CN117770986A

CN117770986A - Multipurpose uterine manipulator with pincer type cervical cup

Info

Publication number: CN117770986A
Application number: CN202410111794.2A
Authority: CN
Inventors: 刘昱升; 刘映池
Original assignee: Nanjing Maternity and Child Healthcare Hospital
Current assignee: Nanjing Maternity and Child Healthcare Hospital
Priority date: 2024-01-26
Filing date: 2024-01-26
Publication date: 2024-03-29

Abstract

The invention provides a multipurpose uterine manipulator with a clamp type cervical cup, which comprises the clamp type cervical cup and a uterine manipulator which are mutually matched and installed. The forceps-type cervical cup consists of a front flap and a rear flap, wherein the front flap is placed into a front fornix of a vagina, the rear flap is placed into a rear fornix of the vagina, the left edge and the right edge of the front flap and the rear flap are mutually overlapped, the overlapped part is gradually thinned from the center of the cup wall to the edge, and the edge of the cup wall of the rear flap is wrapped outside the edge of the cup wall of the front flap; the uterine lifting rod passes through the uterine cavity along the central shaft of the clamp type cervical cup. The invention adopts the clamp type cervical cup, the size of the cervical cup can be changed through the action of the clamp, the cervical size of a patient can be self-adapted, the cervical can be better sealed by the cervical orifice and the clamp and fixed, and the invention can meet the requirements of various clinical applications.

Description

Multipurpose uterine manipulator with pincer type cervical cup

Technical Field

The invention relates to the technical field of uterine lifts, in particular to a multipurpose uterine lifter with a clamp type cervical cup.

Background

The uterus lifting device commonly used at present is an auxiliary device for gynecological operation under a laparoscope, and mainly comprises a lifting Gong Gan, a dome cup, a bracket and a handle. In the operation, the uterine manipulator can be used for various laparoscopic operations requiring control of the uterine position in the operation, a uterine manipulator rod of the uterine manipulator penetrates through a cervical canal to be placed in a uterine cavity, and the uterine position can be controlled by controlling a bracket and a handle; the size of the fornix cup is fixed, the fornix cup is wrapped on the periphery of the cervix, the cervical is lifted, the uterine position can be controlled by matching the cervical lifting rod, and the fornix cup is fixed on the support through threads. The uterine manipulator can better expose the surgical field, facilitate the surgical operation and improve the accuracy and safety of the operation.

At present, the uterus lifting device commonly used in clinic has the following defects:

1. the cervical cup is fixed in size, the cervical size of a patient needs to be judged, and cervical cups with large, medium and small sizes are selected, but are often only approximately matched, so that the effect of ideal fixing and sealing of the cervical canal cannot be achieved in operation;

2. marking points are not arranged on the uterine manipulator, so that the fornix and the incision point of the vaginal wall are blind, repeated confirmation is needed, and the operation time is prolonged;

3. the cervix can not be fixed, the uterine manipulator is required to be taken down when the uterus is taken out by laparoscopic holectotomy, and the uterus is taken out by clamping the cervix by a clamping device; the cervical is exposed in the process of taking out the uterus, and the cervical orifice is opened, so that infection or tumor diffusion is easily caused.

4. The problem that the ideal uterine lifting can not be achieved due to the fact that the uterine lifting rod in the uterine cavity is too large in moving space and the uterine body is not moved due to the fact that the uterine lifting rod moves;

5. in laparoscopic holter hysterectomy, the uterine manipulator needs to be removed and pulled out using an additional clamping mechanism when the resected uterus is removed. Often, when the jaw cervical is pulled out due to oversized uterus, the uterus is extruded into a sphere at the outlet due to the narrow pelvis outlet and is blocked at the outlet, so that the uterus is difficult to take out;

disclosure of Invention

In order to solve the problems, the invention discloses a multipurpose uterine manipulator with a clamp type cervical cup.

The specific scheme is as follows:

a multipurpose uterine manipulator with a clamp-type cervical cup, which is characterized in that: the cervical cup is of a barrel-shaped structure with an opening at the proximal end, and consists of a front flap and a rear flap, wherein the front flap is placed into a front fornix of a vagina, the rear flap is placed into a rear fornix of the vagina, the left edge and the right edge of the front flap are overlapped with each other, the overlapped part is gradually thinned from the center of a cup wall to the edge, and the side edge of the rear flap is wrapped outside the side edge of the front flap; the uterine lifting rod penetrates through the uterine cavity along the central shaft of the clamp-type cervical cup.

As a further improvement of the invention, the inner surface of the clamp-type cervical cup is provided with a plurality of small ridges which are transversely arranged and are used for increasing friction force when the resected uterus is taken out, cervical slipping is prevented, and the middle part of the outer wall of the front flap cup mouth is provided with a ox horn-shaped bulge with a smooth conical top end.

