JP6411420B2 - Retractor holding device - Google Patents

Retractor holding device Download PDF

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JP6411420B2
JP6411420B2 JP2016171718A JP2016171718A JP6411420B2 JP 6411420 B2 JP6411420 B2 JP 6411420B2 JP 2016171718 A JP2016171718 A JP 2016171718A JP 2016171718 A JP2016171718 A JP 2016171718A JP 6411420 B2 JP6411420 B2 JP 6411420B2
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retractor
holding device
core
extending
support
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JP2018033833A (en
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尚伸 高平
尚伸 高平
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Kitasato Institute
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Description

本発明は、レトラクター保持装置に関する。   The present invention relates to a retractor holding device.

近年、疾病や事故、加齢等によって股関節の構成部位が損傷を受け、股関節に痛みを生じさせる変形性股関節症、関節リウマチ、大腿骨頭壊死等に代表される疾患において、保存療法を行っても股関節痛が軽減しない場合や、症状或いは股関節変形がかなり進行している場合等には、損傷を受けた部分を人工股関節に置換する人工股関節置換術が行われている。   In recent years, conservative therapy has been performed for diseases such as osteoarthritis, rheumatoid arthritis, and femoral head necrosis that cause damage to the hip joint due to illness, accidents, aging, etc. When hip pain is not alleviated, or when symptoms or hip joint deformation has progressed considerably, artificial hip joint replacement is performed in which a damaged portion is replaced with an artificial hip joint.

人工股関節置換術では、損傷を受けた股関節を上述の人工股関節に置換するため、術者によって患者の損傷を受けた部分が開創され、開創部をレトラクターと呼ばれる器具によって広げた状態で手術が進められる。レトラクターは、深部の開創手術から小切開手術に至る多種多様な術式や手術手技、患者の体型等に対応するために、数百種類以上の形状で形成されている。   In hip replacement, the damaged hip joint is replaced with the above-mentioned hip prosthesis, so that the surgeon opens the damaged part of the patient and expands the retracted part with a device called a retractor. It is advanced. Retractors are formed in hundreds or more types in order to cope with a wide variety of surgical procedures, surgical techniques, patient body shapes, etc. from deep wound surgery to small incision surgery.

手術時には、術者が術野を見易くなるように、開創部を中心として複数のレトラクターを平面視放射状に配置し、開創部の筋組織等を拡げる。このような配置のレトラクターを固定するための装置として、例えば、特許文献1には、レトラクターをアーム部に固定するレトラクター固定機構がアーム先端側部に対してスライド可能且つ回転可能に構成されたレトラクター固定装置が開示されている。このレトラクター固定装置では、連結機構をロッド部に対してスライドさせることで、アーム部がロッド部の長手方向に平行移動し、連結機構をロッド部に対して回転させることで、アーム部が回転移動する。   At the time of surgery, a plurality of retractors are arranged radially in plan view around the retracted portion so that the surgeon can easily see the operative field, and the muscle tissue and the like of the retracted portion are expanded. As an apparatus for fixing a retractor having such an arrangement, for example, in Patent Document 1, a retractor fixing mechanism that fixes a retractor to an arm part is configured to be slidable and rotatable with respect to the arm tip side part. An improved retractor locking device is disclosed. In this retractor fixing device, the arm mechanism is moved in parallel with the longitudinal direction of the rod part by sliding the connecting mechanism with respect to the rod part, and the arm part is rotated by rotating the connecting mechanism with respect to the rod part. Moving.

実用新案登録第3181075号公報Utility Model Registration No. 3181075

人工股関節置換術において、上述のように、開創部を中心として平面視放射状に配置された複数のレトラクターは、特許文献1に記載のレトラクター固定装置をはじめとするレトラクター専用の固定装置類や助手によって保持されていた。   In artificial hip joint replacement, as described above, a plurality of retractors arranged radially in plan view with the retracted portion as the center are fixed devices for the retractor including the retractor fixing device described in Patent Document 1. And was held by an assistant.

前述のようにレトラクター専用の従来の固定装置を用いてレトラクターを保持すると、レトラクターの位置や姿勢を変更する度に術者によるレトラクターの固定作業が発生し、術者への負担が大きくなるという問題や、レトラクターの固定作業回数が増える程ジョイント部分が硬くなる傾向がみられるという問題、加えてレトラクターが固定装置に強く固定されていることで、患者が多少動いた場合等に筋組織を傷付けかねないという問題があった。また、レトラクターを助手が保持すると、助手が正確なレトラクターの保持に慣れていない場合に、筋組織にダメージを与えてしまう虞や、長時間の保持により助手が疲労し、筋組織等を充分拡げられなくなるという問題があった。   As mentioned above, if the retractor is held using a conventional fixing device dedicated to the retractor, the retractor must be fixed every time the retractor's position or posture is changed, which puts a burden on the surgeon. The problem is that the joint part tends to become harder as the number of times the fixing work of the retractor increases, and the retractor is firmly fixed to the fixing device, so that the patient moves slightly, etc. There was a problem that could damage the muscle tissue. In addition, if the assistant holds the retractor, if the assistant is not used to accurately holding the retractor, the muscle tissue may be damaged, and the assistant may become tired due to prolonged holding, causing muscle tissue, etc. There was a problem that it could not be expanded sufficiently.

本発明は、上述の問題を解決するために、レトラクターの把持部分(ジョイント部分)が硬くなるのを防ぎ、長時間でも筋組織を傷めずに、かつ手術対象部位を塞がないように筋組織を拡げるレトラクターを保持可能なレトラクター保持装置を提供する。   In order to solve the above-mentioned problems, the present invention prevents the retractor's gripping portion (joint portion) from becoming hard, prevents damage to the muscle tissue even for a long time, and does not block the surgical target site. A retractor holding device capable of holding a retractor that expands a tissue is provided.

本発明に係るレトラクター保持装置は、基端部が前記寝台に取り付け可能に形成され、先端部が寝台の上方に延びている支柱と、前記支柱の先端から水平方向へ延びる延出部と、前記延出部の前記支柱とは反対側の端部から上方に延びる芯部と、前記芯部に対して該芯部を中心として周方向に回動可能に接続された回動部と、前記芯部を中心として径方向に沿って延びる軸部と、を有する複数の延伸部と、前記延伸部の先端に設けられた滑車と、一方の端部が前記軸部に接続され、他方の端部が前記レトラクターの把持部に着脱可能に形成され、前記一方の端部と前記他方の端部との間で前記滑車に巻装されると共に、前記一方の端部と前記滑車への巻装部分との間に弾性部を有するレトラクター支持部材と、を備えていることを特徴とする。   The retractor holding device according to the present invention is formed so that the base end portion can be attached to the bed, the tip portion extends above the bed, and the extension portion extending in the horizontal direction from the tip of the bed, A core part extending upward from an end of the extension part opposite to the support; a rotation part connected to the core part so as to be rotatable in the circumferential direction around the core part; and A plurality of extending portions having a shaft portion extending in the radial direction with the core portion as a center, a pulley provided at a tip of the extending portion, one end portion connected to the shaft portion, and the other end Is formed detachably on the gripping portion of the retractor, and is wound around the pulley between the one end and the other end, and is wound around the one end and the pulley. And a retractor support member having an elastic part between the mounting part and

