CN215874758U - Gallbladder retractor used under laparoscope - Google Patents

Abstract

The utility model belongs to the technical field of laparoscopic surgical instruments, and relates to a gallbladder retractor used under a laparoscope, which comprises a loop bar component, wherein the loop bar component comprises a fixed sleeve and an inner pull bar arranged in the inner cavity of the fixed sleeve; a handle assembly is arranged at one axial end of the fixed sleeve, a nipper assembly is arranged at the other axial end of the fixed sleeve, and the nipper assembly is connected with the handle assembly through an inner pull rod, so that the size of an opening of the nipper assembly is adjusted; a puncture suction assembly capable of moving axially is also arranged in the inner cavity of the fixed sleeve; the outer surface of the fixed sleeve is also provided with an outer fixed assembly to support the loop bar assembly. The traction apparatus can facilitate the clinical medical care personnel to carry out laparoscopic cholecystectomy, and can reliably position and puncture and decompress the gallbladder.

Description

Gallbladder retractor used under laparoscope

Technical Field

The utility model belongs to the technical field of laparoscopic surgery instruments, and relates to a gallbladder retractor used under a laparoscope.

Background

The laparoscopic surgery is a newly developed minimally invasive method, which is to make a plurality of small incisions of 5-12 mm in different parts of the abdomen, insert cameras and various special surgical instruments from the incisions, transmit images of organs in the abdominal cavity shot by the cameras inserted into the abdominal cavity to a television screen, and finish the surgery by observing the images and operating in vitro. Compared with the traditional operation, the traditional Chinese medicine has the advantages of small wound, quick postoperative recovery, less bleeding, light pain, short hospitalization time and the like. At present, the technical skill of the endoscope is gradually improved, and the endoscope instruments are continuously improved, so that the laparoscope is gradually brought into more and more surgical fields. In hepatobiliary surgery, various hepatobiliary, splenic-pancreatic surgeries can be performed almost under a laparoscope at the present stage.

The gallbladder is pear-shaped, is located in gallbladder fossa below the right lobe of liver, and is attached to liver by connective tissue, and has functions of concentrating and storing bile. The normal gallbladder is about 5-8cm long, 3-5cm wide, and about 40-60ml in volume, and can be divided into four parts, bottom, body, neck, and tube. The bottom is a blind end, the body part extends towards the left upper part to form a body part, the body part is bent towards the front upper part and narrowed to form a cystic neck, the neck part is connected with a cystic duct, the expanded rear wall of the cystic neck forms a funnel-shaped sac called a Hartmann bag, and the cholecystolithiasis is often embedded at the position. A special area exists between the gallbladder and the liver, which is composed of a cystic duct, a common hepatic duct and a lower edge of the liver, is called a gallbladder triangle, and a gallbladder artery passes through the gallbladder triangle, and is an area which is easy to be accidentally injured in biliary tract operation.

In the current classical laparoscopic cholecystectomy, a surgical incision (observation hole) with a length of about 1 cm is made at the upper edge of the umbilicus to create pneumoperitoneum, the pneumoperitoneum pressure is adjusted, the laparoscope is placed in the umbilical hole, meanwhile, a surgical incision (main operation hole) with a length of about 1 cm is made under the xiphoid process and serves as a main operation hole, surgical incisions with a length of about 0.5 cm are respectively made on the clavicular midline (auxiliary operation hole) and the anterior axillary line (auxiliary hole) at the lower edge of the right rib, and surgical instruments and Trocar puncture outfits are respectively placed in the incisions. The auxiliary hole is internally provided with a grasping forceps for grasping and pulling the gallbladder, and the main operation hole enters a separation forceps or an electric coagulation hook to separate the cystic duct from the cystic artery.

