Split Positioning conductor and using method thereof for anterior mediastinum Minimally Invasive Surgery
Technical field
Patent of the present invention belongs to technical field of medical instruments, relates to a kind of Split Positioning conductor for anterior mediastinum Minimally Invasive Surgery and using method thereof.
Background technology
At present, at new-type chamber mirror under xiphoid-process in the operation process of breastbone postmediastinum enclosed mass excision, owing to operation technique is to carry out in the anterior mediastinum outside pleural space after breastbone, operation process generally requires a kind of special instrument, dissociate to the purpose of bilateral arcus costarum suitable order through xiphoid-process lower cut, require to avoid the damage of bilateral pleura especially right side pleura simultaneously.Finger blunt separation is utilized often to there is the reason of curtailment, in addition the dissection particularity at human body pleura opisthotonos position, it is made to there is following several respects critical defect, so as to this novel anterior mediastinum Minimally Invasive Surgery cannot be applied to: 1, common separation binding clip is excessively sharp keen, the hemorrhage even pleura of torn tissue is caused to break, affecting surgical field of view and operation technique, pleura is likely to be formed pulmonary atelectasis, gas embolism etc. after breaking, and is likely to threat to life time serious.2, finger or elastic separating plier blunt separation are apart from too short, cause that between the mirror of apparatus chamber, spacing is too short, and apparatus activity space is narrow and small, operating difficulties.3, cut arcus costarum place skin when separating to subcutaneous tissue, fix and position device owing to lacking, repeatedly separate and cause unnecessary damage, hemorrhage, have a strong impact on surgical field of view, even the breaking of pleura.4, owing to chamber mirror apparatus inserts and take out relatively frequent repeatedly, cause stamp card position conversion, subcutaneous space is longer, leads and unsuccessfully causes the mistake damage that blindly operation is caused of chamber mirror apparatus.
Summary of the invention
A kind of Split Positioning conductor for anterior mediastinum Minimally Invasive Surgery and using method thereof are it is an object of the invention to provide, to solve anterior mediastinum operation carries out under xiphoid-process gap without suitable instrument to separate and guiding, and existing elastic separating plier owing to binding clip is excessively sharp keen, the too short reason maybe cannot being accurately positioned of length easily cause the problem that pleura breaks.
The first technical scheme of the present invention is, for the Split Positioning conductor of anterior mediastinum Minimally Invasive Surgery, including can corresponding the first locating rack connected and the second locating rack;
First locating rack includes head rod, the two ends of head rod are connected to and are positioned at its homonymy and the first guide being parallel to each other and the first keeper, the internal run-through of the first guide is provided with cylinder cavity and cavity and forms the guide channel passed through for perforator, the first keeper be internally provided with hollow channel;
Second locating rack includes the second connecting rod, the two ends of the second connecting rod are connected to and are positioned at its homonymy and the second guide being parallel to each other and the second keeper, second guide be the hollow semi-circular tube of opening upwards and its uncovered form the guide channel passed through for perforator, the free end of the second keeper is provided with the 3rd keeper of the hollow channel that can be inserted into the first keeper.
Further, the hollow channel of the first keeper is non-revolved body, the cross sectional shape of the cross sectional shape of the 3rd keeper and the hollow channel of the first keeper is identical, 3rd keeper is for, after the passage inserting the first keeper, relatively rotating between the first locating rack and the second locating rack to limit.
Further, the cavity cross-section of the first keeper is shaped as square, rectangle or trapezoidal.
Further, on the first keeper, side away from the first guide is set to opening.
Further, conductor also includes for inserting the first guide or the tube core of the second guide inner passage, and tube core is stock, and the length of tube core is more than the length of the first guide, and the free end of tube core is blunt nosed, and tube core is also associated with perpendicular handle.
Further, shape and the size of the second guide and the first guide meet the following conditions: after the hollow channel of the 3rd fully-inserted first keeper of keeper, and the end face of the second guide and the end face of the first guide coincide.
Further, the cross section of the second guide is the 1/2~1/3 of the first guide cross section.
The second technical scheme that the present invention adopts, for the using method of the Split Positioning conductor of anterior mediastinum Minimally Invasive Surgery, specifically implements according to following steps:
Step 1, first tube core is inserted the first guide from the first guide near one end of head rod, will be equipped with the first guide of tube core and insert in human body through human body xiphoid-process lower cut, make the direction of the first guide just under human body midclavicular line arcus costarum, tube core is allowed to move reciprocatingly at the first guide, to utilize the blunt nosed of tube core that fibrous connective tissue is carried out blunt separation, after the end of the first guide arrives human body subcostal incision appointed part, take out tube core, then by the first guide to jack-up outside skin;
Step 2, by fully-inserted for the connecting rod of the second locating rack the first keeper so that the second guide is with to be positioned at the first internal guide coaxial, and makes the second guide withstand the first guide from external;
Step 3, by the position of the first guide jack-up by incision of skin, perforator is punctured along the second guide to human body, enters after body and be namely punctured in human body anterior mediastinum along the cavity of the first guide.
