CN111603210B - Surgical field expander for minimally invasive orthopedic surgery - Google Patents
Surgical field expander for minimally invasive orthopedic surgery Download PDFInfo
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- CN111603210B CN111603210B CN202010494410.1A CN202010494410A CN111603210B CN 111603210 B CN111603210 B CN 111603210B CN 202010494410 A CN202010494410 A CN 202010494410A CN 111603210 B CN111603210 B CN 111603210B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
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Abstract
The invention discloses a surgical field expander for orthopedic minimally invasive surgery, and relates to the technical field of instruments for keeping wounds open. The device comprises a shell, a handle, an inner rod, a bayonet, an operation device, a sleeve, a connecting plate, a rack, an expansion part and at least two expansion rods; the control device is used for controlling the inner rod to move along the axial direction of the inner rod, the sleeve is sleeved outside the inner rod, the connecting plate is fixedly connected with the sleeve, and the expansion part is sleeved outside the lower end of the inner rod; the expansion part is provided with a support rod groove, at least two expansion blocks are separated, one end of the expansion rod is hinged with the expansion blocks, and the other end of the expansion rod is hinged with the connecting plate. The invention is provided with the expansion block and the hinge structure, the expansion block can horizontally move along the support rod, the range of the surgical field is adjusted, and the operation of medical staff is facilitated.
Description
Technical Field
The invention relates to the technical field of instruments for keeping wounds open, in particular to a surgical field expander for orthopedic minimally invasive surgery.
Background
The minimally invasive surgery is a surgery which can be performed by only cutting a few tiny surgical openings by using modern medical instruments such as a laparoscope, a thoracoscope and the like and related equipment.
The orthopedic minimally invasive surgery is the application of the minimally invasive surgical technology in the orthopedic field. Through special operation approaches, special equipment or new instruments such as endoscopes, puncture needles, special automatic draw hooks, internal fixing devices and the like are assisted, and the effects of smaller tissue trauma, high accuracy and postoperative recovery can be achieved.
At present, the minimally invasive orthopedic surgery has the problem of small surgical field, and the surgical field expander in the prior art has simple structure and various problems.
The invention discloses a Chinese invention 'endoscopic minimally invasive surgery retractor' with the publication number of CN103876792A, and provides an endoscopic minimally invasive surgery retractor which is placed in an abdominal cavity through a minimally invasive surgery incision, then is unfolded to form a support frame, and then vertically lifts the abdominal wall to form an operation space. The retractor comprises a retractor, a lifting joint and a bed rail clamp, and is characterized in that an outer frame arc part, an inner frame arc part, an outer frame neck part and an inner frame neck part which are closed together extend an operation incision to be slowly placed into an abdominal cavity, handles of a left blade and a right blade are adducted, a blade jackscrew of the right blade is screwed, the retractor in an unfolded state is formed in the abdominal cavity, the retractor is fixedly connected through a lifting rod of the lifting joint and the bed rail clamp, a rocking handle of the lifting joint is rocked, and the abdominal wall is vertically lifted to form an operation space. The endoscopic minimally invasive surgery retractor can replace an artificial CO2 pneumoperitoneum to perform laparoscopic surgery by a large part, avoids damage, danger and side effects caused by the artificial CO2 pneumoperitoneum, is simple and convenient to operate, fully exposes the surgical field and shortens the surgery time.
The claw-shaped structure used by the surgical field expander has the risk of causing injury to the wound of the patient due to the fact that the contact surface is small and the pressure generated to the wound of the patient is large in the process of contacting the wound of the patient, and is not beneficial to recovery of the patient.
The invention discloses an adjusting and expanding device for minimally invasive orthopedic surgery, which is published under the number CN108283509B, and provides the adjusting and expanding device for minimally invasive orthopedic surgery, which comprises a fixed sleeve, a first avoidance cavity, a fixed shaft, a supporting plate, a first spring, a supporting rod, a limiting touch panel, a second avoidance cavity, a pressing plate, a second spring, a sealing cover, an adjusting screw rod, a sealing air cushion ring, an adjusting valve, an air injection pipe and an injector.
