CN114869370A - Liver suspension device under peritoneoscope - Google Patents
Liver suspension device under peritoneoscope Download PDFInfo
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- CN114869370A CN114869370A CN202210670744.9A CN202210670744A CN114869370A CN 114869370 A CN114869370 A CN 114869370A CN 202210670744 A CN202210670744 A CN 202210670744A CN 114869370 A CN114869370 A CN 114869370A
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- liver
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
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- A61B17/0281—Abdominal wall lifters
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
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- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
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- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
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Abstract
The invention provides a liver suspension device under a laparoscope, aiming at the defect that the prior operation auxiliary device can not help medical staff to limit the position of the liver under the condition of no wound, so that the operation treatment of the liver and stomach gap can not be effectively carried out, wherein a holding part (1) of the device is clamped and fixed on the first internal tissue of a patient through a clamping port (11) to hold the liver suspension device in the body of the patient in a hanging way; the holding part (1) is configured as a spring double-arm clamp structure, and the clamping opening (11) is provided with a clamping piece (12) on a clamping surface thereof in a manner that the clamping piece can limit the position of the first internal tissue under the condition of holding the shape of the first internal tissue. The invention can non-invasively clamp the first in-vivo tissue, so that the first in-vivo tissue and the left lobe of the liver leave the gap between the liver and the stomach under the drawing action of the elastic sling (2).
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a liver suspension device under a laparoscope.
Background
When performing abdominal surgery, surgeons generally perform endoscopic surgery with a small surgical incision. During surgery, depending on the surgical site, the surgeon needs to temporarily displace other organs in advance to expose the field of view required for the surgery, and the prior art generally operates with a tissue retracting hanger. At present, the organ displacement operation mainly comprises the following two schemes:
the first solution is to use medical instruments that can be clamped at both ends to clamp on the organ tissue to be displaced and the inner wall of the abdominal cavity, which has the disadvantages that the clamp head is easy to fall off when a larger traction force is needed, the clamp head is easy to damage the inner wall of the abdominal cavity, and the support needed by the larger traction force is difficult to provide when the pressure is applied in the abdominal cavity.
Another proposal is to open at least two penetrating holes on the abdominal cavity and then use a linear instrument to hang the organ to be drawn through the superficial tissues. Such procedures have the disadvantage of requiring additional holes for penetration, increasing trauma to the patient and increasing the workload on the physician.
Patent document No. CN103829979A discloses a pneumoperitoneum-free laparoscopic abdominal wall suspension device, which comprises an incision protection sleeve and a splint having a suspension function, wherein the incision protection sleeve having the suspension function is integrally formed by a lifting piece, a ring sleeve and a fixing part from bottom to top, the incision protection sleeve and the splint are fixedly connected through the fixing part, the incision protection sleeve having the suspension function is made of a soft material, the thickness of the lifting piece is greater than that of the ring sleeve, the device further comprises a hollow annular support ring mounted on the inner wall of the ring sleeve, the shape of the support ring is the same as that of the incision protection sleeve, and the hardness of the support ring is greater than that of the incision protection sleeve; the thickness of a lifting piece of the incision protective sleeve with the hanging function close to the central area is smaller than that of the edge area; the abdominal wall under the operation incision can be supported and opened by the device, unnecessary damage to the abdominal wall is avoided, the operation visual field is good, and meanwhile, the device is simple in structure and convenient to operate, pneumoperitoneum-free laparoscopic operation can be completed by using conventional laparoscopic surgical instruments, and adverse reaction caused by pneumoperitoneum is avoided.
Patent publication No. CN104203079A discloses a laparoscopic retractor having a single shaft with a proximal end and a distal end. The distal end of the shaft terminates in a T that is attached to the shaft by one or more hinges. The hinges allow the tee to swivel and/or rotate about the shaft independently. The proximal end of the shaft terminates in a handle that allows the surgeon to manipulate the retractor after it is inserted into the abdominal cavity of a patient. The proximal and distal ends of the T-shaped member each have a grasper that can be controlled by the surgeon. However, this solution has several disadvantages: the first forceps head and the back repair handle cannot be separated, one wound can only be retracted at one position, and the wound needs to be increased when multi-point migration is carried out. Secondly, the first end binding clip and the second end binding clip of this patent are rigid connection, can't separate the operation to the fixed position at its both ends, bring inconvenience for doctor's operation. Thirdly, the distance between the two ends of the binding clip is fixed, and the length of the connecting part can not be adjusted according to actual requirements. In conclusion, the scheme has more defects in operation and use.
Therefore, there is a need for a liver suspension device that can non-invasively clamp and suspend the internal body tissue and liver in response to the deficiencies of the prior art. In particular, there is a need for a liver suspension device that can effectively protect the clamped tissue, suspended organ and suspended tissue and prevent the above-mentioned internal tissue from being damaged during the suspension process, and further, the liver suspension device is required to adjust the suspension position and force of the liver according to the actual change of the surgical environment so that the gap between the liver and the stomach can be always exposed to the field of vision of the surgeon.
Furthermore, on the one hand, due to the differences in understanding to the person skilled in the art; on the other hand, since the inventor has studied a lot of documents and patents when making the present invention, but the space is not limited to the details and contents listed in the above, however, the present invention is by no means free of the features of the prior art, but the present invention has been provided with all the features of the prior art, and the applicant reserves the right to increase the related prior art in the background.
