JPS58159736A - Clamp for surgical operation aid device - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention uses soft non-skeletal tissue to enable access to the surgical site during the surgical procedure.

It relates to surgical aids used in moving and holding entities such as muscles, organs, etc. in moved positions.

Currently, the common practice in hospital surgical rooms is to have a surgeon's assistant who manually moves the entity from the surgical site as required by the surgeon, who of course wears surgical gloves. using a sponge or towel applied to the moved entity, or a rigid hand-held metal instrument.

It is an object of the invention to make unnecessary the use of the assistant's hands and thus to free him or make him unnecessary, as the case may be, to play a more fruitful role during the operation. It is. However, it should be understood that the surgical aid of the present invention is not limited to use in hospital operating rooms, but may also be used in dental surgery or veterinary surgery.

It is also an object of the present invention to provide a surgical aid that minimizes the amount of, for example, towels or towels that may damage the engaged sac surfaces or organs due to their rough surfaces. Towels and sponges can also dry the membrane surface by absorption, thus altering the normal physiology of the organ. Additionally, towels and sponges often dry the membrane surface without adequately protecting it from exposure to air. The assistive device of the present invention is free from these drawbacks and the disadvantages exhibited by other surgical assistive devices that have been proposed but not yet widely used. Many cannot be bent repeatedly into various shapes or do not maintain their curved shape.

or have relatively rough or hard surfaces that may react with body fluids or the saccharine coating, or absorb body fluids and cause drying or damage to organs, or that are moved and retained by organ traps. Either they are subjected to pressure or use and deteriorate rapidly, or they are not designed to provide external support and therefore cannot be maintained securely.

Basically, the present invention is a surgical aid having a main body in the form of a ductile component atomically bonded to a nidistomer component.

The main body extends from the main body in the form of a ductile component that is flexible, non-toxic and compatible with cellular metabolism, and that is also atomically bonded to the elastomeric component. ) 1 pull, the handle is flexible, non-toxic, and compatible with cellular metabolism, so that during surgery, the main body is placed in the surgical area to move and hold the tissue that will not be operated on. and the handle can be grasped at a point external to the surgical site to maintain the main body in a desired position, and the main body and the handle are combined into one It has a function similar to that of a human hand, wrist, and forearm.

Preferably, the main body portion and the 71-strand are comprised of a metal core and an elastomer coating. The core metal is preferably aluminum or an alloy of aluminum,
Or stainless steel.

The elastomer of the coating can also be bonded to the core metal; the currently preferred elastomer is dimethylpolysiloxane polymer.

The metal core may be in the form of a plurality of wires wrapped around the handle and looped within the main body. Alternatively, the metal core may include a rigid piece of metal within the body, a coiled wire extending from the same body into the handle, and tapering outwardly to increase compliance. It may be in the form of a plurality of wires extending radially from the metal piece into the main body.

The assistive device of the present invention can be made into a variety of different shapes for use in a variety of surgeries, and the gauge of the metal used in the heart may vary from the assistive device to the procedure for which the device is intended. Can be selected to provide the most appropriate strength. Additionally, the main part of the assistive device may be provided with a soft wire portion or flap to avoid damaging entities at one surgical site that may come into contact with the edges of the assistive device. I do not care. Such flaps may be coated with miso on one side to make it easier to move the flap in one direction than in the opposite direction, and may also be coated on one side to make it easier for the surgeon to manipulate the flap. It does not matter if there is a small bump that can be pinched. In other cases, the main part of the assistive device may be subdivided remotely from the handle to form fingers, which fingers are individually movable and which can be moved at the surgical site. The fingers will maintain the relative positions moved to suit the anatomy. Such fingers may be provided with small ridges as described above.

It is contemplated that a control device, such as a Bowden cable, may be built into the assistive device to facilitate manipulation of the main body of the assistive device within a surgical site. It is also contemplated that the suction device and/or light source may be included if desired.

The main body of a surgical aid can be held in place within the surgical site by grasping its handle at a location outside the surgical site, so that the surgeon has free hand access to the surgical site. It is possible to reach the user and manipulate the instrument as desired. Although such grasping may be accomplished manually by a surgeon's assistant, it is most often preferred to clamp the retractor frame to a retractor frame that is fixed relative to the surgical site. It has a handle that is held by the handle.

The frame preferably rolls mutually fixed first, second and sixth frame members in parallel in the same direction, with the second and third frame members spaced apart and away from the first frame member. and a fourth frame member mounted on both the second and sixth frame members so as to be adjustable toward and away from the first frame member, and in use, the fourth frame member an unlockable locking member for holding a frame member apart from the first frame member, each of the first and fourth frame members having a pair of locking members slidably mounted thereon in the longitudinal direction; and at least one of said second and sixth frame members having said clamp adjustably mounted thereon. There is.

Slidingly mounting the hook on the frame allows the surgeon greater leeway in selecting the shape of the wound that will allow access to the surgical site.

