CN112075985A - Multifunctional liver operation dissector - Google Patents
Multifunctional liver operation dissector Download PDFInfo
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- CN112075985A CN112075985A CN202010998790.2A CN202010998790A CN112075985A CN 112075985 A CN112075985 A CN 112075985A CN 202010998790 A CN202010998790 A CN 202010998790A CN 112075985 A CN112075985 A CN 112075985A
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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
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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
- 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
- A61B2018/00529—Liver
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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
- 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
- A61B2018/00589—Coagulation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
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Abstract
The application discloses multi-functional liver surgery dissector includes: the two ends of the tubular part are respectively an operating end and a connecting end, the operating end is a tip end, a partition part for dividing the inner cavity into a first sub-cavity and a second sub-cavity is arranged in the inner cavity of the tubular part, and the partition part at least extends to the operating end; a telescopic hemostasis assembly disposed in the first subchamber, the hemostasis assembly having a monopolar coagulation hemostasis mode and a bipolar coagulation hemostasis mode; the opening of the first valve is adjustable, the second sub-cavity is communicated with the connecting end, and a gas-liquid outlet interface and a liquid inlet interface are arranged on the connecting end. The multifunctional liver surgery dissector not only can meet various operation requirements of 'scraping', 'coagulating', 'attracting' and 'flushing/water injecting' in laparoscopic liver surgery, but also can reduce surgery difficulty and improve surgery efficiency by reducing dependence on assistants, and also obviously improves the bleeding stopping effect in surgery.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a multifunctional liver operation dissector.
Background
Laparoscopic surgery is a minimally invasive technique which has been developed in the eighty and ninety years of the last century, and has the advantages of small wound, fast recovery, fine operation and the like, so that the laparoscopic surgery tends to replace the traditional open surgery. In the starting stage of laparoscopic surgery, simple operations such as laparoscopic ovarian cyst removal, laparoscopic cholecystectomy and the like are mainly used, and with the development of surgical instruments and the improvement of surgical techniques, the laparoscopic surgery has been developed into a conventional operation mode in the field of abdominal surgery, and even liver surgery and pancreatic surgery can be developed by adopting laparoscopic techniques.
The laparoscopic liver surgery is a difficult minimally invasive technique, has high technical requirements, and has the biggest technical difficulty of stopping bleeding during the surgery. At present, the common instruments for laparoscopic surgery are various in types and single in function, for example, a separation instrument is used for dissecting and separating tissues, a hemostatic instrument is used for hemostasis, a suction instrument is used for sucking hematocele and the like, the selection and the replacement of the instruments are matched by an assistant, the surgical difficulty is increased, and the surgical efficiency is reduced; in addition, in the process of hemostasis operation, monopolar electrocoagulation (monopolar electrocoagulation is a hemostasis instrument) is adopted for hemostasis, monopolar electrocoagulation can only be used for hemostasis of small blood vessel hemorrhage and small amount of blood seepage, the hemostasis effect on rapid massive hemorrhage is not ideal, in addition, a large amount of smoke is generated in the hemostasis process, the operation visual field is blurred, meanwhile, the pneumoperitoneum pressure (carbon dioxide gas is required to be injected in abdominal wall puncture to form pneumoperitoneum when laparoscopic surgery is carried out) is obviously reduced, sometimes, the operation has to be suspended to wait for the pneumoperitoneum pressure to rise, and the operation efficiency can be seriously influenced.
Disclosure of Invention
In view of this, the invention provides a multifunctional liver surgery dissector, which not only can meet various operation requirements of laparoscopic liver surgery, but also can reduce surgery difficulty and improve surgery efficiency.
In order to achieve the purpose, the invention provides the following technical scheme:
a multi-functional liver surgical dissector comprising:
the device comprises a tubular part, a first clamping piece and a second clamping piece, wherein the two ends of the tubular part are respectively an operating end and a connecting end, the operating end is a tip end, a partition piece for dividing the inner cavity into a first sub-cavity and a second sub-cavity is arranged in the inner cavity of the tubular part, and the partition piece at least extends to the operating end;
a telescopic hemostasis assembly disposed in the first subchamber, the hemostasis assembly having a monopolar coagulation hemostasis mode and a bipolar coagulation hemostasis mode;
the opening of the first valve is adjustable, the second sub-cavity is communicated with the connecting end, and a gas-liquid outlet interface and a liquid inlet interface are arranged on the connecting end.
Preferably, in the above multifunctional liver surgery dissector, the partition member partitions only a part of the inner cavity near the operation end in an axial direction of the tubular member, and the first subchamber partitioned by the partition member is a chamber which communicates with the operation end and does not communicate with the connection end.
Preferably, in the multifunctional liver surgery dissector, the cross-sectional area of the first subchamber is smaller than that of the second subchamber.
Preferably, in the above multifunctional liver surgery dissector, the hemostatic assembly comprises:
a telescopic member disposed in the first subchamber, the telescopic member being reciprocally movable in an axial direction of the tubular member;
the first cutter head and the second cutter head are movably arranged on the telescopic piece and can extend out of the tubular piece from the operation end and retract into the tubular piece under the driving of the telescopic piece; the first cutter head and the second cutter head can be respectively conducted with the negative pole and the positive pole of a power supply, and the first cutter head and/or the second cutter head can be connected and separated through the movement of the telescopic piece.