Disclosure of Invention
In view of the deficiencies of the prior art, the technical scheme of the invention provides a liver suspension device under a laparoscope, which at least comprises a holding part, wherein the holding part holds the liver suspension device in a hanging manner in a patient body in a manner that a clamping port is clamped and positioned on first in-vivo tissues of the patient; the holding part is configured as a resilient double-arm clamp structure, and the clamping opening is provided with clamping pieces on its clamping surfaces in such a way that it can define the position of the first in-body tissue while holding its form, wherein at least two clamping pieces are provided separately on two opposing clamping surfaces where the clamping opening contacts the first in-body tissue. Its advantage lies in, the holding part can carry out the centre gripping to the internal tissue of the internal first body of patient selectively under doctor's the control, optimize through the centre gripping mouth to the holding part, make the centre gripping mouth can also guarantee the integrity of the internal tissue of the first body of its centre gripping effectively under the circumstances of the internal tissue of clamp, make the liver left lobe can leave the liver stomach clearance under liver suspending device's tractive effect, eliminate the sheltering from of liver left lobe to liver stomach clearance, thereby expose the liver stomach clearance under doctor's the field of vision, make things convenient for the doctor to handle the organizational structure in liver stomach clearance.
According to a preferred embodiment, the clamping member is provided with a limiting edge on the surface thereof in a manner that the limiting edge can limit the position of the first in-body tissue clamped by the clamping opening, wherein the clamping member comprises a first clamping member and a second clamping member which can limit the position of the first in-body tissue in the clamping opening; spacing arris are laid along first direction interval the first holder on the surface, spacing arris are still laid along second direction interval the second holder on the surface when the centre gripping mouth takes place to close, first holder and second holder are laminated each other according to the mode that can make setting on both surfaces spacing arris are crisscross each other to it presss from both sides tightly organize in the first body. Its advantage lies in, in first holder and the second holder can increase in the first body area of contact and the lifting surface area between tissue and the holder to can also guarantee in the first body that the lifting surface area of tissue by the clamping part is enough big when having improved the stability of tissue in the holder centre gripping first body, thereby the extrusion force that the tissue received in the effectively dispersion first body, make in the first body the in-process of tissue by centre gripping and tractive can also keep organizational structure's integrity.
According to a preferred embodiment, the surfaces of the first clamping piece and the second clamping piece are respectively provided with a limiting groove capable of being matched with the limiting edge, wherein the surface of the first clamping piece is provided with the limiting grooves at intervals along a second direction in a manner consistent with the arrangement condition of the limiting edges on the surface of the second clamping piece; the surface of the second clamping piece is provided with the limiting grooves at intervals along a first direction in a mode consistent with the arrangement condition of the limiting edges on the surface of the first clamping piece. The clamping device has the advantages that the limiting groove and the limiting ridge are arranged in the spaced mode, so that tissues in a first body, such as retina tissues at the edges of the liver and stomach ligaments and the like, can be better fixed between the first clamping piece and the second clamping piece. Especially, limiting grooves and limiting edges which are arranged along the first direction and the second direction in a staggered mode can better clamp the omentum tissues in a grid form, and the limiting edges at different positions can clamp and fix the omentum tissues along different directions.
According to a preferred embodiment, when the first and second clamping members are fitted to each other, the stopper rib on the first clamping member is capable of cooperating with the stopper groove on the second clamping member, and the stopper groove on the first clamping member is capable of cooperating with the stopper rib on the second clamping member, so that the clamping members can restrict the position of the first internal tissue in such a manner as to increase the contact area of the first and second clamping members with the first internal tissue and to change the clamping form of the first and second clamping members with respect to the first internal tissue.
According to a preferred embodiment, the side of the retaining portion remote from the clamping opening is provided with at least one engagement hole for engaging with a clip applier, said engagement hole being intended to receive an opening force provided by the clip applier, so as to open said clamping opening; the holding part is further provided with an elastic part which can form clamping force aiming at the first tissue in the body at one end far away from the clamping opening, and the elastic part can limit the shape of the holding part under the action of no opening force, so that the clamping opening is closed or the first tissue in the body is clamped under the action of the clamping force of the elastic part.
According to a preferred embodiment, the end of the elastic double-arm clamp away from the clamping opening of the holding part is further connected with an elastic sling capable of pulling the first in-vivo tissue clamped by the clamping opening away from the initial position of the first in-vivo tissue in the patient, and the end of the elastic sling away from the holding part is further connected with a hanger capable of fixing the elastic sling in a hanging manner on a second in-vivo tissue away from the liver.
According to a preferred embodiment, the doctor adjusts the hanging position of the hanger according to the stretching parameters of the elastic sling and the position of the second internal tissue, under the condition that the clamping opening clamps the first internal tissue, so that the first internal tissue and the left lobe of the liver are separated from the hepatogastric gap under the drawing action of the elastic sling.
According to a preferred embodiment, a connecting unit capable of limiting the position of the elastic sling on the elastic element is further arranged on the elastic element of the holding part, and the connecting unit can move the elastic sling on the ring body of the elastic element under the operation of a doctor so as to change the direction of the pulling force provided by the elastic sling.