As a further improvement of the invention, the bottom of the clamp cervical cup is formed by combining a front valve bottom and a rear valve bottom, the rear valve bottom is round-like, a uterine rod lifting movable groove is eccentrically arranged in the middle front-rear direction from the center to the rear, and an arc-shaped gap is arranged at the edge part close to the center of the front valve cup wall; the back valve cup bottom is wrapped on the centrifugal surface of the front valve cup bottom, the near-center surface of the back valve cup bottom is a plane, and the centrifugal surface is an inclined surface which is in a wedge shape gradually thinned from back to front; the cup bottom of the front valve is horseshoe-shaped, a uterine lifting rod moving groove is arranged in the middle front-back direction, and one end of the uterine lifting rod moving groove, facing the rear valve, is opened in a horn shape; when the cervical cup is in the maximum state, the back valve cup bottom completely covers the uterine lifting rod moving groove notch on the front valve cup bottom; the proximal surface of the bottom of the front valve cup is an inclined surface, the centrifugal surface is a plane, and the front valve cup is wedge-shaped which is gradually thinned from front to back.

As a further improvement of the invention, the centrifugal test at the bottom of the clamp type cervical cup is provided with a sealing gasket for sealing the gap at the bottom of the clamp type cervical cup, small arc-shaped gaps are arranged at the front and back of the clamp type cervical cup, the centrifugal surface at the bottom of the clamp type cervical cup is covered with a rear flap cup, a round hole for a lift Gong Gan to pass through is arranged in the middle of the clamp type cervical cup and is matched with the roughness of a lifting rod, the near-center surface of the clamp type cervical cup is matched with the convexity and concavity of the centrifugal surface of the cervical cup, and the centrifugal surface is a plane for ensuring the sealing effect.

As a further improvement of the cervical cup, the sealing nut capable of fixing the sealing gasket in a pressurizing mode is arranged on the far side of the sealing gasket, the sealing nut is matched with corresponding threads on the uterine lifting rod through threads, the sealing nut rotates towards the near center end along the threads on the uterine lifting rod, the sealing gasket can be fixed in a pressurizing mode, and a gap at the bottom of the cervical cup is sealed.

As a further improvement of the invention, the medical rubber walls of the front valve and the rear valve are correspondingly embedded with metal stress brackets, the trunk of the metal stress brackets extends out of the bottom end of the cup body to form clamp arms of the front valve and the rear valve, the two clamp arms extend out of the cup bottom to a certain length and bend towards opposite sides and simultaneously diverge towards left and right, the clamp arms extend towards the inclined arc of the distal end to fold and turn at the intersection point of extension lines of the opposite clamp arms again, the clamp arms extend towards the distal end along the extension lines of the front and rear clamp arms to form front and rear handles of the clamp type cervical cup, the intersection point of the left and right branches is provided with hinges which are riveted and fixed and can rotate mutually, the front and rear forks, the left and right branches intersect, and the left and right branches are folded towards opposite sides to form an annular space structure together, and the annular space structure is used for passing through a uterine lifting rod from the center.

As a further improvement of the invention, the two handles are provided with a handle locking and fixing structure and a uterine lifting rod locking and fixing structure on the distal sections, and the two structures are arranged on the same plane. The handle locking and fixing structure is positioned at the outer side of the handle, is closely adjacent to the inner side of the handle and is provided with a uterus lifting rod locking and fixing structure, and the handle locking and fixing structure is tooth-shaped and is used for locking and fixing the clamp-type cervical cup in the use process; the uterus lifting rod locking and fixing structure comprises parts which are respectively fixed on the two handles, wherein one part is provided with a telescopic retaining ring with a spring, the other part is provided with a retaining ring with a fixed length, and the uterus lifting rod is locked and fixed through the middle of the two retaining rings while locking and fixing the clamp type cervical cup.

As a further improvement of the invention, the uterine lifting rod is a hollow pipeline with a smooth and closed proximal end, a three-way connecting pipe is connected with a distal end by screw threads, and a plurality of small holes are uniformly formed on the side wall of one section of the proximal end (entering the uterine cavity); a first length scale is arranged on the far side with a small hole, and a thread is arranged on the outer surface of the first length scale section of the uterine lifting rod and is matched with the sealing nut; a second length graduated scale is arranged at the distal edge of the uterine lifting rod locking and fixing structure in a distal direction, and the second graduated scale is arranged outside the vagina, so that the depth of the uterine lifting Gong Gan entering the uterine cavity can be conveniently read; a three-way connecting pipe threaded connector is arranged on the far side of the second graduated scale; an external catheter connector is arranged between the distal end and the side wall of the three-way connecting pipe, and a three-way switch is arranged at the initial position of the side pipe and used for switching and communicating the lumen of the uterine lifting rod with the distal catheter or the side wall catheter; the joint of the uterine lifting rod and the three-way connecting pipe is provided with a rubber sealing ring for preventing water leakage and air leakage at the threaded joint.

