CN110051423A - A kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis - Google Patents

A kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis Download PDF

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Publication number
CN110051423A
CN110051423A CN201910469263.XA CN201910469263A CN110051423A CN 110051423 A CN110051423 A CN 110051423A CN 201910469263 A CN201910469263 A CN 201910469263A CN 110051423 A CN110051423 A CN 110051423A
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CN
China
Prior art keywords
chisel
pylorus
head
coagulation
bar
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
CN201910469263.XA
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Chinese (zh)
Inventor
於林军
罗春芬
苏宝利
单王永
黎胜苗
宋代强
刘征吉
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Taizhou Enze Medical Center Group
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Taizhou Enze Medical Center Group
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Publication date
Application filed by Taizhou Enze Medical Center Group filed Critical Taizhou Enze Medical Center Group
Priority to CN201910469263.XA priority Critical patent/CN110051423A/en
Publication of CN110051423A publication Critical patent/CN110051423A/en
Pending legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00482—Digestive system
    • A61B2018/00494—Stomach, intestines or bowel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00607—Coagulation and cutting with the same instrument

Abstract

The present invention provides a kind of pylorus coagulation chisels for treating congenital hypertrophic pylorostenosis, it is dug including pylorus, electric knife and conductor wire, described conductor wire one end with electric knife to be electrically connected, the other end with pylorus chisel to be electrically connected, the pylorus chisel includes chisel grip component and chisel bar assembly, the chisel grip component includes chisel grip ontology, plug and conductive core, the chisel bar assembly includes chisel head, dig bar and insulating layer, the insulating layer is to be covered in the chisel head and chisel bar outer surface, the chisel head outer end portion does not cover the insulating layer, described chisel bar one end is electrically connected with the conductive core, the chisel bar other end is connect with the chisel head.The present invention passes through optimization design, pylorus chisel structure is combined with electric knife, so that pylorus chisel realizes fulguration cutting, electric coagulation hemostasis, the lossless separation of chisel head, to reduce the replacement of medical instrument in art, so as to shorten operating time, success rate of operation and therapeutic effect are improved.

