CN100384382C - Wound retractor device - Google Patents

Wound retractor device Download PDF

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Publication number
CN100384382C
CN100384382C CN 200380100906 CN200380100906A CN100384382C CN 100384382 C CN100384382 C CN 100384382C CN 200380100906 CN200380100906 CN 200380100906 CN 200380100906 A CN200380100906 A CN 200380100906A CN 100384382 C CN100384382 C CN 100384382C
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China
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member
sleeve
proximal
retractor
ring
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CN 200380100906
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Chinese (zh)
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CN1735381A (en
Inventor
弗兰克·博纳迪奥
沙恩·约瑟夫·麦克纳利
特雷弗·沃赫
约翰·巴特勒
艾伦·里德
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阿特波斯有限公司
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Priority to US41578002P priority Critical
Priority to US60/415,780 priority
Priority to US60/428,215 priority
Priority to US60/490,909 priority
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Publication of CN1735381A publication Critical patent/CN1735381A/en
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Publication of CN100384382C publication Critical patent/CN100384382C/en

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Abstract

一种伤口保护器和牵开器装置(1),其包括套筒(2)、远端构件和近端构件,该远端构件由弹性材料的远端环(3)形成,该近端构件由近端环(4)形成。 A wound protector and retractor device (1), comprising a sleeve (2), the distal member and a proximal member, the distal end of the distal member by a ring of resilient material (3) is formed, the proximal end of the member (4) is formed by a proximal end ring. 该套筒(2)环绕在该远端环(3)的周围,并且以滑轮的方式相对于远端环(3)自由轴向移动。 The sleeve (2) surrounds the distal ring (3), and in a manner pulley relative to the distal ring (3) free to move axially. 近端环(4)固定到套筒(2)上,并在这种情况下处于其近侧内端。 The proximal ring (4) is fixed to the sleeve (2), and at its proximal end in this case. 该套筒(2)终止于一手柄或抓取部分,并在这种情况下通过抓环(15)加强。 The sleeve (2) terminates in a handle or gripping portion, and (15) by grasping the reinforcing ring in this case. 该套筒从近端环(4)开始延伸,并且远端环(3)容纳在套筒(2)的内层和外层(2a,2b)之间。 The sleeve ring from the proximal end (4) extends, and a distal ring (3) is accommodated between the sleeve (2) of the inner and outer layers (2a, 2b). 该弹性远端环(3)缩紧并插入穿过切口(6)。 The distal end of the elastic ring (3) is inserted through the incision and tightened (6). 然后,将套筒(2)向上拉起。 Then, the sleeve (2) is pulled up. 在将套筒(2)向上拉起之后,外层(2b)向上拉起,而内层(2a)围绕着端环(3)拉动。 After the sleeve (2) is pulled up, the outer layer (2b) is pulled up, and the inner layer (2a) around the end rings (3) is pulled. 这导致近端环(4)和远端环(3)之间的轴向长度缩短,张紧了该套筒,并对切口(6)的边缘施加了牵引力。 This causes the proximal ring (4) and the axial length between the distal ring (3) is shortened, the tensioning sleeve and the incision (6) is applied to the edge of traction. 由于该切口受到牵引,所以边缘也受到套筒的保护。 Since the cutout is pulled, the edge is also protected by the sleeve. 牵引之后,形成通道口,例如用于外科医生将其手部和/或器械插入,以进行处理。 After towing, the passage opening is formed, for example, for the surgeon to hand and / or instruments inserted for processing. 该装置可以用作开放式外科手术中的牵开器,或者用作阀/密封件的基座,以允许在手工辅助腹腔手术中使用,或用于器械通过或手通过。 The device may be used in open surgical retractor, a base or as a valve / seal, to allow the use of manual assistance in abdominal surgery or used by hand or by instrument.

Description

伤口牵开器装置技术领域本发明涉及一种牵开器。 BACKGROUND open wound retractor device of the present invention relates to a retractor. 特别是,本发明涉及一种牵开器,该牵开器用于牵引切口或自然身体开口的边缘,以产生器官或身体结构的最大程度暴露,从而用于外科手术过程的检查和/或进入,同时对切口组织的暴露侧提供保护。 In particular, the present invention relates to a retractor, the retractor for pulling apart the edge of an incision or a natural body opening, so as to produce the maximum degree of exposure of the organ or body structure, so that a surgical procedure for checking and / or access, while providing protection of the exposed tissue incision. 背景技术已知有各种牵开器。 BACKGROUND ART Various retractor. 某些已知的牵开器使用困难并且麻烦和/或比较昂贵。 Some known retractor cumbersome and difficult to use and / or expensive. 另外,某些已知的牵开器限定用于特殊尺寸的切口和特殊的病人解剖。 Further, some known retractor and defining a notch for a particular size of a particular patient anatomy. 本发明旨在提供一种改进的伤口牵开器,该牵开器将至少可克服这些问题中的一部分,并且另外提供了外科手术过程中的伤口保护措施。 The present invention aims to provide an improved wound retractor, the retractor will overcome at least some of these problems, and in addition provides a surgical wound protection process. 发明内容根据本发明,提供了一种伤口保护器和牵开器装置,包括-纵轴;远端构件;近端构件;以及至少在该远端构件和该近端构件之间延伸的套筒,该套筒具有近端抓取部分,以用于将该套筒向上拉动,从而縮短该远端构件和该近端构件之间的轴向长度。 According to the present invention, there is provided a wound protector and retractor device, comprising - a longitudinal axis; distal member; proximal member; and extending at least between the distal member and the proximal end of the sleeve member the sleeve has a proximal gripping portion for pulling the sleeve upwardly to shorten the axial length between the distal member and the proximal member. 在该装置中,释放抓取部分之后,在不需要另外的锁定装置的情况下,远端构件和近端构件之间縮短的轴向长度基本保持不变。 After the apparatus, the gripping portion is released, without the need for additional locking means, between the distal member and the proximal end to shorten the axial length of the member remains substantially constant.

在一个实施例中,该近端抓取部分设置在该套筒的近端部分处。 In one embodiment, the proximal portion of the proximal gripping portion is provided in the sleeve. 该抓取部分可以通过如抓环之类的加强装置进行加强。 The gripping portion may be reinforced by reinforcing means such as a grip ring or the like. 该抓环可以安装到该套筒上。 The grip ring may be mounted to the sleeve. 在一个实施例中,该套筒在第一端部处固定到该近端构件上,并可在第二端部处移动越过该近端构件。 In one embodiment, the first end of the sleeve is fixed to the proximal end of the member, and the second moving member past the proximal end of the. 该套筒可以在该第二端部处轴向滑过该近端构件。 The sleeve may be slid over the proximal end of the second member at the axial end portion. 在另一实施例中,套筒的第二端部被滑动接收于近端构件的一部分上,以允许套筒和近端构件之间的相对移动,从而縮短套筒在远端构件和近端构件之间的轴向长度。 In another embodiment, the second end portion of the sleeve is slidably received in the proximal end portion of the member to allow relative movement between the sleeve and the proximal end of the member, thereby shortening the sleeve distal end and a proximal end member axial length between members. 滑动地接收该套筒的近端构件的该部分可以包括该近端构件的外部。 The proximal end portion slidably received in the sleeve member may include a proximal end of the outer member. 套筒的第二端部可以偏压抵靠该近端构件。 The second end portion of the sleeve may be biased against the proximal end of the member. 在一个实施例中,近端构件位于套筒中。 In one embodiment, the proximal end of the sleeve member is located. 近端构件可以形成一固定装置的一部分,该固定装置被构造成用于将套筒在远端构件和近端构件之间的轴向长度基本固定为预期长度。 The proximal member may form part of a fixing device, the fixing device is configured for an axial length of the sleeve between the distal member and the proximal member is substantially fixed to the expected length. 套筒可以环绕远端构件从近端构件延伸,并在近端构件的外侧具有返回部分,该返回部分提供近端抓取部分。 May surround the distal end of the sleeve member extending from the proximal end member, and a proximal end having a return portion in the outer member, the return section provides a proximal gripping portion. 在一个实施例中,远端构件包括可以是O形环的远端环。 In one embodiment, the distal end of the distal member comprises an O-ring may be a ring. 该远端环可以由弹性材料制成。 The distal ring may be made of an elastic material. 在一个实施例中,近端构件包括可以是o形环的近端环。 In one embodiment, the proximal end of the proximal member may comprise o-rings. 与远端环相比,该近端环可以相对刚硬。 Compared with the distal ring, a proximal ring which may be relatively stiff. 在一个实施例中,套筒由柔韧材料制成。 In one embodiment, the sleeve is made of a flexible material. 该伤口保护器和牵开器装置可以包括用于套筒的近端部分的导向构件。 The wound protector and retractor means may comprise a guide member proximal end portion of the sleeve. 该套筒可以在该导向构件和该近端构件之间延伸。 The sleeve may extend between the guide member and the proximal member. 该导向构件可以包括用于近端构件的接收器。 The guide member may comprise a receiver for the proximal member. 例如,该导向构件可以具有面向内的凹槽,以用于限定出一用于近端构件的接收器。 For example, the guide member may have a recess facing, for defining a receiver for the proximal end of a member. 在一种 In a