The invention has the beneficial effects that:

1. the cervical cup is clamped by the pliers, the size of the cervical cup can be changed through the clamping action, and the cervical cup is self-adaptive to the cervical size of a patient.

2. The forceps-type cervical cup adopted by the invention is divided into a front flap and a rear flap, the front flap and the rear flap are respectively and correspondingly placed on the front dome and the rear dome of the vagina, and a ox horn-shaped bulge is arranged on the central outer surface of the top of the front flap. This bulge is easily found under laparoscope and can be used as a marker to determine the anterior dome position. The incision position of the vaginal wall can be determined according to the needs of the patient when the uterus is cut off.

3. The cervical lifting device adopts the clamp type cervical cup to be matched with the cervical lifting rod in the cervical canal, so that the cervical can be firmly fixed on the cervical lifting rod, and the cervical lifting device can be used for directly taking out the resected uterus when taking out the uterus through the laparoscopic holter resection.

4. The sealing gasket is adopted to seal the gap at the bottom of the clamp type cervical cup, and meanwhile, the clamp type cervical cup is matched with the uterine lifting rod in the cervical canal, so that the cervical orifice can be sealed, and the cervical and the uterine cavity can be sealed in a sealed space. Can prevent infection or malignant tumor cell diffusion during operation of infection or malignant tumor.

5. The uterine lifting rod adopted by the invention is of a hollow pipeline-shaped structure, a plurality of small holes are formed in the side wall of the proximal end, and the rear end can be connected with a negative pressure aspirator. When the cervical orifice is closed, the uterine cavity can be changed into negative pressure, so that the uterine wall is adsorbed on the uterine lifting rod, the uterine lifting rod has no free space in the uterine cavity, and the purpose of lifting the uterus is easily achieved by moving the uterine lifting rod.

6. In the laparoscopic holohectomy, when the factor uterus is large and is not easy to take out, the length of the uterine rod in the uterine cavity can be increased under the observation of the laparoscope (on the premise of not perforating the uterus), the longitudinal axis of the uterine body is prolonged, the negative pressure in the uterine cavity is increased, the volume of the resected uterus is reduced like a cylinder, and the uterus is easy to take out through a pelvis outlet.

7. The invention is provided with the three-way connecting pipe at the distal end of the uterine cavity lifting rod, so that uterine cavity flushing or oviduct liquid passing operation can be performed. After the cervical orifice is sealed exactly, the invention can freely switch the filling or discharging of the uterine cavity through the three-way control, thereby achieving the purpose of flushing the uterine cavity or hydrotubation.

8. The invention has several side holes at the proximal end of the uterine rod, the lifting Gong Gan is a hollow pipe, the rear end can be connected with the aspirator through the three-way pipe, so that the uterine cavity becomes negative pressure, and the uterine muscle wall is adsorbed to the uterine rod. The negative pressure is regulated, so that the blood vessel between the uterine muscle walls is pressed and blocked, the purpose of temporary hemostasis can be achieved for the bleeding caused by uterine contraction and hypodynamia after delivery, the time is gained for further treatment, and the effect of uterine artery embolism or uterine cavity sliver filling is achieved to a certain extent.

Drawings

FIG. 1 is a schematic diagram of the structure of the present invention.

Fig. 2 is a schematic top view of the front flap cup bottom in the present invention.

Fig. 3 is a schematic top view of the back valve cup bottom in the present invention.

FIG. 4 is a schematic top view of a gasket seal of the present invention.

Fig. 5 is a schematic sectional view of the locking and fixing structure of the handle and the uterine lifting rod in the invention.

FIG. 6 is a schematic view of a metal force-bearing bracket according to the present invention.

Fig. 7 is a schematic view of a uterine lifting rod in the present invention.

List of reference numerals:

the cervical clamp comprises a 1-clamp cervical cup, a 11-front valve, a 12-rear valve, a 13-rear valve lifting rod movable groove, a 14-front valve lifting rod movable groove, a 15-ox horn-shaped bulge, a 2-lifting rod, a 3-sealing gasket, a 31-round hole, a 4-sealing nut, a 5-metal stress bracket, a 6-handle locking and fixing structure, a 7-lifting rod locking and fixing structure, an 8-three-way connecting pipe, a 9-small hole, a 10-three-way connecting pipe threaded interface and a 16-hinge.

Detailed Description

The present invention is further illustrated in the following drawings and detailed description, which are to be understood as being merely illustrative of the invention and not limiting the scope of the invention.

For convenience of explanation, according to the corresponding relation between the invention and the human body of a patient in normal clinical use, the following azimuth nouns are defined: the front direction is the direction facing the front of the human body of the patient; the back refers to the direction facing the back of the human body; the left and right refer to the directions facing the left and right sides of the human body of the patient respectively; proximal, or proximal face refers to the end or face that is proximal to the heart; distal, centrifugal surface refers to the end or surface that is distal to the heart; the inner and outer refer to the directions approaching and separating from the central axis of the present invention, respectively.

