JP6506567B2 - Manufacturing method of all resin retractor - Google Patents

Description

  The present invention relates to a method for producing an all-resin retractor, and more particularly to a method for producing an all-resin retractor which enables wide-area X-ray observation for medical treatment of a surgical site through a low invasive incision. is there.

  After incision of the skin, muscle, etc. covering the part where medical treatment is to be performed, it is used as an instrument for retracting (separating without removing a part of the organ) or pulling soft tissue from the incision wound up to the operation target site. There is a tractor (retractor). In recent years, there has been a tendency to intensify the low invasiveness in order to reduce the damage to the tissue, so the opening at the incision site is made as small as possible, and the operation field will only narrow if treatment is attempted from the opening. The field of view also narrows. Such a retractor is a surgical aid and functions as an instrument for spreading a surgical wound. This is an instrument consisting mainly of an insert and a handle, which is convenient for inserting the insert into the wound to secure a surgical field of view, and which minimizes the risk of damage to soft tissue. It is tapered and formed generally flat.

  If the incision is small, the skin, muscles, etc. exert a strong action to restore, so it becomes necessary to pull these soft tissues and keep them open. A retractor of a shape corresponding to the incisional is required, and a simple-shaped retractor with a front view that is bent or curved in, for example, a V shape, and a substantially straight plane view has other complicated shapes. Used with or without a tractor.

  Such a substantially rod-shaped retractor not only maintains the open state of the incision wound, but often has a nail-like projection or the like formed at its tip, and the projection area etc. It is also used to deal with existing tissue, and to raise and lower hard tissue to lock the posture of the retractor itself.

  By the way, it goes without saying that the retractor must be harmless to the human body and must be disinfectable. Therefore, it has been made of rust-proof metal and other rust-proof metals, and it is extremely easy to increase its rigidity, so it has been developed as a highly reliable medical tool. However, as described above, as the tendency of minimally invasive (less likely to invade tissues) becomes stronger, X-ray irradiation of the operative field becomes inevitable, in which case the metallic instrument produces a partially opaque region of X-rays.

  Therefore, the view of the operative field can not be narrowed, and the treatment may not be speeded up, or a retractor with a different degree of flexion may occur. In consideration of such circumstances, although it is a rod-like retractor, various forms are required for the length and angle of the insertion portion in the wound, the shape and the direction of the claw, and the like. If it is made of metal, it is manufactured by casting, etc. Even if there is a slight difference in shape, a molding die appropriate for each is required, and the unit price of the retractor increases and the treatment cost also rises.

  Also, if the tip of the metal retractor comes in contact with the ceramic implant, etc., the implant is easily damaged due to the difference in hardness. This causes problems such as deterioration of the function of the implant and a decrease in the service life, and the occurrence of frequent re-surgery.

  By the way, it is described in patent document 1 that resin may be coated to the site | part (touch finger) which contacts the structure | tissue of metal made retractor, and it may be made to soften. However, in this case, although the protection performance against tissues and implants by the retractor is improved, the need for molding dies corresponding to various shapes still remains. There is also a proposal to divide and form the retractor into the action part and the grip part and to reduce the number of molding dies by combining these, but since the joining mechanism is added, etc., the weight of the heavy retractor is further increased Increase.

  It is disclosed that resin can be used instead of the metal. It is also stated that the resin may be such as PEEK. However, it is nothing more than an idea, and the resin-made retractors that have been put into practical use until today have not been able to see the sun. The problem lies in the fact that the concrete technology of how to shape and finish the retractor has not been developed.

  Patent Document 2 describes that a grasping portion of the retractor is formed of resin, and X-ray transmission in this grasping portion enables an intra-corporeal treatment while viewing an X-ray irradiation image. It is also proposed that the main body of the retractor be made of resin for this. However, there is no disclosure of this nor its manufacturing procedures.

  By the way, as mentioned above, each patient needs a different type of retractor, or a retractor according to the operation site is needed, but as many as 200 types of retractor may be required. It is said. However, representatively, for example, four types of main body shapes, three types of holding portion shapes, and 48 types of tactile finger shapes require 48 types of retractors. In order to manufacture these, even if it is made of resin, 48 types of molding dies are required.

JP-A-59-141938 Japanese Patent Application Publication No. 2007-143824

  The present invention has been made in view of the above problems, and its object is to achieve overall non-metallization and light weight along with minimally invasiveness which enables X-ray transmission and minimizes the risk of damage to soft tissue. All resin products that realize that the combination of components that make up the retractor can be facilitated to suppress the number of types of molding dies, and that a large reduction in manufacturing costs can be expected. It is to provide a manufacturing method of a retractor.

