CN107496005B - Full-automatic external minimally invasive gallbladder-protecting stone-taking device - Google Patents
Full-automatic external minimally invasive gallbladder-protecting stone-taking device Download PDFInfo
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- CN107496005B CN107496005B CN201710864690.9A CN201710864690A CN107496005B CN 107496005 B CN107496005 B CN 107496005B CN 201710864690 A CN201710864690 A CN 201710864690A CN 107496005 B CN107496005 B CN 107496005B
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- gall bladder
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- 238000001179 sorption measurement Methods 0.000 claims abstract description 115
- 210000000232 gallbladder Anatomy 0.000 claims abstract description 103
- 239000004575 stone Substances 0.000 claims abstract description 43
- 238000000338 in vitro Methods 0.000 claims description 5
- 239000002184 metal Substances 0.000 claims description 3
- 238000011010 flushing procedure Methods 0.000 abstract description 20
- 239000007788 liquid Substances 0.000 abstract description 19
- 210000000683 abdominal cavity Anatomy 0.000 abstract description 16
- 239000002699 waste material Substances 0.000 abstract description 13
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 abstract description 12
- 210000000056 organ Anatomy 0.000 abstract description 8
- 238000011084 recovery Methods 0.000 abstract description 8
- 230000002980 postoperative effect Effects 0.000 abstract description 6
- 230000000694 effects Effects 0.000 abstract description 5
- 208000015181 infectious disease Diseases 0.000 abstract description 3
- 230000017074 necrotic cell death Effects 0.000 description 9
- 238000000034 method Methods 0.000 description 8
- 238000005406 washing Methods 0.000 description 7
- 230000006378 damage Effects 0.000 description 6
- 206010011409 Cross infection Diseases 0.000 description 5
- 206010029803 Nosocomial infection Diseases 0.000 description 5
- 230000008569 process Effects 0.000 description 5
- 210000001953 common bile duct Anatomy 0.000 description 4
- 230000008878 coupling Effects 0.000 description 4
- 238000010168 coupling process Methods 0.000 description 4
- 238000005859 coupling reaction Methods 0.000 description 4
- 210000000750 endocrine system Anatomy 0.000 description 4
- 210000001503 joint Anatomy 0.000 description 4
- 208000005646 Pneumoperitoneum Diseases 0.000 description 3
- 208000027418 Wounds and injury Diseases 0.000 description 3
- 239000002504 physiological saline solution Substances 0.000 description 3
- 206010052428 Wound Diseases 0.000 description 2
- 238000010521 absorption reaction Methods 0.000 description 2
- 238000005452 bending Methods 0.000 description 2
- 210000000941 bile Anatomy 0.000 description 2
- 238000006243 chemical reaction Methods 0.000 description 2
- 238000004891 communication Methods 0.000 description 2
- 239000000835 fiber Substances 0.000 description 2
- 208000001130 gallstones Diseases 0.000 description 2
- 239000007924 injection Substances 0.000 description 2
- 238000002347 injection Methods 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 230000000302 ischemic effect Effects 0.000 description 2
- 238000009991 scouring Methods 0.000 description 2
- 239000000243 solution Substances 0.000 description 2
- 235000017166 Bambusa arundinacea Nutrition 0.000 description 1
- 235000017491 Bambusa tulda Nutrition 0.000 description 1
- 241001330002 Bambuseae Species 0.000 description 1
- 235000015334 Phyllostachys viridis Nutrition 0.000 description 1
- 206010051077 Post procedural haemorrhage Diseases 0.000 description 1
- 206010067268 Post procedural infection Diseases 0.000 description 1
- 208000002847 Surgical Wound Diseases 0.000 description 1
- 210000001015 abdomen Anatomy 0.000 description 1
- 238000001467 acupuncture Methods 0.000 description 1
- 239000011425 bamboo Substances 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 210000003445 biliary tract Anatomy 0.000 description 1
- 238000004140 cleaning Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 230000000968 intestinal effect Effects 0.000 description 1
- 208000028867 ischemia Diseases 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 230000008855 peristalsis Effects 0.000 description 1
- 239000012466 permeate Substances 0.000 description 1
- 230000035790 physiological processes and functions Effects 0.000 description 1
- 238000004064 recycling Methods 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22082—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/007—Auxiliary appliance with irrigation system
Abstract
The invention discloses a totally-enclosed type external minimally invasive gallbladder-protecting stone removing device which comprises an adsorption cylinder matched with a gallbladder, wherein a plurality of negative pressure holes are formed in the inner circumferential wall of the adsorption cylinder, and an air flow passage communicated with the negative pressure holes is formed in the adsorption cylinder. According to the invention, the gall bladder is locally attached through the adsorption cylinder which is suitable for the incision part of the gall bladder, so that the output and recovery of normal saline for flushing at the opening part of the gall bladder are in a controllable state, the infection of flushing waste liquid to other organs in the abdominal cavity is avoided, the curative effect of protecting the gall and taking stones is improved, the stone residues are avoided, and the postoperative recovery time of a patient is shortened.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to a totally-enclosed type external minimally invasive gallbladder-protecting stone removing device.
