JP2001333911A - Unit retaining elevated intrapelvic organs by pressing perineum - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a unit for lifting various kinds of organs in the pelvic bottom by pressing the perineum and retaining a fixed elevated level during operations for long hours without resorting to human strength. SOLUTION: This unit consists of a component pressing the perineum 1, a retainer 2 that retains a fixed elevated level of various organs in the pelvic bottom, a vertical component 5a that fixes a substrate 3 and the retainer 2 to be inserted between a patient's buttock and an operating table to a desired height toward a vertical direction and an L-shaped fixture 5 having a horizontal component 5b that fixes the substrate 3 and the retainer 2 to a desired position toward a horizontal direction.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a perineal pressure relief cage.

[0002]

2. Description of the Related Art Conventionally, rectum, bladder,
When performing surgery on a diseased part such as cancer that has occurred in various organs such as the prostate and uterus, hold the hand of a person and use it as a fist, press the perineum through the cloth, and lift the organs inside the pelvic floor. In order to ensure the surgeon's view of the operation and facilitate the operation, the required lifting state is maintained with the pressing force of the hand for a long time until the operation is completed. Was.

[0003]

However, it is difficult not only to require a considerable amount of labor but also to ensure a state of evacuating with a constant pressing force for a long time by the pressing force of the hand. , It is difficult to secure a certain surgical field of view, causing inconvenience to the operation such as temporarily suspending the operation,
Inconveniences such as inefficiency have occurred.

[0004]

DISCLOSURE OF THE INVENTION The present invention solves the above-mentioned problems of the prior art, and can secure a stable and constant retraction for a long time without manual operation, thereby improving the surgical field of view of the surgeon. It is possible to perform the operation quickly, accurately, and efficiently while securing the inside, and at the same time, to perform the operation smoothly and smoothly without applying excessive pressing force to the patient or damaging the pressing contact part. The present invention provides a perineal pressure elevating cage, which receives a perineal pressure elevating device from the back and presses the perineum from the back, and removes a pelvic floor organ by the elevating device. A holder for fixing and holding in a raised state, a board inserted between a patient's buttocks and an operating table, and a fixture for fixing the holder by a fastener at a desired vertical position in a vertical direction. Vertical members and the substrate can be horizontally oriented Characterized in that it consists of a horizontal member for attaching freely fixed by the fastener L-shaped fixture with consisting in location.

[0005]

Embodiments of the present invention will be described with reference to the accompanying drawings. FIG. 1 is an exploded view of a perineal part pressure elevating holder (hereinafter, referred to as the present apparatus) according to an embodiment of the present invention, FIG. 2 is an assembly view of the present apparatus, and FIG. 3 is a III-III of FIG. FIG. 3 shows a cross-sectional view of the line along the center line. The instrument generally consists of the following four components. That is, in order to fix the perineal pressure elevating device 1 for pressing the perineum and the organ in the pelvic floor by receiving the perineal pressure elevating device 1 from the back side, and to keep the pressure elevating state. , A substrate 3 inserted between a patient's buttocks and an operating table, a vertical member 5a for fixing the holder 2 at a desired vertical position by a fastener 4, and a vertical member 5a. And a horizontal member 5b to which the fixing member 3 is fixed at a desired position in the horizontal direction by a fastener 6.

[0006] The perineal pressure elimination device 1 is made of a sterilizable material selected from metals such as stainless steel and aluminum, hard synthetic resin, hard rubber, stone and the like. It is preferable that the surface 1a is formed as a rounded pressing surface so that the contact with the perineum is soft and smooth, and the organ in the pelvic floor can be lifted up. The shape from the peripheral side surface to the back surface that does not hit the perineum may be formed in a columnar shape or the like. For example, it may be of a shell type, but in the example shown in the figure, the perineal pressure elimination device 1 is a lightweight hollow sphere made of stainless steel, and its size is, for example, 70 mm in diameter.

The holder 2 is also made of a sterilizable metal or hard synthetic resin material. The illustrated one is a processed product made of stainless steel. Its configuration is such that a trumpet-shaped or dish-shaped peripheral wall having a front end with an inner diameter of 67 mm, the diameter of which decreases with decreasing distance toward the rear end, for receiving and supporting the rear spherical surface of the spherical perineal pressure relief device 1 from the back surface. The tip of the mold receiving portion 2a is connected to the circular rear end wall 2a1 of the receiving portion 2a by a screw 7 and extends rearward of the receiving portion 2a.
mm and a connecting portion 2c integrally formed by welding the rear end face of the supporting rod 2b, and the connecting portion 2c is further provided with a connecting tube 2c2 having a through hole 2c1 formed in the vertical direction. And a screw cylinder 2c3 penetrating through the rear wall 2c21 of the connecting cylinder 2c2 and projecting horizontally from the rear wall 2c21. Thus, the holder 2 is inserted into the through hole 2c1 of the connecting portion 2c from below by inserting the vertical member 5a of the L-shaped fixture 5 from below, as will be described in detail later. At this position, the fastener 4 composed of a screw rod or the like is screwed into the screw cylinder 2c3, and the vertical member 5a is connected to the front wall 2c2 of the connecting cylinder 2c2.
2 so that the holder 2 can be freely tightened to a desired height position of the vertical member 5a.