According to the present invention, there is provided an intracorporeal insertion portion provided with a touch finger at an end portion of a main body trunk, which is provided with a touch finger for retracting or pulling soft tissue from an incision wound to a surgical target, The present invention is applied to a method of manufacturing a retractor which comprises a handle portion provided with an operating hand, and the insertion portion is integrated with the handle portion. As its feature, referring to FIG. 1, the endodontic insert portion 1 is provided with a connecting tongue 7 to be welded during subsequent shaping of the handle portion 2 at the proximal end portion of the main body barrel 5, and the main body 5 is formed independently of the handle portion 2 by laminating the semipreg sheet 8 of carbon fiber reinforced thermoplastic resin integrally with the connection tongue 7 and the touch finger 4 (see FIG. 2B) (See (a) of FIG. 5).
With reference to FIG. 3, holding of the intracorporeal insert portion 1 connected with the forming cavity 10 of the handle portion 2 engraved on the forming mold 9 consisting of the lower mold 9D and the upper mold 9U and opened at the forming mold edge 9e The connecting tongue 7 faces the connecting barrel molding area 9s integrally formed in the cavity 11 so as to be integral with the insertion insert of the operating hand 6, and the contact finger portion of the main body 5 is positioned outside the molding die rim As described above, the intracorporeal insertion part 1 which has already been manufactured is accommodated and held. And
A melt of a thermoplastic resin compound blended with carbon fiber chips is pressed into a molding die 9 heated to such an extent that the thermoplastic resin melting temperature is not exceeded around at least any of the cavities, and the operator hand 6 is cast and formed. The connecting cylinder 13 is integrally formed while the connecting tongue surface layer is melted with the compound melt flowing into the upper and lower or upper and lower or around the connecting tongue 7 so that the handle portion 2 is formed.

  The body cylinder 5 may be bent or curved. The touch finger 4 is a hook piece 4A (see FIG. 1 (b)) bent or curved with respect to the main body 5 or a raised piece 4B (see FIG. 7 (c)) having a warp, The touch finger 4 and the connection tongue 7 can be integrally formed in a substantially linear shape in plan view with respect to the main body 5.

  As shown in (e) of FIG. 7, when the touch finger 4 is a bifurcated claw 14, it may be formed by machining the intracorporeal insertion portion 1 after molding.

  On the lateral side of the connecting tongue 7, a left widening area 17 and a right widening area 18 are formed which extend out in the width direction from the connecting cylinder 13 to be formed later (see FIG. 6). The notch engaging projection 20 is provided at the corresponding portion of the cavity so as to prevent the cavity of the endocardium insert 1 from being removed at the time of compound melt pressure injection.

  According to the present invention, the wound insert portion is formed independently of the handle portion by the semipreg sheet lamination of the carbon fiber reinforced thermoplastic resin. The connecting tongue of the other end of the main body which is integral with the touch finger is exposed to the connecting cylinder forming area in the cavity for forming the handle portion in a state where a part of the insertion part in the wound is accommodated and held in the holding cavity. . The melt of the thermoplastic resin compound blended with the carbon fiber tip is pressed into the molding die heated to such an extent that the thermoplastic resin does not exceed the melting temperature of the thermoplastic resin at least around any of the cavities, and the operation hand is cast. The handle portion is formed by integrally forming the articulating cylinder while melting the connecting tongue surface layer with the compound melt flowing on or under the connecting tongue or up and down or around. Because the semi-preg sheet laminated body in which resin is impregnated into unidirectional fibers or woven fabric fibers, the wound insert portion achieves high strength and high rigidity. On the other hand, since the handle portion is a solidified product of the resin compound, an excellent handling hand is formed. The resin forming the intracorporeal insertion portion is the same as the resin of the handle portion, and since the resin is thermoplastic, it can be smoothly integrated by welding or fusion by softening or remelting due to heating.

  Not only the insertion part but also the handle part is made of resin, so it becomes an all resin retractor. Irradiation of X-rays at any of these locations hardly prevents observation of the operative field, and the miniaturization of the incisional wound, that is, the low invasiveness is assisted, and the physical and mental burden on the patient is greatly reduced. Moreover, although it includes the connection process, since it is a one-piece product when it becomes a single retractor, a joint mechanism for connection removal is not necessary, and it is a lightweight medical equipment because it is made of resin. .