情况下,该近端构件包括近端环,并且该凹槽具有与该近端环互补的形状,例如该凹槽的横截面可以基本为c形。 Case, the proximal member comprises a proximal ring and the ring groove having a shape complementary to the proximal end, for example, the cross section of the groove may be substantially c-shaped. 在另一实施例中,可以设置用于将导向构件锁定到近端构件上的锁定件。 In another embodiment, the guide member may be provided for locking the locking member to the proximal member. 导向构件可以与近端构件相配合,以形成该锁定件。 The guide member may cooperate with the proximal member, to form the locking member. 在某些情况下,导向构件可以与近端构件干涉配合。 In some cases, the guide member may be an interference fit with the proximal member. 在一个实施例中,在牵开切口之后,套筒限定出一多余套筒部分, 该多余套筒部分在近端构件和抓取部分之间延伸。 In one embodiment, the retractor after the incision, the sleeve defining a sleeve portion excess, the excess sleeve portion extending between the proximal member and the gripping portion. 该多余套筒部分可以去除。 The excess sleeve portion may be removed. 或者,该多余套筒部分插入穿过牵开器, 并且在这种情况下,可以限定出一器官保持器。 Alternatively, the excess sleeve portion is inserted through the retractor, and in this case, the holder defining an organ. 可选的是,该多余套筒部分被构造成用于形成如前臂密封件或器具密封件之类的密封件。 Alternatively, the excess sleeve portion is configured to form a seal such as a forearm seal or instrument seal or the like. 该密封件可以包括隔膜阀(iris valve)。 The sealing member may include a diaphragm valve (iris valve). 在一个实施例中,该装置包括用于套筒的近端部分的导向构件,并且多余套筒材料安装到该导向构件上。 In one embodiment, the apparatus comprises a guide member for a proximal portion of the sleeve, the sleeve and the excess material is mounted onto the guide member. 该多余套筒材料与导向构件一起可以限定出一腔室。 The excess sleeve material together with the guide member may define a chamber. 该腔室可以具有充气口。 The chamber may have an inflation port. 在一种情况下,充气之后, 该腔室限定出对如外科医生的前臂或器械轴之类的物体的密封件。 In one case, after the inflator, which chamber is defined as a seal on the surgeon's forearm instrument shaft or the like object. 在一个实施例中,该装置包括第一近端安装构件和第二近端安装构件,套筒的至少一部分在它们之间延伸。 In one embodiment, the apparatus includes a first proximal member and the second mounting member mounting a proximal end, at least a portion of the sleeve extending therebetween. 该第一和第二安装构件可以彼此相对移动。 The first and second mounting members can be moved relative to each other. 该安装构件可以彼此相对轴向移动和/或该安装构件可以彼此相对转动。 The mounting member may be moved relative to one another axially and / or the mounting member can be rotated relative to each other. 在一种配置中,该安装构件可以彼此相对移动,以将套筒的近端部分的至少一部分形成一密封件。 In one configuration, the mounting member may be moved relative to each other to at least a portion of the proximal portion of the sleeve forming a seal. 该安装构件可以移动,以扭曲该套筒, 从而形成一隔膜(iris)。 The mounting member may be movable to twist the sleeve, thereby forming a diaphragm (iris). 在一个实施例中,该装置包括偏压构件,用于将密封件偏压成如封闭状态之类的期望状态。 In one embodiment, the apparatus includes a biasing member for biasing the sealing member into the closed state as desired state or the like. 该偏压构件可以是如螺旋弹簧之类的弹簧。 The biasing member may be a spring such as a coil spring or the like. 在一个实施例中,该装置还包括用于将第一和第二安装构件锁定在一起的锁定件。 In one embodiment, the apparatus further comprising means for mounting a first member and a second locking member locked together. 该第二安装构件可以与第一安装构件配合,以形成该锁定件。 The second mounting member may cooperate with the first mounting member, to form the locking member. 该锁定件可以通过安装构件之间的卡扣接头配合形成。 The locking member may be formed by mounting a snap fit joint between the members. 可选的是, 一个安装构件与另一安装构件干涉配合,以形成该锁定件。 Optionally, a mounting member and another mounting member is an interference fit to form the locking member. 在一种情况下,在安装构件之间延伸的套筒为牵开套筒的近端部分。 In one case, the sleeve extending between the mounting member to the proximal portion of the retractor sleeve. 在另一种情况下,在安装构件之间延伸的是一与牵开套筒分离的连接套筒。 In another case, extending between the mounting member and the connecting sleeve is a separate sleeve retractor. 该第一安装构件可以包括环形构件。 The first mounting member may comprise an annular member. 该第二安装构件可以包括环形构件。 The second mounting member may comprise an annular member. 在一个实施例中,该伤口保护器和牵开器装置还包括阀。 In one embodiment, the wound protector and retractor device further comprises a valve. 该阀可以连接到牵开器装置上。 The valve may be coupled to the retractor device. 在一种情况下,该阀连接到套筒的近端部分上。 In one case, the valve is connected to the proximal end portion of the sleeve. 在另一种情况下,在该装置和阀之间设置有连接器。 In another case, between the device and the valve is provided with a connector. 该连接器可以包括连接器套筒。 The connector may include a connector sleeve. 该连接器套筒可以具有基本固定的长度。 The connector sleeve may have a substantially fixed length. 在一个实施例中,在阀和装置之间设置有柔性接头。 In one embodiment, apparatus is provided between the valve and the flexible linker. 在另一实施例中,在阀和装置之间设置有可延展接头。 In another embodiment, apparatus is provided between the valve and with a ductile joint. 在这种情况下,该阀可以相对于伤口牵开器的纵轴偏置。 In this case, the valve may be offset with respect to the longitudinal axis of the wound retractor. 在一个实施例中,该可延展接头通过可延展的连接套筒部分形成。 In one embodiment, the joint is formed by a malleable connecting sleeve section malleable. 该可延展连接套筒部分可以具有波纹状结构。 The malleable connecting sleeve portion may have a corrugated structure. 在一个实施例中,该阀为唇形密封件。 In one embodiment, the valve is a lip seal. 可选的是,该阀为隔膜密封件。 Alternatively, the valve is a diaphragm seal. 该阀可以是前臂密封件或器械密封件。 The valve may be a forearm seal or an instrument seal.

在一个实施例中,该装置包括用于将该装置从牵开状态释放的释放装置。 In one embodiment, the apparatus comprises a releasing means releases the apparatus from the state for the retractor. 该释放装置可以包括拉动装置。 The release means may comprise drawing means. 该拉动装置可以联接到远端构件上。 The pulling device may be coupled to the distal end member. 该拉动装置可以包括拉绳或带子。 The pulling means may comprise a rope or tape. 另一方面,本发明提供一种伤口保护器和牵开器装置,包括:纵轴; 远端构件; 近端构件;以及至少在该远端构件和该近端构件之间延伸的套筒, 在将切口牵开之后,该套筒限定出从近端构件附近延伸的多余套筒部分。 Another aspect, the present invention provides a wound protector and retractor device, comprising: a longitudinal axis; distal member; proximal member; and a sleeve between the distal member and the proximal member extending at least, after the incision retractor, the sleeve defines an excess sleeve portion extending from near the proximal end of the member. 在一个实施例中,该多余套筒部分被构造为形成如前臂密封件或器械密封件之类的密封件。 In one embodiment, the excess sleeve portion is configured to form a seal such as a forearm seal or an instrument seal member or the like. 该密封件可以包括隔膜阀。 The sealing member may comprise a diaphragm valve. 在另一方面,本发明提供一种伤口保护器和牵开器装置,包括:纵轴;远端构件;近端构件;以及至少在该远端构件和该近端构件之间延伸的套筒,该装置还包括第一近端安装构件和第二近端安装构件,套筒的至少一部分在它们之间延伸。 In another aspect, the present invention provides a wound protector and retractor device, comprising: a longitudinal axis; distal member; proximal member; and a sleeve between the distal member and the proximal member extending at least the apparatus further includes a first proximal member and the second mounting member mounting a proximal end, at least a portion of the sleeve extending therebetween. 该第一和第二安装构件可以彼此相对滑动。 The first and second mounting members may slide relative to each other. 该安装构件可以彼此相对轴向移动和/或该安装构件可彼此相对转动。 The mounting member may be moved relative to one another axially and / or the mounting member is rotatable relative to one another. 在一种情况下,该安装构f^可彼此相对移动,以将套筒的近端部分的至少一部分形成一密封件。 In one case, the mounting structure f ^ are movable relative to each other to at least a portion of the proximal portion of the sleeve forming a seal. 该安装构件可以移动,以扭曲套筒,从而形成一隔膜。 The mounting member may be movable to twist the sleeve to form a membrane. 该装置可以包括偏压构件,用于将密封偏压成如封闭状态之类的期望状态。 The apparatus may include a biasing member for biasing the seal into a desired state, such as the closed state or the like. 另一方面,本发明提供一种外科手术装置,其包括伤口牵开器、阀 Another aspect, the present invention provides a surgical apparatus comprising a wound retractor, a valve