上述のレトラクター保持装置によれば、患者の開創部を拡げるためのレトラクターは、開創部の筋組織に係止すると共に、レトラクター支持部材によって筋組織を拡げる方向および滑車とレトラクター支持部材の他方の端部とを結ぶ方向に保持される。このようにレトラクター支持部材を用いてレトラクターの把持部を保持するので、従来のようにレトラクターの把持部が何らかの固定具等によって押圧されることもなく、硬くならない。さらに、手術中に患者が動くことがあっても、レトラクター支持部材の弾性部およびレトラクター自体の張力等によって、レトラクターから開創部の筋細胞あるいは筋組織に伝わる力が適度に分散され、レトラクターの適度な緊張度が保たれ、筋細胞あるいは筋組織へのダメージが抑えられる。   According to the above-described retractor holding device, the retractor for expanding the retracted portion of the patient is locked to the muscle tissue of the retracted portion, and the direction of expanding the muscle tissue by the retractor support member, and the pulley and the retractor support member. It is held in the direction connecting the other end of the. Since the retractor support member is used to hold the retractor gripping portion in this way, the retractor gripping portion is not pressed by any fixture or the like as in the prior art and does not become hard. Furthermore, even if the patient may move during surgery, the force transmitted from the retractor to the muscle cells or muscle tissue of the retracted part is moderately dispersed by the elastic part of the retractor support member and the tension of the retractor itself, The moderate tension of the retractor is maintained and damage to muscle cells or muscle tissue is suppressed.

上述のレトラクター保持装置は、前記レトラクターの把持部に着脱可能に形成された重錘をさらに備えていることが好ましい。
レトラクターの把持部を開創部よりも下方に保持するレトラクターについては、レトラクターの傾斜姿勢に応じて、レトラクターの把持部に重錘を付けることで、レトラクター支持部材がレトラクターを上方に支持する力に対して適度に重力が付加され、所望のレトラクターの傾斜姿勢が容易に保持される。
It is preferable that the above-described retractor holding device further includes a weight that is detachably attached to the grip portion of the retractor.
For retractors that hold the retractor's gripping part below the retracting part, the retractor support member moves the retractor upward by attaching a weight to the retractor's gripping part according to the tilting posture of the retractor. Gravity is moderately applied to the force that supports the desired retractor, so that the desired retractor posture can be easily maintained.

また、上述のレトラクター保持装置では、前記軸部は前記芯部を中心として径方向に沿って伸縮可能であることが好ましい。   Moreover, in the above-mentioned retractor holding device, it is preferable that the said shaft part can be expanded-contracted along a radial direction centering | focusing on the said core part.

また、上述のレトラクター保持装置では、前記レトラクター支持部材の前記一方の端部には、前記芯部に挿通可能に形成された環状の係止部が設けられ、前記係止部には、環状且つ開閉自在に形成された長さ調節部が連結されていることが好ましい。   Further, in the above retractor holding device, the one end portion of the retractor support member is provided with an annular locking portion formed so as to be able to be inserted through the core portion. It is preferable that the length adjustment part formed cyclically | annularly and freely opened and closed is connected.

本発明のレトラクター保持装置によれば、レトラクターの把持部分が硬くなるのを防ぎ、長時間でも筋組織を傷めずに、かつ手術対象部位を塞がないように筋組織を拡げるレトラクターを保持することができる。   According to the retractor holding device of the present invention, there is provided a retractor that prevents the gripping portion of the retractor from being hardened, expands the muscle tissue so as not to damage the muscle tissue even for a long time, and does not block the operation target site. Can be held.

本発明を適用したレトラクター保持装置の概略図である。It is the schematic of the retractor holding device to which this invention is applied. 本発明を適用したレトラクター保持装置の支柱の構成例を示す概略図である。It is the schematic which shows the structural example of the support | pillar of the retractor holding device to which this invention is applied. 本発明を適用したレトラクター保持装置の支柱の別の構成例を示す概略図である。It is the schematic which shows another structural example of the support | pillar of the retractor holding device to which this invention is applied. 本発明を適用したレトラクター保持装置の延伸部および芯部の構造を説明するための概略図である。It is the schematic for demonstrating the structure of the extending | stretching part and core part of the retractor holding device to which this invention is applied. 本発明を適用したレトラクター保持装置のレトラクター支持部材の概略図である。It is the schematic of the retractor support member of the retractor holding device to which this invention is applied. 本発明を適用したレトラクター保持装置を用いたレトラクターの保持方法の変形例を説明するための概略図である。It is the schematic for demonstrating the modification of the retention method of the retractor using the retractor holding device to which this invention is applied.

以下、本発明を適用した一実施形態のレトラクター保持装置について、図面を参照して説明する。なお、以下の説明で用いる図面は模式的なものであり、長さ、幅、厚みの比率等は実際のものと同一とは限らず、適宜変更できる。   Hereinafter, a retractor holding device according to an embodiment to which the present invention is applied will be described with reference to the drawings. The drawings used in the following description are schematic, and the length, width, thickness ratio, and the like are not necessarily the same as the actual ones, and can be changed as appropriate.

本発明を適用した一実施形態(以下、「本実施形態」とする)であるレトラクター保持装置1は、図1に示すように、寝台Bの上に仰向きとされた患者Mの開創部Dを拡げるためのレトラクターR(図1には3本のレトラクターR1,R2,R3を例示)を保持可能に構成されたレトラクター保持装置である。レトラクター保持装置1は、以下に説明する支柱2と、延出部3と、芯部4と、延伸部6と、滑車8と、レトラクター支持部材10と、を備え、重錘14をさらに備えている。   A retractor holding device 1 which is an embodiment to which the present invention is applied (hereinafter referred to as “this embodiment”) is a retractable portion D of a patient M placed on a bed B, as shown in FIG. Is a retractor holding device configured to be able to hold a retractor R (three retractors R1, R2, and R3 are illustrated in FIG. 1). The retractor holding device 1 includes a column 2, an extension portion 3, a core portion 4, an extension portion 6, a pulley 8, and a retractor support member 10 described below, and further includes a weight 14. I have.

レトラクターRは、図1に一例を示すように、ステンレスまたは酸化チタン等の金属製の帯状部材を加工して製造される器具である。帯状部材の一方の端部は屈曲しており、屈曲した部分の内側に開創部Dの筋組織を挿入することで開創部の筋組織に係止する。すなわち、前述の屈曲した部分は、開創部Dの筋組織に係止する筋組織係止部Raとして機能する。帯状部材の他方の端部は把持部Rbとして機能し、他方の端部には、レトラクターRを保持するための器具等との接続を行う際に用いられる貫通孔が形成されている。筋組織係止部Raを筋組織に係止させた状態でレトラクターRを開創部の外方に向って適度に引きつつ保持することで、開創部Dの筋組織は拡げられる。なお、筋組織係止部Raの先端部は、骨組織に係止していてもよい。   As shown in FIG. 1, the retractor R is an instrument manufactured by processing a metal band member such as stainless steel or titanium oxide. One end of the belt-like member is bent, and is locked to the muscle tissue of the wound portion by inserting the muscle tissue of the wound portion D inside the bent portion. That is, the above-described bent portion functions as a muscle tissue locking portion Ra that locks to the muscle tissue of the wound portion D. The other end portion of the belt-like member functions as a gripping portion Rb, and a through hole used when connecting to an instrument or the like for holding the retractor R is formed at the other end portion. By holding the retractor R while appropriately pulling the retractor R toward the outside of the retracting portion in a state where the muscle tissue locking portion Ra is locked to the muscle tissue, the muscle tissue of the retracting portion D is expanded. Note that the distal end portion of the muscular tissue locking portion Ra may be locked to the bone tissue.