The operation field expander can reduce the injury to the wound of a patient, but has the defects of inconvenient operation, fixed expanded operation field range and unfavorable observation of a doctor.
Disclosure of Invention
The invention aims to provide a surgical field expander for orthopedic minimally invasive surgery, which can adjust the surgical field range.
In order to solve the problems, the technical scheme of the invention is as follows:
a surgical field expander for orthopedic minimally invasive surgery, comprising:
the lower end of the shell is in a shape of a circular truncated cone with a small lower part and a large upper part, and an opening is formed in the center of the lower end of the shell;
the handle is fixedly connected to the middle part of the outer side wall of the shell;
the inner rod is arranged inside the shell, the upper end face of the inner rod is fixedly connected with a spring, the other end of the spring is fixedly connected to the center of the upper part of the inner wall of the shell, the lower end of the inner rod extends out of the opening, the lower end of the inner rod is fixedly connected with at least two support rods, and the support rods are horizontally and fixedly connected to the side wall of the inner rod;
the bayonet is arranged on the side wall of the shell along the axial direction of the inner rod, the bayonet is arranged around the handle, and the side wall of the bayonet is provided with a plurality of clamping grooves;
the control device is fixedly connected to the upper end of the inner rod, extends out after passing through the bayonet and is used for controlling the inner rod to move along the axial direction of the inner rod, and can be clamped in the clamping groove;
the sleeve is sleeved outside the inner rod, and the lower end of the sleeve extends out after passing through the opening;
the connecting plate is sleeved outside the inner rod, is horizontally and fixedly connected to the lower end face of the sleeve, and is arranged above the supporting rod;
the rack is arranged parallel to the axis of the inner rod, arranged inside the shell and close to the handle, and is fixedly connected with the upper end of the sleeve, a gear set is arranged inside the handle and meshed with one gear of the gear set, the gear set comprises an operating gear, the upper part of the operating gear protrudes out of the upper end face of the handle, and the operating gear is used for operating the rack to move;
the expansion part is cylindrical, the expansion part is sleeved at the lower end of the inner rod in an externally sleeved mode, the expansion part is arranged below the connecting plate, supporting rod grooves matched with the supporting rods in number and shape are formed in the expansion part, at least two expansion blocks are evenly divided by the expansion part according to the number and the direction of the supporting rods, the expansion blocks are not connected with each other, and one supporting rod groove is formed in each expansion block;
the number of the expansion rods is equal to that of the expansion blocks, one expansion rod is matched with one expansion block, one end of each expansion rod is hinged to one expansion block, and the other end of each expansion rod is hinged to the connecting plate.
Furthermore, the control device comprises a control rod, one end of the control rod is fixedly connected with the upper end of the inner rod, the other end of the control rod extends out after passing through the bayonet, and the height of the longitudinal section of the control rod is smaller than that of the clamping groove.
Furthermore, the control device further comprises a control plate, the control plate is oval, the control plate is fixedly connected with one end, far away from the inner rod, of the control rod, and the control plate is obliquely arranged.
Further, the bayonet and the control board are arranged on the left upper side of the handle.
Further, a rack groove is formed in the inner side wall of the shell, close to the rack, and the width of the rack groove is larger than that of the rack.
Furthermore, the number of the support rods is four, and the support rods are uniformly arranged along the outer circumferential surface of the inner rod.
Further, the cross section of the expansion block is in a sector shape.
Further, the height of the extension block is equal to that of the extension part, and the extension rod is hinged to the upper surface of the extension block.
The expansion board comprises a shell, and is characterized by further comprising a plurality of expansion boards, wherein the lower part of the side wall of the shell is provided with expansion board openings the number of which is the same as that of the expansion boards, the upper parts of the expansion board openings are horizontally provided with expansion board shafts fixedly connected with the shell, the expansion board shafts penetrate through the upper parts of the expansion boards, the inner side wall of the shell is fixedly provided with a clamping strip on the upper side of the expansion board openings, and the clamping strip is inclined to the inner side wall of the shell and arranged downwards.
Further, one end, far away from the shell, of the clamping strip is provided with a radian.
