CN112401982A

CN112401982A - Thyroid gland separator

Info

Publication number: CN112401982A
Application number: CN202011292711.2A
Authority: CN
Inventors: 杨敬; 龚艳萍; 绉秀和; 龚日祥
Original assignee: West China Hospital of Sichuan University
Current assignee: West China Hospital of Sichuan University
Priority date: 2020-11-18
Filing date: 2020-11-18
Publication date: 2021-02-26
Anticipated expiration: 2040-11-18
Also published as: CN112401982B

Abstract

The invention provides a thyroid gland separator, which relates to the technical field of auxiliary instruments for surgical operations and comprises a left arc-shaped plate and a right arc-shaped plate which are oppositely arranged, wherein the left arc-shaped plate and the right arc-shaped plate are connected into a whole through a base, a plurality of edge pincers distributed along the arc direction are arranged on the inner sides of the left arc-shaped plate and the right arc-shaped plate, and the edge pincers are pivotally connected to the left arc-shaped plate or the right arc-shaped plate. The rear side of left arc and right arc top is provided with radian adjustable separation leading truck, and the separation leading truck passes through the support frame to be supported on the base, and the main part of separation leading truck is the transparence, is provided with the guide way on the separation leading truck, is provided with the opaque location strip along the both sides limit of guide way, and the top of separation leading truck is provided with directly penetrates the lamp. The scalpel device is arranged in the guide groove in a sliding mode and comprises a scalpel head, the scalpel head is connected to the telescopic mechanism, and the telescopic mechanism is connected with the telescopic meter. Solves the problem that the accurate excision can not be carried out when the thyroid is excised in a wedge shape in the prior art.

Description

Thyroid gland separator

Technical Field

The invention relates to the technical field of surgical operation auxiliary instruments, in particular to a thyroid gland separator.

Background

Subthreshold thyroidectomy is an effective means for treating simple goiter, hyperthyroidism, thyroid cyst and the like. A subthreshold thyroidectomy generally comprises the steps of: 1. making an arc incision along dermatoglyph at the position of a transverse finger 2 above a notch on the sternum; 2. cutting off the thyroid gland anterior muscle group to expose the thyroid gland; 3. treating the upper thyroid pole; 4. treating hypothyroidism; 5. treating the isthmus; 6. cutting off the thyroid gland in a wedge shape; 7. drainage and suture of incision.

Wherein, the wedge-shaped excision thyroid gland in the step 6 has the following specific operations in the existing clinic: the thyroid gland is turned over from the outer edge of the gland to the front inner side to expose the back of the gland, the boundary of the cut gland is determined, parathyroid gland is required to be reserved below a tangent line to avoid damaging recurrent laryngeal nerves, a little gland tissue is clamped by one row or two rows of mosquito-type vascular clamps along a preset cutting line on the outer side, and then the thyroid gland is cut off in a wedge shape above the vascular clamps. The number of the removed glands depends on the toxic degree of the patient, for example, about 90% of the glands should be removed from the patient with hyperthyroidism, and generally, about one thumb-end-sized sheet of the residual gland tissue on each side covers the parathyroid gland and the recurrent laryngeal nerve, which is enough to maintain the physiological functions of the patients and prevent relapse. For patients with nodular goiter, some more should be retained (about 2 times the retention for patients with hyperthyroidism). The capsule behind the gland should also be retained as much as possible to prevent damage to the parathyroid gland and recurrent laryngeal nerves.

However, in actual operation, due to the influence of many factors such as experience of the operator, control ability of the surgical knife, and physical conditions of the operator during the operation, the resection amount and the resection direction cannot be accurately controlled during the resection of the thyroid gland, and many surgical sequelae are generated. For example, hypothyroidism can result if there is excessive thyroidectomy; when the direction is not precisely controlled during excision, the parathyroid gland is easily injured to cause convulsion, or the recurrent laryngeal nerve is injured to cause hoarseness, and the like.