Description

A kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis
Technical field
The present invention relates to technical field of medical equipment, in particular to a kind of pylorus electricity for treating congenital hypertrophic pylorostenosis Solidifying chisel.
Background technique
Congenital hypertrophic pyloric stenosis is newborn and the common digestive malformation of young infant.Its basic treatment is that row is deep and remote Knocker myotomy.Traditional operation is to make a kerf in upper right abdomen, pylorus is proposed abdominal cavity layman operative treatment, but its scar is bright It is aobvious, unsightly.Alain in 1991 etc. reports pyloromyotomy under three pores laparoscope for the first time.Three pores abdominal cavity at present Mirror downlink pyloromyotomy has proved to be effective, safe, more more attractive than Tradtional laparotomy.As stomach wall is without scar The rise of trace operation, is reported through pyloromyotomy is more and more under the laparoscope of navel list position, and operation utilizes pylorus knife more It carries out, but due to through under the operation of navel list position, pylorus knife and camera lens are intraperitoneal almost parallel, and cutter head is difficult to look at straight, in addition Pylorus knife causes visual area unclear in this way without hemostatic function, and pylorus mucous membrane is be easy to cause to perforate.
For this purpose, the present inventor 09 month 2016 No. 23 applied it is a kind of for treat hypertrophic pylorostenosis pylorus dig Patent, notification number CN206603798U, disclose it is a kind of for treat hypertrophic pylorostenosis pylorus dig, including chisel Handle and chisel bar, the chisel bar front end are equipped with a chisel head, and the chisel head top is equipped with a passivity cambered surface, the passivity cambered surface front and back two Side is respectively equipped with an inclined surface, and the passivity cambered surface is respectively arranged on the left side and the right side an arc-shaped transitional surface, the passivity cambered surface with incline Inclined-plane is in arc transition, and the passivity cambered surface and the arc-shaped transitional surface are in arc transition, and the passivity cambered surface thickness is 0.3mm~0.5mm, the passivity cambered surface width dimensions are 3.0mm~4.0mm, the inclination angle of the inclined surface Relative vertical line Degree is 2 °~8 °.The present invention substitutes traditional pylorus knife by optimization design, using pylorus chisel, shortens the incision of pylorus circular muscle Art reduces intraoperative blood loss, increases surgical field of view clarity, reduces complication probability of happening, has more efficient, hand The feature that art is safer, surgical effect is more preferable.
The present inventor is children surgical department doctor, and long campaigns have clinical position extremely abundant in children's surgical operation Experience gradually finds although former pylorus boring tool may be implemented preferable surgical effect during continuing on, but its because Product itself cannot achieve cutting function, remaining medical instrument needed to be assisted there is also some using limitation, for this purpose, Inventor, which imagines, is combined it with traditional electric knife, improves and tests by a large amount of structures, and gradual perfection simultaneously passes through test, so After be transferred to clinical test application, it is final to obtain pylorus coagulation chisel so that treat congenital hypertrophic pylorostenosis operation it is more convenient, Effectively.
Summary of the invention
The present invention solves above-mentioned deficiency, provides a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis, makes Fulguration cutting, the lossless separation of electric coagulation hemostasis, chisel head are combined as a whole, shorten operating time, improve therapeutic effect.
Technical problem solved by the invention can be realized using following technical scheme:
A kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis, including pylorus chisel, electric knife and conductor wire, it is described to lead Electric wire one end with electric knife to be electrically connected, and for the other end to be electrically connected with pylorus chisel, the pylorus chisel includes chisel grip component With chisel bar assembly, the chisel grip component includes chisel grip ontology, plug and conductive core, and the chisel bar assembly includes chisel head, chisel Bar and insulating layer, the insulating layer do not cover to be covered in the chisel head and chisel bar outer surface, the chisel head outer end portion The insulating layer, described chisel bar one end are electrically connected with the conductive core, and the chisel bar other end is connect with the chisel head.
The chisel grip ontology includes front hand grip and back handle, and the front hand grip and the back handle are pacified by the way that socket joint is fixed Dress, the front hand grip is interior to be equipped with chisel rod cavity and preceding interior core cavity, and core cavity and plug cavity in afterwards, the chisel bar are equipped in the back handle Chamber, preceding interior core cavity, rear interior core cavity and plug cavity are successively head and the tail perforation docking.
The back handle outer surface is equipped with anti-skidding dimpled grain.
The chisel rod cavity digs bar to installation section, and the preceding interior core cavity and rear inner core are intracavitary to install conductive core, The plug cavity is located at rear end, and to install the plug, the plug is to dock cooperation with conductor wire.