As shown in the figure, the multipurpose uterine manipulator with the clamp-type cervical cup comprises the clamp-type cervical cup 1 and a uterine manipulator 2 which are mutually matched and installed, wherein the clamp-type cervical cup 1 is of a barrel-shaped structure with an opening at the proximal end and consists of a front flap 11 and a rear flap 12, the front flap 1 is placed into a front fornix of a vagina, the rear flap 2 is placed into a rear fornix of the vagina, according to the design of human anatomy parameters, the midpoint of the inner surface of the wall of a cup opening is from the midpoint of the inner surface of a cup bottom, the front flap is about 4cm long, the rear flap is about 7cm long, the shape of the front flap 11 and the rear flap 12 is similar to a half barrel shape, the left side edge and the right side edge of the two flaps are mutually overlapped, the overlapped part is gradually thinned from the center of the cup wall to the edge, the edge of the rear flap 12 is wrapped outside the edge of the front flap 11, and the overlapped part is smooth and is not protruded like. The two petals are combined to form a cup mouth similar to an ellipse, the rear petal of the cup wall is inclined towards the front petal to be shortened, and the cup bottom is round and similar to a barrel shape. The uterine lifting rod 2 passes through the center shaft of the clamp type cervical cup 1.

In this embodiment, the inner surface of the clamp-type cervical cup 1 is provided with a plurality of small ridges which are transversely arranged and raised, and the small ridges are used for increasing friction force and preventing cervical slipping when the fixed cervix is taken out from the resected uterus; the middle part of the outer wall of the front flap 11 cup mouth is provided with a 0.5 multiplied by 0.5cm conical-shaped ox horn-shaped bulge 15 with smooth top end.

In the embodiment, the bottom of the clamp-type cervical cup 1 is formed by splicing the bottom of the front flap 11 and the bottom of the rear flap 12, and is approximately circular. According to anatomical parameters and the parameters (inner diameter 46 mm) of the large cervical cup which is commonly used clinically at present, the initial state of the inner diameter of the clamp cervical cup 1 is 4.6cm, the bottom of the back valve 12 cup is round with the inner diameter of 4.6cm, a back valve uterine-lifting rod movable groove 13 which is eccentrically arranged is arranged from the center to the back, the back valve uterine-lifting rod movable groove 13 is arranged in a mode that a round hole with the diameter of 10mm is formed in the center of the circle, the center of the round hole is translated backwards along a straight line for 1cm, a uterine-lifting rod movable groove with two sides being semicircular and the middle being rectangular is obtained, and when the clamp of the cup body is contracted, the uterine-lifting rod can move in the groove to approach the cup wall. The edge part of the bottom of the back valve, which is close to the center of the bottom of the front valve 11 cup, is provided with an arc-shaped gap with the arc height of 1cm, so that the jaw movement of the jaw arms of the front valve can not be blocked when the jaw is used for fixing the cervix. The cup bottom of the rear flap 12 is wrapped on the centrifugal surface of the cup bottom of the front flap 11, the near-center surface of the cup bottom of the rear flap 12 is designed to be a plane, and the centrifugal surface is an inclined surface and is in a wedge shape which is gradually thinned from back to front; the bottom of the front valve 11 is similar to a horseshoe shape, a uterine lifting rod moving groove 14 is arranged in the middle front-back direction, the distance between the top point of the uterine lifting rod moving groove 14 of the front valve and the midpoint of the bottom edge of the cup wall of the front valve 11 is 1.1cm, one backward end of the uterine lifting rod moving groove 14 of the front valve is in a horn shape and is open, the closed end is an arc with the diameter of 10mm, the tangential lines of the left side and the right side of the circle are intersected with the edges of the left side and the right side of the front valve 11, and the two tangential lines form two sides of the uterine lifting rod moving groove 14 of the front valve between the circular arc of the closed end and the edge intersection of the front valve 11; in the initial state (when the cervical cup is maximum), the bottom of the back valve 12 completely covers the gap of the uterine lifting rod moving groove 14 on the bottom of the front valve 11; the cup bottom near center surface of the front flap 11 is designed as an inclined surface, and the centrifugal surface is a plane which is in a wedge shape gradually thinned from front to back.

In this embodiment, the design bottom surface can be reduced by a maximum of 1.9cm in diameter. The diameter of the minimum cup bottom reaches 2.7cm, the middle shaft is a lifting cervical rod with the diameter of 0.9cm, the diameter of a normal cervical is 3-4cm, namely the thickness of the cervical wall can be compressed from 1.5-2cm to 0.9cm, a plurality of small raised ridges are arranged on the inner surface of the matching cup body, and when the cervical clamp is used, the cervical clamp can clamp and fix the cervical with enough force and seal the cervical canal.