Background
The gallbladder protecting and calculus removing method is used for treating common diseases of biliary tract system, such as gall-stone, and mainly adopts conservative treatment methods such as acupuncture treatment, massage treatment, drug treatment and the like due to the lag of medical science and technology; is a gall-stone treatment method which is safe, effective, less in pain and minimally invasive and is more favorable for patients to accept, and is continuously sought and discussed in the medical community for many years. The new concept of protecting gallbladder and taking stones has the main significance of taking the stones and maintaining the balance and physiological functions of a normal human body.
The trauma of the gallbladder-protecting and stone-removing operation is smaller than that of any gallbladder operation, and the operation steps mainly comprise the following steps.
1. Puncturing: the minimally invasive gallbladder-protecting and stone-removing operation needs to be performed by using a laparoscope and a fiber choledochoscope, and during the operation, a pneumoperitoneum needle is firstly used for penetrating and placing the pneumoperitoneum needle into the laparoscope to detect the position, the appearance and whether adhesion exists or not;
2. placing a choledochoscope: if the external part of the gall bladder is normal after puncture, a small incision of 2cm is made at the rib edge downwards to enter the abdomen, the gall bladder is pulled, a choledochoscope is inserted from the gall bladder undercut, and the incision is about 0.5cm in size;
3. stone removal: under the direct vision of the fiber choledochoscope, the bile in the gall bladder is sucked by a negative pressure aspirator, and in order to make the visual field clear when the stone is taken out, the gall bladder cavity can be washed by physiological saline;
4. confirming whether residual calculus exists or not: the small stones are not easy to find, after the stone taking is finished, the choledochoscope is used for repeatedly checking whether the small stones remain in the gall bladder cavity or not, and observing the condition that bile flows into the gall bladder to remove the stones embedded in the gall bladder duct;
5. stitching: after the calculus in the gall bladder is taken out and no residual calculus is confirmed, the gall bladder is carefully sutured into two layers by using an absorbable line, and finally surgical incisions are sutured layer by layer.
However, in the operation implementation step 3, when the normal saline is used for flushing the gallbladder cavity, part of fine broken stones are overflowed into the abdominal cavity along with the normal saline, so that other organs of a human body are infected, namely more postoperative side effects are generated, and finally the conditions of operation time extension, pneumoperitoneum time increase, postoperative bleeding amount, postoperative intestinal peristalsis recovery time extension, hospitalization time increase and postoperative recurrence are caused.
Disclosure of Invention
The invention aims to provide a totally-enclosed type in-vitro minimally invasive gallbladder-protecting and calculus-removing device which is convenient for rapid operation of gallbladder-protecting and calculus-removing, and meanwhile avoids complications caused by overflow of normal saline for cleaning in abdominal cavities.
The invention is realized by the following technical scheme:
the fully-closed type external minimally invasive gallbladder-protecting stone removing device comprises an adsorption cylinder matched with a gallbladder, wherein a plurality of negative pressure holes are formed in the inner circumferential wall of the adsorption cylinder, and an air flow passage communicated with the negative pressure holes is formed in the adsorption cylinder. In the existing gallbladder-protecting and calculus-removing operation, normal saline is generally utilized to directly flush the interior of the gallbladder while removing calculus so as to prevent calculus residues in the interior of the gallbladder, but after an incision of the gallbladder is communicated with the abdominal cavity, the normal saline for flushing easily permeates into the abdominal cavity, so that postoperative infection or other complications are caused; aiming at the defects, the applicant develops a special stone removing device for the gallbladder protecting and stone removing operation, namely, the gallbladder is locally attached through an adsorption cylinder which is matched with the incision part of the gallbladder, so that the output and recovery of normal saline for flushing at the opening of the gallbladder are in a controllable state, the infection of flushing waste liquid to the abdominal cavity or the endocrine system of a human body is avoided, the treatment effect of gallbladder protecting and stone removing is improved, the stone residue is avoided, and the postoperative recovery time of a patient is shortened.
During specific operation, firstly, the end face of the upper end of the adsorption cylinder is centered with the pre-cut part on the gall bladder, a small opening of about 1.5-2.0 cm is cut at the bottom of the gall bladder through the opening of the lower end of the adsorption cylinder, then the air flow passage and the negative pressure hole are pumped to enable the outer wall of the gall bladder to be adsorbed on the inner wall of the upper end of the adsorption cylinder, namely, an inlet and outlet passage of normal saline is the opening of the lower end of the adsorption cylinder and a pipeline connected with the opening of the lower end of the adsorption cylinder in the stone taking process, so that the normal saline can only be temporarily isolated from the abdominal cavity or other endocrine systems through the opening of the lower end of the adsorption cylinder during flushing and recovery, and stones in the gall bladder are observed in real time through a laparoscope in the operation process, so that the repeated alternation of stone breaking and flushing is realized until the stones in the gall bladder are completely cleaned, and the stone is taken out, and then the bottom of the gall bladder and the micro-wound of the abdominal cavity are sutured. Further, in the technical scheme, the adsorption cylinder has a certain thickness, the air flow channel is a cavity formed in the thickness, the negative pressure holes are uniformly distributed on the inner wall of the upper end of the adsorption cylinder, the cavity formed by the air flow channel is respectively communicated with the negative pressure holes, the point where each negative pressure hole is located is an adsorption point of the outer wall of the gall bladder, a certain negative pressure is formed at the opening of the upper end of the adsorption cylinder by using the air flow channel and the negative pressure holes, and further, the outer wall around the gall bladder incision is stably adhered on the inner wall of the adsorption cylinder, namely, the mutual independence between the flow path of flushing liquid and other organs in the abdominal cavity is realized, and the waste liquid after flushing can only be discharged outwards along the independent flow path without cross infection of the other organs in the human body.