According to a preferred embodiment, the surfaces of the first and second clamping elements are further provided with an adhesive layer capable of improving adhesion to the first tissue, said adhesive layer being capable of further defining the configuration of the first tissue in the closed clamping opening in such a way that it absorbs liquid to expand and compresses the receiving space of the first tissue. The adhesive layer has the advantages that the adhesive layer can absorb tissue fluid or mucus flowing out of tissues in a first body, such as the liver and stomach ligament clamped by the first clamping piece and the second clamping piece, and omentum tissues at the edge of the liver and stomach ligament, and the tissue fluid is absorbed and expanded, so that the tissues in the first body can be better clamped by the first clamping piece and the second clamping piece. The adhesion layer can get rid of the interstitial fluid or the mucus on the tissue surface in the first body, make the coefficient of friction between the tissue in first holder, second holder and the first body increase, make tissue in first holder and the second holder can more stably centre gripping in the first body, in addition, the inflation of adhesion layer can compress the accommodation space of the tissue in the first body between first holder and the second holder, make the mutual effort increase between tissue and first holder in the first body, second holder, thereby further inject the relative position between tissue and first holder, second holder in the first body.
The technical scheme of the invention also provides a liver suspension device under the laparoscope, which at least comprises two clamping pieces which are oppositely arranged to limit the position of the first tissue in the body, wherein the surfaces of the clamping pieces are provided with limiting edges in a manner that the clamping pieces can limit the position of the first tissue in the body clamped by the clamping openings, and the clamping pieces comprise a first clamping piece and a second clamping piece which can relatively move to limit the position of the first tissue in the clamping openings; spacing arris are laid along first direction interval the first holder on the surface, spacing arris are still laid along second direction interval the second holder on the surface when the centre gripping mouth takes place to close, first holder and second holder are laminated each other according to the mode that can make setting on both surfaces spacing arris are crisscross each other to it presss from both sides tightly organize in the first body.
Drawings
FIG. 1 is a schematic structural view of a preferred laparoscopic liver suspension device in accordance with the present invention;
FIG. 2 is a schematic structural view of a holding part of a preferred laparoscopic liver suspension apparatus according to the present invention;
FIG. 3 is a plan view of a first clamping member of a preferred laparoscopic liver suspension device in accordance with the present invention;
fig. 4 is a plan view schematically illustrating a second clamping member of a preferred laparoscopic liver suspension device in accordance with the present invention.
List of reference numerals
1: a holding section; 2: an elastic sling; 3: a hanger; 4: a connection unit; 11: a clamping port; 12: a clamping member; 13: a limiting edge; 14: a limiting groove; 15: an engagement hole; 16: an elastic member; 17: an adhesive layer; 121: a first clamping member; 122: a second clamping member.
Detailed Description
The following detailed description is made with reference to the accompanying drawings.
Example 1
The present application provides a liver suspension device under a laparoscope, which may include a holder 1, an elastic sling 2, a hanger 3, and a connection unit 4.
According to a specific embodiment shown in fig. 1, the holding part 1 can non-invasively clamp the first tissue of the patient, and one end of the holding part 1, which is far away from the end clamping the first tissue, is movably connected with an elastic sling 2 through a connecting unit 4. A hanger 3 capable of connecting the elastic sling 2 to a second internal body tissue of the patient is connected to one end of the elastic sling 2 remote from the holding part 1. Under the condition of the tissue in the first body of 1 centre gripping of holding part, the doctor hangs the liver that the tissue was connected in the first body and with the tissue in the first body through the mode of hanging 3 the suspension member that will be connected with elastic sling 2 and fixing on the tissue in the second body for the liver left lobe can leave the liver stomach clearance under liver suspending device's tractive effect, eliminates sheltering from of liver left lobe to the liver stomach clearance, thereby exposes the liver stomach clearance under doctor's the field of vision, makes things convenient for the doctor to handle the organizational structure in liver stomach clearance.
As shown in fig. 2, the holding part 1 forms a holding structure in the form of a resilient double-arm clamp by two intersecting lever members. The tissue carries out the centre gripping in the appointed first body in the front end of clamping structure to under the effect of external force, the tissue moves in the first body of its centre gripping of clamping structure tractive, and then exposes pending operation position under doctor's the field of vision. Preferably, the holder 1 may include a grip opening 11, a grip 12, and a stopper rib 13. The clamping opening 11 is used to clamp and fix a predetermined first body tissue so that the holding portion 1 can be held in a suspended manner in the patient. In particular, the liver suspension device is accessed through a laparoscopic cannula (Trocar, maximum diameter typically 10mm or 12 mm). Under the condition that the liver suspension device is folded, the diameter of the liver suspension device is smaller than that of the laparoscope sleeve, so that the liver suspension device can move directionally in the sleeve. When the liver suspension device is delivered to the inside of the abdominal cavity of the patient, the doctor opens the holding port 11 and positions the holding port 11 at both sides of the tissue in the first body to be held, so that after the opening force applied to the holding part 1 is removed, the holding port 11 is closed, thereby clamping and limiting the tissue in the first body. Preferably, the clamping port 11 is provided with a clamp 12 on its clamping surface in such a way that it can define the position of the first internal tissue while maintaining its form. At least two clamping members 12 are respectively arranged on two opposite clamping surfaces of the clamping opening 11, which are contacted with the first in-body tissue. Preferably, the clamping opening 11 is the end of the rod of two intersecting rods forming the holding part 1, wherein the end of the rod is also detachably mounted with a clamping piece 12 capable of avoiding the clamping opening 11 from causing damage to the tissue in the first body when clamping the tissue in the first body. Preferably, the clamping piece 12 having a plate shape can be parallel to the plate surface of the clamping opening 11.