In this embodiment, a sealing gasket 3 for sealing a gap at the bottom of the clamp-type cervical cup 1 is arranged at the bottom of the clamp-type cervical cup 1, and soft rubber which is easy to deform after being extruded is selected. The shape is an incomplete circle with bow-shaped gaps with the bow height of 0.5cm at the front and rear edges of 4.6cm, the cup bottom of the back valve can be covered, the contraction movement of the cervical cup is not affected, a round hole 31 for the uterine rod 2 to pass through is arranged in the middle and is matched with the roughness of the uterine rod 2, the near-center surface of the circular hole is matched with the convex concave degree of the centrifugal surface of the cup bottom, and the centrifugal surface is a plane for ensuring better sealing effect.

In this embodiment, the centrifugal side of the sealing gasket 3 is provided with a sealing nut 4 capable of fixing the sealing gasket 3 in a pressurized manner, and the sealing nut 4 is matched with a corresponding thread on the uterine lifting rod 2 through the thread. The rotary nut can move forwards and backwards along the uterine lifting rod, and can press and fix or loosen the sealing gasket. The nut is designed into a barrel shape, vertical lines are carved on the outer surface of the nut, so that friction force during manual screwing can be increased, and the nut is convenient to operate.

In the embodiment, the wall and the bottom of the clamp cervical cup are made of medical elastic rubber which has certain toughness and can be suitable for proper deformation in the use process, are non-conductive, can be sterilized by high-temperature, disinfectant, chemical fumigation and other methods, and can be reused.

In this embodiment, the metal stress brackets 5 with certain strength and toughness are embedded in the cup walls of the front and rear petals 11 and 12, the trunk of the metal stress bracket 5 extends out of the far end of the cup bottom to form clamp arms of the front and rear petals 11 and 12, the two clamp arms extend out of the cup bottom distally to 5cm to bend to opposite sides and simultaneously diverge to the left and right, the arc-shaped extending height of the far end is inclined to 1cm to cause the intersection point of extension lines of the opposite clamp arms to be folded together again, and the front and rear handles of the clamp cervical cup are formed by extending (9-10) cm along the extension lines of the front and rear clamp arms to the far end, and in the bifurcation inclined extending process, hinges 16 which are riveted and fixed and can rotate mutually are arranged at the intersection points of the branches of the left and the right sides, namely the rotating shafts of pliers. The front branch and the rear branch are intersected, the left branch and the right branch are intersected, and the left branch and the right branch are folded to the opposite sides to form an annular space structure together, the outer diameter of the annular space structure is similar to the outer diameter of a cervical cup, and the inner diameter of the annular space structure is far greater than the outer diameter of a uterine lifting rod, so that the uterine lifting rod can pass through the center of the uterine lifting rod in the use process. According to the ergonomic principle, the front and rear handles become gradually thicker from the proximal end to the distal end, the thickness is suitable for holding by a right hand and convenient for forced operation, and the rear end is provided with a notch suitable for holding by the right hand. The general adult vagina length is about 9cm (not the depth of the fornix after pregnancy), and the design can lead the annular space structure not to be in the vagina under most use conditions, thus being convenient for operating the sealing gasket and the sealing nut at the bottom of the cup and being convenient for observing the condition in the vagina.

In the embodiment, a handle locking and fixing structure 6 and a uterine lifting rod locking and fixing structure 7 are arranged on a proximal section of the distal end of the handle, the two structures are arranged on the same plane, the distal edge of the locking and fixing structure is 17cm away from the center of the inner surface of the cervical cup bottom, the handle locking and fixing structure 6 is positioned on the outer side of the handle, the uterine lifting rod locking and fixing structure 7 is arranged close to the inner side of the handle, and the handle locking and fixing structure 6 is in a tooth shape of a vascular clamp and is used for locking and fixing the clamp-type cervical cup 1 in the use process; the uterus lifting rod locking and fixing structure 7 comprises parts which are respectively fixed on the two handles, wherein one part is a telescopic retaining ring with a spring, and the other part is a retaining ring with a fixed length. After the front handle and the rear handle of the clamp type cervical cup are close to each other and locked, the lifting Gong Gan between the two rings can be locked and fixed under the action of the elastic force of the springs. The lifting rod locking and fixing structure and the clamp type cervical cup are used together, the lifting rod Gong Gan is locked and fastened on the clamp type cervical cup structure and can move along with the clamp type cervical cup handle, and the uterus position can be changed by operating the handle according to operation requirements.

