Uterine cancer change vaginal canal ring cutting device
Technical Field
The utility model belongs to the technical field of medical instrument technique and specifically relates to a girdling operation device that goes on from the vaginal canal inner wall after uterus canceration.
Background
The cervical cancer is the most common gynecological malignant tumor, the high-incidence age of the carcinoma in situ is 30-35 years old, the invasive cancer is 45-55 years old, the incidence of the carcinoma tends to be younger in recent years, and the carcinoma ranks the third in the most common cancers of women; an appropriate individual treatment scheme is formulated according to the comprehensive consideration of clinical stages, patient ages, birth requirements, general conditions, medical technical levels, equipment conditions and the like, and a comprehensive treatment scheme with operation and radiotherapy as main parts and chemotherapy as auxiliary parts is adopted:
and (3) surgical treatment: the operation is mainly used for early cervical cancer patients; the commonly used surgical formulae are: total hysterectomy; sub-extensive total hysterectomy and pelvic lymph node debridement; extensive total hysterectomy and pelvic lymph node debridement; peri-aortic lymphadenectomy or sampling; the ovary of the young patient can be normally preserved, and the young patient requiring the preservation of the fertility function belongs to the feasible early-stage conization resection or the radical cervictomy.
Radiotherapy: 1) patients in the middle and advanced stages; 2) early stage patients whose systemic condition is not suitable for surgery; 3) preoperative radiotherapy of large cervical lesions; 4) the surgery treatment pathological examination finds the auxiliary treatment with high risk factors.
Chemotherapy: the traditional Chinese medicine composition is mainly used for patients with advanced stage or recurrent metastasis, and is also used for reducing tumor focus and controlling subclinical metastasis by adopting surgery combined with preoperative auxiliary chemotherapy (intravenous or arterial perfusion chemotherapy) in recent years and for radiotherapy sensitization.
Among them, total hysterectomy, the most common procedure, accounts for a large proportion of clinical treatments; due to the plantability of cancer cells, the operation needs to ensure that the cancer cells do not spread and flow out; the existing therapies for this mainly include: 1) open resection: the traditional method is characterized in that an abdominal incision is opened by means of an appliance, a vaginal tube wall is cut by a manual cutter and is sutured, and finally, a uterus is moved out of the incision, so that the wound surface caused by the operation is large, and the healing of abdominal wounds of patients is not facilitated;
2) gradually shearing the periphery of the vaginal canal by an ultrasonic knife inserted through a laparoscopic puncture outfit hole after the vagina is sutured; the operation method comprises the steps of firstly putting a uterine manipulator into a vagina, manually suturing and constraining a vaginal tube to the uterine manipulator through a suture, finally cutting a small opening from the outer wall of the vaginal tube through an ultrasonic knife, gradually shearing along the circumferential direction of the vaginal tube through the small opening, and finally drawing a uterus out of the vaginal tube through a clamp; although the wound surface of a patient is small, the operation is time-consuming and labor-consuming, the binding reliability cannot be guaranteed particularly in the manual suture binding process, the cutting mode is long, and the efficiency is extremely low.
To this end, the present application proposes a means of performing a ring-cut from the inner wall of the vaginal canal to sever the vaginal canal.
SUMMERY OF THE UTILITY MODEL
The utility model aims at providing a device is cut to uterus carcinomatosis vagina tube ring, by the bandage, expansion fastening unit, central siphon and cutting unit are constituteed, after bandage and expansion fastening unit are fixed in the central siphon with the vagina tube, through the blade structure of cutting unit wherein along radial overhanging and pierce through the vagina tube, the rotatory action through the cutting unit this moment drives the blade structure and encircles the vagina tube and cut, consider in addition that the vagina tube follows the blade structure in cutting process and appear the phenomenon of sliding, the uneven follow-up cutting looks rate that influences of vaginal tube wall thickness, this application is structural to add the presser foot structure at the blade, a local portion compresses tightly the vagina tube wall when the cutting, smooth out flat vagina tube wall simultaneously, make its phenomenon of sliding not appear.