Preferably, when the holding port 11 is closed, the specified first in-body combination is held between the holding members 12 provided on the two opposing surfaces of the holding port 11, respectively. Preferably, the clamping member 12 can directly contact with the tissue in the first body, and the clamping member 12 is made of a non-rigid material, so as to reduce the pressure intensity of the clamping member to the tissue in the first body, especially avoid the moment when the opening force disappears, and the inertia force generated by the opposite movement of the two clamping members 12 can generate high-intensity impact compression to the tissue in the first body, so that the clamping member 12 can gradually clamp the tissue in the first body under the clamping force, and in the above process, the clamping member 12 can form a buffer force through slight deformation, and avoid the tissue in the first body from being damaged at the moment when being clamped. Preferably, the clamp 12 is able to adjust the relative relationship between its central axis and the axis of the rod, so that the clamping surface of the clamp 12 can adapt to the morphology and shape of the first body tissue. In particular, when the first in-body tissue has a long extension and a narrow transverse width, the holder 12 can be arranged with its central axis coinciding with the axis of the bar; when the extension length of organizing in the first body is shorter and lateral width is wider, holder 12 can set up to the axis mutually perpendicular of its axis and member for organize in the first body as far as by holder 12 centre gripping, thereby improve the stability of organizing in the first body when by holder 12 centre gripping, thereby when organizing in the first body by the traction of holding part 1, because the high concentration of tractive effort causes the organizing in the first body to take place the damage under the effect of tractive effort.
Preferably, the two holding members 12 are provided with a stopper rib 13 on the surface thereof in such a manner that the stopper rib can restrict the position of the tissue in the first body held by the holding port 11. Specifically, the clamp 12 includes a first clamp 121 and a second clamp 122 provided on the two rod pieces, respectively. When the two lever members constituting the holding portion 1 are moved toward each other to close the nip 11, the first and second clamping members 121 and 122 are moved toward each other and finally attached to each other. Preferably, the gap between first and second clamping members 121, 122 is adapted to receive the first body tissue under the action of the opening force. As shown in fig. 3 and 4, the first clamping member 121 and the second clamping member 122 are respectively provided with a position-limiting rib 13 on opposite surfaces thereof. Further preferably, a plurality of limiting ribs 13 are arranged on the surface of the first clamping member 121 at intervals along the first direction. Further preferably, a plurality of limiting ribs 13 are further arranged on the surface of the second clamping member 122 at intervals along the second direction. When the clamping opening 11 is closed, the first clamping member 121 and the second clamping member 122 are attached to each other so that the stopper ribs 13 provided on the surfaces of the two are staggered with each other, thereby clamping the first tissue inside the body. Preferably, the first direction and the second direction are perpendicular to each other, for example, the first direction may be a length direction of the holder 12, and the second direction may be a width direction of the holder 12. Preferably, the length of the stopper rib 13 is smaller than the width of the clamping member 12, so that the second clamping member 122 is provided with at least two stopper ribs 13 on a width line parallel to the width direction thereof. Preferably, the limiting ribs 13 on the same width straight line are uniformly spaced, so that a gap exists between two adjacent limiting ribs 13 on the same width straight line. Preferably, the limiting ribs 13 on the straight lines with different widths are distributed at intervals in a mutually parallel manner. Preferably, the distance between two mutually parallel limiting edges 13 is greater than the length of a single limiting edge 13, so that the second clamping member 122 can be effectively attached to the first clamping member 121. Similarly, the first clamping member 121 is provided with at least two limiting ribs 13 on a length straight line parallel to the length direction thereof. Preferably, the limiting ribs 13 on the same length straight line are uniformly spaced, so that a gap exists between two adjacent limiting ribs 13 on the same length straight line. Preferably, the limiting ribs 13 on the straight lines with different lengths are distributed at intervals in a mutually parallel manner. Preferably, the distance between two mutually parallel limiting edges 13 is greater than the length of a single limiting edge 13, so that the first clamping member 121 and the second clamping member 122 can be effectively attached. Preferably, the limiting rib 13 on the first clamping member 121 can be inserted into a gap between a plurality of limiting ribs 13 uniformly spaced on the surface of the second clamping member 122 when the first clamping member 121 and the second clamping member 122 are close to each other, so that a clamping space with a zigzag surface profile is formed between the first clamping member 121 and the second clamping member 122, and thus the contact area between the clamping member 12 and the tissue in the first body is effectively increased, and the tissue in the first body is prevented from falling off from the two clamping members 12 arranged oppositely when being pulled by the holding part 1. In addition, the limiting ribs 13 on the surfaces of the first clamping member 121 and the second clamping member 122 are arranged in a staggered manner, so that the stability of the tissue in the first body between the first clamping member 121 and the second clamping member 122 is further improved, and the tissue in the first body and the liver connected with the tissue in the first body can be kept in a relatively fixed connection with the clamping member 12. According to the invention, the limiting edge 13 is arranged on the surface of the clamping piece 12, so that the clamping piece 12 can clamp the first tissue in a more stable and effective manner, the holding part 1 can conveniently drive the first tissue and the liver connected with the first tissue to change the position, particularly the stress area of the first tissue in the body is increased, and the first tissue in the body is prevented from being pulled and damaged due to stress concentration.