和位于该伤口牵开器与该阀之间的连接器,该伤口牵开器包括: 纵轴; 远端构件; 近端构件;以及至少在该远端构件和该近端构件之间延伸的套筒。 And a connector located between the wound retractor with the valve, the wound retractor comprising: a longitudinal axis; distal member; proximal member; and extending at least between the distal member and the proximal member sleeve. 该连接器可以包括连接器套筒,该连接器套筒可以具有基本固定的长度。 The connector may include a connector sleeve, which connecting sleeve can have a substantially fixed length. 该连接器可以包括阀和牵开器之间的柔性接头。 The connector may comprise a flexible linker between the valve and the retractor. 可选的是,该连接器包括阀和牵开器之间的可延展接头。 Alternatively, the connector comprises a malleable joint between the valve and the retractor. 该阀可以相对于伤口牵开器的纵轴偏置。 The valve may be offset with respect to the longitudinal axis of the wound retractor. 该可延展接头由可延展的连接套筒部分形成。 The joint is formed by a malleable connecting sleeve section malleable. 该可延展的连接套筒部分可以具有波纹状结构。 The malleable connecting sleeve portion may have a corrugated structure. 另一方面,本发明提供一种用于将切口牵开的方法,包括如下步骤:在病人身上切开一切口;提供一伤口牵开器,该牵开器包括纵轴、远端构件、近端构件和套筒,该套筒至少在该远端构件和该近端构件之间延伸,该套筒具有近端抓取部分;将远端构件通过该切口插入.,从而该套筒延伸穿过该切口并且该近端构件位于切口外侧;抓住套筒的抓取部分,并向上拉动套筒,以縮短位于远端构件和近端构件之间的套筒的轴向长度。 Another aspect, the present invention provides a method for the incision retractor, comprising the steps of: cutting an incision in the patient; providing a wound retractor, the retractor comprises a longitudinal axis, a distal end member, near end member and sleeve member between the distal end and the proximal end member extending at least, the sleeve having a proximal gripping portion; inserting the distal member through the incision, such that the sleeve extends through. through the incision and the proximal end of the lateral incision member is positioned; seize the gripping portion of the sleeve, the sleeve is pulled upwardly to shorten the axial length of the sleeve between the distal member and the proximal member. 在一个实施例中,将抓取部分释放之后,套筒在远端构件和近端构件之间的已经縮短的轴向长度基本保持不变。 After one embodiment, the gripping portion is released, the sleeve remains substantially constant axial length has been reduced between the distal member and the proximal member. 该套筒可以在第一端部处固定到近端构件上,并在第二端部处延伸越过该近端构件,并且该方法包括随着向上拉动套筒以将套筒位于远端构件和近端构件之间的轴向长度縮短,将套筒移动越过近端构件。 The sleeve may be secured to the first end of the proximal member and extends beyond the proximal end of the second member, and the method comprises a distal member with the upwardly pulling sleeve and the sleeve is located axial length between the proximal member is shortened, the sleeve is moved over the proximal end of the member. 该方法可以包括将套筒相对于近端构件移动的步骤,包括将套筒的一部分抵靠着近端构件的径向外侧部分滑动。 The method may include the step of moving the proximal end of the sleeve member with respect to the slide comprising a radially outer portion against the proximal end portion of the sleeve member. 在一个实施例中,套筒位于远端构件和近端构件之间的部分包括两个材料层。 In one embodiment, the distal end portion between the sleeve member and positioned proximal member comprises two layers of material. 该套筒可以巻绕在远端构件周围,以形成两个材料层。 The sleeve may Volume wound around the distal end member, to form two layers of material. 该方法可以包括将伤口牵开器密封,例如通过将一密封件连接到伤口牵开器上、通过将一密封件可释放地安装到伤口牵开器上进行该密封。 The method may include sealing the wound retractor, for example, by attaching a seal to the wound retractor, the seal carried by a seal member attached to the wound retractor can be released. 可以将密封件安装到伤口牵开器的近端上。 A sealing member may be mounted to the proximal end of the wound retractor's opening. 可以将密封件安装到套筒的近端上。 It may be mounted to the proximal end of the seal sleeve. 在一种情况下,该牵开器包括一安装构件以及该密封件连接在该安装构件上。 In one case, the retractor comprises a mounting member and a sealing member connected to the mounting member. 在一个实施例中,用连接器将该密封件连接到伤口牵开器的近端上。 In one embodiment, the proximal end connected to the wound retractor of the connector seal. 该连接器可以是连接套筒。 The connector may be connected to the sleeve. 该连接器可以至少部分地由柔性材料制成。 The connector may be at least partially made of a flexible material. 可选的是,该连接器至少部分地为可延展材料,并且该方法可以包括将连接器操纵成预期状态的步骤。 Alternatively, the connector is at least partly malleable material, and the method may comprise the step of actuating the connector to a desired state. 在一种情况下,该预期状态为密封件与伤口牵开器的纵轴偏置的状态。 In one case, the state is expected to seal the longitudinal axis and biasing the retractor wound state. 在一个实施例中,该方法包括向上拉动套筒,以形成在伤口牵开器附近延伸的多余套筒部分。 In one embodiment, the method includes pulling the sleeve upwardly to the excess sleeve portion is formed in the vicinity of the wound retractor extends. 在一种情况下,该方法包括将多余套筒部分切除的步骤。 In one case, the method comprising the step of cutting excess portions of the sleeve. 在另一种情况下,该方法包括将多余套筒部分插入通过牵开器的步骤。 In another case, the method includes the step of excess sleeve portion is inserted through the retractor. 该多余套筒材料可以插入通过牵开器,以提供器官保持器。 The excess sleeve material can be inserted through the retractor, to provide an organ retainer. 在另一种情况下,该方法包括操纵多余套筒部分以形成一密封件的步骤。 In another case, the manipulation method comprising the step of excess sleeve portion to form a seal. 在一个实施例中,该牵开器包括近端安装构件,并且多余套筒部分连接到安装构件上。 In one embodiment, the retractor comprises a proximal mounting member, and the excess sleeve portion is connected to the mounting member. 在另一实施例中,多余套筒部分与安装构件形成一腔室。 In another embodiment, the excess sleeve portion is formed with a mounting member chamber. 该腔室可以具有充气口,并且该方法包括将向该腔室充气,以形成一密封件。 The chamber may have an inflation port, and the method will comprise the inflatable chamber to form a seal. 该密封件可以为唇形密封件或隔膜密封件。 The seal may be a lip seal or septum seal.

在一个实施例中,该伤口牵开器用一前臂密封件进行密封。 In one embodiment, the wound retractor Used a forearm seal for sealing. 在另一实施例中,该伤口牵开器用一器械密封件进行密封。 In another embodiment, the wound retractor Used an instrument seal for sealing. 在一种情况下,当牵开时,该切口的尺寸可以容纳一器械。 In one case, when the retractor, the cutout sized to accommodate a device. 在另一种情况下,当牵开时,该切口的尺寸可以容纳前臂。 In another case, when the retractor, the cutout sized to accommodate a forearm. 在又一种情况下,当牵开时,该切口的尺寸可提供一开放性手术部位。 In yet another case, when the retractor, the size of the incision may provide an open surgical site. 根据本发明,提供一种医疗装置,包括:牵开器构件,包括远端部分和近端部分,该远端部分用于插过病人身上的切口,该近端部分用于从切口延伸至病人体外; 远端构件,其与牵开器构件的远端部分相连; 近端构件,其与牵开器构件的近端部分相连;该牵开器构件相对于远端构件可轴向移动,以将近端构件和远端构件向彼此拉动,从而缩短牵开器在近端构件和远端构件之间的轴向长度。 According to the present invention, there is provided a medical device, comprising: a retractor member, comprising a distal portion and a proximal portion, a distal portion for insertion through the patient's incision, the proximal end portion for extending from the incision to the patient vitro; distal member, which is connected to the distal portion of the retractor member; proximal member, which is connected to the proximal end of the retractor member portion; the retractor member axially relative to the distal member may be moved to the distal member and the proximal member is pulled toward each other, thereby shortening the axial length of the retractor member between the proximal member and a distal end. 在一个实施例中,该牵开器构件包括套筒构件。 In one embodiment, the retractor member comprises a sleeve member. 该套筒构件优选围绕远端构件延伸。 The sleeve member preferably extends around the distal end member. 在一个实施例中,该远端构件为如弹性环之类的环形构件,例如O 形环。 In one embodiment, the distal member is an annular member such as an elastic ring or the like, such as an O-ring. 在一个实施例中,该近端构件连接到牵开器构件上。 In one embodiment, the proximal member is coupled to the retractor member. 该近端构件可以是环形构件。 The proximal end of the member may be an annular member. 在一个实施例中,该套筒构件为柔性材料。 In one embodiment, the sleeve member is a flexible material. 在一种配置中,套筒从近端构件环绕远端构件延伸,并且在近端构件外侧具有返回部分。 In one configuration, the sleeve member around the distal end extending from a proximal member, and the return portion having a proximal end outside the member. 该返回部分可以具有如环形构件之类的手柄构件。 The return portion may have a handle member, such as an annular member or the like. 在一个实施例中,该装置包括导向构件。 In one embodiment, the apparatus comprises a guide member. 该牵开器构件可以在导向构件和近端构件之间延伸。 The retractor member may extend between the guide member and the proximal member.

