CN110063759A - 样本取出装置 - Google Patents

样本取出装置 Download PDF

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CN110063759A
CN110063759A CN201910019430.0A CN201910019430A CN110063759A CN 110063759 A CN110063759 A CN 110063759A CN 201910019430 A CN201910019430 A CN 201910019430A CN 110063759 A CN110063759 A CN 110063759A
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wound retractor
loop
external member
vacuum tube
distal
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雅罗斯洛娃·T·马尔科夫斯基
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Covidien LP
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    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/22—Valves or arrangement of valves
    • A61M39/24—Check- or non-return valves
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Abstract

本公开的手术设备包括创口牵开器，该创口牵开器具有附接到其上的样本袋。本公开的套件包括手术设备和真空管。在实施方案中，真空管可以被引入创口牵开器的内腔中。真空源附接到真空管的近端部，以通过真空管抽真空，该真空管又通过真空管的远端部中的开口将组织样本吸入真空管的内腔。然后可以从创口牵开器中移除其中具有组织样本的真空管。还提供了使用本公开的手术设备和/或套件的方法。

Description

样本取出装置
相关申请的交叉引用
本申请要求2018年1月24日提交的美国临时专利申请第62/621,189号的权益和优先权，其全部公开内容通过引用的方式并入本文。
技术领域
本公开一般涉及用于微创外科手术(例如内窥镜手术和/或腹腔镜手术)的手术设备，更具体地，本公开涉及一种手术设备，其包括样本取出袋组件和真空管，所述真空管用于在这些过程中接近该袋组件并收集体组织和/或体液。
背景技术
微创手术，例如内窥镜手术，降低了外科手术的侵入性。内窥镜手术涉及通过体壁进行手术，例如对卵巢、子宫、胆囊、肠、肾、阑尾等进行观察和/或手术。存在许多常见的内窥镜外科手术，仅举几例而言，包括关节镜检查、腹腔镜检查、胃肠镜检查和喉镜检查。在这些手术中，利用套管针产生切口，通过该切口进行内窥镜手术。将套管针导管或插管装置延伸到腹壁中并留在其中，以为内窥镜手术工具提供通路。通过套管针管插入相机或内窥镜，以允许对体腔的视觉检查和放大。然后，外科医生可以借助于专用仪器在手术部位实施诊断和/或治疗程序，所述专用仪器例如设计成适合穿过另外的套管的镊子、抓握器、切割器、涂药器等。为了保护开口免受外科手术器械的意外穿透，通常将创口牵开器放置在开口上。
当从体腔(例如肿瘤组织)移除某些组织时，重要的是肿瘤组织不与健康或未涉及到的组织接触，从而以这种方式避免转移并避免伤害患者。然而，在必须从体腔移除大尺寸肿瘤或大量组织的情况下，微创外科手术可能受到限制。如果在已将肿瘤或患病组织与周围组织分离的位置处必须移除肿瘤组织或组织部分，可将其引入“提取袋”(在本文中也称为“样本袋”)中，之后通常通过套管针或类似装置将样本袋从体内撤回，从而最小化患病组织与健康组织的接触。
仍需要改进的创口牵开器和样本袋，包括能够与真空源一起使用的那些，用于微创外科手术。
