CN108338834B - Endoscope minimally invasive surgical instrument - Google Patents

Endoscope minimally invasive surgical instrument Download PDF

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CN108338834B
CN108338834B CN201810374115.5A CN201810374115A CN108338834B CN 108338834 B CN108338834 B CN 108338834B CN 201810374115 A CN201810374115 A CN 201810374115A CN 108338834 B CN108338834 B CN 108338834B
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shaped
stripping
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handle
cutter head
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CN108338834A (en
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余力
徐霆
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Ninth Peoples Hospital Shanghai Jiaotong University School of Medicine
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Ninth Peoples Hospital Shanghai Jiaotong University School of Medicine
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00333Breast
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00982Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/007Aspiration
    • A61B2218/008Aspiration for smoke evacuation

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  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
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  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Surgical Instruments (AREA)

Abstract

The invention relates to an endoscope minimally invasive surgical instrument which comprises an electrotome electrocoagulator, an A-type separation stripper, a B-type separation stripper and an endoscope sheath; the advantages are as follows: the endoscope minimally invasive surgical instrument improves the surgical instrument combination for secondary deformity treatment after the breast augmentation operation by the armpit under the assistance of the endoscope, establishes a new approach for secondary deformity treatment after the breast augmentation operation and a new operation mode through the approach, is favorable for more accurately and efficiently performing the operation, reduces operation wounds and bleeding, improves the handle control of the operation, reduces operation complications, improves the operation curative effect and the patient satisfaction, meets the new requirements of accurate medicine, can become a novel medical instrument, and has wide prospect in clinical popularization.

Description

Endoscope minimally invasive surgical instrument
Technical Field
The invention relates to the technical field of medical instruments, in particular to an endoscope minimally invasive surgical instrument.
Background
Breast augmentation is one of the common cosmetic procedures. Subsequent deformity and fibrocystic contracture after breast augmentation are common complications of breast augmentation. Surgical treatment is the primary method and means of treating the above common complications. Wherein the technique involves a debonding of the fibrous capsule, an opening of the fibrous capsule, a partial or complete excision of the fibrous capsule, a capsulorhexis, etc. The conventional approach to the surgery is accomplished through areola or lower fold incisions. The armpit access is a common breast augmentation access, but no relevant proper instrument exists at present, and the operation and treatment of the secondary deformity after the breast augmentation operation cannot be completed through the armpit access.
The scholars introduce minimally invasive examination and diagnosis of breast prosthesis leakage and fibrocystotomy after removal of the prosthesis using the original incision tract (armpit) and two additional incisions, the operation using endoscopic retractor to pull open and protect the prosthesis, performing fibrocystotomy, and fibrocystotomy in the case of protecting the prosthesis, but these procedures are not only difficult but also very challenging, with many limitations:
first, additional auxiliary incisions are needed to be added, so that more scars are caused, the scars are proliferated, and the body surface appearance is affected.
Secondly, the treatment approach of the secondary deformity after the primary breast augmentation operation usually adopts an areola or lower fold approach, and under the condition of the existing instrument, the operation can not be successfully completed through the armpit approach and the ideal effect can be obtained. Meanwhile, as the breast augmentation surgery in China mostly adopts an armpit access, the operation access is changed in the second-stage operation, and meanwhile, scars are increased, so that the breast augmentation surgery is unacceptable to many patients. Therefore, the prior art generally completes the operation through the areola access or the lower fold access, the armpit access cannot complete the operation under the prior art condition and the prior instrument cooperation, and the satisfactory operation effect is obtained.
Third, in the prior art, if not operated endoscopically, the surgical operation plane is poor, the hierarchy is unclear, the structural grasp is inaccurate, and some new postoperative complications and adverse effects are often caused.
Fourth, the armpit access, whether surgical, is better in tissue extensibility than the areola access and the lower fold access, but the existing surgical instruments do not meet the technical requirements and do not achieve satisfactory results. Is a blank point of the surgical instrument.