Disclosure of Invention

Aiming at the problems in the prior art, the invention provides a thyroid gland separator, which solves the problem that the thyroid gland can not be accurately cut when being cut in a wedge shape in the prior art.

In order to achieve the purpose of the invention, the technical scheme adopted by the invention is as follows:

the utility model provides a thyroid gland separator, it is including relative left arc and the right arc that sets up, and left arc and right arc pass through the base and connect as an organic wholely, and the inboard of left arc and right arc all is provided with along a plurality of marginal pincers of pitch arc direction distribution, and marginal pincers pivot connection is on left arc or right arc. The rear side of left arc and right arc top is provided with radian adjustable separation leading truck, and the separation leading truck passes through the support frame to be supported on the base, and the main part of separation leading truck is the transparence, is provided with the guide way on the separation leading truck, is provided with the opaque location strip along the both sides limit of guide way, and the top of separation leading truck is provided with directly penetrates the lamp. The scalpel device is arranged in the guide groove in a sliding mode and comprises a scalpel head, the scalpel head is connected to the telescopic mechanism, and the telescopic mechanism is connected with the telescopic meter.

The invention has the beneficial effects that: the left arc plate and the right arc plate are arranged at the left position and the right position which are adjacent to the rear side of the thyroid, the edge tissue of the thyroid can be clamped through edge forceps to fix the whole separator, so that the separation guide frame can be positioned right above the thyroid, the light of a straight spotlight penetrates through the transparent separation guide frame to irradiate on the thyroid, meanwhile, an opaque positioning strip can cast shadow on the thyroid, whether a guide groove is aligned with a surgical line is judged by vertically observing whether two shadow lines are positioned at two sides of the surgical line drawn on the thyroid, when the two shadow lines are not aligned, the guide groove can be aligned by adjusting the radian of the separation guide frame, after the alignment, the scalpel device moves along the guide groove to control the accuracy of an actual cutting position and the surgical line, meanwhile, a telescopic mechanism on the scalpel device can control the cutting depth of a scalpel head, and an operator can timely master the cutting depth through telescopic display, thereby ensuring the accuracy of the operation and reducing the occurrence of complications.

Drawings

Fig. 1 is a schematic front view of a thyroid gland separator.

Fig. 2 is a schematic bottom view of the thyroid separator.

Fig. 3 is a schematic structural view of the scalpel device.

Fig. 4 is a schematic structural view of an edge clamp.

Fig. 5 is a schematic structural view of the buckle.

Fig. 6 is a schematic view of a surgical thread on the thyroid.

Wherein, 1, a left arc-shaped plate; 2. a right arc-shaped plate; 3. a base; 4. edge clamping; 41. fixing the clamp rod; 42. rotating the clamp rod; 43. rotating the sleeve; 44. a pivot; 5. separating the guide frame; 51. a guide groove; 52. a positioning bar; 6. a direct-emitting lamp; 7. a support frame; 71. a first spoke; 72. a second spoke; 721. an arc-shaped guide plate; 73. a third spoke; 74. a support pillar; 75. buckling; 751. an inclined plate; 752. a first spring; 753. a spring box; 754. a baffle plate; 8. a scalpel device; 81. a cutter head; 82. a telescoping mechanism; 821. a central screw; 822. fixing the sleeve; 823. finely adjusting the sleeve; 824. a rotating ring; 825. a grip handle; 83. a telescopic meter; 84. a sliding seat; 841. a sliding groove.

Detailed Description

The following description of the embodiments of the present invention is provided to facilitate the understanding of the present invention by those skilled in the art, but it should be understood that the present invention is not limited to the scope of the embodiments, and it will be apparent to those skilled in the art that various changes may be made without departing from the spirit and scope of the invention as defined and defined in the appended claims, and all matters produced by the invention using the inventive concept are protected.