Preferably, in the above multifunctional liver surgery dissector, the first cutter head and the second cutter head are rotatably disposed on the telescopic member, and the first cutter head and the second cutter head are separated from each other by rotating back to back and engaged with each other by rotating in opposite directions.
Preferably, in the above multifunctional liver surgery dissector, a micro electro mechanical system is disposed in the first sub cavity, and the micro electro mechanical system includes:
the controller controls the first cutter head and/or the second cutter head to rotate and switch on and off, the telescopic piece moves under the control of the controller, and the opening degree of the first valve is changed under the control of the controller;
a plurality of control switches disposed on an exterior of the tubular member and electrically connected to the controller.
Preferably, in the above multifunctional liver surgery dissector, a plurality of the control switches include:
the bipolar electrocoagulation switch is used for controlling the telescopic piece to move forwards so that the first cutter head and the second cutter head extend out of the operating end, and the first cutter head and the second cutter head are separated and are respectively conducted with different electrodes of a power supply;
a monopolar electrocoagulation switch for controlling the first cutter head and the second cutter head to be converted from a separation state to an engagement state, and enabling one of the first cutter head and the second cutter head to be conducted with a positive electrode of a power supply and the other to be not conducted with an electrode;
and controlling the first cutter head and the second cutter head to be powered off, and enabling the telescopic piece to move reversely to drive the first cutter head and the second cutter head to retract to the hemostasis stop switch in the first sub-cavity.
Preferably, in the multifunctional liver surgery dissector, the bottoms of the bipolar coagulation switch and the monopolar coagulation switch are respectively provided with a pressure sensor, and the pressure sensors can detect whether the bipolar coagulation switch and the monopolar coagulation switch are stressed or not and the stress magnitude, so that the controller can control the opening degree of the first valve according to a detection signal of the pressure sensors.
Preferably, in the above multifunctional liver surgery dissector, the circuit for connecting the first cutter head and the second cutter head with the power supply comprises:
the first circuit is connected with a negative electrode of a power supply and the first cutter head, and a first switch for controlling the first circuit to be switched on and off is arranged on the first circuit;
the second circuit is connected with the positive electrode of the power supply and the second tool bit, and a second switch for controlling the on-off of the second circuit is arranged on the second circuit;
and the third circuit is connected with the second switch in parallel, and is provided with a third switch for controlling the on-off of the third circuit.
Preferably, in the multifunctional liver surgery dissector, a second valve for controlling the connection end and the gas-liquid outlet port to be opened and closed, and a third valve for controlling the connection end and the liquid inlet port to be opened and closed are controlled by the controller.
The multifunctional liver operation dissector provided by the invention has the advantages that the operating end of the tubular piece is the pointed end, so that an operator can dissect and separate liver tissues by using the pointed end in an operation, the hemostasis assembly can realize the switching of two hemostasis modes, namely monopolar electric coagulation and bipolar electric coagulation, can perform more targeted and more effective hemostasis operation aiming at different bleeding conditions, can better keep the stability of pneumoperitoneum pressure, improve the operation visual field definition, reduce the replacement of surgical instruments to reduce the dependence on an assistant and complete the laparoscopic liver operation, and can realize the controllable flow of inlet and outlet liquid by adjusting the opening of the first valve, thereby avoiding the situations of fluctuation of pneumoperitoneum pressure and poor suction effect. The multifunctional liver surgery dissector not only can meet various operation requirements of 'scraping', 'coagulating', 'attracting' and 'flushing/water injecting' in laparoscopic liver surgery, but also can reduce surgery difficulty and improve surgery efficiency by reducing dependence on assistants, and also obviously improves the bleeding stopping effect in surgery.
Drawings
In order to more clearly illustrate the technical solutions of the present invention in the application or the prior art, the drawings used in the description of the application or the prior art will be briefly introduced below, and it is obvious that the drawings in the following description are only the application of the present invention, and for those skilled in the art, other drawings can be obtained according to the provided drawings without creative efforts.
FIG. 1 is a schematic structural diagram of the appearance of a multifunctional liver surgery dissector provided by the present application;
FIG. 2 is a front view of the operating end;
FIG. 3 is a schematic diagram of the internal structure of the multifunctional liver surgery dissector;
FIG. 4 is a schematic view of the cooperating structure of the hemostasis assembly and the first lumen in a hemostasis mode of bipolar electrocoagulation;
FIG. 5 is a schematic view of the cooperating structure of the hemostasis assembly and the first lumen in a monopolar coagulation hemostasis mode;
FIG. 6 is a schematic view of the hemostatic assembly mated with the first lumen without hemostasis;
fig. 7 is a diagram of a power circuit for the first and second cutting heads.