Preferably, the surface of the first clamping member 121 is provided with a limiting groove 14 capable of being matched with the limiting rib 13 arranged on the second clamping member 122, so that when the first clamping member 121 and the second clamping member 122 are attached to each other, the limiting rib 13 arranged on the second clamping member 122 can be at least partially embedded into the limiting groove 14 arranged on the first clamping member 121. Preferably, the surface of the second clamping member 122 is provided with a limiting groove 14 capable of matching with the limiting rib 13 arranged on the first clamping member 121, so that when the first clamping member 121 and the second clamping member 122 are attached to each other, the limiting rib 13 arranged on the first clamping member 121 can be at least partially embedded into the limiting groove 14 arranged on the second clamping member 122. Further preferably, the surface of the first clamping member 121 is provided with spacing grooves 14 at intervals along the second direction in a manner consistent with the arrangement of the spacing ribs 13 on the surface of the second clamping member 122. Further preferably, the surface of the second clamping member 122 is provided with spacing grooves 14 at intervals along the first direction in a manner consistent with the arrangement of the spacing ribs 13 on the surface of the first clamping member 121. When the first clamping member 121 and the second clamping member 122 are attached to each other, the stopper rib 13 on the first clamping member 121 can be fitted to the stopper groove 14 on the second clamping member 122, and the stopper groove 14 on the first clamping member 121 can be fitted to the stopper rib 13 on the second clamping member 122, so that the clamping member 12 can restrict the position of the first internal tissue in such a manner that the contact area of the first clamping member 121, the second clamping member 122 and the first internal tissue is increased and the form of the first internal tissue between the first clamping member 121 and the second clamping member 122 is changed. Preferably, the setting of spacing groove 14 can reduce the size of the clearance that probably exists between the two when laminating each other of first holder 121 and second holder 122 to the area of contact of the interior tissue of further improvement first body and holder 12 makes the clamp force that the interior tissue of first body received can be further dispersed, and the clamp force that the interior tissue of avoiding first body received is too concentrated and causes the extrusion damage, and meanwhile, the mutually supporting of spacing arris 13 and spacing groove 14 can improve the stability of being connected between the interior tissue of first body and holder 12.
Preferably, the cross-sectional area of the stopper groove 14 is larger than that of the stopper rib 13. When the limiting rib 13 fills the limiting groove 14, redundant space can be reserved in the groove cavity of the limiting groove 14 to accommodate the tissue in the first body, so that the connection between the tissue in the first body and the clamping piece 12 is more stable. Preferably, the surfaces of the limiting rib 13 and the limiting groove 14 may be further respectively provided with a plurality of protrusions and grooves which are uniformly distributed at intervals, and the protrusions on the surface of the limiting rib 13 are matched with the grooves on the surface of the limiting groove 14. When the first clamping piece 121 and the second clamping piece 122 are mutually attached, the limiting ribs 13 can be filled in the limiting grooves 14, and the protrusions and the grooves of the two surfaces can further define a zigzag surface, so that the tissue clamped between the two bodies has larger contact area and force-bearing area.
Preferably, the side of holder 1 remote from clamping opening 11 is provided with two engagement holes 15 for engaging with a clip applier. Preferably, the rod bodies of the two crossed rods forming the holding part 1 in the form of the elastic double-arm clamp are respectively provided with engagement holes 15 at opposite positions, so that when the clip applier is connected with the engagement holes 15, a doctor controls the clip applier to provide an opening force for the holding part 1, and the engagement holes 15 are used for bearing the opening force provided by the clip applier, so that the initially closed clamping opening 11 is opened under the action of the opening force, and the first body tissue to be clamped is positioned in the opened clamping opening 11. Preferably, the engaging holes 15 may be provided in plural at regular intervals along the shaft axis of the rod member so that the surgeon can control the opening of the gripping opening 11 with different amounts of opening force. Preferably, the holding portion 1 is further provided with an elastic member 16 at an end away from the clamping opening 11, wherein the elastic member 16 can form a clamping force against the first tissue, and the elastic member 16 can define a shape of the holding portion 1 under a non-opening force, so that the clamping opening 11 closes or clamps the first tissue under the clamping force of the elastic member 16. Preferably, the elastic member 16 may be a torsion spring connected with the ends of the two rods arranged alternately, so that the end of the holding part 1 away from the clamping opening 11 can be in an expanded state under the action of the elastic member 16 without the opening force, so that the clamping opening 11 is kept in a closed state under the action of the clamping force generated by the elastic member 16.
