Description of drawings
Figure 1A is the overall structure sketch map of this utility model anastomat for circumcision;
Figure 1B is a cross-sectional view of the present utility model;
Fig. 2 is the overall structure front view of this utility model anastomat for circumcision;
Fig. 3 is the overall structure lateral plan of this utility model anastomat for circumcision;
Fig. 4 is the front view of this utility model anastomat for circumcision outer shroud;
Fig. 5 is the lateral plan of the whole open mode of this utility model anastomat for circumcision;
Fig. 6 is the open mode front schematic view of this utility model anastomat for circumcision outer shroud;
Fig. 7 is the open mode side schematic view of this utility model anastomat for circumcision outer shroud;
Fig. 8 is the open mode reverse side sketch map of this utility model anastomat for circumcision outer shroud;
Fig. 9 is the first half-turn spare front view of this utility model anastomat for circumcision outer shroud;
Figure 10 is the first half-turn spare vertical view of this utility model anastomat for circumcision outer shroud;
Figure 11 is the second half-turn spare front view of this utility model anastomat for circumcision outer shroud;
Figure 12 is the axonometric chart of the two knife-edge part cutting blades of this utility model anastomat for circumcision outer shroud;
Figure 13 A is the two knife-edge part cutting blade structure for amplifying sketch maps of this utility model anastomat for circumcision outer shroud among Figure 10;
Figure 13 B is the section structure for amplifying sketch map of a kind of structure of I-I face among Figure 13 A;
Figure 13 C is the section structure for amplifying sketch map of the another kind of structure of I-I face among Figure 13 A;
Figure 14 A is a kind of lateral plan of this utility model anastomat for circumcision internal ring;
Figure 14 B is the another kind of lateral plan of this utility model anastomat for circumcision internal ring;
Figure 15 is this utility model anastomat for circumcision internal ring front view;
Figure 16 is this utility model anastomat for circumcision internal ring and the bonded cutaway view of elastic tape;
Figure 17 and Figure 18 are the structural representation of elastic tape in this utility model anastomat for circumcision;
Figure 19 to Figure 22 is the structural representation of protective sleeve in this utility model anastomat for circumcision;
Figure 23 and Figure 24 are the another kind of structural representation of protective sleeve in this utility model anastomat for circumcision;
The structural representation that Figure 25 and Figure 26 mate mutually for outer shroud in this utility model anastomat for circumcision and internal ring;
Figure 27 and Figure 28 are the structural representation of incline structure for internal ring in this utility model anastomat for circumcision;
Figure 29 is the structural representation of incline structure for internal ring in this utility model anastomat for circumcision;
Figure 30 A is this utility model anastomat for circumcision outer shroud hilted broadsword mouth structure enlarged diagram;
Figure 30 B is the section structure for amplifying sketch map of a kind of structure of II-II face among Figure 30 A;
Figure 30 C is the section structure for amplifying sketch map of the another kind of structure of II-II face among Figure 30 A.
The specific embodiment
This utility model relates to disposable anastomat for circumcision, extremely shown in Figure 3 as Figure 1A, this anastomat for circumcision comprises outer shroud 1 and internal ring 2, outer shroud 1 and internal ring 2 coupling cover mutually are set as integral body, outer shroud 1 has an opening 3 (shown in Fig. 5,6), this opening 3 makes internal ring 2 be fixed in the inboard of outer shroud 1 by fixture 4 closures.Outer shroud 1 and internal ring 2 can adopt nano plastic, nanometer silver synthetic material antibacterial and medical plastic formulated.
See also Fig. 4 to shown in Figure 11, outer shroud 1 can be structure as a whole and also can be the split structure, realizes that the employed material of outer shroud integrative-structure is a flexible material, can be crooked to cooperate and being connected of internal ring.Certainly, be more easily, outer shroud 1 adopts and divides body structure, includes the link corresponding with opening, and link connects by connecting device.Outer shroud comprises two half-turn spares: the first half-turn spare 1A and the second half-turn spare 1B, this first and second half-turn spare 1A realizes being connected by junction button 5 with 1B, this junction button 5 is a shaft coupling piece in this enforcement profit, can rotate freely, be to be made of the rotating hole 52 on the rotating shaft 51 on the first half-turn spare 1A and the second half-turn spare 1B.The outer shroud split-type design, the degree of opening of outer shroud is big, makes things convenient for the folding of anastomat for circumcision, and is more convenient to operate in operation process, normalizing operation degree height.
