CN209611212U - A kind of traction device and the stretch ring for traction device - Google Patents
A kind of traction device and the stretch ring for traction device Download PDFInfo
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- CN209611212U CN209611212U CN201821161145.XU CN201821161145U CN209611212U CN 209611212 U CN209611212 U CN 209611212U CN 201821161145 U CN201821161145 U CN 201821161145U CN 209611212 U CN209611212 U CN 209611212U
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- traction device
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Abstract
A kind of traction device, including clamping part and tractive unit, tractive unit contain closing hitch structure, closing hitch structure is made of elastic material, clamping part includes holder body and clamp arm, and holder body can pass through the biopsy channel of scope, and clamp arm can clamp closing hitch structure；A kind of stretch ring for traction device, stretch ring are that a closing hitch structure or several closing hitch structures are formed by connecting, and stretch ring is made of elastic material.
Description
Technical field
The utility model relates to a kind of a kind of traction device of medical instruments field and for the stretch ring of traction device,
More particularly to one kind, elasticity is good, does not need external force, and the elastic force for only relying on tractive unit can be achieved with filling the traction of cutting lesion
Divide the exposure surgical procedure visual field；It can pull simultaneously and reduce the big surface of a wound, so that the surface of a wound be facilitated further to press from both sides the traction device closed.
Background technique
EMR (endoscopic mucosal resection, EMR) treats early carcinoma of stomach and is most used for clinic early in Japan,
Before it introduces Japan, gastrectomy is the unique treatment method of early carcinoma of stomach, and the treatment method is being applied extensively at present.
Mucous membrane decollement (endoscopic submucosal dissection, ESD) refers under scope with improvement under scope
Needle knife directly removes mucous membrane from submucosa, from mucosectomy EMR evolution, because its complete resection rate is high, and peace
Good perfection expands alimentary canal morning cancer and the indication of other tumor resections, gradually becomes well accepted microinvasive surgical teatment
Mode.
ESD and EMR, which is realized, cuts off lesion with a common single channel scope, and eliminates abdominal
The excision of pain and organ.The shortcomings that EMR, is that the technology is unable to the relatively large lesion of en bloc resection, the chunky shape sample of taking-up
It is difficult to carry out detailed pathological analysis, neoplasm staging is indefinite, and there are higher tumor recurrence risks.And ESD and laparotomy ventrotomy
And the endoluminal treatment methods such as previous EMR compared, and had 1, wound small, 2, patient be subjected to multiple positions and repeatedly treat, 3, make to cure
It is raw obtain complete histopathology sample for analysis, 4, and form larger for area is irregular or merges ulcer, scar
Tumour carries out 96% or more resection rate, to reduce recurrence probability.
But ESD is long compared with the EMR operating time, risk is big, operation is difficult.The operating time of EMR about 20 minutes or so, and it is most of
In 60-90min, there are the complication such as bleeding, perforation, narrow and postoperative infection in the operating time of ESD, be unfavorable for advising greatly
The promotion and application of mould.Seldom bleeding in EMR art, but during ESD operation, slightly careless, the visual field will be covered by blood,
Constantly to stop blooding and rinse the visual field.The key step of ESD operation are as follows: label, submucosal injection, edge cut, remove, and
Wound treatment.Some ESD are treated with the lesion at difficult position, the submucosal injection being usually taken repeatedly mentions for subsequent peeling operations
For limited surgical field of view, but repeatedly, injection can be such that operating time extends, and increase the danger of bleeding, perforation.It is another simple
Scheme is that adjustment patient posture can be attempted according to the direction of gravity, and release surface is made to obtain ideal tension, obtains the operation visual field, but
In certain operations (being related to upper digestive tract), the optional position of patient is limited, limits its using effect.Therefore how in art
There is provided good " surgical field of view " becomes the key to solve the above problems, and scholars make great efforts to seek that good view can be provided for operation
Open country, the method for realizing safety, accurate cutting and strip operation.