Preferably, the surfaces of the first clamping member 121 and the second clamping member 122 are further provided with an adhesion layer 17 capable of improving adhesion with the first in-vivo tissue, and the adhesion layer 17 can further define the shape of the first in-vivo tissue in the closed clamping opening 11. Preferably, the surfaces of the stopper rib 13 and the stopper groove 14 are also coated with an adhesive layer 17 capable of enhancing adhesion. Preferably, the adhesive layer 17 may also be a medical material that is capable of absorbing tissue fluid and mucus that has flowed out of the first body tissue and is expanded to some extent. Preferably, the adhesive layer 17 contains a polyvinyl alcohol/sodium alginate porous composite (PACF porous composite). The PACF with stable double-network structure is prepared by compounding natural polysaccharide Sodium Alginate (SA) and polyvinyl alcohol (PVA) through glutaraldehyde and Ca 2+ By double cross-linking. The double-network structure not only enables the PACF to obtain excellent biocompatibility, but also enables the PACF to have the capabilities of promoting adhesion of blood cells, promoting rapid formation of thrombus and activating a blood coagulation system, and can promote rapid hemostasis through synergistic effects of liquid absorption enrichment, a porous effect and a charge stimulation multiple hemostasis mechanism. PACF has excellent liquid triggering self-expansion performance, the expansion rate exceeds 2000%, and 3.8N dynamic expansion force can be generated in the expansion process. Preferably, the PACF porous composite is prepared by: preparing PVA aqueous solution with a certain mass fraction, then adding SA with different mass fractions (different from the mass of the PVA) into the PVA solution to form colloidal mixed solution, and cooling to room temperature after the solution is uniformly mixed and the state is stable. Mixing CaSO 4 (1g) Dissolved in 100mL of deionized water, left to stand for 30min, and then centrifuged for 5min to obtain a supernatant. To the mixture of SA and PVA was added a cross-linking agent solution (solute molar ratio in PVA and cross-linking agent was 1.25), a small amount of catalyst solution and additives while increasing the stirring speed. The additive is formed large at higher rotation speedThe bubbles with smaller diameters are distributed on the surface and the inner part of the liquid. The PVA molecule and the chemical group of the cross-linking agent are subjected to cross-linking reaction under the catalysis of the catalyst to generate viscous condensation cross-linking PVA prepolymer. Then, a certain amount of calcium sulfate solution and Ca are added into the prepolymer solution 2+ Can interact with SA in the prepolymer to form SA gel. After the reaction is fully performed, the viscous prepolymer liquid is poured into a mold, and the PACF (Polyvinylitol/alginate composite foam) is obtained by freeze drying. Preferably, the adhesion layer 17 forms a membrane structure capable of controllable expansion in a manner that the incompletely solidified PACF is uniformly coated on the surfaces of the first clamping member 121 and the second clamping member 122, so that when the first clamping member 121 and the second clamping member 122 clamp the tissue in the first body, the PACF can absorb the tissue fluid and/or mucus flowing out of the tissue in the first body to generate certain expansion, and the tissue in the first body can be clamped by the first clamping member 121 and the second clamping member 122 with larger relative force. PACF effectively eliminates the mucus on the tissue surface in the first body through the mode of imbibition inflation, has increased the frictional force between tissue in the first body and first holder 121, second holder 122 for the position removal is difficult to take place for tissue in the first body, makes the position of tissue in the first body 121 and second holder 122 can more firmly inject.
Preferably, the PACF is more easily separated from the first body tissue after imbibing, avoiding the adhesive layer 17 adhering firmly to the tissue surface and failing to separate from the first body tissue without tearing the first body tissue. The adhesive layer 17 can absorb the tissue fluid or the mucus flowing out of the tissue in the first body, such as the ligamentum hepaticum and the omentum tissue around the ligamentum hepaticum held by the first and second holding members 121 and 122, and swells when the tissue fluid is absorbed, so that the tissue in the first body can be better held by the first and second holding members 121 and 122. The adhesion layer 17 can remove tissue fluid or mucus on the surface of the tissue in the first body, so that the friction coefficient between the first clamping member 121 and the tissue in the first body and the second clamping member 122 in the first body is increased, the first clamping member 121 and the second clamping member 122 can clamp the tissue in the first body more stably, in addition, the expansion of the adhesion layer 17 can compress the accommodating space of the tissue in the first body between the first clamping member 121 and the second clamping member 122, the interaction force between the tissue in the first body and the first clamping member 121 and the second clamping member 122 is increased, and the relative position between the tissue in the first body and the clamping members is further defined. Preferably, the accommodating space of the first in-body tissue is a gap space between the first clamping member 121 and the second clamping member 122.
Preferably, the holding part 1 is further connected with an elastic sling 2 capable of pulling the first internal body tissue clamped by the clamping opening 11 away from its initial position in the patient's body. Preferably, a hanger 3 capable of fixing the elastic sling 2 to a second internal tissue distant from the liver in a hanging manner is further connected to one end of the elastic sling 2 distant from the holder 1. Preferably, the first intracorporeal tissue may be ligamentum hepaticum and omentum tissue at the ligamentum hepaticum border, and since the omentum tissue at the ligamentum hepaticum border is at the lower edge of the liver, the position change of the liver can be achieved by pulling the omentum tissue. In addition, the stretching of the omentum tissue can achieve the stretching effect while avoiding the damage of the organ caused by the direct clamping of the liver by the holding part 1. Preferably, the second intracorporeal tissue may be the abdominal wall or diaphragm which can provide traction for the elastic sling 2 and away from the liver. Preferably, the hanger 3 can provide a stable pulling force for the elastic sling 2 by connecting to the abdominal wall or the diaphragm, so that the elastic sling 2 can pull the holding part 1 to move, thereby driving the tissue in the first body and the liver to move, further leaving the liver from the upper part of the gap between the liver and the stomach under the action of the pulling force, directly exposing the gap between the liver and the stomach in the visual field of the doctor, and facilitating the doctor to process the tissue structure in the gap between the liver and the stomach.