  The finished product of the retractor will be permanently integrated, but in the manufacturing stage the endodontic insert will be made independent of the handle. Since the intracorporeal insertion portion can be molded without being influenced by the shape of the handle portion, it is sufficient to prepare only the type of molding die for that purpose. If the shape and dimensions of the body tongue and the connecting tongue of the intracorporeal insertion part are made common, the number of preparation molds for forming the handle part and integrating with the intracorporeal insertion part is also suppressed . It greatly contributes to the fall of the unit price of the retractor.

  If the main body is bent or curved, the retractor can be easily operated even in a small incision, but it is particularly useful for forming the handle even when molding those with different degrees of bending or bending. There are as few restraints and restrictions as possible.

  The touch finger is a hooked piece or bent up and bent piece bent or curved with respect to the main body, and the touch finger and the connection tongue are integrally formed in a substantially linear shape in plan view with respect to the main body. By doing so, the forming by laminating the semi-preg sheets becomes extremely smooth, and it becomes easy to secure strength and rigidity.

  When the touch finger is used as a bifurcated nail, it can be formed by machining after molding the intracorporeal insertion portion. Therefore, since the formation of the bifurcated claws has no relevance to the formation by semipreg sheet lamination, the intracorporeal insertion part is formed in a form of a few-piece molded article having dimensions of a multiple or more of the width be able to. This may be cut to a predetermined width, etc., and the increase in the mold due to the difference between the branched claws is avoided. According to the method of forming a few insert portions in the wound creation, mass production is also possible because the shape of the touch finger is not involved.

  On the lateral side of the connecting tongue, a left widening area and a right widening area extending in the width direction from the connecting cylinder to be formed later are formed, and a notch is formed in the widening area, and a notch is engaged at the corresponding location of the cavity. The provision of the interlocking projections can prevent the cavity insertion of the intracorporeal insertion part from being injected at the time of compound melt pressure injection.

  Whether manufactured by any of the above methods, the retractor is all resin, is lightweight, reduces the operation burden on the operator, and there is no obstruction in the confirmation of the affected area by X-ray irradiation, and the treatment is smoothened. It greatly contributes to the enhancement of accuracy.

A plan view, a front view, a cross-sectional view of the overlapping portion of the connecting cylinder and the connecting tongue and other parts, an exploded plan view of the retractor, and a perspective view of the retractor according to the manufacturing method of the present invention. Figure. The front view of a retractor, and the top view which shows the lamination | stacking state of an insertion part inside a wound. (A) is a perspective view of a state in which a molding for the insertion portion is placed on the lower mold, (b) is a state diagram in which the upper mold is placed and clamped, and (c) is a mold The perspective view of an open state. The top view of the metal mold which made the handle part and was used for two retractors. The perspective view of the shaping | molding die of a wound insertion part, the cutting front view of the formed wound insertion part, the perspective view of the cut wound insertion part, the expansion perspective view of a connection tongue site | part. FIG. 14A is a partial perspective view of a state in which the insertion portion is placed in the mold cavity of the connecting cylinder forming area and a partial perspective view including the mold cavity of the connecting cylinder forming area. FIG. 8 is a perspective view of another embodiment of the retractor, in which the operating hands are different and in which the endocardial insertion portion is different.

  Below, the manufacturing method of the all-resins retractor which concerns on this invention is demonstrated in detail based on the drawing showing the embodiment. FIG. 1 shows an example of a retractor 3 which is composed of an extracorporeal insertion part 1 and a handle part 2 and in which the extracorporeal insertion part is integrated with the handle part. The intracorporeal insert portion 1 includes a touch finger 4 at the distal end portion of the main body barrel 5 for retracting or pulling soft tissue from an incision (not shown) to a surgical target site. The handle portion 2 is provided with an operating hand 6 for causing a touch finger to perform a desired action.

  The insertion insert portion 1 has a connecting tongue 7 to be welded during subsequent shaping of the handle portion 2 at the proximal end portion of the main body barrel 5, and the main body barrel 5 is integral with the connecting tongue 7 and the touch finger 4 And by laminating the carbon fiber reinforced thermoplastic resin semipreg sheet 8 (refer to FIG. 2 (b)), as shown in (c), (d) and (e) in FIG. It has a shape and is formed independently of the handle portion 2 as described later. The semipreg sheet 8 is a thin reinforced resin plate which is in a state in which a resin is impregnated in part or all of the reinforcing carbon fibers and which is heated and pressurized in advance by an autoclave or the like and then gradually cooled. is there. This is also referred to as a prepreg, semipreg, partially impregnated prepreg, etc., and sometimes also referred to as a resin semi-impregnated base, semi-impregnated prepreg.

