CN110742659A - Incision-free tissue grasping device for endoscopy - Google Patents

Abstract

The invention discloses an incision-free tissue grasping device for endoscope. The device has a pair of grasping handles hinged to each other and a pair of grasping forceps correspondingly connected with the front ends of the pair of grasping handles; a pulling wire, one end of which is connected with a pair of grasping handles or one grasping handle; A needle hole connected with the other end of the pulling wire; wherein, a pair of gripping handles are clamped by the pair of clamping forceps, and the pair of grasping forceps are driven by the pair of grasping handles to open first to contain the target tissue and re-closing to grasp the target tissue; wherein, the puncture needle is used to drive the traction wire to pull the grasper after grasping the target tissue, so as to expose the surgical field. The grasping device of the present invention can be applied to tissue pulling in endoscopic surgery, is simple and easy to operate, does not occupy a surgical incision, reduces mutual interference between instruments, and has a good surgical field of vision.

Description

Incision-free tissue grasping device for endoscopy

technical field

The invention relates to the technical field of medical devices, in particular to an incision-free tissue grasping device for endoscope.

Background technique

With the improvement of surgical techniques and the improvement of population health awareness. More and more surgeries can be performed under endoscopy, and the surgical incision of endoscopy is getting smaller and fewer. In recent years, single-port surgery has also increased and has become the mainstream trend. Especially in single-hole surgery, it is inevitable to enter and exit multiple surgical instruments from one surgical incision, and mutual interference between instruments is inevitable. For the smoothness and safety of the operation, the usual practice is to increase the length of the endoscopic incision or add an extra incision, which increases the trauma to the patient. It is also a type of increased trauma. In addition, single-port or few-port endoscopic surgery has high requirements on the operator and a long learning curve, which is not conducive to the training of young doctors, and to a certain extent, aggravates the difficulty and high cost of medical treatment for patients.

SUMMARY OF THE INVENTION

The purpose of the present invention is to solve the above problems, to provide an incision-free tissue grasping device for endoscope, which can be applied to tissue pulling in endoscopic surgery, is simple and easy to operate, does not occupy surgical incisions, and reduces mutual interference between instruments , the surgical field of vision is good.

In order to achieve the above-mentioned object of the present invention, the present invention provides an incision-free tissue grasping device for endoscope, which comprises: a endoscopic releaser, which has a clamping rod and an openable or closed one that is arranged at the front end of the clamping rod and can be opened or closed. Pair of gripping forceps; grasper, with a pair of grasping handles hinged to each other and a pair of grasping forceps correspondingly connected with the front ends of the pair of grasping handles; traction wire, one end of which is connected with a pair of grasping handles or a grasping handle; puncture The needle has a needle hole at its tail end for connecting with the other end of the pulling wire; wherein, a pair of gripping handles are clamped by the pair of gripping pliers, and the pair of gripping grips are driven to advance by the pair of gripping handles open to hold the target tissue, and then close again to grasp the target tissue; wherein, the puncture needle drives the traction wire to pull the grasper after grasping the target tissue, so as to expose the surgical field.

Further, it also includes a quick positioning structure for quickly aligning the pair of clamping forceps of the endoscopic releaser and clamping the pair of gripping handles of the gripper.

Preferably, the quick positioning structure comprises: a pair of bosses arranged on the opposite inner side walls of the pair of clamping jaws; a pair of grooves or a pair of through holes arranged on the pair of gripping handles ; wherein, the pair of bosses can be inserted into the pair of grooves or a pair of through holes.

Or, the quick positioning structure includes: a pair of grooves arranged on the inner side walls of the pair of clamping jaws opposite to each other; a pair of bosses arranged on the opposite outer side walls of the pair of gripping handles; Wherein, the pair of bosses can be inserted into the pair of grooves.

Preferably, the boss is a boss whose cross section is cylindrical or star-shaped, and the groove is a cylindrical or star-shaped groove in cross section.

Wherein, the opposite inner side walls of the pair of graspers of the grasper are provided with a force-enhancing structure that facilitates the pair of graspers to grasp the target tissue.