It is inspired by surgery drawing technology, various scope auxiliary traction technologies are come into being.It can by the position in tractive force source
It is roughly divided into traction in vivo and external traction；Dental floss traction, metal clip silk thread combined drawing can be divided into again by constituting by traction device
Technology, metal clip elastic ring combined drawing technology, S-O metal clip traction technique, magnetic anchor technology etc..
Recent digestive endoscopy has article to point out in discussion part, can be organized although dental floss is relatively good auxiliary ESD
The possibility of damage needs to pay attention to when in use this point, and in addition dental floss traction secures direction, traction end in vitro, so tooth
Line has to the direction parallel with scope, causes lead limited.
Metal clip silk thread combined drawing technology, silk thread is without elasticity, and after cutting a part of lesion, silk thread may be lost
Effect can not continue to pull lesion, and cutting process cannot be gone on smoothly.
Metal clip elastic ring combined drawing technology, elastic ring size is restricted, needs that O-ring is bound in clip with silk thread
On, dedicated epitheca is in addition also used, it is cumbersome, it makes troubles to user.
S-O metal clip traction technique designs a kind of internal traction technique based on spring, metal clip and nylon ring.
This method substitutes elastic ring from the development of metal clip elastic ring combined drawing method, with spring, makes every effort to obtain bigger retractility,
It is cut off to adapt to the ESD of the colon infantile tumour of property shallow to big, table, but spring does not have tension after cutting, and spring occupies
Spatial volume is big, not can enter endoscopic biopsy channel, and needs to take out scope during operation, living with endoscope is stretched out in vitro
It after the metal clip in inspection channel is clamped, is re-fed into vivo, reaches in target location processes, due to exposed in biopsy channel distal end, hold
It easily causes harm to the human body, this method uses limited.
Magnetic anchor traction technique needs dedicated equipment, for example is equipped with standard telescopic arms, constantly changes direction in vitro
Traction, it is cumbersome, and in the course of surgery, if magnet quantity is more, the visual field of operation can be interfered.
Utility model content
The traction device of the utility model is made of clamping part and tractive unit, and tractive unit relies on the elastic force of itself, and bullet occurs
Property deformation extension can provide in vivo traction force drawing lesion, sufficiently exposure the surgical procedure visual field.Due to being not required to provide
External force can not be limited by anatomical position and alimentary canal lumen size, can be drawn to mucous membrane, tissue, organ, especially suitable
For ESD surgical procedure difficult locations, doctor is allowed to implement mucous membrane removing operation in the case where more intuitive, visual,
Operation can be more safe and simple, can greatly shorten the operation used time, reduce patient's pain, the lesion suitable for large area is shelled
From.
Common digestive endoscopy includes biopsy channel, and object lens, LED light source, intake tunnel and exhalant canal etc., wherein biopsy is logical
Road is for being sent into clamping part and tractive unit.
A kind of traction device, the traction device include clamping part and tractive unit, and the tractive unit contains closing traction knot
Structure, the closing hitch structure are made of elastic material；The clamping part includes holder body and clamp arm, the holder body energy
Enough biopsy channels across scope；The clamp arm can clamp the closing hitch structure.
Preferably, closing hitch structure is made of silicon rubber or thermoplastic elastomer (TPE).
Preferably, closing hitch structure is one, two or more.
Preferably, closing hitch structure can be circle, triangle, diamond shape or rectangular etc..
Elastic construction can be connected between two or more closing hitch structures, it is preferable that elastic construction is elastica
Shape structure, the structures such as elastic ring.
Mobile holder body can to close hitch structure generation elastic deformation.
A kind of stretch ring for traction device, the stretch ring are a closing hitch structure or several closing tractions
Structure is formed by connecting, and the stretch ring is made of elastic material, closes and connects elastic construction between hitch structure.
Preferably, elastic construction is elastic linear structure, the structures such as elastic ring.
