CN101686838A - 用于腹腔和骨盆腔检查及手术的医疗仪器 - Google Patents

用于腹腔和骨盆腔检查及手术的医疗仪器 Download PDF

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CN101686838A
CN101686838A CN200780052976A CN200780052976A CN101686838A CN 101686838 A CN101686838 A CN 101686838A CN 200780052976 A CN200780052976 A CN 200780052976A CN 200780052976 A CN200780052976 A CN 200780052976A CN 101686838 A CN101686838 A CN 101686838A
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abdominal cavity
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马塞拉·卡德纳斯
拉斐尔·阿朗戈
海梅·冈萨雷斯
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Abstract

本发明涉及一种医疗仪器，该医疗仪器包括具有一中空端的一套管针，用于一摄像机的通过，在其顶端的一光源和一小型摄像机，其传输图像至一LCD显示屏。本发明还包括在其侧面的两个或更多个工作通道，用于为摘除阑尾或其他相似尺寸的组织的外科设备的引入。该摄像机连接一线缆，该线缆相继连接至一LCD显示屏，以使外科医生的印象是正通过一个窗口观察病人的腹腔。

Description

用于腹腔和骨盆腔检查及手术的医疗仪器
技术领域
本发明涉及一种医疗仪器，该仪器的主要作用是为诊断而高精度地检查腹腔和骨盆腔，以及为确定或放弃外科手术介入而检查内脏器官的炎症或疾病。本器械允许观察腹部和骨盆器官。该器械允许诊断通过直接观察可发觉的各种病状，类似于一种常规的剖腹手术。同样地，本器械也可用于摘除阑尾或其他类似尺寸的组织器官(管状器官、卵巢、膀胱和组织切片样品)。
背景技术
通常地，腹部疼痛的诊断检查和随后的外科手术介入通过剖腹手术或腹腔镜检查来实施。这些手段是在无特定的腹部疼痛的情况下，一旦其他非侵入检查都用尽时被建议采用的。
剖腹手术定义为在腹部壁上形成切口以使外科医生可以观察和触诊腹部区域的器官。其缺点是例如在腹部壁上的大切口，即它是一种侵入的且出血的介入，其带来所有的后果意味着：更高可能性的感染，较慢的恢复，严重的术后疼痛，以及主要的并发症的风险(疝气，肠梗阻)。为实现这一过程，在手术室内必须采取的所有必要措施：消毒的外科手术环境，外科手术设备，多名外科手术护士，多名专业的腹腔镜检查医生，多名麻醉医生和麻醉设备。
腹腔镜检查是在腹腔壁上开有至少三个小切口来实施的。为了进行实施，几项要求是必要的：消毒的外科手术环境，腹腔镜外科手术设备(监视器，吹药器，摄像机，图像处理器，光源)，一系列腹腔镜检查仪器，多名外科手术护士，多名专业的腹腔镜检查医生，多名麻醉医生和麻醉设备。
发明内容
与上述描述的方法相比，本发明新的器械具有以下几方面的优点。一方面，由于该过程通过在肚脐下的一小切口来实施，该过程以一种较小侵入方式允许对腹腔和骨盆腔直接观察。如果对比传统的剖腹手术，感染的可能性降低，恢复更快(住院时间更少，甚至可以对门诊病人实施，减少不能行动的时间)，更小的伤疤，术后更少的疼痛。本发明可用于作为在ERS(清洁的，但未消毒的)内的诊断仪器，带有局部麻醉，使病人放松及镇静。实施该过程的医务人员无需进行腹腔镜检查医生的专门培训。使用本发明的医疗仪器无需腹腔镜检查设备，而像吹药器一样在腹腔内创造一个实际空间以对其进行检查。该空间是由该医疗仪器所使用在腔体内打开的臂来创造的，并且通过机械牵引创造该空间。因为多种气体是在腹腔镜检查过程之前被考虑为一种附加的风险，本发明的这个特点提供几个医学上的益处。采用本医疗仪器，该风险即不存在。其使用会减少腹腔镜检查诊断的费用并且改进了这些设备的可用性，因为，由于腹腔镜检查诊断设备的成本，其从未在ERs中采用。本发明的医疗仪器是一种简单的、便携的、轻巧的、手动操作的并且明显更经济的设备。
本发明医疗仪器，在腹腔镜检查领域中是一种创新。然而，不同于腹腔镜检查，其实施只有一个切口。传统的腹腔镜检查需要至少三个。本发明医疗仪器较腹腔镜检查具有更少的侵入过程。另外，为引入该医疗仪器切口在脐带区域内形成，这样使切口一旦愈合几乎看不到。该医疗仪器具有一手柄，该手柄在其顶端连接牵引器，允许在腹腔内空间的创造不需要使用气体。