The insulating layer is isolating shrinkable set.
The insulating layer material uses PTFE.
The length dimension that the chisel head does not cover the insulating layer is not more than the 1/2 of the chisel head overall length dimension.
The length dimension that the chisel head does not cover the insulating layer is the 1/4 ~ 1/3 of the chisel head overall length dimension.
Chisel head outermost end is equipped with passivity cambered surface.
The chisel head is made of 304 stainless steels or 316 stainless steels.
The present invention by having the following beneficial effects: that by optimization design, pylorus is dug by the present invention compared with prior art Structure is combined with electric knife, so that pylorus chisel realizes fulguration cutting, electric coagulation hemostasis, the lossless separation of chisel head, to reduce in art The replacement of medical instrument improves success rate of operation and therapeutic effect so as to shorten operating time.
The features of the present invention sees the detailed description of the drawings of the present case and following preferable embodiment and obtains clearly Solution.
Detailed description of the invention
Fig. 1 is overall structure diagram of the invention；
Fig. 2 is that pylorus of the invention digs schematic cross-sectional view；
Fig. 3 is chisel head and insulation layer structure schematic diagram of the invention；
Fig. 4 is chisel bar and insulation layer structure schematic diagram of the invention；
Fig. 5 is chisel bar assembly side structure schematic view of the invention；
Fig. 6 is chisel bar assembly overlooking structure diagram of the invention；
Fig. 7 is front hand grip schematic cross-sectional view of the invention；
Fig. 8 is back handle schematic cross-sectional view of the invention；
Wherein, 1, pylorus chisel；11, bar assembly is dug；111, chisel head；112, bar is dug；113, insulating layer；114, passivity cambered surface；12, it digs Handle component；121, front hand grip；1211, rod cavity is dug；1212, preceding interior core cavity；122, back handle；1221, rear interior core cavity；1222, prevent Sliding dimpled grain；1223, plug cavity；123, conductive core；124, plug；2, conductor wire；3, electric knife.
Specific embodiment
In order to be easy to understand the technical means, the creative features, the aims and the efficiencies achieved by the present invention, tie below Conjunction is specifically illustrating, and the present invention is further explained.
As shown in Figures 1 to 8, a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis provided by the invention, packet Include pylorus chisel 1, electric knife 3 and conductor wire 2,2 one end of conductor wire be electrically connected with electric knife 3, the other end to imprison 1 electrical connection of door chisel, pylorus chisel 1 include chisel grip component 12 and chisel bar assembly 11, and chisel grip component 12 includes chisel grip ontology, plug 124 and conductive core 123, chisel bar assembly 11 includes chisel head 111, chisel bar 112 and insulating layer 113, and insulating layer 113 is to be covered in Chisel head 111 and chisel 112 outer surface of bar, 111 outer end portion of chisel head do not cover insulating layer 113, dig 112 one end of bar and conductive core 123 electrical connections, chisel 112 other end of bar are connect with chisel head 111.
In the present embodiment, electric knife 3 is then selected commonly uses electric knife equipment in the prior art, such as Medtronic electric knife, Ke Favour electric knife etc., conductor wire 2 are similarly and commonly use matched conductor wire in the prior art, and one end is to the plug with electric knife Docking, the other end are docked with plug, realize high-frequency high-voltage current input；In the present embodiment, pass through advantageous embodiment, combined treatment The modus operandi of congenital hypertrophic pylorostenosis, as long as required function has fulguration cutting, electric coagulation hemostasis, therefore What is generally selected in monopolar mode, is cut with a complete circuit and solidified structure using monopolar mode, the circuit by Radio-frequency generator, patient's pole plate, conductor wire, conductive core, chisel bar and chisel head composition in electric knife, wherein chisel head is equivalent to Heat electrode.
Chisel grip ontology includes front hand grip 121 and back handle 122 in the present embodiment, and front hand grip 121 and back handle 122 are by holding It inserts and is fixedly mounted, chisel rod cavity 1211 and preceding interior core cavity 1212 are equipped in front hand grip 121, is equipped with core cavity in rear in back handle 122 1221 and plug cavity 1223, chisel rod cavity 1211, preceding interior core cavity 1212, it is rear in core cavity 1221 and plug cavity 1223 be successively to pass through from beginning to end Logical docking；Chisel rod cavity 1211 digs bar 112 to installation section, and preceding interior core cavity 1212 and rear interior core cavity 1221 are interior to install conduction Inner core 123, plug cavity 1223 are located at rear end, and to install plug 124, plug 124 is matched to dock with conductor wire 2 It closes；Optimization uses 122 structure of front hand grip 121 and back handle, facilitates plug 124, conductive core 123 and the docking for digging bar 112 Installation, while front hand grip 121 and back handle 122 are all made of insulating materials and are made.
In the present embodiment, 122 outer surface of back handle is equipped with anti-skidding dimpled grain 1222, the stabilization held when facilitating surgical Property.
In the present embodiment, insulating layer 113 is isolating shrinkable set, and 113 material of insulating layer uses PTFE, avoids conductive interference.