In the above fig. 1-7:
1-a tubular member, 2-an operation end, 3-a connecting end, 4-a separating member, 5-a first sub-cavity, 6-a second sub-cavity, 7-a first valve, 8-a gas-liquid outlet port, 9-a liquid inlet port, 10-a telescopic member, 11-a first cutter head, 12-a second cutter head, 13-a controller, 14-a bipolar electrocoagulation switch, 15-a monopolar electrocoagulation switch, 16-a hemostasis stop switch, 17-a first circuit, 18-a first switch, 19-a second circuit, 20-a second switch, 21-a third circuit, 22-a third switch, 23-a second valve and 24-a third valve.
Detailed Description
The invention provides a multifunctional liver surgery dissector which not only can meet various operation requirements of laparoscopic liver surgery, but also can reduce surgery difficulty and improve surgery efficiency.
The technical solutions in the present application will be described clearly and completely with reference to the accompanying drawings in the present application, and it is obvious that the described applications are only a part of the present invention, not all of them. All other applications which can be obtained by a person skilled in the art without making creative efforts based on the applications in the present invention belong to the protection scope of the present invention.
As shown in fig. 1-7, the present invention provides a multifunctional liver surgery dissector for performing laparoscopic liver surgery, which mainly comprises a tubular member 1, a hemostatic assembly and a first valve 7, wherein the tubular member 1 is a main component of the multifunctional liver surgery dissector, i.e. the general shape of the multifunctional liver surgery dissector is cylindrical, one end of the tubular member 1 is an operation end 2 inserted into the abdominal cavity of a patient during surgery, the other end is a connection end 3 located outside the abdominal cavity for connecting other instruments, the operation end 2 is a tip (the clamp end refers to an inclined plane end formed by obliquely cutting the tubular member 1 relative to the axis of the tubular member 1, as shown in fig. 1), and an operator (hereinafter, the operator is referred to as an operator) can use the tip to perform a "scraping" operation on liver tissue, so as to realize the dissection and separation of liver tissues, a separating part 4 which divides the inner cavity of the tubular member 1 into a first subchamber 5 and a second subchamber 6 is arranged in the inner cavity of the tubular member 1, the separator 4 is arranged to ensure that the multifunctional liver operation dissector has other functions on the basis of having the scraping function, namely, a hemostatic component is arranged in the first sub-cavity 5 to ensure that the multifunctional liver surgery dissector has a hemostatic function, and the second sub-cavity 6 is communicated with the connecting end 3, so that the second sub-chamber 6 can be used as a channel communicated with the outside, and thus liquid (such as blood) and gas (the gas specifically refers to smoke generated in monopolar electrocoagulation) in the abdominal cavity can be sucked out of the abdominal cavity through the second sub-chamber 6, so that the multifunctional liver surgery dissector has the function of suction, and also to let external liquid (e.g. physiological saline) enter the abdominal cavity through the second subchamber 6; the hemostasis assembly is arranged in the first cavity 5 and can stretch out and draw back in the first cavity 5, so that the hemostasis assembly can extend out from the operation end 2 to perform hemostasis operation, the multifunctional liver operation dissector can have a coagulation function, the hemostasis assembly has a monopolar electrocoagulation hemostasis mode and a bipolar electrocoagulation hemostasis mode, namely the hemostasis assembly can realize switching between monopolar electrocoagulation and bipolar electrocoagulation, when diffuse bleeding or small blood vessel bleeding occurs in the operation process (namely the bleeding amount is small), the hemostasis assembly can be switched to the monopolar electrocoagulation to perform the hemostasis operation, and when rapid bleeding or more blood accumulation and liquid accumulation occur in the operation process, the hemostasis assembly is switched to the bipolar electrocoagulation to perform more efficient hemostasis operation; the first valve 7 is arranged in the second sub-chamber 6, and the opening degree of the first valve 7 can be adjusted (the first valve 7 is preferably a throttle valve), and since the second sub-chamber 6 is a passage for liquid and smoke to enter and exit, the flow rate of liquid and smoke to enter and exit, that is, the suction strength can be adjusted by adjusting the opening degree of the first valve 7, for example, the suction flow rate of blood can be adjusted in the hemostasis process to better match with the hemostasis mode of monopolar electrocoagulation or bipolar electrocoagulation, so that the operator can select the proper flow rate to control the suction strength according to the specific situation in the operation; the connecting end 3 is provided with a gas-liquid outlet port 8 and a liquid inlet port 9, the gas-liquid outlet port 8 is mainly used for discharging bleeding and smoke in the abdominal cavity, the liquid inlet port 9 is mainly used for introducing liquid (such as physiological saline) into the abdominal cavity to clean the operation position or better ensure the hemostasis effect of bipolar coagulation (the hemostasis method of bipolar coagulation is that a first cutter head 11 and a second cutter head 12 which are described later are respectively communicated with the negative electrode and the positive electrode of a power supply, and a current loop is formed by the conductivity of electrolyte liquid between the two cutter heads to realize hemostasis, when more bleeding exists in the abdominal cavity, the blood can be used as the electrolyte liquid of the bipolar coagulation, and when the bipolar coagulation is carried out, the blood can be sucked out to the outside of the abdominal cavity through the second sub-cavity 6 (namely, the suction operation is carried out), along with the reduction of the accumulated blood, namely along with the reduction of the electrolyte liquid, the hemostasis effect of bipolar coagulation can be reduced, but the multifunctional liver surgery dissector provided by the application is additionally provided with the liquid introduction interface 9 at the connecting end 3 to avoid the hemostasis effect reduction of bipolar coagulation, so that the physiological saline is injected into the abdominal cavity through the communicated liquid introduction interface 9, the connecting end 3 and the second sub-cavity 6 at the later stage of bipolar coagulation, and the hemostasis effect of bipolar coagulation is ensured by taking the physiological saline as electrolyte liquid), and thus the multifunctional liver surgery dissector has the function of flushing/water injection.