The substrate 3 is also made of a material made of a metal or hard synthetic resin that can be sterilized by steam sterilization or the like, but the one shown in the figure is made of stainless steel. Its configuration and dimensions are, for example, a rectangular substrate main body 3a having a length of 330 mm, a width of 300 mm, and a thickness of 15 mm, and one end face in the longitudinal direction of the substrate main body 3a provided on a central axis of the width. An insertion hole 3b for inserting the horizontal member 5b of the L-shaped mounting member 5 and a long insertion space inside the substrate main body 3a, in which at least the entire length of the horizontal member 5b can be inserted in front of the insertion hole 3b. 3c and the lower wall 2a of the substrate main body 3a located on the back surface of the substrate main body 3a near the insertion opening 3b.
1 and a screw tube 3d provided integrally and protruding downward from the back surface. Thus, a fastener 6 such as a screw rod is screwed into the screw tube 3d, and the insertion port 3b is inserted.
L inserted into the insertion space 3c from the desired length.
The horizontal member 5b of the V-shaped mounting member 5 is fixed to the upper wall 3a2 of the substrate main body 3a by tightening it from the lower surface, and the holder 2 can be mounted at a desired position in the front-rear direction so as to be freely rotatable.

The L-shaped fitting 5 is also made of a sterilizable metal.
The L-shaped member 5 is made of a rigid synthetic resin or the like.
The shape of each of a and 5b may be a rod shape or a plate shape, but as shown in the figure, it is preferable that the shape is a thin and appropriately wide plate shape, and made of stainless steel. In the illustrated example, the vertical member 5a of the fixture 5 has a height of 180 mm and a width of 30 m.
m, a vertical plate-shaped vertical member having a thickness of 3 mm, and the horizontal member 5b is a horizontal plate-shaped horizontal member having a length of 150mm, a width of 30mm, and a thickness of 3mm, but is of course limited to these dimensions. Not something. Accordingly, as shown in the figure, the connecting cylinder of the holder 2 through which the plate-shaped vertical member 5a of the mounting tool 5 is inserted is a flat rectangular connecting cylinder, and penetrates in the vertical direction. The through-hole 2c1 is preferably formed as a rectangular through-hole having a width and a gap suitable for inserting the vertical member 5a just in sliding contact as shown in the figure. The dimension of the insertion port 3b provided in the substrate 3 into which the 5b is inserted is a rectangular insertion port having a width and a height suitable for sliding contact with the four peripheral surfaces of the horizontal member 5b as shown in the figure. At the same time, the height space of the insertion space 3c is the horizontal member 5b to be inserted.
Of the plate-shaped horizontal member 5b, and has a height suitable for being inserted while the upper and lower surfaces of the plate-shaped horizontal member 5b are in sliding contact. The length of the insertion space 3c is equal to the total length of the horizontal member 5b. , It is preferably somewhat longer.
The width of the insertion space 3c is substantially equal to the width of the horizontal member 5b, as shown in the drawing, and is a size that is in sliding contact with both side surfaces of the horizontal member 5b. Thus, the overall shape of the insertion space 3c is It is generally preferable that the space be a long rectangular sheath-like space into which the horizontal member 5b is inserted, but the width is not limited to this. Accordingly, the width of the insertion opening 3B can be appropriately widened, thereby enabling the horizontal member 5b to move slightly left or right from the center. The position in the horizontal direction may be adjusted to the left or right from the right. It is preferable that the distal ends of the vertical member 5a and the horizontal member 5b are formed to have a gradually smaller width so that they can be easily inserted into the slit-shaped through hole 2c1 and the rectangular insertion opening 3b, respectively.

FIGS. 2 and 3 are a perspective view and a cross-sectional view taken along the center of the main unit shown in FIG. 1 in a state where respective constituent members are assembled. As shown in FIG. 3, the holder 2 is slidable in the vertical direction on the vertical member 5a of the L-shaped mounting member 5 as shown by an arrow, so that the holder 2 has a desired height position. The holding member 2 can be set from the desired retreat position to the advance position by freely inserting the holder 5 in the front-rear direction as shown by the arrow. Reference numeral 8 denotes a rectangular thin rubber sheet adhered to substantially the entire back surface of the substrate 3, and as described later, since the surface of the metal substrate 3 is smooth, the operation table and the patient's buttocks are attached. In a state of being used by being used by being inserted between them, it is helpful to appropriately suppress the slip so as not to slip too much.