支柱2は、基端部(基端)2aが寝台Bに取り付け可能に形成され、先端部2zが寝台Bの上方に延びている。支柱2の基端部2aは、図2や図3に例示しているような回施用クランプや手術代固定具等を備え、寝台Bの側部に取り付け可能に形成されている。   The column 2 is formed such that a base end (base end) 2 a can be attached to the bed B, and a tip 2 z extends above the bed B. The base end 2a of the column 2 is provided with a turn clamp, a surgical allowance fixture, and the like as illustrated in FIGS. 2 and 3 and is formed so as to be attachable to the side of the bed B.

図2に示す支柱2の基端部2aの構成例は、把持部に支柱2を挿通可能な貫通孔が形成されたクリップ型の本体61と、該本体の把持部の間に配置可能に形成され、支柱2を挿通可能な貫通孔が形成された介在部材62と、を有するものである。この構成では、クリップ型の本体61と介在部材62のそれぞれの貫通孔に支柱2を挿通させ、所定の位置で介在部材62に設けられている固定ねじを締めることで、支柱2が安定して支持可能とされている。また、クリップ型の本体61のクリップ部分を寝台Bの側部に挟み込むことで、支柱2が安定して寝台Bに取り付け可能とされている。   The configuration example of the base end portion 2a of the support column 2 shown in FIG. 2 is formed so as to be disposed between a clip-type main body 61 in which a through-hole through which the support column 2 can be inserted is formed in the grip portion and the grip portion of the main body. And an interposition member 62 in which a through-hole through which the support column 2 can be inserted is formed. In this configuration, the support column 2 is stabilized by inserting the support column 2 through the respective through holes of the clip-type main body 61 and the interposed member 62 and tightening the fixing screw provided on the interposed member 62 at a predetermined position. It can be supported. In addition, the support 2 can be stably attached to the bed B by sandwiching the clip portion of the clip-type main body 61 between the sides of the bed B.

図3に示す支柱2の基端部2aの構成例は、図2に示すクリップ型の本体61のクリップ部分とは反対側の背部に固定ねじが設けられ、クリップ型の本体61の下部に下方からクリップ部分を締めるねじが設けられたものである。図3に示す支柱2の基端部2aの構成例を用いた場合でも、クリップ型の本体61´に形成された貫通孔に支柱2を挿通させ、固定ねじを締めることで、支柱2が安定して支持可能とされている。また、クリップ型の本体61´のクリップ部分を寝台Bの側部に挟み、クリップ部分を締めるねじを締めることで、支柱2が安定して寝台Bに取り付け可能とされている。   The configuration example of the base end portion 2a of the support column 2 shown in FIG. 3 is provided with a fixing screw on the back side opposite to the clip portion of the clip-type main body 61 shown in FIG. A screw for tightening the clip portion is provided. Even when the configuration example of the base end portion 2a of the support column 2 shown in FIG. 3 is used, the support column 2 can be stabilized by inserting the support column 2 through the through-hole formed in the clip-type main body 61 'and tightening the fixing screw. And can be supported. Moreover, the support | pillar 2 can be attached to the bed B stably by pinching the clip part of the clip-type main body 61 'between the sides of the bed B and tightening the screws for fastening the clip part.

レトラクターRの姿勢や傾斜角度を広い範囲で設定可能とする観点から、支柱2は、高さ調節可能に形成されていることが好ましい。図1に示すように、支柱2は、基端部2a側の部材に、先端部2z側の部材が外嵌し、これらの部材の嵌合位置を固定するための固定具が設けられていることで、先端部2z側の部材が基端部2a側の部材に対してスライド可能とされ、伸縮可能に構成されている。   From the viewpoint of enabling the posture and inclination angle of the retractor R to be set in a wide range, the support column 2 is preferably formed so that the height can be adjusted. As shown in FIG. 1, the support | pillar 2 is provided with the fixture for fixing the fitting position of the member of the front-end | tip part 2z side to the member of the base end part 2a side, and fitting these members. Thus, the member on the distal end portion 2z side is slidable with respect to the member on the proximal end portion 2a side, and is configured to be extendable.

延出部3は、支柱2の先端部(先端)2zから水平方向へ延びている。すなわち、延出部3の基端部3aは、支柱2の先端部2zに接続されている。延出部3の先端部(支柱2とは反対側の端部)3zは、患者Mの開創部Dの上方に配置されている。
延出部3の先端部3zにかかる荷重を支えるために、基端部3a側の延出部3と先端部2z側の支柱2には補強部材30が架橋されている。
The extension part 3 extends in the horizontal direction from the tip part (tip) 2z of the support column 2. That is, the base end portion 3 a of the extension portion 3 is connected to the tip end portion 2 z of the support column 2. A distal end portion (end portion opposite to the support column 2) 3z of the extending portion 3 is disposed above the retracted portion D of the patient M.
In order to support a load applied to the distal end portion 3z of the extending portion 3, a reinforcing member 30 is bridged between the extending portion 3 on the proximal end portion 3a side and the support column 2 on the distal end portion 2z side.

図1等には、支柱2と延出部3が一体化され、支柱2と延出部3が支柱2の先端部2zと延出部3の基端部3aとの接続部分に相当する位置で略直角に屈曲している屈曲部材で構成されている例を示している。図示していないが、支柱2の先端部2zと延出部3の基端部3aとの接続部分が略直角に屈折していても構わない。
勿論、支柱2と延出部3は、互いに別体であってもよい。
In FIG. 1 and the like, the support column 2 and the extension portion 3 are integrated, and the support column 2 and the extension portion 3 correspond to a connection portion between the distal end portion 2z of the support column 2 and the proximal end portion 3a of the extension portion 3. The example comprised by the bending member bent by substantially right angle is shown. Although not shown, the connecting portion between the distal end portion 2z of the support column 2 and the proximal end portion 3a of the extending portion 3 may be refracted substantially at a right angle.
Of course, the support column 2 and the extending portion 3 may be separate from each other.

