CN113017726A

CN113017726A - Incision distraction device in cavity mirror thyroidectomy

Info

Publication number: CN113017726A
Application number: CN202110239646.5A
Authority: CN
Inventors: 王姝姝; 李时飞; 张毅; 曾令娟; 王泽惠; 马丹丹
Original assignee: First Affiliated Hospital of PLA Military Medical University
Current assignee: First Affiliated Hospital of PLA Military Medical University
Priority date: 2021-03-04
Filing date: 2021-03-04
Publication date: 2021-06-25
Anticipated expiration: 2041-03-04
Also published as: CN113017726B

Abstract

The invention relates to a incision opening device in endoscopic thyroidectomy, which comprises a hook pulling assembly and a pusher, wherein the hook pulling assembly comprises a fixed seat, an elastic strip and a plurality of hooks, the pusher is arranged at the top of the fixed seat, the fixed seat is a cylinder, the elastic strip is a spring steel sheet, two ends of the spring steel sheet are fixed on the outer cylindrical surface of the fixed seat in an unconstrained manner, the hooks are arranged on the elastic strip in parallel, the hooks comprise a connecting end and a free end integrally arranged with the connecting end, the connecting end is fixed with the elastic strip, the free end and the connecting end form an included angle, and an opening and closing assembly and a limiting assembly are arranged at two ends of the elastic strip. The invention combines a plurality of pulling hooks on the elastic strip, so that the pulling hooks are in a conical frame structure when combined, are favorable for entering the incision, and are in a rake-shaped structure when opened, are favorable for integrally acting on muscles on one side of the incision, the adhesive force is enhanced, the pulling effect is better, and the exposed state of the incision is better.

Description

Incision distraction device in cavity mirror thyroidectomy

Technical Field

The invention relates to the technical field of medical operation tools, in particular to an internal incision opening device for endoscopic thyroidectomy.

Background

The endoscopic thyroidectomy operation directly reaches the operative field through areola and a subcutaneous tunnel, and the operation is completed under the assistance of an endoscope. Has no scar on the neck after operation, has better cosmetic effect and is gradually accepted by patients, particularly female patients. In the operation, cut an incision as the surgical instrument passageway to the thyroid gland region with the supersound sword, for the exposure level that improves this incision, need strut the processing to the incision to make things convenient for medical personnel to excise and take out the thyroid gland operation, and the incision props horizontal level and form and has important influence to operation quality and efficiency.

In the prior art, a draw hook with a sharp head is placed in an operation incision, then a hand pulls a pull hook along one side of the incision, and the head of the pull hook drives muscles to move towards the same side, so that the incision is opened. This operation can open the incision, but has the following problems:

firstly, the sharp head and the hook body are bent, and have a certain width, so that the sharp head and the hook body are inconvenient to enter an incision and are easy to damage muscles; secondly, when the muscle tissue is pulled, the sharp head may also cause damage to the muscle tissue; in addition, the existing drag hook only has one hook body and only one force point, and the exposure level to the incision is limited, so that an operator cannot observe the incision, and the efficiency and the quality of the operation are influenced.

Therefore, there is a need to develop an incision opening device under endoscopic conditions, which is convenient to operate, can safely enter an incision, has a plurality of force points, can open the incision horizontally to a greater extent, and has important significance for improving the safety of the thyroid tissue excision operation.

Disclosure of Invention

The invention aims to provide an incision opening device in an endoscopic thyroidectomy, which can safely enter an incision without damage and can safely pull the incision open so as to solve the problem of potential safety hazard in the prior art.

In order to solve the technical problems, the technical scheme of the invention is as follows:

an incision opening device in endoscopic thyroidectomy comprises a hook pulling assembly and a pusher, wherein the hook pulling assembly comprises a fixed seat, an elastic strip and a plurality of pulling hooks, the top of the fixed seat is provided with the pusher, the fixed seat is a cylinder, the elastic strip is a spring steel sheet, two ends of the spring steel sheet are fixed on the outer cylindrical surface of the fixed seat without being restricted, the plurality of pulling hooks are parallel to each other and are arranged on the elastic strip at intervals, the hook comprises a connecting end and a free end which is integrally arranged with the connecting end, the connecting end is fixed with the elastic strip, the free end and the connecting end form an included angle, the two ends of the elastic strip are provided with an opening and closing component and a limiting component capable of controlling the opening and closing state of the opening and closing component, when the opening and closing component is opened, the plurality of pulling hooks are of a rake-shaped structure, and when the pulling hooks are closed, the plurality of pulling hooks are of a conical frame structure which can be conveniently inserted into the incision.

