CN107510496A - The minimally invasive TNOTES operative approaches suit of gynaecology - Google Patents

The minimally invasive TNOTES operative approaches suit of gynaecology Download PDF

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Publication number
CN107510496A
CN107510496A CN201610429685.0A CN201610429685A CN107510496A CN 107510496 A CN107510496 A CN 107510496A CN 201610429685 A CN201610429685 A CN 201610429685A CN 107510496 A CN107510496 A CN 107510496A
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CN
China
Prior art keywords
ring
tnotes
suit
minimally invasive
vagina
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
CN201610429685.0A
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Chinese (zh)
Inventor
孙大为
张俊吉
刘海元
张令怡
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Wellcome Medical (beijing) Technology Development Co Ltd
Original Assignee
Wellcome Medical (beijing) Technology Development Co Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Wellcome Medical (beijing) Technology Development Co Ltd filed Critical Wellcome Medical (beijing) Technology Development Co Ltd
Priority to CN201610429685.0A priority Critical patent/CN107510496A/en
Publication of CN107510496A publication Critical patent/CN107510496A/en
Pending legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42Gynaecological or obstetrical instruments or methods
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable

Abstract

A kind of minimally invasive TNOTES operative approaches suit of gynaecology retracts sealing passage, seal operation platform, leakproof protection pad and conveyer by vagina and combined, can comprehensively solve laparoscope TNOTES operative approach seal operation problems, convenience, sealed reliable are inserted, operation apparatus is flexible.

