CN108143449B

CN108143449B - Novel axillary cavity endoscope thyroid surgery retractor

Info

Publication number: CN108143449B
Application number: CN201711278821.1A
Authority: CN
Inventors: 葛明华; 兰霞斌; 郑传铭; 徐加杰
Original assignee: Zhejiang Cancer Hospital
Current assignee: Hangzhou Kangji Medical Instrument Co Ltd
Priority date: 2017-12-06
Filing date: 2017-12-06
Publication date: 2020-02-07
Anticipated expiration: 2037-12-06
Also published as: CN108143449A

Abstract

The invention relates to the technical field of medical instruments and discloses a novel axillary cavity endoscope thyroid surgery retractor. This surgical retractor includes the pull rod and sets up first drag hook and the second drag hook that is parallel to each other in pull rod both sides, still including sawtooth telescopic link and the depression bar of locating the second drag hook below, the tie point of pull rod and second drag hook and the upper end fixed connection of sawtooth telescopic link, the lower extreme of sawtooth telescopic link rotates with the one end of depression bar to be connected, the other end of depression bar is equipped with the crotch of downwarping, depression bar, first drag hook and second drag hook all are located the left side of sawtooth telescopic link, the second drag hook includes the body of rod, establishes at the pull tab head of body of rod left end and establishes the controlling means at the body of rod right-hand member. The surgical retractor is simple to adjust and convenient to operate, and the shape and size of the surgical operation space can be changed according to the surgical operation space requirement.

Description

Novel axillary cavity endoscope thyroid surgery retractor

Technical Field

The invention relates to the technical field of medical instruments, in particular to a novel axillary cavity endoscope thyroid surgery retractor which can stretch and rotate to increase the operation space and the visual field range.

Background

The traditional open thyroid surgery usually has the defects that the neck is transversely cut, the postoperative keloid hyperplasia of the neck affects the beauty, the life of a patient is troubled, and along with the continuous expansion of a minimally invasive concept, the updating of a laparoscopic surgery method and the continuous progress of instruments, the surgery of the neck without the keloid gradually appears. Endoscopic thyroid surgery has been developed in a rapid fashion over the past decade with various procedures, such as total areola approach, axillary areola approach, single-port areola approach, axillary assisted laparoscopy, etc. In recent years, it has been reported that the axillary path endoscopic thyroid single-hole operation is performed, and in the axillary path endoscopic thyroid single-hole operation, a U-shaped retractor is used to pull up the epidermal tissue from the axillary to the neck of a patient.

Chinese patent publication No. CN205379323 discloses a thyroid gland retractor with anti-slip function, which comprises a pull rod, and a first retractor and a second retractor arranged at two ends of the pull rod, wherein the inner surfaces of the first retractor and the second retractor are provided with a plurality of protruding particles, and the first retractor, the second retractor and the protruding particles are integrally formed. In the operation process, the second drag hook stretches into near patient armpit's operation trompil, lifts first drag hook, and the second drag hook pulls up patient's armpit to the epidermis tissue of neck to form operation space, make things convenient for the doctor to insert surgical instruments and cut, press from both sides operation process such as get, but human epidermis tissue upwards draws to rise highly limitedly, causes operation space narrow and small, and the operation degree of difficulty is great, the easy mistake that appears.

Disclosure of Invention

The invention aims to solve the problem of higher operation difficulty caused by narrow operation space of an axilla approach operation in the prior art, and provides a thyroid operation retractor which can enlarge the operation space of the axilla approach operation and is convenient for a doctor to perform subsequent operation.

In order to achieve the purpose, the invention adopts the following technical scheme: including the pull rod and set up first drag hook and the second drag hook that is parallel to each other in pull rod both sides, still including sawtooth telescopic link and the depression bar of locating the second drag hook below, the connecting point of pull rod and second drag hook and the upper end fixed connection of sawtooth telescopic link, the lower extreme of sawtooth telescopic link rotates with the one end of depression bar to be connected, the other end of depression bar is equipped with the crotch of downwarping, depression bar, first drag hook and second drag hook all are located the left side of sawtooth telescopic link, the second drag hook includes the body of rod, establishes at the pull tab head of body of rod left end and establishes the controlling device at the body of rod right-hand member.