Further, the switching subassembly includes fixed block and insertion tongue, the fixed block sets up the one end at the elasticity strip, the insertion tongue sets up the other end at the elasticity strip, the fixed block be provided with insertion tongue matched with jack, insertion tongue inserts in the jack, makes the elasticity strip closure be the ring structure.

Further, stop device includes gag lever post and lifting push rod, the fixing base link up along its axis direction and is provided with the guiding hole, gag lever post slidable ground sets up in the guiding hole, lifting push rod can dismantle to be fixed in the pusher, lifting push rod's push rod tip is fixed with gag lever post one end, promotes the gag lever post and freely goes up and down along the guiding hole to make the other end of gag lever post stretch out the fixing base, control the switching state of switching subassembly.

Furthermore, the inserting tongue is provided with a first limiting hole, the upper surface of the fixing block is provided with a second limiting hole, the limiting rod moves into the first limiting hole and the second limiting hole to lock the elastic strip, and the limiting rod moves out of the second limiting hole and the first limiting hole to expand the elastic strip.

Furthermore, the end part of the free end is provided with a hook head, and the hook head adopts a combined structure of an inner framework and an outer cladding.

Furthermore, the pulling hook is made of a spring steel sheet.

Further, still include the power, the power with lift push rod electric connection.

Further, the pusher is a rubber tube, and the rubber tube is in threaded connection with the fixed seat.

Furthermore, an orientation mark for marking the direction of the hook is arranged on the pusher.

The invention has the technical effects that:

the pulling hook assembly is sent into the incision through the pusher, the incision direction is observed in the endoscope, the pusher and the pulling hook assembly are rotated to enable the unfolding direction of the pulling hook to be consistent with the incision direction, then the pulling hook assembly is opened, the pulling hook is attached to incision muscles in a rake shape, the pusher is pulled along the direction mark outside, the operation incision is opened, and the focus area is fully exposed. The invention creatively combines a plurality of pulling hooks on the elastic strip, so that the pulling hooks are in a conical frame structure when combined, are favorable for entering the incision, and are in a rake-shaped structure when opened, are favorable for integrally acting on muscles on one side of the incision, the adhesive force is enhanced, the pulling effect is better, and the exposed state of the incision is better. The safety of the thyroid tissue excision operation is obviously improved.

Drawings

FIG. 1 is a schematic view of the present invention;

FIG. 2 is a front view of the present invention;

FIG. 3 is a rear view of the present invention;

FIG. 4 is a schematic view of the present invention in an open state;

FIG. 5 is a front view of the elastic strip of the present invention;

FIG. 6 is a top view of the elastic strip of the present invention;

FIG. 7 is a schematic view of the present invention;

fig. 8 is an enlarged sectional view taken along a-a of fig. 2.

Description of reference numerals:

1-pulling the hook component; 2-a pusher; 3-fixing the base; 4-an elastic strip; 5-pulling the hook; 6-control switch; 7-a connecting end; 8-free end; 9-hook head; 10-fixing blocks; 11-inserting tongue; 12-a first limit hole; 13-a second limit hole; 14-a limiting rod; 15-a pilot hole; 16-orientation mark; 17-a power supply; 18-a stop device; 19-lifting push rod; 20-a fastening screw; 21-fixing the sleeve; 22-connecting plate.

Detailed Description

In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. The components of embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.

Thus, the following detailed description of the embodiments of the present invention, presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, it need not be further defined and explained in subsequent figures.

In the above description of the present invention, it should be noted that the terms "one side", "the other side" and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings or orientations or positional relationships that the products of the present invention are conventionally placed in use, and are only for convenience of describing the present invention and simplifying the description, but do not indicate or imply that the device or the element to which the present invention is directed must have a specific orientation, be constructed in a specific orientation, and be operated, and thus should not be construed as limiting the invention. Furthermore, the terms "first," "second," and the like are used merely to distinguish one description from another, and are not to be construed as indicating or implying relative importance.

Further, the term "identical" and the like do not mean that the components are absolutely required to be identical, but may have slight differences. The term "perpendicular" merely means that the positional relationship between the components is more perpendicular than "parallel", and does not mean that the structure must be perfectly perpendicular, but may be slightly inclined.