Description

The minimally invasive TNOTES operative approaches suit of gynaecology
Technical field:
The invention belongs to medical operating articles for use, and in particular to the minimally invasive TNOTES operative approaches of laparoscope gynaecology Suit, it is specifically applied to Via vagina TNOTES operations.
Technical background:
Through natural cavity endoscopic surgery (naturalorifice transluminal endoscopic surgery, NOTES) It is an emerging Minimally Invasive Surgical Technology.NOTES refers to, without skin surface otch, pass through human body using scope Natural duct, such as stomach, vagina, bladder, colon, rectum are performed the operation into body cavity.Opened with traditional Abdomen is performed the operation and laparoscope compares, and NOTES has without visible surgical scars, reduces intra-abdominal adhesions, operation The advantages such as wound is small, postoperative pain is few, recovery is fast.In the selection of many operative approaches, Via vagina path TNOTES performs the operation (Transvaginal NOTES, tNOTES) first by the accreditation of most of clinicians, is The most NOTES operation pathway of clinical practice at present, but at present still without it is special, conveniently, reliable approach Apparatus is the most critical reason for causing TNOTES development to be restricted, and there is an urgent need to performed the operation for TNOTES Carry out special equipment development work.
The content of the invention:
The purpose of the present invention is:It is a set of special according to the use demand of TNOTES operations, innovative design The minimally invasive TNOTES operative approaches suit of TNOTES operative approach apparatuses, i.e. gynaecology.Meet TNOTES hands The requirement of art Special use, substantially reduces operating difficulty, increases surgical facilitation, changes existing TNOTES hands The present situation that art is difficult to carry out and promoted without special equipment.
Technical scheme is used by the present invention solves above-mentioned technical problem:
The minimally invasive TNOTES operative approaches suit of gynaecology retracts sealing passage, seal operation platform, leakproof by vagina Protection pad and conveyer combine.The locating ring and vagina of seal operation platform retract sealing passage turnup ring with Ring fastening type is chimeric to be located by connecting.Conveyer is used to vagina retracting sealing passage inner seal ring from posterior fornix feeding Abdominal cavity.
Vagina retracts sealing passage and is made up of turnup ring, inner seal ring, pipeline and sliding ring and drawing belt (referring to the structural representation of accompanying drawing 1).
Vagina retract sealing communication conduits using high polymer material make, as (polyurethane film, polyethylene film, Silicon rubber etc.).Pipeline can use cylindrical shape or cone barrel, and strip enhancing muscle, enhancing can be designed with duct wall Muscle is used to increase pipeline support;Drawing belt is used to take out vagina traction sealing passage after use terminates, and pulls Band one end is fixed on inner seal ring inwall, and another free end outside pipeline by drawing outside vagina.
Vagina retracts sealing passage inner seal ring and is made up of elastic ring and protection gasket ring integration, and elastic ring is used for embedding Entering posterior fornix otch prevents from, and is made using high resiliency, high resilience high polymer material, such as (polyurethane, Polyethylene etc.) it is made.Protection gasket ring is made of flexibel polyurethane or silicon rubber, for preventing rear vault Gallery tears and keeps sealing when using.
Vagina is retracted sealing passage turnup ring and made using high resiliency, high resilience high polymer material, such as (polyurethane, Polyethylene etc.) it is made, cross sectional shape uses Crossed Circle, and vagina can be carried out with turnup and retracts sealing passage Pipeline folding and unfolding, and chimeric with the locating ring of seal operation platform can be tightly connected.
Vagina retracts the hard ring that sealing passage sliding ring is 20~50 millimeters of a diameter, and material can be selected Metal or high molecule plastic.Sliding ring, which is located at outside pipeline, to be slided between pipeline and vagina, for hand Cervix position is embedded in during art, prevents the gas leakage outside pipeline.
Seal operation platform seals passage, common platform and vent line three parts by multiple operations and formed (in detail See the structural representation of accompanying drawing 2).
Operation sealing passage is made up of lateral and sealed valve.Sealed valve is by housing, crack film, pore membrane And tighten hoop and form, it is characterized in that:All made of high resiliency, high resilience, high tear material, in crack Added outside mould, pore membrane, housing can apply constrictive force tighten hoop.When surgical device enters people's valve, extending bore The mesopore of film, so that mesopore shrinks lock ring apparatus and seals;Closing of fracture seals after removal equipment.It is adapted to sealing Minimum dimension should be slightly larger than mesopore, sealable full-size should be bordering on the mesopore tear limit.For example, Median pore diameter is 2 millimeters, and Materials Fracture elongation is 600%, and its dimension limit should be less than 12 millimeters, choosing It is advisable with 10 millimeters.The apparatus that operable 3,5,10 millimeters of this channel valve.Channel valve surface is through thing The vacuum coating of reason method lubricates or applied lubricant processing, and there is self-lubricating property can reduce operation resistance.
Common platform includes common-use tunnel and rotational positioning ring two parts.Common-use tunnel is one section of flexible channel, special Putting is:Can flexible multidirectional deformation, make by the operating theater instruments of multioperation passage not only can longitudinal push-and-pull move, Also it laterally can (radially, circumferentially) twist, transpose, across position, can bypass apparatus and mutually stop, expand operant activity Scope, avoid interfering.
Rotational positioning ring can take two kinds of patterns:Two kinds are all provided with inner ring, outer shroud, locating ring, and outer shroud can be relative Inner ring rotates.A kind of form is provided with rotary seal circle between two rings;One kind can not set sealing ring, only sliding Dynamic rotation, is sealed using multichannel seal cap common-use tunnel shirt rim.Locating ring designs for cap covering type, passes through rotation Turn sealing ring to be connected with common-use tunnel, retracted with setting convex-concave ring and vagina in block on the outside of sealing passage turnup ring Concavo-convex ring be fitted together to, captive closure positioning.
Common platform was not only deformable but also rotatable, more optimize apparatus anti-interference function.
Vent line is located on locating ring, for establishing pneumoperitoneum environment in surgical procedure.
It is an annular foam cushion for having opening provided with leakproof protection pad, can be placed between locating ring and patient's introitus, For preventing sliding ring failure gas leakage in operative process.
Approach apparatus inserts fornix vaginae and taking-up is one of Operative Puzzle, need to specially design vagina is retracted it is close Seal the conveyer that passage inner seal ring is sent into posterior fornix otch.Design is divided into 1, assistive device is used for multiple times; 2nd, disposable means of delivery.