The second drag hook can adjust the size of the pull tab head at the left end of the rod body as required, the opening area of the pull tab head is adjusted to be minimum before the second drag hook enters the axilla operation opening, the pull tab head can conveniently enter the operation opening, the area of the pull tab head is increased to be proper as required after the second drag hook enters the axilla operation opening, and the contact area of the pull tab head and the pulled and lifted epidermal tissue is increased, so that the operation space is increased, and a doctor can conveniently perform an operation; the first draw hook is used for hoisting the whole draw hook device; the sawtooth telescopic link is used for reducing tissue damage of a patient and freely adjusting the size of a surgical operation space, the sawtooth telescopic link is shortened before a second drag hook and a pressing rod extend into an axillary operation opening of the patient, so that the distance between the second drag hook and the pressing rod which are parallel to each other is reduced, a doctor can conveniently extend the second drag hook and the pressing rod into the axillary operation opening of the patient, and unnecessary damage to body tissues of the patient is reduced; the lower end of the sawtooth telescopic rod is rotatably connected with one end of a pressure rod, the pressure rod not only can move up and down to press down muscle tissues, but also can freely rotate for a certain angle as required, so that an operation space and a visual field space in a specific shape are formed between the muscle tissues and surface tissues, and further, the operation of a doctor is facilitated; the other end of the pressure lever is provided with a hook in a downward direction to stretch the muscle at the lower part of the epidermal tissue outwards so as to increase the operation space and the visual field range behind the muscular tissue.

As preferred, the pull tab head includes the rectangular pulling-on piece of first rectangular pulling-on piece, the rectangular pulling-on piece of second, first bracing piece and second bracing piece, the one end longitudinal extension of the rectangular pulling-on piece of first rectangular pulling-on piece is equipped with first pulling-on piece handle, and the one end longitudinal extension of the rectangular pulling-on piece of second is equipped with second pulling-on piece handle, the tie point of first rectangular pulling-on piece and first pulling-on piece handle articulates in the tie point of the rectangular pulling-on piece of second and second pulling-on piece handle, be equipped with the spring between first pulling-on piece handle and the second pulling-on piece handle, the other end of first pulling-on piece handle articulates with the one end of first bracing piece, and the other end of second pulling-on piece handle articulates with the one end of second bracing piece, be equipped with the fixed axle on the plane direction at the left end perpendicular to pull tab head place of the body of rod.

Constitute between first rectangular pulling-on piece and the rectangular pulling-on piece of second and articulate, according to the required operating space size of operation in-process, adjust the size of contained angle between first rectangular pulling-on piece and the rectangular pulling-on piece of second to change the area that the pulling-on piece head struts.

As preferred, the body of rod is located the interior body of rod outside and rather than sliding fit's the outer body of rod including interior body of rod and cover, operating means includes screw rod, casing and elastic rod, the right-hand member of the outer body of rod is located to the screw rod cover and rather than integrated into one piece, the screw thread of screw rod is located on the screw rod outer wall, be equipped with the nut with screw thread matched with on the outer wall of screw rod, the fixed first elastic rod that is equipped with in the direction of the right-hand member perpendicular to screw rod of screw rod, the outside of screw rod and rather than sliding fit are located to the casing cover, the nut is located the left end of casing and blocks the casing and slides left, the left end of the body of rod including the fixed axle is established, the right-hand member of the interior body of rod passes the screw rod and fixes the right-hand member at the casing, the left end of casing is fixed be equipped with.

The fixed shaft is arranged at the left end of the inner rod body, the other end of the first support rod is hinged with the second support rod through the fixed shaft, the outer rod body is sleeved outside the inner rod body and is in sliding fit with the inner rod body, when the included angle between the first strip-shaped pull piece and the second strip-shaped pull piece needs to be reduced, the outer rod body slides leftwards relative to the inner rod body, the other end of the first support rod and the second support rod tend to be overlapped with each other and gradually enter the inner part of the outer rod body, the included angle between the other end of the first support rod and the second support rod is reduced, the first strip-shaped pull piece and the second strip-shaped pull piece are driven to rotate, and the included angle between the first strip-shaped pull; when needs increase the contained angle between the rectangular pulling-on piece of first rectangular pulling-on piece and the second, slide outer rod body right for the interior body of rod, because be equipped with the spring between first pulling-on piece handle and the second pulling-on piece handle, first pulling-on piece handle and second pulling-on piece handle receive the effect of elasticity to strut first pulling-on piece handle and second pulling-on piece, make the contained angle increase between first rectangular pulling-on piece and the rectangular pulling-on piece of second. The operating device can control the sliding between the inner rod body and the outer rod body, when the nut is rotated clockwise, the nut moves to the right on the screw rod, the outer rod body gradually moves to the left relative to the inner rod body under the blocking effect of the shell, when the nut is rotated anticlockwise, the nut moves to the left on the screw rod, and the outer rod body gradually moves to the right relative to the inner rod body under the elastic action of the spring group between the first elastic rod and the second elastic rod. Adjust the size of contained angle between first rectangular pulling-on piece and the rectangular pulling-on piece of second through swivel nut, easy operation is convenient.