The following problems are often encountered with grasping forceps for laparoscopic cholecystectomy: 1. the above procedure usually requires 3 clinicians to perform simultaneously. The main cutter mainly uses a main operation hole and an auxiliary operation hole. The endoscope hand uses the observation hole, the assistant uses the auxiliary hole, the gallbladder is grabbed and lifted by using the nipper tool, and the main knife is assisted to expose the gallbladder triangle. In actual operation, the major operations of cholecystectomy are performed around the gallbladder triangle, and the assistant needs to adjust the operation in a small amount. In the operation, the physician only needs to hold the gallbladder and then hold the position. 2. In acute cholecystitis, the surface tension of the gallbladder is high and the gallbladder is often obviously oozed, and the grasping forceps are often easy to slip when grasping the gallbladder, so that the exposure of the gallbladder triangle and the operation process are influenced. 3. In the acute stage of gallbladder retention with high-tension neck stones, when a user operates, the gallbladder needs to be punctured and decompressed first, and then cholecystectomy is performed. At this time, the gall bladder is scalded by the electrocoagulation hook directly, so that fel can flow out, and then the fel can be sucked out by the suction apparatus. The operation may cause abdominal infection and even abscess, so a rubber drainage tube is often placed after the operation of a patient with decompression of the gallbladder to timely drain the effusion.

Disclosure of Invention

Aiming at the problems, the utility model provides a gallbladder retractor used under a laparoscope, which can facilitate the laparoscopic cholecystectomy of clinical medical personnel and can reliably position and puncture and decompress a gallbladder.

According to the technical scheme of the utility model: a gallbladder retractor used under a laparoscope is characterized in that: the device comprises a loop bar component, wherein the loop bar component comprises a fixed sleeve and an inner pull rod arranged in the inner cavity of the fixed sleeve;

a handle assembly is arranged at one axial end of the fixed sleeve, a nipper assembly is arranged at the other axial end of the fixed sleeve, and the nipper assembly is connected with the handle assembly through an inner pull rod, so that the size of an opening of the nipper assembly is adjusted;

a puncture suction assembly capable of moving axially is also arranged in the inner cavity of the fixed sleeve;

the outer surface of the fixed sleeve is also provided with an outer fixed assembly to support the loop bar assembly.

As a further improvement of the utility model, the handle assembly comprises a fixed handle which is fixedly connected with the fixed sleeve, a movable handle is hinged on the fixed handle, and the movable handle is linked with the inner pull rod through a transmission system.

As a further improvement of the utility model, the fixed handle is provided with a toothed lock catch, and the movable handle is provided with a lock groove part matched with the toothed lock catch.

As a further improvement of the utility model, the puncture suction assembly comprises a drainage tube, one axial end of the drainage tube is connected with the puncture needle through a fixing ring, the other axial end of the drainage tube is connected with a suction device opening arranged on a suction connecting seat arranged on a fixing sleeve, a sliding handle is arranged on the drainage tube, and a strip-shaped open slot is arranged on the fixing sleeve so that the sliding handle can axially move in the strip-shaped open slot.

As a further improvement of the utility model, the puncture suction assembly also comprises a graduated scale arranged on the fixed sleeve.

As a further improvement of the utility model, the grasping forceps component comprises two grasping forceps handles which are respectively hinged at the axial end parts of the fixed sleeve and can be opened and closed, and a plurality of biting teeth and a plurality of hooking teeth are respectively and uniformly distributed on the working surface of each grasping forceps handle;

the inner cavity of the fixed sleeve is provided with a T-shaped pipe, one axial end of the T-shaped pipe is fixedly connected with the inner pull rod, the other axial end of the T-shaped pipe is hinged with two connecting rods, and the two connecting rods are respectively connected with corresponding grasping forceps handles.

As a further improvement of the utility model, the external fixing component comprises a rotating sleeve, the rotating sleeve is sleeved on the fixing sleeve, one axial end of the rotating sleeve is connected with the movable clamp through a pin, a torsion spring is sleeved on the pin, two torsion arms of the torsion spring respectively prop against the movable clamp and the rotating sleeve, a clamping part of the movable clamp is clamped on the surface of the fixing sleeve, and a clamping part of the movable clamp is integrally connected with a handle; the other axial end of the rotating sleeve is uniformly provided with a plurality of pulley devices along the circumferential direction, and each pulley device is respectively and rotatably connected with the movable support.

