CN105963013A - Low temperature endoscope blood vessel collecting device and method - Google Patents

Low temperature endoscope blood vessel collecting device and method Download PDF

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Publication number
CN105963013A
CN105963013A CN201610412603.1A CN201610412603A CN105963013A CN 105963013 A CN105963013 A CN 105963013A CN 201610412603 A CN201610412603 A CN 201610412603A CN 105963013 A CN105963013 A CN 105963013A
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shears
sleeve pipe
low temperature
endoscope
coagulation
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CN105963013B (en
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李雷
谢茜
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Beijing meadows Medical Equipment Co., Ltd
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BEIJING MEDOS AT BIOTECHNOLOGY CO LTD
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1482Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00607Coagulation and cutting with the same instrument
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00714Temperature
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/126Generators therefor characterised by the output polarity bipolar
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • A61B2018/1452Probes having pivoting end effectors, e.g. forceps including means for cutting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • A61B2018/146Scissors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002Irrigation

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Endoscopes (AREA)

Abstract

The invention discloses a low temperature endoscope blood vessel collecting device and method, and belongs to the technical field of medical treatment. A rigid tube endoscope is structurally composed of a steel tube. A lens for collecting images is arranged at the tip of the steel tube. The tail end is provided with threads and used for being connected with a collecting casing pipe and a free casing pipe and fixed. A light guiding connector connected with optical fiber and a connecting device connected with a video camera are arranged on the endoscope. A short-opening trocar is structurally characterized in that an annular air bag is connected to the periphery of the shell, the annular air bag is wrapped by rubber, the main shell is connected with an annular air bag inflation opening and a carbon dioxide tube end, the top end of the main shell is connected with a body seal, and the carbon dioxide tube end is connected with a CO inlet. The device has the advantages that the bridge blood vessel perfectness ratio is improved, hidden bridge blood vessel injuries are avoided, the bypass surgery successful rate is increased, the bridge blood vessel re-blocking probability is decreased, and therefore the survival time of a patient is prolonged.

Description

A kind of low temperature endoscopic vessel harvester and method
Technical field
The present invention relates to a kind of low temperature endoscopic vessel harvester and method, belong to field of medical technology.
Background technology
In bypass surgery, it is necessary to by gathering a bridge blood vessel in the patient, typically now choose great saphenous vein or radial artery.In traditional operation, be by skin, muscular tissue is completely exfoliated, and target blood is separated with collateral blood vessels under direct-view.Operation typically to cut an otch suitable with target blood length, usual 20-25cm patient legs or arm part.Patient's is painful big, and post-operative recovery time is long, and the chance of infection is big, and pain is strong and the persistent period is long, and cicatrix is obvious.
Wicresoft's endoscope vascular acquisition system can help doctor to implement Minimally Invasive Surgery at leg or arm now, and doctor has only to cut the little otch of 1 to 2 1-2cm on patient's leg or forearm, it is possible to taken out by wanted blood vessel easily.The method is the least to patient trauma, reduces and infects and complication probability, reduces pain, shortens post-operative recovery time, the most attractive in appearance.
Since endoscope vascular acquisition system comes out for 1997, the patient in the whole world existing more than 100 ten thousand receives the operation of technique, also has several ten thousand examples in China, through 5 years its unimpeded rates at a specified future date of Clinical Follow-up and tradition strip off operation indifference.The standard procedures that cardiothoracic surgery association of international Wicresoft recommends Microendoscopic blood vessel collection operation to be bypass surgery.The annual utilization rate of the U.S. reaches more than 70%, but domestic less than 5%.Mesh competition in this field is more weak, and the only product of import firm and the product of my company is commercially sold.
Summary of the invention
In order to overcome the deficiencies in the prior art, the present invention provides a kind of low temperature endoscopic vessel harvester and method.