Preferably, closing hitch structure can be circle, triangle, diamond shape or rectangular etc..
In the actual operation process, electric knife can be marked in lesion locations along border, by electric knife or external
Syringe fluid injection, so that pathological tissues swell, and forming fluid cushion layer under mucous membrane is " water cushion ", and " water cushion " is in muscle layer and disease
It is formed and is effectively isolated between change tissue, while also effectively preventing heat transfer, keep surgical field of view apparent, blood vessel is squeezed by water cushion
Press seal closes, and the risk of bleeding significantly reduces.After completing pre-separation mucous membrane in vivo, electric knife is exited, by the first of traction device
Clamping part is opened, and the clamp arm of the first clamping part is clamped to one end of closing hitch structure, by the first clamping part and closing traction knot
Structure is placed in the biopsy channel of scope together, behind the distal end for reaching biopsy channel, by the way that under the eyepiece observation of scope, first is clamped
The clamp arm in portion is opened, and one end of the tissue of pre-separation and one end of closing hitch structure are clamped.At this time again by the first clamping part
Holder body proximally and distally separates, so that the distal end of the holder body of the first clamping part and closing hitch structure stay in the body.
Continue to repeat preamble operation, by the biopsy channel of the second clamping part merging scope, behind the distal end for reaching biopsy channel, passes through scope
Eyepiece observation under, the clamp arm of the second clamping part is opened, across the other end of closing hitch structure, with the help of scope,
It is pulled to the other end of the tissue of pre-separation and folder closes the edge of pre-separation tissue.Again by the close of the holder body of the second clamping part
End and distal end separate, so that the holder body distal end of the second clamping part and closing hitch structure stay in the body.Since closing is drawn
Structure has elastic force, and during surgical cut, the lesion cut is because the effect of tractive unit elastic force is turned up, as surgical cut operates
Progress, the lesion cut is gradually disengaged by continuous drawing and muscle layer, until complete pull-up, is properly completed lesion
Separation, this mode make lesion be byed to dig while cutting on one side, open surgical field of view, in direct view under endoscope it can be found that
The blood vessel under target is cut, bleeding is avoided, so that surgical procedure is more convenient, safety, shortens operating time.If lesion mistake
Greatly, clamping part and closing hitch structure can be increased, so that the lesion cut pulls completely, or selection is containing flexible
The tractive unit of linear structure, so that the elastic deformation range of entire tractive unit increases, to pull the lesion of larger area.
The utility model has the advantages that
Clamping part and tractive unit are combined and are integrated by the traction device of the utility model, and tractive unit has elasticity, can rely on
The extension of itself can provide active force in vivo.It, can not be big by anatomical position and alimentary canal lumen due to being not required to provide external force
Small limitation, especially suitable for ESD surgical procedure difficult locations.Elasticity is good for material, and it is big can to adjust drawing range according to demand
It is small, meet the needs of different size of lesion cutting, the visual field of open ESD operation improves the speed of ESD operation, saves
Operating time.
The product in actual use, if it find that have traction loosen situation, several clampings can be further added by
Closing hitch structure is clamped in portion, is pulled to other directions, and then folder closes, and forms polygonized structure, can continue to provide drawing
Power, the open operation visual field, until tissue is kept completely separate, so that separation process is gone on smoothly.