Chinese patent document CN97248211.3, filing date 19971103, patent name: a breast augmentation device, which discloses a health care apparatus, in particular to a vacuum breast augmentation device. The cup comprises a cup and a nipple cover fixed in the cup, the narrow end of the cup is connected with an air suction pipe, and the other end of the air suction pipe is communicated with a vacuum aspirator. The vacuum suction device is provided with a vacuum degree regulator. The vacuum degree can be adjusted, and air can be put into the cup through the air release valve, so that the cup can be conveniently taken down. However, with respect to an improved endoscope-assisted surgical instrument combination for treating a secondary deformity after an armpit breast augmentation surgery, a new approach for treating the secondary deformity after the breast augmentation surgery and a new surgery through the approach are established, which are helpful for more accurate and efficient surgery, reduce surgical wounds and bleeding, improve the handling control of surgical operations, reduce surgical complications, and improve the curative effect of the surgery and the satisfaction of patients. The technical proposal meeting the new requirements of accurate medicine is not disclosed correspondingly.
In view of the above, there is a need for an improved surgical instrument combination for the treatment of secondary deformity after an axillary approach breast augmentation surgery with the assistance of an endoscope, and for establishing a new approach for the treatment of secondary deformity after an augmentation breast surgery and a new surgery through the approach, which are helpful for more accurate and efficient surgery, reducing surgical trauma and bleeding, improving the handling control of surgical operation, reducing surgical complications, and improving surgical efficacy and patient satisfaction. An endoscope minimally invasive surgical instrument meeting the new requirements of accurate medicine is not reported at present.
Disclosure of Invention
Aiming at the defects in the prior art, the invention provides an endoscope minimally invasive surgical instrument which is used for improving the surgical instrument combination for treating the secondary deformity after the operation of the endoscopic approach breast augmentation operation, establishing a new approach for treating the secondary deformity after the operation of the breast augmentation operation and a new operation type of the approach, being beneficial to more accurately and more efficiently performing the operation, reducing the operation wound and the bleeding amount, improving the handle control of the operation, reducing the operation complications, improving the operation curative effect and the patient satisfaction degree and meeting the new requirements of accurate medicine.
In order to achieve the above purpose, the technical scheme adopted by the invention is as follows:
an endoscope minimally invasive surgical instrument comprises an electrotome electrocoagulator, an A-type separation stripper, a B-type separation stripper and an endoscope sheath;
the electric knife electrocoagulator comprises a handle, a long shaft pipe body and an electric knife head; one end of the long shaft pipe body is provided with an electric cutter head, and the other end of the long shaft pipe body is provided with a handle; the handle and the long shaft tube body are hollow structures, and the internal channels of the handle and the long shaft tube body are communicated; the handle comprises a finger clamping part and a palm holding part; the hand grasping and holding part is in a structure form of an inward concave arc surface, one end of the palm grasping and holding part is connected with the finger clamping part, and the other end is connected with the aspirator joint; the aspirator connector is connected with an aspirator; the electric knife head is L-shaped and has a flat tongue-shaped structure; the long shaft tube body comprises an inner surface layer and an outer surface layer; the inner surface layer is made of soft and tough materials; the outer surface layer is a high-temperature-resistant insulating heat-shrinkable tube;
the A-type separating stripper comprises an A-type stripping cutter head, an A-type stripping rod and an A-type stripping handle; one end of the A-shaped stripping rod is fixedly connected with a stripping cutter head, and the other end of the A-shaped stripping rod is fixedly connected with a stripping handle; the outline of the head end of the A-shaped stripping tool bit is in a sharper structure; the A-type stripping cutter head is of a flat tongue-shaped structure, the A-type stripping cutter head is provided with an arc surface protrusion, and the included angle between the stripping cutter head with the arc surface protrusion and the A-type stripping rod is 0-30 degrees; the working length of the A-shaped stripping cutter head is designed by referring to the required distance between the armpit access end and the lower fold level;
the B-type separating stripper comprises a B-type stripping cutter head, a B-type stripping rod and a B-type stripping handle; one end of the B-type stripping rod is fixedly connected with the B-type stripping cutter head, and the other end of the B-type stripping rod is fixedly connected with the B-type stripping handle; the working length of the B-type stripping cutter head is designed by referring to the required distance between the armpit access end and the lower fold level;
the endoscope sheath comprises a sheath body and a drag hook; the drag hook is arranged at one side of the sheath body; the distal end of the sheath body is provided with a tongue-shaped protrusion part, the inclination direction of the tongue-shaped protrusion part is opposite to the direction of the drag hook, and the width of the tongue-shaped protrusion part is reduced to 2.5cm; a rear supporting plate is arranged on one side of the tongue-shaped protruding part, and the width of the rear supporting plate is 2cm; the proximal end of the sheath body is provided with an endoscope fixing piece and a mushroom head device, and is provided with a negative pressure suction tube.