发明内容
本公开涉及用于微创手术的手术设备和套件。该手术设备包括创口牵开器，该创口牵开器具有附接到其上的样本袋，用于将病变组织放置在其中。在实施方案中，本公开的套件包括手术设备和真空管，所述真空管用于辅助从身体移除组织样本。
在一些实施方案中，本公开的套件包括具有创口牵开器和样本袋的创口牵开器和样本袋组件。创口牵开器包括近端环、远端环和设置在近端环与远端环之间的薄膜，样本袋附接到创口牵开器的远端环。该套件还包括一个真空管。
在实施方案中，创口牵开器的近端环限定大致圆形的开口并且是可变形的。
在一些实施方案中，创口牵开器的远端环限定大致圆形的开口并且是可变形的。
在实施方案中，近端环与远端环之间的创口牵开器的薄膜的长度是可调节的。
在其他实施方案中，通过诸如粘合剂粘合、焊接、热封及其组合的方法将样本袋附接到创口牵开器的远端环。
在一些实施方案中，创口牵开器包括系绳。
在实施方案中，真空管包括限定大致圆形开口的远端部，限定较窄件的大致圆形开口的较窄近端部和限定在远端部与较窄近端部之间的内腔的细长轴。
在一些实施方案中，真空管包括阀。
在其他实施方案中，本公开的套件还包括适于与真空管连通的真空源。在一些实施方案中，真空源包括注射器。
在其他实施方案中，本公开的套件包括具有创口牵开器和样本袋的创口牵开器和样本袋组件，该创口牵开器包括近端环、远端环和设置在近端环与远端环之间的薄膜，样本袋附接到创口牵开器的远端环。在实施方案中，套件还包括真空管和真空源，该真空源包括适于与真空管连通的注射器。
在一些实施方案中，创口牵开器的近端环限定大致圆形的开口并且是可变形的。创口牵开器的远端环还可以限定大致圆形的开口并且是可变形的。
在实施方案中，近端环与远端环之间的创口牵开器的薄膜的长度是可调节的。
在一些实施方案中，通过诸如粘合剂粘合、焊接、热封及其组合的方法将样本袋附接到创口牵开器的远端环。
在其他实施方案中，创口牵开器包括系绳。
在实施方案中，真空管包括限定大致圆形开口的远端部，限定较窄件的大致圆形开口的较窄近端部和限定在远端部与较窄近端部之间的内腔的细长轴。
在其他实施方案中，真空管包括阀。
还提供了使用本公开的支架的方法。在实施方案中，本公开的方法包括：插通过身体开口将创口牵开器和样本袋组件插入体腔，所述创口牵开器和样本袋组件包括创口牵开器和样本袋，所述创口牵开器具有近端环、远端环和设置在近端环与远端环之间的薄膜，所述样本袋附接到远端环之间；使组织样本通过由创口牵开器的近端环、薄膜和远端环限定的开口进入样本袋；通过身体开口从体腔移除近端环，使得薄膜邻近包围身体开口的组织；将近端环拉离远端环，使得远端环与围绕身体开口的组织的内表面邻接；将近端环绕其自身滚动，使得薄膜围绕近端环卷起，以使近端环与组织的外表面邻接；将真空管通过近端环引入样本袋；将真空源附接到真空管；通过真空管抽真空，将样本袋内的一部分组织样本吸入真空管的远端部；以及从创口牵开器移除具有组织样本部分的真空管。
在实施方案中，本公开的方法还包括滚动近端环，以缩回切口并使近端环与组织的外表面邻接。
附图说明
本文参考附图描述了本发明公开的创口牵开器和样本袋组件的各种实施方案，其中：
图1是包括本发明公开的创口牵开器和样本袋组件的示例性实施方案的套件的部件的立体图，所述套件具有真空管和真空源；
图2是患者身体的剖视图，示出了伤口、切口和待从体腔移除的组织样本；
图3是图1所示的样本袋和卷绕牵开器组件的立体图；
图4A是图3中所示的在体腔内的创口牵开器和样本袋组件的剖视图，相邻的组织待从体腔内取出；
图4B是在图4A中所示的通过切口从体腔移除创口牵开器和样本袋组件期间的立体局部剖视图；
图5是图4B中所示的创口牵开器和样本袋组件的立体图，该创口牵开器被插入组织中的切口中，以及样本袋被放置在体腔内；
图6是图5中所示的创口牵开器和样本袋组件的局部剖视图，真空管通过创口牵开器被插入样本袋中，以及真空源被固定在真空管上；
图7是图6中所示指定细节区域的放大视图；
图8是图6中所示的创口牵开器和样本袋组件的局部剖视图，示出真空源通过真空管抽真空并将组织从样本袋拉入真空管中；
图9是图8中所示指定细节区域的放大视图；