Detailed description of the invention
Figure 1A is the cross-sectional view and main view that tractive unit is two annular enclosed hitch structures
Figure 1B is the schematic diagram that tractive unit is three annular enclosed hitch structures
Fig. 1 C is the schematic diagram that tractive unit is four annular enclosed hitch structures
Fig. 1 D is the cross-sectional view and main view of triangle Shape closed hitch structure
Fig. 2 is clamping part and tractive unit mutual cooperation schematic diagram
Fig. 3 is that clamping part and tractive unit are sent into endoscopic biopsy channel schematic diagram
Fig. 4 is that scope guides lower first clamping part and annular enclosed hitch structure to clamp lesion schematic diagram
Fig. 5 is that scope guides lower second clamping part and annular enclosed hitch structure to clamp lesion schematic diagram
Fig. 6 is that clamping part and annular enclosed hitch structure cooperate and separate lesion schematic diagram
Fig. 7 is that traction device separates lesion schematic diagram in space relatively narrower
Fig. 8 is the linear structural schematic diagram of connection elasticity between annular enclosed hitch structure
Fig. 9 A-9C is that traction device reduces the lesion surface of a wound schematic diagram when lesion surface of a wound is larger
1, tractive unit, 11, closing hitch structure, 2, clamping part, the 21, first clamping part, the 22, second clamping part, 23, clamping
Main body, 24, clamp arm, 25, holder body, 26, clamp arm, 3, scope, 4, biopsy channel, 5, lesion, 6, mucous layer, 7, muscle layer, 8,
Lumen opposite side mucous layer
Specific embodiment
In order to make the purpose of the utility model, technical solutions and advantages more clearly understood, below in conjunction with attached drawing and implementation
Example, the present invention will be further described in detail.It should be appreciated that specific embodiment described herein is only to explain this
Utility model is not used to limit the utility model.
Hereinafter, it is proximal end that scope, which is leaned on one end of proximal operator, the one end that will be far from operator is defined as distal end.
If Figure 1A -1D and Fig. 8 are different types of closing hitch structure schematic diagrames.Figure 1A is there are two tractive unit 1 contains
The schematic diagram of annular enclosed hitch structure, two cyclic structure closings connect and compose the tractive unit 1 of closing hitch structure.Figure 1B and
1C is the schematic diagram that tractive unit 1 is three annular enclosed hitch structures and four annular enclosed hitch structures.Fig. 1 D is triangle
Close the cross-sectional view and main view of hitch structure.As shown in figure 8, tractive unit 1 can also install elasticity in closing hitch structure
Linear structure, closing hitch structure and elastic linear structure can generate elastic deformation, so that lesion 5 is divided with mucous layer 6 completely
From this structure is especially suitable for the bigger situation of lesion 5.Closing hitch structure 11 can be made of elastic material, it is preferable that
The elastic material is silicon rubber or thermoplastic elastomer (TPE), and closing hitch structure can be one, two or more.Actual use
In the process, can according to the difference of focal size, select different type tractive unit carry out drawing separation, be suitable for mucous membrane, tissue,
Organ etc..
Hereinafter, illustrating traction device in the utility model in case where tractive unit only closes hitch structure composition
Isolated use process is drawn for mucous membrane.In actual mechanical process, electric knife can be inserted into lesion by endoscopic biopsy channel
Adjacent tissue is marked around lesion locations, after the completion of label, by electric knife or external syringe fluid injection, makes to fall ill
Become tissue protuberance, and forming fluid cushion layer under mucous membrane is " water cushion ".As shown in figures 2-6, Fig. 2 is clamping part 2 and tractive unit 1
Mutual cooperation schematic diagram, clamping part 2 include holder body 23 and 25 and clamp arm 24 and 26.Pre-separation mucous membrane is completed in vivo
Afterwards, electric knife is exited, opens the clamp arm 24 of traction device clamping part 2, clamp arm 24 is clamped to the closing hitch structure 11 of tractive unit 1
One end.As shown in Figure 3 and Figure 4, the first clamping part 21 and closing hitch structure 11 are placed in the biopsy channel of scope 3 together
4, behind the distal end for reaching biopsy channel 4, under the eyepiece observation of scope 3, the clamp arm 24 of the first clamping part 21 is opened, keeps it same