図4に示すように、芯部4は、延出部3の支柱2とは反対側の端部、すなわち延出部3の先端部3zから上方に延びている。芯部4の基端部4aには、フランジ20が設けられている。レトラクター保持装置1の組み立て時には、フランジ20の外周に延出部3の先端部3zが接続可能とされている。
フランジ20の上面には、周方向に沿って所定のピッチを有する凹凸構造からなる嵌合部22が形成されている。フランジ20の上面には、上方に延びる棒状部材24が接続されている。棒状部材24の所定の位置から下部は、ねじ切りされている。
As shown in FIG. 4, the core portion 4 extends upward from the end portion of the extension portion 3 on the side opposite to the column 2, that is, from the tip portion 3 z of the extension portion 3. A flange 20 is provided at the base end portion 4 a of the core portion 4. When the retractor holding device 1 is assembled, the distal end portion 3z of the extending portion 3 can be connected to the outer periphery of the flange 20.
On the upper surface of the flange 20, a fitting portion 22 having a concavo-convex structure having a predetermined pitch along the circumferential direction is formed. A bar-like member 24 extending upward is connected to the upper surface of the flange 20. The lower part from the predetermined position of the rod-shaped member 24 is threaded.

延伸部6は、芯部4に対して芯部4を中心として周方向に回動可能に接続された回動部26と、芯部4を中心として径方向に沿って延びる軸部28と、を有する。   The extending portion 6 is connected to the core portion 4 so as to be rotatable in the circumferential direction around the core portion 4, and a shaft portion 28 extending along the radial direction around the core portion 4. Have

回動部26は、芯部4のフランジ20と略同等の径寸法を有する円筒部材で構成されている。回動部26の上面には、嵌合部22と同様の凹凸構造からなる嵌合部27が形成されている。回動部26の底面には、嵌合部22または嵌合部27に嵌合可能な被嵌合部25が形成されている。すなわち、被嵌合部25は、嵌合部22および嵌合部27の凹凸構造と同一の所定のピッチを有する凸凹構造を有している。回動部26の中心には、円筒部材の軸線方向に沿って、芯部4の棒状部材24を挿通可能な貫通孔26hが形成されている。貫通孔26hの内壁面は、芯部4の棒状部材24の下部に形成されたねじ切り部分に螺合可能となるように、ねじ切りされている。なお、貫通孔26hの内壁面は、自由に回動してもよいように、ねじ切りされていなくてもよい。   The rotating part 26 is configured by a cylindrical member having a diameter that is substantially the same as the flange 20 of the core part 4. On the upper surface of the rotating portion 26, a fitting portion 27 having the same uneven structure as the fitting portion 22 is formed. A fitted portion 25 that can be fitted to the fitting portion 22 or the fitting portion 27 is formed on the bottom surface of the rotating portion 26. In other words, the fitted portion 25 has an uneven structure having a predetermined pitch that is the same as the uneven structure of the fitting portion 22 and the fitting portion 27. A through-hole 26h through which the rod-like member 24 of the core portion 4 can be inserted is formed at the center of the rotating portion 26 along the axial direction of the cylindrical member. The inner wall surface of the through-hole 26h is threaded so that it can be screwed into a threaded portion formed in the lower part of the rod-shaped member 24 of the core part 4. The inner wall surface of the through hole 26h may not be threaded so that it can freely rotate.

最上部に配置される回動部26の上面を保護し、芯部4からの回動部26の抜けを防止する観点から、最上部に配置される回動部26の上に配置可能な蓋部29が用意されていてもよい。その場合、蓋部29の下方に配される部材、すなわち回動部26が固定されるように、蓋部29の内壁面は、芯部4の棒状部材24の下部に形成されたねじ切り部分に螺合可能となるように、ねじ切りされている。   From the viewpoint of protecting the upper surface of the rotating part 26 arranged at the uppermost part and preventing the rotating part 26 from coming off from the core part 4, a lid that can be arranged on the rotating part 26 arranged at the uppermost part. The part 29 may be prepared. In that case, the inner wall surface of the lid portion 29 is a threaded portion formed at the lower portion of the rod-shaped member 24 of the core portion 4 so that the member disposed below the lid portion 29, that is, the rotating portion 26 is fixed. It is threaded so that it can be screwed together.

軸部28は、棒状部材で構成されている。レトラクターRの姿勢や傾斜角度を広い範囲で設定可能とする観点から、軸部28は、芯部4を中心として径方向に沿って伸縮可能であることが好ましい。そのため、軸部28は、基端部28a側の部材に、先端部28z側の部材が外嵌し、これらの部材の嵌合位置を固定するための固定具が設けられていることで、先端部28z側の部材が基端部2a側の部材に対してスライド可能とされ、伸縮可能に構成されている。   The axial part 28 is comprised with the rod-shaped member. From the viewpoint of enabling the posture and inclination angle of the retractor R to be set in a wide range, the shaft portion 28 is preferably extendable along the radial direction around the core portion 4. Therefore, the shaft portion 28 is provided with a fixture for fixing the fitting position of these members by fitting the members on the distal end portion 28z side to the members on the proximal end portion 28a side. The member on the side of the portion 28z is slidable with respect to the member on the base end 2a side, and is configured to be extendable.

貫通孔26hに芯部4の棒状部材24を貫通させ、被嵌合部25に嵌合部27を嵌合させることで、芯部4に複数の延伸部6を接続可能とされている。芯部4に接続する延伸部6の数は、特に限定されず、手術等に使用されるレトラクターRの数に合わせて適宜設定されることが好ましく、例えば二本以上四本以下とされている。   A plurality of extending portions 6 can be connected to the core portion 4 by allowing the rod-like member 24 of the core portion 4 to pass through the through hole 26 h and fitting the fitting portion 27 to the fitted portion 25. The number of extending portions 6 connected to the core portion 4 is not particularly limited, and is preferably set as appropriate according to the number of retractors R used for surgery or the like, for example, two or more and four or less. Yes.

滑車8は、延伸部6の先端部(先端)6z、すなわち軸部28の先端部28zに設けられている。詳しくは、滑車8の軸の両端部を支持する支持部材が軸部28の先端部28zに連設されている。また、滑車8における延伸部6の先端部6zとは反対側には、滑車8に巻装されるレトラクター支持部材10への衝突を防止し、レトラクター支持部材10を保護するための保護部8cが設けられている。   The pulley 8 is provided at the tip end (tip) 6 z of the extending portion 6, that is, the tip end 28 z of the shaft portion 28. Specifically, a support member that supports both end portions of the shaft of the pulley 8 is connected to the tip end portion 28 z of the shaft portion 28. Moreover, the protection part for preventing the collision with the retractor support member 10 wound by the pulley 8 and protecting the retractor support member 10 on the opposite side to the front-end | tip part 6z of the extending | stretching part 6 in the pulley 8 is provided. 8c is provided.

支柱2と、延出部3と、芯部4と、延伸部6および滑車8をそれぞれ構成する材質は、患者Mの第一の脚Ldに直接接触しても変質等を生じないものであれば特に限定されないが、例えばステンレス(SUS)やアルミニウム、酸化チタン等が挙げられる。   The material constituting the support column 2, the extending portion 3, the core portion 4, the extending portion 6 and the pulley 8 should not change in quality even if they directly contact the first leg Ld of the patient M. Although not particularly limited, for example, stainless steel (SUS), aluminum, titanium oxide, and the like can be given.