FIG. 4 shows an example of use of the present instrument. For example, when performing an operation on the affected part of the rectum / anal tract, before starting the operation, first, as shown in FIG. 4 (a), between the operating table A and the buttocks B of the patient lying on the operating table A. In this case, the screw cylinder 3d protruding from the rear surface of the rear end of the substrate 3 is positioned so as to protrude rearward from the rear end of the operating table A, and the center of the rear end surface is inserted. Is positioned on the center line of the patient's perineum.
In addition, upon insertion, the sheet 9 is interposed between the buttocks B of the patient and the board 3 over the entire upper surface of the board 3 so as to prevent energization of the board 3 when using an electric scalpel or the like in surgery. To

From this state, the leading end of the horizontal member 5b of the L-shaped fixture 5 is appropriately inserted into the substrate 3 and placed at the retracted position, and the screw 6 is temporarily screwed into the screw cylinder 3d. Then, the horizontal member 5b is tightened and set at that position. In this state, the holding tool 2 is inserted into the upper end of the vertical member 5a of the mounting tool 5 through the slit-shaped through hole of the connecting portion 2c, and the fastening tool 4 is screwed into the screw cylinder 2c3. Tightening,
The holder 2 is set at the preparation position.

At the same time, on the other hand, the operator holds the spherical perineal pressure lifting device 1 in his hand H and presses strongly against the perineum C via the cover 10 as shown in FIG. Fig. 4
As shown in (b), the various organs D such as the rectum and anal canal in the pelvic floor are raised. On the other hand, another worker once loosens the holder 2 set in the preparation state of FIG. 4 (a), and as shown in FIG. Down to the tightening set again,
By tightening the screw 3d, the L-shaped attachment 5 is
4C, the perineal pressure lifting device 1 is received and pressed from the back by a trumpet-shaped dish-shaped receiving portion 2a at the tip of the device, as shown in FIG. While holding, the horizontal member 4b is tightened again by the screw rod 3d, and the holder 2 is set at the above-described required retraction position advance position. Thus, thereafter, the manual pressing force is eliminated, and instead, the required retraction state can be secured by the device for a long time from the start of the operation to the end of the operation. The visual field is secured, and the operation can be performed stably and efficiently with high efficiency.

When the holder 2 connected to the base plate 3 is used and an excessive pressing force is applied to the perineum C by using the device, the holder is placed on the operating table A. Since the substrate 3 which has just been retracted by itself is moderately retracted, it does not cause damage such as congestion due to excessive pressure on the perineum during the operation,
Surgery can be performed well with confidence. In addition, since the pressing surface 1a of the retraction device 1 against the perineum C is also spherical, the hit is soft and there is no danger of damage.

After the operation, the instrument can be removed from the operating table and disassembled into its components, so that the sterilization operation can be performed well and the space for storage can be small.

As a modification of the present invention, although not shown, the perineal part pressure lifting device 1 and the receiving portion 2a of the holder 2 are not shown.
And the periphery of the body are previously joined together by welding or adhesive,
The device may be configured to reduce the number of components to facilitate handling such as carrying. However, as in the previous embodiment, the perineal pressure relief provided separately from the holder 2 is used. It is common to hold the upper tool 1 in hand and press the perineum, so that a finely adjusted retraction state is obtained.

[0017]

As described above, the present device can solve the above-mentioned conventional problem of pressing the perineum with a conventional fist of a hand to relieve and raise various organs in the pelvic floor, and can end the operation from the start of the operation. Since a constant retraction can be ensured for a long time until the operation, the operation can be performed easily, accurately and efficiently.
In addition, the holder can be set vertically and continuously on the vertical member of the L-shaped fixture so as to be finely adjustable according to the patient, and the horizontal member can be attached to the board in the front-rear direction. Since it can be continuously and finely set at the desired front-rear position, the distance in the front-rear direction of the holder and the degree of pressing and holding the retraction device for pressing the perineum can be set as desired. Bring the effect. In addition, since the substrate is inserted between the operating table and the buttocks of the patient, it is preferable that the pressing force against the patient's perineum, which is pressed by the holder attached to the substrate via the mounting tool, be applied unduly. Surgery can be performed on the condition.

[Brief description of the drawings]

FIG. 1 is an exploded perspective view of a perineal pressure retraction cage according to an embodiment of the present invention.

FIG. 2 is a perspective view of the device in an assembled state.

FIG. 3 is a sectional view taken along line III-III of FIG. 2;

4A and 4B are side views of a use state of the present device, in which FIG. 4A is a view of a state where a perineal pressure lifting device is held in hand and is applied to a patient's perineum, and FIG. FIG. 4C is a diagram showing a state in which various organs in the pelvic floor are pressed and evacuated and lifted, and FIG.

[Explanation of symbols]

REFERENCE SIGNS LIST 1 perineal pressure lifting device 1 a rounded pressing surface 2 holder 3 substrate 4 clamp 5 L-shaped fixture 6 clamp

Claims (1)

[Claims] A perineal pressure relief device for pressing the perineum;
A holder for receiving the perineal elevating device from the back and fixing the organ of the pelvic floor by the elevating device in a required elevating state, and inserted between the patient's buttocks and the operating table. A substrate, a vertical member for fixing the holder at a desired vertical position so as to be fixed by a fastener, and a horizontal member for fixing the substrate at a desired position in the horizontal direction so as to be fixable by a fastener. And a L-shaped fitting comprising: