CN117462235A - Dedicated curer of three-purpose laparoscopic surgery electrotome of inhaling of cutting of mammary gland operation - Google Patents

Abstract

The invention provides a special three-purpose endoscopic surgical knife for breast surgery, which consists of a liquid-air channel component, an electrotome component, a rod component and a sleeve component, wherein the electrotome component is sleeved on the outer layer of the liquid-air channel component, the rod component is sleeved on the outer wall of a knife tube of the electrotome component in a ring mode, and the sleeve component is of an outermost layer structure of the whole device. The electric knife is a telescopic knife head, so that risks such as accidental injury can be prevented and treated, convenience of different operation lengths is realized by the telescopic rod, and a series of adverse effects caused by frequent replacement of the electric knife are avoided; the focus size can be intuitively measured through the scale marks; the inclined port design of the suction port improves the observation visual angle of an operator; the integrated design of the cutting button and the condensing button is convenient for operators to use. The invention has reasonable design, the main body material is made of high polymer material, and the risk of hospital infection is avoided; the whole operation process is simple and easy to implement when in use, and is suitable for clinical popularization and application of the endoscopic electrotome special for breast surgery.

Description

Dedicated curer of three-purpose laparoscopic surgery electrotome of inhaling of cutting of mammary gland operation

Technical Field

The invention belongs to medical equipment, relates to a special three-purpose endoscopic surgical electrotome for breast surgery, and is an electrotome tool suitable for a current endoscopic surgical system of breast.

Background

A high-frequency electric knife (high-frequency surgical instrument) is an electrosurgical instrument that performs tissue cutting instead of a mechanical surgical knife. The tissue is heated when the high-frequency high-voltage current generated by the tip of the effective electrode contacts with the body, so that the separation and solidification of the body tissue are realized, and the purposes of cutting and hemostasis are achieved. The current operation field is developed towards the field of endoscope minimally invasive, and an endoscope system is most commonly used together with a high-frequency electrotome.

Endoscopic surgery: as technology advances, it has become possible to perform surgery through smaller incisions. In this way, the damage to the tissue is less than in conventional surgery. Through the keyhole-sized incision, the surgeon may insert tiny light sources, cameras, and surgical instruments. The surgeon directs the manipulation of the surgical instrument to perform the procedure by transmitting images into the monitor. Such a surgical operation is called a laparoscopic operation when performed in the abdominal cavity, a arthroscopic operation when performed in a joint, and a thoracoscopic operation when performed in the chest cavity.

The endoscope system is combined with a high-frequency electrotome to be the trend of the current operation, and the conventional breast endoscope minimally invasive operation process is exemplified as follows: three buttonhole-sized incisions are formed on the skin surface of the mammary gland, and the first incision is an endoscope probing hole and provides light source and shooting functions; the second incision is a hemostat access hole and provides a traction auxiliary function; the third notch is an electric knife detection hole and provides the functions of electric knife in-out and straw in-out. Compared with other organ operations with natural cavity, the breast endoscopic operation has the requirements of position restriction, accurate positioning, gentle operation and the like. The depth of the incision needed to be accessed is different during the mammary gland operation, and the original electrotome needs to be taken out from the electrotome access hole so as to replace the electrotome with proper length for operation; when cutting, the surgical field is blocked by blood seepage, the electrotome needs to be taken out from the electrotome detection hole, and the suction pipe of the aspirator is replaced to suck exudates such as blood; when cutting or coagulation, burning smoke appears, and the electric knife needs to be taken out from the electric knife detection hole, and the suction pipe of the liquid suction device is replaced to suck harmful gases such as smoke. The current device brings the following disadvantages to the operation: (1) The electric knife frequently enters and exits the detection hole, so that the infection risk of the detection hole is increased, and the moving risk of the operation field position is increased; (2) The electric knife frequently enters and exits the detection hole and cannot be contained, so that the risk of mechanical abrasion from the detection hole to the operation field path is increased; (3) The length of the electric knife is fixed, so that the length of the electric knife cannot be quickly changed according to the distance between the operation opening and the surgical field, thereby being suitable for operation requirements; (4) The electric blade cannot be stored, and the risk of mechanical scratch operation can be brought by the movement in the operation; (5) The electrotome geometry limits such that a blocking cut point occurs during surgery. Therefore, it is desirable to provide a breast-specific electrotome that is adapted to current endoscopic systems.

Disclosure of Invention

The invention aims to make up the defects and the loopholes of the prior art and devices, provides a special three-purpose endoscopic surgical knife for breast surgery, and is a special high-frequency electrotome for mammary glands, which is suitable for endoscopic systems. The device comprises a liquid-gas channel component, an electric knife component, a rod component and a sleeve component, wherein the electric knife component is sleeved on the outer layer of the liquid-gas channel component, the rod component is sleeved on the outer wall of a knife tube of the electric knife component in a ring manner, and the sleeve component is of an outermost layer structure of the whole device. The electrotome component is positioned at the head end of the whole device, the liquid-gas channel component is positioned at the tail end of the device, and the connection between the four components is detailed later.