在传统的外科手术中，当外科医生的手在工作时，外科医生必须看着通常位于病人上方的显示屏。外科医生看不到他工作的手并且看不到病人的腹部；眼-手-目标物的轴线被打破。这样情形使学习这项技术变得复杂，这项技术需要长期并刻苦的训练得以掌握。本医疗仪器简化该学习的时间，因为屏幕设置于腹部的上方，使得腹部的内部可以得到观察，就像一个窗口，允许外科医生来观察自然发生的情况以及观察他手的移动情况。这个特点使得在较短时间内可以大部分掌握这项技术。
本发明医疗仪器的主要目的是在决定实施外科手术介入之前，进行高精确度诊断病人是否患有阑尾炎、盲肠炎，或任何其他腹部病症。它同样的可以用于外科手术介入。在类似条件或环境中，该仪器可以被使用，两种运用均有几项优势，因为其不需要手术室，高级专业人员和全身麻醉。其应用是作为医疗器械在手术室中使用，具有全身麻醉，但无需高级专业人员。本医疗仪器较已知的医疗器械是一种大幅简单化并更为经济的器械；其可以在短期训练后很容易的被使用。本仪器有一个具有中空端的套管针以允许小型摄像机的通过。套管针已经被改进并具有创新的设计；其具有一光源并且在其顶端具有一小型摄像机，该小型摄像机将图像传送至一LCD显示屏。其具有两个或更多的侧向工作通道，以使外科手术材料在阑尾切除或其他类似尺寸结构必须发生切除时被引导。该摄像机连接一线缆，该线缆相继连接至一LCD显示屏，这给外科医生的印象是他或她正在通过一个窗口观察病人的腹腔。
在诊断阶段中，本仪器会改进在很多ERs中仍然存在的传统的腹膜泵送(peri toneal pumping)。
本医疗仪器进一步减少诊断所需的检测数量、采用治疗方案所需的时间、在诊断过程中的疼痛和病人的不舒适、误诊的数量、诊断费用，在物质资源和人力方面、相关过程中的文件，以及为诊断而使病人留待观察的时间。同样地，其在诊断过程中最大化专家的介入及通过诊断检查所获得的腹腔的“可视性”。
附图说明
图1为本发明医疗仪器及其部件的立体图。
图1中的附图标记为：
(1)主体：套管针  (2)工作通道  (3)通用孔
(4)外科手术器械  (5)工效手柄(Ergonomic Handle)
(6)中空端  (7)光源  (8)小型摄像机  (9)臂  (10)支架
(11)LCD显示屏
具体实施方式
本发明医疗仪器由作为其主体(1)的套管针(注：套管针-穿过人体的外科手术器械，用来在内窥镜检查手术中使得内窥镜检查器械轻松的交换，参见http://www.nj surgery.com/html/Procedures/glossary.shtml)构成，其具有带光源(7)的中空端(2)，允许小型摄像机通过至顶端(8)的通道。该摄像机传送图像至LCD显示屏(11)，如图1所示，LCD显示屏(11)通过一支架连接所述的主体，以使该显示屏可以移动甚至可以拆除。本发明医疗仪器的主体(1)具有除中心工作通道以外的两个侧工作通道(2)，其包含在主体(1)中。在进行医疗使用中这些被认为是为了引导必要的外科手术材料(4)，以至没有额外的切口产生。这就是为什么这两个侧通道(2)伸出至一通用孔(12)，通过该通用孔医疗介入可以实施或退出，其可由该侧通道(2)和中心通道(3)伸出。小型摄像机(8)和光源(7)穿过该侧通道(2)和中心通道(3)，该侧通道(2)是为介入病人的外科手术器械插入的位置，以使外科医生可以看到。在其顶端设置有通用出口孔(12)，该医疗仪器具有两个打开及闭合的臂(9)，以分开组织并允许介入病人。该摄像机(8)通过中心通道(3)连接一线缆，其相继连接至一LCD显示屏(11)，给外科医生的印象是通过一面镜子观察病人的腹腔内部，并因此保持眼-手-目标物的轴线，使得使用该医疗仪器的人不需要像使用其他系统时所发生的不得不看其他地方的情况。该医疗仪器通过一工效手柄(5)把持，以使得其易于使用，以成为一种多用的和便携的器械。虽然在市场上有相类似的元件存在，如套管针，小型摄像机，LCD显示屏，但这种方式的组合、改进和使用至该仪器使之与在先技术相比具有创造性，尤其是因为其具有三个独立的通道伸出至一个通用孔。
为诊断使用：
在诊断期间，医生在肚脐下切一个1.5至2cm的小切口，并且在复苏室内，未消毒的环境中插入本医疗仪器。病人必须是服用镇静剂的、松弛的并且具有局部麻醉的。一旦在屏幕上显示已经进入腹腔，医生会打开本医疗仪器的控制，以打开在其顶端的臂。这会创造一个类似于气腹的空间。在修正该腔体之后，如果对诊断有疑问或者如果有必须研究的特殊情况，采用一种注射并回收生理盐水的方案以进行研究。采用这种方式，除了生理盐水方案的回收，能够直接并且在ER中检查腹腔，以提高检查的准确性。
为治疗使用：
为了摘除阑尾或其他类似尺寸的组织器官(管状器官、卵巢、膀胱和组织切片样品)，外科医生必须通过本医疗仪器的一个工作通道插入一带有预先准备的结的缝合线，包裹该组织并打结。然后，外科医生重复该动作并通过该工作通道插入内窥镜检查的剪刀并在两个结之间剪切。之后，外科医生通过这个创造的切口摘除该组织，以在肚脐中插入本医疗仪器。切口的最大尺寸是2厘米，由于它的位置和尺寸，其最终将变得看不到。
与腹腔镜检查不同，采用本医疗仪器无需三个小切口。除了该工具提供的美容优势，病人可以再当天返回家，并且甚至在第二天工作。病人的疼痛会减少，减少止痛药的需要。