图10是图6中所示的创口牵开器和样本袋组件的替代的局部剖视图，示出真空源通过真空管抽真空，并将组织从样本袋拉入真空管中；以及
图11是图10中所示细节区域的放大视图。
具体实施方式
本公开提供了一种用于微创外科手术的创口牵开器和样本袋组件以及真空管。如本文中参考本公开所使用的那样，微创外科手术涵盖腹腔镜手术、关节镜手术和内窥镜手术，并且涉及利用具有能够通过皮肤中的小切口插入的相对狭窄的操作部分的观测设备或类似装置的手术。
可以修改本公开的方面以连同用于在微创外科手术(有时在本文中称为微创手术)过程中用于取回组织样本的各种方法一起使用。微创手术的实例包括例如胆囊移除术、阑尾移除术、肾移除术、结肠移除术和脾移除术等。
如本文所使用的那样，术语远侧指的是创口牵开器和样本袋组件距离使用者最远的部分，而术语近侧是指本公开的创口牵开器和样本袋组件的最接近使用者的部分。
本公开的创口牵开器和样本袋组件包括具有样本袋固定在其上的创口牵开器。创口牵开器部件包括具有至少两个环的套筒构件，所述环包括近端环和远端环，薄膜在两个环之间延伸。样本袋部件被附接到创口牵开器的远端环。在使用中，样本袋组件穿过切口并被放置在体腔内，并且待从其移除的组织(在实施方案中称为“组织样本”)穿过创口牵开器部件并被放置在样本袋内。然后将创口牵开器部件的近端环从体腔移除并邻近皮肤放置在邻近切口的身体的外表面上，套筒构件的远端环和样本袋保持在体内，使得薄膜延伸通过切口并与包围切口的组织相邻。本发明公开的创口牵开器和样本袋组件适用于任何手术，其中进入身体内部的入口限于一个或多个相对小的切口，如在微创手术中。
本公开的套件包括上述创口牵开器和样本袋组件以及真空管组件两者。真空管组件允许从样本袋移除组织样本，而不需要用手术刀或一些其他粉碎装置破坏组织，有时在本文中称为组织的粉碎。
现在参考各图详细描述本公开的实施方案，图中相同附图标记在若干视图中的每个视图中标示相同或相对应的元件。在以下描述中，没有详细描述公知的功能或构造，以避免以不必要的细节使本公开模糊。
图1示出了根据本公开的包括创口牵开器和样本袋组件10的本公开的套件。创口牵开器和样本袋组件10包括创口牵开器100和样本袋200两者。本公开的套件还包括真空管300和真空源，在实施方案中为注射器400，用于通过真空管300抽真空。
还参考图2-图4B所示，包括创口牵开器100和样本袋200的创口牵开器和样本袋组件10适于通过切口“I”插入伤口“W”并放置在体腔“BC”(图4A)内，如下面进一步详细描述的。切口“I”可以是例如通过腹部衬里或腹薄膜衬里的单个切口或天然存在的孔(即口腔、肛门或阴道)。
创口牵开器100包括近端环120、远端环140和设置在它们之间的大致圆柱形薄膜130。创口牵开器和样本袋组件10还限定由近端环120、远端环140和薄膜130共用的纵向轴线“L”，以及样本袋200。可以设想，近端环120和远端环140可以分别通过本领域技术人员知识范围内的任何方式可拆卸地联接或永久地附接到薄膜130的近端部132和远端部134，所述方式例如胶合、缝合、脉冲焊接、化学或机械结合和包覆成型工艺等。在一些实施方案中，近端环120、薄膜130和远端环140是单片一体的，使得创口牵开器100是一统一的结构。薄膜130与环120、140的连接可以在环120、140周围连续，或者可以是不连续的，只要环120、140充分固定到薄膜130，以允许薄膜130绕近端环120如下所述那样滚动。
如上所述，近端环120和远端环140沿纵向轴线“L”沿着轴向对齐，薄膜130设置在它们之间。近端环120具有大致圆形的构造，所述构造限定圆形开口122(参见图1)，并且可绕近端环122滚动，以张紧薄膜130并缩回切口“I”。更具体地，近端环120可以沿着纵向轴线“L”朝向远离环140滚动或远离远端环140滚动，以使薄膜130围绕近端环120卷起或展开。远端环140还具有大致圆形的构造，所述构造限定大致圆形的开口(未示出)。