The liquid-gas channel component is a liquid-gas sucking channel of the whole component, and the part is the innermost device of the whole component. The liquid-gas channel component consists of a crown bridge, a liquid-gas channel, female threads, male threads, a taper pipe, a hose, an adjusting disk and a disk seat. The conical cone is hollow inside and has a front port and a rear port, wherein the front port of the cone is larger than the rear port. The front end opening of the taper pipe is provided with a male thread in a turning mode, and the rear end opening of the taper pipe is connected with a hose. The hose is a tubular structure made of soft silica gel, and the rear end of the hose is connected with the negative pressure device. The upper part of the hose is embedded with a disc seat, and the center of the top of the disc seat is provided with an adjusting disc. The inside of the circular tube-shaped liquid gas channel is hollow, female threads are turned in the rear port of the liquid gas channel, the female threads and the male threads are meshed with each other to realize connection of the liquid gas channel and the taper pipe, and the maximum outer diameters of the liquid gas channel and the taper pipe are consistent. The top of the front port of the liquid air passage is connected with a crown bridge which is of a square sheet structure. The square-sheet-shaped crown bridge is obliquely connected with the outer edge of the front end of the liquid-gas channel.

The electric knife component is a high-frequency electric knife cutting part which is sleeved on the outer layer of the liquid-gas channel component. The electric knife component consists of a knife head, a knife pipe orifice, a knife pipe, an electrode pipe, a square push, an electrode and an electrode wire. The inside of the cutter tube with the tubular structure is hollow, the rear port of the cutter tube is round, and the front port of the cutter tube is an elliptical cutter tube orifice with an oblique opening. The tool bit is rectangle slice structure, and the one end of tool bit connects the sharp-pointed lower edge of sword pipe sword, and the other end of tool bit is free. The upper edge of the rear end opening of the cutter tube is connected with an electrode, and the lower edge of the electrode is flush with the inner wall edge of the cutter tube. The other end of the electrode is connected with an electrode tube, an electrode wire runs in the electrode tube, and the other end of the electrode tube is free. The left outer side surface of the cutter tube is connected with a square push at a position near the rear port. The square push is a device similar to a mushroom, the square push mushroom handle is cylindrical, and the square push mushroom umbrella is square. When the electric knife assembly is combined with the liquid air channel assembly, the outer wall of the liquid air channel is clung to the inner wall of the knife tube, the liquid air channel can slide back and forth in the tube of the knife tube, and the sliding of the knife tube is stopped forward at the crown bridge. The top end of the crown bridge exceeds the outer wall of the cutter tube. The liquid air passage exceeds the rear end of the knife tube, and the rear end of the electrode tube is not reached to the rear end of the liquid air passage.

The rod assembly is of a sleeve structure and plays a role in extending and protecting the cutter head. The rod assembly is sleeved on the outer wall of the cutter tube. The rod component consists of a telescopic rod, a knife shrinking groove, scale marks, a suction port and a positioning component. The tubular telescopic rod is hollow, and the telescopic rod is provided with a front port and a rear port, wherein the front port is called a suction port, and the suction port is an elliptical inclined port. The bevel angle of the suction port is consistent with the opening of the cutter pipe. The outer wall of the suction port is provided with scale marks which share roots and are arranged in parallel at uniform intervals. The left side outer wall of the telescopic rod is provided with a knife shrinking slot near the rear port, and the knife shrinking slot is long. A positioning component is arranged at the position of the right outer wall of the telescopic rod near the rear port. The front window ends of the positioning component and the knife shrinking groove are in left and right relative positions. The positioning component consists of a movable tooth, a round pushing shaft, a tooth elastic sheet, a round pushing and a tooth seat. The whole assembly is connected to the outer wall of the right side of the telescopic rod through a tooth seat. The tooth holder is of a cubic-like structure, and the inner surface of the tooth holder is connected with the cambered surface of the outer wall of the right side of the telescopic rod. The rear face of the tooth seat is connected with the tooth elastic sheet, the tooth elastic sheet is made of elastic materials, the upper surface of the near end of the tooth elastic sheet is connected with the movable tooth, the movable tooth is triangular, the tip end of the triangular column of the movable tooth is vertically upwards, one end of the cuboid round pushing shaft is connected with the side face of the tooth elastic sheet and is flush with the end face, and the other end of the round pushing shaft penetrates through the center of the round pushing shaft. The round push is of a disc-shaped structure. The tooth tip of the movable tooth will sink when the circle is pushed downwards. When the electric knife assembly, the liquid-gas channel assembly and the rod assembly are combined, the telescopic rod is sleeved on the outer wall of the knife tube, the top side surface of the crown bridge is fixedly connected with the suction port top edge, and the knife tube can move back and forth in a cavity gap between the telescopic rod and the liquid-gas channel. The crown bridge is the limiting point of forward movement of the cutter tube. The square push penetrates through the knife shrinking groove, the square push 'mushroom handle' moves in the knife shrinking groove, and the square push 'mushroom umbrella' protrudes out of the outer wall of the telescopic rod. Pushing the square push will realize the forward and backward movement of the cutter tube relative to the telescopic rod. The cutter tube moves back and forth to drive the cutter head to be exposed or retracted into the suction port.