In some cases the surgeon may desire a narrow shape, while in other cases a nearly round shape may be preferred.

Engagement of the retractor hook by the musculature surrounding the wound holds the locking member in a locked position and the frame in a fixed position relative to the surgical site, thus making it the primary surgical aid. This ensures that the main body maintains its position within the surgical site unless adjusted by the surgeon during surgery.

Embodiments of the invention will now be described, by way of example, with reference to the accompanying drawings, in which: FIG.

As shown in FIG. 1 of the accompanying drawings, a surgical aid according to the present invention has a main body part 1 and a handle part 2. As shown in FIG. Both parts are made of an inner core of metal, such as an aluminum alloy, and an outer coating of elastomer, such as a dimethylpolysiloxane polymer, with the materials bonded together.

Because they are joined in this way, there are no voids inside the assistive device, and the ductility and elasticity of the image components are combined. Dimethylpolysiloxane polymers are well known for their compatibility with cellular metabolism, and their chemical inertness allows them to retain microorganisms in the unlikely event that they are accidentally cut or punctured. I will not do it. Yet again. Although the polymer easily withstands repeated sterilization and is a poor conductor of heat and electricity, all of which make it ideal for the purposes of the present invention, other elastomers are, of course, entirely satisfactory. be.

FIG. 2 illustrates the functional similarity between surgical aids and the human hand, wrist, and forearm. If there are assistive devices,
Although it is not necessary to have the cuts 3 subdividing the lower edge of the main body, these cuts serve in this embodiment to explain the above-mentioned similarity even more clearly. The part 4 delimited by the division 3 can therefore be compared to a human finger 5 and the upper part 6 of the first part 4 can be compared to the palm 7 of a person's hand, the main part 1 and the handle part. 2 can be compared with the wrist 9, and the part 1o of the handle part adjacent to the connection point 8 can be compared with the part 11 of the forearm adjacent to the wrist. Moreover, the assistive device has the advantage that the handle part can be bent, whereas the person's forearm cannot.

The entire assistive device can be straight, as in FIG. 1, or the parts of the device can be moved into any of the vertical positions as shown in FIG. , and these parts will remain in such positions until forced out of such positions. The surgeon can thus manipulate the parts within the surgical site to give him the exact position he desires in order to properly hold and stabilize the moved entity 12.

The assistive instrument can be retained by placing the handle portion outside the surgical site so as to minimize the obstruction of the available space within the surgical site. Although it is possible for an assistant to grasp the handle by hand, it is most often preferred to grasp it by a flange mounted on a frame that is trapped to hold it in fixed relation to the surgical site, so that the surgeon can grasp it by hand. The goal is to free up assistants to take on more productive roles during a surgery, or to eliminate the need for such assistants. As shown in FIG. 6, the frame 13 includes a first member 14, a second member 14 and a sixth member
Both members 15 and 16. Fourth member 17 and fifth member 18
It consists of Although members 14, 15, 16 and 18 form a fixed rectangle, member 17
and 16 between the members 14 and 18. A pair of retractor hooks 19 and 20 are attached to member 14.
It is mounted on the same member so that it can frictionally slide in the longitudinal direction of the
A similar pair of retractor hooks 21 and 22 are also similarly frictionally slidably mounted to member 17 for engagement with the edges of the surgical incision and is held open to allow the surgeon access to the surgical site. The four hooks are slidably mounted, allowing the surgeon to widen the incision to create any shape of open wound desired. Thus, by having six pairs of hooks in close proximity, the surgeon can give the wound an elongated shape, or by spacing the hooks relatively far apart, the surgeon can give it an almost round shape.

Each of members 15 and 16 has teeth 2 along its respective outer surface.
3, and these teeth point away from the member 14. Part 1 has locking members 24 and 25 mounted on fulcrum pins 26 and 27, respectively, at opposite ends of the member, which fulcrum pins extend through slots 2B and 29, respectively, in member 17. You can slide.

Each locking member has a certain amount of clearance between member 15.
It is in the form of a block through which a passageway 30 is wide enough to pass one of the 16 passages. Therefore.

When the surgeon makes the incision, he can insert the hook into the incision with members 14 and 1T closely spaced apart, and then he simply inserts members 14 and 1T until a wound of the desired width is obtained. can be pushed away. Although the stretched musculature around the wound will of course tend to bring members 14 and 17 back into contact, the pulling force on hooks 21 and 22, as shown in FIG. Therefore, passage 3
0 edge 31 in contact with the tooth 23 and the diagonally opposite edge 3
2 is brought into contact with the inner surface of frame members 15 and 16 passing through the same passage. When the edge 31 engages one of the teeth 23, the frame member 17 is held in its adjusted position. Of course, once the surgery is complete and the surgeon wishes to close the wound, he simply applies pressure to member 17 and the locking member to move them into the position shown in FIG. 5 as occupied by member 25. and he then moved both members 14 and 17
The plate can then be reattached by simply sliding it on and the plate removed from the patient.