As shown in fig. 1 to 8, in an embodiment, an incision opening device in endoscopic thyroidectomy is provided, which includes a hook component 1 and a pusher 2, wherein the pusher is used for delivering the hook component 1 to a target position, specifically:

the hook pulling assembly comprises a fixed seat 3, an elastic strip 4 and a plurality of pulling hooks 5, the fixed seat is a cylinder, the elastic strip is a spring steel sheet, certain elastic force is achieved, changes of different forms are conducted, the middle area of the elastic strip is fixed on the fixed seat, the freedom degrees of two ends of the elastic strip are at least guaranteed, free movement can be achieved, the elastic strip is better, a fastening screw can be arranged between the elastic strip and the fixed seat, the elastic strip and the fixed seat are fixed together, the elastic strip can be stretched into a straight strip shape, and the elastic strip can be curled into a circular ring shape.

As shown in fig. 4, the plurality of pulling hooks are parallel to each other and arranged on the elastic strip at intervals, each pulling hook comprises a connecting end 7 and a free end 8, the connecting ends and the free ends are integrally arranged, the connecting ends are fixed with the elastic strip, the free ends and the connecting ends are arranged at included angles, as shown in fig. 7, the two ends of the elastic strip are also provided with an opening and closing component and a limiting device 18, the limiting device can control the opening and closing component to be opened and closed, when the opening and closing component is opened, the plurality of pulling hooks are in a rake-shaped structure, as shown in fig. 4, the pulling state can be formed by bisecting the notches, and when the opening and closing component is closed, the plurality of pulling hooks are in a conical frame structure, as shown in. In this embodiment, the hook head 9 is disposed at the end of the free end, as shown in fig. 7, and the hook head adopts a combination structure of an inner frame and an outer covering layer, the inner frame can be made of stainless steel sheet or other spring steel, and the outer covering layer can be made of silica gel, so as to form a hook body with high supporting strength, soft surface and good affinity. When the incision is pulled out, the muscle tissue can not be damaged.

In this embodiment, as shown in fig. 5 and 6, the opening and closing assembly includes a fixing block 10 and a tongue 11, the fixing block is disposed at one end of the elastic strip, the tongue is disposed at the other end of the elastic strip, the fixing block is provided with a socket engaged with the tongue, and the tongue is inserted into the socket to close the elastic strip into a circular structure. Furthermore, the inserting tongue is provided with a first limiting hole 12, the fixing block is provided with a second limiting hole 13, and when the inserting tongue is inserted, the second limiting hole is aligned with the first limiting hole.

In this embodiment, as shown in fig. 8, the limiting device includes a limiting rod 14 and a lifting push rod 19, the fixing base is provided with a guide hole 15 along the axis direction thereof, and a gap is formed between the guide hole and the limiting rod, so that the limiting rod can move in the guide hole in a lifting manner, the lifting push rod can be detachably fixed in the pusher, and the end of the lifting push rod is fixed to one end of the limiting rod. When the lifting push rod stretches out, the limiting rod is pushed to descend along the guide hole, the other end of the limiting rod stretches out of the fixing seat and sequentially enters the first limiting hole and the second limiting hole, the limiting ring structure is expanded, the elastic strip is locked, and when the lifting push rod contracts, the limiting rod moves out of the second limiting hole and the first limiting hole, the elastic strip is expanded, and a rake shape is formed.

Preferably, the pusher is provided with orientation markings 16, as shown in fig. 2, which can be used for orientation determination during external operation. Specifically, the mark can correspond to the fixed position of the elastic strip and the fixed seat, and when the expansion operation is needed, an operator only needs to drag the mark along the marking direction.

Before use, the lifting push rod is in an extending state, the elastic strip is locked, and the hook pulling assembly is in a conical frame shape. In the operation, the pulling hook component is firstly sent into the incision through the pusher to reach a proper depth, the incision direction is observed in the endoscope, the pusher and the pulling hook component are rotated to enable the unfolding direction of the pulling hook to be consistent with the incision direction, then the pulling hook component is opened, the pulling hook is attached to incision muscles in a rake shape, the pusher is pulled along the direction mark outside, the operation incision is opened, and the focus area is fully exposed.

This embodiment will a plurality of hooks combinations of pulling out be the circular cone frame structure on the elasticity strip, do benefit to and get into the incision when making its combination, and when opening, be the harrow column structure, do benefit to on whole acts on the muscle of incision one side, its adhesive force reinforcing, pull out the effect better, make the incision show the state better, make the security of bad tissue excision operation of thyroid gland obtain showing and promote.

The pusher of this embodiment can be rubber tube or silicone tube, has certain intensity, can carry out the propelling movement operation, and has certain compliance, the curved operation of tearing open of being convenient for, and the rubber tube adopts threaded connection with the fixing base, makes both detachably combinations be in the same place.