In this embodiment, the uterine lifting rod 2 is designed as a hollow pipeline with a smooth and closed proximal end, and the centrifugal end is in threaded connection with the three-way connecting pipe 8. According to the anatomical parameters of adults, the maximum outer diameter of the uterine lifting rod is 9mm, and a plurality of small holes 9 are uniformly formed in the tube wall within the range of 4cm at the proximal end; a first length graduated scale is arranged on the far side with small holes, the initial graduation number is 4cm, each 0.5cm interval is carved with a graduation line, graduation values are marked at the position of the integral cm, and the graduation values are marked to the position of 12cm and stopped; extending distally from the 5cm scale value to a position which is 2cm far from the 12cm scale value, the outer surface of the uterine lifting rod 2 is provided with threads which are matched with the sealing nut 4. The thread is ground flat at the scale to facilitate the marking of the scale. The outer diameter of the uterine cavity lifting rod is equal to the inner diameter of the thread from the distal end of the thread to the distal end of the uterine cavity lifting rod, so that the sealing nut is sleeved in the uterine cavity lifting rod from the distal end of the uterine cavity lifting rod. A second length graduated scale is arranged at a position 17cm away from the proximal end of the uterine lifting rod (the distance from the center of the inner surface of the cervical cup bottom to the distal edge of the locking fixed structure on the handle is 17 cm), the initial graduation number is 4cm each time 0.5cm each time one graduation line is carved, graduation values are marked at the position of the integral centimeters, and the graduation values are stopped at the position of 12 cm. The second graduated scale is arranged outside the vagina and is used for reading the depth of the lifting Gong Gan 2 entering the uterine cavity; a three-way connecting pipe threaded connector 10 is arranged at a position 5cm far away from the scale value of the second scale 12; the three-way connecting pipe 8 can be designed to be 5-10cm long, an external catheter connector is arranged between the far end and the side wall, and a three-way switch is arranged at the initial position of the side pipe and used for switching and communicating the lumen of the uterine lifting rod 2 with a rear end catheter or a side wall catheter; and a rubber sealing ring is arranged at the joint 10 of the uterine lifting rod 2 and the three-way connecting pipe and is used for preventing water and air leakage at the threaded joint.

In this embodiment, some of the values described herein may be continuously optimized during a particular clinical application.

The specific practical principle of the invention is as follows:

the patient takes the lithotomy position, disinfects the vulva and the vagina and spreads the towel, expands the vagina by using the vaginal dilator, clamps and fixes the cervix by using the cervical dilator, expands the cervical canal to the point that the uterine rod can be conveniently inserted into the uterus, inserts the proximal end (the end with small holes on the side wall) of the uterine rod to directly reach the uterine bottom, reads the scale value at the external opening of the cervix, and fixes the uterine rod by hand so as not to lead the uterine rod to slide out of the uterus. And taking out the vaginal dilator and the cervical clamp, and sleeving an annular space structure formed by the cervical cup bottom, the sealing rubber pad, the sealing nut and the cervical cup clamp arm respectively from the distal end of the uterine lifting rod. The anterior valve of cervical cup is put into anterior fornix of vagina, the posterior valve is put into posterior fornix of vagina, and the mouth of the cervical cup is respectively put at the top of anterior and posterior fornix of vagina by probing with finger. And reading out a scale value from the second scale at the distal edge of the handle locking structure, and adjusting the depth of the uterine cavity entering the uterine cavity by the uterine lifting rod to make the scale value at the position equal to the numerical value read out at the first scale for the first time. The sealing gasket is pushed to the near end and clings to the centrifugal surface of the cervical cup bottom, and after the sealing gasket is matched with the convex and concave surfaces of the cup bottom, the sealing nut is screwed to the near end, so that the sealing gasket is fixed on the outer surface of the cervical cup bottom in a sealing way. The distal uterine lifting rod is placed into the front and rear locking and fixing buckles of the uterine lifting rod on the handle, the front and rear handles of the clamp arms are tightened (medical liquid paraffin oil can be used for lubrication at the overlapped part of the cup bottom and the side edge for reducing friction), and the handle locking structure is locked when the uterine lifting rod is in a proper position, at the moment, the cervix, the lifting Gong Gan and the handle are simultaneously locked and fixed, and the uterine cavity is sealed at the cervical canal. The handle of the cervical cup clamp arm is operated to drive the uterine lifting rod to move, so that the position of the uterine body can be adjusted according to the requirement, and the laparoscopic intraperitoneal operation is convenient.

If the uterine cavity is oversized, the free movement space of the proximal end of the uterine lifting rod in the uterine cavity is large, the uterine body does not move along with the uterine lifting rod, and when the uterine lifting is difficult, the rear end of the uterine lifting rod can be connected with a three-way connecting pipe, an external connecting pipe interface is selected, a negative pressure suction system is connected, and the negative pressure value is regulated, so that the uterine body is adsorbed on the proximal end of the uterine lifting rod, and the uterine lifting is easy.

When the uterus is resected and the vaginal wall is cut, a ox horn-shaped bulge mark point on the cervical cup at the anterior fornix part of the vagina can be found under the laparoscope, if the mark point is not definite, the cervical cup can be gently rotated, and the vaginal wall bulge at the anterior fornix part of the vagina moves along with the cervical cup, so that the mark point can be confirmed. With the mark point as a reference, the vaginal wall excision site can be easily determined according to the needs of the illness.