可以设想，近端环120和远端环140可以由弹性材料制成，使得近端环120和远端环140可以在通过切口“I”插入创口牵开器100期间在使用过程中恢复到大致圆形的构造的同时暂时变形成大致椭圆形的构造。例如，以名称出售的热塑性聚氨酯提供了灵活性和各种硬度。例如，近端环120可以由2363-80A、2363-90A以及2363-80A和2363-90A的50/50组合物或本领域已知的任何替代物制造。远端环140对于额外小的和小的尺寸可由例如2363-90A制造，对于中型和大型尺寸可由2363-55D制造，对于大尺寸可由2363-90A和2363-55D的50/50组合物制造，或由本领域技术人员的知识范围内的任何替代物制造。近端环120和远端环140可以由相同或不同的材料制成。
薄膜130限定大致圆柱形形状，以在近端环120与远端环140之间形成内腔。近端环120和远端环140的圆形构造分别将薄膜130保持在膨胀状态，以将内腔保持在非收缩状态。薄膜130在近端部132处联接到近端环120，并且在远端部134处联接到远端环140，使得薄膜130不会相对于近端环120或远端环140的任一个的表面滑动或移动。薄膜130可以由透明的非弹性材料例如聚氨酯制成。可替代地，可以设想薄膜130可以由多种材料形成，包括不透明材料和透明材料。
近端环120和远端环140之间的长度“X”(图3)是可调节的。更具体地，通过将近端环120朝向远端环140滚动以使薄膜130绕近端环120卷绕，可以减小长度“X”。类似地，通过使近端环120远离远端环140滚动以围绕近端环120展开薄膜130，可以增加长度“X”。如上所述，当近端环120朝向远离环140或远离远端环140滚动时，薄膜130围绕近端环120卷起或展开。应当理解，当薄膜130围绕近端环120卷起时，它减小了薄膜130的长度“X”，因此近端环120与远端环140之间的薄膜中的张力增加，以提供切口“I”内的沿着径向向外的力。
可以设想，创口牵开器100可具有各种尺寸，以适当地配合并适应一系列切口直径。例如，对于额外的小创口牵开器，近端环120和远端环140的外直径可以是约2.5英寸；对于小创口牵开器，近端环120和远端环140的外直径可以约为3.9英寸；对于中等尺寸的创口牵开器，近端环120和远端环140的外直径可以是约5.1英寸；对于大创口牵开器，近端环120和远端环140的外直径可以是约7.5英寸；并且对于超大的创口牵开器，近端环120和远端环140的外直径可以是大约9.4英寸。
本发明的样本袋由本领域技术人员知识范围内的柔性且耐用的材料制成，在实施方案中为聚合物材料。样本袋是可充气的并且能够允许外科医生将切割装置引入样本袋中以减小其中的组织样本的尺寸，从而便于从身体移除样本袋。用于形成样本袋的材料是抗静电、无热原、无毒的和可消毒的。在实施方案中，用于形成上述创口牵开器的薄膜部分的材料可用于形成样本袋。在其他实施方案中，样本袋由与用于形成创口牵开器的薄膜的那些材料不同的材料形成。样本袋可以是不透明的或透明的。
通过本领域技术人员知识范围内的方法，样本袋200可以在薄膜130的远端部134处连接到创口牵开器的远端环140，所述方法包括但不限于粘接、焊接、热封和其组合等。可替代地，在相同材料的实施方案中，样本袋200可与薄膜130一体形成。
如上所述，近端环120和远端环140两者均可以从大致圆形构型折叠成大致椭圆形构造(未示出)，以便与样本袋200一起通过切口“I”插入。更具体地，当从业者沿着径向向内挤压近端环120和远端环140的相对侧时，近端环120和远端环140的大致圆形开口从大致圆形构造变形为大致椭圆形构造(未示出)，使得近端环120和远端环140呈现较小的轮廓，以便于通过切口“I”插入。一旦插入，从业者释放近端环120和远端环140，并且材料的弹性将近端环120和远端环140推向其大致圆形构造。
在实施方案中，当担心样本袋200内的组织样本“TS”患病例如患有癌症，并且期望使组织样本“TS”与健康组织的接触最小化，但是粉碎或用于粉碎样本袋200内的组织的其他方式是不可行或不可取的(为了避免损坏样本袋200和/或创口牵开器100)时，可以将真空管300穿过创口牵开器100的内腔插入样本袋200，以从体腔“BC”移除组织样本“TS”。
本公开的套件(图1)包括真空管300。真空管300具有限定内腔314(图6)的细长主体310。细长主体310具有限定大致圆形的开口的远端部312和与远端部312相比的较窄的近端部316。与远端部312相比，较窄的近端部316限定了具有较窄的大致圆形开口318的较窄的内腔。