Assistive device is used for multiple times to be made by medical stainless steel, special auxiliary front end sets bifurcation shape, interior close available for pushing away Seal ring enters fornix otch.Other end is that arc is hook-shaped, and the drawing belt failure of sealing passage is retracted to prevent vagina, Assistive device arc shaped hook can be used to take out.
Disposable dedicated transport instrument is made using medical plastic material, by handle, interior ejector sleeve and outer tube Form.Outer tube is flat tube shape, and one end is provided with sliding groove, and other end one side front end is provided with round and smooth projection, It is exposed that another side is provided with pipeline after fluting retracts the inner seal ring insertion of sealing passage so as to vagina.Interior ejector sleeve is provided with Push handle and ejector sleeve, push handle is set to be embedded in outer tube sliding groove with ejector sleeve rear portion, push handle, and ejector sleeve is placed in overcoat In pipe, push push handle can utilize ejector sleeve that the vagina being placed in outer tube is retracted into sealing passage inner seal ring top Go out.Handle is placed in outer tube and is provided with sliding groove one end, prevents interior ejector sleeve abjection outer tube.
The present invention has following beneficial effect:
1. comprehensively solve laparoscope TNOTES operative approach seal operation problems, insert convenience, sealed reliable, behaviour It is flexible to make apparatus;
2. vagina, which retracts sealing passage, which is designed with sliding ring and inner seal ring protection gasket ring, can both protect outer fornix The gas leakage outside pipeline can be prevented again.
3. the design of seal operation platform rotating ring makes common platform not only deformable but also rotatable, more to optimize apparatus anti-dry Function is disturbed, greatly increases the operation of pneumoperitoneum air-proof condition menisectomy in TNOTES arts direction, angle change Flexibility, increase operation ease.
It is easy to operation to implement 4. being designed with special-purpose assorted conveyer.
Brief description of the drawings:
Fig. 1 vaginas retract sealing channel design schematic diagram
Fig. 2 seal operation platform appearance schematic diagrams
Fig. 3 sealing ring closed type rotational positioning ring assembling schematic diagrams
Fig. 4 shirt rims closed type rotating ring assembling schematic diagram
Assistive device structural representation is used for multiple times in Fig. 5
The disposable conveyer construction schematic diagrames of Fig. 6
Fig. 7 vaginas retract sealing passage, seal operation platform assembling schematic diagram
Embodiment:
Embodiment one
As shown in Figure 1, Figure 2, shown in Fig. 4, Fig. 5:The minimally invasive TNOTES operative approaches suit of the gynaecology is by vagina Retract sealing passage 1, seal operation platform 2, leakproof protection pad 3 and assistive device 4 is used for multiple times forms.It is cloudy Road retracts sealing passage 1 by turnup ring 1-1, inner seal ring 1-2, pipeline 1-3 and sliding ring 1-4, drawing De- band 1-5 is formed, and inner seal ring 1-2 is provided with soft protection gasket ring 1-2-1, and pipeline 1-3 is provided with reinforcement 1-3-1. Seal operation platform 2 seals passage 2-1, common platform 2-2 and vent line 2-3 three parts by multiple operations Form (referring to the structural representation of accompanying drawing 2).Operating walk way 2-1 is by lateral 2-1-1 and sealed valve 2-1-2 Composition.Sealed valve 2-1-2 is by housing, crack film, pore membrane and tightens hoop and forms;Common platform 2-2 includes Common-use tunnel 2-2-1 and rotational positioning ring 2-2-2 two parts.
Common-use tunnel 2-2-1 be provided with passage 2-2-1-1, passage outer 2-2-1-2, interior sealing shirt rim 2-2-1-3, Locating ring 2-2-1-4;Rotating ring 2-2-2 is provided with outer shroud 2-2-2-1, inner ring 2-2-2-2.Common-use tunnel outer 2-2-1-1 It is socketed in side ring 2-2-2-1-1,2-2-2-2-1 of the inner ring and outer rings of rotational positioning ring respectively with shirt rim 2-2-1-2 On, rotational positioning ring inner ring 2-2-2-2 is clamped together in locating ring 2-2-1-4 annular groove 2-2-2-4-1, is shared flat Platform 2-2 sides are provided with two gas valves pipeline 2-3, inner groove 2-2-2-4-2 and turned over vagina traction sealing passage Roll up the chimeric sealing positioning of ring 1-1.
When rotating multichannel seal cap by hand, its common-use tunnel drives rotating ring outer shroud to rotate, its shirt rim and rotation Turn locating ring inner ring and keep sealing.
Supporting that assistive device 4 is used for multiple times, special auxiliary front end is bifurcation shape, and one is that arc is hook-shaped.
Embodiment two
As shown in Figure 1, Figure 2, shown in Fig. 3, Fig. 6:The minimally invasive TNOTES operative approaches suit of the gynaecology is by vagina Sealing passage 1, seal operation platform 2, leakproof protection pad 3 and disposable means of delivery 5 is retracted to form. Vagina retracts sealing passage 1 by turnup ring 1-1, inner seal ring 1-2, pipeline 1-3 and sliding ring 1-4 Form, inner seal ring 1-2 is provided with soft protection gasket ring 1-2-1, and pipeline 1-3 is provided with reinforcement 1-3-1.Sealing Operating platform 2 seals passage 2-1, common platform 2-2 and vent line 2-3 three parts by multiple operations and formed (referring to the structural representation of accompanying drawing 2).Operating walk way 2-1 is by lateral 2-1-1 and sealed valve 2-1-2 groups Into.Sealed valve 2-1-2 is by housing, crack film, pore membrane and tightens hoop and forms;Common platform 2-2 is included altogether With passage 2-2-1 and rotational positioning ring 2-2-2 two parts.
Common-use tunnel 2-2-1 is provided with passage 2-2-1-1, locating ring 2-2-1-2;Rotating ring locating ring 2-2-2 is provided with Outer shroud 2-2-2-1, inner ring 2-2-2-2, sealing ring 2-2-2-3.Passage 2-2-1-1 is bonded in outside rotational positioning ring On ring 2-2-2-1, rotational positioning ring inner ring 2-2-2-2 clamps together the annular groove 2-2-1-2-1 in locating ring 2-2-1-2 Interior, common platform 2-2 sides are provided with two gas valves pipeline 2-3, inner groove 2-2-1-2-2 and retracted with vagina Seal the chimeric sealing positioning of passage turnup ring 1-1.
When rotating multichannel seal cap by hand, its common-use tunnel drives rotating ring outer shroud to rotate, its shirt rim and rotation Turn locating ring inner ring and keep sealing.
Supporting disposable means of delivery 5, it is made up of handle 5-1, interior ejector sleeve 5-2 and outer tube 5-3.Outside Sleeve pipe 5-3 is flat tube shape, and one end is provided with sliding groove, and other end one side front end is provided with round and smooth projection, another It is exposed that side is provided with pipeline after fluting retracts the inner seal ring insertion of sealing passage so as to vagina.Interior ejector sleeve 5-2 is provided with and pushed away Handle 5-2-1 and ejector sleeve 5-2-2, push handle is set to be embedded in outer tube sliding groove with ejector sleeve rear portion, push handle, ejector sleeve It is placed in outer tube, push push handle can utilize ejector sleeve to retract the vagina being placed in outer tube in sealing passage Sealing ring ejects.Handle 5-1 is placed in outer tube and is provided with sliding groove one end, prevents interior ejector sleeve abjection outer tube.