レトラクター支持部材10は、所定の長さを有する組み合わせ部材として構成されている。図1に示すように、レトラクター支持部材10の基端側の端部(一方の端部)10aは、芯部4に接続可能に形成されている。レトラクター支持部材10の先端側の端部(他方の端部)10zは、レトラクターRの把持部Rbに着脱可能に形成されている。また、レトラクター支持部材10は、端部10a,10zの間で滑車8に巻装されると共に、一方の端部10aと滑車8への巻装部分との間に弾性部12を有する。   The retractor support member 10 is configured as a combination member having a predetermined length. As shown in FIG. 1, an end portion (one end portion) 10 a on the proximal end side of the retractor support member 10 is formed to be connectable to the core portion 4. An end portion (the other end portion) 10z on the distal end side of the retractor support member 10 is detachably formed on the grip portion Rb of the retractor R. The retractor support member 10 is wound around the pulley 8 between the end portions 10a and 10z, and has an elastic portion 12 between one end portion 10a and a portion wound around the pulley 8.

図5に示すように、レトラクター支持部材10は、端部10aから端部10zに向って、芯部接続部40と、芯部接続部40に接続された弾性部12と、一端が弾性部12の芯部接続部40とは反対側に接続され、所定の長さを有する長尺の支持部42と、支持部42の他端に接続されたレトラクター係止部44と、を備えている。   As shown in FIG. 5, the retractor support member 10 includes an end portion 10 a toward the end portion 10 z, a core portion connecting portion 40, an elastic portion 12 connected to the core portion connecting portion 40, and one end being an elastic portion. 12 is connected to the opposite side of the core connecting portion 40, and has a long support portion 42 having a predetermined length, and a retractor locking portion 44 connected to the other end of the support portion 42. Yes.

芯部接続部40は、例えば、芯部4の棒状部材24を上方から挿通可能な環状部材50で構成されている。
レトラクターRの姿勢や傾斜角度を広い範囲で設定可能とする観点から、レトラクター支持部材10の端部10aには、芯部4に挿通可能に形成された環状の係止部16が設けられ、係止部16には、環状且つ開閉自在に形成された長さ調節部18が連結されていることが好ましい。具体的には、環状部材50には、芯部4の棒状部材24を上方から挿通可能かつ開閉自在に形成された環状部材52からなる長さ調節部18が複数連結されている。このような構成により、芯部4の棒状部材24に、環状部材50または複数の環状部材52のうちの何れかを挿通させることができる。また、長さ調節部18のレトラクター支持部材10への着脱が容易になる。この際、芯部4の棒状部材24に挿通させる環状部材50または複数の環状部材52を適宜選択することで、レトラクター支持部材10の長さが調節可能とされている。なお、長さ調節部18は、環状部材52の他に、環状部材50,52に着脱可能なS字部材53を含んでもよい。
The core connecting portion 40 is constituted by, for example, an annular member 50 through which the rod-like member 24 of the core 4 can be inserted from above.
From the viewpoint of allowing the posture and inclination angle of the retractor R to be set in a wide range, the end portion 10a of the retractor support member 10 is provided with an annular locking portion 16 formed so as to be able to be inserted through the core portion 4. It is preferable that a length adjusting portion 18 formed in an annular and freely openable / closable manner is connected to the locking portion 16. Specifically, the annular member 50 is connected to a plurality of length adjusting portions 18 each including an annular member 52 formed so that the rod-like member 24 of the core portion 4 can be inserted from above and can be opened and closed. With such a configuration, either the annular member 50 or the plurality of annular members 52 can be inserted into the rod-like member 24 of the core portion 4. Moreover, the attachment / detachment to the retractor support member 10 of the length adjustment part 18 becomes easy. At this time, the length of the retractor support member 10 can be adjusted by appropriately selecting the annular member 50 or the plurality of annular members 52 inserted into the rod-like member 24 of the core portion 4. The length adjusting unit 18 may include an S-shaped member 53 that can be attached to and detached from the annular members 50 and 52 in addition to the annular member 52.

弾性部12は、例えばばねで構成されている。レトラクターの適度な緊張度を保つ観点から、弾性部12を構成するばねのばね係数は10N/m以上200N/m以下であることが好ましい。弾性部12を構成するばねのばね係数が上述の範囲内であれば、1kgから20kg程度までの重さの重錘14を使用しても、弾性部12が重錘14の重みに耐え、良好に機能する。   The elastic part 12 is comprised by the spring, for example. From the viewpoint of maintaining an appropriate degree of tension of the retractor, the spring coefficient of the spring constituting the elastic portion 12 is preferably 10 N / m or more and 200 N / m or less. If the spring coefficient of the spring constituting the elastic portion 12 is within the above range, the elastic portion 12 can withstand the weight of the weight 14 even if the weight 14 having a weight of about 1 kg to 20 kg is used. To work.

支持部42は、軟網線、ケーブル、ひも、チェーン等であって、ある程度の伸び特性を有する部材で構成されている。支持部42を構成するロープ状の部材は、曲げることができ、適度な弾性を有しているものが好ましい。詳しくは、ロープ状の部材の引張強度は20kg以上150kg以下の重さに耐えられる程度であることが好ましい。ロープ状の部材が適度な弾性と前述の範囲の引張強度とを有することで、ロープ状の部材を通じてレトラクター支持部材10に適度な弾性と引張強度が付与され、レトラクターを保持する際の緊張度がより良好に保たれる。   The support portion 42 is a soft net wire, cable, string, chain, or the like, and is configured of a member having a certain degree of elongation characteristics. The rope-shaped member constituting the support portion 42 is preferably one that can be bent and has appropriate elasticity. Specifically, the tensile strength of the rope-shaped member is preferably such that it can withstand a weight of 20 kg to 150 kg. Since the rope-shaped member has appropriate elasticity and the tensile strength in the above-described range, appropriate elasticity and tensile strength are imparted to the retractor support member 10 through the rope-shaped member, and tension when holding the retractor. The degree is kept better.

支持部42は滑車8に巻装されることで滑車8に接触し、擦れる可能性がある部分であるため、手術中の破断を防止する観点から、ロープ状の部材は、接触摩擦に対して所定の耐性を有する材質で構成されていることが好ましい。このようなロープ状の部材を構成する材質としては、例えば、ステンレス(SUS)やタングステン等が挙げられるが、重錘14の重さに耐えられる強度を有し、かつ滅菌操作をしても再使用が可能なものであれば特に限定されない。   Since the support portion 42 is a portion that may be rubbed with the pulley 8 by being wound around the pulley 8, the rope-shaped member is resistant to contact friction from the viewpoint of preventing breakage during the operation. It is preferable to be made of a material having a predetermined resistance. Examples of the material constituting such a rope-shaped member include stainless steel (SUS) and tungsten. However, the material has a strength that can withstand the weight of the weight 14 and can be reused even after sterilization. There is no particular limitation as long as it can be used.

レトラクター係止部44は、レトラクターRの把持部Rbに形成されている貫通孔に係止可能に形成されているものであり、例えばフック状に形成された部材で構成されている。   The retractor locking portion 44 is formed so as to be locked in a through-hole formed in the gripping portion Rb of the retractor R, and is configured by a member formed in a hook shape, for example.