真空管300可以由坚硬的刚性材料形成。用于形成真空管的合适材料包括，例如，聚烯烃例如聚乙烯(包括超高分子量聚乙烯)和包括无规立构聚丙烯、全同立构聚丙烯、间同立构聚丙烯和它们的共混物的聚丙烯；聚乙二醇(PEG)；聚环氧乙烷；聚乙烯和聚丙烯的共聚物；聚异丁烯和乙烯-α烯烃共聚物；氟代聚烯烃，如氟乙烯，氟代丙烯，氟代PEG和聚四氟乙烯；聚酰胺；多胺；聚亚胺；聚对苯二甲酸乙二醇酯，聚萘二甲酸乙二醇酯，聚对苯二甲酸丙二醇酯，聚对苯二甲酸丁二醇酯等聚酯类；聚醚；聚丁烯；聚四亚甲基醚二醇；1,4-丁二醇；聚氨酯；丙烯酸聚合物；甲基丙烯酸类；卤乙烯聚合物和共聚物，如聚氯乙烯；聚乙烯醇；聚乙烯基醚，如聚乙烯基甲醚；聚偏二卤乙烯，如聚偏二氟乙烯和聚偏二氯乙烯；氯氟乙烯；聚丙烯腈；聚芳醚酮；聚乙烯酮；聚乙烯基芳烃，如聚苯乙烯；聚乙烯酯如聚醋酸乙烯酯；乙烯基单体彼此与烯烃的共聚物如乙烯-甲基丙烯酸甲酯共聚物；丙烯腈-苯乙烯共聚物；丙烯腈丁二烯苯乙烯树脂；乙烯-乙酸乙烯酯共聚物；醇酸树脂；聚碳酸酯；聚甲醛；磷嗪；聚酰亚胺；环氧树脂；芳纶纤维；有机硅；及它们的共聚物和组合。
本发明的套件还包括真空源，在实施方案中为注射器400，用于通过真空管300抽真空，从而通过将组织样本“TS”吸入到真空管300的远端部312来从样本袋200中移除组织样本“TS”。用于抽真空的其它可能的来源包括，例如，机械或手动操作的泵(未示出)，简单电动真空泵(未示出)，或其它类似的设备。真空管300的较窄近端部316可连接到真空源，在实施方案中是注射器400。将用于将真空管300的较窄近端部316连接到真空源(在实施方案中，为注射器400)的设备在本领域技术人员的知识能力范围内，并且包括例如摩擦配合、在真空管300的较窄近端部316的圆形开口318的内腔中密封件的使用、鲁尔型联接和它们的组合等。
参考图2和图4-图11，将描述根据本公开的操作手术设备10的方法。如图2和4A-5所描述的那样，为了接近位于体腔“BC”(图2)内的组织样本“TS”，外科医生首先使创口牵开器100的近端环120和远端环140折叠并变形成椭圆形构造，用于通过切口“I”(图4A)插入到伤口“W”中。一旦创口牵开器100和样本袋200通过切口“I”放置，并且近端环120和远端环140被释放，近端环120和远端环140恢复其大致圆形构造，使得手术设备10是邻近组织样本“TS”，以从体腔移除(图4A)。然后，外科医生可以通过使用钳子、抓紧器或任何其它合适的医疗装置将组织样本“TS”通过近端环120、薄膜130和远端环140引入样本袋200中。
一旦将组织样本“TS”引入样本袋200中，外科医生就然后使用镊子、抓紧器或类似器械使近端环120折叠和变形，并通过切口“I”撤回近端环120。在其他实施方案中，近端环120上具有系绳124(在图4B中以虚线示出)，所述系绳124可由外科医生向近侧拉动，以从体腔“BC”撤回近端环120。如图4B所示，外科医生可以拉动近端环120(图4B中的箭头“A”所示)，以在样本“TS”定位在样本袋200内之后从切口“I”移除近端环120。
如图5所示，近端环120通过切口“I”从体腔移除，使得其靠近切口“I”抵靠在外皮4上，并且外科医生调整薄膜130和近端环120，例如向近侧拉动近端环120，以拉伸薄膜130，使得远端环140与伤口“W”的内表面8邻接。远端环140定位在伤口“W”的内表面8附近，并且恢复到其大致圆形的构造，使得远端环140的大致圆形开口包围伤口“W”的内表面8(图5)。
在远端环140与伤口“W”的内表面8邻接的情况下，近端环120朝向远端环140和伤口“W”的外表面4向远侧滚动到期望位置，使得薄膜130在近端环120(未示出)周围卷起并由此张紧。
如图5所示，一旦创口牵开器100和样本袋200就位，手术工具和器械就可以穿过创口牵开器100的内腔114，远端环140与伤口“W”的内表面8邻接，并且近端环120滚动到所需位置和/或与伤口“W”的外表面4邻接。创口牵开器100可以进一步张紧，以提供切口“I”的缩回，从而增加切口直径。