Wherein, outer shroud 1 inboard has edge of a knife structure, this edge of a knife structure is laid in one week of outer shroud, this edge of a knife structure forms first half edge of a knife junction 111 and Lower Half edge of a knife junction 112 respectively in the both sides of outer shroud 1 opening, this first half edge of a knife junction 111 and Lower Half edge of a knife junction 112 are formed at the two ends of outer ring opening respectively and stretch out an extension X, the outside of this first half edge of a knife junction 111 and Lower Half edge of a knife junction 112 is the fillet structure that mates mutually, and the fillet structure at two ends can overlap fully and form seamless smooth connection, this first half edge of a knife junction 111 and Lower Half edge of a knife junction 112 are thinner than the edge of a knife structure on next door, on being somebody's turn to do, Lower Half edge of a knife junction 111 and 112 staggered floor up and down are connected, make that when the edge of a knife was closed, this opening formed the seamless level and smooth integral knife edge structure of the edge of a knife with the next door.The staggered floor design of this edge of a knife junction makes outer ring opening stacked coincidence by upper and lower edge of a knife junction in closing course realize closure gradually, can avoid the situation of folder meat in the real operation process operation technique standardization level height to occur fully.This edge of a knife junction is extended a segment distance from the outer ring opening edge to the outside makes the operating surface of operation increase, make edge of a knife closure have guidance quality, this extended distance is through the repetition test demonstration, if it is too short, then can not realize not pressing from both sides meat, if long, then cause the aesthetic property of unnecessary waste and apparatus poor, influence the closed and then influence operation enforcement of apparatus.The outer arc length of this extension X is 1 millimeter to 15 millimeters, and wherein the most commonly used is 6 millimeters to 9 millimeters, and 8 millimeters be the best.In addition, the blade of each edge of a knife also has certain requirement in this utility model, and according to the actual operation needs, the thickness of this blade is good with 0.2 millimeter to 0.8 millimeter.
In addition, because the split-type design of outer shroud, relate to the combination connection of the edge of a knife equally at the link of outer shroud, therefore, the design of this link is similarly the staggered floor design of edge of a knife junction, upper and lower half, this link has edge of a knife junction, second upper and lower half 113 and 114, makes outer shroud have guide effect from opening in the closed procedure process, and the realization closing course is not pressed from both sides meat.The same, this edge of a knife junction, second upper and lower half 113 and 114 is formed at link, and the one second extension X ' that stretches out, and this second extension X ' is provided with identical with extension X extended distance.
A kind of disposable circumcision anastomat of the present utility model; in the present embodiment; the described edge of a knife 11 is the hilted broadsword mouth structure; the side of this hilted broadsword mouth structure is provided with some cutting blades 7 that are used for foreskin is cut into small pieces; each cutting blade 7 is not less than the height of the adjacent edge of a knife along the height of edge of a knife direction; can be shown in Figure 30 B, to equal edge of a knife height; or shown in 30C, be higher than edge of a knife height; to be advisable a little more than the adjacent edge of a knife; and the height along outer shroud outer direction of this cutting blade 7 is lower than the height of this outer shroud outer; utilize this difference in height to form an accommodation space 70; be equipped with the ring protection pad (not marking among the figure) that prevents that antibacterial from entering in this accommodation space 70; the size and the accommodation space of this ring protection pad are complementary, to reach the effect that prevents that antibacterial from entering.
In another embodiment, outer shroud 1 has two edge of a knife structures at least, feasible the having higher success rate of performing the operation of the structural design of multitool mouth, and postoperative effect is better.See also Fig. 8 and Figure 10, it is an a pair of edge of a knife structure, has first edge of a knife 11 and second edge of a knife 11 ' on the outer shroud 1, and this first edge of a knife 11 and second edge of a knife 11 ' all have the staggered floor construction of edge of a knife junction, described upper and lower half in opening and link.