Compared with the prior art, the invention has the following beneficial effects:
1. the medical nursing bed is provided with the handle, so that the medical nursing bed is convenient to hold and is beneficial to the operation of medical staff;
2. the invention is provided with the bayonet and the control device, which is beneficial to controlling the movement and the fixation of the inner rod and the expansion part at the end part of the inner rod;
3. the invention is provided with a plurality of clamping grooves, which can accurately control the moving distance of the expansion part;
4. the bayonet and the control board are arranged on the left upper side of the handle, so that the medical staff can operate the medical staff conveniently;
5. the invention is provided with the rack and the gear set, the upper part of the control gear protrudes out of the upper end surface of the handle, the medical staff can operate the handle conveniently, and the expansion of the expansion part can be accurately controlled through the gear, so that the size of the operative field can be adjusted at will;
6. the invention is provided with the expansion block and the hinge structure, and the expansion block can horizontally move along the supporting rod to adjust the range of the surgical field.
7. The invention is provided with the supporting rod, and the supporting rod plays a supporting role and can expand the expansion block;
8. the invention can expand the expansion part firstly or later, which is suitable for various practical situations;
9. the invention is provided with a gear set, a rack, a sleeve and a connecting plate structure, wherein the sleeve and the connecting plate are sleeved outside the inner rod, the whole design is feasible, the operation is simple and the production is easy.
Drawings
The following describes embodiments of the present invention in further detail with reference to the accompanying drawings.
FIG. 1 is a schematic front view of the present invention;
FIG. 2 is a schematic front view of the present invention after pressing the control panel downward;
FIG. 3 is a schematic front view of the extended portion of the present invention;
FIG. 4 is a schematic view in partial cross-section of the present invention;
FIG. 5 is a schematic bottom view of the expanding portion of the present invention;
FIG. 6 is a schematic bottom view of the expansion portion of the present invention;
FIG. 7 is a schematic cross-sectional view of a portion of the handle of the present invention;
FIG. 8 is a schematic view of the hinge portion of the extension of the present invention;
FIG. 9 is a schematic view of the expansion board of the present invention in an expanded state;
wherein, 1 is a shell; 2 is a handle; 3 is an inner rod; 4 is a supporting rod; 5 is a bayonet; 6 is a control lever; 7 is a control panel; 8 is a sleeve; 9 is a connecting plate; 10 is a rack; 11 is a control gear; 12 is an expansion part; 13 is a strut groove; 14 is an expansion block; 15 is an expanding rod; 16 is an expansion board; 17 is a card strip.
Detailed Description
In order to make the technical means, the technical features, the technical purpose and the technical effects of the invention easier to understand, the invention is further described in the following combined with the specific drawings.
Example 1:
fig. 1-9 show a surgical field expander for orthopedic minimally invasive surgery. The method comprises the following steps:
the shell 1 is cylindrical, the lower end of the shell 1 is in a shape of a circular truncated cone with a small lower part and a large upper part, and an opening is formed in the center of the lower end of the shell 1. The opening is cylindrical, the size of the opening is slightly larger than the outer diameter of the sleeve 8, and the opening plays a supporting role. The round platform shape with the small lower part and the large upper part is beneficial to inserting a wound of a patient, and the bottom surface of the round platform is provided with an arc-shaped chamfer. The size of the housing 1 is set according to actual needs, and the size of the expansion part 12 may be larger than the size of the lower end of the housing 1 or smaller than the size of the lower end of the housing 1.
The handle 2 and the handle 2 are fixedly connected to the middle portion of the outer side wall of the housing 1, and the rack 10 is arranged in the middle portion and is used for controlling the rack 10, because the rack 10 moves downwards along with the movement of the inner rod 3, when the expansion part 12 is controlled to move downwards, the rack 10 is displaced by a distance.
An interior pole 3, interior pole 3 sets up in the inside of shell 1, and 3 up end fixedly connected with springs in interior pole, the other end fixed connection of spring locate at the inner wall upper portion center of shell 1, and the lower extreme of interior pole 3 stretches out behind the opening, and 3 lower extreme fixedly connected with of interior pole is no less than two branch 4, and 4 horizontal fixed connections of branch are in 3 lateral walls in interior pole. The spring is arranged to stabilize the inner rod 3 and to increase the hand feeling during manipulation.
