CN208481527U - A kind of suspender belt implantation instrument for treating stress incontinence - Google Patents

Abstract

The utility model discloses a kind of suspender belt implantation instrument for treating stress incontinence, including an implantation female patient ureter bottom side in the suspender belt and a coiled casing with coiling-resistant of hanging shape, it is exposed shape before the tape surgery managed, the length dimension of the coiled casing adapts to penetrate suspender belt from the opening of vagina roof one, is pierced by through pubis proparea, back zone or pubis closed pore and in stomach wall, and the coiled casing has the first section for the puncture and lead needle for being tightly sleeved conveyer and is connected to main paragraph therein for suspender belt with flat state activity.Using the suspender belt implantation instrument of the utility model, reduce suspender belt conveying capacity needed for soft tissue and stomach wall, suspender belt can be allowed to keep flat state implantation soft tissue, increase soft tissue to clamping (adhesion) power of suspender belt and reduce the risk for being subjected to displacement sliding after suspender belt implantation；The cumbersome high-leveled and difficult operation for connecing and separating in art must be worn in groups in conjunction with sheath by having changed traditional suspender belt simultaneously, be conducive to improve procedure efficiency and post surgery stabilization.

Description

A kind of suspender belt implantation instrument for treating stress incontinence

Technical field

The utility model belongs to surgical operating instrument technical field, and in particular to a kind of for treating stress incontinence Suspender belt is implanted into surgical operating instrument.

Background technique

Female incontinence is women common disease, and at present according to world statistics, illness rate is close to 50%, and wherein about half is pressure The property urinary incontinence (Stress Urinary Incontinence, SUI).Stress incontinence refers to that bladder pressure is greater than maximum urethra When pressure, in the state that no detrusor urinae of bladder is shunk, also per urethram collar extension overflows urine in spite of oneself, mostly increases suddenly in abdominal pressure Added-time is for example: occurring whens laugh, sneeze, cough etc..Post menopausal crowd more susceptible disease.Pathogenic factor majority produces when because giving a birth Wound, the decline of postmenopausal estrogen level, Pen Di soft tissue relaxation etc..SUI started to be considered as influencing the mankind in the mid-90 One of the five big diseases of health, referred to as " social cancer ".Especially in China, as population is further aging, SUI is increasingly It is valued by people.Nearest one simple Beijing area urinary incontinence morbidity survey finds that 23%-45% has in women population The different degrees of urinary incontinence, 7% or so has apparent incontinence, wherein about 50% is stress incontinence.It is one group external Report 60 years old or more urinary incontinence disease incidence women 37.7%.For this purpose, seeking the method for effectively treating SUI, have urgent, again Big clinical meaning.

In order to treat the urinary incontinence, US granted patent US6808485, Japanese Laid-Open Patent JP1998-155897, Korea Spro It is described in multiple data such as state's publication bulletin KR2003-34218 and is inserted into elastic plugin to the inside of vagina or in urethra Or the technology of hydrogel (hydrogel) particle (polymer: polymer) is injected in periureteric soft tissue.It is controlled in operation No-station pole canopy vaginal tape (Tension-free vaginal tape, TVT) is the gold mark of SUI treatment in treatment It is quasi-.It is now recognized that the advantages such as TVT cure rate is high, easy to operate, wound is small, post-operative recovery is fast, few intercurrent disease, recurrence rate are low and Clinically it is used widely.

For stress incontinence treatment in history there are many method, wherein the curative effect of operative treatment is ideal, urine Road or bladder neck suspender art are most efficient methods in operative treatment.It is sent out recently as scientific and technological progress and to the urinary incontinence The deep understanding of raw principle, a variety of invasive methods are applied, i.e., damage the smallest surgical procedure and skill to patient by taking Art method obtains optimal therapeutic effect.At present for a kind for the treatment of of stress incontinence be Via vagina mid-urethral without Power suspension, i.e., do the notch of 2cm or so in anterior vaginal wall, and a suspender belt for preparing to be placed in mid-urethral bottom passes through puncture Instrument is put into internal soft tissue gap, enhances supporting role of the basin bottom soft tissue to urethra.In this way when abdominal pressure increases, The suspender belt limitation that the amplitude that urethra moves down is implanted, oppresses and is closed ureter, control the leakage of urine phenomenon of patient.