See also Fig. 8 to shown in Figure 10, some cutting blades 7 that are used for downright bad foreskin is cut into fritter are set between the double-pole mouth structure of this outer shroud 1.This cutting blade 7 is vertical setting with adjacent first edge of a knife 11 and second edge of a knife 11 ', also can be to be obliquely installed, and the angle of inclination can be for arbitrarily angled.The distance that cutting blade is set according to the actual needs, be arranged in a week of outer shroud uniformly, utilize these cutting blades 7, can be in carrying the process of girdling device, downright bad foreskin is cut into fritter, making needed the operating procedure of hand cut directly to finish originally, made operation standardize more, and operation process is simpler.Please be simultaneously referring to shown in Figure 12 and Figure 13 A-C, the height along edge of a knife direction of this cutting blade 7 is not less than adjacent edge of a knife height, can be to equal edge of a knife height shown in Figure 13 B, or be higher than edge of a knife height shown in 13C, to be advisable a little more than the adjacent edge of a knife.It is emphasized that, the function of cutting blade is that downright bad foreskin is cut into fritter, so the sharpness of its blade will be higher than the blade sharpness of the edge of a knife structure of girdling device, the thickness of the blade of each cutting blade is thinner than the thickness of adjacent edge of a knife upper knife edge, generally adopts 0.2 millimeter thickness to be advisable.
In addition, because this utility model adopts the design of multitool mouth, form the medicine chamber 12 of ccontaining medicine between per two edge of a knife structures naturally, ointment can be applied in the medicine chamber 12 before operation, after operation was finished, pharmaceutical efficacy discharged gradually, cooperate surgery recovery, diminish inflammation, protect from infection.Certainly, if liquid medicine, this utility model can leave an injection orifice 13 in advance between medicine chamber 12 and outer shroud 1, by this injection orifice 13, can carry out the medicine injection orifice in operation or after the operation.At this moment, on the lamellar body of each cutting blade 7, will correspondingly offer and be used for the through hole 71 that medicinal liquid passes through, the bottom that this through hole 71 can be a cutting blade also can be the optional position of cutting blade, and shape also can be any setting, has provided the different structure of two kinds of through holes as Figure 13 B and 13C.As required, also can come to pass through between the adjacent two medicine chambeies by on the cutter hub of the edge of a knife, reserving through hole for medicinal liquid.
In addition,, be provided with elastic tape between internal ring 2 and the outer shroud 1, on outer shroud 1, have edge of a knife structure, be arranged with elastic tape 9 on the corresponding internal ring 2 for the even outer shroud edge of a knife is applied to external force on the foreskin.On the contrary, on internal ring 2, have edge of a knife structure, be arranged with elastic tape on the corresponding outer shroud 1.See also Figure 14 A to Figure 16, it is the structural representation of internal ring 2, and internal ring 2 can be the overall structure that shows among the figure, also can be made into the branch body structure.Present embodiment is to have the edge of a knife on the outer shroud 1, and have elastic tape 9 on the internal ring 2 at the fit system that describes the edge of a knife and elastic tape, the two ends of internal ring 2 openings are outward extended with the outer respectively in the present embodiment: first outer 21 and second outer 22, be formed with an annular accommodation space 23 between this first outer 21 and second outer 22, the height of the height of elastic tape and this annular accommodation space is complementary, elastic tape 9 is placed in the annular accommodation space 23, prevents that elastic tape from sliding.Be arranged with elastic tape 9 on the internal ring 2, edge of a knife structure and this elastic tape 9 of outer shroud 1 lean, and are making in the whole circumference edge of a knife uniform force application, can play the airtight effect of buffering.This utility model can also be another kind of embodiment, asks emphasis referring to shown in Figure 14 B, and internal ring 2 is provided with edge of a knife structure, is formed with the annular accommodation space of ccontaining rubber ring on the corresponding outer shroud inwall.
