CN210990590U - Novel aseptic protective sheath suitable for NOSES excision drags out formula operation - Google Patents
Novel aseptic protective sheath suitable for NOSES excision drags out formula operation Download PDFInfo
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- CN210990590U CN210990590U CN201921271204.3U CN201921271204U CN210990590U CN 210990590 U CN210990590 U CN 210990590U CN 201921271204 U CN201921271204 U CN 201921271204U CN 210990590 U CN210990590 U CN 210990590U
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Abstract
The utility model provides a novel aseptic protective sheath suitable for NOSES excision drags out formula operation, solves violating aseptic principle that prior art exists, and the emergence probability of tumour dissemination, postoperative infection and anastomotic fistula is high, and the sample drags out the problem that the process caused the damage to surrounding tissue easily. Including the protective sheath main part, its characterized in that: one end of the protective sleeve main body is provided with a resection specimen inlet, and the other end of the protective sleeve main body is provided with a closed tail end; the excision sample puts the entrance and is provided with the entry ligature that is used for sealing the entry of putting, and on the lateral wall of protective sheath main part, still is provided with the cover body line of tightening that is used for reducing the sample volume. The device has reasonable design and compact structure, and can put the excised specimen into the device to isolate the stump of the specimen from the abdominal cavity, thereby preventing intestinal contents and tumor cells from entering the pelvic cavity and natural cavity; and the volume of the specimen can be effectively reduced, the side damage to surrounding tissues is reduced, and the specimen is easy to pull out.
Description
Technical Field
The utility model belongs to the technical field of the medical treatment assistive device, concretely relates to can put into it with the intestines tube of excision in, make sample stub and abdominal cavity keep apart, avoid intestines content and tumor cell to get into pelvic cavity and natural chamber way, and can effectively reduce the sample volume, reduce the vice damage that causes to tissue on every side, the novel aseptic protective sheath that is applicable to NOSES excision drag-out formula operation that easily drags out.
Background
In the course of traditional surgical development, surgical scarring and pain are considered to be inevitable products of surgery. In recent years, with the development of laparoscopic surgery, the problem of incision cutting is greatly solved; however, in the case of a colorectal surgery, since a surgical specimen is large, a 5-8 cm incision is required to be cut again for taking out the specimen even in the case of a laparoscopic surgery. The natural orifice specimen taking (NOSES) is a new one of minimally invasive surgery, which not only shows perfect minimally invasive effect, but also gives consideration to good safety and operability. The NOSES operation can be divided into three categories according to the different modes of specimen collection, which are: excising the specimen in vitro by eversion (excising type by eversion), excising the specimen in vitro by pulling out (excising type by pulling out), excising the specimen in vivo and pulling out the specimen in vitro (excising and pulling out); and the cutting and pulling-out type is most widely applicable.
At present, most of samples taken out by NOSES excision pull-out type operations at home and abroad adopt a mode of putting a stomach tube in through a natural cavity, fixing the stomach tube in the sample and then pulling the sample out of the body. In addition, some of the modes of taking out the specimen by adopting the common specimen sleeve have a certain protection effect, but the contents of the intestines are often extruded out of the intestinal canal and are remained on the inner side surface of the specimen sleeve due to the extrusion of a natural cavity, and in the subsequent process of taking out the specimen sleeve, the contents of the intestines can break through the stub and enter the pelvic cavity under the condition of being pressed, so that the risks of tumor dissemination, postoperative infection and anastomotic fistula are increased. Meanwhile, because the free specimen has a large volume, in the process of pulling out the specimen, the risk of drag exists, the damage to the tissues around the rectum is easily caused, and the normal function of the anus after operation is influenced. There is a need for improvements in the prior art NOSES resection pull-out surgical procedures and aids.
SUMMERY OF THE UTILITY MODEL
The utility model discloses just to above-mentioned problem, provide one kind and can put into it with the intestines tube of excision in, make sample stub and abdominal cavity keep apart, avoid intestines content and tumor cell to get into pelvic cavity and natural chamber way, and can effectively reduce the sample volume, reduce the vice damage that leads to the fact to tissue on every side, the novel aseptic protective sheath that is applicable to NOSES excision drag-out type operation that easily drags out.