该导向构件可以包括用于近端构件的接收器。 The guide member may comprise a receiver for the proximal member. 该导向构件可以包括导向环容纳构件。 The guide member may include a guide ring receiving member. 该套筒返回部分可以构造成提供一整体阀构件。 The sleeve return section may be configured to provide a unitary valve member. 在这种情况下,该套筒返回部分可以扭曲,以形成一隔膜阀。 In this case, the return portion of the sleeve may be twisted to form a diaphragm valve. 在另一实施例中,套筒返回部分安装到导向构件上。 In another embodiment, the return portion of the sleeve is mounted to the guide member. 该套筒返回部分可以延伸到由套筒构件所限定的开口中。 The return portion may extend into the sleeve by the sleeve member as defined in the opening. 该装置可以包括用于将导向构件锁定到近端构件上的锁定件。 The apparatus may comprise means for guiding the locking member to the locking member on the proximal end member. 典型地,该导向构件与近端构件配合,以形成该锁定件。 Typically, the proximal end of the guide member and the mating member, to form the locking member. 该导向构件可以与近端构件干涉配合。 The guide member may be an interference fit with the proximal member. 在本发明的一个实施例中,该装置包括阀,如隔膜型的阀。 In one embodiment of the present invention, the apparatus comprises a valve, such as a diaphragm type valve. 在一个实施例中,该装置包括偏压构件,以用于将阀偏置到如关闭位置之类的预期位置处。 In one embodiment to the embodiment, the apparatus includes a biasing member for biasing the valve to a closed position such as the desired position. 在一种配置中,该装置包括位于近端构件附近的导向构件,并且在近端构件和导向构件之间设置有偏压装置。 In one configuration, the apparatus comprising a guide member located near the proximal end of the member, and biasing means disposed between the proximal member and the guide member. 该偏压装置可以包括如螺旋弹簧之类的弹簧。 The biasing means may comprise a spring such as a coil spring or the like. 在一个实施例中,套筒部分在近端构件和导向构件之间延伸,并且偏压装置环绕套筒设置。 In one embodiment, the sleeve portion between the proximal member and the guide member extends, and biasing means disposed around the sleeve. 该套筒构件可以是牵开器构件的延伸。 The sleeve member may be an extension of the retractor member. 在一个实施例中,该装置包括用于将装置从切口释放的释放构件。 In one embodiment, the apparatus comprises means for releasing the release member from the incision. 该释放构件可以包括从装置的远端延伸的伸长构件,如拉带或弹簧。 The release member may comprise an elongated member extending from the distal end of the device, such as a pull strip or a spring. 该释放构件可以从远端构件延伸。 The release member may extend from the distal end member. 在一个实施例中,该阀位于或者可位于近端构件附近。 In one embodiment, the valve may be located at or near the proximal end of the member. 可以在阀和近端构件之间设置柔性材料。 The flexible material may be provided between the valve member and a proximal end. 该柔性材料可以包括牵开器构件的近端延伸。 The flexible material may include a proximal retractor opening member extends. 在一个实施例中,该柔性材料包括套筒部分。 In one embodiment, the flexible material comprises a sleeve portion. 在另一实施例中,该阀为唇形密封件。 In another embodiment, the valve is a lip seal. 本发明还提供一种用于将切口牵开的方法,包括如下步骤: 提供一装置,该装置包括牵开器构件、远端构件和近端构件,该牵开器构件具有远端部分和近端部分,该远端构件与远端部分相连,该近端构件与近端部分相连;将远端构件和牵开器构件的远端部分插入通过病人身上的切口;以及相对于远端构件轴向拉动牵开器构件,以将近端构件和远端构件彼此拉近,从而縮短牵开器构件在近端构件和远端构件之间的轴向长度, 并牵开切口。 The present invention also provides a method for the incision retractor, comprising the steps of: providing an apparatus comprising a retractor member, the distal member and a proximal member, the retractor member having a distal portion and a near an end portion, a distal portion of the distal member is connected to the proximal end member connected to the proximal portion; distal portion of the distal member and the retractor member is inserted through the patient's incision; and with respect to the distal end of the shaft member to pull the retractor member to the proximal member and a distal member toward each other, thereby shortening the axial length of the retractor member between the proximal member and a distal member, and the incision retractor. 附图说明从下面参照附图对通过例子给出的一些实施例的描述中,将可以更加清楚地理解本发明,其中:图1是根据本发明的牵开器的透视图; 图2是图1的装置的剖视图;图3和图4是示出了图1和2的装置的形成方式的透视图; 图5和6分别是图3和4的剖视图; 图7和8是示出了该装置的使用的透视图; 图9和IO是示出了该装置的使用方法的剖视图; 图11是根据本发明处于准备使用状态的另一装置的剖视图; 图12是图11的装置的透视图,其中远端部分插入穿过一切口; 图13是图11的装置的剖视图,其中远端部分插入穿过一切口; 图14是图11的装置的剖视图,其处于与已牵开的切口一起使用的状态;图15是呈图14所示形态的该装置的透视图; 图16是位于原始位置的该装置的透视图,其中去除了多余套筒部分; 图17是位于原始位置的该装置的剖视图,其中多余套筒部分 Brief description of the drawings given by way of example in some embodiments, will be more clearly understood from the present invention, wherein the reference from the following: FIG. 1 is a perspective view of a retractor according to the invention; FIG. 2 is a cross-sectional view of the device 1; FIG. 3 and FIG. 4 is a diagram illustrating a perspective view formed embodiment of the device of Figures 1 and 2; Figures 5 and 6 are cross-sectional view of FIG. 3 and 4; FIG. 7 and 8 are diagrams illustrating the a perspective view of the use of the apparatus; FIGS. 9 and IO is a diagram illustrating a cross-sectional view showing a method used in the apparatus; FIG. 11 is a sectional view of another device in a ready to use state according to the present invention; FIG. 12 is a perspective view of the device of FIG. 11 wherein the distal end portion inserted through an incision; FIG. 13 is a sectional view of the device of FIG. 11, wherein the distal end portion inserted through an incision; FIG. 14 is a sectional view of the device of FIG. 11, in conjunction with the retractor has a cutout used state; FIG. 15 is a perspective view showing a state of the apparatus shown in FIG. 14 form; FIG. 16 is a perspective view of the device in the original position, wherein the excess sleeve portion is removed; FIG. 17 is a home position of the device is located cross-sectional view, wherein the excess sleeve portion 后延伸到切口中;图18是位于原始位置的该装置的透视图,其中多余套筒部分被扭曲;图19是类似于图18的透视图,其中多余套筒部分被进一步扭曲,以提供一隔膜阔;图20是根据本发明位于原始位置的另一装置的剖视图;图21是图20的装置的剖视图,其中多余套筒部分被安装到一导向构件上;图22是图21的装置的剖视图,其中多余套筒部分被膨胀,以提供整体外翻的通道部分;图23是与一释放装置结合的本发明的另一牵开器的透视图,图24是图23的牵开器的剖视图;图25是示出了图23的装置的形成方式的透视图;图26是处于图25所示结构的该装置的剖视图;图27是图23至26的牵开器处于使用状态的剖视图;图28是图23至27的牵开器的剖视图,示出了一释放装置的操作;图29是根据本发明的另一装置处于插入结构时的透视图;图30是图29的装置位于切口中时的透视 After extending into the incision; FIG. 18 is a perspective view of the device in the original position, wherein the excess sleeve portion is twisted; FIG. 19 is a perspective view similar to FIG. 18, wherein the excess sleeve portion is further twisted to provide a membrane width; FIG. 20 is a cross-sectional view of another device in the original position according to the present invention; FIG. 21 is a cross-sectional view of the device of FIG. 20, wherein the excess sleeve portion is mounted on a guide member; FIG. 22 is a device of FIG. 21 cross-sectional view, wherein the excess sleeve portion is expanded to provide an overall channel everted portion; FIG. 23 is a perspective view of another embodiment of the opening device of the invention in combination with a pull relief device, FIG. 24 is a view of the retractor 23 cross-sectional view; FIG. 25 is a diagram showing a perspective view of formed embodiment of the device of FIG. 23; FIG. 26 is a cross-sectional view of the device in the configuration shown in FIG. 25; FIG. 27 is a sectional view of the retractor 23 to 26 in the used state ; FIG. 28 is a cross-sectional view of the retractor of Figures 23 to 27 illustrates the operation of a release device; FIG. 29 is a perspective view of an insertion structure of another apparatus according to the invention; FIG. 30 is a device 29 is located fluoroscopy incision ;图31是图30的装置的另一透视图;图32是图31的装置的另一视图,其中外部被切断并形成一阀;图33是图32的装置的视图,其中阀被关闭;图34与图29-33的装置类似的另一装置的透视图,其中一阀被关闭;图35是图34的装置的剖视图;图36是与图29-33的装置类似的另一装置的透视图,其结合有一呈 ; FIG. 31 is another perspective view of the apparatus of FIG. 30; FIG. 32 is another view of the device of FIG. 31, wherein the external form is cut off and a valve; FIG. 33 is a view of the device of FIG. 32, wherein the valve is closed; FIG 34 is a perspective view of another apparatus similar to the apparatus of FIG. 29-33, wherein a valve is closed; FIG. 35 is a cross-sectional view of the device of FIG. 34; FIG. 36 is another means of the apparatus similar to FIG. 29-33 perspective view of a form which binds

插入形态的偏压装置;图37是处于牵开状态的图36的装置的另一透视图;图38是处于另一形态且去除多余套筒的图37的装置的另一透视图;图39是图38的装置的透视图,其带有关闭的阀;图40是图39的装置的透视图,其带有部分打开的阀;图41是图39的装置的透视图,其带有一插入该阀的物体;图42是根据本发明的另一装置的透视图;图43是位于一切口中的图42的装置的剖视图;图44是图43的装置的剖视图,其带有一延伸穿过的物体;图45是类似于图44的剖视图,其带有一偏离该装置的纵轴的物体;图46是根据本发明插入一切口中的另一装置的剖视图;图47是带有一牵开的切口的图46的装置的剖视图;图48和49是图47的装置的剖视图,示出了一隔膜阀的形成过程;图50是另一通道口的剖视图;图51是图50的通道口的剖视图,其具有一就位的器械;图52-55是另一通道口的 Aspect of the biasing means is inserted; FIG. 37 is another perspective view of the apparatus in the state of the retractor of FIG. 36; FIG. 38 is removed in another aspect and another perspective view of the sleeve of FIG. 37, extra apparatus; FIG. 39 It is a perspective view of the apparatus of FIG. 38, with the valve closed; FIG. 40 is a perspective view of the apparatus 39, which with the valve partially open; FIG. 41 is a perspective view of the apparatus 39, which is inserted with a objects of the valve; FIG. 42 is a perspective view of another device according to the present invention; FIG. 43 is a cross-sectional view of the device 42 is located in FIG all mouth; FIG. 44 is a sectional view 43 of the device, with an extending therethrough an object; FIG. 45 is a sectional view similar to FIG. 44, the object having a longitudinal axis offset from the apparatus; FIG. 46 is a cross-sectional view of another apparatus all mouth insert according to the invention; FIG. 47 is provided with a cutout of the retractor a cross-sectional view of the device of FIG. 46; FIGS. 48 and 49 are sectional views of FIG. 47 apparatus, illustrating the formation of a diaphragm; FIG. 50 is a cross-sectional view of another channel port; FIG. 51 is a cross-sectional view of the channel 50 of the opening, having an instrument in place; FIG. 52-55 is another channel port 视图;图56和57是又一通道口的剖视图;图58和59是另一通道口的剖视图;图60至62是又一通道口的剖视图;图63至66是另一通道口的剖视图;图67-72是本发明的另一通道口的剖视图。 View; FIGS. 56 and 57 are cross-sectional view of yet another channel port; FIGS. 58 and 59 are sectional views of another channel port; FIGS. 60 to 62 are cross-sectional view of yet another channel port; FIGS. 63 to 66 are sectional views of another channel port; 67-72 is a cross-sectional view of another channel port of the present invention. 具体实施方式参照附图,并首先参照图1至10,示出了一装置1,该装置1包括牵开器构件、远端构件和近端构件,该牵开器构件通过套筒2形成,该 DETAILED DESCRIPTION Referring to the drawings, and referring first to FIG 1 to 10, there is shown an apparatus 1, the apparatus 1 comprises a retractor member, the distal member and a proximal member, the retractor member 2 is formed by a sleeve, that