A bayonet 5, bayonet 5 sets up in shell 1 lateral wall along the axis direction of interior pole 3, and bayonet 5 sets up around handle 2, and bayonet 5 lateral wall is provided with a plurality of draw-in groove.
The control device is fixedly connected to the upper end of the inner rod 3, extends out of the bayonet 5 and is used for controlling the inner rod 3 to move along the axis direction of the inner rod 3, and the control device can be clamped in the clamping groove.
The control device comprises a control rod 6, one end of the control rod 6 is fixedly connected with the upper end of the inner rod 3, the other end of the control rod 6 extends out after passing through the bayonet 5, and the height of the longitudinal section of the control rod 6 is smaller than that of the clamping groove, so that the control rod 6 is clamped in the clamping groove. The control device further comprises a control plate 7, the control plate 7 is oval, the control plate 7 is fixedly connected with one end, far away from the inner rod 3, of the control rod 6, and the control plate 7 is obliquely arranged. The bayonet 5 and the control panel 7 are arranged at the upper left side of the handle 2, so that the medical staff can operate conveniently. When the operating rod 6 is engaged with the slot, the inner rod 3 rotates a certain angle, and accordingly, the rack 10 also rotates a certain angle, so that when the rack 10 is engaged with the gear, a certain margin is taken into consideration to enable the rack to be directly engaged. Alternatively, a certain margin may be provided to accommodate the deflection of the inner rod 3 when the expansion rod 15 is articulated.
A sleeve 8, the sleeve 8 is sleeved outside the inner rod 3, the lower end of the sleeve 8 extends out after passing through the opening, and the sleeve 8 can slide along the inner rod 3.
A connecting plate 9, connecting plate 9 are the ring shape, and connecting plate 9 overcoat is in interior pole 3, and connecting plate 9 horizontal fixed connection is in sleeve pipe 8 lower terminal surface, and connecting plate 9 sets up in branch 4 top, and the upper end of connecting plate 9 is pushing up the lower terminal surface of shell 1, plays certain supporting role. The lower end face of the connecting plate 9 is provided with at least two hinged supports, and the directions of the hinged supports are arranged according to the direction of the support rod 4. The hinged support of the hinged support is used to hinge the expansion rod 15.
The rack 10 is arranged parallel to the axis of the inner rod 3, the rack 10 is arranged inside the shell 1, the rack 10 is close to the handle 2, the rack 10 is fixedly connected with the upper end of the sleeve 8, a gear set is arranged inside the handle 2, the rack 10 is meshed with one gear of the gear set, the gear set comprises an operating gear 11, the upper portion of the operating gear 11 protrudes out of the upper end face of the handle 2, and the operating gear 11 is used for operating the rack 10 to move. The rack 10 is arranged in the rack 10 groove, the rack 10 groove is arranged on the inner side wall of the shell 1 and close to the rack 10, and the width of the rack 10 groove is larger than that of the rack 10 so as to be suitable for the left-right translation of the rack 10.
The gear train has two gears, the gear meshing with the rack 10 comprising a coaxial driven gear meshing with a steering gear 11. The control gear 11 may further be provided with a ratchet for fixing, which will not be described herein.
The expansion part 12 is cylindrical, the expansion part 12 is sleeved at the lower end of the inner rod 3, the expansion part 12 is arranged below the connecting plate 9, the expansion part 12 is internally provided with strut grooves 13 matched with the number and the shape of the struts 4, the expansion part 12 is evenly divided into at least two expansion blocks 14 according to the number and the direction of the struts 4, the expansion blocks 14 are not connected with each other, and each expansion block 14 internally comprises one strut groove 13.
The number of the expansion rods 15 is equal to that of the expansion blocks 14, one expansion rod 15 is matched with one expansion block 14, one end of each expansion rod 15 is hinged with the corresponding expansion block 14, and the other end of each expansion rod 15 is hinged with the connecting plate 9.