The sleeve component is of an outermost layer structure, the sleeve component is sleeved on the outer wall of the telescopic rod in a ring mode, and the sleeve component plays a role in holding. The sleeve component consists of a fixed tooth, a rod shrinkage groove A, a rod shrinkage groove B, a button seat, a cutting button, a coagulation button, a control tube, a telescopic sleeve and an electric wire. The tubular bellows has two free circular ports. The flaky button seat is connected to the top of the telescopic sleeve, the front and rear positions of the top center of the button seat are respectively embedded with a cutting button and a condensing button, the front end of the control tube is connected with the tail of the button seat, and the rear end of the control tube is divided into two branches: one straight-out relay extends backwards beyond the rear port of the telescopic sleeve and is free, and an electric wire runs in the straight-out relay; the electrical wires will be connected to other power sources such as a controller. The other branch at the rear end of the control tube is U-shaped and faces the inside of the telescopic sleeve, and is opposite to the free opening of the electrode tube, and an electrode wire running in the electrode tube passes through the U-shaped branch and is connected with an electric wire. The left outer wall of the telescopic sleeve is provided with a long rod shrinkage groove B, wherein the distance between the front end of the rod shrinkage groove B and the front edge of the telescopic sleeve is shorter than the distance between the rear end of the rod shrinkage groove B and the rear edge of the telescopic sleeve. The outer wall of the right side of the telescopic sleeve is provided with a long rod shrinkage groove A, wherein the front end of the rod shrinkage groove A is opposite to the front end of the rod shrinkage groove B left and right. The rear end of the rod shrinkage groove A is not opposite to the rear end of the rod shrinkage groove B in left and right directions, and the rear end of the rod shrinkage groove A is positioned in the middle of the outer wall of the right side of the telescopic sleeve. Fixed teeth are distributed at the top of the rod shrinkage groove A. When the sleeve component 4 is combined with the rest components, the sleeve component is the outermost layer structure of the whole device, the square-pushing mushroom handle operates in the rod shrinkage groove B, and the square-pushing mushroom umbrella protrudes out of the outer wall of the telescopic sleeve. The round pushing protrusion is arranged on the outer wall of the telescopic sleeve, and the tooth holder and the tooth spring sheet are arranged in the shrinking groove A of the operating rod, so that the tooth holder and the tooth spring sheet can not touch the tip of the fixed tooth. The movable teeth are meshed with the fixed teeth.

The invention provides a special high-frequency electrotome for breast endoscopic surgery, which is of disposable design, and the main material of the device is made of high polymer material, so that the risk of hospital infection is avoided; the telescopic design of the cutter head realizes safe operation such as preventing and treating accidental injury; the telescopic design of the telescopic rod realizes the convenience of different operation lengths, and avoids a series of adverse consequences (increased risk of infection of the access hole and increased risk of moving the position of the operation field) caused by frequent replacement of the electric knife; the design of the scale marks realizes the visual measurement of the focus size; the inclined port design of the suction port improves the observation visual angle of an operator; the cutting button and the condensing button are designed integrally, so that the use of operators is facilitated. The invention has scientific and reasonable design, and the whole operation process is simple and feasible when in use, and is suitable for clinical popularization and application of the endoscopic electrotome special for breast surgery.

Drawings

Fig. 1 is a schematic view of the overall structure of the present invention.

Fig. 2 is a schematic view of the left rear side of the liquid-gas channel assembly 1.

Fig. 3 is a schematic view of the left front side of the liquid-gas channel assembly 1.

Fig. 4 is a schematic view of the left front side of the electric knife assembly 2.

Fig. 5 is a left rear side view of the electric knife assembly 2.

Fig. 6 is a left front side view schematic diagram of the electric knife assembly 2 and the liquid air channel assembly 1 when combined.

Fig. 7 is a schematic front view of the electrotome assembly 2 and the liquid-gas pathway assembly 1 when combined.

Fig. 8 is a schematic front side view of the electrotome assembly 2 and the liquid-gas pathway assembly 1 when combined.

Fig. 9 is a rear end schematic view of the electric knife assembly 2 and the liquid-gas channel assembly 1 when combined.

Fig. 10 is a schematic view of the overall structure of the lever assembly 3.

Fig. 11 is a schematic view of the front end view of the lever assembly 3.

Fig. 12 is a schematic view of the positioning assembly 23.

Fig. 13 is a schematic view of the left front side view of the lever assembly 3.

Fig. 14 is a schematic view of the structure of the electric knife assembly 2, the liquid-gas channel assembly 1 and the rod assembly 3 from the left front side.