Preferably, the force-boosting structure comprises: a concave structure or a protruding structure provided on the inner side wall of the first grasper in the pair of graspers; A protruding structure or a concave structure on the inner side wall; wherein, the concave structure is matched with the protruding structure, so as to increase the strength of the pair of graspers to clamp the target tissue, and when the target tissue is clamped Uniform force to avoid damage.

Wherein, the protruding structure includes a convex point, a tooth-shaped protrusion or a wave-shaped protrusion, and the concave structure includes a concave pit or a tooth-shaped concave matching with the convex point, the tooth-shaped protrusion or the wave-shaped protrusion Grooves or wavy grooves.

Preferably, the rear end of the pair of gripping handles or one gripping handle is provided with a fixing hole, and one end of the pulling wire is directly or indirectly fixed on the fixing hole.

Preferably, the cross section of the puncture needle is star-shaped, so as to increase the puncturing ability of the needle and reduce the damage to the target tissue.

Compared with the prior art, the incision-free tissue grasping device for endoscope of the present invention has the following advantages:

The incision-free tissue grasping device for endoscope of the present invention can be applied to tissue pulling in endoscopic surgery. The grasping device is pulled outside the patient's body cavity far from the operation incision through the traction wire, which fully exposes the surgical field and is convenient for doctors to operate. It is simple and easy to operate, does not occupy surgical incisions, and reduces mutual interference between instruments.

The embodiments of the present invention will be described in detail below with reference to the accompanying drawings.

Description of drawings

FIG. 1 is a schematic structural diagram of the incision-free tissue grasping device for endoscope according to the present invention (a pair of graspers are in a closed state);

FIG. 2 is a schematic structural diagram of the incision-free tissue grasping device for endoscope according to the present invention (a pair of graspers are in an open state);

Fig. 3 is the structural representation of the cavity mirror releaser of the present invention;

Fig. 4 is the structural schematic diagram of the present invention when the clamping forceps head and the grasping forceps are to be matched;

Fig. 5 is the structural schematic diagram of the gripper of the present invention;

Fig. 6 is the structure schematic diagram that the V-shaped groove and the boss are arranged on the grasping forceps of the present invention;

7 is a schematic structural diagram of a toothed groove provided on a grasping forceps of the present invention;

Fig. 8 is a structural schematic diagram of a pair of gripping handles of the gripper of the present invention being hinged;

9 is a schematic structural diagram of the gripper of the present invention after being assembled with a traction wire and a puncture needle;

Figure 10 is a front view of the needle portion of the puncture needle of the present invention;

Figure 11 is a left side view of the needle shown in Figure 10;

Figure 12 is a perspective view of the needle portion of the puncture needle of the present invention;

Figure 13 is a left side view of the needle shown in Figure 12 .

Detailed ways

As shown in Figure 1 and Figure 2, it is a schematic structural diagram of a pair of grasping forceps of the incision-free tissue grasping device for endoscope provided in the embodiment of the present invention in two states: closed and open, respectively. From Figures 1 and 2 It can be seen that the incision-free tissue grasping device for endoscope of the present invention includes: a endoscopic releaser 1, which has a clamping rod 13 and a pair of clamping forceps 14 that are arranged at the front end of the clamping rod 13 and can be opened or closed; The grasper 2 has a pair of grasping handles 21 hinged to each other and a pair of grasping forceps correspondingly connected with the front ends of the pair of grasping handles 21; the pulling wire 4, one end of which is connected with a pair of grasping handles or a grasping handle; the puncture needle 5 , its tail end is provided with a pinhole for connecting with the other end of the pulling wire 4; wherein, a pair of gripping grips 21 are clamped by a pair of gripping pliers 14, and a pair of gripping grippers are driven by a pair of gripping grips 21 to first Open to hold the target tissue, and then close again to grasp the target tissue; wherein, the traction wire 4 is driven by the puncture needle 5 to pull the gripper 2 after grasping the target tissue, so as to fully expose the surgical field. Specifically, as shown in FIGS. 1 to 3 , the endoscopic releaser 1 of this embodiment includes a handle 11 with a fixed handle and a movable handle, a clamping rod 13 connected to the handle 11 , and a clamping rod 13 and the handle sleeved on the clamping rod 11 . 11 The runner 12 at the connection point, and a pair of clamping pliers 14 arranged at the front end of the clamping rod 13 . The operator can adjust the angle of the pair of clamping jaws 14 at the front end by turning the wheel 12 with the index finger, and by moving the movable handle relative to the fixed handle to clamp or open the handle 11 to clamp or open the pair of clamping jaws 14 , to drive a pair of grasping forceps of the grasper 2 to release or grasp the target tissue.