The invention can reduce the volume of the resected uterus and is easy to take out the uterus through the pelvis outlet. At present, in the hysterectomy under a cavity microscope, when the resected uterus is taken out, a uterus lifting device is often required to be taken down, in addition, the cervical clamp is pulled out outwards from the abdominal cavity, often because the uterus is oversized, when the cervical clamp is pulled out outwards, the pelvis outlet is narrow, so that the uterus is extruded into a sphere at the outlet and clamped at the outlet, and the uterus is difficult to take out. Under the observation of a laparoscope, the length of the uterine rod in the uterine cavity is increased (on the premise of not perforating the uterus), the longitudinal axis of the uterine body is prolonged, the uterine wall is adsorbed on the uterine rod by negative pressure, the uterine body is contracted, the uterine is changed from a spherical shape into an approximate cylindrical shape, and the uterus can be taken out easily.

When the cervical cup is used, the cervical and the bottom of the cervical cup can be effectively sealed, and the cervical cup can be suitable for various clinical application requirements. In laparoscopic malignant tumor radical treatment, when taking out resected uterus, the uterus lifting device is often needed to be taken down, in addition, the cervical is pulled out of the abdominal cavity by using the clamping device to clamp the cervical, at the moment, the cervical orifice is opened, the cervical is exposed, the overflow of uterine cavity contents can be caused, pathological tissues on the cervical surface fall off, and malignant tumor cells or infectious pathogens are spread and planted, so that secondary injury is caused. If the tissue pathological specimens falling off from the uterine cavity are required to be collected, a negative pressure collecting bottle can be additionally arranged on the negative pressure suction system. When the uterine cavity is infected for uterine cavity flushing, the external catheter connector of the three-way connecting pipe connected with the rear end is connected with the water inlet pipe and the water outlet pipe, and the water inlet or the water outlet is freely switched through the three-way switch, so that the infection diffusion of pathogens in the vagina can not be caused. When the oviduct is connected, the water inlet pipe can be connected with a pressure indicator, and whether the oviduct is unobstructed or not can be judged by observing the change of the pressure value in the uterine cavity, so that misdiagnosis caused by the condition that the cervical canal is not tightly sealed and liquid leaks can be avoided. After delivery through vagina, the invention can be used for adjusting the magnitude of negative pressure to adsorb uterine wall on a uterine lifting rod, so that the blood vessel between uterine muscle walls is pressed and blocked to play a temporary hemostasis role, and the invention can play a role in further treating abnormal blood systems of puerpera and winning time for operation, playing a role in filling uterine artery embolism or uterine cavity sliver to a certain extent, and can be repeatedly used intermittently until bleeding stops.

The technical means disclosed by the scheme of the invention is not limited to the technical means disclosed by the embodiment, and also comprises the technical scheme formed by any combination of the technical features. It should be noted that modifications and adaptations to the invention may occur to one skilled in the art without departing from the principles of the present invention and are intended to be within the scope of the present invention.

Claims

1. A multipurpose uterine manipulator with a clamp-type cervical cup, which is characterized in that: comprises a clamp type cervical cup (1) and a uterine lifting rod (2) which are mutually matched and installed; the clamp-type cervical cup (1) is of a barrel-shaped structure with an opening at the proximal end and consists of a front flap (11) and a rear flap (12), the front flap (1) is placed into a front fornix of a vagina, the rear flap (2) is placed into a rear fornix of the vagina, the left side edge and the right side edge of the front flap (1) and the right side edge of the rear flap (2) are mutually overlapped, the overlapped part is gradually thinned from the center of a cup wall to the edge, and the cup wall edge of the rear flap (2) is wrapped outside the cup wall edge of the front flap (1); the uterine lifting rod (2) passes through and is placed in the uterine cavity along the central shaft of the clamp-type cervical cup (1).

2. A multipurpose uterine manipulator with a clamp-on cervical cup as claimed in claim 1, wherein: the inner surface of the clamp-type cervical cup (1) is provided with a plurality of small ridges which transversely move and are used for increasing friction force when the fixed cervix is taken out and the uterus is resected, cervical slipping is prevented, and the middle part of the outer wall of the rim of the front flap (11) is provided with a ox horn-shaped bulge (15) with a smooth conical top end.

3. A multipurpose uterine manipulator with a clamp-on cervical cup as claimed in claim 2, wherein: the bottom of the clamp cervical cup (1) is formed by splicing the bottom of a front flap (11) and the bottom of a rear flap (12), the bottom of the rear flap (12) is round-like, a uterine lifting rod movable groove (13) is eccentrically arranged in the middle front and rear from the center to the rear, and an arc-shaped gap is formed in the edge part close to the center of the front flap (11) cup wall; the cup bottom of the rear flap (12) is wrapped on the centrifugal surface of the cup bottom of the front flap (11), the near-center surface of the cup bottom of the rear flap (12) is a plane, and the centrifugal surface is an inclined surface which is in a wedge shape gradually thinned from back to front; the cup bottom of the front flap (11) is horseshoe-shaped, a uterine-lifting rod moving groove (14) is arranged in the middle front-back direction, and one end of the uterine-lifting rod moving groove (14) of the cup bottom of the front flap, which faces the rear flap (12), is opened in a horn shape; when the cervical cup is in the maximum state, the bottom of the back valve (12) completely covers the gap of the uterine lifting rod moving groove (14) on the bottom of the front valve (11); the near-center surface of the bottom of the front valve (11) is an inclined surface, the centrifugal surface is a plane, and the centrifugal surface is a wedge-shaped gradually thinned from front to back.