The multifunctional liver surgery dissector integrates multiple functions of scraping, coagulating, attracting, flushing/water injecting and the like, can meet multiple operation requirements in laparoscopic liver surgery, can reduce the replacement times of surgical instruments, and reduces the dependence on assistants.
In the existing liver surgery dissector, firstly, only monopolar electrocoagulation can be carried out, and when a large amount of bleeding occurs, the electrode electrocoagulation cannot meet the requirement for hemostasis, so that surgical instruments need to be replaced through assistance of an assistant, and the surgical efficiency is low; secondly, the suction force of the existing liver operation dissector is uncontrollable, the gas-abdominal pressure is obviously reduced due to overlarge force, the smoke and the accumulated blood cannot be effectively absorbed in time due to the overlarge force, so that the scraping and coagulating operations cannot be continuously performed, namely, the existing liver operation dissector cannot be performed while scraping, coagulating and sucking, but the multifunctional liver operation dissector provided by the application can realize the control of the suction force by arranging the first valve 7 with adjustable opening degree in the second sub-cavity 6, can accurately adjust the suction force according to different conditions, can maintain the stability of the gas-abdominal pressure, can also realize the scraping, coagulating and sucking, for example, the accumulated blood or smoke generated by a single pole can be sucked while performing the monopolar electrocoagulation, therefore, the visual field of the operation can be clearer, and the operation difficulty is reduced; thirdly, the existing liver operation dissector can not realize bipolar coagulation, so the function of injecting liquid into the abdominal cavity does not exist, and the multifunctional liver operation dissector provided by the application adds a hemostasis mode of bipolar coagulation, and adds a liquid leading-in interface 9 at the connecting end 3 of the tubular part 1 for better ensuring the hemostasis effect of bipolar coagulation, so that the multifunctional liver operation dissector has the function of flushing/water injection, and the hemostasis effect is obviously improved.
As shown in fig. 3, the present application preferably divides the inner cavity only in a part near the operation end 2 by the partition 4 in the axial direction of the tubular member 1, and makes the first subchamber 5 divided by the partition 4 a chamber communicating with the operation end 2 and not communicating with the connection end 3. The partition piece 4 only partitions the part of the inner cavity close to the operation end 2, so that the whole inner cavity close to the connection end 3 can be used for guiding liquid or gas, and the tubular part 1 can suck out hematocele or introduce physiological saline more timely and efficiently; the first sub-cavity 5 is only communicated with the operation end 2 and not communicated with the connection end 3, because the first sub-cavity 5 is only a cavity for accommodating the hemostasis component and a Micro Electro Mechanical System (MEMS) which is described later, and the cavity is not communicated with the connection end 3, on the basis of ensuring the normal work and setting of the hemostasis component and the MEMS, the hemostasis component and the MEMS can be better protected.
Preferably, as shown in fig. 2, the cross-sectional area of the first subchamber 5 is smaller than the cross-sectional area of the second subchamber 6. That is, when the partition 4 is provided, the plate-like partition 4 is not positioned at the center of the tubular member 1 but positioned on the side of the axis of the tubular member 1, so that the cross-sectional area of the first subchamber 5 is smaller than half of the cross-sectional area of the tubular member 1, and the cross-sectional area of the second subchamber 6 is larger than half of the cross-sectional area of the tubular member 1. Through so setting up, under the prerequisite of guaranteeing hemostasis subassembly, micro-electromechanical system normal setting and normal work, the cross sectional area of second minute chamber 6 as the passageway can furthest's increase to make leading-in, the derivation of liquid can be more timely, abundant.