Preferably, the sawtooth telescopic link comprises a sawtooth rod and a sleeve rod sleeved outside the sawtooth rod, sawteeth are arranged on the outer wall of the sawtooth rod in the longitudinal direction, a screw hole and a screw hole matched with the screw hole are formed in the outer side of the sleeve rod, and the screw penetrates through the sawteeth of the screw hole and is clamped on the sawtooth rod.

When needs extension sawtooth telescopic link, the screw in the loop bar outside is unscrewed the back, and tensile sawtooth pole and loop bar make the sawtooth telescopic link extend suitable length, then screws up the screw, make the sawtooth looks joint on screw and the sawtooth pole to play the effect of fixed flexible sawtooth pole. The length of the sawtooth telescopic rod can be freely adjusted by mutually matching and sliding the stretching sawtooth rod and the loop bar, the distance between the second drag hook and the pressure bar is increased, and the operation and the visual field space are enlarged.

Preferably, the compression bar is a telescopic compression bar and comprises a first telescopic rod and a second telescopic rod, the second telescopic rod is sleeved outside the first telescopic rod and is in sliding fit with the first telescopic rod, the right end of the second telescopic rod is connected with the lower end of the sawtooth telescopic rod, and the hook is arranged at the left end of the first telescopic rod.

Through the length that freely controls the compression lever that mutually supports of first telescopic link and second telescopic link slides, the convenience is outwards stretched musculature, increases operation space and field of vision scope.

Preferably, the inner surface of the hook is provided with a dotted protrusion.

The point-shaped protrusions have the function of increasing the friction force between the hook and the muscle tissue, and the hook and the muscle tissue are not easy to slide relatively.

Preferably, the included angle α between the first and second elongated tabs is 0-120 °.

When the included angle α between the first strip-shaped pulling piece and the second strip-shaped pulling piece is 0-120 degrees, the size of the area of the upper epidermis tissue supported by the pulling piece head is reasonably controlled, and an operation space which is more beneficial to the operation is constructed.

Preferably, a smoke absorbing pipe parallel to the second draw hook is arranged between the second draw hook and the pressure rod.

The smoke absorbing pipe is used for absorbing the operation smoke to ensure that the operation visual field is clear.

Therefore, the invention has the following beneficial effects: (1) the operation space and the visual field range are enlarged; (2) the shape and the size of the operation space can be changed according to the requirement of the operation space; (3) the operation drag hook is simple to adjust and convenient to operate.

Drawings

FIG. 1 is a schematic diagram of an embodiment of the present invention.

Fig. 2 is a schematic view of the retractor.

Fig. 3 is a schematic structural view of the sawtooth telescopic rod.

Fig. 4 is a schematic view of the structure of the hook.

Reference numerals

The device comprises a pull rod 1, a first drag hook 2, a second drag hook 3, a sawtooth telescopic rod 4, a pressure rod 5, a smoking pipe 6, a hook 51, a rod body 31, a pull tab head 32, an operating device 33, a first long pull tab 321, a second long pull tab 322, a first support rod 323, a second support rod 324, a first pull tab handle 325, a second pull tab handle 326, a spring 327, a fixed shaft 313, an inner rod body 311, an outer rod body 312, a screw 331, a shell 332, an elastic rod 333, a nut 334, a spring group 337, a sawtooth rod 41, a loop rod 42, sawteeth 43, a screw hole 44, a screw 45, a first telescopic rod 52, a second telescopic rod 53 and a point-shaped protrusion 54.