4. A multipurpose uterine manipulator with a clamp-on cervical cup as claimed in claim 3, wherein: the cervical cup is characterized in that a sealing gasket (3) for sealing a bottom gap is arranged on the centrifugal side of the bottom of the cervical cup (1), small arc-shaped gaps are formed in the front and the rear of the cervical cup, the centrifugal surface of the bottom of the rear valve cup (12) is covered, a round hole (31) for a uterine lifting rod (2) to pass through is formed in the middle of the sealing gasket (3) and is matched with the thickness of the uterine lifting rod (2), the near-center surface of the sealing gasket is matched with the convex-concave degree of the centrifugal surface of the bottom of the rear valve cup, and the centrifugal surface is a plane and is used for guaranteeing sealing effect.

5. A multipurpose uterine manipulator with a clamp-on cervical cup as defined in claim 4, wherein: the centrifugal side of sealing gasket (3) is equipped with sealing nut (4) that can pressurize fixed sealing gasket (3), sealing nut (4) are through corresponding screw thread assorted on screw thread and the palace pole (2) of lifting, and sealing nut (4) are along the screw thread on the palace pole to near the heart end rotation, can pressurize fixed sealing gasket (3), seal pincer formula cervical cup (1) bottom gap.

6. A multipurpose uterine manipulator with a clamp-on cervical cup as defined in claim 5, wherein: the medical rubber walls of the front valve (11) and the rear valve (12) are correspondingly embedded with metal stress brackets (5), the trunk of the metal stress brackets (5) extends out of the bottom end of the cup body to form clamp arms of the front valve (11) and the rear valve (12), the two clamp arms extend out of the cup bottom to a certain length to extend to the far end, bend to the opposite sides and simultaneously diverge to the left and the right, the arc extends to the far end to incline to cause the intersection point of extension lines of the opposite sides to fold and turn again, the extension lines extend to the far end along the extension lines of the front and the rear clamp arms to form front and rear handles of the clamp type cervical cup, the intersection point of the left and the right side branches is provided with a hinge (16) which is riveted and fixed and can rotate mutually, and the front and the rear bifurcation, the left and the right side branches intersect and the left and the right side branches are folded to the opposite sides to form an annular space structure together, and the annular space structure is used for passing through a uterine lifting rod from the center.

7. A multipurpose uterine manipulator with a clamp-on cervical cup as defined in claim 6, wherein: the two handle distal sections are provided with a handle locking and fixing structure (6) and a uterine lifting rod locking and fixing structure (7), and the two structures are arranged on the same plane; the handle locking and fixing structure (6) is positioned at the outer side of the handle, a uterine lifting rod locking and fixing structure (7) is arranged close to the inner side of the handle, and the handle locking and fixing structure (6) is in a tooth-buckling shape and is used for locking and fixing the clamp-type cervical cup (1) in the use process; the uterus lifting rod locking and fixing structure (7) comprises parts which are respectively fixed on the two handles, wherein one part is a flexible retaining ring with a spring, the other part is a retaining ring with a fixed length, and the uterus lifting rod is locked and fixed through the middle of the two retaining rings while locking and fixing the clamp type cervical cup (1).

8. A multipurpose uterine manipulator with a clamp-on cervical cup as defined in claim 7, wherein: the uterine lifting rod (2) is a hollow pipeline with a smooth closed proximal end, the distal end is in threaded connection with a three-way connecting pipe (8), and a section of side wall of the proximal end is uniformly provided with a plurality of small holes (9); a first length scale is arranged on the far side of the small hole (9), and threads are arranged on the outer surface of the first length scale section of the uterine lifting rod (2) and are matched with the sealing nut (4); a second length graduated scale is arranged on the far section of the locking position of the uterine lifting rod (2), and the second graduated scale is arranged outside the vagina, so that the depth of the uterine lifting rod (2) entering the uterine cavity can be conveniently read; a three-way connecting pipe threaded connector (10) is arranged on the far side of the second graduated scale; an external catheter connector is arranged between the far end and the side wall of the three-way connecting pipe (8), and a three-way switch is arranged at the initial position of the side pipe and used for switching and communicating the lumen of the uterine lifting rod (2) with a rear end catheter or a side wall catheter; the uterus lifting rod (2) and the joint (10) of the three-way connecting pipe are provided with rubber sealing rings for preventing water leakage and air leakage at the threaded joint.