The opening area of the upper end of the adsorption cylinder is larger than that of the lower end of the adsorption cylinder. Preferably, the opening area of the upper end of the adsorption cylinder is larger than the opening area of the lower end of the adsorption cylinder, and the opening shape of the upper end of the adsorption cylinder can be matched with the shape of a non-standard elliptic gall bladder so as to avoid a gap between the outer wall of the gall bladder and the inner wall of the upper end of the adsorption cylinder, prevent the adsorption failure of the adsorption cylinder, and the opening area of the lower end of the adsorption cylinder is smaller, so that a certain flow speed can be ensured by flushing liquid passing through the part, and the flushing can be performed only on the incision part of the gall bladder, so that the damage to the non-incision part of the gall bladder caused by excessive impact is reduced, and the secondary damage in the operation is reduced.
The lower end of the adsorption cylinder is provided with a connector, and an annular groove is formed in the outer circumferential wall of the connector along the circumferential direction of the connector. Further, the connector that the absorption section of thick bamboo lower extreme set up can be through ring channel and receiving stone bag or wash pipe joint, shortens the time that the calculus was taken out promptly, the circulation route of extension scour solution, reduces the time of protecting courage and getting the stone art in the at utmost.
The air flow passage is characterized by further comprising a connecting hose which is arranged in the connector and communicated with the air flow passage, and a suction nozzle is arranged on the connecting hose. Further, the connecting hose is communicated with the negative pressure hole through the air flow channel, and the suction nozzle can timely realize interruption or continuous injection of negative pressure air flow, so that an operator can accurately adjust the air pressure and flow of the air flow generating negative pressure according to specific reaction of the outer wall of the gallbladder in operation, and necrosis caused by overlarge suction force on the tissue of the outer wall of the gallbladder is prevented.
The air flow channel comprises a cavity arranged on the adsorption cylinder along the outline of the adsorption cylinder, and the cavity is communicated with the negative pressure holes. Because the air flow channel is respectively communicated with the plurality of negative pressure holes, and the plurality of negative pressure holes are uniformly distributed on the inner wall of the upper end of the adsorption cylinder, the empty cavity needs to be distributed around the outline of the outer wall of the adsorption cylinder so as to realize the communication between the empty cavity and the plurality of negative pressure holes, and further, gaps are avoided between the outer wall of the gall bladder and the inner wall of the upper end of the adsorption cylinder.
The air flow channel comprises an annular primary main air channel and an annular secondary main air channel which are arranged on the adsorption cylinder along the outline of the adsorption cylinder, wherein a plurality of primary branch air channels communicated with the primary main air channel are arranged on the primary main air channel, a plurality of secondary branch air channels communicated with the secondary main air channel are arranged on the secondary main air channel, a plurality of primary branch air channels and a plurality of secondary branch air channels are distributed in a staggered mode, and a plurality of negative pressure holes are respectively communicated with the primary branch air channels and the secondary branch air channels. When the outer wall of the gall bladder is adsorbed by using the negative pressure hole, the probability of necrosis of a single point on the outer wall of the gall bladder is increased along with the increase of adsorption time, and in order to avoid the occurrence of the situation, in the technical scheme, the air flow channel is not a single cavity arranged along the outline of the adsorption cylinder, but comprises a primary main air channel and a secondary main air channel which are all annular, a plurality of primary branch air channels and a plurality of secondary branch air channels which are communicated with the negative pressure hole are respectively arranged on the primary main air channel and the secondary main air channel, and the plurality of primary branch air channels and the plurality of secondary branch air channels are arranged in a staggered manner, wherein the primary main air channel and the secondary main air channel are respectively communicated with different air pipes, namely two sets of air channels with different flow paths are formed in the adsorption cylinder wall, namely the whole surface coverage of the inner wall at the upper end of the adsorption cylinder is realized on the premise of ensuring that all the negative pressure holes are kept communicated, so as to ensure the complete adsorption of the outer wall at the bottom of the gall bladder; in the operation, the specific condition of the outer wall of the gall bladder is observed in real time through the laparoscope, the two sets of air paths can be alternately used at fixed time, and the two sets of air paths can be simultaneously used on the premise of smaller air flow, namely, the conditions that the suction force generated by the suction hole appears on the same point on the outer wall of the gall bladder for a long time and with large suction force as far as possible under the premise of ensuring the stable suction of the inner wall at the upper end of the suction cylinder to the gall bladder are avoided, and the conditions that necrosis and the like appear on the outer wall of the gall bladder in the operation are avoided.
