CN102018542A - Puncture type multifunctional poking rod used under laparoscope - Google Patents
Puncture type multifunctional poking rod used under laparoscope Download PDFInfo
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- CN102018542A CN102018542A CN2009101763112A CN200910176311A CN102018542A CN 102018542 A CN102018542 A CN 102018542A CN 2009101763112 A CN2009101763112 A CN 2009101763112A CN 200910176311 A CN200910176311 A CN 200910176311A CN 102018542 A CN102018542 A CN 102018542A
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Abstract
The invention provides a puncture type multifunctional poking rod used under a laparoscope. The puncture type multifunctional poking rod comprises a handle, a needle type operating rod and an operating head. According to the requirements of a surgery, the needle type operating rod connected with the handle is punctured into an abdominal cavity on different parts of the abdomen, and the operating head is transmitted into the abdominal cavity through other thecal canals to be connected with the tip of the operating rod, so that visceral organs and pathological tissues can be exposed through pushing, poking, ejecting and pulling action; the operating head can carry ligatures and tissues can be ligatured under the laparoscope and under the help of a pair of operating pincers; after the ligaturing operation, the operating head can be detached under the laparoscope and can be taken out through other thecal canals; and the operating rod is very thin, so only a pinhole is displayed on the abdominal wall after the surgery. Various laparoscopic surgeries, which comprise two-hole method laparoscopic cholecystectomy, three-hole method laparoscopic common bile duct exploration, transumbilical single-hole laparoscopic appendectomy and the like, can be finished through the common laparoscopic surgical instruments under the cooperation of the puncture type multifunctional poking rod.
Description
Technical field:
The present invention relates to a kind of operating theater instruments of appearing and tiing a knot of under peritoneoscope, being used to, a kind ofly can dial rod in the multi-functional knotting of puncture type of intraperitoneal charge and discharge operations head.
Background technology:
Along with the development of laparoscopic technique and patient to the raising that Minimally Invasive Surgery requires, further reduce trauma of abdomi napwall and cicatrix and become the target that the surgeon constantly pursues.Be used at present that internal organs appear or the about 5mm of apparatus diameter of auxiliary knotting, all need to enter the abdominal cavity, stomach wall is stayed be about the cicatrix (incision length=3.14 * apparatus external diameter ÷ 2) of 8mm by the sheath pipe of external diameter 5.5mm.Bao Dao " pin type " laparoscopic instrument external diameter is thin in recent years, and sharp can directly puncture of operating head enters the abdominal cavity, and operational approach and common Minimally Invasive Surgery are as good as, and can obviously dwindle the stomach wall cicatrix.But, grasp the easy slippage of thing (Luo Jian etc., the auxiliary laparoscopic appendectomy 40 example reports of pin type apparatus because its operating head poor rigidity, jaw are little.Xian Medical Univ's journal was rolled up for the 3rd phase in 2000 the 21st), and its operating head is too sharp, cause the danger of visceral organ injury when operating in vivo in addition, thereby its application is restricted.Recently, have report to adopt triple channel sheath Guan Fajing umbilicus single-hole laparoscopic cholecystectomy both at home and abroad, this method adopts traditional Minimally Invasive Surgery apparatus, and two operating apparatuss and peritoneoscope all enter the abdominal cavity through the omphalos otch, make the operative incision concealment in omphalos, can't see operative scar from the stomach wall outward appearance; But apparatus collides mutually during operation technique, gallbladder appears difficulty, operating time prolongs and various complication (Sang Kuon Lee, et al.Single-portTransumbilical Laparoscopic Cholecystectomy:A Preliminary Study in 37Patients with Gallbladder Disease.Journal of Laparoendoscopic ﹠amp easily takes place; Advanced Surgical Techniques, ahead of print.doi:10.1089/lap.2008.0424.), thereby this method is difficult in clinical application.In recent years, the someone has proposed through natural tract endoscopic surgery (natural orifice transluminal endoscopic surgery--NOTES), and has carried out experimentation and clinical principium exploration.This method is to enter the abdominal cavity through natural tracts such as stomach or vaginas to carry out interior arthroscopic diagnosis, and stomach wall can not have any operative scar; But operating apparatus equipment requirements height, cost an arm and a leg, complicated operating process and other internal organs have been constituted damage in the disease in treatment, thereby this operation method is difficult to become a kind of practical Minimally Invasive Surgery (C.Daniel Smith.A Critical Assessment of NOTES:A Pessimistic Viewfrom an Optimist.Journal of Laparoendoscopic; Advanced SurgicalTechniques.September 1,2008,18 (5): 665-667.doi:10.1089/lap.2008.9994.).