Claims (7)

1. a kind of minimally invasive TNOTES operative approaches suit of gynaecology by vagina retract sealing passage, seal operation platform, Leakproof protection pad and conveyer combine, can comprehensively solve laparoscope TNOTES operative approach seal operations Problem, inserts convenience, sealed reliable, and operation apparatus is flexible.
2. the minimally invasive TNOTES operative approaches suit of gynaecology according to claim 1, it is characterized in that:Vagina retracts Sealing communication conduits wall is provided with strip enhancing muscle and is used to increase pipeline support;Provided with 20~50 millimeters of diameter Hard sliding ring be used for prevent the gas leakage outside pipeline;Inner seal ring is provided with soft protection gasket ring and is used for Sealing is kept when preventing posterior fornix from tearing and using.
3. the minimally invasive TNOTES operative approaches suit of gynaecology according to claim 1, it is characterized in that:Seal operation Platform seals passage by rotational positioning ring transition attended operation and retracts sealing passage with vagina, between the two It can rotate against.
4. the minimally invasive TNOTES operative approaches suit of gynaecology according to claim 1, it is characterized in that:Rotational positioning Ring is connected by outer shroud ring side with common-use tunnel, can be rotated relative to inner ring, and inner ring ring side and locating ring are mutual Interlocking, it is chimeric that locating ring can retract sealing passage turnup ring positioning with vagina.
5. the minimally invasive TNOTES operative approaches suit of gynaecology according to claim 1, it is characterized in that:Rotational positioning Sealing, which can use to carry rotating seal ring or only slide rotatable engagement, between ring inner and outer rings utilizes common-use tunnel Outer and shirt rim are wrapped up inner and outer rings mode and sealed respectively.
6. the minimally invasive TNOTES operative approaches suit of gynaecology according to claim 1, it is characterized in that:Special design The conveyer that vagina is retracted to the outer fornix of sealing passage inner seal ring feeding is inserted for solving approach apparatus Fornix vaginae and taking-up difficult point, are used for multiple times assistive device and are made by medical stainless steel, special auxiliary front end If bifurcation shape, other end is that arc is hook-shaped.
7. the minimally invasive TNOTES operative approaches suit of gynaecology according to claim 1, it is characterized in that:Provided with leakproof Protection pad is an annular foam cushion for having opening, can be placed between locating ring and patient's introitus, for pre- Sliding ring failure gas leakage in anti-operative process.
CN201610429685.0A 2016-06-17 2016-06-17 The minimally invasive TNOTES operative approaches suit of gynaecology Pending CN107510496A (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109171839A (en) * 2018-10-25 2019-01-11 上海市第妇婴保健院 A kind of single-port laparoscope instrument system for V-NOTES operation
CN112603388A (en) * 2020-12-08 2021-04-06 四川大学华西第二医院 Device is put into to operation passageway
CN109171839B (en) * 2018-10-25 2024-04-23 上海市第一妇婴保健院 Single-port laparoscope instrument system for V-NOTES operation