As a preferable technical scheme, the finger clamping part is provided with finger clamping surfaces, the finger clamping surfaces are straight surfaces, and the number of the finger clamping surfaces is two and the finger clamping surfaces are distributed on two sides of the finger clamping part.
As a preferable technical scheme, the electric knife head is made of medical stainless steel, and the model is 2CR13.
As a preferable technical scheme, the outer surface of the far end of the long shaft tube body of the L-shaped horizontal part of the electric knife head extends out by 2.5-3mm.
As a preferable technical scheme, the A-type stripping handle is of an asymptotic structural design, and the radial dimension specification from the stripping handle end to the stripping cutter end is gradually reduced.
As a preferable technical scheme, the A-shaped stripping rod is made of flexible materials, and the bending angle of the A-shaped stripping rod is 0-30 degrees.
As a preferable technical scheme, the B-type stripping cutter head is made of a ductile material; the B-type stripping rod is cylindrical; the B-type stripping handle is provided with a friction surface.
As a preferable technical scheme, one side of the finger clamping part is provided with a connecting pipe.
As a preferable technical scheme, the B-type stripping cutter head and the B-type stripping rod form an L shape, and the shape of the B-type stripping cutter head is like the batting part of a golf club.
The invention has the advantages that:
1. the endoscope minimally invasive surgical instrument improves the surgical instrument combination for secondary deformity treatment after the breast augmentation operation by the armpit under the assistance of the endoscope, establishes a new approach for secondary deformity treatment after the breast augmentation operation and a new operation mode through the approach, is favorable for more accurately and efficiently performing the operation, reduces operation wounds and bleeding, improves the handle control of the operation, reduces operation complications, improves the operation curative effect and the patient satisfaction, meets the new requirements of accurate medicine, can become a novel medical instrument, and has wide prospect in clinical popularization.
2. The electric knife electric coagulation device is arranged, is of a hollow structure design, is connected with the aspirator, can absorb electric coagulation smoke, keeps the visual field clear, and avoids serious shortage of surgical definition caused by that high-heat smoke fills the surgical field cavity.
3. The long shaft tube body in the electric knife electrocoagulator is made of flexible materials, and can be bent and has certain tension. The bending angle is between 0 and 80 degrees, the functional wall can not be broken and the lumen can not be compressed at random.
4. The electric knife head on the electric knife electrocoagulator is made of medical stainless steel, and the model is 2CR13; the electric knife head is L-shaped and has a flat tongue-shaped structure; the outer surface of the far end of the long shaft tube body of the L-shaped horizontal part of the electric knife head stretches out 2.5-3mm. The technical effect of this design scheme is: can easily separate the fibrous capsule in the area outside the chest, and relieve the blind spot of the operation in the area.
5. A type separation stripper and a type B separation stripper are arranged, in a use state, the near end of the fibrous bag reaches from the armpit access to the back surface of the fibrous bag after the highest point of the center of the fibrous bag, and the blind area range passing through the armpit access is arranged behind the highest point. Can separate and resect fibrous capsule tissues with different thickness, strength and toughness in the region, especially fibrous capsules which are embedded in pectoral large muscles, are seriously adhered and have great operation difficulty.
6. The A-shaped stripping handle is designed in an asymptotic manner, the radial dimension specification from the stripping handle end to the stripping cutter head end is gradually reduced, the force can be accurately transmitted from the handle end to the cutter head end, and the accurate control can be realized.
7. The profile of the head end of the A-shaped stripping tool bit is in a sharper structure, the A-shaped stripping tool bit is in a flat tongue-shaped structure, the A-shaped stripping tool bit is provided with cambered surface protrusions, and the included angle between the stripping tool bit with the cambered surface protrusions and the A-shaped stripping rod is 0-30 degrees; the working length of the A-shaped stripping cutter head is designed by referring to the required distance between the armpit access end and the lower fold level; the technical effect of the technical scheme is as follows: can be closely attached to the outer surface of the fibrous capsule, is separated between the fibrous capsule and pectoral large muscle, reduces tissue injury as much as possible, and can easily cross the highest point of the fibrous capsule to be integrated into a rear blind area. Greatly increases the effectiveness and safety of the surgical operation.