In fact, the rubber tube is a through structure, so that the lifting push rod cannot be effectively fixed. To solve this problem, in this embodiment, a fixing sleeve 21 is provided in the rubber hose, as shown in fig. 8, the fixing sleeve is fixed to the wall of the rubber hose by screws, and the rod seat of the lifting push rod is fixed to the end of the fixing sleeve by screws, so that the lifting push rod is fixed in the rubber hose.

Meanwhile, the opening and closing assembly of the elastic strip is arranged at the joint of the two ends of the elastic strip and is not positioned in the center of the fixed seat or the lifting push rod, so that the elastic strip and the fixed seat cannot be directly connected. To solve this problem, the present embodiment is provided with a connecting plate 22 between the two, as shown in fig. 8, which can transmit the lifting force to the stopper rod.

The lifting push rod of the embodiment can be a hydraulic cylinder, an air cylinder or an electric push rod and the like in the prior art. The present embodiment is preferably an electric push rod.

As a necessity, the present embodiment further includes a power source 17 electrically connected to the electric putter and capable of providing driving power for the electric putter. The power of this embodiment is fixed on the support, through wire and electric putter intercommunication.

The embodiment is also provided with a control switch 6 which is arranged on the lead and can control the action of the electric push rod.

Finally, the above embodiments are only for illustrating the technical solutions of the present invention and not for limiting, although the present invention has been described in detail with reference to the preferred embodiments, it should be understood by those skilled in the art that modifications or equivalent substitutions may be made to the technical solutions of the present invention without departing from the spirit and scope of the technical solutions of the present invention, and all of them should be covered in the claims of the present invention.

Claims

1. Incision distraction device in chamber mirror thyroidectomy, its characterized in that: including pulling out hook component and pusher, it includes fixing base, elastic strip and a plurality of hook of pulling out to pull out hook component, the top of fixing base sets up pusher, the fixing base is the cylinder, elastic strip is spring steel sheet, spring steel sheet's both ends are fixed unrestrained on the outer face of cylinder of fixing base, and is a plurality of it is parallel to each other and is the interval setting and is in to pull out the hook on the elastic strip, pull out the hook including the link and with the integrative free end that sets up of link, the link is fixed with elastic strip, the free end is the contained angle setting with the link, the both ends of elastic strip are provided with the switching subassembly and can control the spacing subassembly of switching subassembly switching state, when the switching subassembly was opened, a plurality of hooks of pulling out were harrow column structure, when closed, a plurality of hooks of pulling out were and can conveniently insert notched circular cone frame structure.

2. The endoscopic thyroidectomy incision distracting device of claim 1, wherein: the opening and closing assembly comprises a fixing block and an inserting tongue, the fixing block is arranged at one end of the elastic strip, the inserting tongue is arranged at the other end of the elastic strip, the fixing block is provided with a jack matched with the inserting tongue, and the inserting tongue is inserted into the jack to enable the elastic strip to be closed and to be of a circular ring structure.

3. The endoscopic thyroidectomy incision distracting device of claim 2, wherein: stop device includes gag lever post and lifting push rod, the fixing base link up along its axis direction and is provided with the guiding hole, gag lever post slidable ground sets up in the guiding hole, lifting push rod can dismantle to be fixed in the pusher, lifting push rod's push rod tip is fixed with gag lever post one end, promotes the gag lever post and freely goes up and down along the guiding hole to make the other end of gag lever post stretch out the fixing base, control the switching state of switching subassembly.

4. The endoscopic thyroidectomy incision distracting device of claim 3, wherein: the inserting tongue is provided with a first limiting hole, the upper surface of the fixing block is provided with a second limiting hole, the limiting rod moves into the first limiting hole and the second limiting hole to lock the elastic strip, and the limiting rod moves out of the second limiting hole and the first limiting hole to expand the elastic strip.

5. The endoscopic thyroidectomy incision distracting device of claim 1, wherein: the end part of the free end is provided with a hook head, and the hook head adopts a combined structure of an inner framework and an outer cladding.

6. The endoscopic thyroidectomy incision distracting device of claim 1, wherein: the pulling hook is made of a spring steel sheet.

7. The endoscopic thyroidectomy incision distracting device of claim 3, wherein: still include the power, the power with lift push rod electric connection.

8. The incision distraction device of any of claims 1-7, wherein: the pusher is a rubber tube, and the rubber tube is in threaded connection with the fixed seat.

9. The incision distraction device of any of claims 1-7, wherein: and the pusher is provided with an orientation mark for marking the direction of the hook.