See also Fig. 1,4,6 and Fig. 7, on each edge of a knife on the outer shroud, be laid with and mention 8, this is mentioned 8 even structure or a week that is arranged in the edge of a knife heterogeneous, mention that 8 can be arcual projection for the outside, its effect is in the process of operation, alleviates the positive symptom of postoperative edema and prevents that foreskin from moving the effect of destroying operation.Another technical scheme of the present utility model sees also shown in Figure 14 B, is provided with edge of a knife structure in internal ring, is laid with on each edge of a knife structure of internal ring and mentions.
Fixture 4 comprises the first zigzag clamping block 41 and the second zigzag clamping block 42 that is arranged at the opening two ends in this utility model, and the mutual interlock of first, second zigzag clamping block is fixed.The interlock of this first, second zigzag clamping block is unidirectional operation, can't open once more after the interlock, can only shakedown, for the dismounting of adapting device, the arranged outside of this first or second zigzag clamping block has the open keyhole 6 that penetrates this first or second zigzag clamping block.Opening device destroys one of them zigzag clamping block after inserting open keyhole 6, makes snap-in structure destroy fully, realizes opening of apparatus, guarantees disposable use, safety, health, simple in structure.
The fixture 4 that adopts among the present invention can also be by being that the mode of screw, screw realizes connecting except that above-mentioned zigzag clamping block, and any syndeton in the prior art.
In the actual operation process, for fear of collapsing out of the occlusion structure of first, second zigzag clamping block, on fixture, be arranged with and prevent the protective sleeve 43 that flicks, the shape and the fixture of this protective sleeve are complementary.This protective sleeve comprises body 431 and the lid 432 that cooperatively interacts; wherein, this body 431 has base plate, two side and roof, and base plate, two side and roof surround accommodation space; this body is sheathed on fixture, and fixture is placed in the accommodation space of body.See also Figure 19 to shown in Figure 22, body 431 is connected with the mode of lid 432 by inserting column and slot, inserting column 434 is arranged on the cover cap 432, the two side of body 431 and roof are provided with the jack 433 that matches with inserting column 434, and the grafting by inserting column 434 and jack 433 realizes that lid is placed on accommodation space and airtight this accommodation space.In addition, see also Figure 23 and Figure 24, above-mentioned body 431 two sides and roof be provided with slot 435, the space between this slot 435 and the base plate can ccontaining fixture, when plate 436 inserts in the slots 435, realizes covering of lid 432 and body 431.Protective sleeve structure in this utility model can effectively prevent the danger of collapsing out of expanding and bringing to first, second zigzag clamping block engagement connection from penis, has guaranteed 100% success rate of operation.
Simultaneously, the outer shroud of the disposable circumcision anastomat that the utility model proposes and internal ring can be set to the incline structure of shape such as Figure 27 to Figure 29, wherein the ring wall inclination certain angle of outer shroud 1 and internal ring 2 is to adapt to the incline structure of glans penis coronary sulcus, make in the ring cutting operation process, alleviate the discomfort of operator.And outer shroud 1 and internal ring 2 can also be set to ellipsoidal structure, and external annulus and internal ring wall make girdling device can adapt to anyone body structure along long axis of ellipse or the certain angle of minor axis inclination, enlarge the audient crowd of ring cutting operation.
The whole apparatus skin of this utility model disposable circumcision anastomat is coated with protective layer M, sees also shown in the accompanying drawing 1B, and this protective layer can be the medicament protection layer, and this medicament protection layer is a povidone iodine, to guarantee the apparatus safety asepsis.In addition, this protective layer can also be that the mode that is coated with the protection mould realizes vacuum and aseptic.And, in order to increase the skidproof effect in the operation process, hand steered positions such as outer in outer shroud outer wall, internal ring inwall, following internal ring are provided with anti-skid structure 10, this anti-skid structure can be structures such as frosted structure, bump structure, convex line structure or protruding wave, avoid causing the apparatus landing owing to hands contact bonding liquid in the operation process, avoid the unnecessary risk of performing the operation.And, anti-skid structure is set after, make to be more prone in the following ring process of postoperative.