8. The working length of the B-type stripping cutter head is designed by referring to the required distance between the armpit access end and the lower fold level; the B-type stripping cutter head is made of a ductile material; the technical effect of this design scheme is: since the fibrous capsule containing the prosthesis is a spherical object, it has a certain or considerable tissue tension, resulting in difficulty in tissue separation. The design scheme enables the operator to cling to the outer surface of the fibrous capsule, separate the fibrous capsule from pectoral large muscle, reduce tissue injury as much as possible, and greatly increase the effectiveness and safety of the operation
9. The endoscope sheath comprises a sheath body and a drag hook, wherein the distal end of the sheath body is provided with a tongue-shaped protruding part, the inclination direction of the tongue-shaped protruding part is opposite to the direction of the drag hook, and the width of the tongue-shaped protruding part is reduced to 2.5cm. The technical effect of this design scheme is: the operation plane is good, the hierarchy is clear, the tissue structure is accurately grasped, and postoperative complications and postoperative adverse effects are reduced; a rear supporting plate is arranged on one side of the tongue-shaped protruding part, and the width of the rear supporting plate is 2cm; ensuring the stability and reliability thereof.
Drawings
FIG. 1 is a block diagram of an endoscopic minimally invasive surgical instrument of the present invention.
Fig. 2 is a schematic structural view of the electric knife electrocoagulator.
Fig. 3 is a schematic diagram of a cross-sectional structure of the long shaft tube body.
FIG. 4 is a schematic diagram of the structure of a type A separation stripper.
Fig. 5 is a schematic structural view of a type B separation stripper.
Fig. 6 is a schematic view of the structure of an endoscope sheath.
Detailed Description
The following detailed description of the invention provides specific embodiments with reference to the accompanying drawings.
Reference numerals and components referred to in the drawings are as follows:
1. electrotome electrocoagulator 11. Handle
111. Finger grip 112 palm grip
113. Aspirator tab 114 finger grip surface
115. Adapter 12. Long shaft tube body
121. Inner skin 122. Outer skin
13. Electric knife 2.A type separating stripper
A stripping blade 22.A stripping rod
Type a peel handle type 3.B separation peeler
Stripping blade 32.B type stripping rod
B-peel handle 331 friction surface
4. Endoscope sheath 41. Sheath body
42. Draw hook 43 tongue-like protrusion
44. Endoscope fixing piece and mushroom head device
For the sake of more clear description of the technical solution of the present invention, and the terms "a type" and "B type" are used in the technical solution, this is for the convenience of distinguishing technical features, and does not represent a specific shape.
Referring to fig. 1, fig. 1 is a block diagram of an endoscopic minimally invasive surgical instrument according to the present invention. An endoscope minimally invasive surgical instrument comprises an electric knife electrocoagulator 1, an A-type separation stripper 2, a B-type separation stripper 3 and an endoscope sheath 4.
Referring to fig. 2, fig. 2 is a schematic structural view of the electrotome electrocoagulator 1. The electric knife electrocoagulator 1 comprises a handle 11, a long shaft pipe body 12 and an electric knife head 13; one end of the long shaft tube body 12 is provided with an electric knife head 13, and the other end is provided with a handle 11; the handle 11 and the long shaft tube body 12 are hollow structures, and the internal channels of the handle and the long shaft tube body are communicated. The handle 11 comprises a finger holding part 111 and a palm holding part 112; the palm holding part 112 is in a structure form of an inward concave arc surface, one end of the palm holding part 112 is connected with the finger holding part 111, and the other end is connected with the aspirator joint 113; the finger clamping part 111 is provided with finger clamping surfaces 114, the finger clamping surfaces 114 are straight surfaces, and the number of the finger clamping surfaces 114 is two and the two finger clamping surfaces 114 are distributed on two sides of the finger clamping part 111; the aspirator joint 113 is connected with an aspirator; one side of the finger clamping part 111 is provided with a connecting pipe 115; the electric knife head 13 is made of medical stainless steel, and the model is 2CR13; the electric knife head 13 is L-shaped and has a flat tongue-shaped structure; the outer surface of the far end of the long shaft tube body of the L-shaped horizontal part of the electric knife head stretches out 2.5-3mm.