Claims (4)

1.一种用于腹腔和骨盆腔检查及手术的医疗仪器，其特征在于：具有两个侧工作通道(2)的主体(2)和带有一光源(7)的中心通道(3)，以及引导外科手术器械(4)的小型摄像机(8)，具有带有一中空端(6)的工效手柄(5)，该中空端(6)允许摄像机(8)通过，具有光源(7)和在其端部(11)上的小型摄像机，具有带有一支架(10)的三个臂(9)，该支架(10)放置一LCD显示屏(11)，该LCD显示屏(11)接收摄像机(8)传输的图像。
2.根据权利要求1所述的用于腹腔和骨盆腔检查及手术的医疗仪器，其特征在于：由主体(1)构成，具有两个侧工作通道(2)，以引导外科手术器械(4)，伸出至一通用孔(12)。
3.根据权利要求1所述的用于腹腔和骨盆腔检查及手术的医疗仪器，其特征在于：其具有一通过支架(10)与主体(1)连接的LCD显示屏(11)，允许移动和拆除该显示屏(11)。
4.一种用于腹腔和骨盆腔检查及手术的医疗仪器，其特征在于：具有开启和关闭动作的两个臂(9)，其位于主体(1)的末端部。
CN200780052976A 2007-06-05 2007-06-05 用于腹腔和骨盆腔检查及手术的医疗仪器 Pending CN101686838A (zh)

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