Specifically, as shown in fig. 3-6, a preferred hemostatic assembly comprises: a telescopic member 10 disposed in the first chamber 5, the telescopic member 10 being capable of reciprocating in the axial direction of the tubular member 1; the first cutter head 11 and the second cutter head 12 are movably arranged on the telescopic piece 10, and the first cutter head 11 and the second cutter head 12 can extend out of the tubular piece 1 from the operation end 2 and retract into the tubular piece 1 under the driving of the telescopic piece 10; the first cutter head 11 and the second cutter head 12 can be respectively conducted with the negative pole and the positive pole of a power supply, and the first cutter head 11 and/or the second cutter head 12 can realize the connection and the separation of the first cutter head 11 and the second cutter head 12 through the movement on the telescopic piece 10. Wherein, the first cutter head 11 and the second cutter head 12 are two electrodes of bipolar coagulation, the two electrodes are respectively communicated with the negative electrode and the positive electrode of a power supply, the rod-shaped telescopic piece 10 is used for driving the first cutter head 11 and the second cutter head 12 to extend out of the first sub-cavity 5 to the outer side of the operation end 2 or driving the first cutter head 11 and the second cutter head back into the first sub-cavity 5 from the outer side of the operation end 2, the movement of the telescopic piece 10 can be realized by the driving of a micro-motor, an air cylinder and other parts, when the bipolar coagulation is needed for hemostasis, the telescopic piece 10 drives the first cutter head 11 and the second cutter head 12 to extend out of the first sub-cavity 5, the first cutter head 11 and the second cutter head 12 are relatively moved and separated, then the first cutter head 11 is conducted with the negative pole of the power supply, the second cutter head 12 is conducted with the positive pole of the power supply, then the first cutter head 11 and the second cutter head 12 are moved to the wound position, and the bleeding is conducted to form a circuit loop so as to stop bleeding at the wound position; when hemostasis by monopolar electrocoagulation is required, the first cutter head 11 is disconnected from the negative pole of the power supply, and the first cutter head 11 and the second cutter head 12 are relatively moved to be jointed, so that the first cutter head 11 and the second cutter head 12 become one electrode (namely a monopolar electrode), and the jointed first cutter head 11 and second cutter head 12 are moved to the wound position to realize hemostasis on the wound position because the second cutter head 12 is still conducted with the positive pole of the power supply.
Preferably, the first and second bits 11 and 12 are rotatably disposed on the telescopic member 10, and the first and second bits 11 and 12 are separated from each other by rotating in a back direction and engaged with each other by rotating in an opposite direction, as shown in fig. 4. The first cutting head 11 and the second cutting head 12 are relatively movable, which means that the first cutting head 11 and the second cutting head 12 can rotate and/or move relatively, that is, the engagement and the disengagement between the two cutting heads can be realized through relative rotation, relative movement or the rotation and the movement at the same time, in the application, the first cutting head 11 and the second cutting head 12 are preferably separated and engaged through relative rotation, because the movement space required by relative rotation is smaller, and the mounting and the use on the multifunctional liver surgery dissector with smaller volume are more facilitated. Furthermore, as mentioned above, the first cutting head 11 and the second cutting head 12 can be engaged and disengaged by relative movement, for example, the first cutting head 11 is fixedly arranged on the telescopic member 10, and the second cutting head 12 can move on the telescopic member 10 along the radial direction of the tubular member 1, so as to approach and separate from the first cutting head 11.
Further, as shown in fig. 3, in the present application, it is preferable that a micro-electromechanical system is disposed in the first sub-chamber 5, and the micro-electromechanical system is used to automatically control the hemostatic assembly, the first valve 7, and other components, and the micro-electromechanical system includes: a controller 13 for controlling the rotation and power on/off of the first cutter head 11 and/or the second cutter head 12, and the telescopic member 10 moves under the control of the controller 13, and the opening degree of the first valve 7 is changed under the control of the controller 13; a plurality of control switches disposed outside the tubular member 1 and electrically connected to the controller 13. The micro electro mechanical system has the characteristics of small volume, rich control function, high control precision and the like, can better meet the working requirements of the multifunctional liver surgery dissector provided by the application, and can also better realize the installation in the tubular part 1 with narrow space, so the micro electro mechanical system is preferably used as the control system of the multifunctional liver surgery dissector in the application. Specifically, the mems is installed in the first sub-chamber 5, and in order to avoid the mems affecting the movement of the telescopic member 10, the mems is preferably installed at a position away from the operation end 2 of the first sub-chamber 5, and the mems is also preferably used to control the parts requiring movement, start/stop and power on/off, for example, the mems can control the telescopic member 10 to reciprocate to achieve the extension and retraction of the cutter head, the first cutter head 11 and the second cutter head 12 to rotate relatively to achieve the engagement and disengagement of the two, the first cutter head 11 and/or the second cutter head 12 to ensure the normal operation of monopolar electrocoagulation and bipolar electrocoagulation, and the first valve 7 can be controlled to open to adjust the flow rate of the sucked blood, smoke and the flow rate of the injected water, The start, stop, and switching of the separating, powering on and off, opening change, etc. actions are controlled by control switches, preferably buttons arranged on the outer peripheral wall of the tubular member 1, i.e. the operator starts, ends, switches, and adjusts the actions by touching the buttons (adjusting specifically refers to adjusting the opening of the first valve 7, which can be achieved by pressing different strokes on the buttons).