Detailed Description

The technical solution of the present invention is further illustrated by the following specific examples.

Example 1

As shown in fig. 1, which is a schematic structural view of the present invention, a novel axillary cavity endoscope thyroid surgery retractor comprises a pull rod 1, a first retractor 2 and a second retractor 3 which are arranged on two sides of the pull rod and are parallel to each other, the pull rod, the first retractor and the second retractor form a U shape, the second retractor comprises a rod body 31, a pull-tab head 32 arranged at the left end of the rod body, and an operating device 33 arranged at the right end of the rod body, the pull-tab head comprises a first elongated pull-tab 321, a second elongated pull-tab 322, a first support rod 323 and a second support rod 324, one end of the first elongated pull-tab longitudinally extends to form a first pull-tab handle 325, one end of the second elongated pull-tab longitudinally extends to form a second pull-tab handle 326, a connecting point of the first elongated pull-tab is hinged to a connecting point of the second pull-tab handle, a spring 327 is arranged between the first elongated pull-tab handle and the second pull-tab handle, the first elongated pull-tab handle is hinged to one end of the first support rod, the second elongated pull-tab is hinged to one end of the first pull-tab, a sawtooth rod, a push rod 52, a push rod is arranged on the second pull-tab, a push rod nut is arranged on the second pull rod, a push rod nut is arranged on the push rod, a push rod nut is arranged on the push rod, a push rod, a push rod, a push rod.

Before the operation is carried out by using the drag hook, the length of the sawtooth telescopic rod is firstly shortened to be shortest, the nut is clockwise rotated, the sawtooth telescopic rod and the second drag hook can conveniently enter an operation opening, the nut is clockwise rotated to move the nut to the right on the screw rod, the outer rod body gradually moves leftwards relative to the inner rod body due to the blocking effect of the shell, the other end of the first support rod and the second support rod tend to be mutually overlapped and gradually enter the inner part of the outer rod body, the included angle between the other end of the first support rod and the second support rod is reduced, so that the first strip-shaped pull piece and the second strip-shaped pull piece are driven to rotate, the included angle between the first strip-shaped pull piece and the second strip-shaped pull piece is reduced, the first strip-shaped pull piece and the second strip-shaped pull piece are mutually overlapped, in addition, the length of the sawtooth telescopic rod is shortened to be, the second drag hook and the pressure lever can extend into the small operation opening of the patient, and after the second drag hook and the pressure lever enter the operation opening to a proper depth, the distance between the epidermal tissue and the muscle below the epidermal tissue can be adjusted by using the sawtooth telescopic rod, so that the operation space for operation implementation is increased; the area of the first strip pulling piece and the second strip pulling piece for pulling the epidermis tissue can be adjusted by using the second drag hook, the nut is rotated anticlockwise, the nut moves leftwards on the screw rod, the outer rod body gradually moves rightwards relative to the inner rod body due to the elastic action of the spring group between the first elastic rod and the second elastic rod, the outer rod body slides rightwards relative to the inner rod body, the spring is arranged between the first pulling piece handle and the second pulling piece handle, the first pulling piece handle and the second pulling piece handle are propped open by the elastic action of the first pulling piece handle and the second pulling piece handle, the included angle between the first strip pulling piece and the second strip pulling piece is increased, the area of the first strip pulling piece and the second strip pulling piece for pulling the epidermis tissue is increased, and the operation space for operation implementation is increased; the compression bar can pull the muscle tissue outwards through the draw hook, so that the visual field range behind the muscle tissue is enlarged, and a doctor can perform an operation conveniently;

the angle between the sawtooth telescopic rod and the pressure rod can be adjusted, the angle of pressing muscles and pulling muscles of the pressure rod can be adjusted according to the operation requirement, so that the region which is difficult to observe in the operation process is exposed, and a doctor can conveniently perform the operation.

Example 2

Example 2 differs from example 1 in that the angle α between the first elongate tab and the second elongate tab is 60 °.

Example 3

Example 3 differs from examples 1 and 2 in that the angle α between the first elongate tab and the second elongate tab is 120 °.

Although the present invention has been described with reference to a preferred embodiment, it should be understood that various changes, substitutions and alterations can be made herein without departing from the spirit and scope of the invention as defined by the appended claims.