The suspender belt both ends of implantation generally can be by two kinds of approach travelings in vivo, after drawing skin, suspender belt outer body It is wiped out, internal body portion plays the role of anchoring to suspender belt with growing into for surrounding soft tissue.One is approach after pubis, wear Thorn instrument takes at the both ends of suspender belt from abdomen stomach wall out of behind pubis, and this approach has damage bladder or Retropubic other soft Tissue, such as the possibility of plexus vasculosus, so that serious complication occur.Another kind is through closed pore approach, and puncture instrument passes through closed pore, Suspender belt both ends are drawn along vagina mucosa lower layer to two sides pelvis closed pore direction, outside medial thigh skin lead body.After A kind of operation of approach is referred to as through closed pore reconstructed urethra, due to the big blood vessel important far from bladder and pelvic cavity, complication It is rare, it is easy to operate, be conducive to promote, be at present compared with frequently with method.

Pass through closed pore there are two types of mode through closed pore reconstructed urethra puncture instrument.In from anterior vaginal wall notch to thigh Side skin (from inside to outside) and pass through closed pore outside thigh to anterior vaginal wall notch, retract and take it out after being connect with suspender belt (by Outside inwards).Both modes will be separated between vaginal incision to closed pore under vagina mucosa with surgical scissors passivity or sharp property Layer, so that puncture instrument passes through and places suspender belt.Vagina mucosa lower layer is normally open texture, and separation level is correct When operative hemorrhage it is seldom.

In the TVT implant surgery of existing treatment SUI, suspender belt used is mostly thickness 1mm, width 10mm, length 40mm The polypropylene woven net of left and right, and often edge is very coarse for this kind of suspender belt, directly use can generate soft tissue experienced Stimulation or damage, suspender belt will also tend to be pulled out of shape or damage, therefore suspender belt is often closed among a thin polyethylene jacket, is made Edge-smoothing is obtained, while preventing the hidden danger of suspender belt deformed damaged in draw process.Although such suspender belt is such It was continued to use in operation for ten several years, but has undergone the clinical operation of considerable amount, the composite structure of the suspender belt and polyethylene jacket is increasingly Mostly affect operation and the postoperative effect of operation.It is worn together to find out its cause, needing doctor that the suspender belt is connected sheath in the operation Enter soft tissue, and the polyethylene jacket is separated again with suspender belt after the intense adjustment for completing sling-tension, extracts soft tissue out.The mistake It is high to the level requirement of operator doctor in journey, suspender belt displacement occurs when such as press-offing, then the suspender belt pressure carefully adjusted will be sent out It is raw to change, or lead to sling-tension tension, patient can not urine or the excessively loose mesh for not reaching the treatment urinary incontinence of sling-tension , to be unable to reach expected effect.And the operation is unsuitable for secondary operation, does not have invertibity.For this purpose, in order to keep Tension stability after suspender belt implantation process and implantation, pole is it is necessary to improve traditional instruments, to advanced optimize correlation Surgical procedure.

Summary of the invention

In view of the defect of the above-mentioned prior art, the purpose of this utility model is directed to a kind of stress incontinence for the treatment of and hangs Surgical instruments with implantation.

The utility model realizes that the technical solution of above-mentioned purpose is, a kind of suspender belt implantation for treating stress incontinence Instrument, characterized by comprising: suspender belt and scratching with coiling-resistant of the implantation female patient ureter bottom side in hanging shape Property casing, be exposed shape before the tape surgery managed, suspender belt is open by the length dimension adaptation of the coiled casing from vagina roof one It penetrates, be pierced by through pubis proparea, back zone or pubis closed pore and in stomach wall, and the coiled casing has and is tightly sleeved conveyer The first section of puncture and lead needle and main paragraph therein is connected to flat state activity for suspender belt.

Further, the coiled casing perpendicular to length to cross sectional shape be at least circular ring shape, oval ring or mouth Lip ring shape.It is preferred that more flat oval ring, is able to maintain suspender belt and keeps flat state conveying.

Further, the endpiece of the coiled casing is set as horn mouth.

Further, the circumferentially distributed cutting of the horn mouth has two or more seams, receipts when in favor of penetrating soft tissue Mouthful, it avoids damaging surrounding soft tissue.

Further, the first section end of the coiled casing is closed or openning shape.

Further, the suspender belt be porous polypropylene woven net, and suspender belt length to both ends be made hardness increase And the puncture and lead needle of elongated shape, convenient for being pierced by patient body-surface from coiled casing.

Further, the suspender belt is equipped with colored mark line in place to center in length.