简要地参考图6，在样本袋中的组织样本“TS”太大而不能通过切口移除的情况下，真空管300通过创口牵开器100的内腔114引入(图6)。如图6-图11所示，注射器400或任何其他能够抽真空的装置然后可以附接到真空管300的较窄的近端部316，以在真空管300的内腔314内抽真空，从而包含在样本袋200内的组织样本“TS”吸入真空管300的远端部312。
在注射器400用作真空源的情况下，注射器400的柱塞410可以首先被向远侧推动(如图10和11中用箭头“P”表示)，从注射器400排出空气。如图10和图11，柱塞410可以具有小的单向阀，以允许空气从注射器400排出。单向阀可以是允许单向空气流出注射器400的任何类型的捕集器。如图10和11所示的那样，合适的单向阀的示例包括球阀500。当柱塞410被向远侧推动时，存在于注射器400中的空气通过球阀500自身排空(在图10和图11中用箭头“P”表示)。没有空气返回到注射器400中。
如图11所示，球阀500具有轮辐512、514，所述轮辐512、514防止球500阻挡球阀500的近端开口530，而在同一时间允许空气从注射器400穿过的球阀500的远端开口516、穿过球阀500的近端开口530并且离开注射器400。
如图6-图9所示，真空管300包括位于真空管300的较窄近端部316内的阀。在实施方案中，如图6和图9中所描述的那样，阀可包括球阀318，所述球阀318包括球320和突出到球阀318的内腔328中的突出件322、324。突出件322、324防止球320阻挡球阀318的近端开口330，同时允许空气(由图9中的箭头“Z”表示)从样本袋200穿过球阀318的远端开口326、穿过球阀318的内腔328、穿过球阀318的近端开口330并且离开真空管300的较窄的近端部316。其他阀，例如单向阀、止回阀或任何其他阀设备均可包括在真空管300的较窄近端部316内，以帮助在真空管300的内腔314内抽真空并保持真空。
在使用中，注射器400的柱塞410被向远侧推动(在图10和图11中用箭头“P”表示)，注射器400内的空气通过球阀500自身排出。柱塞的注射器400然后410向近侧被拉动(由箭头“Y”，在图8中所示)，以产生能够将组织样本“TS”从样本袋200吸入到真空管300的前端部312的真空。必要时，可以重复上述循环(向远侧推动注射器400的柱塞410然后向近侧拉动注射器400的柱塞410)，以确保产生足够的真空状态，能够将组织样本“TS”从样本袋200吸入真空管300的远端部312。该过程可以重复多次，以实现将组织样本“TS”吸入真空管300所需的真空。
例如，注射器400的柱塞410至少第二次被按下以重复该循环(在图图10和图11中用箭头“P”表示)，准备另一个近端拉力(图8中用箭头“Y”表示)以从真空管300抽空更多的空气(图9中用箭头“Z”表示)。注射器400的柱塞410的球阀500允许重复循环以产生足够的真空，而无需在每次近侧拉动之后断开注射器400。
一旦将组织样本“TS”拉入真空管300的远端部312中，就可以从创口牵开器100移除真空管300。在实施方案中，如果当组织样本“TS”被拉入真空管300的远端部312时待移除的组织样本“TS”分离并且其部分保留在样本袋200中，外科医生可以使用镊子或其他抓紧器抓住那些额外的组织片，和/或使用真空源以从样本袋200移除组织样本“TS”的任何剩余部分。在其他实施方案中，样本袋200中的组织样本“TS”的体积以及来自组织样本“TS”的任何流体可以减少到样本袋200可以穿过切口“I”而不需要任何进一步的真空的点，任何剩余组织和/或任何流体在其中。
在实施方案中，一旦从创口牵开器100移除真空管300，可以使用销(未示出)或一些类似的设备来提起球320，以便它不再阻挡真空管300的较窄近端部316的远端开口326，以使空气进入真空管300，并且辅助从真空管300在释放组织样本“TS”。可替代地，如图10和11所描述对的那样，在实施方案中，真空管300可具有插塞600。如图11中所描述的那样，在实施方案中，真空管300可以具有螺纹开口610，并且插塞600可以螺纹连接并且可旋转地容纳在螺纹开口610内。插塞600的旋转允许其与真空管300附接和/或从真空管300移除。从螺纹开口610去除插塞600，让空气进入真空管300，并且有助于从真空管300释放组织样本“TS”。