When clamp pre-separation lesion 5 side and closing hitch structure 11 one end, at this time again by the clamping master of the first clamping part 21
Body 23 proximally and distally separates, so that the distal end of 21 holder body of the first clamping part and closing hitch structure 11 stay in the body, takes
Holder body 23 out.As shown in figure 5, the second clamping part 22 to be inserted into endoscopic biopsy channel 4 to the distal end for reaching biopsy channel 4
Afterwards, under the eyepiece observation of scope 3, the clamp arm 26 of the second clamping part 22 is opened, the other end of closing hitch structure 11 is clamped,
With the help of scope, it is pulled to the other side of the lesion 5 of pre-separation.Again by 25 proximal end of holder body of the second clamping part 22
It is separated with distal end, so that the distal end of the holder body of the second clamping part 22 and closing hitch structure 11 stay in the body.Due to closing
Hitch structure 11 has elastic force, and during surgical cut, the lesion 5 cut is because the effect of 1 elastic force of tractive unit is turned up, with operation
The progress of cutting operation, the lesion 5 cut is gradually disengaged by continuous drawing and muscle layer 7, until complete pull-up, thoroughly
The separation of lesion 5 is completed, this mode makes lesion 5 be byed to dig while by cutting, and open surgical field of view is straight in scope
Depending on the lower blood vessel caning be found that under mucous membrane, bleeding is avoided, so that surgical procedure is more convenient, safety, shortens operating time.If
Lesion 5 is excessive, can increase clamping part 2 and closing hitch structure, so that the lesion 5 cut pulls completely, Huo Zheru
Tractive unit 1 of the selection shown in Fig. 8 containing elastic linear structure, so that the elastic deformation range of entire tractive unit 1 increases, with drawing
The lesion 5 of larger area.
It as shown in figs. 4 and 7,, can be with when ESD performs the operation such as in enteron aisle when lesion 5 is bigger, and space is smaller
First the side of lesion 5 is cut, such as Fig. 4, the clamp arm 24 for first passing through the first clamping part 21 clamps the lesion 5 of incision, at this point, again
It is sent into the second clamping part 22 by scope 3, by the way that under the eyepiece observation of scope 3, the clamp arm 26 of the second clamping part 22 is clipped to intestines
On road lumen opposite side mucous layer 8, the clamp arm 26 of the second clamping part 22 is closed to the lesion 5 tightly cut in closing hitch structure 11
Elastic force effect under, as the progress of surgical cut operation is got up by continuous drawing, keep surgical field of view, facilitate surgical procedure.
As shown in Figure 9A-9C, when the surface of a wound of lesion 5 is bigger, with the help of scope 3, first with the first clamping part
Clamp arm 24 clamps one end of the side of the surface of a wound of lesion 5 and closing hitch structure 11, then with the help of scope 3, then uses
The clamp arm 26 of second clamping part clamps the other side of the surface of a wound of lesion 5 and closing 11 other end of hitch structure, since closing is led
The elastic force of guiding structure 11 inwardly draws the surface of a wound two sides of lesion 5, so that the surface of a wound of lesion 5 reduces, to facilitate the surface of a wound of lesion 5
Further folder closes.
It is only the preferred embodiment of the application described in upper, makes skilled artisans appreciate that or realizing the application's
Utility model.A variety of modifications and combination for these embodiments will be apparent for those skilled in the art
, the general principles defined herein can without departing from the spirit or scope of the application, in other embodiments
Middle realization.Therefore, the application will not be limited in the embodiments shown herein, and be to fit to it is disclosed herein
Principle and the consistent widest scope of features of novelty.
Claims (13)
1. a kind of traction device, which is characterized in that the traction device includes clamping part and tractive unit, and the tractive unit contains envelope
Hitch structure is closed, the closing hitch structure is made of elastic material；The clamping part includes holder body and clamp arm, the folder
The biopsy channel of scope can be passed through by holding main body；The clamp arm can clamp the closing hitch structure.
2. traction device according to claim 1, which is characterized in that the closing hitch structure is by silicon rubber or thermoplasticity
Elastomer is made.