Referring to fig. 3, fig. 3 is a schematic cross-sectional structure of the long shaft tube. The long shaft tube body 12 comprises an inner surface layer 121 and an outer surface layer 122; the inner surface layer 121 is made of soft and tough materials; the outer surface layer 122 is a high temperature resistant insulating heat shrink tube.
Referring to fig. 4, fig. 4 is a schematic structural diagram of a type a separation stripper 2. The A-type separating stripper 2 comprises an A-type stripping cutter head 21, an A-type stripping rod 22 and an A-type stripping handle 23; one end of the A-shaped stripping rod is fixedly connected with a stripping cutter head, and the other end of the A-shaped stripping rod is fixedly connected with a stripping handle 11; the A-shaped stripping handle 23 is of an asymptotic structural design, and the radial dimension specification from the end of the stripping handle 11 to the end of the stripping cutter is gradually reduced; the outline of the head end of the A-shaped stripping cutter head 21 is in a sharper structure; the A-type stripping cutter head 21 is of a flat tongue-shaped structure, the A-type stripping cutter head 21 is provided with a cambered surface protrusion, and an included angle between the cambered surface protrusion and the A-type stripping rod 22 is 0-30 degrees; the working length of the a-shaped stripping blade 21 is designed with reference to the distance required between the armpit access end and the lower fold level; the A-shaped stripping rod 22 is made of flexible materials, and an included angle between the stripping cutter head 21 with cambered surface protrusions and the A-shaped stripping rod 22 is 0-30 degrees.
Referring to fig. 5, fig. 5 is a schematic structural view of the type B separation stripper 3. The B-type separating stripper 3 comprises a B-type stripping cutter head 31, a B-type stripping rod 32 and a B-type stripping handle 33; one end of the B-type stripping rod 32 is fixedly connected with the B-type stripping cutter head 31, and the other end is fixedly connected with the B-type stripping handle 33; the B-type stripping cutter head 31 and the B-type stripping rod 32 form an L shape, and the shape of the B-type stripping cutter head 31 is like the batting part of a golf club; the working length of the B-shaped stripping blade 31 is designed with reference to the distance required between the armpit access end and the lower fold level; the B-type stripping cutter head 31 is made of a ductile material; the B-shaped stripping rod 32 is cylindrical; the B-shaped peeling handle 33 is provided with a friction surface 331.
Referring to fig. 6, fig. 6 is a schematic view of the structure of the endoscope sheath 4. The endoscope sheath 4 comprises a sheath body 41 and a draw hook 42; the drag hook 42 is arranged at one side of the sheath 41; the distal end of the sheath 41 is provided with a tongue-shaped protrusion 43, the inclination direction of the tongue-shaped protrusion 43 is opposite to the direction of the drag hook 42, and the width of the tongue-shaped protrusion 43 is reduced to 2.5cm; a rear supporting plate is arranged on one side of the tongue-shaped protruding part 43, and the width of the rear supporting plate is 2cm; the proximal end of the sheath 41 is provided with an endoscope fixing member and a mushroom head device 44, and is attached with a negative pressure suction tube.
It should be noted that: the electrotome electrocoagulator 1 is of a hollow structure design, and the electrotome electrocoagulator 1 is connected with an aspirator, so that the electrocoagulation smog can be absorbed, the visual field is kept clear, and the serious defect of operation definition caused by the fact that high-heat smog fills the cavity of the surgical field is avoided.
The electric knife electrocoagulator 1 is provided with an insulating heat shrinkage tube, which can protect human tissues and avoid damage caused by burning of high-temperature gas and metal on important tissues and organs of the human body. And at the same time, the service life of the instrument is also prevented from being influenced. .
The long shaft tube body 12 in the electrotome electrocoagulator 1 is made of flexible materials, and can be bent and has certain tension. The bending angle is between 0 and 80 degrees, the tube wall can not be broken and the tube cavity can not be compressed at random.
The electric knife head 13 on the electric knife electrocoagulator 1 is made of medical stainless steel, and the model is 2CR13; the electric knife head 13 is L-shaped and has a flat tongue-shaped structure; the L-shaped horizontal part of the electric knife head 13 extends out of the outer surface of the far end of the long shaft tube body 12 by 2.5-3mm. The technical effect of this design scheme is: can easily separate the fibrous capsule in the area outside the chest, and relieve the blind spot of the operation in the area.