In order to solve the problems that in the prior art, when the vaginal tube needs to be resected due to uterine canceration, the cutting efficiency is low, and after the cutting is finally completed, a clamp needs to be additionally placed to pull and move the disconnected uterus out, and the operation type procedures are complicated and cannot be coherent; therefore, the application provides a ring cutting device for a uterine cancer vaginal tube, which specifically comprises a binding band, an expansion fastening unit, an axle tube and a cutting unit;
a band having a connector for connecting the ends of the band around the vaginal canal during surgery;
the expansion fastening unit is sleeved on the shaft tube, is arranged between the inner end surface of the shaft tube and the cutting unit, is used for being arranged in the vaginal tube in the operation process, presses the vaginal tube on the inner ring surface of the binding band wound on the periphery of the vaginal tube through the expansion action of the expansion fastening unit, and simultaneously realizes the fixed connection of the binding band and the expansion fastening unit;
the cutting unit comprises an extending structure, a cutter body structure, a cutter rest and a rotating structure; the knife body structure is assembled on the knife rest, the inner edge of the rotating structure is rotatably sleeved on the shaft tube, and the outer edge of the rotating structure is fixedly connected with the knife rest; the extending structure is arranged between the knife body structure and the rotating structure and is used for pushing the knife body structure out of the knife rest and puncturing the vaginal tube in the operation process; the vagina cutting knife further comprises a presser foot structure, the presser foot structure is movably inserted into the knife body structure through a presser foot rod arranged in the radial direction, a compression spring is sleeved on the presser foot rod, one end of the compression spring is connected to the presser foot structure, the other end of the compression spring is connected to the knife body structure, and the presser foot structure is used for smoothening the wall of the vagina tube on the inner circle surface of the binding band during cutting.
Further, the present application provides a ring cutting device for a pessary of uterine cancer, wherein the presser foot structure is located at the outer end of the blade structure in the radial direction and in a free state; along with the extending action of the extending structure, the knife body structure and the presser foot structure move outwards along the radial direction, the presser foot structure is firstly pressed against the vaginal tube, and the pressing spring is further compressed until the knife body structure pierces the vaginal tube.
Preferably, in order to enable the presser foot structure to more closely attach the vaginal tube to the inner ring surface of the binding band, the presser foot structure is curved in an arc shape along the length direction, and the radius of the arc shape is equal to the inner diameter of the binding band in a wound state.
Preferably, the ring-cutting device for the uterine cancer vaginal canal provided by the application has the advantages that in order to enable the ring-cutting process to be smoother and unlikely to block, the two ends of the presser foot structure along the length direction are arc-shaped and tilted, the tilting direction points to the inner cavity of the vaginal canal, so that the front end of the presser foot structure in the rotating advancing process is always higher than the wall of the vaginal canal, and the blocking phenomenon is eliminated.
Further, the uterus cancer becomes pessary ring-cutting device that this application provided, in order to avoid shifting out in-process blade structure incised wound vagina pipe wall at later stage tractive, wherein, still include reset spring, reset spring installs between blade structure and knife rest for in the blade structure pull-back knife rest that will push out the knife rest outer lane face after the cutting is accomplished.
Further, the utility model provides a uterus cancer becomes pessary ring-cutting device, wherein, overhanging structure is annular gasbag b, annular gasbag b leads to through the trachea the outer end of central siphon, wherein, be equipped with the check valve structure in the tracheal tube way.
Preferably, the pessary ring-cutting device is become to uterus cancer that this application provided, wherein, expansion fastening unit includes expansion ring and annular gasbag an, the expansion ring is enclosed by a plurality of independent expansion pieces, annular gasbag an set up in the expansion ring with between the central siphon, annular gasbag a runs through the trachea the central siphon, and cause via the central siphon inner chamber the outer end of central siphon, wherein, be provided with the check valve structure in the tracheal tube way.