Fig. 15 is a schematic view of the front end structure of the electrotome assembly 2, the liquid-gas passage assembly 1 and the rod assembly 3 when they are combined.

Fig. 16 is a schematic view of the rear end structure of the electrotome assembly 2, the liquid-gas passage assembly 1 and the rod assembly 3 when they are combined.

Fig. 17 is a left side view of the electric knife assembly 2 and the rod assembly 3 when combined.

Fig. 18 is a right rear view schematic structural diagram of the electric knife assembly 2, the liquid-gas channel assembly 1 and the rod assembly 3 when they are combined.

Fig. 19 is a schematic view of the left front side view of the sleeve assembly 4.

Fig. 20 is a schematic view of the left rear side view of the jacket assembly 4.

Fig. 21 is a schematic view of the right rear side view of the jacket assembly 4.

Fig. 22 is a schematic view of the left front side view of the integrated device.

Fig. 23 is a schematic view of the left side view of the integrated device.

Fig. 24 is a schematic view of the structure of the right rear side of the integrated device.

Fig. 25 is a schematic view of the exploded positioning assembly 23 and tooth 29 relationship.

Fig. 26 is a diagram showing the relationship between the positioning unit 23 and the rod shrinkage groove a 30.

Fig. 27 is a schematic diagram showing a left side view of the head 14 in a telescopic state.

Fig. 28 is a schematic diagram showing a front view of the head 14 in a telescopic state.

Fig. 29 is a schematic diagram showing a right side view of the telescopic rod 7 in a telescopic state.

Fig. 30 is a schematic diagram showing a left side view of the telescopic rod 7 in a telescopic state.

Detailed Description

The invention is further described with reference to the drawings and examples.

Example 1A three-purpose endoscopic surgical knife for breast surgery

Referring to fig. 1, the device is composed of a liquid-gas channel assembly 1, an electrotome assembly 2, a rod assembly 3 and a sleeve assembly 4. The parts are nested therein, and the interrelationship and detailed composition of the parts will be described later.

Referring to fig. 2, the liquid-gas channel assembly 1 is a liquid, gas extraction channel of the entire assembly, which is the innermost device of the entire assembly. The liquid air passage component 1 is composed of a crown bridge 5, a liquid air passage 6, female threads 8, male threads 9, a taper pipe 10, a hose 11, an adjusting disk 12 and a disk seat 13. The conical cone 10 is hollow inside, the cone 10 having a front port and a rear port, wherein the front port of the cone 10 is larger than the rear port. The front end of the taper pipe 10 is provided with a male thread 9, and the rear end of the taper pipe 10 is connected with a hose 11. The hose 11 is a tubular structure made of soft silica gel, and the rear end of the hose 11 is connected with a negative pressure device. The upper part of the hose 11 is embedded with a disc seat 13, and the center of the top of the disc seat 13 is provided with an adjusting disc 12. The dial 12 may control the amount of flow within the lumen of the hose 11. The inside of the circular tube-shaped liquid gas channel 6 is hollow, female threads 8 are arranged in the rear port of the liquid gas channel 6 in a turning mode, the female threads 8 are meshed with male threads 9, and the liquid gas channel 6 is connected with a taper pipe 10. After the liquid air passage 6 and the taper pipe 10 are connected, the maximum outer diameter of the taper pipe 10 is flush with the outer wall of the liquid air passage 6. Referring to fig. 3, a crown bridge 5 is connected to the top of the front port of the liquid-gas channel 6, and the crown bridge 5 is of a square sheet structure. The square sheet-shaped crown bridge 5 is obliquely connected with the outer edge of the front end of the liquid-gas channel 6.

Referring to fig. 4, the electric knife assembly 2 is a high frequency electric knife cutting part which is sleeved on the outer layer of the liquid-gas channel assembly 1. The electrotome assembly 2 is composed of a tool bit 14, a tool orifice 15, a tool tube 16, an electrode tube 17, a square push 18, an electrode 19 and an electrode wire 38. The inside of the cutter tube 16 with the tubular structure is hollow, the rear port of the cutter tube 16 is round, and the front port of the cutter tube 16 is a bevel oval cutter tube orifice 15. The cutter head 14 is of a rectangular sheet-shaped structure, one end of the cutter head 14 is connected with the lower edge of the front end opening of the cutter tube 16, and the other end of the cutter head 14 is free. Referring to fig. 5, an electrode 19 is attached to the rear end port of the cutter tube 16, and the lower edge of the electrode 19 is flush with the inner wall edge of the cutter tube 16. The other end of the electrode 19 is connected with the electrode tube 17, an electrode wire 38 runs in the electrode tube 17, and the other end of the electrode tube 17 is free. A square push 18 is connected to the left outer side of the cutter tube 16 near the rear port. The square push 18 is a device similar to a mushroom, the mushroom stem of the square push 18 is cylindrical, and the mushroom umbrella of the square push 18 is square. Referring to fig. 6, 7 and 8, when the electrotome assembly 2 and the liquid air channel assembly 1 are combined, the outer wall of the liquid air channel 6 is closely attached to the inner wall of the cutter tube 16, the liquid air channel 6 can slide back and forth in the tube of the cutter tube 16, and the sliding of the cutter tube 16 is stopped forward at the crown bridge 5. The top end of the crown bridge 5 extends beyond the outer wall of the cutter tube 16. Referring to fig. 9, the liquid-gas path 6 extends beyond the rear end of the blade tube 16, and the rear end of the electrode tube 17 is not as far as the rear end of the liquid-gas path 6.