The number of the supporting rods 4 is four, and the supporting rods 4 are uniformly arranged along the outer circumferential surface of the inner rod 3 and are positioned on the same horizontal plane. The cross-section of the expansion block 14 is fan-shaped. The upper surface of the expansion block 14 is provided with a hinged support, the height of the expansion block 14 is equal to that of the expansion part 12, and the expansion rod 15 is hinged on the upper surface of the expansion block 14.
The shape and number of the expansion blocks 14 are not limited, and it is preferable to expand the range of the surgical field as much as possible.
The position of the strut 4 is not limited, and is preferably as effective as possible to manipulate the expansion block 14.
The lower end face of the expansion portion 12 is provided with a chamfer to facilitate entry into the wound site of the patient.
The expansion board is characterized by further comprising a plurality of expansion boards 16, the lower portion of the side wall of the shell 1 is provided with expansion board openings the number of which is the same as that of the expansion boards 16, six expansion boards 16 are uniformly arranged, the upper portion of each expansion board opening is horizontally provided with an expansion board shaft fixedly connected with the shell 1, each expansion board shaft penetrates through the upper portion of each expansion board 16, a clamping strip 17 is fixedly arranged on the upper side of the expansion board opening on the inner side wall of the shell 1, and each clamping strip 17 is inclined to the inner side wall of the shell 1 and arranged downwards. One end of the clamping strip 17 far away from the shell 1 is provided with a certain radian. The expansion board 16 is rotatable about a shaft and is engaged by an engagement strip 17. The expansion plate 16 is used to support the wound tissue of the patient.
Example 2:
furthermore, the extension portion 12 can be uniformly divided into six blocks and eight blocks, the extension portion 12 can be completely divided, or a part of the extension portion 12 can be left at intervals and still connected to the extension portion 12, so as to independently divide the extension block 14. The number of the expansion rods 15 is also correspondingly set, and generally, the expansion rods 15 should be fixedly connected to the upper surface of the expansion block 14 to reduce the contact with the wound muscle tissue of the patient.
And (3) running:
the expansion portion 12 is aligned with the wound site of the patient and the handle 2 is pressed down, the expansion portion 12 and the lower end of the housing 1 enter the wound. The upper part of the expansion board 16 is pressed to clamp the expansion board 16 on the clamping strip 17 so as to support the wound tissue of the patient and expand the surgical field range.
When the control panel 7 is pressed downwards, the inner rod 3 moves downwards, meanwhile, the support rod 4 drives the expansion part 12 to move downwards, the expansion part 12 drives the sleeve 8 and the rack 10 to move downwards, the control panel 7 is stopped being pressed, the control rod 6 is clamped in the clamping groove, and the position of the expansion part 12 is kept still.
The control gear 11 is rotated, the rack 10 drives the sleeve 8 to move downwards, the sleeve 8 drives the connecting plate 9 to move downwards, the connecting plate 9 presses the expansion rod 15, and the expansion rod 15 drives the expansion block 14 to expand along the supporting rod 4, so that the surgical field range is enlarged.
The operating gear 11 can be adjusted arbitrarily to adjust the range of the surgical field. The timing of the gear adjustment is arbitrary and can be adjusted before the start of pressing the handle 2.
It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, and that various changes and modifications may be made without departing from the spirit and scope of the invention as defined in the appended claims. The scope of the invention is defined by the appended claims and equivalents thereof.