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102228384A (en) * 2011-07-07 2011-11-02 威海威高齐全医疗设备有限公司 Single-port operation channel
DE202012102878U1 (en) * 2012-07-31 2012-08-22 Lagis Enterprise Co., Ltd. Surgical access device
CN103405251A (en) * 2013-08-16 2013-11-27 凌安东 Full-vagina sleeve cylindrical expansion and pneumoperitoneum integrated device
CN203341706U (en) * 2013-07-25 2013-12-18 于永玲 Leakage-proof hysteroscope for gynecological operation
CN203662895U (en) * 2013-09-11 2014-06-25 张令天 Novel multi-channel sheath
CN203943696U (en) * 2014-06-05 2014-11-19 姜永光 For transvaginal laparoscopically surgical operation highway device
CN204049798U (en) * 2014-09-05 2014-12-31 张敏 Anti-gas-leak equipment for holding uterus
US20150209073A1 (en) * 2012-06-28 2015-07-30 Korea University Research And Business Foundation Vaginal endoscopic port unit module
CN206080657U (en) * 2016-06-17 2017-04-12 助医维康(北京)科技发展有限公司 TNOTES of wicresoft of gynaecology operation approach suit

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102228384A (en) * 2011-07-07 2011-11-02 威海威高齐全医疗设备有限公司 Single-port operation channel
US20150209073A1 (en) * 2012-06-28 2015-07-30 Korea University Research And Business Foundation Vaginal endoscopic port unit module
DE202012102878U1 (en) * 2012-07-31 2012-08-22 Lagis Enterprise Co., Ltd. Surgical access device
CN203341706U (en) * 2013-07-25 2013-12-18 于永玲 Leakage-proof hysteroscope for gynecological operation
CN103405251A (en) * 2013-08-16 2013-11-27 凌安东 Full-vagina sleeve cylindrical expansion and pneumoperitoneum integrated device
CN203662895U (en) * 2013-09-11 2014-06-25 张令天 Novel multi-channel sheath
CN203943696U (en) * 2014-06-05 2014-11-19 姜永光 For transvaginal laparoscopically surgical operation highway device
CN204049798U (en) * 2014-09-05 2014-12-31 张敏 Anti-gas-leak equipment for holding uterus
CN206080657U (en) * 2016-06-17 2017-04-12 助医维康(北京)科技发展有限公司 TNOTES of wicresoft of gynaecology operation approach suit

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109171839A (en) * 2018-10-25 2019-01-11 上海市第妇婴保健院 A kind of single-port laparoscope instrument system for V-NOTES operation
CN109171839B (en) * 2018-10-25 2024-04-23 上海市第一妇婴保健院 Single-port laparoscope instrument system for V-NOTES operation
CN112603388A (en) * 2020-12-08 2021-04-06 四川大学华西第二医院 Device is put into to operation passageway
CN112603388B (en) * 2020-12-08 2022-04-05 四川大学华西第二医院 Device is put into to operation passageway

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