芯部接続部40を構成する環状部材50,52、弾性部12を構成するばねおよびレトラクター係止部44を構成するフック状の部材を構成する材質としては、例えばステンレスやアルミニウム、酸化チタン等が挙げられる。   Examples of materials constituting the annular members 50 and 52 constituting the core connecting portion 40, the spring constituting the elastic portion 12, and the hook-like member constituting the retractor locking portion 44 include stainless steel, aluminum, titanium oxide, and the like. Is mentioned.

重錘14は、公知の重錘の上部に、レトラクターRの把持部Rbに形成されている貫通孔に係止可能に形成されたフック状の部材を備えたものである。重錘14の重さは、レトラクターRの姿勢や傾斜角度を広い範囲で設定可能とするために、レトラクター支持部材10の上述の各構成要素の物性等を勘案して、適切に設定されている。また、レトラクターRを所望の姿勢や傾斜角度で保持する観点から、複数の種類の重さの重錘14が用意されていることが好ましい。   The weight 14 is provided with a hook-like member formed on the upper part of a known weight so as to be able to be locked in a through hole formed in the gripping portion Rb of the retractor R. The weight of the weight 14 is appropriately set in consideration of the physical properties of the above-described components of the retractor support member 10 so that the posture and inclination angle of the retractor R can be set in a wide range. ing. Further, from the viewpoint of holding the retractor R in a desired posture or inclination angle, it is preferable that a plurality of weights 14 of different types are prepared.

以上説明したレトラクター保持装置1を用いる際には、先ず、図1に示すように、支柱2を寝台Bの側部に取り付け、支柱2と、延出部3と、芯部4と、をそれぞれ接続する。次に、図4に示すように、芯部4の棒状部材24に、回動部26の貫通孔26hを挿通させつつ、延伸部6を芯部4に取り付ける。芯部4に取り付ける延伸部6の数は、手術等に使用するレトラクターRの数に合わせる。最上部の延伸部6の回動部26に蓋部29を取り付ける。   When using the retractor holding device 1 described above, first, as shown in FIG. 1, the support column 2 is attached to the side of the bed B, and the support column 2, the extension portion 3, and the core portion 4 are attached. Connect each one. Next, as shown in FIG. 4, the extending portion 6 is attached to the core portion 4 while the through-hole 26 h of the rotating portion 26 is inserted into the rod-shaped member 24 of the core portion 4. The number of extending portions 6 attached to the core portion 4 is adjusted to the number of retractors R used for surgery or the like. A lid portion 29 is attached to the rotating portion 26 of the uppermost extending portion 6.

次に、図1に示すように、芯部4の棒状部材24に、芯部4に取り付けた延伸部6の数と同数のレトラクター支持部材10を用意し、それぞれのレトラクター支持部材10における所望の位置の環状部材50または複数の環状部材52のうちの何れかを挿通させる。それぞれのレトラクター支持部材10の支持部42を滑車8に巻装し、レトラクター支持部材10のレトラクター係止部44をレトラクターRの把持部Rbに形成されている貫通孔に係止させる。レトラクターRの保持姿勢に合わせ、必要に応じて、レトラクターRの把持部Rbに形成されている貫通孔に重錘14をかける。また、芯部4の周方向におけるレトラクター支持部材10の角度を変える際には、該当するレトラクター支持部材10を上方に持ち上げる。その後、レトラクター支持部材10の被嵌合部25とその下方のレトラクター支持部材10の嵌合部27、または芯部4のフランジ20の嵌合部22との嵌合状態を一旦解除し、レトラクター支持部材10を芯部4の周方向に回し、所望の偏光位置で下降させ、再び被嵌合部25と嵌合部27または嵌合部22とを嵌合させればよい。   Next, as shown in FIG. 1, the same number of retractor support members 10 as the number of extending portions 6 attached to the core portion 4 are prepared in the rod-shaped member 24 of the core portion 4. Either the annular member 50 or the plurality of annular members 52 at a desired position is inserted. The support portions 42 of the respective retractor support members 10 are wound around the pulley 8, and the retractor locking portions 44 of the retractor support members 10 are locked in the through holes formed in the gripping portion Rb of the retractor R. . In accordance with the holding posture of the retractor R, the weight 14 is applied to the through hole formed in the gripping portion Rb of the retractor R as necessary. Moreover, when changing the angle of the retractor support member 10 in the circumferential direction of the core part 4, the corresponding retractor support member 10 is lifted upward. Thereafter, the fitting state between the fitted portion 25 of the retractor support member 10 and the fitting portion 27 of the retractor support member 10 below or the fitting portion 22 of the flange 20 of the core portion 4 is once released. The retractor support member 10 may be rotated in the circumferential direction of the core portion 4 and lowered at a desired polarization position, and the fitted portion 25 and the fitting portion 27 or the fitting portion 22 may be fitted again.

上述の作業により、複数のレトラクターRを患者Mの開創部Dを拡げるように保持することができる。   By the above-described operation, a plurality of retractors R can be held so as to expand the retracted portion D of the patient M.

以上説明したレトラクター保持装置1では、患者Mの開創部Dを拡げるためのレトラクターRは、開創部Dの筋組織に係止すると共に、レトラクター支持部材10によって筋組織を拡げる方向、すなわち図1に示すように、滑車8とレトラクター支持部材10の端部10zとを結ぶB1方向に引かれ、保持される。このようにレトラクター支持部材10を用いてレトラクターRの把持部Rbを保持するので、従来のようにレトラクターRの把持部Rbが何らかの固定具等によって押圧されることもなく、硬くならない。さらに、手術中に患者が動くことがあっても、レトラクター支持部材10の弾性部12および支持部42の張力等によって、レトラクターRから開創部Dの筋細胞あるいは筋組織に伝わる力が適度に分散され、レトラクターRの適度な緊張度が保たれ、筋細胞あるいは筋組織へのダメージが抑えられる。   In the retractor holding device 1 described above, the retractor R for expanding the retracted portion D of the patient M is locked to the muscle tissue of the retracted portion D, and the direction in which the retractor support member 10 expands the muscle tissue, that is, As shown in FIG. 1, the pulley 8 and the end portion 10 z of the retractor support member 10 are pulled and held in the B1 direction. Thus, since the holding part Rb of the retractor R is held using the retractor support member 10, the holding part Rb of the retractor R is not pressed by any fixing tool or the like as in the conventional case, and does not become hard. Furthermore, even if the patient moves during the operation, the force transmitted from the retractor R to the muscle cells or muscle tissue of the retracted portion D is moderate due to the tension of the elastic portion 12 and the support portion 42 of the retractor support member 10. The moderate tension of the retractor R is maintained, and damage to muscle cells or muscle tissue is suppressed.