Referring to fig. 10 and 11, the rod assembly 3 is a third winding structure, and the rod assembly 3 is sleeved on the outer wall of the cutter tube 16 in a ring manner, and the assembly plays a role of extending and protecting the cutter head. The rod assembly 3 is composed of a telescopic rod 7, a knife shrinking groove 20, graduation marks 21, a suction opening 22 and a positioning assembly 23. The tubular telescopic rod 7 is hollow, and the telescopic rod 7 is provided with a front port and a rear port, wherein the front port is called a suction port 22, and the suction port 22 is an elliptical bevel. The bevel angle of the suction opening 22 coincides with the knife nozzle 15. The outer wall of the suction port 22 is provided with graduation marks 21, and 12 graduation marks 21 are uniformly arranged in parallel at intervals. The left outer wall of the telescopic rod 7 is provided with a knife shrinking groove 20 near the rear opening end, and the knife shrinking groove 20 is long. A positioning component 23 is arranged at the position of the right outer wall of the telescopic rod 7 near the rear opening end. The positioning component 23 and the front window end of the knife shrinking slot 20 are in left-right relative positions. Referring to fig. 12 and 13, the positioning assembly 23 is composed of a movable tooth 24, a circular pushing shaft 25, a tooth spring 26, a circular pushing 27 and a tooth holder 28. The whole assembly is connected to the right outer wall of the telescopic rod 7 through a tooth holder 28. The tooth holder 28 is of a cubic-like structure, and the inner surface of the tooth holder 28 is connected with the cambered surface of the right outer wall of the telescopic rod 7. The rear face of the tooth holder 28 is connected with the tooth elastic sheet 26, the tooth elastic sheet 26 is made of elastic materials, the upper surface of the near end of the tooth elastic sheet 26 is connected with the movable tooth 24, the movable tooth 24 is triangular, the tip of the triangular prism of the movable tooth 24 is vertically upwards, one end of a cuboid round pushing shaft 25 is connected with the side face of the tooth elastic sheet 26 and is flush with the end face, and the other end of the round pushing shaft 25 penetrates through the center of the round pushing shaft 27. The round push 27 is of a disc-shaped structure. Pushing down on the round push 27, the tip of the movable tooth 24 will sink. After the round push 27 releases the hand, the elastic tooth spring 26 will return to its original position. Referring to fig. 14, when the electric knife assembly 2, the liquid-gas channel assembly 1 and the rod assembly 3 are combined, the telescopic rod 7 is sleeved on the outer wall of the knife tube 16, referring to fig. 15, the top side surface of the crown bridge 5 is fixedly connected with the top edge of the suction port 22, and the knife tube 16 can move back and forth in the cavity between the telescopic rod 7 and the liquid-gas channel 6. The crown bridge 5 is the limiting point for the forward movement of the cutter tube 16. Referring to fig. 16, 17 and 18, the square push 18 penetrates the knife shrinking slot 20, the mushroom stem of the square push 18 will run in the knife shrinking slot 20, and the mushroom umbrella of the square push 18 protrudes out of the outer wall of the telescopic rod 7. Pushing the push 18 will effect a forward and backward movement of the knife tube 16 relative to the telescopic rod 7. The forward and backward movement of the cutter tube 16 causes the cutter head 14 to be exposed or retracted into the mouth edge of the suction opening 22.