As shown in fig. 1, the thyroid gland separator comprises a left arc plate 1 and a right arc plate 2 which are oppositely arranged (the left, right, front and back described in the scheme are all visual angles of the operator facing to the incision position), and the radian of the left arc plate 1 and the right arc plate 2 are respectively close to the edge of the rear side of the thyroid gland. Left side arc 1 and right arc 2 are connected as an organic wholely through base 3, and base 3 need avoid the lower extreme of thyroid gland, still need reserve the space of turning over the thyroid gland inboard forward from the gland outer fringe, and the effect that base 3 played is that connection left side arc 1 and right arc 2 can support separation leading truck 5 simultaneously.

The inner sides of the left arc-shaped plate 1 and the right arc-shaped plate 2 are both provided with a plurality of edge pincers 4 distributed along the arc direction, and the edge pincers 4 are pivotally connected to the left arc-shaped plate 1 or the right arc-shaped plate 2. Preferably, the edge forceps 4 comprises a fixed forceps rod 41 and a rotating forceps rod 42 which are hinged to each other at the middle, a rotating return spring is arranged at the hinged position, the forceps head parts of the fixed forceps rod 41 and the rotating forceps rod 42 are the same as the forceps head part of the mosquito-blood vessel forceps, in a natural state, the forceps heads are clamped, when clamping is needed, the forceps arms of the fixed forceps rod 41 and the rotating forceps rod 42 are pinched, the forceps heads are opened and clamped on the edge of the thyroid gland, then the forceps arms are loosened, and clamping is carried out under the return action of the torsion spring at the hinged position.

As shown in fig. 4, the fixed clamp lever 41 has a rotating sleeve 43 fixed to the clamp arm end, the rotating sleeve 43 is rotatably sleeved on a pivot 44, and the pivot 44 is fixed to the left arc-shaped plate 1 or the right arc-shaped plate 2. The pivot shaft 44 includes a central shaft inserted with clearance in the rotating sleeve 43 and a nut or the like that axially restricts the rotating sleeve 43.

The rear side of left side arc 1 and the 2 tops of right arc is provided with radian adjustable separation leading truck 5, and separation leading truck 5 supports on base 3 through support frame 7. As shown in fig. 2, the main body of the separation guide frame 5 is transparent, the main body is preferably made of transparent plastic material with better plasticity, the separation guide frame 5 is arch-shaped, one end of the separation guide frame 5 is fixed, the middle part of the separation guide frame is supported, and finally the curvature of the separation guide frame 5 can be adjusted within a certain range through the other end of the separation guide frame, so that the separation guide frame is closer to an operation line drawn on the thyroid by an operator. As shown in fig. 6, the operation line is an optimal cutting position of the thyroid gland which is determined by the operator through comprehensive judgment of the disease condition of the patient, the size of the thyroid gland, the recurrent laryngeal nerve and the position of the parathyroid gland before the operation cutting, and is drawn on the surface of the thyroid gland for guiding the cutting.

Be provided with guide way 51 on the separation leading truck 5, guide way 51 is the strip-shaped groove that extends and run through along thickness direction along the main part length direction of separation leading truck 5, and on vertical direction, the central line of guide way 51 aligns the back with the operation line, can lead to the accuracy that guarantees the cutting position to scalpel device 8. But how is the center line of the guide groove 51 aligned with the surgical line judged in a limited space at the thyroid? Since the operator cannot observe the guide groove 51 from directly above, there is a deviation in oblique observation. Therefore, in order to accurately judge whether the guide groove 51 is aligned with the operation line, the straight spot lamp 6 is arranged right above the guide groove 51, the straight spot lamp 6 is supported by the support frame 7, the light of the straight spot lamp 6 penetrates through the transparent main body of the separation guide frame 5, the operation part of the thyroid gland can be illuminated, then the lightproof positioning strips 52 are arranged along two side edges of the guide groove 51, the lightproof positioning strips 52 block the light to penetrate, two shadow lines can be formed on the thyroid gland, and whether the guide groove 51 is aligned with the operation line can be judged by observing whether the operation line is positioned in the two shadow lines. Preferably, the positioning bar 52 is an iron sheet embedded in the main body of the separation guide 5, and the iron element content in the iron sheet is required to ensure that the iron sheet is not broken when the bending degree of the separation guide 5 is adjusted.