Summary of the invention:
Enter the abdominal cavity in order to solve the thick and sheath of sting pipe that must wear long of existing laparoscopic procedure apparatus, other operating apparatuss and method are used problems such as limited, but rod is dialled in the multi-functional knotting of puncture type that the invention provides a kind of charge and discharge operations head.The pin type action bars of this group rod can enter the abdominal cavity in abdominal part different parts puncture according to the operation needs, and operating head is connected with action bars is most advanced and sophisticated after other sheath pipe is sent into the abdominal cavity, thereby pushes away, dials, pushes up, draws, operation such as knotting.Because of action bars is very thin, the operation back only shows a pin hole on stomach wall.
Technical solution of the present invention is:
But rod is dialled in the multi-functional knotting of a kind of puncture type of charge and discharge operations head, it is characterized in that: handle is arranged, and pin type action bars and operating head, the three is by being inserted in connection.Handle is made by stainless steel material, and its front portion is round table-like rear portion and is cylindric, and front, center has a stringer connecting hole, and long 3～5cm is 2/3 circular cross-section and is connected so that be inserted in the connecting portion of action bars end; Establish a threaded fixing hole that communicates perpendicular to connecting hole and with connecting hole in its front portion, the action bars and the handle that are inserted in can be fixed by fixing hole with bolt.The pin type action bars is made by the cylindric rustless steel of real core, diameter 1.2～2mm, and long 25～35cm, an end is a needle tip, establishes 1～2 annular groove behind the needle point and is connected and fixes so that be inserted in operating head; The other end is established the handle connecting portion, and long 3～5cm is 2/3 circular cross-section.Operating head is made by polypropylene material, the branch amphitypy: the I type is cylindric, diameter 3～5mm, long 4～8cm; Thin cylindric in thick back before the II type is, long 4～8cm, the thickness place of dividing a word with a hyphen at the end of a line is round table-like, former minister 2～4cm, diameter 8～10mm, latticed anti-skidding stricture of vagina is established on the surface, back minister 2～4cm, diameter 5mm.The anterior top of amphitypy operating head all is hemispherical, is followed successively by through wires hole and hanging wire groove thereafter, and there is a stringer connecting hole in rear portion central authorities, and long 2～4cm establishes 1～2 annular convex rib in the hole, fixedlys connected so that form to be inserted in the groove of action bars.The clamp area that a long 1cm is established in the rear end outside.
When laparoscopic surgery is operated, earlier be connected and use bolting external handle and action bars are inserted in, under the peritoneoscope direct-view, select proper site that the action bars puncture is entered the abdominal cavity, according to the operation needs different model operating head is sent into the abdominal cavity through operation sheath pipe, at intraperitoneal operating head is inserted in the tip of action bars and is connected, then by pushing away, dial, the top directly appears internal organs or pathological tissues, can utilize the stitching draught line on its hanging wire groove push-and-pull internal organs or the pathological tissues to appear, the line segment that also can utilize its through wires hole to carry is organized ligation under another apparatus is assisted.With gripper clamp operating head is separated with action bars behind the EO, and take out through other sheath pipes; Or external lever is separated with the puncture shank, operating head is taken out through other sheath pipes together with action bars.In the operation that appears difficulty, also can select a plurality of groups of rods to finish through the multiple spot puncture as required and appear.
The invention has the beneficial effects as follows, in laparoscopic surgery, can replace the operating apparatus of 5mm and the sheath pipe that punctures accordingly, thereby reduce the stomach wall operative scar, reach Wicresoft and surgical effect attractive in appearance more.
Description of drawings
The present invention is further described below in conjunction with drawings and Examples:
Fig. 1 is front view, right view, upward view and the cutaway view of operating head I type of the present invention
Fig. 2 is front view, right view, the upward view of operating head II type of the present invention
Fig. 3 is the sketch map of pin type action bars of the present invention.