The utility model adopts the technical proposal that: this novel aseptic protective sheath suitable for NOSES excision drags out formula operation includes the protective sheath main part, its characterized in that: one end of the protective sleeve main body is provided with a cut sample placing port for placing a cut sample into the protective sleeve, and the other end of the protective sleeve main body is provided with a closed tail end; the excision sample puts the entrance and is provided with the entry ligature that is used for sealing the entry of putting, just on the lateral wall of protective sheath main part, still be provided with the cover body line of tightening that is used for reducing whole sample volume.
The protective sleeve comprises a protective sleeve body and a protective sleeve body, wherein the protective sleeve body is composed of a cylindrical sleeve body, one end of the cylindrical sleeve body is a closed tail end, the other end of the cylindrical sleeve body is a cut specimen placing inlet, and a specimen containing cavity is arranged inside the cylindrical sleeve body; the outer side wall of the cylindrical sleeve body is provided with two groups of tightening connecting sheets which are respectively arranged on the left side and the right side of the cross section of the cylindrical sleeve body along the length direction of the cylindrical sleeve body, and each group of tightening connecting sheets is also respectively provided with a plurality of tightening wire through holes which are arranged along the length direction of the cylindrical sleeve body; the sleeve tightening wires sequentially and respectively cross the tightening wire through holes of the two groups of tightening connecting sheets. The sample that puts into the protective sheath main part with the sample with the excision puts into the mouth via the excision sample holds the intracavity to put into the mouth with the excision sample earlier and seal with the entry ligature, later, utilize set body tightening wire to inwards tighten up two sets of tightening connection pieces on the cover lateral wall of cylindric cover, and then reduce the volume of whole protective sheath main part and its inside sample, conveniently follow dragging out of nature chamber way.
The side wall of the end part of the cylindrical sleeve body of the protective sleeve main body at the position of the cut specimen inlet is provided with a mouth opening handle; the outer side wall of the opening supporting handle is provided with a lifting part which is convenient for opening the entrance in the operation process. Put the entry with excision sample through the portion of drawing of carrying that sets up on propping a mouthful handle and strut to do benefit to and put the sample of excision into the sample of protective sheath main part and hold the intracavity, effectively promote operating efficiency.
The number of the opening supporting handles arranged at the position of the cutting specimen entrance of the protective sleeve main body is four, and the opening supporting handles are arranged at equal intervals along the circumference of the cross section of the cylindrical sleeve body. To improve the flexibility of use of the appliance.
The sample of the cylindrical sleeve body of the protective sleeve main body is accommodated in the cavity and is positioned on one side of the closed tail end, and an overflow collecting cavity for accommodating intestinal contents overflowing from the sample is arranged. So as to prevent intestinal contents and tumor cells from entering the pelvic cavity and the natural cavity in the process of dragging out.
The cover body tightening line arranged on the outer side wall of the protective cover main body is divided into a plurality of sections and can be independently tightened. With each section of tightening wire that utilizes cover body tightening wire, put into the mouth by the excision sample of protective sheath main part and tie in proper order to closed end to in pushing gradually the terminal overflow thing of the cylindric cover body collection chamber with the intestines content in the sample, when showing reduction protective sheath main part volume, the tightening up operation of the protective sheath main part of also being convenient for.
The outer surface of the protective sleeve main body is provided with a non-stick coating. So as to reduce the friction coefficient when the sterile protective sleeve is operated and reduce the pain of the patient.
The utility model has the advantages that: because the utility model adopts the technical scheme that one end of the protective sleeve main body is provided with the excision specimen inlet for putting the excised specimen into the protective sleeve, and the other end of the protective sleeve main body is provided with the closed end; an inlet ligature for closing the placing inlet is arranged at the cut specimen placing inlet, and a sleeve tightening line for reducing the volume of the whole specimen is arranged on the outer side wall of the protective sleeve main body, so that the protective sleeve is reasonable in design and compact in structure, can be placed into a pelvic cavity through a laparoscope puncture outfit (poking and clamping), places a cut intestinal canal into a specimen accommodating cavity of the protective sleeve main body, and reduces the volume of the specimen through the sleeve tightening line; meanwhile, the elastic space reserved in the overflow collecting cavity at the closed end of the protective sleeve main body can prevent the contents of the sample intestine and tumor cells from being extruded to enter the pelvic cavity and the natural cavity. And, utilize this novel aseptic protective sheath with the sample via the in-process that the natural chamber says to drag out for the sample stub is effectively isolated with the abdominal cavity, and reduces the sample of volume and the degree of lubrication and the mobility in the chamber way better, has reduced the drag out degree of difficulty of sample, and alleviate the vice damage of dragging out the process to surrounding tissue, is showing the probability that reduces NOSES operation postoperative infection and coincide mouthful and leak and take place.