In the present embodiment, chisel head 111 does not cover the length dimension of the insulating layer 113 no more than 111 total length ruler of chisel head Very little 1/2；Preferably, chisel head 111 do not cover the insulating layer 113 length dimension be 111 overall length dimension of chisel head 1/10 ~ 1/3, the non-overlay length of usual chisel head 111 is 4mm ~ 6mm.
In the present embodiment, 111 outermost end of chisel head is equipped with passivity cambered surface 114.
In the present embodiment, chisel head 111 is made of 304 stainless steels or 316 stainless steels.
In above structure, wherein 111 position specific size of chisel head, structure design are referred to notification number and are Disclosed pylorus chisel in CN206603798U.
Wherein, in the present embodiment, using the method for pylorus coagulation chisel are as follows: pylorus chisel, electric knife and conductor wire is conductive Connection starts electric knife, so that the chisel head position of pylorus chisel has fulguration cutting function, to the placenta percreta for needing cutting part It realizes cutting, after completing cutting, closes electric knife using chisel head position passivity structure itself and directly dig into pylorus muscle layer (no Damage mucous membrane), and rotated, expand muscle layer Separation, then pylorus elastic separating plier is inserted into, separate pylorus muscle layer, bulging is viscous Film.
According to above structure, clinical operation related data involved in the present invention: the affiliated department of the present inventor is received by statistics The congenital hypertrophic pyloric stenosis infant using pylorus in the prior art chisel treatment controlled is 21 total, using pylorus coagulation Infant 12 of operative treatment are dug, are operated by the same doctor.Case is included in standard: having non-bilious vomiting history, examines through B ultrasound Pyloric muscle thickness degree > 4 mm are looked into, upper digestive tract lipiodol angiography shows that pylorus pipeline sample becomes or do not develop with delayed gastric emptying, prompts deep and remote The obstruction of door portion.
In above-mentioned case, because traditional pylorus chisel application time is more long, therefore use case is more, and pylorus coagulation chisel is because making Relatively late with the time, case is relatively fewer.
Pylorus chisel group 21, pylorus coagulation dig 12.Pylorus chisel group male 13, female 8, age 17d~72d, weight 2.3kd~4.1kg.Pylorus coagulation chisel group male 8, female 4, age 15d~72d, weight 2.5kg~4.5kg.Two groups of infants Not, the difference of age, weight, preoperative albumin and total protein is not statistically significant (equal P > 0.05).When two groups of infants are admitted to hospital There are malnutrition, water and electrolyte disorder, disturbance of acid-base balance etc. to a certain degree, it is preoperative to be controlled by stringent fluid infusion and nutrition It treats, makes infant tolerance operation.
Pylorus chisel operation method in the prior art is with reference to disclosure in CN206603798U.
The preoperative parameter list of infant in two kinds of comparative examples
Two groups of pyloromyotomy observation index comparison sheets
Group Operating time (min) The tearing of pylorus serous coat Postoperative eating time (h) Post-operative hospital stay (d) Postoperative vomiting incidence Postoperative pyrexia incidence
Pylorus chisel group (n=21) 24.2±3.9 1(4.8%) 11.7±2.4 3.7±1.2 15(71.4%) 3(14.3%)
Pylorus coagulation chisel group (n=12) 21.8±2.3 0 11.4±2.7 3.1±1.1 7(58.3%) 1(8.3%)
T(χ2) value t=2.223 χ2=1.914 t=0.319 t=1.458 χ2=0.457 χ2=1.353
P value 0.034 0.167 0.753 0.157 0.833 0.245
Compared with pylorus chisel group, pylorus coagulation chisel group operating time is short, few intercurrent disease, postoperative eating time, post-operative hospital stay, Postoperative vomiting incidence, postoperative pyrexia (body temperature > 38.5 DEG C) incidence relatively have no obvious statistical difference, see in above-mentioned table and join Number result.There is the tearing of pylorus placenta percreta in pylorus chisel group 1.2 groups do not occur infection of incisional wound, incisional hernia.Equal follow-up 1 year, suffer from Youngster normally feeds, and growth and development is good (height, weight are similar with child of the same age), and umbilical notch cut is without clear scar.
Operative treatment is carried out in conclusion digging using pylorus coagulation, electrocoagulation system and pylorus chisel are combined, cutting is played Stop blooding and chisel the effect of pylorus muscle layer, reduces instrument disengaging and time that Trocar is replaced repeatedly, shorten operating time, and The operation that can carry out electric coagulation hemostasis at the first time, ensure that surgical quality and effect.
The present invention is combined by optimization design, by pylorus chisel structure with electric knife, so that pylorus chisel realization fulguration cutting, The lossless separation of electric coagulation hemostasis, chisel head, so as to shorten operating time, improves hand to reduce the replacement of medical instrument in art Art success rate and therapeutic effect.
As known by the technical knowledge, the present invention can pass through the embodiment party of other essence without departing from its spirit or essential feature Case is realized.Therefore, embodiment disclosed above, in all respects are merely illustrative, not the only.Institute Have within the scope of the present invention or is included in the invention in the change being equal in the scope of the present invention.