The primary main air passage is close to the upper end part of the adsorption cylinder, the secondary main air passage is close to the lower end part of the adsorption cylinder, and the primary branch air passages and the secondary branch air passages are uniformly distributed along the direction that the upper end of the adsorption cylinder points to the lower end of the adsorption cylinder. Preferably, the primary main air passage and the secondary main air passage are respectively arranged at positions close to the upper end and the lower end of the adsorption cylinder, and the plurality of primary branch air passages and the secondary branch air passages are uniformly distributed along the direction of the upper end of the adsorption cylinder to the lower end of the adsorption cylinder, so that the negative pressure holes can be prevented from being intensively distributed on a certain section of the adsorption cylinder to correspondingly reduce the adsorption area of the adsorption cylinder, and seamless butt joint between the outer wall of a gall bladder and the inner wall of the adsorption cylinder in operation is ensured.
Still include negative pressure pipe I and negative pressure pipe II, and negative pressure pipe I one end and primary main air flue intercommunication, negative pressure pipe I the other end with coupling hose intercommunication, negative pressure pipe II one end and secondary main air flue intercommunication, the negative pressure pipe II the other end with coupling hose intercommunication. Further, the negative pressure pipe I and the negative pressure pipe II are respectively communicated with the primary main air passage and the secondary main air passage so as to realize mutual independence of two sets of air passages in the adsorption cylinder, and control switches are arranged at the joints of the negative pressure pipe I and the negative pressure pipe II and the connecting hose, namely, operators can be assisted to control the different use of the two sets of air passages; wherein, can arrange negative pressure pipe I and negative pressure pipe II in the coupling hose to reduce in the operation in the device in the abdominal cavity occupy the space, improve the stone efficiency of getting indirectly.
The adjusting clamp comprises a U-shaped body, a cavity is formed in the middle of a horizontal section of the body, through holes communicated with the cavity are formed in two vertical sections of the body respectively, a support column is arranged in the cavity, the middle of one side wall of a bridge plate made of metal is hinged with the end part of the support column, an electromagnet I and an electromagnet II are respectively arranged on two sides of the support column, the electromagnet I and the electromagnet II are respectively opposite to two ends of the other side wall of the bridge plate, a connecting rod is slidably arranged in each through hole, one end of the connecting rod is connected with the bridge plate, the other end of the connecting rod is hinged with a movable clamp, a fixing clamp matched with the movable clamp is arranged on the end face of the vertical section of the body, and a spring opposite to the movable clamp is arranged on the fixing clamp; when the electromagnet I is electrified, the bridge plate is attracted by the electromagnet I and then drives the connecting rod to move towards the direction close to the electromagnet I, the part of the movable clamp moves into the through hole, the spring is compressed and deformed after being extruded by the movable clamp, and the movable clamp and the fixed clamp are combined to form a clamping area matched with the cholecyst tube. Further, since the gall bladder tube of the gall bladder is communicated with the common bile duct, when stones are washed by using normal saline, broken stones and washing waste liquid easily enter the common bile duct along the gall bladder tube, so that cross infection occurs, in this way, the applicant designs a device for cutting off the flow path of the washing waste liquid, namely an adjusting clamp, and the adjusting clamp needs to cut off the flow path of the washing waste liquid when in use, and meanwhile, the normal operation of the gall bladder tube needs to be ensured, namely when clamping components on the adjusting clamp are used alternately, the same position of the gall bladder tube can be prevented from being continuously clamped to cause ischemic necrosis; specifically, in the initial state, the movable clamp and the fixed clamp are partially staggered and separated from each other, when the clamp is used, two clamping areas respectively formed by the fixed clamp and the movable clamp are respectively acted on the gall bladder tube, the electromagnet I is electrified, the electromagnet II is powered off, attractive force generated by the electromagnet I drives the bridge plate to rotate anticlockwise in the cavity, the connecting rod moves along with the bridge plate in the direction close to the electromagnet I until the fixed clamp and the movable clamp form a clamping area which is completely matched with the gall bladder tube, the connecting rod moves in the other through hole in the direction far away from the electromagnet II, the movable clamp and the fixed clamp at the position cannot form a closed clamping area, after the clamp is adjusted to keep the state for a period of time, the electromagnet I is powered off, the electromagnet II is electrified, attractive force generated by the electromagnet II drives the bridge plate to rotate anticlockwise in the cavity, and the connecting rod moves along with the bridge plate in the direction close to the electromagnet II, so that the clamping point of the gall bladder tube is transferred, and the gall bladder tube is ensured to keep a clamping point on the gall bladder tube in operation all the time, and the activity of the gall bladder tube is ensured.
The movable clamp and the fixed clamp are combined to form a rectangular clamping area. Preferably, the movable clamp and the fixed clamp are combined to form a rectangular clamping area, so that when the cholecyst tube is clamped, the deformation quantity of the cholecyst tube is in the normal bending deformation range, the wall of the cholecyst tube at the previous clamping point after the clamping point is switched is convenient to recover quickly, and the damage to the cholecyst tube is reduced.