Fig. 4 is front view, vertical view and the partial sectional view of handle of the present invention.
Fig. 5 is the sketch map after each one of the present invention connects
1. through wires holes among the figure, 2. hanging wire groove, 3. clamp area, 4. operating head connecting hole, 5. annular convex rib, 6.II type operating head front portion, the portion 7.II type operating head thickness is divided a word with a hyphen at the end of a line, 8.II type operating head rear portion, 9. annular groove, 10. virtual striping, 11. handle connecting portions, 12. set bolts, 13. the screw thread fixing hole, 14. handle connecting holes, 15. operating heads, 16. the virtual gap of pin type action bars, 17. handles.
Fig. 6～Figure 10 is the application sketch map of the present invention in two hole method laparoscopic cholecystectomys.
Figure 11 is the application sketch map of the present invention in three hole method laparoscopic exploration of common bile duct.
Figure 12～Figure 14 is that the present invention is at the application sketch map in umbilicus single hole method laparoscopic appendectomy.
The specific embodiment
Embodiment 1: the application in two hole method laparoscopic cholecystectomys.By two sheath pipes of the parallel insertion of omphalos otch, insert handling tongs and peritoneoscope respectively, insert gallbladder by the xiphoid-process lower cut and sew up the band wire pin, on seromuscular layer at the bottom of the gallbladder, wear a silk thread (Fig. 6).Withdraw from the band wire pin, insert 5mm sheath pipe and handling tongs, be knotted into a wire loop (Fig. 7) with the silk thread of two handling tongs at the bottom of with gallbladder by the xiphoid-process lower cut.The pin type action bars of this invention is thrust the abdominal cavity under the right midclavicular line costal margin, operating head sheath pipe under xiphoid-process sent into the abdominal cavity and be connected (Fig. 8) with action bars, wire loop at the bottom of the gallbladder is enclosed within on the divinatory symbol wire casing of operating head,, can makes calot's triangle well be appeared (Fig. 9) to liver back upper place jack-up.After finishing separation ligation cystic artery and cystic duct, peel off gallbladder (Figure 10) from gallbladder bottom direct motion.Therefore, the advantage of using this invention when two hole method gallbladder removals is: gallbladder is well appeared, can finish from gallbladder bottom direct motion and peel off gallbladder.
Embodiment 2: be used for appearing of three hole method laparoscopic exploration of common bile duct.I type operating head of the present invention is inserted the abdominal cavity through 5mm sheath pipe, and 5cm under right anterior axillary line costal margin thrusts the abdominal cavity with the pin type action bars, with the wire loop jack-up of the gallbladder bottom being sewed up after operating head is connected.II type operating head is inserted the abdominal cavity through 10mm sheath pipe, the pin type action bars is thrust the abdominal cavity on the umbilicus upper left side, and gastric antrum portion and pyloric cap are pushed to the back lower place after operating head is connected, thereby common bile duct is fully appeared.Can finish choledochoscope by 10mm main operation hole under the xiphoid-process and right midclavicular line 5mm auxiliary operation hole detects and common bile duct myometrial suture (Figure 11).The also available II type operating head jack-up that liver made progress on the round ligament of liver right side when appearing common bile duct.II type operating head front end has anti-skidding stricture of vagina than thick and surface, and hepatic tissue or slippage on organ surface are difficult for stabbing.
Embodiment 3: through umbilicus single hole method laparoscopic appendectomy.By two sheath pipes of the parallel insertion of omphalos otch, insert peritoneoscope and handling tongs respectively.Insert two pin type action bars respectively in the bottom right abdomen,, utilize its pushing effect compounding practice pincers to appear vermiform appendix at intraperitoneal attended operation head.Dial rod with two vermiform appendix is clamped, will dial the ligature that excellent operating head carries with handling tongs and pass mesoappendix (Figure 12), and dial excellent with handling tongs and this band wire mesentery ligation (13).Sheath pipe insertion electricity colludes with fixed attention or shears cuts off mesoappendix through operating then, uses snare ligation appendix root (14) under group rod is assisted, and finishes appendectomy at last.This method only shows two pin holes at stomach wall, and the concealment of omphalos otch does not show.