The support frame 7 comprises a support column 74 with the bottom end fixed on the base 3, the support column 74 extends upwards from the base 3 to the upper part of the separation guide frame 5 and is provided with a direct light 6, and the direct light 6 needs to ensure that the separation guide frame 5 can orthographically project. The first spoke 71, the second spoke 72 and the third spoke 73 are fixed at the middle part of the supporting column 74 in a divergent shape, the first spoke 71, the second spoke 72 and the third spoke 73 are distributed along the radial direction of the supporting column 74,

one end of the separation guide frame 5 is fixed on the first spoke 71, the end of the second spoke 72 is fixed with an arc guide plate 721 for supporting the middle part of the separation guide frame 5, and the outer side of the arc guide plate 721 in the radial direction is provided with an arc groove for the separation guide frame 5 to bypass, so that the middle part of the separation guide frame 5 is always arc-shaped when the radian is adjusted.

The third spoke 73 is provided with a plurality of buckles 75 along the radial direction, the other end of the separation guide frame 5 is adjustably connected into the buckles 75, the separation guide frame 5 can have different radians through different buckles 75 in clamping connection, the requirements of different lines for separating the thyroid are met, the thyroid is separated more accurately, the physiological function of the thyroid can be maintained, and the thyroid cannot relapse.

As shown in fig. 5, the clip 75 includes an inclined plate 751, the inclined plate 751 is supported by a first spring 752, the first spring 752 is disposed in a spring box 753, the spring box 753 is disposed in the third spoke 73, two ends of the inclined plate 751 are both fixed with a baffle 754, and one end of the inclined plate 751 far away from the supporting column 74 is a lower end and the lower end is flush with the third spoke 73. The end of the separation guide 5 is fixed with a short column with a cambered bottom surface, the short column slides along the inclined plate 751 from the lower end to the upper end and falls onto the top surface of the third spoke 73 after continuing sliding, and the short column can be stably fixed by blocking the upper end.

The scalpel device 8 is slidably disposed in the guide groove 51, as shown in fig. 3, the scalpel device 8 includes a scalpel head 81, the scalpel head 81 is a portion of the thyroid scalpel without a handle, the scalpel head 81 is connected to a telescopic mechanism 82, and the telescopic mechanism 82 is connected to a telescopic gauge 83.

Preferably, the telescopic mechanism 82 includes a central screw 821, a fixed sleeve 822 is screwed on the central screw 821, a fine adjustment sleeve 823 is screwed on the fixed sleeve 822, the central screw 821 is connected with the fine adjustment sleeve 823, one end of the central screw 821 is detachably connected with the tool bit 81, the other end of the central screw is fixed with a rotating ring 824, and knurling is processed on the outer cylindrical surface of the rotating ring 824 to improve the friction force during rotating and holding. Rotate swivel 824 and drive central screw 821 and rotate, rotate the round, central screw 821 can be along a pitch of fixed sleeve 822 axial displacement for tool bit 81 can be to the inside pitch of cutting the depth of thyroid gland, can finely tune the degree of depth of tool bit 81 through fine setting sleeve 823 after big degree of depth adjustment has been good, makes the adjustment more accurate.

Be provided with the direction boss on the location strip 52, be connected with sliding seat 84 on the fixed sleeve 822, be provided with the sliding tray 841 that supplies to lead the boss embedding on sliding seat 84's the bottom surface, sliding seat 84 can remove along the direction boss to drive tool bit 81 and remove the cutting along the operation line, prevent because the operation accident that the condition such as art person hand trembled caused, the accuracy of operation cutting is guaranteed through the device, reduces experience and operation ability dependency to the art person. The fixing sleeve 822 is fixed with a holding handle 825, the shape of the holding handle 825 is not shown in the figure, and the specific shape should be the same as that of the holding handle of the existing scalpel, so that the operator can conveniently hold the holding handle according to the standard action.