Among the above-mentioned components of the endoscopic release 1, the structure of the other components except the pair of clamping forceps 14 can refer to the structure of the endoscopic separation forceps used in endoscopic surgery in the prior art, so here The structures of these components are not described in detail.

In order to quickly align and hold a pair of gripping handles 21 of the gripper 2 when the endoscope release 1 grips the gripper 2, the present embodiment also has a quick positioning structure, which can be used as shown in the figure The structure shown in Fig. 4 includes: a pair of bosses 141 arranged on the opposite inner side walls of a pair of clamping jaws 14; a pair of grooves 211 arranged on a pair of gripping handles 21, the grooves being perpendicular to the gripping handles in the thickness direction; wherein, a pair of bosses 141 can be inserted into a pair of grooves 211 . Alternatively, a pair of through holes (as shown in FIG. 5 ) are provided on a pair of gripping handles 21 , and a pair of bosses 141 can be inserted into the pair of through holes correspondingly. Alternatively, the quick positioning structure of the present invention can also adopt the following structure (not shown in the figure), including: a pair of grooves arranged on the inner side walls of a pair of clamping forceps opposite to each other; A pair of bosses on the outer side wall of the radiator; wherein, a pair of bosses can be inserted into a pair of grooves.

When designed, the clamping forceps head 14 is in the shape of a hook as shown in FIG. 4 , that is, the clamping forceps head 14 has a connecting section 143 whose extension direction is consistent with the lengthwise extension direction of the clamping rod 13 and is vertically connected to the front end of the connecting section 143 The vertical section 142, and the boss 141 or the groove is arranged on the inner side wall of the vertical section 142 facing the other clamping jaw, and the convex direction of the boss 141 or the concave direction of the groove is the same as that of the connecting section 143. The length of the extension direction is vertical.

By inserting the boss into the groove or the through hole, the endoscopic releaser 1 can be quickly aligned and clamped to the pair of gripping handles 21 of the gripper 2, thereby improving the operation efficiency. In order to further improve the positioning speed and accuracy of the pair of clamping jaws 14 when clamping the pair of gripping handles 21, the bosses in this embodiment can be made of magnetic materials, such as magnets. Correspondingly, recesses are provided. At least a portion of the slot member is made of a material that can be attracted to the magnet, such as iron or the like.

In order to prevent the pair of clamping forceps 14 of the endoscopic release 1 from loosening when clamping the pair of handles 21 of the grasper 2, the boss adopts a cylindrical cross-section (not shown in the figure). The boss, correspondingly, the groove adopts a cylindrical groove in cross section. Alternatively, as shown in FIG. 4 , the boss is a boss with a star-shaped cross section, and correspondingly, the groove is a star-shaped groove.

Of course, in order to prevent the clamping jaws 14 from being loosened when clamping the pair of gripping handles 21 , convex and concave can also be provided on the inner side walls of the pair of clamping jaws 14 for clamping the pair of gripping handles 21 . Uneven textures, such as wavy or serration. When in use, the endoscopic releaser 1 of this embodiment clamps the gripper 2 outside the body (when the endoscopic releaser 1 clamps the gripper 2, the pair of clamping forceps 14 of the endoscopic releaser 1 is opened. To clamp a pair of gripping handles of the grasper 2; then the grasper 2 is sent into the chest cavity through the surgical incision, when reaching the target position, the handle of the endoscopic release 1 is grasped to close the pair of clamping forceps heads , in order to drive a pair of grasping forceps to open through a pair of grasping handles, so that the jaws of a pair of grasping forceps hold the target tissue, and then release the handle, the closing force of a pair of grasping forceps heads becomes smaller, so that a pair of grasping forceps can hold the target tissue. The jaws are gradually closed, so that the target tissue to be grasped can be grasped by a pair of grasping forceps 2; after the handle of the endoscopic releaser is completely released, the grasper for grasping the target tissue is separated from the endoscopic releaser, and the The endoscopic releaser 1 is withdrawn from the thoracic cavity. In this way, subsequent operations can be performed without the need for the endoscopic releaser 1, which solves the following problems in the operation in the prior art: during the operation, the endoscopic release is required. The device 1 is always inserted into the incision, and multiple surgical instruments go in and out of the same incision together, thereby causing operational interference between multiple surgical instruments; The trauma caused by the patient is not conducive to the patient's physical recovery.