As a further improvement of the utility model, the movable support is a telescopic support.

As a further improvement of the utility model, the pulley device comprises two bracket ears integrally connected with the end part of the movable bracket, the two bracket ears are supported and connected with pulley rods, the pulley rods are respectively and rotatably provided with a pulley corresponding to the outer side rod body of the bracket ears, the rod body of the pulley rod corresponding to the position between the two bracket ears is sleeved with a second spring, and the axial outer ends of the pulley rods are connected with buttons.

The utility model has the technical effects that: the product of the utility model has simple, reasonable and ingenious structure, and can effectively reduce the number of operating doctors when the laparoscopic cholecystectomy is clinically carried out; the biting teeth and the hooking teeth on the grasping forceps component can effectively avoid the gallbladder slipping during grasping; after the gallbladder is firmly grabbed, the convenient and fast puncture decompression operation can be carried out on the gallbladder.

Drawings

FIG. 1 is a schematic structural diagram of the present invention.

Fig. 2 is a top view of the present invention with the handle assembly removed.

Fig. 3 is a top view of the mobile clip.

Fig. 4 is a schematic view of the connection of the external fixation assembly and the fixation sleeve.

Fig. 5 is a schematic view of the mobile stent of fig. 4 after deployment and extension.

Fig. 6 is a schematic view of the installation position of the pulley device.

Fig. 7 is a schematic structural view of the pulley device.

Detailed Description

The following further describes embodiments of the present invention with reference to the drawings.

In fig. 1 to 7, the forceps assembly includes a forceps assembly 10, a forceps handle 11, a biting tooth 12, a hook tooth 13, a T-shaped tube 14, a first spring 15, a loop bar assembly 20, a fixed sleeve 21, an inner pull rod 22, a puncture suction assembly 30, a puncture needle 31, a sliding handle 32, a drainage tube 33, a suction device port 34, a suction seat 35, a fixed ring 36, a scale 37, a handle assembly 40, a fixed handle 41, a moving handle 42, a toothed lock 43, a transmission system 44, an outer fixed assembly 50, a rotating sleeve 51, a movable clamp 52, a pulley device 53, a pulley rod 53-1, a pulley 53-2, a bracket ear 53-3, a button 53-4, a second spring 53-5, a movable bracket 54, a handle 55, a pin 56, a torsion spring 57, a clamping plate 58, and the like.

As shown in fig. 1 to 7, the utility model relates to a gallbladder retractor used under a laparoscope, which comprises a sleeve rod assembly 20, wherein the sleeve rod assembly 20 comprises a fixed sleeve 21 and an inner pull rod 22 arranged in an inner cavity of the fixed sleeve 21.

The axial one end of fixed sleeve 21 sets up handle components 40, and the axial other end of fixed sleeve 21 sets up nipper subassembly 10, nipper subassembly 10 is connected through inner pull rod 22 with handle components 40 to the realization is to the regulation of nipper subassembly 10 opening size.

The fixed cannula 21 is also provided with a puncture suction assembly 30 which can move axially in the inner cavity.

The outer surface of the retaining sleeve 21 is also provided with an outer retaining assembly 50 to provide support for the stem assembly 20.

The handle assembly 40 comprises a fixed handle 41, the fixed handle 41 is fixedly connected with the fixed sleeve 21, a movable handle 42 is hinged on the fixed handle 41, the movable handle 42 is linked with the inner pull rod 22 through a transmission system 44, a toothed lock catch 43 is arranged on the fixed handle 41, and a lock groove part matched with the toothed lock catch 43 is arranged on the movable handle 42. Finger connecting holes are respectively formed in the lower parts of the fixed handle 41 and the movable handle 42, so that medical staff can conveniently hold the medical staff. The transmission system 44 mainly serves the purpose of connecting the upper end of the movable handle 42 with the inner pull rod 22, and in a specific arrangement, the transmission system 44 can be a connecting rod member.