したがって、レトラクター保持装置1を用いることで、従来のようにレトラクターを装置等に固定するのではなく、レトラクターRを開創部Dの周囲の筋肉の生理的弾性度に合致した自然な状態で保持することができる。そして、レトラクター保持装置1によれば、レトラクターRの把持部Rbが硬くなるのを防ぎ、長時間でも筋組織を傷めずに、かつ手術対象部位を塞がないように筋組織を拡げるレトラクターRを保持することができる。また、術者によるレトラクターRの挟み直しやジョイント変更の作業の削減を図り、少人数の助手しかいない施設においても複数のレトラクターRを所望の配置で保持可能な環境を提供することができる。   Therefore, by using the retractor holding device 1, the retractor R is not fixed to the device or the like as in the prior art, but the retractor R is in a natural state that matches the physiological elasticity of the muscles around the wound portion D. Can be held in. According to the retractor holding device 1, the gripping portion Rb of the retractor R is prevented from becoming hard, the muscle tissue is expanded so as not to damage the muscle tissue even for a long time and not to block the operation target site. The tractor R can be held. In addition, it is possible to provide an environment where a plurality of retractors R can be held in a desired arrangement even in a facility having only a small number of assistants by reducing the operation of re-pinching the retractor R and changing the joints by the surgeon. .

上述のレトラクター保持装置1によれば、従来のレトラクター把持装置で見られたレトラクターRの把持部Rbが硬くなるということはなく、上述のように、長時間でも筋組織を傷めずに、かつ手術対象部位を塞がないように筋組織を拡げることが可能になる。すなわち、術者や助手の技量に左右されずに、安心安全に最小侵襲手術である筋間アプローチ(進入法)などの筋腱温存手術をサポートすることできる。   According to the retractor holding device 1 described above, the gripping portion Rb of the retractor R seen with the conventional retractor gripping device does not become hard, and as described above, the muscle tissue is not damaged even for a long time. In addition, the muscle tissue can be expanded so as not to block the surgical target site. That is, it is possible to support a muscle tendon preserving operation such as an intermuscular approach (entry method) that is a minimally invasive operation without worrying about the skill of an operator or an assistant.

また、上述のレトラクター保持装置1は、レトラクターRの把持部Rbに着脱可能に形成された重錘14をさらに備えている。これにより、レトラクターRの把持部Rbを開創部Dよりも下方に保持するレトラクターRの傾斜姿勢に応じて、レトラクターRの把持部Rbに重錘14を付けることで、レトラクター支持部材10がレトラクターRを上方に支持する力(すなわち、図1に示すB1方向の力)に対して適度に重力(すなわち、図1に示すB2方向の力)が付加され、レトラクターRは、上方に支持する力と重錘14による重力とを合成した力のB3方向に引かれ、保持される。したがって、開創部Dに対する相対方向によらず、レトラクターRを所望の傾斜姿勢で容易に保持することができる。   Moreover, the above-mentioned retractor holding | maintenance apparatus 1 is further provided with the weight 14 formed in the holding part Rb of the retractor R so that attachment or detachment was possible. Thereby, by attaching the weight 14 to the gripping part Rb of the retractor R according to the inclination posture of the retractor R that holds the gripping part Rb of the retractor R below the retracting part D, the retractor support member Gravity (that is, the force in the B2 direction shown in FIG. 1) is moderately applied to the force that the 10 supports the retractor R upward (that is, the force in the B1 direction shown in FIG. 1). It is pulled and held in the B3 direction of the force that combines the upward support force and the gravity by the weight 14. Therefore, the retractor R can be easily held in a desired inclined posture regardless of the relative direction with respect to the retracted portion D.

また、上述のレトラクター保持装置1によれば、軸部28は芯部4を中心として径方向に沿って伸縮可能に構成されているので、開創部Dに対するレトラクターRの角度をより広い範囲で調整することができ、レトラクターRを所望の姿勢で容易に保持し、必要に応じてその姿勢を容易に変更することができる。   In addition, according to the retractor holding device 1 described above, the shaft portion 28 is configured to be expandable and contractable along the radial direction with the core portion 4 as the center, so that the angle of the retractor R with respect to the retracted portion D can be set in a wider range. The retractor R can be easily held in a desired posture, and the posture can be easily changed as necessary.

また、上述のレトラクター保持装置1によれば、レトラクター支持部材10の端部10aに、環状の係止部16が設けられ、係止部16には長さ調節部18が連結されていることで、芯部4に接続する係止部16または長さ調節部18の位置を変更し、レトラクター支持部材10の全長を容易に調節することができる。これにより、レトラクターRを所望の姿勢で容易に保持し、必要に応じてその姿勢を容易に変更することができる。   Further, according to the retractor holding device 1 described above, the annular locking portion 16 is provided at the end portion 10 a of the retractor support member 10, and the length adjusting portion 18 is connected to the locking portion 16. Thereby, the position of the latching | locking part 16 connected to the core part 4 or the length adjustment part 18 can be changed, and the full length of the retractor support member 10 can be adjusted easily. Thereby, the retractor R can be easily held in a desired posture, and the posture can be easily changed as necessary.

上述したように、本発明によれば、長時間であっても複数のレトラクターRを患者Mの開創部Dを拡げるように保持することができる。したがって、本発明に係るレトラクター保持装置は、人工股関節置換術の手術中等の場面に限らず、所望の配置でレトラクターRを保持することを必要とする広い分野で応用可能である。すなわち、本発明に係るレトラクター保持装置は、人工関節全置換術あるいは人工骨頭置換術だけでなく、広く整形外科領域の手術全般において、生理的な開創部周囲の筋肉の張力と合致した自然な圧迫力で創部を開大させるレトラクターRの保持装置として利用可能である。   As described above, according to the present invention, a plurality of retractors R can be held so as to expand the retracted portion D of the patient M even for a long time. Therefore, the retractor holding device according to the present invention is not limited to a scene such as during a hip replacement operation, and can be applied in a wide field that requires holding the retractor R in a desired arrangement. That is, the retractor holding device according to the present invention is not only a total joint replacement or artificial head replacement, but also a wide range of orthopedic surgery in general. It can be used as a holding device for the retractor R that opens the wound with compression force.

以上、本発明の好ましい実施形態について詳述したが、本発明は係るレトラクター保持装置は、特定の実施形態に限定されるものではなく、特許請求の範囲内に記載された本発明の要旨の範囲内において、種々の変形・変更が可能である。   The preferred embodiment of the present invention has been described in detail above. However, the retractor holding device according to the present invention is not limited to the specific embodiment, and is based on the gist of the present invention described in the claims. Various modifications and changes can be made within the range.

例えば、レトラクター保持装置1では、レトラクターRの把持部Rbに形成されている貫通孔にレトラクター係止部44を係止させているレトラクター支持部材10の端部10a側の環状部材50を芯部4から抜き、図6に示すように、このレトラクター支持部材10の支持部42を滑車8の延伸部6側(すなわち、内側)からその反対側に巻き直し、環状部材50に重錘14をかけることができる。このような配置構成では、重錘14の重力がレトラクター支持部材10の支持部42を介して、レトラクターRの把持部Rbを下方へ引く力として、レトラクターRに伝わる。重錘14の重さを調節することで、レトラクターRの把持部Rbを下方へ引く力およびレトラクターRの傾斜角度や姿勢を容易に変更することができる。   For example, in the retractor holding device 1, the annular member 50 on the end portion 10a side of the retractor support member 10 in which the retractor locking portion 44 is locked in the through hole formed in the gripping portion Rb of the retractor R. As shown in FIG. 6, the support portion 42 of the retractor support member 10 is rewound from the extending portion 6 side (that is, the inner side) of the pulley 8 to the opposite side to overlap the annular member 50. A weight 14 can be applied. In such an arrangement, the gravity of the weight 14 is transmitted to the retractor R as a force pulling the gripping portion Rb of the retractor R downward through the support portion 42 of the retractor support member 10. By adjusting the weight of the weight 14, the force for pulling the gripping portion Rb of the retractor R downward and the inclination angle and posture of the retractor R can be easily changed.