However, after the gripper 2 in this embodiment is sent into the chest cavity by the endoscopic releaser, in addition to grasping the target tissue in the patient's chest cavity, it can also be connected with a traction wire 4 and a puncture needle 5, so that the puncture needle 5 can drive traction The wire 4 is passed through the patient's body cavity, and then the gripper 2 is pulled outside the patient through the pulling wire, so as to pull the target tissue through the gripper 2, fully expose the surgical field, and do not occupy the operation incision, which can be different from The direction of the incision pulls the target tissue, which is in line with the doctor's normal operation habits, that is, in line with the doctor's habit of not operating under the laparoscope.

As shown in FIG. 5 , the grasper 2 of this embodiment has a pair of grasping handles 21 hinged to each other and a pair of grasping forceps correspondingly connected to the front ends of the pair of grasping handles 21 , namely the first grasping forceps 22 and the second grasping forceps twenty three. A pair of graspers can be clamped against each other.

Wherein, on the opposite inner side walls of the pair of graspers (that is, the surfaces that are attached to each other during clamping and fitting), a force-boosting structure is arranged to facilitate the pair of graspers to grasp the target tissue. The force-boosting structure can adopt the following structures, including: setting A concave structure on the inner side wall of the first grasper 22 in a pair of graspers; a protruding structure provided on the inner side wall of the second grasper 23 in a pair of graspers; or, the following structures may be adopted, including: A protruding structure provided on the inner sidewall of the first grasper 22 in a pair of graspers; a concave structure provided on the inner sidewall of the second grasper 23 in a pair of graspers. The above-mentioned concave structure is matched with the protruding structure, so as to increase the strength of the pair of grasping forceps to clamp the target tissue, and make the target tissue receive even force when being clamped to avoid damage.

Wherein, the protruding structure can use multiple convex points (not shown in the figure), or one or more tooth-shaped protrusions, or wave-shaped protrusions, and correspondingly, the concave structure can use the same convex point or tooth-shaped protrusion. Concave or tooth-shaped grooves (as shown in Figure 6) or wave-shaped grooves to which the protrusions or wave-shaped protrusions fit.

When designing, the structure shown in FIG. 6 can be adopted, a tooth-shaped groove 221 extending along the length of the inner side wall of the first grasper 22 is arranged in the center, and a tooth-shaped groove 221 extending along the length is arranged on the inner side wall of the second grasper 23. A tooth-shaped protrusion 231, the protrusion 231 can be inserted into the groove 221. Alternatively, a plurality of tooth-shaped grooves as shown in FIG. 7 may be used.

The pair of grasping handles 21 and the pair of grasping forceps of the grasper 2 can be made of memory metal respectively. After the pair of graspers grasps the target tissue and the endoscopic releaser is withdrawn from the thoracic cavity, a pair of graspers can be automatically closed to clamp the target tissue through the closed jaws.

Alternatively, a pair of gripping handles 21 of the gripper 2 can be hinged together using the structure shown in FIG. 8 , that is, a pair of gripping handles 21 can be connected together through a hinge shaft, and a spring 24 is sheathed on the hinge shaft, so as to The opened pair of grasping forceps is closed by the elastic restoring force of the spring 24 itself. For the structure in which the pair of grip handles 21 are hinged to each other, reference may also be made to the hinge structure of clothespins in the prior art and other structures that enable the hinged elements to be automatically closed after being opened, and will not be repeated here.