Preferably, with the clamping mouth 11 clamping the first internal tissue, the doctor adjusts the hanging position of the hanger 3 according to the stretching parameters of the elastic sling 2 and the position of the second internal tissue, so that the first internal tissue and the left lobe of the liver are separated from the hepatogastric gap by the pulling action of the elastic sling 2. Preferably, a connection unit 4 capable of defining the position of the elastic sling 2 on the elastic member 16 is further provided on the elastic member 16 of the holding part 1, and the connection unit 4 is capable of moving the elastic sling 2 on the ring body of the elastic member 16 under the operation of the doctor so as to change the direction of the pulling force provided by the elastic sling 2. Preferably, the stretch parameters of the elastic sling 2 may include its own length, its own tension and its angle to the holder 1. Preferably, the connection unit 4 may be a connection ring fitted over the ring body of the elastic member 16. Further preferably, the connection unit 4 may be provided with a connection structure capable of moving on the ring body of the elastic member 16, and particularly, the connection unit 4 may adjust a pulling direction of the elastic sling 2.
Example 2
This embodiment is a further improvement of embodiment 1, and repeated contents are not described again.
Preferably, the method of use of the liver suspension device is as follows:
(1) the liver suspension device is placed into the abdominal cavity via a laparoscope.
(2) The clip applier is engaged with the engagement hole 15 of the liver suspension device, and an opening force is transmitted to the holder 1 of the liver suspension device by the clip applier, so that the clamping mouth 11 in a closed state is opened.
(3) The first internal body tissue is clamped by the clamping opening 11, and the elastic sling 2 connected to the holding part 1 is fixed to a second internal body tissue far from the liver in a hanging manner, so that the first internal body tissue and the left lobe of the liver are separated from the gap between the liver and the stomach by the pulling action of the elastic sling 2.
(4) The connection unit 4 adjusts the direction and length of the pulling force provided by the elastic sling 2 according to the detected stretching parameters of the elastic sling 2, thereby maintaining the hepatogastric gap in an exposed state.
It should be noted that the above-mentioned embodiments are exemplary, and that those skilled in the art, having benefit of the present disclosure, may devise various arrangements that are within the scope of the present disclosure and that fall within the scope of the invention. It should be understood by those skilled in the art that the present specification and figures are illustrative only and are not limiting upon the claims. The scope of the invention is defined by the claims and their equivalents. Throughout this document, the features referred to as "preferably" are only an optional feature and should not be understood as necessarily requiring that such applicant reserves the right to disclaim or delete the associated preferred feature at any time.
Claims (10)
1. A laparoscopic liver suspension device comprising at least a holding part (1), characterized in that the holding part (1) holds the liver suspension device in a patient in a hanging manner by clamping it in a first tissue of the patient positioned in the body through a clamping port (11);
the holding part (1) is designed as a spring double-arm clamp, and the clamping opening (11) is provided with clamping elements (12) on its clamping surfaces in such a way that it can define the position of the first internal tissue while holding its form, wherein at least two clamping elements (12) are arranged on two opposite clamping surfaces of the clamping opening (11) that are in contact with the first internal tissue.
2. Laparoscopic liver suspension device according to claim 1, wherein said clamping member (12) is provided with a stop rib (13) on its surface in such a way that it can limit the position of said first intracorporeal tissue clamped by said clamping port (11), wherein,
the clamp (12) comprises a first clamp (121) and a second clamp (122) able to limit the position of the first intracorporeal tissue located within the clamping mouth (11);
the limiting ribs (13) are arranged on the surface of the first clamping piece (121) at intervals along a first direction, the limiting ribs (13) are further arranged on the surface of the second clamping piece (122) at intervals along a second direction, and when the clamping opening (11) is closed, the first clamping piece (121) and the second clamping piece (122) are mutually attached in a mode that the limiting ribs (13) arranged on the surfaces of the first clamping piece and the second clamping piece can be mutually staggered, so that the first tissue in the body is clamped.
3. The laparoscopic liver suspension device according to claim 2, wherein the first holding member (121) and the second holding member (122) further have a limiting groove (14) formed on the surface thereof, respectively, to be engaged with the limiting rib (13),
the surface of the first clamping piece (121) is provided with the limiting grooves (14) at intervals along a second direction in a mode consistent with the arrangement condition of the limiting ribs (13) on the surface of the second clamping piece (122);
the surface of the second clamping piece (122) is provided with the limiting grooves (14) at intervals along a first direction in a mode consistent with the arrangement condition of the limiting ribs (13) on the surface of the first clamping piece (121).
4. The laparoscopic liver suspension device according to claim 3, wherein, when said first clamping member (121) and said second clamping member (122) are engaged with each other, the limiting edge (13) on the first clamping piece (121) can be matched with the limiting groove (14) on the second clamping piece (122), and the limiting groove (14) on the first clamping piece (121) can be matched with the limiting rib (13) on the second clamping piece (122), the clamp (12) can thereby restrict the position of the first internal tissue so as to increase the contact area between the first and second clamps (121, 122) and the first internal tissue and change the clamping state of the first and second clamps (121, 122) to the first internal tissue.
5. Laparoscopic liver suspension device according to claim 4, wherein the holding part (1) is provided with at least one engagement hole (15) for engagement with a clip applier at a side remote from the clamping port (11), said engagement hole (15) being adapted to receive an opening force provided by the clip applier to open said clamping port (11);
the holding part (1) is further provided with an elastic element (16) capable of forming a clamping force for the first in-vivo tissue at one end far away from the clamping opening (11), and the elastic element (16) can define the shape of the holding part (1) under the action of no opening force, so that the clamping opening (11) is closed or clamps the first in-vivo tissue under the action of the clamping force of the elastic element (16).