The disposable circumcision anastomat that the utility model proposes has been overturned existing foreskin operation, have safety, Wicresoft, easy, attractive in appearance, and do not operate on, do not have stitching, pain is few, operating time only need 3-5 minute, the operation after can take a shower, can operate as normal, the no obvious cicatrix and smooth smooth of performing the operation, use this medical apparatus and instruments simple to operate, be easy to the training of standard chemical combination, post-operative complication is few, the patient can nurse voluntarily, to outward appearance satisfaction height.
This technology has been filled up blank both domestic and external, has obtained the great attention of World Health Organization (WHO), and the Kang Naier university of the U.S., Yale University, Harvard University, University of Pennsylvania hospital all send expert, professor to come Wuhu to carry out the study of new technique and view and emulate.Official Mr. HARGREAV of World Health Organization " anti-Chinese mugwort " admires extravagantly, to world health organisation recommendations and be scheduled to this product, international nonprofit organizations such as the healthy reproduction tissue of the U.S., FHI's tissue, Mei Linda Gates associating foundation tissue, all send the expert to investigate this product, solve the cross infection problem of African acquired immune deficiency syndrome (AIDS).
Operative procedure according to reality describes the beneficial effects of the utility model in detail below:
1, under the state that penis does not erect, measure the girth of 1cm place, glans penis below penis with tape, determine the anastomat for circumcision specifications and models.With the abundant wiping of the inside and outside skin zone of penis one time, complete operation hole towel with sterilized cotton ball, select corresponding anastomat for circumcision model;
2, the adult is each with 3-5ml 2% lignocaine anesthetis; The child uses 2-3ml 2% lignocaine anesthetis at every turn, goes in ring to inject 1/3 place of glans penis to root.3, after the anesthesia satisfaction, with rubber band ligation radix penis part, interim occlude blood circulation;
4, internal ring is placed penis foreskin place, the position of adjusting internal ring;
5, clamp the foreskin edge with vascular forceps, foreskin is turned up entangle internal ring, keep 1 centimeter of frenulum;
6, check whether inner and outer plates is smooth, and the outer shroud edge of a knife is pressed into unnecessary foreskin place on the internal ring, check that the inner and outer ring side keeps level, closed outer shroud, by the upper and lower edge of a knife of the outer shroud junction closed outer shroud that leads, and card is gone up first tooth; With foreskin be adjusted to satisfied after, all teeth of fixture on the card are that the fixture outer end is arranged with protective sleeve, prevent that the tooth on the card from flicking;
7, the tip forward that is in the unnecessary foreskin of far-end after will turning up is drawn, and cuts unnecessary foreskin with medical curved scissors along the end of internal ring, and that removes the radix penis part ligation subsequently is used for occlude blood circulation rubber band;
8, the edge of a knife on the outer shroud stops the foreskin blood circulation, makes the foreskin necrosis; And, utilize the cutting blade that is provided with between two edges of a knife fixedly in the outer shroud downright bad foreskin being cut into fritter, in case unnecessary foreskin ischemic necrosis constriction penis is avoided producing because of circulatory disturbance causes edema;
9, postoperative is torn ring open with special use after 9 days and is knocked open keyhole open, removes outer shroud, and reuse eliminating cold for resuscitation water was with in the entry of Glans penis and internal ring bubble 10 minutes;
10, internal ring is slowly retreated to radix penis part;
11, cut with sharp mouth internal ring is cut off into two joints, and take out internal ring, use the saline cleaning skin, till reuse is dried ring cutting place and surrounding skin dried up.
This utility model has increased the medicament protection layer in apparatus integral body, makes when apparatus dispatches from the factory, and with regard to having carried out unified aseptic process, avoids sterilizing separately in operation process the standardization level height.
In sum, this utility model from application target, on the usefulness, viewpoint such as progressive and novelty sets forth, the practical improvement that it has, function enhancement and practical important document that the utility model patent method is emphasized have been accorded with, shown in the implementation and accompanying drawing that this utility model is above, be one of this utility model preferred embodiment, be not to limit to this utility model with this, be with, such as with approximate, identical person such as structure of the present utility model, device, feature, all should belong to of the present utility model founding within purpose and the claim.