Compared with the prior art, the utility model, a vaginal canal ring cutting device for uterine cancer change has the following advantages: on one hand, the technical scheme provided by the application fixes the part to be separated to the shaft tube before the vaginal tube is cut, so that the part to be separated is conveniently and directly pulled and moved out through the shaft tube after the cutting is finished, and the surgical method is different from the traditional method of additionally placing a clamp for pulling, and is coherent; on the other hand, an intra-vaginal ring cutting mode is proposed for the first time, and the bandage is wound on the outer wall of the vaginal tube to serve as a cutting chopping block, so that the possibility of ring cutting from the inner cavity of the vaginal tube is realized; in addition, in the ring cutting process, considering that the vaginal tube slides along with the cutter body structure in the cutting process, and the uneven wall thickness of the vaginal tube affects the subsequent cutting phase rate, the presser foot structure is additionally arranged on the cutter body structure and used for locally pressing the vaginal tube wall during cutting and flattening the vaginal tube wall to avoid the sliding phenomenon.
Drawings
FIG. 1 is a schematic structural view of a device for cutting a uterine cancer vaginal canal;
FIG. 2 is a schematic diagram of a structure of a cutting unit removing blade carrier of a device for cutting a vaginal tube from uterine cancer;
fig. 3 is a schematic structural diagram of a cutting unit of the uterine cancer vaginal tube ring cutting device according to the present application.
Wherein: 1. binding bands; 2. an expansion fastening unit; 3. an axle tube; 4. a cutting unit; 5. an annular air bag a; 6. an expansion block; 7. an overhang structure; 8. a blade structure; 9. a tool holder; 10. a rotating structure; 11. a presser foot structure; 12. a presser bar; 13. a compression spring; 14. a return spring.
Detailed Description
The technical scheme of the utility model is further elaborated in detail with the accompanying drawings;
it should be noted that, in the present application, the "inner end", "outer end", "inner end face" and "outer end face" refer to the end of the surgical instrument inserted into the vaginal canal as the inner end, and the other end as the outer end, which are only specified for convenience of description and are not intended to limit the technical solution of the present application.
As shown in the drawings, the ring cutting device for the vaginal tube of uterine cancer provided by this embodiment includes a binding band 1 (in this embodiment, the binding band is made of a metal spring piece), an expansion fastening unit 2, a shaft tube 3 and a cutting unit 4;
the bandage 1 is provided with a connecting piece for connecting two ends of the bandage 1 in a circling way and is used for circling the outer wall of the vaginal canal in the operation process;
the expansion fastening unit 2 is sleeved on the shaft tube 3, is arranged between the inner end surface of the shaft tube 3 and the cutting unit 4, is used for being arranged in the vaginal tube in the operation process, presses the vaginal tube on the inner ring surface of the binding band 1 wound on the periphery of the vaginal tube through the expansion action of the expansion fastening unit 2, and simultaneously realizes the fixed connection of the binding band 1 and the expansion fastening unit 2; the expansion fastening unit 2 specifically comprises an expansion ring and an annular air bag a5, wherein the expansion ring is enclosed by a plurality of independent expansion blocks 6, the annular air bag a5 is arranged between the expansion ring and the shaft tube 3, the annular air bag a5 penetrates through the shaft tube 3 through an air tube and is led to the outer end of the shaft tube 3 through the inner cavity of the shaft tube 3, and a one-way valve structure (not shown in the figure) is arranged in the air tube.
The cutting unit 4 comprises an overhanging structure 7, a blade structure 8, a tool rest 9 and a rotating structure 10; the blade structure 8 is assembled on the blade holder 9, the inner edge of the rotating structure 10 is rotatably sleeved on the shaft tube 3, and the outer edge is fixedly connected to the blade holder 9; the overhanging structure 7 is arranged between the blade body structure 8 and the rotating structure 10, and is used for pushing the blade body structure 8 out of the knife rest 9 and puncturing the vaginal tube through the overhanging structure 7 in the surgical process; the vagina cutting device is characterized by further comprising a presser foot structure 11, wherein the presser foot structure 11 is movably inserted into the knife body structure 8 through a presser bar 12 arranged in the radial direction, a compression spring 13 is sleeved on the presser bar 12, one end of the compression spring 13 is connected to the presser foot structure 11, and the other end of the compression spring 13 is connected to the knife body structure 8 and is used for smoothening the wall of the vagina to the inner ring surface of the binding band 1 during cutting; the overhanging structure 7 is an annular balloon b which is led to the outer end of the shaft tube 3 through a trachea, wherein a one-way valve structure (not shown in the figure) is arranged in the trachea line.