Drawings
Fig. 1 is a schematic structural diagram of the present invention.
Fig. 2 is a top view of fig. 1.
Figure 3 is a schematic view of one construction of the body of the case of figure 1.
Fig. 4 is a longitudinal sectional view of fig. 3.
Fig. 5 is a transverse cross-sectional view of fig. 3.
Fig. 6-8 are schematic diagrams illustrating the steps of the novel sterile protective sheath of the present invention for assisting the nases resection and pull-out surgery.
The sequence numbers in the figures illustrate: 1 protective sheath main part, 2 cover body tighten up the line, 3 excision sample are put into the mouth, 4 entry ligatures, 5 closed end, 6 cylindric covers, 7 tighten up the connection piece, 8 tighten up the line perforation, 9 prop a mouthful handle, 10 are carried the portion of drawing, 11 sample and are held the chamber, 12 overflow thing collection chamber, 13 colon rectum, 14 pathological change affected parts, 15 upper limb that breaks, 16 lower limb that breaks, 17 sample, 18 aseptic protective sheaths of excision.
Detailed Description
The specific structure of the present invention is described in detail with reference to fig. 1 to 8. The novel sterile protective sleeve suitable for NOSES excision pull-out type surgery comprises a protective sleeve main body 1 which is made of medical rubber and has certain elasticity, wherein the protective sleeve main body 1 is composed of a cylindrical sleeve body 6. One end of a cylindrical sleeve body 6 of the protective sleeve main body 1 is provided with a closed tail end 5, and the other end of the cylindrical sleeve body 6 is provided with a cut specimen placing inlet 3 for placing a cut specimen 17 into the protective sleeve; and a specimen accommodating cavity 11 for accommodating a specimen is arranged in the cylindrical sleeve body 6. The surface of the cylindrical sheath 6 of the sheath body 1 is smooth and, depending on the size of the specimen 17 to be excised, sterile sheaths 18 of different specifications can be selected, for example: the thickness of the wall of the cylindrical sleeve body 6 can be 0.5mm, the diameter of the cylindrical sleeve body 6 can be 8cm, and the length of the cylindrical sleeve body 6 can be 20 cm. Meanwhile, in order to reduce the friction coefficient during the operation of the sterile protective sleeve and reduce the pain of a patient, the outer surface of the cylindrical sleeve body 6 of the protective sleeve main body 1 can be provided with a non-stick coating made of polytetrafluoroethylene.
Two groups of tightening connecting sheets 7 for reducing the volume of the cylindrical sleeve body 6 are arranged on the outer side wall of the cylindrical sleeve body 6 of the protective sleeve main body 1; and two sets of tightening connecting sheets 7 are respectively arranged at the left and right sides of the cross section of the cylindrical sleeve body 6 along the length direction of the cylindrical sleeve body 6 (as shown in fig. 5). Each group of tightening connecting sheets 7 is respectively provided with a plurality of tightening wire through holes 8 which are arranged along the length direction of the cylindrical sleeve body 6. On the lateral wall of the cylindrical cover body 6 of the protective cover main body 1, a cover tightening wire 2 for reducing the volume of the whole specimen is further arranged, and the cover tightening wire 2 sequentially and respectively penetrates through the tightening wire through holes 8 of the two sets of tightening connecting pieces 7 in a crossed manner. In addition, an inlet ligature 4 for closing the incision is provided at the incision insertion port 3 of the protective cover body 1. Then the excised specimen 17 is put into the specimen containing cavity 11 of the protective sleeve main body 1 through the excised specimen placing inlet 3, and the excised specimen placing inlet 3 is sealed by the inlet ligature 4; then, the two groups of tightening connecting sheets 7 on the outer side wall of the cylindrical sleeve body 6 are tightened inwards by using the sleeve body tightening wire 2 so as to reduce the volume of the whole protective sleeve main body 1 and the specimen inside the protective sleeve main body, and the whole sterile protective sleeve 18 is conveniently pulled out from a natural cavity.