Further, the puncture and lead needle that there is the conveyer handle of proximal end and distal end to extend, the puncture and lead needle are equipped with suitable It should be open and penetrate, through pubis and the dissection curvature that is pierced by stomach wall from vagina roof one, and the delivery instrument is there are two types of more than The specification of corresponding puncture and lead needle diameter.

Using the surgical instruments of the utility model, have substantive distinguishing features outstanding and significant compared to the such instrument of tradition Progressive: the surgical instruments significantly reduces suspender belt across conveying capacity needed for soft tissue and stomach wall, and suspender belt can be allowed to keep flat Flat state is transferred to soft tissue from coiled casing, increases soft tissue to clamping (adhesion) power of suspender belt and after reducing suspender belt implantation The risk of displacement and sliding, the operating technology for thus reducing medical instrument requires and operating time, and avoids sling-tension Change in the course of surgery；Meanwhile the utility model has thoroughly been changed traditional suspender belt and must have been worn in groups in conjunction with sheath and connect and art The cumbersome high-leveled and difficult operation of middle separation is conducive to the curative effect for improving procedure efficiency and post surgery stabilization.

Detailed description of the invention

Fig. 1 is the suspender belt implantation instrument stereochemical structure total figure that the utility model treats stress incontinence.

Fig. 2 is the detailed structure schematic diagram of suspender belt in suspender belt implantation instrument shown in Fig. 1.

Fig. 3 is the detailed structure schematic diagram of coiled casing in suspender belt implantation instrument shown in Fig. 1.

Fig. 4 is the structural schematic diagram of conveyer required when the utility model suspender belt implantation instrument uses.

Fig. 5 is the cross section structure schematic diagram of another embodiment of coiled casing in the utility model suspender belt implantation instrument.

Fig. 6 is the cross section structure schematic diagram of the another embodiment of coiled casing in the utility model suspender belt implantation instrument.

Fig. 7 is the process status schematic diagram of the utility model suspender belt implantation instrument application method.

Specific embodiment

Just attached drawing in conjunction with the embodiments below, is described in further detail specific embodiment of the present utility model, so that this Utility model technical solution is more readily understood, grasps, to make relatively sharp define to the protection scope of the utility model.

Suspender belt implantation instrument and its operate with side of the utility model designer for traditional treatment stress incontinence Method has made intensive studies, and the root of the existing multiple operation drawbacks of summary and induction is opened up thinking and is implanted into from the overall situation to suspender belt Instrument is improved, so that a kind of suspender belt implantation instrument for treating stress incontinence is proposed, to solve current suspender belt Implant surgery difficulty is big, and suspender belt is implanted into the not satisfactory problem of backward pull effect.

First from the point of view of the architectural characteristic of the suspender belt implantation instrument: the suspender belt implantation instrument of the treatment stress incontinence, Main as shown in Figure 1 includes suspender belt 1 and a flexibility with coiling-resistant of the implantation female patient ureter bottom side in hanging shape 2 two parts of casing further include the required equal conventional instruments of the conveyer 3 used in other arts, as shown in Figure 4 certainly.It is different from biography The instrument characteristics of system: as shown in Fig. 2, it is exposed shape that the suspender belt 1 is preoperative, i.e., no any film sheath only needs in actual use It is taken out from disposable hygienic packaging bag.Illustrating the visible suspender belt 1 is porous polypropylene woven net, is had commercially available extensively Product maturity.However, the creation 1 length of suspender belt to both ends be made hardness increase and elongated shape puncture and lead needle 11, It is passed in and out to make it easy to the free shuttling from coiled casing.

The length dimension of the coiled casing 2 adapts to penetrate suspender belt from the opening of vagina roof one, through pubis proparea, back zone or Pubis closed pore is simultaneously pierced by stomach wall.And structure feature is tightly sleeved connecting for conveyer 3 as shown in figure 3, the coiled casing 2 has The first section 21 of needle 31 and main paragraph 22 therein is connected to flat state activity for suspender belt 1.Here, coiled casing 2 has on the whole There is a degree of flexibility, connect sliding in order to comply with puncture and lead needle bending, wear in soft tissue, and keeps certain knot again Structure toughness prevents excessive soft and is deformed by soft tissue compressing after puncture and lead needle extraction, occludes cavity or directly curled bad Situation occurs.Relatively low, first section 21 is convenient for being connected to soft tissue, and end is usually in cone shape, efficiently with puncture and lead needle It is worn in soft tissue and connects and reduce degree of injury.And main paragraph 22 is then worn for the ease of suspender belt 1 and is connect, and usually has maximum inner diameter big In the cavity of suspender belt width.And its radial cross-sectional shape is circular ring shape in the present embodiment.It connects suspender belt of course for convenient for wearing and protects Hold that its is flat, prevents axial twist, the radial cross-sectional shape of aforementioned body section 22a is also possible to elliptical ring as shown in Figure 5 Shape or main paragraph 22b are also possible to lip annular as shown in FIG. 6.