To achieve these goals, the technical solution adopted in the present invention is:
A kind of low temperature endoscopic vessel harvester, is made up of rigid pipe endoscope, the short mouth trocar, free sleeve pipe, collection sleeve pipe, bipolar shears and low temperature coagulation shears:
The structure of rigid pipe endoscope is: rigid pipe endoscope is made up of steel pipe, and the tip of steel pipe is the camera lens gathering image, end be threaded for gather sleeve pipe and dissociate telescopic joint and fix;Endoscope is provided with the guide-lighting union joint being connected with optical fiber and the attachment means being connected with video frequency pick-up head;
The structure of the short mouth trocar is: the periphery of housing connects annular air-pocket, wraps up in rubber outside annular air-pocket, and main casing connects annular air-pocket inflation inlet and carbon dioxide pipe port, and the top of main casing connects main body sealing, and carbon dioxide pipe port connects CO air inlet;
The structure of free sleeve pipe is: free sleeve pipe is made up of steel pipe and conical head, is surrounded by PVC protective layer outside steel pipe, and one end of steel pipe is fixed on handle by free sleeve pipe, and the other end of steel pipe is connected with conical head;
The structure gathering sleeve pipe is: one end of sleeve pipe is connected with bindiny mechanism, and bindiny mechanism is fixed on handle, and handle connects sliding button;Endoscope is locked on handle by nut;Cannula cavity has shears through hole arranged in parallel and endoscope's through hole, capillary tube through hole, supporting steel wire through hole and carbon dioxide hole;Being inserted with endoscope in endoscope's through hole, capillary tube through hole is inserted with capillary tube, and capillary tube front end connects the lens cleaning device in C-shaped ring, and end connects cleanout fluid injection port;Carbon dioxide hole is inserted with air inlet pipe, the end link carbon dioxide gas injection port of air inlet pipe;C-shaped ring connecting rod inserts supporting steel wire through hole, and C-shaped ring connecting rod front end is provided with C-shaped ring;Sleeve pipe is fixed on handle by bindiny mechanism, and handle is installed sliding button and lens bracket;Nut locks endoscope;
The structure of bipolar shears is: upper crescent shear blade, thread form shear blade next month are fixed on electrode by rivet, and the material of electrode is pottery, overcoat pyrocondensation insulation tube;Connect sheet and be connected with electrode cable by electrode connected, outside electrode cable, wrap up in insulated sleeve;Two electrode cables are fixed together with scissors handle by Flos Mume wheel by injection;One end of electrode cable extended line connects plug, and the other end is connected with electrode cable by the wire guide on scissors handle;
The structure of low temperature coagulation shears is: upper crescent shear blade, thread form shear blade next month are fixed on electrode by rivet, and the material of electrode is pottery, is cased with upper crescent shear blade, next month the silica gel sheath of insulation outside thread form shear blade;Upper crescent shear blade, thread form shear blade next month are served only for clamping blood vessel, will not shear blood vessel;Coagulation sheet is fixed on crescent shear blade, next month thread form shear blade, and is connected with electrode cable by connecting sheet;Wrapping up in insulated sleeve outside transmission steel wire, one end connects with being connected sheet, and the other end is tied on scissors handle by foam cotton firmly;Pushing hands drives transmission steel wire by fixing card;Electrode cable one end in insulated sleeve connects coagulation sheet, and the other end connects coagulation switch;Coagulation switch connects plug by electrode cable extended line;Pushing hands is maintained forward tilted positions by big spring;Pushing hands manually can be made shear blade clamp toward post-tensioning by operator;Coagulation switch will be triggered toward post-tensioning pushing hands again, make coagulation sheet be energized, ligation, separating blood vessel.
Effective length 20-45cm of rigid pipe endoscope, diameter 3-8mm, optics working distance are 20mm, effective field depth is 0 ° and the angle of visual field is 75 ° at 3-100mm, viewing directional angle.
The a length of 1-3cm of annular air-pocket of the short mouth trocar, a diameter of 2-5cm after inflation;Main body sealing has two kinds of sizes, and a kind of a diameter of 6-15mm is for coordinating with collection sleeve pipe;Another kind of a diameter of 3-10mm is for coordinating with free sleeve pipe 20.
The effective length of free sleeve pipe is: 25-40cm;Free sleeve outer is 5-15mm;Conical head external diameter is 9-18mm.