Specifically, as shown in fig. 3, the plurality of control switches include: a bipolar electrocoagulation switch 14 for controlling the telescopic piece 10 to move forward to make the first cutter head 11 and the second cutter head 12 extend out of the operation end 2, and making the first cutter head 11 and the second cutter head 12 separate and respectively conducted with different electrodes of the power supply; a monopolar electrocoagulation switch 15 for controlling the first cutter head 11 and the second cutter head 12 to be changed from a separation state to an engagement state, and enabling one of the first cutter head 11 and the second cutter head 12 to be conducted with the positive electrode of the power supply and the other to be not conducted with the electrode; the first cutter head 11 and the second cutter head 12 are controlled to be powered off, and the telescopic piece 10 is made to move reversely to drive the first cutter head 11 and the second cutter head 12 to retract to the hemostasis stop switch 16 in the first cavity 5. That is, in the present invention, it is preferable that only three operation switches are provided, because the smaller the number of operation switches provided, the more convenient the operation of the operator is, and the operation efficiency of the operation can be remarkably improved. While the three switches are preferably used to realize different hemostasis modes, that is, the bipolar coagulation switch 14 is used to control all actions of the whole bipolar coagulation operation, so that the bipolar coagulation can be realized in one step by one switch operation, that is, a plurality of actions of extending, separating and conducting different electrodes can be realized by pressing the bipolar coagulation switch 14 once (the monopolar coagulation switch 15 and the hemostasis stop switch 16 also have similar functions), and the specific realization of the plurality of actions can be realized under the control of the controller 13, for example, the controller 13 can detect (or memorize) the position of the cutter head, when the controller 13 detects that the cutter head is positioned in the first sub-chamber 5, the telescopic member 10 is controlled to move forward to remove the two cutter heads from the operation end 2, and then the controller 13 controls the first cutter head 11 and the second cutter head 12 to change from the joint state to the separation state (because the space in the first sub-chamber 5 is small, therefore, in order to ensure the normal storage of the two cutter heads in the first sub-chamber 5, the first cutter head 11 and the second cutter head 12 can be set in the controller 13 in advance to be in the joint state when being positioned in the first sub-chamber 5, so that the first cutter head 11 and the second cutter head 12 need to be separated when bipolar coagulation is required after being extended out), and the specific structure for realizing the transition between the joint state and the separation state can be as follows: a micro-motor controlled by a controller 13 is arranged on the telescopic element 10, and the micro-motor drives the first cutter head 11 and/or the second cutter head 12 to rotate on the telescopic element 10 to realize the connection and the separation of the two cutter heads (or electromagnets can be respectively arranged in the first cutter head 11 and the second cutter head 12, and the acting force between the two electromagnets is converted between the repulsive force and the attractive force by switching on the electromagnets in different directions to realize the connection and the separation of the two cutter heads). After the first cutter head 11 and the second cutter head 12 are separated, the first cutter head 11 is communicated with the negative pole of a power supply, the second cutter head 12 is communicated with the positive pole of the power supply, and then the operation end 2 is moved to a wound position and the bipolar coagulation can perform hemostasis operation through the conduction of electrolyte liquid. When the monopolar electrocoagulation switch 15 is pressed by the operator, the telescopic piece 10, the first cutter head 11 and the second cutter head 12 perform the same actions as described above, except that the first cutter head 11 and the second cutter head 12 are in a joint state, the first cutter head 11 is not powered, and the second cutter head 12 is communicated with a positive pole (after the monopolar electrocoagulation switch 15 is pressed by the operator, the first cutter head 11 is disconnected from the negative pole of the power supply and the first cutter head 11 and the second cutter head 12 are changed from a separation state to a joint state when the monopolar electrocoagulation is switched on. When the operator presses the hemostatic stop switch 16 when the hemostatic operation is no longer needed, the controller 13 detects (or memorizes) the position of the cutter head, and when the controller 13 detects that the cutter head is located outside the first sub-chamber 5, the controller controls the first cutter head 11 and the second cutter head 12 to be switched to the engaged state (if the engaged state is not needed), and both the cutter heads are powered off, and then the controller 13 controls the telescopic member 10 to move the telescopic member 10 in the reverse direction so that the two cutter heads move back into the first sub-chamber 5.
Further, without considering the degree of complexity of the operation, more control switches may be provided so that they correspond to each of the above-described operations one by one.
Further, it is preferable that pressure sensors (not shown in the figure) are arranged at the bottoms of the bipolar electrocoagulation switch 14 and the monopolar electrocoagulation switch 15, and the pressure sensors can detect whether the bipolar electrocoagulation switch 14 and the monopolar electrocoagulation switch 15 are stressed or not and the stress magnitude, so that the controller 13 can control the opening degree of the first valve 7 according to detection signals of the pressure sensors, and by means of the arrangement, the suction or flushing/water injection force can be simultaneously controlled and adjusted according to the operation condition of electrocoagulation while the monopolar electrocoagulation and bipolar electrocoagulation operation is controlled by one key, so that the operation is simpler and more convenient, and the hemostasis effect of the multifunctional liver operation dissector provided by the application is further improved. Specifically, the bipolar electrocoagulation switch 14 and the monopolar electrocoagulation switch 15 both have a larger pressing stroke, so that the two sensors respectively located below the two keys can fully detect the pressing force borne by the two keys, i.e., the larger the stroke of the pressed key is, the larger the pressing force is, when an operator starts to press the switch, the hemostasis operation of monopolar electrocoagulation or bipolar electrocoagulation starts to be performed, along with the continuous pressing of the operator on the switch, through the cooperation of the pressure sensor and the controller 13, the opening degree of the first valve 7 is gradually increased under the control of the controller 13, the flow rate of the sucked blood, smoke or injected physiological saline is increased, so that the hemostasis effect can be improved, the visual field is cleaned, the operation difficulty is reduced, and the operation efficiency is improved. In addition, the opening degree of the first valve 7 can be controlled by setting a special switch.