The side wall of the end part of the cylindrical sleeve body 6 of the protective sleeve main body 1 at the position of the excision specimen inlet 3 is provided with four opening handles 9 which are arranged at equal intervals along the circumference of the cross section of the cylindrical sleeve body 6. The outer side wall of each flap opening handle 9 is provided with a lifting part 10 which is convenient for opening the placing opening in the operation process; it will be appreciated that the pull portion 10 may be of an annular configuration to facilitate pulling, depending on the particular application. Thereby through setting up and carrying portion 10 on propping a mouthful handle 9, put into mouth 3 with the excision sample and strut, and then do benefit to and put into the sample of protective sheath main part 1 with the sample 17 of excision and hold the chamber 11 in, when improving the utensil and using the flexibility, effectively promote operating efficiency, shorten the operation time.
In order to avoid the intestinal content and tumor cells from entering the pelvic cavity and the natural cavity in the dragging-out process, an elastic overflow collecting cavity 12 for accommodating the intestinal content overflowed by the specimen is arranged in the specimen accommodating cavity 11 of the cylindrical sleeve body 6 of the protective sleeve main body 1 and on one side of the closed tail end 5. In addition, in order to facilitate the tightening operation of the protective sleeve main body 1, the sleeve tightening wires 2 arranged on the outer side wall of the protective sleeve main body 1 can be divided into four sections, and the four sections of tightening wires can be independently tightened respectively; with each section of the tightening line of utilizing the sleeve body tightening line 2, the excision sample placing opening 3 of the protective sleeve main body 1 is sequentially tied to the closed tail end 5, so that the intestinal content in the sample is gradually pushed to the overflow collecting cavity 12 at the tail end of the cylindrical sleeve body 6, the volume of the protective sleeve main body 1 is obviously reduced, and the tightening operation of the protective sleeve main body 1 is facilitated.
When the novel sterile protective sleeve suitable for the NOSES excision pull-out type operation is used (taking a specimen taking process in sigmoidectomy as an example), firstly, an operator completely detaches the upper detached edge 15, the lower detached edge 16 and the tied membrane of a lesion 14 of the colorectal 13 to complete the complete dissociation of the excised intestinal section (as shown in figure 6). Then, the operator cuts off the descending colon by a linear cutting closer at the upper edge of the tumor, and cuts open the rectal wall transversely at the upper end of the rectal pre-cutting line; thereafter, in the event that sufficient lower margin is determined, the rectum is completely transected; at this point, the whole colon specimen was completely dissociated and excised. Then, the operating doctor selects a novel sterile protective sleeve 18 with a proper specification, sleeves the protective sleeve main body 1 on the separating forceps, further utilizes the separating forceps to carry the novel sterile protective sleeve 18, enters the pelvic cavity through a laparoscope puncture outfit (poking card), and clamps the broken end of the unclosed side of the cut specimen 17; thereafter, the physician assistant grips the pulling portion 10 of the opening handle 9 at the incision site of the protective cover body 1 with the separating clip, and pulls the pulling portion in the opposite direction to the surgeon to place the excised specimen 17 into the specimen-holding chamber 11 of the protective cover body 1 (see fig. 7).
After the cut specimen 17 completely enters the protective sleeve main body 1, exhausting the air in the protective sleeve main body 1 as much as possible; then, ligating an inlet ligature 4, and further closing the excision specimen placing inlet 3; each section of tightening line of the sleeve tightening line 2 is utilized again, and the cut specimen placing opening 3 of the protective sleeve main body 1 is used for sequentially ligating the cut specimen to the closed tail end 5, so that the two groups of tightening connecting pieces 7 on the outer side wall of the cylindrical sleeve body 6 are tightened inwards, the intestinal content of the specimen sealed in the specimen accommodating cavity 11 is gradually pushed into the elastic overflow collecting cavity 12 at the tail end of the cylindrical sleeve body 6. And, the tightening of the sleeve tightening wire 2 and the tightening connecting sheet 7 reduces the volume of the whole protective sleeve main body 1 and the specimens inside the protective sleeve main body, and facilitates the dragging out of the whole novel sterile protective sleeve 18 from the natural cavity. Then, after the anus is completely expanded, the physician assistant enters the pelvic cavity through the natural cavity of the patient by using the oval forceps, clamps the lifting part 10 of the opening lifting handle 9 of the protective sleeve main body 1 which is closed and reduced in volume, and lightly and slowly pulls out the novel sterile protective sleeve 18 completely (as shown in fig. 8). Finally, a large amount of iodophor saline is used for flushing the pelvic cavity, and the reconstruction of the digestive tract is started after the detection of the absence of bleeding points.