The effective length gathering sleeve pipe is 20-45cm, external diameter is 9-20mm;Bushing outer surface is prismatic surface;Shears through hole and endoscope's through-hole diameter are respectively 4-9mm;The a length of 8-15cm of handle, a diameter of 2-5cm;Handle becomes 15-30 degree angle with gathering sleeve pipe.
Bipolar shears has coagulation and shears vascular function, and its effective length should be 40-70cm, and opening is at 4-8mm;Effectively can be condensed by blood vessel when bipolar shears connects the surgery power source generator that output is 30-50w, and be sheared by blood vessel by two shear blades, scissors bit can realize 360 degree of rotations by Flos Mume wheel.
Low temperature coagulation scissors tool has coagulation function and shearing function, and the coagulation of blood vessel can a step complete with shearing, and shears can be used in combination with existing coagulation generator;Blood vessel can be condensed when output is less than 30W;Effective length is 40-70cm;Shears opening is at 4-8mm.
A kind of low temperature endoscopic vessel acquisition method, containing following steps;
Low temperature coagulation shears acquisition step and two kinds of acquisition step of bipolar shears,
Bipolar shears acquisition step: first pass through high temperature that electric current produces by vascular ligation, then by two shear blades, blood vessel is cut off;
Low temperature coagulation shears acquisition step: the shear blade of low temperature coagulation shears cannot direct shearing blood vessel, during use, shear blade is clamped blood vessel and ligatures blood vessel at relatively low temperature by electric current, automatic by blood vessel pinch off wait ligation to complete after.
The advantage that the protected target blood of low temperature coagulation scissors tool and surrounding tissue affect from high temperature, but long relative to its shear time of bipolar shears.
The invention have the advantage that
Low temperature endoscope vascular acquisition system of the present invention can help doctor to implement Wicresoft at leg or arm and take vascular surgery, and wound is the little otch of 1-2cm, so can be substantially reduced infection chance, reduces pain, shortens post-operative recovery time, the most attractive in appearance.
The short mouth trocar in system component is used for protecting otch, and by the annular air-pocket carried, the short mouth trocar can be effectively fixed in incision, to prevent the movement gathering sleeve pipe or free sleeve pipe from damaging wound or to cause infecting.Free sleeve pipe is except for separating great saphenous vein with surrounding tissue, it is also possible to for taking the great saphenous vein at shank and radial artery.This has widened the scope of application of the present invention significantly.
Additionally, low temperature endoscope vascular acquisition system of the present invention includes common coagulation shears (having another name called bipolar shears) and low temperature coagulation shears, doctor can select with patient profiles according to personal experience.The most both having ensured that doctor implemented Microendoscopic blood vessel collection smoothly, protection target blood is exempted from affected by the high temperature again.
Free sleeve pipe is except for separating great saphenous vein with surrounding tissue, it is also possible to for taking the great saphenous vein at shank and radial artery.This has widened the scope of application of the present invention significantly.
Accompanying drawing explanation
When considered in conjunction with the accompanying drawings, by referring to detailed description below, can more completely be more fully understood that the present invention and easily learn the advantage that many of which is adjoint, but accompanying drawing described herein is used for providing a further understanding of the present invention, constitute the part of the present invention, the schematic description and description of the present invention is used for explaining the present invention, is not intended that inappropriate limitation of the present invention, such as figure wherein:
Fig. 1 is the structural representation of the endoscope vascular acquisition system entirety of the present invention;
Fig. 2 is the structural representation of the rigid pipe endoscope of the present invention;
Fig. 3 is the structural representation of the short mouth trocar of the present invention;
Fig. 4 is the structural representation of the free sleeve pipe of the present invention;
Fig. 5 is the structural representation gathering sleeve pipe of the present invention;
Fig. 6 is the A-A sectional drawing of Fig. 5;
Fig. 7 is the right view of Fig. 5;
Fig. 8 is the structural representation of the bipolar shears of the present invention;
Fig. 9 is the structural representation of the low temperature coagulation shears of the present invention;
The present invention is further described with embodiment below in conjunction with the accompanying drawings.