また、図6に示すように、レトラクターRの把持部Rbには、複数(図6では二つ)の貫通孔が形成されている場合がある。その場合には、二つの貫通孔に図6の実線および一点鎖線で示す重錘14を係止し、複数の重錘14による重力の合計値を変更することで、レトラクターRにかかる力の方向を調整してもよい。   Further, as shown in FIG. 6, a plurality of (two in FIG. 6) through holes may be formed in the gripping portion Rb of the retractor R. In that case, the weight 14 indicated by the solid line and the alternate long and short dash line in FIG. 6 is locked in the two through holes, and the total value of gravity by the plurality of weights 14 is changed, so that the force applied to the retractor R can be reduced. The direction may be adjusted.

また、図示していないが、レトラクターRの把持部Rbに形成されている貫通孔のそれぞれには、二個以上の重錘14を係止してもよい。この際、貫通孔に係止する複数の重錘14の重さは、同一であってもよく、互いに異なっていてもよい。このように、一つの貫通孔に対して複数の重錘14を係止することで、レトラクターRの把持部Rbにかかる重力の合計値を容易に変更し、レトラクターRの把持部Rbを下方へ引く力を調整することができる。   Although not shown, two or more weights 14 may be engaged with each of the through holes formed in the gripping portion Rb of the retractor R. At this time, the weights of the plurality of weights 14 locked in the through holes may be the same or different from each other. In this way, by locking the plurality of weights 14 with respect to one through hole, the total value of gravity applied to the gripping portion Rb of the retractor R can be easily changed, and the gripping portion Rb of the retractor R can be changed. The pulling force can be adjusted.

さらに、レトラクター支持部材10の支持部42を術者または助手が把持するか、または押さえて、所定の方向に支持すると共に移動させてもよい。このような支持方法によっても、レトラクターRの傾斜角度や姿勢を微調整することができる。   Further, the supporter 42 of the retractor support member 10 may be grasped or pressed by an operator or assistant to support and move in a predetermined direction. Also by such a support method, the inclination angle and posture of the retractor R can be finely adjusted.

1…レトラクター保持装置
2…支柱
2a…基端部(基端)
3…延出部
3a…基端部
3z…先端部(支柱2とは反対側の端部)
4…芯部
6…延伸部
8…滑車
10…レトラクター支持部材
14…重錘
16…係止部
18…長さ調節部
26…回動部
28…軸部
B…寝台
D…開創部
M…患者
R,R1,R2,R3…レトラクター
DESCRIPTION OF SYMBOLS 1 ... Retractor holding device 2 ... Support | pillar 2a ... Base end part (base end)
3 ... Extension part 3a ... Base end part 3z ... Tip part (end part on the opposite side to the support | pillar 2)
4 ... Core part 6 ... Extending part 8 ... Pulley 10 ... Retractor support member 14 ... Weight 16 ... Locking part 18 ... Length adjusting part 26 ... Turning part 28 ... Shaft part B ... Bed D ... Retracting part M ... Patient R, R1, R2, R3 ... retractor

Claims (4)

寝台上の患者の開創部を拡げるためのレトラクターを把持可能に構成されたレトラクター保持装置であって、
基端部が前記寝台に取り付け可能に形成され、先端部が寝台の上方に延びている支柱と、
前記支柱の先端から水平方向へ延びる延出部と、
前記延出部の前記支柱とは反対側の端部から上方に延びる芯部と、
前記芯部に対して該芯部を中心として周方向に回動可能に接続された回動部と、前記芯部を中心として径方向に沿って延びる軸部と、を有する複数の延伸部と、
前記延伸部の先端に設けられた滑車と、
一方の端部が前記芯部に接続され、他方の端部が前記レトラクターの把持部に着脱可能に形成され、前記一方の端部と前記他方の端部との間で前記滑車に巻装されると共に、前記一方の端部と前記滑車への巻装部分との間に弾性部を有するレトラクター支持部材と、
を備えていることを特徴とするレトラクター保持装置。
A retractor holding device configured to be able to grip a retractor for expanding a patient's wound part on a bed,
A base end is formed so as to be attachable to the bed, and a column having a tip extending above the bed;
An extending portion extending in the horizontal direction from the tip of the support column;
A core portion extending upward from an end portion of the extension portion opposite to the support;
A plurality of extending portions each having a rotating portion connected to the core portion so as to be rotatable in the circumferential direction around the core portion, and a shaft portion extending along the radial direction around the core portion; ,
A pulley provided at a tip of the extending portion;
One end is connected to the core, and the other end is detachably formed on the grip of the retractor, and is wound around the pulley between the one end and the other end. And a retractor support member having an elastic part between the one end and the winding portion around the pulley,
A retractor holding device comprising:
前記レトラクターの把持部に着脱可能に形成された重錘をさらに備えていることを特徴とする請求項1に記載のレトラクター保持装置。 The retractor holding device according to claim 1, further comprising a weight detachably formed on a grip portion of the retractor. 前記軸部は前記芯部を中心として径方向に沿って伸縮可能であることを特徴とする請求項1または請求項2に記載のレトラクター保持装置。   The retractor holding device according to claim 1, wherein the shaft portion is extendable and contractable along a radial direction with the core portion as a center. 前記レトラクター支持部材の前記一方の端部には、前記芯部に挿通可能に形成された環状の係止部が設けられ、
前記係止部には、環状且つ開閉自在に形成された長さ調節部が連結されていることを特徴とする請求項1から請求項3の何れか一項に記載のレトラクター保持装置。

The one end portion of the retractor support member is provided with an annular locking portion formed so as to be able to be inserted into the core portion,
The retractor holding device according to any one of claims 1 to 3, wherein a length adjusting portion formed in an annular shape so as to be freely opened and closed is connected to the locking portion.

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US5065739A (en) * 1989-08-24 1991-11-19 Forrest William J Retractor support assembly
US5074291A (en) * 1990-09-17 1991-12-24 Carter Peter R Hand traction surgical table
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JP3141321B2 (en) * 1996-03-25 2001-03-05 高砂医科工業株式会社 Surgical abdominal wall retractor
US5984866A (en) * 1998-01-23 1999-11-16 Rultract, Inc. Surgical support apparatus with splined coupling, cross bar support and head-to-toe extension for surgical retractor apparatus
US7691058B2 (en) * 2006-06-15 2010-04-06 Boston Scientific Scimed, Inc. Surgical retractor device and method of use
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