一旦真空管300已经从创口牵开器100移除，外科医生然后使用镊子、抓紧器或类似器械使创口牵开器100的远端环140折叠和变形，并且远端环140和样本袋200通过切口“I”撤回。在其他实施方案中，远端环140上具有系绳(未示出)，所述系绳可由外科医生向近侧拉动，以从体腔“BC”移除远端环140和样本袋200。
在将样本袋200从体腔“BC”移除之后，可以从样本袋200中移除保留在其中的任何组织以进行进一步检查，或者可以丢弃样本袋200。
本公开的套件和样本袋在微创外科手术结束时提供安全的组织提取。可以从身体移除患病组织而不需要接种腹部内溢出的组织细胞。本公开的创口牵开器/样本袋的设计通过上述真空管允许外科医生从身体移除组织，而不需要粉碎器或其他机械装置，所述粉碎器或其他机械装置可能以其他方式撕裂样本袋并且可能将组织内容物释放回到患者体内。进一步设想可以修改使用本公开的样本袋的方法以适应给定程序的需要和/或外科医生的偏好。进一步设想本文公开的实施方案可用于从身体移除任何组织或物体。
应理解，可对本文中所公开的实施方案作出各种修改。例如，可以使用用于将本公开的样本袋引入患者体内的其他方法。另外，可以使用其他样本袋形状。此外，各种实施方案的类似组件的术语不应被解释为具体于任何特定实施方案。因此，上文的描述不应解释为限制性的，而仅仅是作为优选实施方案的例证。所属领域的技术人员将设想在本文所附的权利要求书的范围和精神内的其它修改。

Claims (18)

1.一种套件，包括：
创口牵开器和样本袋组件，所述创口牵开器和样本袋组件包括创口牵开器和样本袋，所述创口牵开器包括：
近端环，
远端环，和
薄膜，所述薄膜设置在所述近端环与所述远端环之间，
所述样本袋附接到所述创口牵开器的远端环；和
真空管。
2.根据权利要求1所述的套件，其中所述创口牵开器的近端环限定大致圆形的开口并且是可变形的。
3.根据权利要求1所述的套件，其中所述创口牵开器的远端环限定大致圆形的开口并且是可变形的。
4.根据权利要求1所述的套件，其中所述近端环与远端环之间的所述创口牵开器的薄膜的长度是可调的。
5.根据权利要求1所述的套件，其中所述样本袋通过选自粘接、焊接、热封和它们的组合的方法附接到所述创口牵开器的远端环。
6.根据权利要求1所述的套件，其中所述创口牵开器包括系绳。
7.根据权利要求1所述的套件，其中所述真空管包括限定大致圆形开口的远端部、限定较窄的大致圆形开口的较窄近端部和限定所述远端部与所述较窄近端部之间的内腔的细长轴。
8.根据权利要求7所述的套件，其中所述真空管包括阀。
9.根据权利要求1所述的套件，其进一步包括真空源，所述真空源适于与所述真空管连通。
10.根据权利要求9所述的套件，其中所述真空源包括注射器。
11.一种套件，包括：
创口牵开器和样本袋组件，所述创口牵开器和样本袋组件包括创口牵开器和样本袋，所述创口牵开器包括近端环、远端环和设置在所述近端环与所述远端环之间的薄膜，所述样本袋附接到所述创口牵开器的远端环；
真空管；和
真空源，所述真空源包括适于与所述真空管连通的注射器。
12.根据权利要求11所述的套件，其中所述创口牵开器的近端环限定大致圆形的开口并且是可变形的。
13.根据权利要求11所述的套件，其中所述创口牵开器的远端环限定大致圆形的开口并且是可变形的。
14.根据权利要求11所述的套件，其中所述近端环与所述远端环之间的所述创口牵开器的薄膜的长度是可调的。
15.根据权利要求11所述的套件，其中所述样本袋通过选自粘接、焊接、热封和它们的组合的方法附接到所述创口牵开器的远端环。
16.根据权利要求11所述的套件，其中所述创口牵开器包括系绳。
17.权利要求11的套件，其中所述真空管包括限定大致圆形的开口的远端部、限定较窄的大致圆形开口的近端部和限定所述远端部与较窄近端部之间的内腔的细长轴。
18.根据权利要求17所述的套件，其中所述真空管包括阀。
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