Further, after the puncture of step 3 completes, connecting rod is moved to the opening direction of the first keeper, just the second locating rack and the first locating rack are separated.
Further, in step 2, after the second guide is coaxial with the first guide, tube core is placed on the second guide, towards the position pressing of the corresponding first guide jack-up of skin, on skin, namely carries out puncture marks.
The invention has the beneficial effects as follows, locating effect is reliable, after first locating rack and the second locating rack are installed, second guide is namely coaxial with the first guide, and the hard pipeline that both are the interruption that internal diameter is identical, can be positioned at skin surface by tube core via the second guide, cut skin and be placed into perforator, can ensure that in the process using perforator punching, the position of punching is accurate, avoid in operative process, repeatedly insert the tissue damage by mistake that apparatus causes, can effectively ensure the safety of operation, conveniently operate and operation and anesthesia duration can be saved;And the blunt nosed structure of tube core both can be soft push open and chorista, the probability of sharp-pointed binding clip damage pleura can be prevented effectively from again simultaneously.
Accompanying drawing explanation
Fig. 1 is the present invention structural representation for Split Positioning conductor first locating rack of anterior mediastinum Minimally Invasive Surgery;
Fig. 2 is the present invention structural representation for Split Positioning conductor second locating rack of anterior mediastinum Minimally Invasive Surgery;
Fig. 3 is the present invention structural representation for the Split Positioning conductor tube core of anterior mediastinum Minimally Invasive Surgery;
Fig. 4 is the present invention for the structural representation after the first locating rack of the Split Positioning conductor of anterior mediastinum Minimally Invasive Surgery and the combination of the second locating rack.
In figure, 1. head rod, 2. the first guide, 3. the first keeper, 4. the second guide, 5. the second connecting rod, 6. the second keeper, 7. the 3rd keeper, 8. tube core, 9. handle, 10. blunt nosed.
Detailed description of the invention
Below in conjunction with the drawings and specific embodiments, the present invention is described in detail.
The invention provides a kind of Split Positioning conductor for anterior mediastinum Minimally Invasive Surgery, including can corresponding the first locating rack connected and the second locating rack;
First locating rack includes head rod 1, the two ends of head rod 1 are connected to the first guide 2 and the first keeper 3 being positioned at its homonymy and being parallel to each other, the internal run-through of the first guide 2 is provided with cylinder cavity and cavity and forms the guide channel passed through for perforator, the first keeper 3 be internally provided with hollow channel;
Second locating rack includes the second connecting rod 5, the two ends of the second connecting rod 5 are connected to the second guide 4 and the second keeper 6 being positioned at its homonymy and being parallel to each other, second guide 4 is the hollow semi-circular tube of opening upwards and forms the guide channel passed through for perforator therein, and the free end of the second keeper 6 is provided with the 3rd keeper 7 of the hollow channel that can be inserted into the first keeper 3;
The relative position relation of above all parts is as follows: after the hollow channel of fully-inserted first keeper 3 of the 3rd keeper 7, it is ensured that the guide channel of the first guide 2 and the second guide 4 is coaxial and the first guide 2 and the second guide 4 end face contact.
nullOwing to the first guide 2 and the first keeper 3 are for be arrangeding in parallel,Second guide 4 and the second keeper 6 are also for be arrangeding in parallel,And first the spacing of guide 2 and the first keeper 3 equal with the spacing of the second guide 4 and the second keeper 6,And between head rod 1 and the second connecting rod 5,The length sum of the first guide 2 and the second guide 4 is equal to the length sum of the first keeper 3 and the second keeper 6,So selecting suitable angle that the 3rd keeper 7 is inserted the first keeper 3,And by after the first keeper 3 and the second keeper 6 compact siro spinning technology,Necessarily can so that the first guide 2 naturally coaxially contacts placement relatively with two guide channels in the second guide 4,Achieve the guarantee to the first guide 2 and the second guide 4 axiality,Thus ensure that the accuracy of the puncture path of perforator.
Wherein, the hollow channel of the first keeper 3 is non-revolved body, and the cavity cross-section shape of the first keeper 3 is usually arranged as square, rectangle or trapezoidal.And the cross sectional shape of the 3rd keeper 7 is set to identical with the channel cross-sectional shape of the first keeper 3, to ensure that the 3rd keeper 7 can be inserted into smoothly in the first keeper 3 and take out simultaneously, 3rd keeper 7 is for, after the passage inserting the first keeper 3, relatively rotating between the first locating rack and the second locating rack to limit.
Owing to the cavity inner wall of the first keeper 3 is non-revolved body, make will not relatively rotate between the first keeper 3 and the 3rd keeper 7 of matched connection, and then play the effect of detachable to the first locating rack and the second locating rack fixing connection, and prevent simultaneously and make the first guide 2 and the second guide 4 deviate owing to the second connecting rod 5 rotates, thus the problem affecting positioning precision when perforator punctures.