The handle 11 of the electrotome electrocoagulator 1 comprises a finger clamping part 111 and a palm clamping part 112; the palm gripping portion 112 is of a concave arc-shaped surface structure, one end of the palm gripping portion 112 is connected with the finger gripping portion 111, the finger gripping portion 111 is provided with the finger gripping surface 114, the finger gripping surface 114 is a straight surface, and the number of the finger gripping surfaces 114 is two, so that medical staff cannot fall off easily during operation, the holding force is good, the operability is good, and the accuracy is good.
In the use state, the A-type separation stripper 2 and the B-type separation stripper 3 reach the proximal end of the fibrous bag from the armpit access to the back surface of the fibrous bag after the highest point of the center of the fibrous bag, and the blind area range passing through the armpit access is arranged behind the highest point. Can realize the separation and excision of tissues of various different thicknesses, intensities and toughness fiber capsules in the region, especially aims at the embedding of the fiber capsules and pectoral large muscles, is seriously adhered, has higher operation difficulty and can obtain better operation effect.
The A-type separation stripper 2 comprises an A-type stripping cutter head 21, an A-type stripping rod 22 and an A-type stripping handle 23, wherein the A-type stripping handle 23 is of an asymptotic design, the radial dimension specification from the end of the stripping handle 11 to the end of the stripping cutter head is gradually reduced, the force can be accurately transmitted from the end of the handle 11 to the end of the cutter head, and the accurate control can be realized.
The profile of the head end of the A-shaped stripping tool bit 21 is in a sharper structure, the A-shaped stripping tool bit 21 is in a flat tongue-shaped structure, the A-shaped stripping tool bit 21 is provided with a cambered surface protrusion, and the included angle between the cambered surface protrusion and the A-shaped stripping rod 22 is 0-30 degrees; the working length of the a-shaped stripping blade 21 is designed with reference to the distance required between the armpit access end and the lower fold level; the technical effect of the technical scheme is as follows: the fiber bag can be closely attached to the outer surface of the fiber bag, the fiber bag is separated between pectoral major muscles, the tissue injury is reduced as much as possible, and the highest point of the fiber bag can be easily crossed and integrated into a rear blind area. Greatly increases the effectiveness and safety of the surgical operation.
The type B separating stripper 3 comprises a type B stripping cutter head 31, a type B stripping rod 32 and a type B stripping handle 33, wherein the type B stripping cutter head 31 is shaped like a batting part of a golf club; the working length of the B-shaped stripping blade 31 is designed with reference to the distance required between the armpit access end and the lower fold level; the B-type stripping cutter head 31 is made of a ductile material; the technical effect of this design scheme is: since the fibrous capsule containing the prosthesis is a spherical object with a certain or considerable tissue tension, the control of the delamination level is difficult. The designed surgical instrument is favorable for separation between the fibrous capsule and pectoral large muscle, can be peeled off by being clung to the outer surface of the fibrous capsule, reduces tissue damage as much as possible, and can be easily integrated into a rear blind area by crossing the highest point of the fibrous capsule. Greatly increases the effectiveness and safety of the surgical operation.
The endoscope sheath 4 comprises a sheath body 41 and a draw hook 42, wherein a tongue-shaped protrusion 43 is arranged at the distal end of the sheath body 41, the inclination direction of the tongue-shaped protrusion 43 is opposite to the direction of the draw hook 42, and the width of the tongue-shaped protrusion 43 is reduced to 2.5cm. The technical effect of this design scheme is: the operation comfort level is good, the visual field is not blocked, the hierarchy is clear, the tissue structure is accurately grasped, and postoperative complications and adverse effects are reduced.
A rear supporting plate is arranged on one side of the tongue-shaped protruding part 43, and the width of the rear supporting plate is 2cm; ensuring the stability and reliability thereof.