From shown in Fig. 1 and Fig. 3 as it can be seen that the endpiece 23 of the coiled casing 2 is set as horn mouth.The purpose designed in this way be in order to Insertion is aligned convenient for the end of suspender belt, and is suitable for observation suspender belt and penetrates into the process being pierced by from coiled casing, ensures suspender belt Flat state.Preferably, the circumferentially distributed cutting of the horn mouth has two or more seams, and closing in when in favor of penetrating soft tissue avoids Surrounding soft tissue is damaged, preferred way is symmetrically to cut two seams.Certain asymmetric is cut, or is cut more A plurality of seam is also feasible.As long as ensureing can close up when coiled casing is extracted out from soft tissue, the skin incision that bursts apart is avoided.

As the further refinement of above preferred embodiment, the one side suspender belt 1 is in length to center equipped with colored It mark line 12 in place can be with the middle position of accurate observation suspender belt 1, especially in this way in the use process of the suspender belt implantation instrument It is in tension adjustment stages.On the other hand, 21 end of first section of the coiled casing 2 can be closed, be also possible to be open Shape.The embodiment that closed can be used in the case of meticulous for conveyer puncture and lead needle, to reduce needle point to soft tissue Degree of injury.

In addition, the process status schematic diagram of suspender belt implantation instrument application method as shown in Figure 7 is as it can be seen that wherein used The puncture and lead needle 31 that there is conveyer 3 handle 32 of proximal end and distal end to extend, which, which is equipped with, adapts to open from vagina roof one It mouthful penetrates, through pubis and the dissection curvature that is pierced by stomach wall, and there are two types of the rule of the above corresponding puncture and lead needle diameter for the delivery instrument Lattice.

Secondly, the application method feature of the suspender belt implantation instrument from this kind treatment stress incontinence.As shown in fig. 7, from Series of operation steps are completely shown below.

I, the puncture and lead needle 31 of conveyer 3 coiled casing 2 to first section 21 and 31 end of puncture and lead needle is inserted into first to be tightly sleeved, Handle 32 of the horn mouth of coiled casing 2 close to conveyer 3.Herein, puncture and lead needle insertion need to act soft, avoid exposing used flexible bush The tube wall of pipe；And when puncture and lead needle reaches first section since internal diameter becomes smaller, gradually fit closely with puncture and lead needle and is moderately tensioned first section Tube wall.

II, a longitudinal cut, usual 2cm of size incision or so then are cut in the position that vagina roof corresponds to ureter. The conveyer 3 for being socketed with coiled casing 2 is inserted into from longitudinal cut, along one side of ureter, (left or right side is arbitrarily optional One) pubis peripheral soft tissues are passed through, abdominal skin is pierced by and terminates in horn mouth close to longitudinal cut.Here with puncture and lead needle Dissection curvature can accurately shuttle in soft tissue, reach desired position.Extract conveyer 3 and its puncture and lead needle 31 out, it is flexible in this way Casing 2, which is persisted, to be located in soft tissue.

III, then one end of suspender belt 1 is penetrated to the coiled casing 2 being first put into from horn mouth and keeps flat form to suspender belt It is pierced by abdominal skin, keeps extracting coiled casing from abdominal skin out in the case where suspender belt stable state, suspender belt is stayed in into ureter one In the soft tissue of side.Here, one is mainly formed in the soft tissue using coiled casing needed for operation has support enough The cavity channel of power, thus facilitate suspender belt therefrom smoothly penetrate by, reach desired position.And suspender belt end is formed by The puncture and lead needle of higher hardness and elongated shape, so that suspender belt has more accurate tracking ability.

IV, step I is then repeated and along another side of ureter (opposite with side selected in step II), repetition step Relevant operation is put into coiled casing in II, and the coiled casing being put into after the other end of suspender belt is penetrated from horn mouth simultaneously keeps suspender belt Abdominal skin is pierced by flat form to suspender belt below ureter.This is to persist positioning flexibility in another side with similar in step II The step of casing, operating method and operation skill are all the same, only need to keep appropriateness soft, avoid touching drawing step III and have been implanted into Suspender belt.