远端构件通过如O形环之类的弹性材料的远端环3形成,该近端构件通过也可以是0形环的近端环4形成。 3 is formed by the distal end of the distal end of the ring member as the elastic material of the O-ring type, which may be the proximal end of the proximal member through the O-ring 4 is formed a ring. 套筒2可以由任何合适的材料、如柔软的塑料薄膜材料制成,并且包括远端部分5和近端部分8,该远端部分5用于插入穿过一切口6,在该例子中,该切口6在病人的腹腔7中形成,该近端部分8用于从该切口6延伸并穿出病人体外。 Sleeve 2 may be made of any suitable material such as a flexible plastic film material, and includes a proximal portion and a distal end portion 5 8, the distal end portion 5 for insertion through an incision 6, in this example, the cutout 6 is formed in the patient's abdominal cavity 7, which extends from the proximal portion 8 to the outside of the patient and out of the notch 6. 在该例子中,远端环3没有固定到套筒2上,而是套筒环绕在该环3 的周围,并且在一定程度上以滑轮的方式相对于远端环3可自由轴向移动。 In this example, the distal ring 3 is not fixed to the sleeve 2, but the sleeve surrounds the ring 3, and to some extent in a manner pulley relative to the distal ring 3 is free to move axially. 近端环4固定到套筒2上,并在这种情况下位于其近侧内端。 Ring 4 is fixed to the proximal end of the sleeve 2, and in this case located in the proximal end thereof. 该套筒2终止于一手柄或抓取部分,该手柄或抓取部分在这种情况下通过一抓环15加强。 The sleeve 2 terminates in a handle or gripping portion of the handle or gripping portion in this case by a reinforcing ring 15 grip. 为构造本发明所述的牵引装置,套筒2首先设置有固定在一端的抓环15和固定在另一端的近端环4 (图3、 5)。 Traction device is configured according to the present invention, the sleeve 2 is provided with a first fixed ring 15 at one end of the grip proximal end and fixed to the other end of the ring 4 (FIG. 3, 5). 然后,将远端环3放置在套筒2上,如图4和6所示。 Then, the distal ring 3 is placed on the sleeve 2, 4 and 6 as shown in FIG. 然后,抓环15用于操纵套筒2,从而套筒2在其自身上向后折叠成图1和2所示的结构,其中抓环15处于最上端。 Then, a ring 15 for grasping the operating sleeve 2, whereby the sleeve 2 is folded back into the configuration shown in FIGS. 1 and 2 on its own, in which the gripping ring 15 at the top. 该套筒从近端环4开始延伸,并且远端环3容纳在套筒2的内层和外层2a、 2b之间。 The sleeve extends from the proximal ring 4 and the distal end, between the inner and outer layers 3 housed in the sleeve 2 2a 2b ring. 现在,该装置处于准备使用状态。 Now, the device is ready for use condition. 弹性远端环3縮紧并用套筒2的远端5插过切口6,如图4所示。 And tightening the elastic ring 3 with the distal end of the sleeve distal end 52 is inserted through the slit 6, as shown in FIG. 然后,将套筒2沿图8至10中的箭头A的方向向上拉起。 Then, the sleeve 2 in the direction along the arrow A in Figures 8 to 10 is pulled up. 在将套筒2向上拉起之后,外层2b向上拉起,而内层2a围绕着近端环3拉动。 After the sleeve 2 is pulled up, the outer layer 2b is pulled up, while the inner ring 2a is pulled around the proximal end 3. 这导致近端环4和远端环3之间的轴向长度縮短,张紧了该套筒,并对切口6 的边缘施加了牵开力。 This results in shortening the axial length between the proximal 3 and distal rings ring 4, the tensioning sleeve and the cut edge 6 of the force applied to the retractor. 因为当张力施加于套筒2上并且拉动力释放时环3、 4保持就位且施加牵开力,所以该系统表现出自锁现象。 Because when tension is applied to the sleeve 2 and the ring 3 when the pulling force is released, and 4 is applied to the retractor in place holding force, so the system performance by lock phenomenon. 这种结构中套筒的各层之间的摩擦配合可能有助于这种自锁。 This structure friction fit between the layers of the sleeve may contribute to this self-locking. 随着切口牵开,其边缘也受到套筒的保护。 As the incision retractor, which is also protected by the sleeve edge. 牵开后,形成一通道口, After retraction, forming a passage opening,