Referring to fig. 19, the sleeve assembly 4 is of an outermost structure, the sleeve assembly 4 is looped around the outer wall of the telescopic rod 7, and the assembly is held by hand. The sleeve assembly 4 is composed of a fixed tooth 29, a rod shrinkage groove A30, a rod shrinkage groove B31, a button seat 32, a cutting button 33, a setting button 34, a control tube 35, a telescopic sleeve 36 and an electric wire 37. The tubular bellows 36 has two free circular ports. The sheet-shaped button seat 32 is connected to the top of the telescopic sleeve 36, the front and rear positions of the top center of the button seat 32 are respectively embedded with a cutting button 33 and a condensing button 34, referring to fig. 20 and 21, the front end of the control tube 35 is connected to the tail of the button seat 32, and the rear end of the control tube 35 is divided into two branches: one straight out relay extends back beyond the rear port of the telescopic sleeve 36 and is free, an electric wire 37 runs in, and the electric wire 37 is connected with other power supplies such as an external controller; the other end of the control tube 35 is formed in a "U" shape and faces the inside of the telescopic tube 36, and an electrode wire 38 running in the electrode tube 17 is connected to an electric wire 37 (see fig. 24) through the "U" shape. The left outer wall of the telescopic sleeve 36 is provided with a long rod shrinkage groove B31, wherein the distance between the front end of the rod shrinkage groove B31 and the front edge of the telescopic sleeve 36 is shorter than the distance between the rear end of the rod shrinkage groove B31 and the rear edge of the telescopic sleeve 36. An elongated rod shrinkage groove A30 is formed on the right outer wall of the telescopic sleeve 36, wherein the front end of the rod shrinkage groove A30 is opposite to the front end of the rod shrinkage groove B31 in a left-right manner. The rear end of the rod shrinkage groove A30 is not opposite to the rear end of the rod shrinkage groove B31 from left to right, and the rear end of the rod shrinkage groove A30 is positioned at the middle position of the right outer wall of the telescopic sleeve 36. Fixed teeth 29 are distributed on the top of the rod shrinkage groove A30. Referring to fig. 22, when the sleeve assembly 4 is combined with the rest of the assembly, the sleeve assembly 4 is the outermost structure of the whole device, and referring to fig. 23, the mushroom stem of the square push 18 runs in the rod shrinkage groove B31, and the mushroom umbrella of the square push 18 protrudes out of the outer wall of the telescopic sleeve 36. Referring to fig. 24, the round push 27 protrudes out of the outer wall of the telescopic sleeve 26, and referring to fig. 25 and 26, the tooth holder 28 and the tooth spring 26 run in the lever shrinkage groove a30, and the tooth holder 28 and the tooth spring 26 do not touch the tip of the fixed tooth 29. The movable teeth 24 are engaged with the fixed teeth 29. Pushing down on the round push 27, the tip of the movable tooth 24 will sink. The movable teeth 24 and the fixed teeth 29 are in a mutually disengaged state, at the moment, the round push 27 is pushed forward by force, the tooth holder 28 moves forward along the rod shrinkage groove A30, the telescopic rod 7 connected with the tooth holder 28 also moves forward, after the round push 27 loosens hands, the elastic tooth elastic sheet 26 returns to the original position, and the telescopic rod 7 stops moving forward or backward, so that the extension of a working section is realized, and conversely, the telescopic rod 7 is shortened.

Example 2 Using the device

After determining the position of a breast focus, three buttonhole-sized incisions are formed on the surface of the skin of the breast at the disease side, wherein the first incision is an endoscope probing hole and provides light source and shooting functions; the second incision is a hemostat access hole and provides a traction auxiliary function; the third incision is an electrotome detection hole. The device will be advanced from the third hole. With reference to fig. 27 and 28, when the outer wall of the telescopic sleeve 36 is held by hand, and the index finger abdomen is lightly placed on the cutting button 33 or the condensing button 34, the thumb pushes the mushroom umbrella of the push 18 forward, so that the cutter tube 16 moves forward relative to the telescopic rod 7. The forward movement of the cutter tube 16 brings the cutter head 14 to expose the mouth edge of the suction opening 22. The cutter head 14 is close to the tissue to be separated, the cutter button 33 is gently touched and pressed, the tissue to be cut is separated along the incision, the electric cutter head instantaneously gasifies the tissue to generate smoke in the process of separating the tissue, blood and the like can be generated when blood vessels are cut, the bleeding and the smoke pollute the operation vision, the operation progress is blocked, the adjusting disk 12 is opened at the moment, and the bleeding tissue, the smoke and the like can respectively reach the negative pressure device to be led out of the operation area through the liquid air pipe 6, the taper pipe 10 and the hose 11. If the amount of blood vessel bleeding is large, the blood vessel will be occluded by pressing the coagulation knob 34 with a finger, thereby achieving hemostasis. In order to avoid accidental injury of surrounding tissue by the cutter head 14 when the midfield is stopped or bleeding needs to be cleared in a large scale, the cutter head 14 can be integrally retracted to the inner edge of the suction port 22: the thumb pulls back the mushroom umbrella of the square push 18, realizing the backward movement of the knife tube 16 relative to the telescopic rod 7. The rearward movement of the cutter tube 16 will bring the cutter head 14 entirely down to the inner edge of the suction opening 22. At this point the sharp cutting-head 14 will temporarily hide into the suction opening 22 and the sucking operation will be safe and efficient.