The telescopic gauge 83 includes a grating scale for measuring the elongation of the central screw 821 relative to the fixed sleeve 822, and an integrated circuit and a display screen for converting the elongation measured by the grating scale into numbers for displaying. The display of the measurement length according to the grating technology is similar to that of an electronic micrometer in the prior art, and is not described herein again.

Claims

1. The thyroid gland separator is characterized by comprising a left arc-shaped plate (1) and a right arc-shaped plate (2) which are oppositely arranged, wherein the left arc-shaped plate (1) and the right arc-shaped plate (2) are connected into a whole through a base (3), a plurality of edge clamps (4) distributed along the arc direction are arranged on the inner sides of the left arc-shaped plate (1) and the right arc-shaped plate (2), and the edge clamps (4) are pivotally connected to the left arc-shaped plate (1) or the right arc-shaped plate (2);

a separation guide frame (5) with adjustable radian is arranged on the rear side above the left arc-shaped plate (1) and the right arc-shaped plate (2), the separation guide frame (5) is supported on the base (3) through a support frame (7), the main body of the separation guide frame (5) is transparent, a guide groove (51) is arranged on the separation guide frame (5), two lighttight positioning strips (52) are arranged along two side edges of the guide groove (51), and a direct-emitting lamp (6) is arranged above the separation guide frame (5);

the scalpel device (8) is arranged in the guide groove (51) in a sliding mode, the scalpel device (8) comprises a scalpel head (81), the scalpel head (81) is connected to a telescopic mechanism (82), and a telescopic meter (83) is connected to the telescopic mechanism (82).

2. The thyroid gland separator according to claim 1, wherein the edge forceps (4) comprises a fixed forceps rod (41) and a rotating forceps rod (42) which are hinged to each other at the middle part, a rotating return spring is arranged at the hinged part, a rotating sleeve (43) is fixed at the forceps arm end of the fixed forceps rod (41), the rotating sleeve (43) is rotatably sleeved on a pivot (44), and the pivot (44) is fixed on the left arc-shaped plate (1) or the right arc-shaped plate (2).

3. The thyroid gland separator according to claim 1, wherein the support frame (7) comprises a support pillar (74) with one end fixed on the base (3), the middle of the support pillar (74) is fixed with a first spoke (71), a second spoke (72) and a third spoke (73) which are divergently arranged, one end of the separation guide frame (5) is fixed on the first spoke (71), the end of the second spoke (72) is fixed with an arc-shaped guide plate (721) for supporting the middle of the separation guide frame (5), the third spoke (73) is provided with a plurality of buckles (75) along the radial direction, and the other end of the separation guide frame (5) is adjustably connected in the buckles (75).

4. Thyroid separator according to claim 3, wherein the clasp (75) comprises an inclined plate (751), the inclined plate (751) being supported by a first spring (752), the first spring (752) being arranged in a spring box (753), the spring box (753) being arranged in the third spoke (73), the inclined plate (751) being fixed at both ends with a stop (754), the inclined plate (751) being at the lower end remote from the support column (74).

5. The thyroid separator according to claim 1, wherein the positioning strip (52) is provided with a guide boss, the scalpel device (8) is provided with a sliding seat (84), and a sliding groove (841) for the guide boss to be embedded is formed on the bottom surface of the sliding seat (84).

6. The thyroid gland separator according to claim 1, wherein the telescoping mechanism (82) comprises a central screw (821), a fixed sleeve (822) is connected to the central screw (821) in a threaded manner, a fine adjustment sleeve (823) is connected to the fixed sleeve (822) in a threaded manner, the fine adjustment sleeve (823) is connected to the central screw (821), one end of the central screw (821) is detachably connected to the cutter head (81), and a rotating ring (824) is fixed to the other end of the central screw.

7. Thyroid separator according to claim 6, wherein a gripping handle (825) is fixed to the fixation sleeve (822).

8. Thyroid separator according to claim 6, wherein the telescopic gauge (83) comprises a grating ruler for measuring the elongation of the central screw (821) relative to the fixed sleeve (822) and an integrated circuit and a display screen for converting the elongation measured by the grating ruler into numbers for display.