Detailed description of the invention
Obviously, the many modifications and variations that those skilled in the art are done based on spirit of the invention belong to protection scope of the present invention.
Those skilled in the art of the present technique are appreciated that unless expressly stated, and singulative used herein " ", " one ", " described " and " being somebody's turn to do " may also comprise plural form.Should be further understood that, the wording used in the description of the present invention " includes " referring to there is described feature, integer, step, operation, element and/or assembly, but it is not excluded that existence or adds other features one or more, integer, step, operation, element, assembly and/or their group.It should be understood that when we claim element to be " connected " or during " coupled " to another element, and it can be directly connected or coupled to other elements, or can also there is intermediary element.Additionally, " connection " used herein or " coupling " can include wireless connections or couple.Wording "and/or" used herein includes one or more any cell listing item being associated and all combinations.
Those skilled in the art of the present technique are appreciated that unless otherwise defined, all terms used herein include technical term and scientific terminology have with the those of ordinary skill in art of the present invention be commonly understood by identical meaning.Should also be understood that those terms defined in such as general dictionary should be understood that have the meaning consistent with the meaning in the context of prior art, and unless defined as here, will not explain by idealization or the most formal implication.
For ease of the understanding to the embodiment of the present invention, as a example by several specific embodiments, it is further explained explanation below in conjunction with accompanying drawing, and each embodiment is not intended that the restriction to the embodiment of the present invention.
Embodiment 1: a kind of low temperature endoscopic vessel harvester, is formed 11, free sleeve pipe, collection sleeve pipe, bipolar shears and low temperature coagulation shears by rigid pipe endoscope 2, the short mouth trocar and forms;
As it is shown in figure 1, gather the connectivity port trocar 11 of sleeve pipe 1, one end of sleeve pipe 1 is connected with bindiny mechanism 14, and bindiny mechanism 14 is fixed on handle 12, and handle 12 connects sliding button 13;Endoscope 2 being locked on handle 12 by nut 16, bipolar shears inserts in shears through hole 10.
In the structural representation of rigid pipe endoscope 2 shown in Fig. 2: rigid pipe endoscope 2 is made up of steel pipe 50, the tip of steel pipe 50 is the camera lens gathering image, end be threaded 51 for gather sleeve pipe and dissociate telescopic joint and fix.Endoscope is provided with the guide-lighting union joint 52 being connected with optical fiber and the attachment means 53 being connected with video frequency pick-up head.
In the structural representation of the mouth trocar 11 short shown in Fig. 3: the periphery of housing 47 connects annular air-pocket 48, rubber 42 is wrapped up in outside annular air-pocket 48, main casing 47 connects annular air-pocket inflation inlet 43 and carbon dioxide pipe port 44, the top of main casing 47 connects main body sealing 46, and carbon dioxide pipe port 44 connects CO2 air inlet 45;
In the structural representation of sleeve pipe free shown in Fig. 4: free sleeve pipe is made up of steel pipe 20 and conical head 21, is surrounded by PVC protective layer 22 outside steel pipe 20, and one end of steel pipe 20 is fixed on handle 4 by free sleeve pipe 20, and the other end of steel pipe 20 is connected with conical head 21.
In the structural representation gathering sleeve pipe shown in Fig. 5, Fig. 6 and Fig. 7: one end of sleeve pipe 1 is connected with bindiny mechanism 14, bindiny mechanism 14 is fixed on handle 12, and handle 12 connects sliding button 13;Endoscope 2 is locked on handle 12 by nut 16.Sleeve pipe 1 inner chamber has shears through hole 10 arranged in parallel and endoscope's through hole 3, capillary tube through hole 15, supporting steel wire through hole 17 and carbon dioxide hole 18.Being inserted with endoscope 2 in endoscope's through hole 3, capillary tube through hole 15 is inserted with capillary tube 6, and capillary tube 6 front end connects the lens cleaning device in C-shaped ring 5, and end connects cleanout fluid injection port 7;Carbon dioxide hole 18 is inserted with air inlet pipe 8, the end link carbon dioxide gas injection port 9 of air inlet pipe 8;C-shaped ring connecting rod 19 inserts supporting steel wire through hole 17, and C-shaped ring connecting rod 19 front end is provided with C-shaped ring 5;Sleeve pipe 1 is fixed on handle 12 by bindiny mechanism 14, and on handle, 12 install sliding button 13 and lens bracket 4;Nut 16 locks endoscope 2.