The endoscope minimally invasive surgical instrument improves the surgical instrument combination for secondary deformity treatment after the breast augmentation operation by the armpit under the assistance of the endoscope, establishes a new approach for secondary deformity treatment after the breast augmentation operation and a new operation type through the approach, is favorable for more accurately and efficiently performing the operation, reduces the operation wound and the bleeding amount, improves the handle control of the operation, reduces the operation complications, improves the operation curative effect and the patient satisfaction, and meets the new requirement of accurate medicine. Can become a novel medical instrument and has wide prospect in clinical popularization; the electric knife electric condenser 1 is arranged, the electric knife electric condenser 1 is of a hollow structure design, and an aspirator is connected to the electric knife electric condenser 1, so that electric coagulation smoke can be absorbed, the visual field is kept clear, and the serious defect of operation definition caused by the fact that high-heat smoke fills an operation field cavity is avoided; the long shaft tube body 12 in the electrotome electrocoagulator 1 is made of flexible materials, and can be bent and has certain tension. The bending angle is between 0 and 80 degrees, the functional wall can not be broken and the lumen can not be compressed while the angle can be formed randomly; the electric knife head 13 on the electric knife electrocoagulator 1 is made of medical stainless steel, and the model is 2CR13; the electric knife head 13 is L-shaped and has a flat tongue-shaped structure; the distal end of the electric knife head 13 extends outwards by 2mm relative to the outer surface of the long shaft tube body 12. The technical effect of this design scheme is: the fibrous bag of the near chest outer side area can be easily separated, and the blind spot of the operation in the area is relieved; a type separation stripper 2 and a type B separation stripper 3 are provided, and in the use state, the near end of the fibrous bag reaches from the armpit access to the back surface behind the highest point of the center of the fibrous bag, and the blind area range passing through the armpit access is arranged behind the highest point. A variety of different thicknesses, strengths and types of tissue separation and ablation of the capsule of tenacity fibers can be achieved in this region. Especially, the fibrous sac is embedded with pectoral large muscle, the adhesion is too heavy, the operation difficulty is high, and the ideal effect can be obtained; the A-shaped stripping handle 23 is of an asymptotic design, and the radial dimension specification from the end of the stripping handle 11 to the end of the stripping cutter is gradually reduced, so that the force can be accurately transmitted from the end of the handle 11 to the end of the cutter head, and the accurate control can be realized; the profile of the head end of the A-shaped stripping tool bit 21 is in a sharper structure, the A-shaped stripping tool bit 21 is in a flat tongue-shaped structure, the A-shaped stripping tool bit 21 is provided with a cambered surface protrusion, and the included angle between the cambered surface protrusion and the A-shaped stripping rod 22 is 0-30 degrees; the working length of the a-shaped stripping blade 21 is designed with reference to the required working distance between the armpit access end and the lower fold level; the technical effect of the technical scheme is as follows: the fiber bag can be closely attached to the outer surface of the fiber bag, the fiber bag is separated between pectoral major muscles, the tissue injury is reduced as much as possible, and the highest point of the fiber bag can be easily crossed and integrated into a rear blind area. Greatly increases the effectiveness and safety of the operation; the working length of the B-type stripping blade 31 is designed with reference to the required working distance between the level of the lower fold reached through the armpit access end; the B-type stripping cutter head 31 is made of a ductile material; the technical effect of this design scheme is: can be closely attached to the outer surface of the fibrous capsule, is separated between the fibrous capsule and pectoral large muscle, reduces tissue injury as much as possible, and can easily cross the highest point of the fibrous capsule to be integrated into a rear blind area. Greatly increases the effectiveness and safety of the surgical operation. At the same time, the operation difficulty caused by the prosthesis-containing fibrous capsule with certain or quite large tissue tension can be overcome; the endoscope sheath 4 comprises a sheath body 41 and a drag hook 42, wherein a tongue-shaped protrusion 43 is arranged at the distal end of the sheath body 41, the inclination direction of the tongue-shaped protrusion 43 is opposite to the direction of the drag hook 42, and the width of the tongue-shaped protrusion 43 is reduced to 2.5cm. The technical effect of this design scheme is: the operation comfort level is good, the visual field is not blocked, the hierarchy is clear, the tissue structure is accurately grasped, and the postoperative complications and adverse effects are reduced; a rear supporting plate is arranged on one side of the tongue-shaped protrusion 43, and the width of the rear supporting plate is 2cm; ensuring the stability and reliability thereof.
The foregoing is merely a preferred embodiment of the present invention, and it should be noted that modifications and additions may be made to those skilled in the art without departing from the method of the present invention, which modifications and additions are also to be considered as within the scope of the present invention.