Compared with the prior art, the invention has the following advantages and beneficial effects:
1. the totally-enclosed type external minimally invasive gallbladder-protecting and calculus-removing device disclosed by the invention has the advantages that the gallbladder is locally attached through the adsorption cylinder which is matched with the incision part of the gallbladder, so that the output and recovery of normal saline for flushing at the opening of the gallbladder are in a controllable state, the infection of flushing waste liquid to the abdominal cavity or the endocrine system of a human body is avoided, the gallbladder-protecting and calculus-removing treatment effect is improved, the calculus residues are eliminated, and the postoperative recovery time of a patient is shortened;
2. the invention relates to a totally-enclosed type external minimally invasive gallbladder-protecting and stone-removing device, wherein negative pressure holes are uniformly distributed on the inner wall of the upper end of an adsorption cylinder, cavities formed by air flow passages are respectively communicated with a plurality of negative pressure holes, so that the point of each negative pressure hole is an adsorption point of the outer wall of a gallbladder, a certain negative pressure is formed at the opening of the upper end of the adsorption cylinder by the air flow passages and the negative pressure holes, the outer wall of the periphery of a gallbladder incision is stably bonded on the inner wall of the adsorption cylinder, namely, the mutual independence between the flow path of flushing liquid and other organs in the abdominal cavity is realized, and the waste liquid after flushing can only be discharged outwards along the independent flow path without cross infection of the other organs in the human body;
3. the invention relates to a totally-enclosed type external minimally invasive gallbladder-protecting and stone-removing device, which is used for ensuring the normal operation of a cholecyst tube when an adjusting clamp cuts off a flushing waste liquid flow path, namely, when clamping parts on the adjusting clamp are used alternately, the same position of the cholecyst tube can be prevented from being continuously clamped to cause ischemia necrosis.
Drawings
The accompanying drawings, which are included to provide a further understanding of embodiments of the invention and are incorporated in and constitute a part of this application, illustrate embodiments of the invention. In the drawings:
FIG. 1 is a schematic diagram of the structure of the present invention;
FIG. 2 is a top view of the present invention;
FIG. 3 is a cross-sectional view of the present invention;
FIG. 4 is a partial cross-sectional view of an adsorption cartridge;
FIG. 5 is a schematic view of the structure of the gallbladder;
FIG. 6 is a transverse cross-sectional view of the adjustment clamp;
fig. 7 is a longitudinal sectional view of the adjusting clamp.
In the drawings, the reference numerals and corresponding part names:
the device comprises a 1-adsorption cylinder, a 2-connector, a 3-annular groove, a 4-suction nozzle, a 5-connecting hose, a 6-negative pressure hole, a 7-cavity, an 8-primary main air passage, a 9-primary branch air passage, a 10-negative pressure pipe II, an 11-secondary branch air passage, a 12-secondary main air passage, a 13-negative pressure pipe I, a 14-gall bladder, a 15-gall bladder pipe, a 16-adjusting clamp, a 17-electromagnet I, a 18-electromagnet II, a 19-bridge plate, a 20-pillar, a 21-connecting rod, a 22-through hole, a 23-movable clamp, a 24-spring and a 25-fixed clamp.
Detailed Description
For the purpose of making apparent the objects, technical solutions and advantages of the present invention, the present invention will be further described in detail with reference to the following examples and the accompanying drawings, wherein the exemplary embodiments of the present invention and the descriptions thereof are for illustrating the present invention only and are not to be construed as limiting the present invention.
Example 1
As shown in fig. 1, 2 and 5, the present embodiment includes an adsorption cylinder 1 matched with a gallbladder 14, a plurality of negative pressure holes 6 are formed in the inner circumferential wall of the adsorption cylinder 1, and an air flow passage communicating with the plurality of negative pressure holes 6 is formed in the adsorption cylinder 1.
Firstly, the end face of the upper end of the adsorption cylinder 1 is centered with the pre-cut part on the gall bladder, a small opening of about 1.5-2.0 cm is cut at the bottom of the gall bladder through the lower end opening of the adsorption cylinder 1, then the air flow passage and the negative pressure hole 6 are sucked to enable the outer wall of the gall bladder to be adsorbed on the inner wall of the upper end of the adsorption cylinder 1, namely, an inlet and outlet passage of physiological saline is the lower end opening of the adsorption cylinder 1 and a pipeline connected with the lower end opening of the adsorption cylinder 1 in the stone taking process, so that the physiological saline can only be temporarily isolated from the abdominal cavity or other endocrine systems through the lower end opening of the adsorption cylinder 1 in the scouring and recycling process, namely, stones in the gall bladder are observed in real time through a laparoscope in the operation process, so that repeated alternation of stone breaking and flushing is realized until the stones in the gall bladder are completely cleaned, and minimally invasive wounds of the bottom of the gall bladder and the abdominal cavity are sutured after the stones are taken out. Further, in the technical scheme, the adsorption cylinder 1 has a certain thickness, the air flow channel is a cavity formed in the thickness, the negative pressure holes 6 are uniformly distributed on the inner wall of the upper end of the adsorption cylinder 1, the cavity formed by the air flow channel is respectively communicated with the plurality of negative pressure holes 6, the point of each negative pressure hole 6 is an adsorption point of the outer wall of the gall bladder, a certain negative pressure is formed at the opening of the upper end of the adsorption cylinder 1 by utilizing the air flow channel and the negative pressure holes 6, and the outer wall of the periphery of the gall bladder incision is stably adhered on the inner wall of the adsorption cylinder 1, namely, the mutual independence between the flow path of flushing liquid and other organs in the abdominal cavity is realized, and the waste liquid after flushing can only be discharged outwards along the independent flow path without cross infection of the other organs in the human body.