V, it finally, the activity in the coiled casing being put into after based on suspender belt adjusts the tension of suspender belt, and is reached in suspender belt The suspender belt penetrated at fixed coiled casing horn mouth when to required tension, in the case where not changing sling-tension by used flexible bush Pipe is extracted out from abdominal skin, and suspender belt is completely stayed in surrounding soft tissue, the exposed suspender belt of abdominal skin is wiped out.This In, due to the supporting and space between soft tissue that coiled casing provides, so that the tension adjustment of suspender belt becomes easier to operate, and It deforms without having to worry about suspender belt or is pulled by soft tissue.And since the fixation position of suspender belt will not influence the tension variation in affected part, therefore The process of extraction coiled casing is worth trusting to the stability of surgical effect.

Need additional description: the application method of the suspender belt implantation instrument, wherein the operation that is put into of coiled casing 2 is applicable in Before suspender belt 1 to be placed on to pubis, a variety of operation plans after pubis and across pubis hole.And in addition, by operating above The detailed description of application method, it is conceivable that being equally applicable to treatment Male stress with understanding, the suspender belt implantation instrument and urinating Incontinence and it is required implantation suspender belt surgical operation, or treatment it is any other need to be implanted into suspender belt provide soft tissue tension surgery Operation.

To sum up about the detailed description of the utility model suspender belt implantation instrument as it can be seen that compared to the such instrument of tradition and method Have substantive distinguishing features outstanding and significant progress: the surgical instruments significantly reduces suspender belt across soft tissue and stomach wall institute The conveying capacity needed can allow suspender belt that flat state is kept to be transferred to soft tissue from coiled casing, increase clamping of the soft tissue to suspender belt (adhesion) power and reduce suspender belt implantation after displacement and sliding risk, thus reduce medical instrument operating technology require and Operating time, and avoid the change of sling-tension in the course of surgery；Meanwhile the utility model has thoroughly changed traditional suspender belt The cumbersome high-leveled and difficult operation for connecing and separating in art must be worn in groups in conjunction with sheath, be conducive to the treatment for improving procedure efficiency and post surgery stabilization Effect.

Claims (8)

1. a kind of suspender belt implantation instrument for treating stress incontinence, characterized by comprising: an implantation female patient ureter Bottom side has the coiled casing of coiling-resistant in the suspender belt of hanging shape and one, is exposed shape, the coiled casing before the tape surgery managed Length dimension adapt to penetrate suspender belt from the opening of vagina roof one, wear through pubis proparea, back zone or pubis closed pore and in stomach wall Out, and the coiled casing has the first section for the puncture and lead needle for being tightly sleeved conveyer and is connected to it for suspender belt with flat state activity In main paragraph.

2. treating the suspender belt implantation instrument of stress incontinence according to claim 1, it is characterised in that: the coiled casing Perpendicular to length to cross sectional shape be at least circular ring shape, oval ring or lip annular.

3. treating the suspender belt implantation instrument of stress incontinence according to claim 1, it is characterised in that: the coiled casing Endpiece be set as horn mouth.

4. treating the suspender belt implantation instrument of stress incontinence according to claim 3, it is characterised in that: the horn mouth week The seam for there are two or more is cut to distribution.

5. treating the suspender belt implantation instrument of stress incontinence according to claim 1, it is characterised in that: the coiled casing First section end be closed or openning shape.

6. treating the suspender belt implantation instrument of stress incontinence according to claim 1, it is characterised in that: the suspender belt is more The polypropylene woven net in hole, and suspender belt length to both ends be made hardness increase and elongated shape puncture and lead needle.

7. treating the suspender belt implantation instrument of stress incontinence according to claim 6, it is characterised in that: the suspender belt is in length It spends to center and is equipped with colored mark line in place.

8. treating the suspender belt implantation instrument of stress incontinence according to claim 1, it is characterised in that: the delivery instrument There are the handle of proximal end and the puncture and lead needle of distal end extension, the puncture and lead needle, which is equipped with, to be adapted to penetrate, from the opening of vagina roof one through pubis And the dissection curvature being pierced by stomach wall, and there are two types of the specifications of the above corresponding puncture and lead needle diameter for the delivery instrument.