6. The laparoscopic liver suspension device according to claim 5, wherein the end of the elastic double-arm clamp formed by the holding part (1) far from the clamping port (11) is further connected with an elastic sling (2) capable of pulling the first internal body tissue clamped by the clamping port (11) away from its original position in the patient, and the end of the elastic sling (2) far from the holding part (1) is further connected with a hanger (3) capable of positioning the elastic sling (2) in a hanging manner on a second internal body tissue far from the liver.
7. The laparoscopic liver suspension device according to claim 6, wherein, in the state that the clamping mouth (11) clamps the first internal tissue, the doctor adjusts the hanging position of the hanger (3) according to the stretching parameters of the elastic sling (2) and the position of the second internal tissue, so that the first internal tissue and the left lobe of the liver leave the gap between the liver and the stomach under the pulling action of the elastic sling (2).
8. The laparoscopic liver suspension device according to claim 7, wherein a connection unit (4) capable of defining a position of the elastic sling (2) on the elastic member (16) is further provided on the elastic member (16) of the holding part (1), and the connection unit (4) is capable of pulling the elastic sling (2) to move on the ring body of the elastic member (16) under the operation of a doctor, thereby changing a direction of a pulling force provided by the elastic sling (2).
9. The laparoscopic liver suspension device according to claim 8, wherein the surfaces of said first and second clamping members (121, 122) are further provided with an adhesive layer (17) capable of improving adhesion to the tissue within the first body, said adhesive layer (17) being capable of further defining the configuration of the tissue within the first body in the closed clamping port (11) in such a way that the accommodation space of the tissue within the first body is compressed by imbibition of liquid.
10. A laparoscopic liver suspension device comprising at least two clamps (12) defining the position of a first tissue in vivo in an oppositely disposed manner, characterized in that,
the clamping piece (12) is provided with a limiting edge (13) on the surface thereof according to the mode that the clamping piece can limit the position of the first in-body tissue clamped by the clamping opening (11), wherein,
the clamp (12) comprises a first clamp (121) and a second clamp (122) able to limit the position of the first intracorporeal tissue located within the clamping mouth (11);
the limiting ribs (13) are arranged on the surface of the first clamping piece (121) at intervals along a first direction, the limiting ribs (13) are further arranged on the surface of the second clamping piece (122) at intervals along a second direction, and when the clamping opening (11) is closed, the first clamping piece (121) and the second clamping piece (122) are mutually attached in a mode that the limiting ribs (13) arranged on the surfaces of the first clamping piece and the second clamping piece can be mutually staggered, so that the first tissue in the body is clamped.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202210670744.9A CN114869370A (en) | 2022-06-13 | 2022-06-13 | Liver suspension device under peritoneoscope |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202210670744.9A CN114869370A (en) | 2022-06-13 | 2022-06-13 | Liver suspension device under peritoneoscope |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN114869370A true CN114869370A (en) | 2022-08-09 |
Family
ID=82681667
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202210670744.9A Pending CN114869370A (en) | 2022-06-13 | 2022-06-13 | Liver suspension device under peritoneoscope |
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| Country | Link |
|---|---|
| CN (1) | CN114869370A (en) |
Citations (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5499997A (en) * | 1992-04-10 | 1996-03-19 | Sharpe Endosurgical Corporation | Endoscopic tenaculum surgical instrument |
| US5542949A (en) * | 1987-05-14 | 1996-08-06 | Yoon; Inbae | Multifunctional clip applier instrument |
| US5582577A (en) * | 1995-02-13 | 1996-12-10 | Vance Products Incorporated | Surgical retractor including central elastic member |
| US20070179526A1 (en) * | 1997-02-03 | 2007-08-02 | Hart Charles C | Surgical clamp with improved traction |
| JP2008062004A (en) * | 2006-09-09 | 2008-03-21 | Taichi Sakamoto | Medical holder, medical treatment apparatus and medical clip |
| CN104083190A (en) * | 2014-06-18 | 2014-10-08 | 北京航空航天大学 | Design of surface appearance occlusion part of medical surgical clamping device |
| KR20190078070A (en) * | 2017-12-26 | 2019-07-04 | 연세대학교 산학협력단 | Retractor of organ for laparocopic surgery |
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2022
- 2022-06-13 CN CN202210670744.9A patent/CN114869370A/en active Pending
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5542949A (en) * | 1987-05-14 | 1996-08-06 | Yoon; Inbae | Multifunctional clip applier instrument |
| US5499997A (en) * | 1992-04-10 | 1996-03-19 | Sharpe Endosurgical Corporation | Endoscopic tenaculum surgical instrument |
| US5582577A (en) * | 1995-02-13 | 1996-12-10 | Vance Products Incorporated | Surgical retractor including central elastic member |
| US20070179526A1 (en) * | 1997-02-03 | 2007-08-02 | Hart Charles C | Surgical clamp with improved traction |
| JP2008062004A (en) * | 2006-09-09 | 2008-03-21 | Taichi Sakamoto | Medical holder, medical treatment apparatus and medical clip |
| CN104083190A (en) * | 2014-06-18 | 2014-10-08 | 北京航空航天大学 | Design of surface appearance occlusion part of medical surgical clamping device |
| KR20190078070A (en) * | 2017-12-26 | 2019-07-04 | 연세대학교 산학협력단 | Retractor of organ for laparocopic surgery |
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