  As the thermoplastic resin, polyetheretherketone (PEEK) and polyetherimide (PEI) which are harmless to the human body and which neither soften nor melt unless the temperature exceeds 300 ° C. are used. They are tough and do not absorb moisture and are excellent in weatherability. In any case, since it is reinforced with, for example, 200 to 650 GPa high elastic carbon fiber, it can be sufficiently substituted for expensive non-rust metal such as stainless steel or titanium. Therefore, it can be set as the Retractor 3 which is not toxic to the living body or allergenicity.

  Incidentally, carbon fibers, ceramic fibers, glass fibers, aramid fibers and the like can be exemplified as reinforcing fibers among composite materials, and those fibers are long fibers such as filiform, scaly, woven, non-woven, etc. It is possible to use it in the form of what was or what was chopped as a short fiber. In particular, carbon fibers are preferable, and among them, highly elastic carbon fibers are most preferable. Further, as the resin, in addition to the above-mentioned polyether ether ketone and polyether imide, polyether ketone, poly acrylic ether ketone, polyphenylene sulfide, polysulfone and the like can also be mentioned. In addition, it is further better to apply a sizing process to carbon fiber in advance to improve the adhesiveness with the resin.

  Since semipreg sheets containing unidirectional fibers and semipreg sheets containing woven fibers are laminated alternately, for example (see FIG. 2 (b)), as shown in FIG. Even in the cross-sectional shape, it is possible to form a high strength and high rigidity intra-wound insertion portion 1. If the touch finger 4 and the connection tongue 7 are both substantially linear in plan view with respect to the main body 5 (see FIGS. 1 (a) and 1 (f)), the semi-preg sheet 8 is integrally formed. Since it is only necessary to cut linearly, it is also easy to laminate strip-like in a molding die not shown. Incidentally, the number of laminated semipreg sheets in the connection tongue 7 is gradually reduced from the number of laminated layers in the other part of the main body 5. The number of stacks in the touch finger 4 is substantially equal to the number of stacks in the other part of the main body barrel 5, and only the tip is sharply reduced.

  As shown in FIG. 3, a mold 9 for molding the handle portion 2 is composed of a lower mold 9D and an upper mold 9U, and a cavity 10 for forming the handle portion 2 is engraved in the mold. The holding cavity 11 of the endoprosthesis insert 1 is also formed to be continuous with the cavity. Although it is sufficient that the opening is made by the molding die edge 9e, the connecting cylinder forming area in which the connecting tongue 7 of the already formed wound insertion portion 1 is integrally formed closer to the wound insertion portion of the operating hand 6 I will come to 9s. The touching finger portion of the main body 5 is located outside the molding die rim. Then, a compound melt of the same kind of thermoplastic resin of the carbon fiber chip mix is passed through the passage 12 in FIG. 4 into the molding die heated so as not to exceed the thermoplastic resin melting temperature around at least any of the cavities. The press-in is performed, and the operating hand 6 is casted. Incidentally, the illustration is for two pieces, and the passage 12 is branched into right and left. The connecting cylinder 13 is integrally formed while melting the surface layer of the connecting tongue 7 with the compound melt flowing into the upper, lower, upper or lower or around the connecting tongue 7, and the handle portion 2 is formed (see FIG. 3C). .

  In addition, as shown to Fig.5 (a)-(c), the main body trunk | drum 5 can be bent or curved and shape | molded. Such a shape facilitates the operation of the retractor even in a small incisional wound, and the molding of the handle portion 2 even when molding ones with different degrees of bending or bending (see FIG. 7 described later). The impact of special restraints and restrictions will be reduced as much as possible. In such a healing insert 1, a hook piece 4A (see FIG. 1 (b)) or a raised piece 4B (see FIG. 7) in which the touch finger 4 is bent or curved with respect to the main body barrel 5. See (c) and (e). In addition to restricting or pulling soft tissue, the ability to anchor to hard tissue is also enhanced. If this touch finger 4 and the connection tongue are integrally formed in a substantially linear shape in plan view with respect to the body barrel 5, as described above, the formation by laminating the semipreg sheets 8 is extremely smooth. Also, it is easy to secure strength and rigidity.