Claims (7)
1. A novel sterile protective sheath suitable for NOSES resection drag-out surgery, comprising a protective sheath body (1), characterized in that: one end of the protective sleeve main body (1) is provided with a cut specimen inlet (3) for placing a cut specimen (17) into the protective sleeve, and the other end of the protective sleeve main body (1) is provided with a closed tail end (5); the excision sample is provided with entry ligature (4) that are used for sealing the entry of putting into department of putting into entry (3), just on the lateral wall of protective sheath main part (1), still be provided with the cover body line of tightening (2) that are used for reducing whole sample volume.
2. The novel sterile protective sheath for NOSES resection pull-out surgery according to claim 1, wherein: the protective sleeve comprises a protective sleeve body (1) and a protective sleeve body (6), wherein one end of the cylindrical sleeve body (6) is a closed tail end (5), the other end of the cylindrical sleeve body (6) is a cut specimen inlet (3), and a specimen accommodating cavity (11) is formed in the cylindrical sleeve body (6); two groups of tightening connecting sheets (7) are arranged on the outer side wall of the cylindrical sleeve body (6), the two groups of tightening connecting sheets (7) are respectively arranged on the left side and the right side of the cross section of the cylindrical sleeve body (6) along the length direction of the cylindrical sleeve body (6), and a plurality of tightening wire through holes (8) arranged along the length direction of the cylindrical sleeve body (6) are respectively arranged on each group of tightening connecting sheets (7); the sleeve tightening wires (2) sequentially and respectively cross the tightening wire through holes (8) of the two sets of tightening connecting sheets (7).
3. The novel sterile protective sheath for NOSES resection pull-out surgery according to claim 2, wherein: a mouth opening handle (9) is arranged on the side wall of the end part of the cylindrical sleeve body (6) of the protective sleeve main body (1) at the position of the excision specimen placing inlet (3); the outer side wall of the opening supporting handle (9) is provided with a lifting part (10) which is convenient for opening the opening in the operation process.
4. The novel sterile protective sheath for NOSES resection pull-out surgery according to claim 3, wherein: the number of the opening supporting handles (9) arranged at the position of the cut specimen entrance (3) of the protective sleeve main body (1) is four, and the opening supporting handles are arranged at equal intervals along the circumference of the cross section of the cylindrical sleeve body (6).
5. The novel sterile protective sheath for NOSES resection pull-out surgery according to claim 2, wherein: the sample of protective sheath main part (1) cylindric cover body (6) holds chamber (11) in, is located the one side of closed end (5), is provided with overflow thing collection chamber (12) that are used for accomodating the intestines content that the sample spills over.
6. The novel sterile protective sheath for NOSES resection pull-out surgery according to claim 1, wherein: the sleeve tightening line (2) arranged on the outer side wall of the protective sleeve main body (1) is divided into a plurality of sections and can be independently tightened.
7. The novel sterile protective sheath for NOSES resection pull-out surgery according to claim 1, wherein: the outer surface of the protective sleeve main body (1) is provided with a non-stick coating.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201921271204.3U CN210990590U (en) | 2019-08-07 | 2019-08-07 | Novel aseptic protective sheath suitable for NOSES excision drags out formula operation |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201921271204.3U CN210990590U (en) | 2019-08-07 | 2019-08-07 | Novel aseptic protective sheath suitable for NOSES excision drags out formula operation |
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110353766A (en) * | 2019-08-07 | 2019-10-22 | 辽宁省肿瘤医院 | A kind of novel asepsis protective case suitable for NOSES excision breech pregnancy operation |
| CN111772689A (en) * | 2020-08-06 | 2020-10-16 | 中南大学湘雅医院 | Sample containing device for right-half-colon NOSES operation and using method thereof |
| CN114366184A (en) * | 2021-12-30 | 2022-04-19 | 中南大学湘雅二医院 | NOSES operation sample remove device |
-
2019
- 2019-08-07 CN CN201921271204.3U patent/CN210990590U/en active Active
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110353766A (en) * | 2019-08-07 | 2019-10-22 | 辽宁省肿瘤医院 | A kind of novel asepsis protective case suitable for NOSES excision breech pregnancy operation |
| CN111772689A (en) * | 2020-08-06 | 2020-10-16 | 中南大学湘雅医院 | Sample containing device for right-half-colon NOSES operation and using method thereof |
| CN111772689B (en) * | 2020-08-06 | 2024-01-30 | 中南大学湘雅医院 | Sample containing device for right half-colon NOSES operation and use method thereof |
| CN114366184A (en) * | 2021-12-30 | 2022-04-19 | 中南大学湘雅二医院 | NOSES operation sample remove device |
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