As shown in fig. 2, the puncture suction assembly 30 includes a drainage tube 33, one axial end of the drainage tube 33 is connected with the puncture needle 31 through a fixing ring 36, the other axial end of the drainage tube 33 is connected with a suction device port 34 arranged on a suction connecting seat 35 arranged on the fixing sleeve 21, a sliding handle 32 is arranged on the drainage tube 33, and a strip-shaped opening groove is arranged on the fixing sleeve 21 so that the sliding handle 32 can axially move in the strip-shaped opening groove. Because one end of the drainage tube 33 is connected with the aspirator port 34, and the puncture needle 31 is fixed at the other end, in order to realize the axial movement adjustment of the drainage tube 33, a plurality of annular expansion parts extending axially are arranged on the drainage tube 33, two adjacent annular expansion parts are connected through an annular folding part, and the combination of the annular expansion parts and the annular folding part enables the drainage tube 33 to carry out the axial telescopic movement adjustment, namely, the puncture operation of the puncture needle 31 is realized.

The puncture suction assembly 30 further comprises a graduated scale 37 arranged on the fixed sleeve 21, and the graduated scale 37 is used for accurately measuring the extending length of the drainage tube 33 so as to realize accurate measurement of the puncture depth of the puncture needle 31. After the puncture needle 31 punctures the gall bladder, the aspirator port 34 is connected with an external negative pressure aspirator, so that the felon can be led out, the gall bladder decompression is completed, and the felon can not flow into the abdominal cavity to cause infection. Because the fixed sleeve 21 is provided with an axially through inner cavity, the inner pull rod 22 is arranged in the fixed sleeve 21 and is coaxially arranged with the fixed sleeve 21, and the T-shaped pipe 14 is arranged in the inner cavity of the fixed sleeve 21, it can be understood that the T-shaped pipe 14 is in positioning fit with the inner wall of the front end of the fixed sleeve 21; the puncture needle 31 of the puncture suction assembly 30 may be extended from the inner cavity of the fixed cannula 21 at a position corresponding to the lower position of the T-shaped tube 14.

As shown in fig. 1, the grasper assembly 10 includes two grasper handles 11 hinged to the axial ends of the fixing sleeve 21 respectively and capable of being opened and closed, and a plurality of engaging teeth 12 and a plurality of hook teeth 13 are uniformly distributed on the working surface of each grasper handle 11 respectively. The biting teeth 12 are arc-shaped, the hook teeth 13 are hook-shaped, the opening degree of the grasping forceps handle 11 is larger than 120 degrees, and compared with the traditional laparoscopic grasping forceps, the opening and closing angle of the grasping forceps is larger; the gripping force can be adjusted and controlled by utilizing the closing degree of the handle, the toothed lock catch 43 on the fixed handle 41 is matched with the lock groove on the movable handle 42, and under the condition of lower closing degree, the arc-shaped biting teeth 12 can reduce the damage to the gallbladder wall. Under the condition of tight closure degree, even if the surface of the gallbladder is smooth and is not easy to grasp, the hook teeth 13 can play a role of firmly grasping the gallbladder.

The inner cavity of the fixed sleeve 21 is provided with a T-shaped pipe 14, one axial end of the T-shaped pipe 14 is fixedly connected with the inner pull rod 22, the other axial end of the T-shaped pipe 14 is hinged with two connecting rods 16, and the two connecting rods 16 are respectively connected with corresponding grasping forceps handles 11. The first spring 15 is sleeved on the axial extension part of the T-shaped pipe 14, one axial end of the first spring 15 is tightly pressed on the radial extension part of the T-shaped pipe 14, and the other axial end of the first spring 15 is tightly pressed on the closing part of the fixed sleeve 21.