In the design, the grip handle of this embodiment can adopt a two-stage structure as shown in FIG. 5 , that is, the rear part of the grip handle and the front part of the grip handle, and the rear part of the grip handle and the front part of the grip handle are bent and arranged to correspond to the grip handle. The connected grasping forceps extend forwardly from the front section of the grasping handle along the extension direction of the clamping rod. When designing, the grasping forceps extending forward can be made to extend forward in an arc shape, for example, the arc center of the grasping forceps is located on the extension line of the entire length of the grasper 2 or is located below the extension line. Alternatively, the forwardly extending grasping forceps may extend straight forward.

Wherein, the bosses, grooves or through holes arranged on the gripping handle are all arranged on the rear section of the gripping handle. In addition, in order to facilitate the connection of the pulling wire 4 to the gripper 2, in this embodiment, a pair of gripping handles or a rear end of one gripping handle is also provided with a fixing hole 212 (as shown in FIG. 5, at the rear end of the pair of gripping handles The rear end is provided with a fixing hole), and one end of the pulling wire 4 is directly or indirectly fixed on the fixing hole 212, for example, one end of the pulling wire is directly tied to the fixing hole 212, or, one end of the pulling wire 4 can be tied and fixed. The connecting ring 3 is inserted through the fixing hole 212 (as shown in FIG. 9 ).

A puncture needle 5 is connected to the other end of the pulling wire 4 , and the tail end of the puncturing needle 5 is provided with a needle hole for connecting with the other end of the pulling wire 4 . In the design, the needle head of the puncture needle 5 can adopt the structure shown in FIGS. 10-13 , that is, the needle head 51 is conical, and the outer circumference of the cross section of the needle head 51 is in the shape of a thin star (as shown in FIGS. 11 and 13 ). ), that is, the outer wall of the needle is provided with ribs and grooves at intervals, so as to increase the sharpness of the puncture needle 5 when puncturing the tissue, and can reduce the damage to the tissue.

In the design, the traction wire 4 adopts a single-strand suture with a length of about 30 cm, and a scale is provided every 1 cm on the traction wire 4 to facilitate the measurement of the distance between the gripper and the chest wall. The puncture needle 5 can be a pointed needle with a length of about 8 cm. The puncture needle 5 drives the traction wire 4 to pass through the patient's body cavity, and then, the grasper 2 after grasping the tissue is pulled by the traction wire 4 to expose the surgical field.

Next, the use process of the gripping device of this embodiment will be described.

Grasping process: The endoscopic releaser clamps a pair of handles at the rear end of the grasper outside the patient's body and sends the grasper into the thoracic cavity through the surgical incision. The pair of grasping forceps at the front end are opened, and the opened pair of grasping forceps press against the target tissue that needs to be grasped, and then slowly release the endoscopic releaser, then the pair of grasping forceps of the grasper can grasp the target tissue that needs to be grasped. organize. Fully loosen the handle of the endoscope release and withdraw the endoscope release from the chest cavity. After holding the puncture with a needle holder (which is a conventional surgical instrument in the prior art) to perform the required suturing on the tissue, the puncture needle penetrates the chest wall from the inside to the outside according to the required traction direction, and the puncture needle brings out part of the traction line, and then Pulling the traction wire outside the chest wall can achieve the effect of pulling the tissue.

Release/removal process: After the pulling operation is completed, use scissors to cut the traction wire in the chest cavity, extend the endoscopic releaser into the chest cavity and hold a pair of handles of the grasper, and hold the handle of the endoscopic releaser tightly , then a pair of grasping forceps of the grasper opens and releases the grasped tissue, and then withdraws the endoscopic releaser and the grasper.

The grasping device of the present invention is developed in view of the following situations in the prior art: currently, all tissue graspers under the endoscope need to be operated through an incision, and the current endoscopic surgery tends to be single-port and less-port. Multiple surgical instruments entering and exiting the same incision will inevitably interfere with each other. The pulling angle is too concentrated, and it is impossible to achieve angular pulling and expose the position of the target tissue, which increases the difficulty of surgery and even increases the risk of surgery, which is not conducive to surgery. Safe and convenient.