As shown in fig. 2, the rotary structure 10 of this embodiment specifically includes a gear plate, an elastic sheet, an axial connecting pipe and a radial connecting plate surface, the axial connecting pipe is sleeved on the shaft tube, and one end of the axial connecting pipe is connected to the inner edge of the radial connecting plate, the outer edge of the radial connecting plate is connected to the tool rest, wherein the gear plate is fixedly sleeved on the shaft tube, the elastic sheet is fixed to the inner wall of the axial connecting pipe, the elastic sheet is set to be in a shape similar to the tooth structure of the gear plate, and the elastic sheet is engaged with the gear plate and is connected with the gear plate, so that a.
As shown in fig. 2, the presser foot structure 11 is located at the outer end of the blade structure 8 in the radial direction, the presser foot structure 11 is curved in an arc shape along the length direction, the radius of the arc is equal to the inner diameter of the bandage 1 in the wound state, two ends of the presser foot structure 11 in the length direction are raised in an arc shape, the raising direction points to the inner cavity of the vaginal tube, along with the extending action of the extending structure 7, the blade structure 8 and the presser foot structure 11 move outwards along the radial direction together, the presser foot structure 11 is firstly abutted against the vaginal tube, and the compression spring 13 is further compressed until the blade structure 8 pierces the vaginal tube.
Simultaneously, in order to avoid the unexpected incised wound phenomenon of utility model among the later stage tractive in-process, reset spring 14 is still add to this embodiment, reset spring 14 is installed between blade structure 8 and knife rest 9 for in the blade structure 8 pull-back knife rest that will release the outer lane face of knife rest 9 after the cutting is accomplished.
The working process and principle are as follows: after the device is placed in a vaginal tube, a binding band 1 is wound on the outer wall of the vaginal tube, an air pumping device is controlled to pump air to an annular air bag a5, an expanding block 6 is pushed to expand outwards along the radial direction along with the inflation of an annular air bag a5, the vaginal tube wall is tightly pressed on the inner ring surface of the binding band 1, the vaginal tube wall is fixed, meanwhile, the binding band 1, the vaginal tube and an expansion fastening unit 2 are fixed on an axle tube 3, the air pumping device is controlled to pump air to an annular air bag b at the moment, a knife body structure 8 is pushed to move outwards along the radial direction along with the inflation of an annular air bag b, meanwhile, a presser foot structure 11 also moves outwards under the action of a pressing spring 13 and a presser foot rod 12, the presser foot structure 11 firstly abuts against the inner wall of the vaginal tube, in the further outward movement process, the pressing spring 13 is compressed by force to tightly press the inner wall of the vaginal tube, and the presser foot structure 11 penetrates through the vaginal tube and abuts against the inner ring 1 along with the, at the moment, the rotating structure 10 is rotated to complete circumferential cutting of the vaginal canal, and finally the shaft tube 3 is pulled to move out the broken uterus; on one hand, the technical scheme provided by the application fixes the part to be separated to the shaft tube 3 before the vaginal tube is cut, so that the part to be separated is conveniently pulled and moved out through the shaft tube after the cutting is finished, and the operation is coherent compared with the traditional method of additionally placing a clamp for pulling; on the other hand, an intra-vaginal ring cutting mode is proposed for the first time, and the bandage 1 is wound on the outer wall of the vaginal tube to serve as a cutting chopping block, so that the possibility of ring cutting from the inner cavity of the vaginal tube is realized; in addition, in the ring cutting process, considering that the vaginal tube slides along with the knife body structure 8 in the cutting process, and the uneven thickness of the vaginal tube wall influences the subsequent cutting phase rate, the presser foot structure 11 is additionally arranged on the knife body structure 8 and used for locally pressing the vaginal tube wall in the cutting process and simultaneously smoothing the vaginal tube wall to prevent the vaginal tube wall from sliding.
Finally, it is to be noted that: the above embodiments are only used for illustrating the technical solutions of the present invention and not for limiting, although the present invention has been described in detail with reference to the embodiments, those skilled in the art should understand that the technical solutions of the present invention can be modified and replaced with equivalents without departing from the spirit and scope of the technical solutions of the present invention, which should be covered by the scope of the claims of the present invention.