As shown in fig. 4 to 7, the external fixing assembly 50 includes a rotating sleeve 51, the rotating sleeve 51 is sleeved on the fixing sleeve 21, one axial end of the rotating sleeve 51 is connected to the movable clamp 52 through a pin 56, the pin 56 is sleeved with a torsion spring 57, two torsion arms of the torsion spring 57 respectively prop against the movable clamp 52 and the rotating sleeve 51, a clamping portion of the movable clamp 52 is clamped on the surface of the fixing sleeve 21, and a clamping portion of the movable clamp 52 is integrally connected to a handle 55; the other axial end of the rotating sleeve 51 is uniformly provided with a plurality of pulley devices 53 along the circumferential direction, each pulley device 53 is rotatably connected with a movable support 54, and the movable support 54 is a telescopic support.

The pulley device 53 comprises two bracket ears 53-3 integrally connected to the end of the movable bracket 54, pulley rods 53-1 are supported and connected on the two bracket ears 53-3, pulleys 53-2 are respectively and rotatably arranged on the outer side rod bodies of the pulley rods 53-1 corresponding to the bracket ears 53-3, second springs 53-5 are sleeved on the rod bodies of the pulley rods 53-1 corresponding to the two bracket ears 53-3, and buttons 53-4 are connected to the axial outer ends of the pulley rods 53-1.

As shown in fig. 3, when cholecystectomy is performed under a four-port laparoscope, medical staff can pull the gallbladder to expose gallbladder triangles, and in operations requiring few times of position adjustment, the movable clamp is designed in a matching manner. At the beginning of the operation, by adjusting the position of the grasper assembly 10, the entire grasper assembly 10 is clamped against the skin by the movable clamp in vitro, and the position of the entire grasper assembly 10 is fixed by the friction between the skin and the grasper assembly 10, and the movable clamp functions as an assistant. The operation which can be completed by three persons can be completed by the doctor with the main knife and the hand of the endoscope.

As shown in fig. 4 to 7, for the obese patient, the fixing effect of the movable clamp may be poor, and an external fixing component 50 is further designed, the external fixing component 50 is fixed on the surface of the fixed sleeve 21 by a movable clamp 52, and the movable clamp 52 is connected with a rotating sleeve 51. In use, the movable clamp 52 is separated from the stationary sleeve 21 by grasping the handle 55 of the movable clamp 52, so that the entire outer fixing assembly 50 can be moved axially and rotated relative to the stationary sleeve 21 to change the position of the movable bracket 54. When the three-end-push-button type rotary sleeve is used, when the two-end-push-button type rotary sleeve 51 is pressed, the second spring 53-5 is pressed, the gap between the bracket ear 53-3 and the pulley 53-2 is increased, the movable bracket 54 can freely move, and the angle between the movable bracket 54 and the fixed sleeve 21 can be conveniently adjusted. When the both-end button 53-4 is released, the second spring 53-5 is extended, and the bracket ear 53-3 is fixed between the second spring 53-5 and the pulley 53-2 so as not to be moved, thereby fixing the movable bracket 54. A telescopic ring is arranged between the movable brackets 54, and the angle between the movable brackets 54 and the fixed sleeve 21 can be changed by adjusting the length of the telescopic ring. Also extracorporeally, the entire grasper assembly 10 is held in the adjusted position extracorporeally by the mobile clamp, serving as an assistant.

Claims (9)

1. A gallbladder retractor used under a laparoscope is characterized in that: the telescopic rod comprises a sleeve rod component (20), wherein the sleeve rod component (20) comprises a fixed sleeve (21) and an inner pull rod (22) arranged in the inner cavity of the fixed sleeve (21);

a handle assembly (40) is arranged at one axial end of the fixed sleeve (21), a nipper assembly (10) is arranged at the other axial end of the fixed sleeve (21), and the nipper assembly (10) is connected with the handle assembly (40) through an inner pull rod (22) so as to adjust the size of an opening of the nipper assembly (10);

a puncture suction component (30) capable of moving axially is also arranged in the inner cavity of the fixed sleeve (21);

the outer surface of the fixed sleeve (21) is also provided with an outer fixed assembly (50) to realize the support of the sleeve rod assembly (20).