Wherein, the open area of adsorption tube 1 upper end is greater than the open area of its lower extreme, and the open shape of adsorption tube 1 upper end can be with nonstandard oval gall bladder appearance phase-match, in order to avoid appearing the clearance between gall bladder outer wall and the inner wall of adsorption tube 1 upper end, prevent adsorption tube 1 absorption inefficacy, and the open area of adsorption tube 1 lower extreme is less, make the washing liquid through this part can guarantee certain flow velocity, can wash to gall bladder incision portion simultaneously, receive the damage with the excessive impact that reduces the non-incision portion of gall bladder and receive, reduce the secondary injury in the art.
Further, the connector 2 that adsorption cylinder 1 lower extreme set up can receive stone bag or wash pipe joint through ring channel 3, shortens the time that the calculus was taken out promptly, prolongs the circulation path of scouring liquid, reduces the time of protecting courage and getting the stone art in the furthest.
The embodiment also comprises a connecting hose 5 which is arranged in the connector 2 and communicated with the air flow passage, and a suction nozzle 4 is arranged on the connecting hose 5. Further, the connecting hose 5 is communicated with the negative pressure hole 6 through the air flow channel, and the suction nozzle 4 can timely realize interruption or continuous injection of negative pressure air flow, so that an operator can accurately adjust the air pressure and flow of the air flow generating negative pressure according to the specific reaction of the outer wall of the gallbladder in operation, and the necrosis caused by overlarge suction force on the tissue of the outer wall of the gallbladder is prevented.
Example 2
As shown in fig. 1, 2, 3, 5, the flow path in this embodiment includes a cavity 7 provided on the adsorption cylinder 1 along the contour of the adsorption cylinder 1, and the cavity 7 communicates with a plurality of the negative pressure holes 6. Because the air flow channel is respectively communicated with the plurality of negative pressure holes 6, and the plurality of negative pressure holes 6 are uniformly distributed on the inner wall of the upper end of the adsorption cylinder 1, the cavity 7 needs to be distributed around the outline of the outer wall of the adsorption cylinder 1 so as to realize the communication between the cavity 7 and the plurality of negative pressure holes 6, and further, gaps are avoided between the outer wall of the gall bladder and the inner wall of the upper end of the adsorption cylinder 1.
Example 3
As shown in fig. 1, 2, 4 and 5, in this embodiment, the flow channel includes an annular primary main air channel 8 and an annular secondary main air channel 12 disposed on the adsorption cylinder 1 along the contour of the adsorption cylinder 1, a plurality of primary branch air channels 9 communicating with the primary main air channel 8 are disposed on the primary main air channel 8, a plurality of secondary branch air channels 11 communicating with the secondary main air channel 12 are disposed on the secondary main air channel 12, a plurality of primary branch air channels 9 and a plurality of secondary branch air channels 11 are staggered, and a plurality of negative pressure holes 6 are respectively communicating with the primary branch air channels 9 and the secondary branch air channels 11. When the negative pressure hole 6 is used for adsorbing the outer wall of the gall bladder, the probability of necrosis of a single point on the outer wall of the gall bladder is increased along with the increase of adsorption time, and in order to avoid the occurrence of the situation, in the technical scheme, the air flow passage is not a single cavity 7 arranged along the outline of the adsorption cylinder 1, but comprises a primary main air passage 8 and a secondary main air passage 12 which are all annular, a plurality of primary branch air passages 9 and a plurality of secondary branch air passages 11 which are communicated with the negative pressure hole 6 are respectively arranged on the primary main air passage 8 and the secondary main air passage 12, and the plurality of primary branch air passages 9 and the plurality of secondary branch air passages 11 are arranged in a staggered manner, wherein the primary main air passage 8 and the secondary main air passage 12 are respectively communicated with different air pipes, namely two sets of air passages with different circulation paths are formed in the wall of the adsorption cylinder 1, namely, on the premise of ensuring that all the negative pressure holes 6 are kept communicated, the whole surface of the inner wall at the upper end of the adsorption cylinder 1 is covered, so that the adsorption of the outer wall at the bottom of the gall bladder is ensured; in operation, the specific condition of the outer wall of the gall bladder is observed in real time through the laparoscope, the two sets of air paths can be alternately used at fixed time, and the two sets of air paths can be simultaneously used on the premise of smaller air flow, namely, the conditions that the suction force generated by the suction hole appears on the same point on the outer wall of the gall bladder for a long time and with large suction force as far as possible under the premise of ensuring the stable suction of the inner wall at the upper end of the suction cylinder 1 to the gall bladder are avoided, and the conditions that necrosis and the like appear on the outer wall of the gall bladder in operation are avoided.
The embodiment further comprises a negative pressure pipe I13 and a negative pressure pipe II 10, wherein one end of the negative pressure pipe I13 is communicated with the primary main air passage 8, the other end of the negative pressure pipe I13 is communicated with the connecting hose 5, one end of the negative pressure pipe II 10 is communicated with the secondary main air passage 12, and the other end of the negative pressure pipe II 10 is communicated with the connecting hose 5. Further, the negative pressure pipe I13 and the negative pressure pipe II 10 are respectively communicated with the primary main air passage 8 and the secondary main air passage 12 so as to realize mutual independence of two sets of air passages in the adsorption cylinder 1, and control switches are arranged at the joints of the negative pressure pipe I13 and the negative pressure pipe II 10 and the connecting hose 5, so that operators can be assisted to control the different use of the two sets of air passages; wherein, can place negative pressure pipe I13 and negative pressure pipe II 10 in the coupling hose 5 to reduce the space that the device in the abdominal cavity occupies in the operation, improve stone efficiency indirectly.