Claims (5)
1. one kind is used to multi-functional group of rod of puncture type of appearing and tiing a knot under peritoneoscope, it is characterized in that: form by handle, pin type action bars and operating head, handle and pin type action bars are inserted in and are connected and fix by the screw thread fixing hole of bolt and handle, and pin type action bars and operating head are inserted in and are connected and fix by the annular convex rib in annular groove on the action bars and the operating head connecting hole.
2. multi-functional group of rod according to claim 1, it is characterized in that: operating head is made by polypropylene, be cylindric, long 4～8cm, diameter 3～5mm, anterior top is hemispherical, thereafter be followed successively by through wires hole and hanging wire groove, there is a stringer connecting hole in rear portion central authorities, long 2～4cm, establish 1～2 annular convex rib in the hole, the clamp area that a long 1cm is established in the rear end outside.
3. multi-functional group of rod according to claim 2 is characterized in that: the anterior thick rear portion of operating head is thin, and the thickness place of dividing a word with a hyphen at the end of a line is round table-like, former minister 2～4cm, and diameter 8～10mm, latticed anti-skidding stricture of vagina is established on the surface, back minister 2～4cm, diameter 5mm.
4. multi-functional group of rod according to claim 1, it is characterized in that: the pin type action bars is made by the cylindric rustless steel of real core, diameter 1.2～2mm, long 25～35cm, one end is a needle tip, establishes 1～2 annular groove behind the needle point, and the other end is established the handle connecting portion, long 3～5cm is 2/3 circular cross-section.
5. multi-functional group of rod according to claim 1, it is characterized in that: handle is made by stainless steel material, its front portion is round table-like rear portion and is cylindric, front, center has a stringer connecting hole, long 3～5cm, be 2/3 circular cross-section, a threaded fixing hole that communicates perpendicular to connecting hole and with connecting hole is forwardly arranged.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2009101763112A CN102018542A (en) | 2009-09-14 | 2009-09-14 | Puncture type multifunctional poking rod used under laparoscope |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2009101763112A CN102018542A (en) | 2009-09-14 | 2009-09-14 | Puncture type multifunctional poking rod used under laparoscope |
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Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102440812A (en) * | 2011-09-22 | 2012-05-09 | 中国人民解放军第四军医大学 | Deep knotting forceps |
| CN102579090A (en) * | 2012-01-19 | 2012-07-18 | 徐秀杰 | Ligamentum teres hepatis suspending probe for single-port laparoscopic gallbladder surgery and operation method |
| CN104825201A (en) * | 2015-05-31 | 2015-08-12 | 江苏省中医药研究院 | Improved percutaneous full-endoscopic minimally-invasive intervertebral disk operation fiber ring stitching instrument |
| CN112826544A (en) * | 2020-11-19 | 2021-05-25 | 曲波 | Surgical instrument and method for traceless invisibility of television endoscopic surgery |
| CN114601529A (en) * | 2022-04-16 | 2022-06-10 | 苏州大学附属第二医院 | Laparoscope auxiliary forceps and laparoscopic surgical instrument |
-
2009
- 2009-09-14 CN CN2009101763112A patent/CN102018542A/en active Pending
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102440812A (en) * | 2011-09-22 | 2012-05-09 | 中国人民解放军第四军医大学 | Deep knotting forceps |
| CN102579090A (en) * | 2012-01-19 | 2012-07-18 | 徐秀杰 | Ligamentum teres hepatis suspending probe for single-port laparoscopic gallbladder surgery and operation method |
| CN104825201A (en) * | 2015-05-31 | 2015-08-12 | 江苏省中医药研究院 | Improved percutaneous full-endoscopic minimally-invasive intervertebral disk operation fiber ring stitching instrument |
| CN112826544A (en) * | 2020-11-19 | 2021-05-25 | 曲波 | Surgical instrument and method for traceless invisibility of television endoscopic surgery |
| CN114601529A (en) * | 2022-04-16 | 2022-06-10 | 苏州大学附属第二医院 | Laparoscope auxiliary forceps and laparoscopic surgical instrument |
| CN114601529B (en) * | 2022-04-16 | 2024-04-12 | 苏州大学附属第二医院 | Laparoscopic auxiliary forceps and laparoscopic surgical instrument |
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Application publication date: 20110420 |