2. A laparoscopic gallbladder retractor as claimed in claim 1 wherein: the handle assembly (40) comprises a fixed handle (41), the fixed handle (41) is fixedly connected with the fixed sleeve (21), a movable handle (42) is hinged to the fixed handle (41), and the movable handle (42) is linked with the inner pull rod (22) through a transmission system (44).

3. A laparoscopic gallbladder retractor as claimed in claim 2, wherein: the fixed handle (41) is provided with a toothed lock catch (43), and the movable handle (42) is provided with a lock groove part matched with the toothed lock catch (43).

4. A laparoscopic gallbladder retractor as claimed in claim 1 wherein: puncture attraction subassembly (30) include drainage tube (33), and puncture needle (31) are connected through solid fixed ring (36) to the axial one end of drainage tube (33), and the axial other end of drainage tube (33) is connected with aspirator mouth (34) that set up on attraction connecting seat (35) that set up on fixed sleeve pipe (21), sets up slide handle (32) on drainage tube (33), is provided with the bar open slot on fixed sleeve pipe (21) to slide handle (32) can axial displacement in the bar open slot.

5. A laparoscopic gallbladder retractor as claimed in claim 4 wherein: the puncture suction assembly (30) further comprises a graduated scale (37) arranged on the fixed sleeve (21).

6. A laparoscopic gallbladder retractor as claimed in claim 1 wherein: the grasping forceps assembly (10) comprises two grasping forceps handles (11) which are respectively hinged to the axial end parts of the fixed sleeve (21) and can be opened and closed for adjustment, and a plurality of biting teeth (12) and a plurality of hooking teeth (13) are respectively and uniformly distributed on the working surface of each grasping forceps handle (11);

the inner cavity of the fixed sleeve (21) is provided with a T-shaped pipe (14), one axial end of the T-shaped pipe (14) is fixedly connected with the inner pull rod (22), the other axial end of the T-shaped pipe (14) is hinged with two connecting rods (16), and the two connecting rods (16) are respectively connected with corresponding grasping forceps handles (11).

7. A laparoscopic gallbladder retractor as claimed in claim 1 wherein: the outer fixing component (50) comprises a rotating sleeve (51), the rotating sleeve (51) is sleeved on the fixing sleeve (21), one axial end of the rotating sleeve (51) is connected with the movable clamp (52) through a pin (56), a torsion spring (57) is sleeved on the pin (56), two torsion arms of the torsion spring (57) are respectively propped against the movable clamp (52) and the rotating sleeve (51), a clamping part of the movable clamp (52) is clamped on the surface of the fixing sleeve (21), and a clamping part of the movable clamp (52) is integrally connected with a handle (55); the other axial end of the rotary sleeve (51) is uniformly provided with a plurality of pulley devices (53) along the circumferential direction, and each pulley device (53) is respectively connected with a movable support (54) in a rotating way.

8. A laparoscopic gallbladder retractor as claimed in claim 7 wherein: the movable support (54) is a telescopic support.

9. A laparoscopic gallbladder retractor as claimed in claim 7 wherein: the pulley device (53) comprises two support ear parts (53-3) integrally connected to the end part of the movable support (54), pulley rods (53-1) are supported and connected on the two support ear parts (53-3), pulleys (53-2) are respectively rotatably arranged on the outer side rod body of each pulley rod (53-1) corresponding to the support ear part (53-3), a second spring (53-5) is sleeved on the rod body of each pulley rod (53-1) corresponding to the position between the two support ear parts (53-3), and buttons (53-4) are connected to the axial outer ends of the pulley rods (53-1).

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