Claims

1. A novel axillary cavity endoscope thyroid surgery retractor comprises a pull rod (1), and a first retractor (2) and a second retractor (3) which are arranged on two sides of the pull rod and are parallel to each other, and is characterized in that the first retractor is used for lifting the whole surgery retractor; the surgical retractor further comprises a sawtooth telescopic rod (4) and a pressing rod (5) which are arranged below the second retractor, the connecting point of the pulling rod and the second retractor is fixedly connected with the upper end of the sawtooth telescopic rod, the lower end of the sawtooth telescopic rod is rotatably connected with one end of the pressing rod, the other end of the pressing rod is provided with a hook (51) which bends downwards, the pressing rod, the first retractor and the second retractor are all positioned on the left side of the sawtooth telescopic rod, and the second retractor comprises a rod body (31), a pull piece head (32) arranged at the left end of the rod body and an operating device (33) arranged at the right end of the rod body;

the pull piece head comprises a first strip pull piece (321), a second strip pull piece (322), a first supporting rod (323) and a second supporting rod (324), wherein one end of the first strip pull piece longitudinally extends to form a first pull piece handle (325), one end of the second strip pull piece longitudinally extends to form a second pull piece handle (326), a connecting point of the first strip pull piece and the first pull piece handle is hinged to a connecting point of the second strip pull piece and the second pull piece handle, a spring (327) is arranged between the first pull piece handle and the second pull piece handle, the other end of the first pull piece handle is hinged to one end of the first supporting rod, the other end of the second pull piece handle is hinged to one end of the second supporting rod, a fixed shaft (313) is arranged in the plane direction where the left end of the rod body is perpendicular to the pull piece head, the other end of the first supporting rod is hinged to the other end of the second supporting rod through the fixed, the plane where the pulling sheet head is located is perpendicular to the pulling rod;

the rod body comprises an inner rod body (311) and an outer rod body (312) which is sleeved outside the inner rod body and is in sliding fit with the inner rod body, the operating device comprises a screw rod (331), a shell (332) and an elastic rod (333), the screw rod is sleeved at the right end of the outer rod body and is integrally formed with the outer rod body, the screw thread of the screw rod is arranged on the outer wall of the screw rod, a nut (334) matched with the thread is arranged on the outer wall of the screw rod, a first elastic rod (335) is fixedly arranged at the right end of the screw rod in the direction vertical to the screw rod, the shell is sleeved outside the screw rod and is in sliding fit with the screw rod, the nut is positioned at the left end of the shell and blocks the shell from sliding leftwards, the fixed shaft is arranged at the left end of the inner rod body, the right end of the inner rod body passes through the screw rod and is fixed at the right end of the shell, a second elastic rod (336) corresponding to the first elastic rod is fixedly arranged at the left end of the shell, and a spring group (337) is arranged between the first elastic rod and the second elastic rod.

2. The novel endoscopic axillary cavity thyroid surgery retractor according to claim 1, wherein the sawtooth expansion link comprises a sawtooth rod (41) and a sleeve rod (42) sleeved outside the sawtooth rod, the sawtooth (43) is arranged on the outer wall of the sawtooth rod in the longitudinal direction, a screw hole (44) and a screw (45) matched with the screw hole are arranged on the outer side of the sleeve rod, and the screw penetrates through the sawtooth hole and is clamped on the sawtooth rod.

3. The novel axillary cavity endoscope thyroid surgery retractor according to claim 1, wherein the pressure rod is a telescopic pressure rod, and comprises a first telescopic rod (52) and a second telescopic rod (53), the second telescopic rod is sleeved outside the first telescopic rod and is in sliding fit with the first telescopic rod, the right end of the second telescopic rod is connected with the lower end of the sawtooth telescopic rod, and the hook is arranged at the left end of the first telescopic rod.

4. A novel endoscopic axillary access thyroid surgery retractor according to any one of claims 1, wherein the inner surface of said hook is provided with punctiform protrusions (54).

5. The novel endoscopic axillary cavity surgery thyroid surgery retractor according to claim 1, wherein the included angle α between the first and second elongated pull tabs is 0-120 °.

6. A novel axillary endoscopic thyroid surgery retractor according to any one of claims 1, wherein a smoking pipe (6) parallel to the second retractor is arranged between the second retractor and the pressure bar.