Referring to fig. 29 and 30, as the penetration depth increases, the front end of the telescopic sleeve has been pushed against the outer edge of the penetration hole (cannot be further entered), the length of the telescopic rod 7 in the body has not been adapted to the operation, and at this time, the remaining telescopic rod 7 (overlapped with the telescopic sleeve) needs to be extended to continue the deep operation: the index finger is moved onto the circular push 27 on the right side of the device, pushing the circular push 27 downwards, with reference to fig. 25, the tip of the movable tooth 24 will sink. The movable teeth 24 and the fixed teeth 29 are in a mutually disengaged state, at the moment, the round push 27 is pushed forward by force, the tooth holder 28 moves forward along the rod shrinkage groove A30, the telescopic rod 7 connected with the tooth holder 28 also moves forward, after the round push 27 loosens hands, the elastic tooth elastic sheet 26 returns to the original position, and the telescopic rod 7 stops moving forward or backward, so that the extension of the working section of the telescopic rod 7 is realized. At this time, the distal tissue may be separated, for example, until the end of the entire operation. The visual measurement of the size of the focus can be measured and referred by the scale marks 21, the image pickup is completed by matching with a camera, the later recording and comparison are convenient, and the design of the inclined suction opening 22 is convenient for sucking gap dirt and facilitating the transverse observation of an operator.

In the whole operation process, the device realizes the extension and contraction of the effective working section, the extension and contraction of the cutter head and the removal of blood gas, the measurement of the focus size, and secondary pollution is avoided only by once entering and exiting the exploratory hole.

Claims (6)

1. The utility model provides a special three-purpose endoscopic surgical electrotome for breast surgery, which is characterized in that the electrotome consists of a liquid-air channel component (1), an electrotome component (2), a rod component (3) and a sleeve component (4); the liquid-gas channel assembly (1) consists of a crown bridge (5), a liquid-gas channel (6), female threads (8), male threads (9), a taper pipe (10), a hose (11), an adjusting disc (12) and a disc seat (13); the electric knife assembly (2) is composed of a knife head (14), a knife pipe orifice (15), a knife pipe (16), an electrode pipe (17), a square push (18), an electrode (19) and an electrode wire (38); the rod assembly (3) consists of a telescopic rod (7), a knife shrinking groove (20), scale marks (21), a suction opening (22) and a positioning assembly (23); the sleeve assembly (4) consists of a fixed tooth (29), a rod shrinkage groove A (30), a rod shrinkage groove B (31), a button seat (32), a cutting button (33), a coagulation button (34), a control tube (35), a telescopic sleeve (36) and an electric wire (37); the electric knife component (2) is sleeved on the outer layer of the liquid air channel component (1), the rod component (3) is sleeved on the outer wall of the knife tube (16) in the electric knife component (2), the sleeve component (4) is of an outermost layer structure of the whole device, the electric knife component (2) is located at the head end of the whole device, and the liquid air channel component (1) is located at the tail end of the device.

2. The three-purpose endoscopic surgical knife for cutting, condensing and sucking according to claim 1, wherein a conical taper pipe (10) of the liquid-gas channel component (1) is hollow, a male thread (9) is arranged on a front port of the taper pipe (10), a rear port of the taper pipe (10) is connected with a hose (11), a negative pressure device is connected with the rear end of the hose (11), a disc seat (13) is embedded in the upper portion of the hose (11), an adjusting disc (12) is arranged in the center of the top of the disc seat (13), a female thread (8) is arranged in the rear port of the tubular liquid-gas channel (6), the female thread (8) is meshed with the male thread (9) to realize connection of the liquid-gas channel (6) and the taper pipe (10), the outer diameters of the liquid-gas channel (6) and the taper pipe (10) are consistent, a crown bridge (5) is connected to the top of the front port of the liquid-gas channel (6), the crown bridge (5) is of a square sheet structure, and the square crown bridge (5) is obliquely connected to the outer edge of the front end of the liquid-gas channel (6).

3. The three-purpose endoscopic surgical knife with coagulation suction as claimed in claim 1, wherein the knife assembly (2) is a high-frequency knife cutting part, the interior of the knife tube (16) with a tubular structure is hollow, the rear port of the knife tube (16) is circular, the front port of the knife tube (16) is a knife orifice (15) with an oblique oval shape, the knife head (14) is of a rectangular sheet-shaped structure, one end of the knife head (14) is connected with the lower edge of the knife orifice (15), the other end of the knife head (14) is free, the rear port of the knife tube (16) is connected with an electrode (19), the lower edge of the electrode (19) is flush with the inner wall edge of the knife tube (16), the other end of the electrode (19) is connected with an electrode wire (38), the other port of the electrode tube (17) is free, the left outer side face of the knife tube (16) is connected with a square push (18), the square push (18) is similar to a mushroom shape, the mushroom handle of the square push (18) is cylindrical, the mushroom is free from the lower edge of the knife tube (18), the lower edge of the knife tube (16) is connected with the inner wall (16) of the knife tube (16) in a sliding way, the inner wall (6) of the knife tube (16) is provided with a sliding channel (6) and the top end is in front, the top of the knife tube (16) is sliding channel (6) is sliding on top of the top tube (16) and the top tube (16) is sliding top tube (6) and the top tube (6) is sliding top tube 5, the liquid air passage (6) exceeds the rear end of the knife tube (16), and the rear end of the electrode tube (17) is not in reach with the rear end of the liquid air passage (6).