Claims (10)
1. A surgical field expander for orthopedic minimally invasive surgery, comprising:
the lower end of the shell is in a shape of a circular truncated cone with a small lower part and a large upper part, and an opening is formed in the center of the lower end of the shell;
the handle is fixedly connected to the middle part of the outer side wall of the shell;
the inner rod is arranged inside the shell, the upper end face of the inner rod is fixedly connected with a spring, the other end of the spring is fixedly connected to the center of the upper part of the inner wall of the shell, the lower end of the inner rod extends out of the opening, the lower end of the inner rod is fixedly connected with at least two support rods, and the support rods are horizontally and fixedly connected to the side wall of the inner rod;
the bayonet is arranged on the side wall of the shell along the axial direction of the inner rod, the bayonet is arranged around the handle, and the side wall of the bayonet is provided with a plurality of clamping grooves;
the control device is fixedly connected to the upper end of the inner rod, extends out after passing through the bayonet and is used for controlling the inner rod to move along the axial direction of the inner rod, and is clamped in the clamping groove;
the sleeve is sleeved outside the inner rod, and the lower end of the sleeve extends out after passing through the opening;
the connecting plate is sleeved outside the inner rod, is horizontally and fixedly connected to the lower end face of the sleeve, and is arranged above the supporting rod;
the rack is arranged parallel to the axis of the inner rod, arranged inside the shell and close to the handle, and is fixedly connected with the upper end of the sleeve, a gear set is arranged inside the handle and meshed with one gear of the gear set, the gear set comprises an operating gear, the upper part of the operating gear protrudes out of the upper end face of the handle, and the operating gear is used for operating the rack to move;
the expansion part is cylindrical, the expansion part is sleeved at the lower end of the inner rod in an externally sleeved mode, the expansion part is arranged below the connecting plate, supporting rod grooves matched with the supporting rods in number and shape are formed in the expansion part, at least two expansion blocks are evenly divided by the expansion part according to the number and the direction of the supporting rods, the expansion blocks are not connected with each other, and one supporting rod groove is formed in each expansion block;
the number of the expansion rods is equal to that of the expansion blocks, one expansion rod is matched with one expansion block, one end of each expansion rod is hinged to one expansion block, and the other end of each expansion rod is hinged to the connecting plate.
2. The surgical field expander for minimally invasive orthopedic surgery according to claim 1, wherein the control device comprises a control rod, one end of the control rod is fixedly connected with the upper end of the inner rod, the other end of the control rod extends out after passing through the bayonet, and the height of the longitudinal section of the control rod is smaller than that of the clamping groove.
3. An operative field expander for use in minimally invasive orthopedic surgery as claimed in claim 2, wherein said operating device further comprises an elliptical operating plate, said operating plate is fixedly connected to one end of said operating rod away from said inner rod, and said operating plate is disposed obliquely.
4. A surgical field expander for minimally invasive surgery of orthopaedics according to claim 3, wherein said bayonet and said control plate are arranged at the upper left side of said handle.
5. A surgical field expander for minimally invasive orthopedic surgery as claimed in claim 1, wherein a rack slot is provided on the inner side wall of the housing near the rack, and the width of the rack slot is greater than the width of the rack.
6. The surgical field expander for minimally invasive orthopedic surgery as claimed in claim 1, wherein the number of said struts is four, and said struts are uniformly arranged along the outer circumferential surface of said inner rod.
7. A surgical field expander for minimally invasive surgery of the orthopaedics department according to claim 6, wherein the cross section of the expanding block is fan-shaped.
8. A surgical field expander for minimally invasive orthopedic surgery as claimed in claim 7, wherein the height of said expansion block is equal to the height of said expansion part, and said expansion rod is hinged on the upper surface of said expansion block.
9. The surgical field expander for minimally invasive orthopedic surgery according to claim 1, further comprising a plurality of expansion plates, wherein the lower portion of the sidewall of the housing is provided with expansion plate openings having the same number as the expansion plates, the upper portion of the expansion plate openings is horizontally provided with expansion plate shafts fixedly connected with the housing, the expansion plate shafts penetrate through the upper portions of the expansion plates, the inner sidewall of the housing is fixedly provided with a clamping strip on the upper side of the expansion plate openings, and the clamping strip is inclined to the inner sidewall of the housing and arranged downward.
10. A surgical field expander for minimally invasive orthopedic surgery as claimed in claim 9, wherein an end of said clip strip distal from said housing is provided with a curvature.
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CN116370048A (en) * | 2023-03-02 | 2023-07-04 | 中国人民解放军总医院第四医学中心 | Gun type spine minimally invasive surgery channel expander |
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CN102639182A (en) * | 2009-10-13 | 2012-08-15 | 玛特纳医疗公司 | Methods and apparatus for preventing vaginal lacerations during childbirth |
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