With the grasping device of the present invention, the rear end of the grasper is connected to the puncture needle through a pulling wire, and the puncture needle can be pulled out of the body to pull the tissue without occupying the operating incision, and the tissue can be punctured from a direction different from the incision. Pulling, so as to achieve the purpose of reducing the length of the surgical incision and the number of incisions, and at the same time, it can also be stretched from the direction of the non-surgical incision, which conforms to the operating habits of normal surgery, avoids mutual interference between instruments, improves surgical efficiency, and facilitates surgery. the purpose of the operation. In addition, the reduction of incisions and surgical instruments can reduce the trauma to the patient's body and reduce the patient's medical costs. The endoscopic releaser can quickly align and clamp the gripper, which can shorten the operation time and improve the work efficiency.

Although the embodiments of the present invention are described in detail above, the embodiments of the present invention are not limited thereto, and those skilled in the art can make modifications according to the principles of the embodiments of the present invention. Various modifications should be understood as falling within the protection scope of the embodiments of the present invention.

Claims (10)

1. An incision-free tissue grasping device for an endoscope, comprising:

the endoscope releaser is provided with a clamping rod and a pair of clamping forceps heads which are arranged at the front end of the clamping rod and can be opened or closed;

the gripper is provided with a pair of gripping handles which are hinged with each other and a pair of gripping tongs correspondingly connected with the front ends of the gripping handles;

one end of the traction wire is connected with the pair of the grabbing handles or one grabbing handle;

the tail end of the puncture needle is provided with a needle hole used for being connected with the other end of the traction wire;

the pair of grasping handles are grasped by the pair of grasping forceps heads, and the pair of grasping forceps are driven by the pair of grasping handles to open to contain the target tissue and close to grasp the target tissue;

wherein, the puncture needle drives the traction wire to pull the gripper after gripping the target tissue so as to expose the operation field.

2. The incision-free tissue grasping device for an endoscope according to claim 1, further comprising a quick positioning structure for quickly aligning a pair of grasping forceps heads of the endoscope releaser and grasping a pair of grasping handles of the grasper.

3. The incision-free tissue grasping device for an endoscope according to claim 2, wherein the quick positioning structure comprises:

a pair of bosses provided on opposite inner side walls of the pair of gripping bits;

a pair of grooves or a pair of through holes provided on the pair of grip handles;

wherein the pair of bosses are insertable into the pair of grooves or the pair of through holes.

4. The incision-free tissue grasping device for an endoscope according to claim 2, wherein the quick positioning structure comprises:

a pair of grooves provided on opposite inner side walls of the pair of gripping bits;

the pair of bosses are arranged on the outer side walls of the pair of grabbing handles which are opposite to each other;

wherein the pair of bosses are insertable within the pair of grooves.

5. The incision-free tissue grasping device for an endoscope according to claim 3, wherein the boss is a boss having a cylindrical or star-shaped cross section, and the groove is a groove having a cylindrical or star-shaped cross section.

6. An incision-free tissue grasping device for an endoscope according to any one of claims 1 to 5, wherein opposing inner side walls of a pair of graspers of said grasper are provided with a force application structure facilitating grasping of a target tissue by the pair of graspers.

7. The incision-free tissue grasping device for an endoscope according to any one of claims 1 to 5, wherein the urging structure comprises:

a recessed or protruding formation provided on an inner side wall of a first of the pair of graspers;

a male or female formation provided on an inner side wall of a second of the pair of graspers;

the concave structure is matched with the convex structure so as to increase the force of the pair of graspers for grasping the target tissue and ensure that the target tissue is uniformly stressed and is prevented from being damaged when being grasped.

8. The incision-free tissue grasping device for an endoscope according to claim 7, wherein the protruding structure comprises a convex point or a tooth-shaped protrusion or a wave-shaped protrusion, and the recessed structure comprises a concave pit or a tooth-shaped groove or a wave-shaped groove adapted to the convex point or the tooth-shaped protrusion or the wave-shaped protrusion.

9. The incision-free tissue grasping device for an endoscope according to claim 1, wherein a rear end of the pair of grip handles or one grip handle is provided with a fixing hole, and one end of the traction wire is directly or indirectly fixed to the fixing hole.

10. An incision-free tissue grasping device for an endoscope according to claim 1, wherein said puncture needle tip has a star-shaped cross section to increase the puncture ability of the needle tip and to reduce the damage to the target tissue.

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