As shown in fig. 7, the circuit for communicating the first and second tool bits 11 and 12 with the power source includes: a first line 17 for connecting the negative pole of the power supply and the first blade head 11, wherein the first line 17 is provided with a first switch 18 for controlling the on-off of the first line 17; a second line 19 for connecting the positive pole of the power supply and the second tool bit 12, wherein a second switch 20 for controlling the on-off of the second line 19 is arranged on the second line 19; and a third line 21 connected in parallel with the second switch 20, wherein a third switch 22 for controlling the on/off of the third line 21 is arranged on the third line 21. During the bipolar electrocoagulation, the third switch 22 is switched off, the first switch 18 and the second switch 20 are both switched on, so that the first line 17 and the second line 19 are simultaneously communicated, at the moment, the first cutter head 11 in a separated state is communicated with the negative pole of the power supply through the first line 17, and the second cutter head 12 is communicated with the positive pole of the power supply through the second line 19; during monopolar electrocoagulation, the third switch 22 is closed, the first switch 18 and the second switch 20 are both opened, the third line 21 is communicated, the first line 17 and the second line 19 are both opened, the first cutter head 11 in the joint state is not communicated with the negative electrode, and the second cutter head 12 is communicated with the positive electrode through the third line 21; when the hemostatic operation is not performed, the first switch 18, the second switch 20, and the third switch 22 are all off, the first line 17, the second line 19, and the third line 21 are not connected, and the first blade 11 and the second blade 12 in the engaged state are not energized.
In addition, as shown in fig. 3, the second valve 23 for controlling the connection end 3 and the gas-liquid outlet port 8 to be opened and closed, and the third valve 24 for controlling the connection end 3 and the liquid inlet port 9 to be opened and closed are controlled by the controller 13. That is, "attract" and "wash/water injection" also can realize automatic switch-over through controller 13 to corresponding special change over switch that sets up simultaneously, thereby make the operation go on simple, convenient more. Furthermore, the third valve 24 is preferably a throttle valve with an adjustable opening degree, so that the flow rate of flushing/water injection can be controlled, the purpose of randomly and properly filling the physiological saline in the bipolar electrocoagulation process is realized, and the hemostasis effect is better improved.
In summary, in a plurality of functional liver dissectors provided by the present application:
by applying the micro-electro-mechanical system and the throttle valve, the controllable flow of 'suction' can be realized, so that the monopolar electrocoagulation and 'suction' can be combined (namely, can be carried out simultaneously), and the hemostatic effect of the monopolar electrocoagulation with the maximum efficiency can be exerted. When a large range and a large amount of bleeding occur or the hemostatic effect of monopolar electrocoagulation is poor, the mode can be switched to the bipolar electrocoagulation mode, namely, an operator can switch between the monopolar electrocoagulation mode and the bipolar electrocoagulation mode at any time according to specific conditions by simultaneously configuring the hemostatic assemblies with the monopolar electrocoagulation function and the bipolar electrocoagulation function. According to the hemostasis principle of bipolar coagulation, the two cutter heads are required to have dielectric liquid for playing the role of hemostasis, so that the flushing/water injection function is added, and the physiological saline can be dripped when the bipolar coagulation is used, so that the physiological saline can be used as the electrolyte liquid between the two cutter heads, and the bipolar coagulation can play a better hemostasis effect;
the functions of scraping (the functions of dissecting and separating liver tissues), coagulating (the function of hemostasis), attracting (the functions of keeping clear operation visual field and enhancing monopolar electrocoagulation hemostasis effect) and flushing/water injecting (the functions of keeping clear operation visual field and enhancing bipolar electrocoagulation hemostasis effect) are integrated into a whole, so that an operator can independently complete the laparoscopic liver operation possibly on the premise of not replacing operation instruments and depending on assistant assistance as little as possible, and the operation efficiency is greatly improved;
the flow controllable function can enhance the hemostasis effect of monopolar electric coagulation and bipolar electric coagulation, plays a vital role in maintaining the stability of pneumoperitoneum pressure in the operation process, and an operator can adjust the force of suction or flushing/water injection at any time by using the flow controllable function according to specific conditions, timely remove smoke, hematocele and flushing fluid generated in the operation, keep the operation visual field clear, maintain the stability of pneumoperitoneum pressure, avoid fluctuation of pneumoperitoneum pressure, so that the operation can be performed without pause, and the operation efficiency is remarkably improved.
The application provides a plurality of function liver dissectors possesses a plurality of advantages such as multi-functional, single bipolar electrode congeals and switches, the controllable and washing of flow/water injection, has reached convenient to use, security strong, hemostatic effect is good, a plurality of purposes such as operation efficiency height.
The structure of each part is described in a progressive mode in the specification, the structure of each part is mainly described to be different from the existing structure, and the whole and partial structures of the functional liver dissector can be obtained by combining the structures of the parts.