  The touch finger 4 may be formed into a spatula, may be a single nail as shown in FIG. 7 (c), or may be a branch nail 14 as shown in FIG. 7 (e). A single claw or a branched claw can be formed by machining after the completion of the endodontic insert portion 1. Therefore, since the formation of the bifurcated claws itself is not related at all to the formation by semipreg sheet lamination, the wound insertion portion 1 has dimensions of a multiple or more of the width as shown in (a) and (b) of FIG. It can be molded in the form of a few-piece molded product 15 having a shape, which may be cut to a predetermined width (see FIG. 5 (c)), and the increase in the mold due to the difference in the shape of the nail is avoided. Cost reduction can also be promoted. The same applies to the case of using the spatula-like touch finger 4 as well as the case of using a branched nail. Therefore, according to the formation method for the several generational insertion parts 1, cost reduction can be achieved without being restricted by the shape of the touch finger 4, and mass production becomes possible.

  As can be understood from the above description, the healing insert portion 1 is molded by the mold 16 shown in FIG. 5A independently of the handle portion 2 by semipreg sheet lamination of a carbon fiber reinforced thermoplastic resin. An example of this shaping will be described later. As shown in FIG. 3 (b), the connection tongue 7 of the other end of the main body barrel integrally formed with the touch finger 4 is a handle portion in a state where a part of the creation insert 1 is accommodated and held in the holding cavity 11. The connecting cylinder molding area 9s in the second forming cavity 10 is exposed. Thermoplastic resin compound containing carbon fiber (chopped fiber), carbon nano fiber, carbon nanotube such as carbon nano fiber, carbon nanotube (carbon fiber), carbon nanotube, carbon nanotube (carbon fiber), carbon nano tube, carbon nano fiber, carbon nano fiber The melt is pressed in and the operator hand 6 is injected and formed. The connecting cylinder 13 is integrally formed while the connecting tongue surface layer is melted with the compound melt flowing into the upper, lower, upper or lower or around the connecting tongue 7, and the handle portion 2 is formed.

  The intracorporeal insertion portion 1 achieves high strength and high rigidity because it is a semi-preg sheet laminate in which resin is impregnated into unidirectional fibers or woven fabric fibers. On the other hand, since the handle portion 2 is a solidified product of the resin compound, an excellent operating hand 6 with a good touch is formed (the elastic modulus can be changed by adjusting the amount of the mixed fiber). The resin forming the intracorporeal insertion portion 1 and the resin of the handle portion 2 are made of the same type, and since the resin is thermoplastic, integration can be smoothly achieved by welding or fusion due to softening or remelting due to heating. . In many cases, the integral part of the connecting cylinder with the connecting tongue is formed so as to sandwich the connecting tongue from above and below, and the connecting cylinder 13 is formed with a fork having an upper piece and a lower piece split into forks. (See FIG. 1 (c)). According to the pinching of the connection tongue 7, the integration becomes even stronger.

  Since not only the wound insertion portion 1 but also the handle portion 2 is made of resin, it becomes an all-resin retractor 3. Therefore, even if X-rays are irradiated to any of these portions, observation of the operative field is hardly hindered. The miniaturization of the incision, that is, the low invasiveness is assisted, and the physical and mental burden on the patient is greatly reduced. In other words, the visual field of the operator is hardly disturbed. Moreover, although it includes a connection process via a connection tongue, since it is an integral part when it becomes one retractor, a joint mechanism for connection removal is not necessary, and it is lightweight because it is made of resin. Medical equipment.

  Although the finished product of the retractor 3 is permanently integrated, in the production stage, the insertion insert 1 is made independently of the handle 2. Since the intracorporeal insertion part 1 can be molded without being influenced by the shape of the handle part 2, if only the kind of the molding die 16 for the intracorporeal insertion part as shown in FIG. 5A is prepared Good (for example, molded by resin film bag-covered vacuum forming of a mold or the like). If the shape and dimensions of the connecting tongue 7 of the endodontic insert 1 and the body barrel 5 in the vicinity thereof are made common, a molding die 9 for molding the handle 2 and integrating with the endocardial insert 1 is provided. The number of preparations is also reduced. Even if all 48 types of retractors as described above are desired, 48 types of molds are not required, and a total of 16 pieces, ie 12 pieces for the insert in the wound area and 4 pieces for the handle part are required. It is possible to do with the preparation of the mold of the number of / 3. This greatly contributes to the decrease in the unit price of the retractor 3. The operator hand 6 is formed with a finger hook or pull tool locking ring such as a round hole 6A and an oval hole 6B (see FIG. 1 (a)). There is no such thing as a surge.