Preferably, the primary main air passage 8 and the secondary main air passage 12 are respectively arranged at positions close to the upper end and the lower end of the adsorption cylinder 1, and the plurality of primary branch air passages 9 and the secondary branch air passages 11 are uniformly distributed along the direction of the upper end of the adsorption cylinder 1 pointing to the lower end of the adsorption cylinder, so that the negative pressure holes 6 can be prevented from being intensively distributed on a certain section of the adsorption cylinder 1, the adsorption area of the adsorption cylinder 1 is correspondingly reduced, and the seamless butt joint between the outer wall of a gallbladder and the inner wall of the adsorption cylinder 1 in operation is ensured.
Example 4
As shown in fig. 5, 6 and 7, the embodiment further includes an adjusting clamp 16, the adjusting clamp 16 includes a U-shaped body, a cavity is formed in the middle of a horizontal section of the body, through holes 22 communicated with the cavity are respectively formed in two vertical sections of the body, a support post 20 is installed in the cavity, the middle of a side wall of a bridge plate 19 made of metal is hinged with the end of the support post 20, an electromagnet i 17 and an electromagnet ii 18 are respectively installed on two sides of the support post 20, the electromagnet i 17 and the electromagnet ii 18 respectively face against two ends of the other side wall of the bridge plate 19, a connecting rod 21 is slidably arranged in each through hole, one end of the connecting rod 21 is connected with the bridge plate 19, a movable clamp 23 is hinged at the other end of the connecting rod 21, a fixed clamp 24 matched with the movable clamp 23 is arranged on the end face of the vertical section of the body, and a spring 24 facing the movable clamp 23 is installed on the fixed clamp 24; when the electromagnet I17 is electrified, the bridge plate 19 is attracted by the electromagnet I17 to drive the connecting rod 21 to move towards the direction close to the electromagnet I17, the part of the movable clamp 23 moves into the through hole 22, the spring 24 is compressed and deformed after being extruded by the movable clamp 23, and the movable clamp 23 and the fixed clamp 24 are combined to form a clamping area matched with the cholecyst tube 15. Because the gall bladder tube 15 of the gall bladder 14 is communicated with the common bile duct, when stones are washed by using normal saline, the stones and washing waste liquid easily enter the common bile duct along the gall bladder tube 15, so that cross infection occurs, in this way, the applicant designs a device for cutting off the flow path of the washing waste liquid, namely an adjusting clamp, and the adjusting clamp needs to cut off the flow path of the washing waste liquid when in use, and meanwhile, the normal work of the gall bladder tube 15 needs to be ensured, namely when clamping components on the adjusting clamp are used alternately, the same position of the gall bladder tube 15 can be prevented from being continuously clamped to generate ischemic necrosis; specifically, in the initial state, the movable clamp 23 and the fixed clamp 24 are partially staggered and separated from each other, when the clamp is used, two clamping areas respectively formed by combining the fixed clamp 24 and the movable clamp 23 are respectively acted on the gall bladder tube 15, the electromagnet I17 is electrified, the electromagnet II 18 is powered off, the attractive force generated by the electromagnet I17 drives the bridge plate 19 to rotate anticlockwise in the cavity, the connecting rod 21 moves along with the bridge plate 29 towards the direction close to the electromagnet I17 until the fixed clamp 24 and the movable clamp 23 form a clamping area completely matched with the gall bladder tube 15, the connecting rod 21 in the other through hole 22 moves towards the direction far away from the electromagnet II 18, the movable clamp 23 and the fixed clamp 24 at the position cannot form a closed clamping area, after the adjusting clamp maintains the state for a period of time, the electromagnet I17 is powered off, the electromagnet II 18 is electrified, the attractive force generated by the electromagnet II 18 drives the bridge plate 19 to rotate anticlockwise in the cavity, the connecting rod 21 moves along with the bridge plate 19 towards the direction close to the electromagnet II 18, so that the clamping point of the gall bladder tube 15 is transferred, and the clamping point of the gall bladder tube 15 is always kept at the clamping point 15 in the gall bladder tube 15, and the gall bladder tube 15 is ensured to be kept active.
Preferably, the movable clamp 23 and the fixed clamp 24 are combined to form a rectangular clamping area, so that when the cholecyst tube is clamped, the deformation amount of the cholecyst tube 15 is within the normal bending deformation range, the cholecyst tube 15 at the previous clamping point after the clamping point is switched is convenient to recover quickly, and the damage to the cholecyst tube 15 is reduced.
The foregoing description of the embodiments has been provided for the purpose of illustrating the general principles of the invention, and is not meant to limit the scope of the invention, but to limit the invention to the particular embodiments, and any modifications, equivalents, improvements, etc. that fall within the spirit and principles of the invention are intended to be included within the scope of the invention.