The previous description of the disclosed application is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these applications will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other applications without departing from the spirit or scope of the invention. Thus, the present invention is not intended to be limited to the applications shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.
Claims (10)
1. A multi-functional liver surgical dissector, comprising:
the device comprises a tubular part, a first clamping piece and a second clamping piece, wherein the two ends of the tubular part are respectively an operating end and a connecting end, the operating end is a tip end, a partition piece for dividing the inner cavity into a first sub-cavity and a second sub-cavity is arranged in the inner cavity of the tubular part, and the partition piece at least extends to the operating end;
a telescopic hemostasis assembly disposed in the first subchamber, the hemostasis assembly having a monopolar coagulation hemostasis mode and a bipolar coagulation hemostasis mode;
the opening of the first valve is adjustable, the second sub-cavity is communicated with the connecting end, and a gas-liquid outlet interface and a liquid inlet interface are arranged on the connecting end.
2. The multi-functional liver surgery dissector of claim 1 wherein in an axial direction of the tubular member, the partition partitions only a part of the inner cavity near the operation end, and the first subchamber partitioned by the partition is a chamber that communicates with the operation end and does not communicate with the connection end.
3. The multi-functional liver surgical dissector of claim 2 wherein the first subchamber has a smaller cross-sectional area than the second subchamber.
4. The multi-functional liver surgical dissector of claim 1 wherein the hemostasis assembly comprises:
a telescopic member disposed in the first subchamber, the telescopic member being reciprocally movable in an axial direction of the tubular member;
the first cutter head and the second cutter head are movably arranged on the telescopic piece and can extend out of the tubular piece from the operation end and retract into the tubular piece under the driving of the telescopic piece; the first cutter head and the second cutter head can be respectively conducted with the negative pole and the positive pole of a power supply, and the first cutter head and/or the second cutter head can be connected and separated through the movement of the telescopic piece.
5. The multi-functional liver surgical dissector of claim 4 wherein the first and second cutting heads are rotatably disposed on the telescoping member, the first and second cutting heads being configured to disengage from each other by rotation in a reverse direction and engage with each other by rotation in an opposite direction.
6. The multi-functional liver surgery dissector of claim 5 wherein the first compartment has a micro-electro-mechanical system disposed therein, the micro-electro-mechanical system comprising:
the controller controls the first cutter head and/or the second cutter head to rotate and switch on and off, the telescopic piece moves under the control of the controller, and the opening degree of the first valve is changed under the control of the controller;
a plurality of control switches disposed on an exterior of the tubular member and electrically connected to the controller.
7. The multi-functional liver surgical dissector of claim 6 wherein the plurality of control switches comprises:
the bipolar electrocoagulation switch is used for controlling the telescopic piece to move forwards so that the first cutter head and the second cutter head extend out of the operating end, and the first cutter head and the second cutter head are separated and are respectively conducted with different electrodes of a power supply;
a monopolar electrocoagulation switch for controlling the first cutter head and the second cutter head to be converted from a separation state to an engagement state, and enabling one of the first cutter head and the second cutter head to be conducted with a positive electrode of a power supply and the other to be not conducted with an electrode;
and controlling the first cutter head and the second cutter head to be powered off, and enabling the telescopic piece to move reversely to drive the first cutter head and the second cutter head to retract to the hemostasis stop switch in the first sub-cavity.
8. The multifunctional liver surgery dissector of claim 7 wherein the base of the bipolar coagulation switch and the monopolar coagulation switch are each provided with a pressure sensor capable of detecting whether and how much the bipolar coagulation switch and the monopolar coagulation switch are subjected to a force, so that the controller can control the opening of the first valve according to a detection signal of the pressure sensor.
9. The multi-functional liver surgical dissector of claim 7 wherein the electrical circuit that the first and second cutting heads communicate with a power source comprises:
the first circuit is connected with a negative electrode of a power supply and the first cutter head, and a first switch for controlling the first circuit to be switched on and off is arranged on the first circuit;
the second circuit is connected with the positive electrode of the power supply and the second tool bit, and a second switch for controlling the on-off of the second circuit is arranged on the second circuit;
and the third circuit is connected with the second switch in parallel, and is provided with a third switch for controlling the on-off of the third circuit.
10. The multifunctional liver surgery dissector of claim 6 wherein a second valve controlling the connection end and the gas-liquid outlet port and a third valve controlling the connection end and the liquid inlet port are both opened and closed under the control of the controller.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010998790.2A CN112075985A (en) | 2020-09-22 | 2020-09-22 | Multifunctional liver operation dissector |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202010998790.2A CN112075985A (en) | 2020-09-22 | 2020-09-22 | Multifunctional liver operation dissector |
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Cited By (2)
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| CN114431953A (en) * | 2022-03-03 | 2022-05-06 | 核工业总医院 | Flexible suction electrocoagulation set under neuroendoscopy |
| CN115381547A (en) * | 2022-07-18 | 2022-11-25 | 乔逸 | Electric coagulation hemostasis device used under nephroscope |
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