat against each other. This ensures that the two parts are guided toward each other.

A further improvement is achieved by bending the two parts of the central part transversely to its direction of movement.

According to a preferred embodiment of the invention, one of the two parts is provided with at least one longitudinal slit, into which at least one part is held in the other part.
Two guide members protrude. Preferably, the distance of the guide member from the other part is adjustable between a clamped position and a released position, in said clamped position both parts are firmly pressed together and in the released position. In the case both parts are movable relative to each other. By adjusting the guide member between two positions, both parts can be quickly moved relative to each other and then fixed again in the desired relative position, so that the spatial needs can be adapted at any time during the surgery. can be done.

It is advantageous if the guide element is a clamping screw that is screwed into the other part.

It is particularly advantageous if two parallel longitudinal slits are formed in one part and two guide elements protrude into each longitudinal slit.

In this way, the two parts can be guided to each other very precisely.

In the case of a particularly preferred embodiment of the invention, the holding area of the valve can be adapted without problems even if the instrument has already been inserted into the wound. This is possible in that the two mutually movable parts of the central part are adjustable relative to each other in the direction of movement by the drive, when the instrument is inserted into the wound. can be driven outside the wound.

As the driving means, for example, a combination of a torque rod or a rack rail that can be tightened and fixed and a pinion that meshes with the rack rail can be considered.

Advantageously, the drive means includes a rotatable pin with a threaded part, a guide element with an internal thread part that engages with the thread of the pin, and a fixed bearing, in which case the guide element and the fixed bearing are attached to different parts of the central part and guide the pin parallel to the direction of movement,
Hold. By rotating the pin, precise adjustment of the holding area of the valve is effected at any time. In this case, no special clamping elements are required to secure the two movable parts of the central part of the valve to each other. This is because the tightening force of the drive member itself is sufficient for the tightening effect. Furthermore, the complementary internal thread of the guide member can be formed in the following manner, ie, in such a way that the internal thread can perform the function of a guide member for guiding the movement movement.

In a preferred embodiment of the device, the guide member is held in the part supporting the projecting edge, and the fixed bearing is provided in the central part, which is fixed to the base. This prevents the pin from falling out of the valve and protruding into an obstruction when adjusting the holding area.

It is a good idea to protect the pins with a cover. The actuating member of the adjustable valve is thereby protected from dirt. This is also advantageous from a sanitary point of view. This is because by covering it, you can avoid the dents where dirt accumulates.

When handling the instrument, it is further preferable to form a hexagonal groove in the end of the pin on the base side. This prevents the tools necessary for adjusting the valve from slipping out when adjusting the holding area of the valve.

Preferably, the central portion is fixed against rotation with respect to the base using a pin.

〔Example〕

Next, two preferred embodiments of the present invention will be described in detail using the drawings.

The figure shows two valves 1 and 20, each of which comes from two parts, namely a fixed part 2
22 and edge portions 3 to 23.

In the case of the valve shown in FIGS. 1 to 3, the fixed part 2 consists essentially of a bent plate in the shape of an L, with an annular groove 6 on the outside of the shorter side 4. A fixing pin 5 is attached. The other side 5, unlike the first side 4, is bent in a direction perpendicular to the vertical direction so as to have a concave surface when viewed from the outside.

The edge portion is similarly formed into a plate shape, and is bent in the direction orthogonal to the longitudinal direction as follows, that is, so as to flatly attach to the lower side of the side 7. The end of the edge portion that is far from the short side 4 of the fixed portion is a tip portion 8 that is bent at a nearly right angle, and the direction in which this tip portion 8 projects from the edge portion 3 is the short side. This is the same direction as the side 4 protrudes from the fixed part.

The long side 7 and the edge part 3 together form a central part 9 of the bulb 1, by which the short side 4 used for fixing and the bent tip 8 are connected to each other. There is.

Two vertical slits 10 and 11 are formed in the long side 7 of the central portion, parallel to the longitudinal direction of the bulb, and the upper side of the bulb of these slits is widened in stages. Four screws 12, 13°, 14.15 are inserted from above through these vertical slits 10 and 11, and their heads 16°, 17°, 18, 19 are inserted into the vertical slits 10 and 11 in stages. You will be guided to the widening section. These screws are screwed into the edge part 3 which adjoins the long side 7 flatly. The screw thus forms a guide member that guides the relative movement between the edge part and the fixed part. The two screws are pivotally supported so that they can move relative to each other.
Since the two parts can be tightened together, the two parts can be fixed in a desired relative position. In FIG. 1, there are shown two positions where the edge part can move relative to the fixed part, and in the position shown by the dashed line, the distance between the tip part 8 and the fixed side 4 is small, but The distance is large at the position indicated by the solid line.

It can be adjusted to any distance in between.