3. traction device according to claim 1, which is characterized in that the closing hitch structure be one, two or
It is multiple.
4. traction device according to claim 3, which is characterized in that can be between two or more closing hitch structures
Connect elastic construction.
5. traction device according to claim 4, which is characterized in that the elastic construction is elastic linear structure.
6. traction device according to claim 4, which is characterized in that the elastic construction is elastic ring.
7. traction device described in any one of -6 according to claim 1, which is characterized in that the closing hitch structure is circle
Shape, triangle, diamond shape are rectangular.
8. traction device according to claim 1, which is characterized in that the holder body of mobile clamping part can to seal
It closes hitch structure and elastic deformation occurs.
9. a kind of stretch ring for traction device, which is characterized in that the stretch ring is a closing hitch structure or several
A closing hitch structure is formed by connecting, and the stretch ring is made of elastic material.
10. stretch ring according to claim 9, which is characterized in that connect elastic construction between the closing hitch structure.
11. stretch ring according to claim 10, which is characterized in that the elastic construction is elastic linear structure.
12. stretch ring according to claim 10, which is characterized in that the elastic construction is elastic ring.
13. stretch ring according to claim 9, which is characterized in that the closing hitch structure is circle, triangle, water chestnut
Shape, it is rectangular.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201821161145.XU CN209611212U (en) | 2018-07-20 | 2018-07-20 | A kind of traction device and the stretch ring for traction device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201821161145.XU CN209611212U (en) | 2018-07-20 | 2018-07-20 | A kind of traction device and the stretch ring for traction device |
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| CN209611212U true CN209611212U (en) | 2019-11-12 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201821161145.XU Active CN209611212U (en) | 2018-07-20 | 2018-07-20 | A kind of traction device and the stretch ring for traction device |
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US10952717B2 (en) | 2019-05-16 | 2021-03-23 | Boston Scientific Scimed, Inc. | Tissue retraction bands and methods of use thereof |
| CN113397621A (en) * | 2021-07-23 | 2021-09-17 | 中国人民解放军陆军军医大学第二附属医院 | Traction method and traction device for self-made endoscope minimally invasive surgery |
| CN114469266A (en) * | 2022-01-26 | 2022-05-13 | 中国人民解放军北部战区总医院 | Metal dental floss clamping integrated traction forceps assisting endoscope submucosal stripping and method |
-
2018
- 2018-07-20 CN CN201821161145.XU patent/CN209611212U/en active Active
Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US10952717B2 (en) | 2019-05-16 | 2021-03-23 | Boston Scientific Scimed, Inc. | Tissue retraction bands and methods of use thereof |
| US11890001B2 (en) | 2019-05-16 | 2024-02-06 | Boston Scientific Scimed, Inc. | Tissue retraction bands and methods of use thereof |
| CN113397621A (en) * | 2021-07-23 | 2021-09-17 | 中国人民解放军陆军军医大学第二附属医院 | Traction method and traction device for self-made endoscope minimally invasive surgery |
| CN114469266A (en) * | 2022-01-26 | 2022-05-13 | 中国人民解放军北部战区总医院 | Metal dental floss clamping integrated traction forceps assisting endoscope submucosal stripping and method |
| CN114469266B (en) * | 2022-01-26 | 2023-07-07 | 中国人民解放军北部战区总医院 | Metal clamp dental floss integrated traction forceps and method for assisting endoscopic submucosal stripping |
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Address after: 210032 10 hi tech three road, hi tech Industrial Development Zone, Pukou District, Nanjing, Jiangsu Co-patentee after: Beijing Friendship Hospital Affiliated to Capital Medical University Patentee after: Nanwei Medical Technology Co., Ltd Address before: 210032 10 hi tech three road, hi tech Industrial Development Zone, Pukou District, Nanjing, Jiangsu Co-patentee before: Beijing Friendship Hospital Affiliated to Capital Medical University Patentee before: Micro-Tech (Nanjing) Co., Ltd. |