  By the way, as shown in FIG. 6 (a), on the side of the connection tongue 7, a left widening area 17 and a right widening area 18 protruding in the width direction from the connecting cylinder to be formed later are formed. Notches 19 may be formed in the area, and notch engaging projections 20 (see FIG. 6 (b)) may be provided at corresponding locations of the cavities. In this way, it is possible to prevent the cavity insertion (extraction from the mold) of the creation insert portion 1 at the time of compound melt pressure injection. The left and right widening zones 17 and 18 are removed by grinding after forming the handle portion, and the connecting barrel 13 and the body barrel 5 form a smooth continuous outer shape, and the sense of incongruity in gripping with the operating hand 6 or the patient. Unwanted contact with the skin etc. can be significantly reduced.

  No matter whether manufactured by any of the above methods, the retractor uses the entire matrix as resin, is lightweight, reduces the operation burden on the operator, and pulls the small incision in the direction to open it. There is a view of the surgical field by exclusion and traction. There is nothing that is blocked because of the all-resin in the confirmation of the affected area by X-ray irradiation, which greatly contributes to the promotion of smoothing and accuracy of the treatment. As described above, although the number of molds is reduced, as shown in FIG. 7, the length of the main body cylinder 5 may be different, the degree of bending or bending may be changed, or the shape of the handle portion 2 may be desired. In particular, it is possible to realize a retractor according to the preference of the operator with a small number of mold forms.

  DESCRIPTION OF SYMBOLS 1 ... Insertion part in a wound, 2 ... Handle part, 3 ... Retractor, 4 ... Touching finger, 4A ... Hook piece, 4B ... Uplift piece, 5 ... Body body, 6 ... Operation hand, 6A ... Round hole, 7 ... Connecting tongue, 8: Semipreg sheet, 9: mold, 9e: molding die edge, 9s: connecting cylinder molding area, 9D: lower mold, 9U: upper mold, 10: forming cavity, 11: holding cavity, 13: Articulating cylinder, 14: bifurcated claw, 15: several-piece molded article, 16: insert for insertion part molding die, 17: left widening area, 18: right widening area, 19: notch, 20: notch engagement Alignment.

Claims (5)

An intracorporeal insertion section provided with a touch finger at the tip of the body trunk for retracting or pulling soft tissue from the incision wound up to the operation target site, and an operation hand for desired action on the touch finger In a method of manufacturing a retractor, comprising: a handle portion provided, wherein the intracorporeal insertion portion is integrated with the handle portion,
The endoprosthesis insert comprises a connecting tongue at the proximal end of the body barrel which is welded during subsequent shaping of the handle portion, the body barrel being integral with the connecting tongue and the touch finger and carbon fiber Molded independently of the handle portion by semi-preg sheet lamination of reinforced thermoplastic resin,
The connecting tongue is connected to the holding cavity of the wound insert portion which is continuous with the forming cavity of the handle portion engraved in the forming die consisting of the lower mold and the upper die and opened at the forming die edge. The above-mentioned wound insert portion is manufactured so as to face the connecting cylinder forming area integrally formed closer to the inner insert portion and to position the touch and touch portion of the main body cylinder outside the molding die rim. Contain and hold,
The operation hand is injected and formed by pressing a melt of a thermoplastic resin compound blended with carbon fiber chips into a molding die heated so as not to exceed the melting temperature of the thermoplastic resin at least around any of the cavities. In addition, the connecting cylinder is integrally formed while the connecting tongue surface layer is melted with a compound melt flowing into the upper, lower, upper or lower or around the connecting tongue, and the handle portion is formed. Manufacturing method of a made retractor.   The method for producing an all-resin retractor according to claim 1, wherein the main body is formed by bending or curving.   The touch finger is a hooked piece bent or curved with respect to the main body, or a bent up bent piece, and the touch finger and the connection tongue are integrally formed in a substantially linear shape in plan view with respect to the main body. A process for producing the all-resin retractor according to claim 1 or 2, characterized in that   4. The method according to any one of claims 1 to 3, wherein, when the touch finger is a bifurcated nail, it is formed by machining the insertion part inside the wound after molding. Manufacturing method of plastic retractor.   On the lateral side of the connecting tongue, a left widening area and a right widening area extending in the width direction from the connecting cylinder to be formed later are formed, and a notch is formed in the widening area to correspond to the cavity 5. The method according to any one of claims 1 to 4, characterized in that a notch engaging protrusion is provided to prevent the cavity of the endocardial insert from being removed at the time of compound melt pressure injection. Of making all-plastic retractors.