4. The three-purpose endoscopic surgical knife for cutting, condensing and sucking as claimed in claim 1, wherein the rod assembly (3) is of a sleeve structure, the assembly plays roles of extending and protecting a knife head, the inside of the circular tubular telescopic rod (7) is hollow, the front port of the telescopic rod (7) is called a suction port (22), the suction port (22) is an elliptical inclined port, the inclined port angle of the suction port (22) is consistent with that of a knife nozzle (15), scale marks (21) are arranged on the outer wall of the suction port (22), the scale marks (21) are 12 in total and are uniformly arranged in parallel at intervals, a knife shrinkage groove (20) is formed at the position of the left side outer wall of the telescopic rod (7) close to the rear port, the knife shrinkage groove (20) is of a strip shape, a positioning assembly (23) is arranged at the position of the right side outer wall of the telescopic rod (7) close to the rear port, the front window end of the positioning assembly (23) and the knife shrinkage groove (20) are in left and right opposite positions, the positioning assembly (23) is composed of a movable tooth (24), a circular pushing shaft (25), a tooth spring piece (26), a circular pushing piece (27) and a tooth holder (28) are formed by the movable tooth (24), the circular pushing piece (27) and the tooth holder (28), the positioning assembly (23) is connected with the outer wall of the tooth holder (28) of the telescopic rod (7) in a cuboid structure, the upper surface of the near end of the tooth elastic sheet (26) is connected with the movable tooth (24), the movable tooth (24) is triangular, the tip of the triangular prism of the movable tooth (24) is vertically upwards, one end of a cuboid-shaped round pushing shaft (25) is connected with the side surface of the tooth elastic sheet (26) and is flush with the end surface, the other end of the round pushing shaft (25) penetrates through the center of the round pushing shaft (27), the round pushing shaft (27) is of a circular disc-shaped structure, the round pushing shaft (27) is downwards stirred, the tooth tip of the movable tooth (24) can sink, the electric knife assembly (2), the liquid channel assembly 91 and the rod assembly (3) are combined, the telescopic rod (7) is sleeved on the outer wall of the knife tube (16), the top side surface of the crown bridge (5) is fixedly connected with the top edge of the suction port (22), the knife tube (16) moves forwards and backwards in a cavity between the telescopic rod (7) and the liquid channel (6), the crown bridge (5) is a limiting point for the forward movement of the knife tube (16), the square pushing shaft (18) penetrates through the shrinkage groove (20), the mushroom handle (18) can sink downwards, the telescopic rod (18) protrudes inwards in the telescopic rod (18), and the telescopic rod (18) is pushed forwards, or the telescopic rod (18) is pulled forwards and is retracted towards the telescopic rod (18) to move forwards, and the telescopic rod (18) is pushed forwards, so that the telescopic rod (18) is moved forwards, and is retracted towards the telescopic rod (18.

5. The three-purpose endoscopic surgical knife for cutting and sucking according to claim 1, wherein the sleeve component (4) is sleeved on the outer wall of the telescopic rod (7) of the rod component (3) in a ring mode, the sleeve component (4) plays a role of holding, the tubular telescopic sleeve (36) is provided with two free round ports, the sheet-shaped button seat (32) is connected to the top of the telescopic sleeve (36), the front and rear positions of the top center of the button seat (32) are respectively embedded with the cutting button (33) and the condensing button (34), the front end of the control tube (35) is connected with the tail of the button seat (32), and the rear end of the control tube (35) is divided into two parts: one branch goes straight and goes beyond the back end opening of the telescopic sleeve (36) and is free, an electric wire (37) runs in the telescopic sleeve, the electric wire (37) is connected with a controller or other power sources, the other branch at the back end of the control tube (35) is U-shaped and faces the inside of the telescopic sleeve (36), the electrode wire (38) runs in the electrode tube (17) and passes through the U-shaped branch electric wire (37), a long rod shrinkage groove B (31) is formed on the left outer wall of the telescopic sleeve (36), the distance between the front end of the rod shrinkage groove B (31) and the front edge of the telescopic sleeve (36) is short, a long rod shrinkage groove A (30) is formed on the right outer wall of the telescopic sleeve (36), the front end of the rod shrinkage groove A (30) is opposite to the front end of the rod shrinkage groove B (31), the rear end of the rod shrinkage groove A (30) is not in contact with the mushroom shrinkage groove B (18) when the front end of the telescopic sleeve (30) is pushed out of the telescopic sleeve (18), the mushroom assembly is in a position between the front end of the telescopic sleeve (18), the round push (27) protrudes out of the outer wall of the telescopic sleeve (26), the tooth holder (28) and the tooth elastic piece (26) are in the operation rod shrinkage groove A (30), the tooth holder (28) and the tooth elastic piece (26) cannot touch the tip of the fixed tooth (29), and the movable tooth (24) is meshed with the fixed tooth (29).

6. The three-purpose endoscopic surgical knife according to claim 1, wherein the hose (11) is made of soft silica gel, and the tooth elastic sheet (26) is made of elastic material.