以便于例如外科医生将其手部和/或器械插入,以进行手术。 For example, a surgeon in his or her hand and / or insertion instrument to perform surgery. 该装置在开放式外科手术中可以用作牵开器,或者用作阀/密封件的基座,以允许其被用于手工辅助腹腔手术,或用于使器械或手通过。 The apparatus in open surgical retractor may be used as, or as a base valve / seal, to allow it to be used for manual assistance abdominal surgery, or for the instrument or by hand. 在切口外面的多余套筒部分20可以例如被切掉。 The excess sleeve portion 20 outside the notch can be cut, for example. 该牵开器适用于一定范围的切口尺寸并易于生产。 The retractor is adapted to a range of incision size and easy to produce. 在使用中也比较易于操纵。 In use, relatively easy to handle. 它不仅牵开而且保护切口。 Not only does it protect the incision and retraction. 现在参照图11至19,示出了本发明的另一装置50,它类似于上面参照图1至IO所描述的装置,并且同样的部件用相同的附图标记表示。 Referring now to FIGS. 11-19, there is shown another apparatus 50 according to the present invention, which is similar to the IO device 1 described above with reference to FIG, and like parts are designated by the same reference numerals. 在该例子中,该装置包括用于近端环4的导向构件51。 In this example, the apparatus comprises a guide member proximal end 514 of the ring. 该导向构件51呈环形环构件的形式,并带有面向内的C形凹槽52,该凹槽的尺寸可以容纳所示环4。 The guide member 51 in the form of an annular ring member, and with a C-shaped recess 52 facing the inner dimensions of the recess can accommodate the ring 4 in FIG. 套筒2的外层设置在环4和导向构件51之间,以进一步控制套筒的拉动,并因而进一步控制牵引力的施加。 The outer sleeve 2 is provided between the ring 4 and the guide member 51 to further control the pulling sleeve, and thus further application of traction control. 该导向构件51也有助于稳定近端环4。 The guide member 51 also contributes to stabilizing the proximal ring 4. 在图12至15中示出的该装置50的使用与上面所描述的类似。 Similarly in Figures 12 to 15 above using the apparatus 50 shown herein. 如环51之类的任何合适的导向构件均可以在拉起套筒以将切口牵开的过程中有助于将近端环4保持/稳定在预期位置处。 Any suitable guide means such as ring 51 or the like in the process can be retracted incision helps in maintaining the proximal ring 4 / at a stable position in the intended pull sleeve. 该导询构件可以位于环4的近侧。 The guide member may be located proximal ring inquiry 4. 该导向构件设置有监控构件,如阀之类的装置可以连接到该监控构件上。 The guide member is provided with a monitoring means, such as valve means or the like may be connected to the monitoring member. 参照图16,将会注意到,在一种情况下,多余套筒部分20可以切掉。 16, will be noted that, in one case, the excess sleeve portion 20 may be cut off. 参照图17,在这种情况下,多余套筒部分60回翻到切口中。 Referring to FIG 17, in this case, the excess sleeve portion 60 to turn back into the incision. 在这种结构中,它可以起到器官牵开器的作用,或者为外科医生提供在里面工作的开放通道。 In this structure, it can play the role of an organ retractor, or to provide an open channel in which the surgeon's work. 参照图18和19,在这种情况下,多余套筒部分被扭曲,以形成一隔膜&1 (iris diaphragm valve ) 65。 Referring to FIGS. 18 and 19, in this case, the excess sleeve portion is twisted to form a membrane & 1 (iris diaphragm valve) 65. 在图20至22所示的实施例中,本发明的装置70具有整体密封件/ 阀(Integral seal/valve) 71。 In the embodiment illustrated in FIGS. 20 to 22, the apparatus 70 of the present invention having an integral seal / valve (Integral seal / valve) 71. 该装置70类似于上述参照图11至19所描述的装置,并且同样的部件用相同的附图标记表示。 70 is similar to the apparatus described above with reference to FIGS. 11-19 described the apparatus, and the same parts are designated by the same reference numerals. 在这种情况下,导向构件50具有外部凹槽75,以容纳图21中所示的抓环15。 In this case, the guide member 50 has an outer groove 75 to receive the gripping ring 15 of FIG. 21. FIG. 该多余套筒部分20被向外和向下折叠,并且该抓环15接合到凹槽75中,以提供气密密封。 The excess sleeve portion 20 is folded outwardly and downwardly, and the grip ring 15 engages into the groove 75 to provide a hermetic seal. 在这种结构中,多余套筒可以通过充气口76 (图22)膨胀,以提供整体通道阀(integral access valve) 71。 In such a configuration, the excess sleeve may be inflated through a port 76 (FIG. 22) is inflated, to provide an overall passage valve (integral access valve) 71. 该阀可以用于密封接合手部、 器械或穿过它的类似物。 The valve may be used for sealing engagement with the hand, through the instrument or its analogs. 限定该阀的膨胀套筒部分可外翻到穿过它的物体上。 The valve sleeve defining an expansion portion may be everted into it through the object. 参照图23至28,示出了本发明的另一牵开器80,它类似于上述牵开器,并且同样的部件用相同的附图标记表示。 Referring to FIGS. 23 to 28, illustrate another embodiment of the invention retractor 80, which is similar to the above-described retractor, and like parts are designated by the same reference numerals. 在这种情况下,牵开器80具有释放机构,该释放机构在这种情况下由释放绳或带81形成,该释放绳或带81在一端82处连接到内环3上,并终止于用户可以抓住的外部自由端83处。 In this case, the retractor 80 has a release mechanism, the release mechanism is formed by a rope or belt 81 is released in this case, to release the rope or belt 81 is connected to the inner ring 3 at one end 82, and terminates in a users can grab the free end 83 outside. 在装配之后,该释放带81经引导穿过近端环4和外导向构件51之间的间隙,从而定位在近端环4和导向构件之间。 After assembly, the release tape 81 is directed through the gap between the proximal ring 4 and the outer guide member 51 to be positioned between the proximal ring 4 and the guide member. 该释放带81有助于释放位于切口中的处于使用状态的该自锁套筒。 The release tape 81 helps to release the locking sleeve is located in use in the cutout. 拉动释放带81 将把内环3拉动,以允许内环3从切口的内壁中释放,从而释放该装置。 Pulling the release tape 81 will pull the inner ring 3, so as to allow the release of the inner ring 3 from the inner wall of the incision, thereby releasing the device. 内环3的柔性有助于该移动。 The flexible movement of the inner ring 3 help. 该配置的优点是,用户能够很容易地将该装置从其自锁的牵开结构中释放。 The advantage of this configuration is that the user can easily release the locking means from its retractor structure. 参照图29至33,示出了本发明的另一装置90,其中与上述装置的部件相类似的部件用相同的附图标记表示。 Referring to FIGS. 29-33, there is shown a further device 90 according to the invention, wherein the device member similar to the above-described components denoted by the same reference numerals. 在这种情况下,该装置90具有用于近端环4的下导向环51以及由上导向环91与第二近端环92形成的外部导向组件,套筒2在上导向环和第二近端环之间进行引导。 In this case, the device 90 has a lower guide ring 4 in the proximal end ring 51 and guide ring 91 and the external guide ring assembly 92 is formed of a second proximal end, the sleeve 2 and the upper guide ring on a second between the proximal guide ring. 在所有相关实施例中,如上导向环91之类的上部导向可以具有第二安装构件, 该第二安装构件位于如下导向环51之类的第一导向构件附近,该第一导向构件也具有安装构件。 In all embodiments, the upper guide ring 91 as a guide or the like may have a second mounting member, the second mounting member is located in the vicinity of the guide ring as a first guide member 51 or the like, the first guide member also has a mounting member. 该装置首先用于将如上所述的切口牵开。 First, the apparatus as described above for the incision retractor. 在该阶段期间,该外部导向组件方便地位于导向构件51和近端环4外部。 During this phase, the outer guide assembly guide member 51 is conveniently located proximal ring 4 and the outside. 实际上,它可以完全与套筒2分离,并随后在适当的阶段连接到套筒2上, 如当切口如图30所示那样牵开时。 In fact, it can be completely separated from the sleeve 2, and then connected to the sleeve 2 at an appropriate stage, such as when the retractor 30 as shown in FIG incision. 然后,该外部导向组件朝着图31所示的切口向下移动。 Then, the outer guide assembly is moved downwardly towards the cutout 31 shown in FIG. 这可以通过同时将套筒2向上拉起获得。 This can be achieved by simultaneously pulling the sleeve 2 upwardly. 当导向装置与导向构件51相邻时,可以如图32所示那样将多余套筒部分切断。 When the guide means and the guide member 51 adjacent to and to be as shown in FIG cutting the excess sleeve portion 32. 通过将导向组件相对于导向构件51扭曲,该套筒2被扭曲,从而关闭套筒2的内腔,并形成如图33所示的隔膜类型的通道阀95。 By twisting the guide assembly relative to the guide member 51, the sleeve 2 is twisted so as to close the lumen of the sleeve 2, and forming the diaphragm of the type shown in Figure 33 the valve passage 95. 通过这种方式, 一密封的通道口被提供,以用于使手和/或器械通过该切口。 In this manner, a sealed passage opening is provided for the hand and / or instruments through the incision. 将会认识到,尽管已经参照由外科医生所作的切口进行了描述,但是本发明的装置也可以用于如身体开口之类的任何开口的牵开。 It will be appreciated that although reference has been made the incision by the surgeon has been described, but the present invention can also be used as an opening of the body in any type of retractor opening. 参照图34和35,示出了本发明的另一牵开器装置100,它类似于图29至33的装置,并且同样的部件用相同的附图标记表示。 Referring to FIGS. 34 and 35, there is shown another embodiment of the invention, the retractor apparatus 100, which is similar to the apparatus of FIGS. 29 to 33, and like parts are denoted by the same reference numerals. 在这种情况下, 设置有可释放的锁定件,以用于保持通道阀95封闭。 In this case, provided with a releasable locking member for holding the valve passage 95 is closed. 为了联锁,在这种情况下,上导向环91是与下导向环51的干涉配合件。 For interlocking, in this case, the guide ring 91 is an interference fit with the lower guide member 51 in the ring. 也可以使用其他各种锁定结构,如螺纹或卡口型配合、磁铁、夹子及类似物。 It may also be used a variety of other locking structures, such as a threaded or bayonet-type fitting, magnets, clamps, and the like. 参照图36至41,示出了本发明的另一牵开器装置110,它与图29 至33的装置类似,并且同样的部件用相同的附图标记表示。 Referring to FIGS. 36 to 41, the present invention is shown another retractor device 110, which is similar to the apparatus of FIGS. 29 to 33, and like parts are denoted by the same reference numerals. 在这种情况下,该装置结合一偏压装置,以将一整体阀偏压到关闭位置。 In this case, the device incorporated a biasing means to bias the valve to a closed position integrally. 该偏压装置在这种情况下由螺旋弹簧111形成,该螺旋弹簧在导向环51、 91之间位于套筒周围。 The biasing means 111 is formed in this case by the coil spring, the coil spring guide ring 51 positioned around the sleeve 91 between. 使用时,除了在上导向环91向下移动过程中弹簧lll也向下朝着下导向环51移动从而初步移动到图38所示位置之外,该装置以与图29至33类似的方式使用。 When used, in addition to the guide ring 91 is moved downward during the downward spring lll also moves toward the lower guide ring 51 so that the initial position shown in FIG 38 is moved to the outside of the apparatus used in a similar manner to FIGS. 29 to 33 . 在此阶段中,多余套筒材料可以去掉。 At this stage, the excess sleeve material can be removed. 弹簧111随着上导向环91的旋转而张紧,同时向下推动上导向环91。 Spring 111 with the rotation of the guide ring 91 is tensioned, while pushing down on the guide ring 91. Two