A second embodiment of the valve according to the invention, shown in FIGS. 4 to 8, is provided with a fixed portion 22, which consists of a generally L-shaped plate bent in the longitudinal direction. A fixing pin 5 having an annular groove 6 on the circumferential surface is attached to the outside of the short side 24 thereof. If rotation of the valve 20 with respect to the pedestal holding this pin is not desired, a pin 42 is provided next to the fixed pin 5 on the short side 24, which fits into a complementary pocket hole in the pedestal.

Unlike the first side 24, both vertical edges of the other side 27 are formed with a U-shaped bent portion,
This portion is used as a guide member 44 for guiding the edge portion 23 (see FIG. 7).

The edge portion 23 is formed as a simple plate, and the end portion of the fixing member 22 far from the short side 24 is formed with a tip portion 8 bent at a nearly right angle. The direction in which the short side 24 protrudes from the fixed portion 22 is the same as the direction in which the short side 24 protrudes from the fixed portion 22.

The long side 27 and the edge portion 23 basically form the valve 2.
A central portion 29 of 0 is formed, and the short side 24 used for fixing and the bent tip portion 8 are connected to each other by this central portion.

The edge portion 23 is guided by a guide member 44 of the fixed portion 22 so as to be flatly attached to the lower end of the long side 27. The edge portion 23 is formed in a semi-cylindrical shape inside the edge portion 23 and extends along the longitudinal edge 4 of the guide member 44.
Further guidance is provided by a portion 34 inserted into the gap between 50 and 50. This section 34 extends longitudinally up to the tip 8 of the edge section and thereby serves at the same time as a cover 38 over the pin 30.

This portion 34 is formed with a hole 46 having a female thread in parallel to the longitudinal direction, and a complementary male thread 3 is formed in this hole.
6 can be screwed together. pin 30
is further held on the short side 24 by a fixed bearing 32. A head 48 is provided at the end of the pin 30 on the stand side, and a hexagonal groove 40 is formed in this head.

The base side of the fixed bearing 32 has a head 48 provided on the short side 24.
The opposite side is constituted by an annular groove 33 formed in the pin 30 having a retaining ring 35 that fits into the groove, and the retaining ring 35 is formed on the surface of the short side 24 opposite to the base. Attach to.

The pin 30 is fixed in position relative to the short side 24 by a fixed bearing 32 in such a way that the edge portion 23 cannot be moved relative to the fixed portion 22 without turning the pin 30.

The function of this fixed bearing is to fix the pin 30 within the fixed part 22 and to absorb the axial forces acting on the pin 30 when adjusting the restraining area.

Therefore, once adjusted, the suppression area of the valve cannot be changed unintentionally. Of course, the construction of the fixed bearing is not limited to the method described above, but can of course be carried out in any other manner known to those skilled in the art. By rotating the pin 30,
The male thread 36 enters or exits the complementary female thread of the bore 46, thereby locking the pin 30 into the fixed bearing 3.
2 forces a relative movement between the edge portion 23 and the fixing portion 22, which movement adjusts the longitudinal extension of the valve and, accordingly, its restraint area. be able to.

FIG. 8 shows a valve 20 inserted into a surgical wound.
and is close to the wound 50. The dash-dotted edge portion 23 and the double arrow indicate how the length of the valve is adapted to the depth of the tissue to be preserved. This valve can be used to open the surgical wound very wide, allowing access to the surgical area.

FIG. 8 particularly clarifies that if the amount of expansion of the valve can be adjusted from outside the surgical wound, it will be easier to adjust the amount of expansion of the valve that has already been inserted into the wound. . Since the specific depth of a surgical wound is determined when the surgical field is opened and the valve inserted, it is of particular interest to be able to insert a valve that has already been inserted into the wound. That's true.

The valve shown in the figure can be inserted into a holding device of a stand (not shown) using a fixing pin, and in this case a spring member fits into the groove 6 and fixes the valve so that it does not fall out. . The valve is then held rotatably about the vertical axis of the fixing pin 5.

If you do not want the valve to rotate relative to the base,
Rotation of the valve can be prevented using a pin 42 that fits into a complementary recess of a retaining device provided in the base.

By using length-adjustable valves, it is no longer necessary to use a set of valves of different lengths to change the length of the valve; Either by loosening the screw connecting the two parts, moving the two parts to the desired relative position, and then tightening the screw again, or by threading the externally threaded part of the pin into the complementary internally threaded part of the edge part. The length can be adjusted to the desired length at any time by inserting or removing it. In the latter case, other fastening means of the two parts of the valve can be dispensed with.

This is because the force of the threaded pin itself is sufficient to provide a lasting fixation.

In either case, the length adjustment can also be made intraoperatively, and in the embodiment shown in FIGS. It also has the further advantage of being able to be used in valves outside of.