First keeper 3 will be set to open type away from the side of the first guide 2, then coordinate the second guide 4 of opening upwards, it is possible to after puncture completes, easily the second locating rack and the first locating rack are separated up and down.Concrete operations are, after the first locating rack and the second locating rack are fully connected, perforator is punctured into the human body along the second guide 4 and the first keeper 3, after completing puncture, the position keeping perforator is motionless, again the 3rd keeper 7 of the second locating rack and the second keeper 6 are directly separating with the first keeper 3 downwards, it is arranged above open design due to the second guide 4, so the second guide 4 can also separate with perforator easily, without the impact by perforator position, convenient separation.
Shape and the size of the second guide 4 and the first guide 2 meet the following conditions: after the hollow channel of fully-inserted first keeper 3 of the 3rd keeper 7, and the end face of the second guide 4 and the end face of the first guide 2 coincide.The cross section of usual second guide 4 is the 1/2~1/3 of the first guide 2 cross section, such setting, both ensure that second guide 4 accuracy to the guide track of perforator puncture action, and be easy to again after puncture completes and the second guide 4 is separated up and down with perforator, effective.
The Split Positioning conductor for anterior mediastinum Minimally Invasive Surgery of the present invention also includes the tube core 8 for inserting the first guide 2 or the second guide 4, and tube core 8 is stock, and the length of tube core 8 is more than the length of the first guide 2.
By tube core 8 from the first guide 2 near the termination of head rod 1 insert after, owing to the bar footpath of tube core 8 is less than the internal diameter of the first guide 2, tube core can 4 move reciprocatingly smoothly in the first guide 2, the length of tube core 8 is again more than the length of the first guide 2, make the blunt nosed of tube core 8 can pass first guide 2 part, thus when tube core 8 moves reciprocatingly, it is possible to just right pushes human body pleura open and separates fibrous connective tissue.
Simultaneously, the free end of tube core 8 is blunt nosed 10, it is possible to be prevented effectively from the probability of sharp-pointed binding clip damage human body pleura, it is possible to when not damaging human body breastbone and rib, it is operated along human body breastbone and rib edge, it is to avoid pleura breaks the harmful effect to operation technique.
Additionally, tube core 8 rear end is provided with perpendicular handle 9, it is simple to medical personnel grip tube core 8, in that context it may be convenient to operation tube core 8 is reciprocating in the first guide 2, substantially increase speed and the intensity of motion, so that increasing separating rate in the process of tube core 8 chorista.
Present invention provide for the using method of the Split Positioning conductor of anterior mediastinum Minimally Invasive Surgery, implement according to following steps:
Step 1, first tube core 8 is inserted the first guide 2 from the first guide 2 near one end of head rod 1, and make tube core 8 be provided with blunt nosed one end to expose from the end of the first guide 2, will be equipped with the first guide 2 of tube core 8 and insert internal through human body xiphoid-process lower cut place, make the direction of the first guide 2 just under midclavicular line arcus costarum, tube core 8 is allowed to move back and forth in the first guide 2, push pleura open by the blunt nosed acceleration of tube core 8 and separate fibrous connective tissue, when after body surface operation mark under the outer end arrival human body bilateral costal margin of the first guide 2, take out tube core 8, again by the first guide 2 to jack-up outside skin.
Step 2, the connecting rod 7 of the second locating rack is inserted the first keeper 3, owing to the cavity geometry of the first keeper 3 is any non-revolved body, so when using the connecting rod 7 of correspondingly-shaped to insert, choose insertion angle, ensure when after fully-inserted first keeper 3 intracavity of connecting rod 7, the guide channel of the second guide 4 is natural coaxial with the guide channel of the first guide 2 in human body, and make the second guide 4 from the external termination withstanding the first guide 2, namely the second guide 4 and the first guide 2 define one be interrupted coaxial guide channel puncture for perforator, this guide channel all points to body surface operation mark under human body costal margin, the puncture path of perforator can be guided by this guide channel, ensure that the accuracy of puncture.
Step 3, with tube core 8 along the second guide 4 towards under human body costal margin body surface operation mark pressing, it is possible to improve puncture accuracy.By the position of the first guide 2 jack-up by incision of skin, then by perforator along the second guide 4 to internal puncture, enter internal after will enter human body along the cavity of the first guide 2, it is ensured that be punctured in human body anterior mediastinum the precision of appointed part.
After puncture completes, connecting rod 7 is moved to the opening direction of the first keeper 3, just the second locating rack and the first locating rack are separated.
The overall material for the Split Positioning conductor of anterior mediastinum Minimally Invasive Surgery of the present invention is stainless steel alloy, and hardness is suitable for, and will not cause device deformation because of operation, uses separating effect definite in operation.According to clinical needs, this location conductor can also be designed to the model varied in size, to adapt to the situation of different patient, it is ensured that result of use.
The Split Positioning conductor for anterior mediastinum Minimally Invasive Surgery of the present invention, it may be achieved the purpose of location, guiding and chorista effectively reliably, reaches to accelerate operation technique process, reduces the purpose of surgical risks.