In the structural representation of shears bipolar shown in Fig. 8: upper and lower crescent shear blade 26 is fixed on electrode 24 by rivet 25, the material of electrode 24 is pottery, overcoat pyrocondensation insulation tube.Connect sheet 39 and be connected with electrode cable 38 by electrode 24 connected, outside electrode cable 38, wrap up in insulated sleeve 28;Two electrode cables 38 are fixed together with scissors handle 32 by Flos Mume wheel 41 by injection;One end of electrode cable extended line 35 connects plug 36, and the other end is connected with electrode cable 38 by the wire guide 40 on scissors handle 32.
In the structural representation of the shears of low temperature coagulation shown in Fig. 9: upper and lower crescent shear blade 26 is fixed on electrode 24 by rivet 25, the material of electrode 24 is pottery, is cased with the silica gel sheath 23 of insulation outside shear blade.Two shear blades are served only for clamping blood vessel, will not shear blood vessel.Coagulation sheet 27 is fixed on upper and lower crescent shear blade 26, and is connected with electrode cable 38 by connecting sheet 39.Wrapping up in insulated sleeve 28 outside transmission steel wire 30, one end connects with being connected sheet 39, and the other end is tied on scissors handle 32 by foam firmly cotton 29.Pushing hands 31 is by fixing card 34 drive transmission steel wire 30.Electrode cable 38 one end in insulated sleeve 28 connects coagulation sheet 27, and the other end connects coagulation switch 37.Coagulation switch 37 connects plug 36 by electrode cable extended line 35.Pushing hands 31 is maintained forward tilted positions by big spring 33.Pushing hands manually can be made upper and lower crescent shear blade 26 clamp toward post-tensioning by operator;Coagulation switch 37 will be triggered toward post-tensioning pushing hands again, make coagulation sheet 27 be energized, ligation, separating blood vessel.
Embodiment 2: in effective length 20-45cm of rigid pipe endoscope, diameter 3-8mm, optics working distance be 20mm, effective field depth be 0 ° and the angle of visual field is 75 ° at 3-100mm, viewing directional angle.
The a length of 1-3cm of annular air-pocket of the short mouth trocar, a diameter of 2-5cm after inflation;Main body sealing has two kinds of sizes, and a kind of a diameter of 6-15mm is for coordinating with collection sleeve pipe;Another kind of a diameter of 3-10mm is for coordinating with free sleeve pipe 20.
The effective length of free sleeve pipe is: 25-40cm;Free sleeve outer is 5-15mm;Conical head external diameter is 9-18mm.
The effective length gathering sleeve pipe is 20-45cm, external diameter is 9-20mm;Bushing outer surface is prismatic surface;Shears through hole and endoscope's through-hole diameter are respectively 4-9mm;The a length of 8-15cm of handle, a diameter of 2-5cm;Handle becomes 15-30 degree angle with gathering sleeve pipe.
Bipolar shears effective length should be 40-70cm, and opening is at 4-8mm;Scissors bit does 360 degree of rotations by Flos Mume wheel.
Low temperature coagulation shears effective length is 40-70cm;Shears opening is at 4-8mm.
Embodiment 3: a kind of low temperature endoscopic vessel acquisition method, containing following steps;
First endoscope 2 is inserted free sleeve pipe 20, installs free 21;
The short mouth trocar 11 is enclosed within sleeve pipe 20, will advance to target after inserting operative site for free 21 through the short mouth trocar 11;
After arriving surgery location when free 21, take out free sleeve pipe 20, and therefrom extract endoscope 2;
Endoscope 2 is inserted the endoscope's through hole 3 gathering sleeve pipe, low temperature coagulation shears or bipolar shears insertion shears through hole 10. collection sleeve pipe is inserted operative site through the short mouth trocar 11;
Under the supervision of endoscope 2, if pushing c shape ring 5 to target blood. camera lens is fuzzy by blood or fat, and cleanout fluid injection port 7 connects the syringe of 5cc normal saline, and pushing syringe sprays victory normal saline to clean camera lens from the lens washing hole of c shape ring 5;
Low temperature coagulation shears or bipolar shears, coagulation cutting vessel branch is advanced to target site;
After operation terminates, take out and gather sleeve pipe and shears.