个导向环51、 91之间的套筒材料受到扭曲,从而形成图39所示的隔膜型阀112。 A guide ring 51, between the sleeve material 91 is distorted and thereby the valve diaphragm 112 is formed as shown in FIG. 39. 为了打开阀112,以使得如器械、手部、胳膊或类似物穿过, 可以施加向下的力,以克服弹簧的偏置力将上导向环91向着下导向环51 推动。 To open the valve 112, such as the instrument, the hand, arm or the like through the downward force may be applied to overcome the biasing force of the spring guide ring 91 of the upper guide ring 51 is pushed toward the next. 该形态在图40中示出。 This aspect is shown in FIG. 40. 当插入物体时,上导向环构件91被释放, 从而允许该阀环绕着该物体关闭。 When an object is inserted, the guide ring member 91 is released, allowing the valve body to the closed surrounding. 装置110的操作在图41 (a)至41 (d) 中可明显看出。 Operating means 110 may be evident in FIG. 41 (a) to 41 (d). 在图41 (a)中,阔112处于关闭静止状态。 In FIG 41 (a), the width 112 is in a closed stationary state. 图41 (b) 示出了施加向下的力,以打开阀112。 FIG. 41 (b) shows the force applied downwardly to open the valve 112. 在图41 (c)中示出了如器械113 之类的物体插入通过打开的阈112。 (C) in FIG. 41 shows a device 113 such as the object inserted through the opening 112 threshold. 在图41 (d)中,上导向环91上的向下压力被释放,从而允许阀112环绕物体113关闭。 In FIG. 41 (d), the downward pressure on the guide ring 91 is released, thereby allowing the valve 112 to close around the object 113. 现在参照图42至45,示出了本发明的另一装置120,它在某些方面类似于图11至18的装置,并且同样的部件用相同的附图标记表示。 Referring now to FIGS. 42-45, there is shown another apparatus 120 according to the present invention, the apparatus of FIGS. 11 to 18 which is similar in some respects, and like parts are denoted by the same reference numerals. 在这种情况下,该装置具有唇形密封件121。 In this case, the device 121 having a lip seal. 该唇形密封件121由带中心孔122的隔膜形成,如器械之类的物体123穿过该中心孔。 The lip seal 121 is formed by a diaphragm with a central hole 122, the instrument 123 such as the object passes through the central bore of. 该唇形密封121 位于套筒2上导向环51的附近,从而形成近端柔性套筒部分125。 The lip seal 121 is located near the sleeve 2 on the guide ring 51, thereby forming a proximal end portion of the flexible sleeve 125. 该套筒部分125在帮助物体123偏移移动方面非常有用,如图45所示。 The sleeve portion 125 is very useful in helping the object 123 being displaced aspect, shown in Figure 45. 该套筒部分125适应物体123的移动,同时保持唇形密封件121和物体123 之间的密封配合。 The sleeve portion 125 accommodate movement of the object 123, while maintaining a sealing engagement between the lip seal 121 and the object 123. 将会认识到,该特征与上述其它特征一样,可与除了附图中所示的之外的其它结构的伤口保护器/牵开器和通道部件一起使用。 It will be appreciated that the above features and other features of the same, and the retractor channel can be used in conjunction with a wound protector member to another structure shown in the drawings except in /. 参照图46至48,示出了本发明的另一装置130,它具有与图ll至15的装置相类似的一些特征,且同样的部件用相同的附图标记表示。 Referring to FIGS. 46 to 48, there is shown another apparatus 130 according to the present invention, which has some features in Fig. Ll means 15 similar to, and the same parts are designated by the same reference numerals. 在这种情况下,当该装置处于牵开结构时,该套筒在伤口外面具有近端部分。 In this case, when the device is in the structure of the retractor, the sleeve having a proximal portion outside the wound. 该近端套筒部分包括第一部分131和第二部分132,第一部分131从导向环51开始延伸,第二部分132从第一部分131开始延伸。 The proximal end of the sleeve portion comprises a first extending portion 131 and 132, the first portion 131 from second portion of the guide ring 51 starts, a second portion 132 extending from the first portion 131 starts. 第二部分132限定在两个隔开的隔膜环134、 135 (iris ring)之间。 The second portion 132 defines two spaced-apart diaphragms rings 134, 135 (iris ring) between. 将注意到,该隔膜环134、 135具有如突起和凹槽之类的配合特征,以用于装配中的内部配合。 It will be noted that the diaphragm ring 134, 135 has a mating feature, such as projections and recesses or the like, for the internal fitting assembly. 该隔膜环134也具有配合元件,其在这种情况下由凹槽137形成,以用于在装配中与导向环51的相应配合元件配合,该导向环51的配合元件在这种情况下由突起138形成。 The diaphragm ring 134 also has a mating element which is formed by a groove 137 in this case, with a corresponding mating element for the guide ring 51 fitted in the assembly, the guide element mating ring 51 is in this case the projection 138 is formed. 如上所述,该装置适于牵开伤口,并使第一和第二套筒部分131、 132 在近端延伸。 As described above, the apparatus is adapted to the wound retractor, and the first and second sleeve portions 131, 132 extending at the proximal end. 第一套筒部分131是多余的,可以在第一隔膜环134装配到导向环138上后去除或者蜷縮起来,如图48所示。 A first sleeve portion 131 is redundant, to be a first diaphragm ring 134 fitted in the guide ring 138 is removed after or curled up shown in Figure 48. 然后,第二或上隔膜环135被转动,以将套筒部分132扭曲,从而形成如图49所示的隔膜型密封件。 Then, a second or upper diaphragm ring 135 is rotated to twist the sleeve portion 132 to form a diaphragm-type seal 49 as shown in FIG. 该隔膜环135如图所示与隔膜环134配合,以使阀保持关闭。 The diaphragm ring and the diaphragm ring 134 135 As shown in FIG cooperate to keep the valve closed. 在上述的一些实施例中, 一阀829直接安装到一牵开器基座811上。 In some of the above embodiments, a valve 829 is mounted directly to a retractor base 811. 可以在牵开器811和阀829之间提供柔性联接。 The flexible coupling may be provided between the retractor 811 and the valve 829. 例如,如图93和94所示,这种柔性联接由在牵开器811和阀829之间延伸的一段柔性套筒830 形成。 For example, as shown in FIG. 93 and 94, the flexible coupling 830 is formed from a length of flexible sleeve between the retractor 811 and the valve 829 extends. 该柔性套筒830可以通过连接到阔829上的多余牵开器套筒材料形成。 The flexible sleeve 830 may be formed by connecting the extra width 829 to the retractor sleeve material. 在图52至57所示的本发明的另一实施例中,以有助于在它们之间柔性结合的方式, 一阀860可以连接到牵开器811上。 Another of the present invention shown in FIGS. 52-57 embodiment in order to facilitate binding between them a flexible manner, a valve 860 may be coupled to the retractor 811. 例如,固定长度的套筒862可以在牵开器811的外近端环863和阀860之间延伸。 For example, the fixed length between the sleeve 863 and the ring 862 may extend outside the proximal end of the valve 860 of the retractor 811. 从牵开器811多出的套筒材料864可以穿过阀860。 The sleeve material 864 from the retractor 811 may pass through the extra valve 860. 可以将该阀860向下推动, 并且向上拉起多余套筒,以将牵开器基座811紧紧锁定在切口中。 The valve 860 can be pushed down, and the excess sleeve pulled up to the retractor base 811 firmly locked in the cutout. 如果需要的话,多余套筒材料864可以切掉和去除。 If desired, the excess sleeve material 864 may be cut and removed. 在不影响阀对器械/物体814的轴的密封的情况下,该柔性套筒864允许器械倾斜,如图57所示。 In the case of the instrument does not affect the sealing of the shaft / valve body 814, the flexible sleeve 864 allows the instrument to the inclination, shown in Figure 57. 如图58和59所示,为了具有更多的可控制柔性,可以将弹簧867 设置在阀860和牵开器近端环863之间。 As shown in FIG. 58 and 59, it can be controlled in order to have more flexibility, the spring 867 may be disposed between the valve 860 and 863 at the proximal end of the retractor ring. 现在参照图60至62,描述另一种模块化系统,其中阀870可释放地 Referring now to FIGS. 60 to 62, describes another modular system, wherein the valve is releasably 870

安装到牵开器811上。 Mounted to the retractor 811. 该牵开器811可以具有近端环871,该近端环带有容纳阀870的凹槽872。 The retractor 811 may have a proximal ring 871, the proximal end ring having a recess receiving the valve of 872,870. 器械轴814能够很容易地穿过阀870和牵开器811。 Instrument shaft 814 can easily pass through the valve 870 and the retractor 811. 至少轴814的部分873可以紧靠牵开器的远端进行弯曲或者转向。 At least a portion of the shaft 814 can abut a distal end 873 of the retractor bending or steering. 现在参照图63至66,任何合适的阀880均可以通过从牵开器811 上多出的套筒材料881被联接到牵开器811上。 Referring now to FIGS. 63-66, any suitable valve 880 may each be coupled 881 to the retractor 811 by the sleeve material 811 from the retractor extra. 可以将阀880向上拉动, 以展开牵开器基座811。 Valve 880 may be pulled upwardly to expand the retractor base 811. 该多余套筒材料881设置有柔性颈部,它有助于如器械883之类的物体、甚至是具有弯曲轴的物体轻松导入(图119)。 The excess sleeve material 881 is provided with a flexible neck, it helps the device 883 such as an object, even an object having easily introduced (FIG. 119) of the bending axis. 如图120所示,通过允许阀880移动至更靠近牵开器基座811,这种配置也有助于辅助器械的到达。 FIG 120, by allowing the valve 880 to move closer to the retractor base 811, this configuration also contributes to the auxiliary equipment. 参照图67至72,描述了包括伤口保护器和牵开器装置811以及阀900的另一通道口。 Referring to FIGS. 67-72, describes a further passage opening comprising a wound protector and retractor device 811 and a valve 900. 该阀900通过套筒902连接到牵开器装置811的外导向环卯l上,该套筒902在这种情况下由呈波纹结构的延展性材料制成, 其以如可弯曲饮用麦管的可弯曲铰接部分的方式皱折。 The valve 900 is connected through the sleeve 902 to the outer guide means 811 on the retractor ring d L, the sleeve 902 in this case is made of a ductile material is corrugated structure, which is as bendable drinking straw corrugations bendable hinge portion of the embodiment. 套筒902可以预成形为偏离牵开器的纵轴,以有助于器械或类似物的轻松插入。 Sleeve 902 may be preformed into a longitudinal axis offset from the retractor, to facilitate easy insertion instrument or the like. 波纹状套筒902可以如图68所示那样进行压縮,以提供较小的外形,从而有助于描绘出如图69和70所示的任何多余牵开器套筒的轮廓。 Corrugated sleeve 902 as shown in Fig. 68 may be compressed to provide a smaller profile, thus contributing to depict the outline of any excess retractor sleeve 69 and 70 shown in FIG. 因此,该波纹状套筒902可以延伸/延长,并且易于操纵成所期望的结构。 Thus, the corrugated sleeve 902 may be extended / extended, and easily manipulated into a desired configuration. 由于套筒902是可延展的,所以即使当腹部增压时,它也将保持期望的弯曲形状。 Since sleeve 902 is malleable, even when the abdomen when pressurized, it will maintain a desired bent shape. 任何多余的牵开器套筒材料905均可以如所示出的那样或者如上述所使用的那样切除。 Any excess retractor sleeve material 905 can be as shown or that cut as used above. 在上下文中,术语"可延展的"用于表示一元件,该元件能够操纵至预期位置和/或方位,并且当出于预期目的用于病人时,例如在腹腔镜器械部分插入其间,可在所施加的典型应力和应变下保持在该操纵位置和/或方位。 In this context, the term "extensible" is used to indicate an element which can be manipulated to a desired position and / or orientation, and when used in patients for the intended purpose, such as inserting portion therebetween in laparoscopic instruments, can be held in the operating position and / or orientation of typical stress and strain applied. 本发明的通道口可以用数种方式使用。 Passage opening present invention can be used in several ways. 在其中一种方法中,如上所 In one method, as described