[Brief explanation of the drawing]

Figure 1 is a side view of a valve whose length can be adjusted, Figure 2 is a top view of the valve based on Figure 1, and Figure 3 is 3-3 in Figure 2.
FIG. 4 is a cross-sectional view taken along line 4--4 of another embodiment of the valve according to the present invention; FIG. 5 is a cross-sectional view taken along line 4--4;
6 is a front view of the valve shown in FIG. 4, FIG. 7 is a sectional view taken along line 7-7 in FIG. 5,
FIG. 8 is a side view of two adjustable length bulbs inserted into the wound. 1... Valve, 2... Fixed part, 3... Edge part, 4... Short side, 5... Fixed pin,
6... Annular groove, 7... Long side, 8... Tip, 9... Center, 1.0, 11... Vertical slit, 12-15... Screw, 16- 19...
・Head, 20...Valve, 22...Fixed part, 23...Edge part, 24...Short side, 27...
Long side, 29...center, 30...pin,
31...Stopper, 32...Okiichi bearing, 33
...Annular groove, 34...Part, 35...Retaining ring, 36...Male thread portion, 38...Cover, 4
0... Hexagonal groove, 42... Pin, 44... Guide Md5U, 45... Vertical edge, 46... Hole, 48... Head, 50... Wound, 5
2...Organization. Margin below

Claims (1)

[Claims] 1. At least one bulb attached to the edge of the wound, each having a shovel-shaped central part and an edge protruding approximately at right angles thereto; and a protruding central part of the valve; A surgical instrument for widening the edges of a wound with an edge and a stand holding the opposite ends, in which the central part (9; 29) has two parts movable relative to each other (fixed part 2 to 22; edge part 3 to 23), one of which is supported on the platform and the other supports a protruding edge (tip 8), and because both parts can be fixed to each other in various relative positions, The central part formed (9;
29) and the associated protruding edges (
Surgical instrument for widening the edges of a wound, characterized in that various distances between the tip 8) and the platform occur. 2. According to claim 1, the two parts (side 7, edge part 3; side 27, edge part 23) of the central part (9; 29) are flatly overlapped with each other. Surgical instruments. 3. A patent claim characterized in that two parts (side 7, edge part 3; side 27, edge part 23) of the central part (9; 29) are bent in a direction transverse to the direction of movement thereof. The surgical instrument according to item 1 or 2. 4. At least one longitudinal slit (10, 11) is provided in one of the two parts (side 7), and at least one guide member is held in the other part (edge part 3) in this slit. (Screws 12, 13, 14, 1
5) The surgical instrument according to any one of claims 1 to 3, wherein the surgical instrument has a protruding portion. 5. The distance between the guide member (screws 12, 13, 14, 15) and the other part (side 7) is the tightening position where the two parts (side 7, edge part 3) are pressed and fixed to each other; 5. A surgical instrument according to claim 4, wherein the two parts are adjustable between a released position and a release position in which the two parts are movable relative to each other. 6. Surgery according to claim 5, characterized in that the guide member is a tightening screw (12, 13, 14, 15) which is screwed into the other part (edge part 3). utensils. 7. In one part (side 7), make two parallel vertical slits (
10, 11), and two guide members (screws 12, 13, 14, 15) protrude into each longitudinal slit (10, 11). A surgical instrument according to scope 5 or 6. 8. Two parts of the central part (29) that can be moved with respect to each other (
The sides 27 and the edge portions 23) are adjustable relative to each other in the direction of movement by means of the drive member (pin 30, fixed bearing 32, guide member 34), so that when the instrument is inserted into the wound, the wound 8. A surgical instrument according to any one of claims 1 to 7, characterized in that the drive member can be operated outside the surgical instrument. 9. The driving member includes a rotatable pin (30) having a threaded portion (36), a guide member (34) having an internal thread that is screwed into the threaded portion of the pin, and a fixed bearing (32). The guide member (34) and the fixed bearing (32) are attached to different parts of the central part (29) to guide and hold the pin (30) parallel to the direction of movement. A surgical instrument according to claim 8. 10. The guide member (34) is held in the part (edge part 23) that supports the protruding edge (tip part 8), and the fixed bearing (32) is fixed to the stand in the central part (29). 10. The surgical instrument according to claim 9, wherein the surgical instrument is disposed in a fixed portion (fixed portion 22). 11. Surgical instrument according to claim 9 or 10, characterized in that the pin (30) is protected by a cover (38). 12. Claims 9 to 12, characterized in that a hexagonal groove (40) is formed at the end of the pin (30) on the stand side.
A surgical instrument according to any one of paragraphs 11 to 12. 13. Surgical instrument according to any one of claims 1 to 12, characterized in that the central part is fixed against rotation with respect to the table by a pin (42).