As it has been described above, explained embodiments of the invention, but as long as can have a lot of deformation essentially without the inventive point and effect departing from the present invention, this will be readily apparent to persons skilled in the art.Therefore, within such variation is also integrally incorporated in protection scope of the present invention.

Claims (9)

1. a low temperature endoscopic vessel harvester, it is characterised in that by rigid pipe endoscope, short mouth The trocar, free sleeve pipe, collection sleeve pipe, bipolar shears and low temperature coagulation shears composition:
The structure of rigid pipe endoscope is: rigid pipe endoscope is made up of steel pipe, and the tip of steel pipe is for gathering figure As camera lens, end be threaded for gather sleeve pipe and dissociate telescopic joint and fix;Inside peep Mirror is provided with the guide-lighting union joint being connected with optical fiber and the attachment means being connected with video frequency pick-up head;
The structure of the short mouth trocar is: the periphery of housing connects annular air-pocket, wraps up in rubber outside annular air-pocket, Main casing connects annular air-pocket inflation inlet and carbon dioxide pipe port, and the top of main casing connects main body envelope Mouthful, carbon dioxide pipe port connects CO air inlet;
The structure of free sleeve pipe is: free sleeve pipe is made up of steel pipe and conical head, is surrounded by PVC outside steel pipe Protective layer, one end of steel pipe is fixed on handle by free sleeve pipe, the other end of steel pipe and conical head Connect;
The structure gathering sleeve pipe is: one end of sleeve pipe is connected with bindiny mechanism, and bindiny mechanism is fixed on hands On handle, handle connects sliding button;Endoscope is locked on handle by nut;Cannula cavity has flat The shears through hole of row arrangement and endoscope's through hole, capillary tube through hole, supporting steel wire through hole and carbon dioxide Air inlet;Being inserted with endoscope in endoscope's through hole, capillary tube through hole is inserted with capillary tube, capillary tube front end Connecting the lens cleaning device in C-shaped ring, end connects cleanout fluid injection port;Carbon dioxide hole is inserted There is air inlet pipe, the end link carbon dioxide gas injection port of air inlet pipe;C-shaped ring connecting rod inserts supporting steel Silk through hole, C-shaped ring connecting rod front end is provided with C-shaped ring;Sleeve pipe is fixed on handle by bindiny mechanism, Sliding button and lens bracket are installed on handle;Nut locks endoscope;
The structure of bipolar shears is: upper crescent shear blade, thread form shear blade next month are fixed on by rivet On electrode, the material of electrode is pottery, overcoat pyrocondensation insulation tube;Connect sheet by electrode with Electrode cable connects and is connected, and wraps up in insulated sleeve outside electrode cable;Flos Mume wheel is by being molded two electrodes Wire is fixed together with scissors handle;One end of electrode cable extended line connects plug, and the other end leads to The wire guide crossed on scissors handle is connected with electrode cable;
The structure of low temperature coagulation shears is: rivet is by upper crescent shear blade, thread form shear blade next month admittedly Being scheduled on electrode, the material of electrode is pottery, upper crescent shear blade, thread form shear blade next month It is cased with outward the silica gel sheath of insulation;Upper crescent shear blade, thread form shear blade next month are served only for clamping blood vessel, Blood vessel will not be sheared;Coagulation sheet is fixed on crescent shear blade, next month thread form shear blade, and leads to Cross connection sheet to be connected with electrode cable;Wrapping up in insulated sleeve outside transmission steel wire, one end connects with being connected sheet, The other end is tied on scissors handle by foam cotton firmly;Pushing hands drives transmission steel wire by fixing card;Absolutely Electrode cable one end in edge sleeve pipe connects coagulation sheet, and the other end connects coagulation switch;Coagulation switch is logical Cross electrode cable extended line and connect plug;Pushing hands is maintained forward tilted positions by big spring;Operator is manual Shear blade can be made to clamp toward post-tensioning pushing hands;Coagulation switch will be triggered toward post-tensioning pushing hands again, make coagulation Sheet is energized, ligation, separating blood vessel.