Claims (7)

1. An endoscope minimally invasive surgical instrument for treating secondary deformity after breast augmentation operation through armpit access, which is characterized by comprising an electrotome electrocoagulator, an A-type separation stripper, a B-type separation stripper and an endoscope sheath;
the electric knife electrocoagulator comprises a handle, a long shaft pipe body and an electric knife head; one end of the long shaft pipe body is provided with an electric cutter head, and the other end of the long shaft pipe body is provided with a handle; the handle and the long shaft tube body are hollow structures, and the internal channels of the handle and the long shaft tube body are communicated; the handle comprises a finger clamping part and a palm holding part; the hand grasping and holding part is in a structure form of an inward concave arc surface, one end of the palm grasping and holding part is connected with the finger clamping part, and the other end is connected with the aspirator joint; the aspirator connector is connected with an aspirator; the electric knife head is L-shaped and has a flat tongue-shaped structure; the long shaft tube body comprises an inner surface layer and an outer surface layer; the inner surface layer is made of soft and tough materials; the outer surface layer is a high-temperature-resistant insulating heat-shrinkable tube;
the A-type separating stripper comprises an A-type stripping cutter head, an A-type stripping rod and an A-type stripping handle; one end of the A-shaped stripping rod is fixedly connected with the stripping cutter head, and the other end of the A-shaped stripping rod is fixedly connected with the stripping handle; the outline of the head end of the A-shaped stripping tool bit is in a sharper structure; the A-type stripping cutter head is of a flat tongue-shaped structure, the A-type stripping cutter head is provided with an arc surface protrusion, and the included angle between the stripping cutter head with the arc surface protrusion and the A-type stripping rod is 0-30 degrees; the working length of the A-shaped stripping cutter head is designed by referring to the required distance between the armpit access end and the lower fold level;
the B-type separating stripper comprises a B-type stripping cutter head, a B-type stripping rod and a B-type stripping handle; one end of the B-type stripping rod is fixedly connected with the B-type stripping cutter head, and the other end of the B-type stripping rod is fixedly connected with the B-type stripping handle; the working length of the B-type stripping cutter head is designed by referring to the required distance between the armpit access end and the lower fold level;
the endoscope sheath comprises a sheath body and a drag hook; the drag hook is arranged at one side of the sheath body; the distal end of the sheath body is provided with a tongue-shaped protrusion part, the inclination direction of the tongue-shaped protrusion part is opposite to the direction of the drag hook, and the width of the tongue-shaped protrusion part is reduced to 2.5cm; a rear supporting plate is arranged on one side of the tongue-shaped protruding part, and the width of the rear supporting plate is 2cm; an endoscope fixing piece and a mushroom head device are arranged at the proximal end of the sheath body, and a negative pressure suction tube is attached,
the outer surface of the far end of the long shaft tube body of the L-shaped horizontal part of the electric tool bit extends out by 2.5-3mm, the B-shaped stripping tool bit is made of ductile materials, the B-shaped stripping tool bit and the B-shaped stripping rod form an L shape, and the shape of the B-shaped stripping tool bit is like the batting part of a golf club.
2. The minimally invasive surgical endoscope instrument of claim 1, wherein the finger grip portion is provided with finger grip surfaces, the finger grip surfaces are straight surfaces, and the number of finger grip surfaces is two, and the finger grip surfaces are distributed on two sides of the finger grip portion.
3. The endoscopic minimally invasive surgical instrument of claim 1 wherein the electrical blade is fabricated from medical stainless steel, model 2CR13.
4. The endoscopic minimally invasive surgical instrument of claim 1 wherein the a-peel handle is of an asymptotic design.
5. The minimally invasive endoscopic surgical instrument according to claim 1, wherein the a-shaped peel rod is made of a flexible material, and the a-shaped peel rod itself is bendable through an angle ranging from 0 degrees to 30 degrees.
6. The endoscopic minimally invasive surgical instrument of claim 1 wherein the B-shaped peel bar is cylindrical; the B-type stripping handle is provided with a friction surface.
7. The endoscopic minimally invasive surgical instrument according to claim 1, wherein one side of the finger grip is provided with a nipple.
CN201810374115.5A 2018-04-24 2018-04-24 Endoscope minimally invasive surgical instrument Active CN108338834B (en)

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