Claims (10)

1. a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis, including pylorus chisel (1), electric knife (3) and conduction Line (2), it is characterised in that: described conductor wire (2) one end with electric knife (3) to be electrically connected, and the other end with pylorus to dig (1) it is electrically connected, the pylorus chisel (1) includes chisel grip component (12) and chisel bar assembly (11), and the chisel grip component (12) includes chisel Handle ontology, plug (124) and conductive core (123), the chisel bar assembly (11) include chisel head (111), chisel bar (112) and exhausted Edge layer (113), the insulating layer (113) is to be covered in the chisel head (111) and chisel bar (112) outer surface, the chisel head (111) outer end portion does not cover the insulating layer (113), and the chisel bar (112) one end is electrically connected with the conductive core (123) It connects, chisel bar (112) other end is connect with the chisel head (111).
2. a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis according to claim 1, it is characterised in that: institute Stating chisel grip ontology includes front hand grip (121) and back handle (122), and the front hand grip (121) and the back handle (122) are by holding It inserts and is fixedly mounted, chisel rod cavity (1211) and preceding interior core cavity (1212), the back handle (122) are equipped in the front hand grip (121) It is interior to be equipped with core cavity (1221) and plug cavity (1223) in rear, the chisel rod cavity (1211), preceding interior core cavity (1212), rear interior core cavity (1221) and plug cavity (1223) is successively head and the tail perforation docking.
3. a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis according to claim 2, it is characterised in that: institute Back handle (122) outer surface is stated equipped with anti-skidding dimpled grain (1222).
4. a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis according to claim 2, it is characterised in that: institute State chisel rod cavity (1211) and dig bar (112) to installation section, it is described before in core cavity (1212) and it is rear in core cavity (1221) it is interior to It installs conductive core (123), the plug cavity (1223) is located at rear end, to install the plug (124), the electric mortiser Head (124) is to dock cooperation with conductor wire (2).
5. a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis according to claim 1, it is characterised in that: institute Stating insulating layer (113) is isolating shrinkable set.
6. a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis according to claim 5, it is characterised in that: institute Insulating layer (113) material is stated using PTFE.
7. a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis according to claim 1, it is characterised in that: institute State 1/2 of length dimension no more than the chisel head (111) overall length dimension that chisel head (111) does not cover the insulating layer (113).
8. a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis according to claim 7, it is characterised in that: institute Stating chisel head (111) and not covering the length dimension of the insulating layer (113) is the 1/4 ~ 1/3 of the chisel head (111) overall length dimension.
9. a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis as claimed in any of claims 1 to 8, It is characterized by: chisel head (111) outermost end is equipped with passivity cambered surface.
10. a kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis according to claim 9, it is characterised in that: The chisel head (111) is made of 304 stainless steels or 316 stainless steels.
CN201910469263.XA 2019-05-31 2019-05-31 A kind of pylorus coagulation chisel for treating congenital hypertrophic pylorostenosis Pending CN110051423A (en)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN200948169Y (en) * 2006-09-08 2007-09-19 上海交通大学医学院附属新华医院 Fulguration knife for cutting muscle layer of celioscope pylorus
CN202699275U (en) * 2012-05-17 2013-01-30 杭州安杰思医学科技有限公司 High frequency cutting knife
CN206603798U (en) * 2016-09-23 2017-11-03 於林军 A kind of pylorus chisel for being used to treat hypertrophic pylorostenosis
CN210494220U (en) * 2019-05-31 2020-05-12 台州恩泽医疗中心(集团) Pylorus electrocoagulation chisel for treating congenital hypertrophic pyloric stenosis

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN200948169Y (en) * 2006-09-08 2007-09-19 上海交通大学医学院附属新华医院 Fulguration knife for cutting muscle layer of celioscope pylorus
CN202699275U (en) * 2012-05-17 2013-01-30 杭州安杰思医学科技有限公司 High frequency cutting knife
CN206603798U (en) * 2016-09-23 2017-11-03 於林军 A kind of pylorus chisel for being used to treat hypertrophic pylorostenosis
CN210494220U (en) * 2019-05-31 2020-05-12 台州恩泽医疗中心(集团) Pylorus electrocoagulation chisel for treating congenital hypertrophic pyloric stenosis

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