述使用牵开器,将远端内导向环插入到切口中,滑动外导向环,以可控制地径向扩展切口。 Using said retractor, the distal end of the inner guide ring is inserted into the incision, the outer sliding guide rings to controllably radially expanding cut. 然后将牵开器锁定在该位置处。 The retractor is then locked at this position. 如果必要的话,可以进一步向下移动外导向环,以产生更大的切口。 If necessary, can be further downward movement of the outer guide ring, to a greater cutout. 在某些配置中,可以将一器械手动弯曲到体外,该弯曲的器械通过该通道口输送,以很容易地到达手术部位。 In some configurations, a device can be manually bent to the outside of the curved conveyance passage opening through which the instrument, it is easy to reach the surgical site. 在另一实施例中, 一器械插入到通道口中,外科医生用腹壁自身来弯曲器械,然后将弯曲的部分进一步插入到腹腔中。 In another embodiment, an instrument is inserted into the channel mouth, the surgeon to bend the instrument with the abdominal wall itself, and then the bent portion is further inserted into the abdominal cavity. 在各种情况下,均可以通过抓住安装在其上的阀或其它元件来抓住套筒。 In each case, you can be caught by a catch sleeve valve or other elements mounted thereon. 本发明的通道口至少具有下面一些优点: 可控制的径向扩展1. 使用较小的切口而得到较大的通道2. 能够根据需要改变切口尺寸(例如,大肠杆菌消除期间的样本去除)更强的密封能力1. 不会有气体从伤口边缘泄漏2. 不会意外从切口中拉出3. 可以密封任何切口,并且不需要辅助密封方法(缝合,汉森口等)消除腹内轮廓1. 在腹腔中提供更大的操作空间(在骨盆外科手术中非常关键)2. 如根治性前列腺切除术之类的手术中进入会阴。 Channel port of the present invention at least has the following advantages: 1. The extended radially controllable obtained using a smaller incision larger channels 2. The incision size can be changed as needed (e.g., during removal of the sample to eliminate E. coli) and more 1. strong sealing capability without gas leakage from the edges of the wound 2 is not accidentally pulled from the incision may be sealed in any incision 3, and no auxiliary sealing methods (sewing, Hansen mouth, etc.) to eliminate abdominal profile 1. surgical operations offer a larger space in the abdominal cavity (in a critical pelvic surgery) 2 as radical prostatectomy the class into the perineum. 保护伤口免于感染和致癌1. 紧密密封不产生"烟囱"效应2. 拆下之后,所有潜在污染区域与切口隔离 After protect the wound from infection and does not produce carcinogenic tight seal 1. "chimney" effect 2. Remove all potential contamination cutout region isolated from

降低的外腹部轮廓1. 将增加器械的有效工作长度2. 在腹腔外部具有较大的工作区域增加传统腹腔器械的移动自由度本发明不仅局限于参照附图给出的上述实施例,其可以在结构和细节上进行变化。 1. The outer contour of the abdominal reduced to increase the effective working length of the instrument 2 having a larger working area to increase the freedom of movement of the conventional apparatus abdominal present invention is not limited to the above embodiments given with reference to the accompanying drawings in the abdominal cavity externally, it may changes in the structure and details.

Claims (17)

1.一种伤口保护器和牵开器装置,包括: 纵轴; 远端构件; 近端构件; 至少在该远端构件和该近端构件之间延伸的套筒,以及用于该套筒的近端部分的导向构件; 该套筒在远侧从该近端构件向该远端构件延伸、环绕着该远端构件延伸、在近侧从该远端构件延伸,并具有返回部分,该返回部分在近侧在该导向构件和该近端构件之间延伸,该套筒在第一端部处固定到该近端构件上,并可在该返回部分处轴向滑过该近端构件,该返回部分提供一近端抓取部分,以用于将该套筒向上拉动,从而缩短该远端构件与该近端构件之间的轴向长度。 1. A wound protector and retractor device, comprising: a longitudinal axis; distal member; proximal member; sleeve between the distal member and the proximal member extending at least, and for the sleeve the proximal end of the guide member portion; the sleeve extends distally to the distal end of the member from the proximal end of the member that surrounds the distal member extends, extends proximally from the distal end member, and having a return portion, which return portion between the guide member and the proximal member extends proximally of the sleeve at the first end fixed to the proximal end of the member, and the return axially slid over the proximal end portion of the member the return section provides a proximal gripping portion for pulling the sleeve upwardly to shorten the axial length between the distal member and the proximal member.
2. 根据权利要求1所述的伤口保护器和牵开器装置,其特征在于, 释放该近端抓取部分之后,在不需要另外的锁定装置的情况下,该远端构件和该近端构件之间的縮短的轴向长度基本保持不变。 The wound protector retractor of claim 1 and a device as claimed in claim, characterized in that, after release of the proximal gripping portion, without the need for additional locking means, the distal member and the proximal end shortening the axial length between the members remains substantially constant.
3. 根据权利要求1或2所述的伤口保护器和牵开器装置,其特征在于,该近端抓取部分设置在该套筒的近端部分处。 3. The wound protector of claim 1 or 2 and the retractor device according to claim, wherein the proximal gripping portion of the proximal end portion of the sleeve is provided.
4. 根据权利要求1或2所述的伤口保护器和牵开器装置,其特征在于,该近端抓取部分可以通过加强装置进行加强。 4. The wound protector of claim 1 or 2 and the retractor device according to claim, wherein the proximal gripping portion may be reinforced by reinforcing means.
5. 根据权利要求1或2所述的伤口保护器和牵开器装置,其特征在于,该近端构件形成一固定装置的一部分,该固定装置被构造成用于将该套筒在该远端构件和该近端构件之间的轴向长度基本固定为预期长度。 Wound protector according to claim 1 or 2 and retractor device as claimed in claim, wherein a portion of the proximal end of the member fixing means is formed, the fixing device is configured for the sleeve in the distal the axial length between the end member and the proximal member is substantially fixed to the expected length.
6. 根据权利要求1或2所述的伤口保护器和牵开器装置,其特征在于,该远端构件包括远端环。 6. A wound protector of claim 1 or 2 and the retractor device according to claim, wherein the distal member comprises a distal ring.
7. 根据权利要求1或2所述的伤口保护器和牵开器装置,其特征在于,该近端构件包括近端环。 Wound protector according to claim 1 or 2 and retractor device as claimed in claim, wherein the proximal member comprises a proximal ring.
8. 根据权利要求1或2所述的伤口保护器和牵开器装置,其特征在于,该套筒由柔韧材料制成。 Wound protector according to claim 1 or 2 and retractor device as claimed in claim, wherein the sleeve is made of a flexible material.
9. 根据权利要求1或2所述的伤口保护器和牵开器装置,其特征在于,在牵开切口之后,该套筒限定出一多余套筒部分,该多余套筒部分在该近端构件和该近端抓取部分之间延伸。 Wound protector according to claim 1 or 2 and retractor device as claimed in claim, wherein, after the incision retractor, the sleeve defines an excess sleeve portion, the sleeve portion in excess near the the proximal end member and extending between the gripping portions.
10. 根据权利要求1或2所述的伤口保护器和牵开器装置,其特征在于,还包括一阀。 10. A wound protector of claim 1 or 2 and the retractor device according to claim, wherein further comprising a valve.
11. 根据权利要求1或2所述的伤口保护器和牵开器装置,其特征在于,该装置包括一用于将该装置从牵开状态释放的释放装置。 Wound protector according to claim 1 or 2 and retractor device as claimed in claim, characterized in that the device comprises a releasing means releases the apparatus from the state for the retractor.
12. 根据权利要求1或2所述的伤口保护器和牵开器装置,其特征在于,在牵开切口后,该套筒限定出一从该近端构件附近延伸的多余套筒部分。 12. The wound protector of claim 1 or 2 and the retractor device according to claim, wherein, after the incision retractor, the sleeve defines an excess sleeve portion extending from a vicinity of the proximal end of the member.
13. 根据权利要求12所述的伤口保护器和牵开器装置,其特征在于, 该多余套筒部分被构造成形成一密封件。 12 13. A wound protector and retractor device of claim, wherein the excess sleeve portion is configured to form a seal.
14. 一种外科手术装置,包括根据权利要求1或2所述的伤口保护器和牵开器装置、阀和位于该伤口保护器和牵开器装置与该阀之间的连接器。 14. A surgical device, comprising a connector between the wound protector 1 or claim 2 and a retractor device, and a valve located in the wound protector and retractor device and the valve according to claim.
15. 根据权利要求14所述的外科手术装置,其特征在于,该连接器包括一连接器套筒。 15. The surgical apparatus according to claim 14, wherein the connector comprises a connector sleeve.
16. 根据权利要求14所述的外科手术装置,其特征在于,该连接器包括位于该阀与该伤口保护器和牵开器装置之间的柔性接头。 16. The surgical apparatus according to claim 14, wherein the connector comprises a flexible joint between the valve and the wound protector and retractor device.
17. 根据权利要求14所述的外科手术装置,其特征在于,该连接器包括位于该阀与该伤口保护器和牵开器装置之间的可延展接头。 17. The surgical apparatus according to claim 14, wherein the connector comprises a malleable joint between the valve and the wound protector and retractor device.
CN 200380100906 2002-10-04 2003-10-06 Wound retractor device CN100384382C (en)

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US8920314B2 (en) * 2009-10-07 2014-12-30 Covidien Lp Universal height foam port
EP3007630B1 (en) * 2013-06-12 2017-08-30 UMC Utrecht Holding B.V. Surgical device for providing access to a surgical site
CN103505255A (en) * 2013-10-11 2014-01-15 魏东 Auxiliary incision sealing device for laparoscopic operation and using method thereof
CN104224248A (en) * 2014-09-23 2014-12-24 张占学 Operation conversion device

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WO2001008581A2 (en) 1999-07-30 2001-02-08 Gaya Limited Hand access port device
US6254534B1 (en) 1999-10-14 2001-07-03 Atropos Limited Retractor
CN1329474A (en) 1998-12-01 2002-01-02 阿特波斯有限公司 A surgical device for retracting and/or sealing an incision
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CN1329474A (en) 1998-12-01 2002-01-02 阿特波斯有限公司 A surgical device for retracting and/or sealing an incision
US6171282B1 (en) 1999-07-23 2001-01-09 Edgar K. Ragsdale Soft cannula and methods for use
WO2001008581A2 (en) 1999-07-30 2001-02-08 Gaya Limited Hand access port device
US6254534B1 (en) 1999-10-14 2001-07-03 Atropos Limited Retractor

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