Claims (5)
1. Totally enclosed type is external to be protected courage and is got stone device by wicresoft, its characterized in that: comprises an adsorption cylinder (1) matched with a gall bladder (14), wherein a plurality of negative pressure holes (6) are formed in the inner circumferential wall of the adsorption cylinder (1), and an air flow passage communicated with the negative pressure holes (6) is formed in the adsorption cylinder (1);
a connector (2) is arranged at the lower end of the adsorption cylinder (1), and an annular groove (3) is formed in the outer circumferential wall of the connector (2) along the circumferential direction;
the air flow passage is characterized by further comprising a connecting hose (5) which is arranged in the connector (2) and communicated with the air flow passage, and a suction nozzle (4) is arranged on the connecting hose (5);
the air flow passage comprises an annular primary main air passage (8) and an annular secondary main air passage (12) which are arranged on the adsorption cylinder (1) along the outline of the adsorption cylinder (1), wherein a plurality of primary branch air passages (9) communicated with the primary main air passage are arranged on the primary main air passage (8), a plurality of secondary branch air passages (11) communicated with the secondary main air passage are arranged on the secondary main air passage (12), the primary branch air passages (9) and the secondary branch air passages (11) are distributed in a staggered manner, and a plurality of negative pressure holes (6) are respectively communicated with the primary branch air passages (9) and the secondary branch air passages (11);
the device also comprises a negative pressure pipe I (13) and a negative pressure pipe II (10), wherein one end of the negative pressure pipe I (13) is communicated with the primary main air passage (8), the other end of the negative pressure pipe I (13) is communicated with the connecting hose (5), one end of the negative pressure pipe II (10) is communicated with the secondary main air passage (12), and the other end of the negative pressure pipe II (10) is communicated with the connecting hose (5) so as to form two mutually independent sets of air passages in the wall of the adsorption cylinder (1);
the opening area of the upper end of the adsorption cylinder (1) is larger than the opening area of the lower end of the adsorption cylinder.
2. The totally enclosed type in vitro minimally invasive gallbladder-preserving stone removal device of claim 1, wherein: the air flow channel comprises a cavity (7) arranged on the adsorption cylinder (1) along the outline of the adsorption cylinder (1), and the cavity (7) is communicated with a plurality of negative pressure holes (6).
3. The totally enclosed type in vitro minimally invasive gallbladder-preserving stone removal device of claim 1, wherein: the primary main air passage (8) is close to the upper end part of the adsorption cylinder (1), the secondary main air passage (12) is close to the lower end part of the adsorption cylinder (1), and the plurality of primary branch air passages (9) and secondary branch air passages (11) are uniformly distributed along the direction of the upper end of the adsorption cylinder (1) pointing to the lower end of the adsorption cylinder.
4. The totally enclosed type in vitro minimally invasive gallbladder-protecting stone removing device according to any one of claims 1-3, wherein: the adjusting clamp (16) comprises a U-shaped body, a cavity is formed in the middle of a horizontal section of the body, through holes (22) communicated with the cavity are formed in two vertical sections of the body respectively, a support column (20) is installed in the cavity, the middle of one side wall of a bridge plate (19) made of metal is hinged to the end of the support column (20), an electromagnet I (17) and an electromagnet II (18) are installed on two sides of the support column (20) respectively, the electromagnet I (17) and the electromagnet II (18) are opposite to two ends of the other side wall of the bridge plate (19) respectively, a connecting rod (21) is slidably arranged in each through hole, one end of the connecting rod (21) is connected with the bridge plate (19), a movable clamp (23) is hinged to the other end of the connecting rod (21), a fixed clamp (25) matched with the movable clamp (23) is arranged on the end face of the vertical section of the body, and a spring (24) opposite to the movable clamp (23) is installed on the fixed clamp (25); when the electromagnet I (17) is electrified, the bridge plate (19) is attracted by the electromagnet I (17) and then drives the connecting rod (21) to move towards the direction close to the electromagnet I (17), the part of the movable clamp (23) moves into the through hole (22), the spring (24) is compressed and deformed after being extruded by the movable clamp (23), and the movable clamp (23) and the fixed clamp (25) are combined to form a clamping area matched with the cholecyst tube (15).
5. The totally enclosed type in vitro minimally invasive gallbladder-preserving stone removal device of claim 4, wherein: the movable clamp (23) and the fixed clamp (25) are combined to form a rectangular clamping area.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710864690.9A CN107496005B (en) | 2017-09-22 | 2017-09-22 | Full-automatic external minimally invasive gallbladder-protecting stone-taking device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710864690.9A CN107496005B (en) | 2017-09-22 | 2017-09-22 | Full-automatic external minimally invasive gallbladder-protecting stone-taking device |
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| CN107496005A CN107496005A (en) | 2017-12-22 |
| CN107496005B true CN107496005B (en) | 2024-03-26 |
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| CN201710864690.9A Active CN107496005B (en) | 2017-09-22 | 2017-09-22 | Full-automatic external minimally invasive gallbladder-protecting stone-taking device |
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| CN116273429B (en) * | 2023-03-21 | 2023-09-26 | 西安交通大学第二附属医院 | Collecting device for prostatectomy |
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