A kind of low temperature endoscopic vessel harvester the most according to claim 1, its feature exists It is 20mm in effective length 20-45cm of rigid pipe endoscope, diameter 3-8mm, optics working distance, has Effect field depth is 0 ° and the angle of visual field is 75 ° at 3-100mm, viewing directional angle.
A kind of low temperature endoscopic vessel harvester the most according to claim 1, its feature exists In a length of 1-3cm of annular air-pocket of the short mouth trocar, a diameter of 2-5cm after inflation;Main body is sealed Having two kinds of sizes, a kind of a diameter of 6-15mm is for coordinating with collection sleeve pipe;Another kind of a diameter of 3-10mm is for coordinating with free sleeve pipe 20.
A kind of low temperature endoscopic vessel harvester the most according to claim 1, its feature exists Effective length in free sleeve pipe is: 25-40cm;Free sleeve outer is 5-15mm;Outside conical head Footpath is 9-18mm.
A kind of low temperature endoscopic vessel harvester the most according to claim 1, its feature exists Effective length in collection sleeve pipe is 20-45cm, external diameter is 9-20mm;Bushing outer surface is prismatic surface; Shears through hole and endoscope's through-hole diameter are respectively 4-9mm;The a length of 8-15cm of handle, a diameter of 2-5cm;Handle becomes 15-30 degree angle with gathering sleeve pipe.
A kind of low temperature endoscopic vessel harvester the most according to claim 1, its feature exists Having coagulation in bipolar shears and shear vascular function, its effective length should be 40-70cm, and opening exists 4-8mm;Bipolar shears connect when output is the surgery power source generator of 30-50w can effectively by Blood vessel condenses, and is sheared by blood vessel by two shear blades, and scissors bit can realize 360 by Flos Mume wheel Degree rotates.
A kind of low temperature endoscopic vessel harvester the most according to claim 1, its feature exists There are coagulation function and shearing function in low temperature coagulation scissors tool, and the coagulation of blood vessel can a step with shearing Completing, shears can be used in combination with existing coagulation generator;Output can less than during 30W So that blood vessel is condensed;Effective length is 40-70cm;Shears opening is at 4-8mm.
8. a low temperature endoscopic vessel acquisition method, it is characterised in that containing following steps;
Low temperature coagulation shears acquisition step and bipolar shears acquisition step,
Two kinds of acquisition step of bipolar shears: first pass through high temperature that electric current produces by vascular ligation, then pass through Blood vessel is cut off by two shear blades;
Low temperature coagulation shears acquisition step: the shear blade of low temperature coagulation shears cannot direct shearing blood vessel, During use, shear blade is clamped blood vessel and ligatures blood vessel at relatively low temperature by electric current, waits ligation Automatically by blood vessel pinch off after completing.
A kind of low temperature endoscopic vessel acquisition method the most according to claim 8, its feature exists In containing following steps;First endoscope is inserted free sleeve pipe, installs free head;
By short mouth Trocar sleeve on sleeve pipe, through the short mouth trocar, free head is inserted operative site backward Target advances;
After free head arrives surgery location, take out free sleeve pipe, and therefrom extract endoscope;
Endoscope inserts the endoscope's through hole gathering sleeve pipe, low temperature coagulation shears or bipolar shears insert Shears through hole, will gather sleeve pipe and insert operative site through the short mouth trocar;
Under the supervision of endoscope, if pushing c shape ring to target blood. camera lens is by blood or fat Fuzzy, cleanout fluid injection port is connected the syringe of 5cc normal saline, pushing syringe is from c shape ring Lens washing hole in spray victory normal saline to clean camera lens;
Low temperature coagulation shears or bipolar shears, coagulation cutting vessel branch is advanced to target site;
After operation terminates, take out and gather sleeve pipe and shears.
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