Referring again to FIG. 6 (which shows the movable state of the clamps before they are attached to the frame members 15, 16), two clamps 33 and 34 are attached to the frame members 15, 16.
5 and 16, respectively, thereby holding surgical aids 35 and 36, respectively, by the handle portion.

Each main section extends to the surgical site to hold surgical elements. Each of the surgical aids has a metal core in the form of a coiled wire 37 in the handle and a loop 38 in the main body. The handle portion has a square cross section and the main body is in the form of a substantially rectangular flat pad.

Referring now to FIG. 4, which shows the clamp attached to member 18, the clamp is shown to be easily manipulated by the surgeon and which the surgeon wishes to install. It can be easily adjusted along the frame member. The clamp is attached to the base portion 39.
A fixed jaw 40 extending upward from one end of the base portion
．． A movable arm 41 is rotatably mounted at 42 on the base. Same movable jaw.

The knee link mechanism 45 is moved between open and closed positions by a lever 43 attached to a member 44, the knee link mechanism being rotatably mounted at 46 on the top of the jaw 41 and at the opposite end of the knee link mechanism. is rotatably attached to the base portion 39 at 47. Knee link mechanism 2
The pivot or fulcrum 4B between members 44 and 49 is moved overcenter by operating lever 43 either upwardly to open the clamp or downwardly to close the clamp. Therefore, it is convenient for the surgeon to place the handle of the surgical aid between the jaws of the clamp when the jaws are in the open position, and then press lever 43 down with the thumb to place the aid in the proper position. It's easy.

Kula 7zo is the same raw material used for La'zo.
; it can be mounted to the frame member in any desired position by means of a mechanically operated mounting mechanism 50, so that by pressing down on the lever 51 the clamp is mounted at the desired position on the frame; It is also easy for the surgeon to do. The movable jaw 52 of the mounting mechanism has a padded surface on the frame member to accommodate various thicknesses of the frame member and to provide a positive grip thereon. I don't mind.

Figure 6 shows frame 13 in place, hooks 19 and 2
0 engages the musculature 53 around the margins of the surgical site, one surgical aid 54 holds open the incised bladder 55 at 56, and the other surgical aid 57 is placed under this instrument. The actual surgical site is shown with the intestines 58 being held down so that the vertebrae 59 are present. It should be understood that each surgical aid is adapted to its own function.

FIG. 7 shows an embodiment of the surgical aid of the present invention, in which the metal core is in the form of a rigid metal piece 60.
A metal coil 61 extends upwardly into the handle portion, and a plurality of wires 62 extend radially outward from the metal piece 60 into the main body of the assistive device. wire 6
2 may be tapered as it extends outwardly from the metal piece 60 to provide increasing flexibility to the main portion of the assistive device.

Figures 8 and 9 show another embodiment of the surgical aid, in which the main part 1 has a flap 63 on the lower edge of the gyrus and a flap 64 on the upper edge of the gyrus. , and has a laterally extending lug 65 on each side edge of the gyri.

The flaps 63 and 64 are provided with grooves 66 so that they can be bent more easily in the direction indicated by the arrow than in the opposite direction.

These flaps are designed for various surgical space adjustments and tissue retention adjustments.

The function of the ear piece 65 is also similar. These flaps and ears have no metal core and therefore have a cushioning effect on the tissue they come into contact with.

Figures 10-19 show various other embodiments of the surgical aid of the present invention, each of which is adapted for a specific function.

Accordingly, FIG. 10 shows a surgical aid particularly suitable for restraining the intestines during gallbladder surgery. FIG. 11 shows an assistance device particularly suitable for use during brain surgery and having one side fitted with a thick cushion of soft elastomer. Prisoner 12 shows an assistive device designed to hold down his lungs during thoracic aorta surgery. The handle of the device has increased strength to withstand lung pressure. Figure 13 shows an assistive device adapted to restrain the lungs, with the protruding edges at the top of the main part engaging the liver lobes. FIG. 14 shows an assistive device particularly suitable for muscle traction. Figure 15 shows an esophageal retainer with a lengthened handle for use during abdominal entry. The organ enters the abdominal cavity, follows the diaphragm, and then wraps around the esophagus. Figure 16 shows the surgical aid adapted to hold the bladder closed, while Figure 17 shows the surgical aid adapted to hold the incised bladder as in Figure 6. 19 shows a surgical aid adapted to keep the base of the lungs away from the diaphragm during surgical assistance, and FIG. 19 shows an aid particularly suited for holding the heart during such procedures. It shows.

It is clear that the surgical aid according to the invention can be used in all body cavity surgeries, for example cardiac, thoracic, cerebral or abdominal surgeries. The invention can of course also be used in veterinary surgery and dentistry. Instead of the operating surgeon moving the object to a desired position and then the assistant holding it in place and moving it when commanded, the surgical aid of the present invention can be combined with the frame described above to allow the surgeon to move the object into the desired position. It allows him to place the topic accurately to his own preference and to adjust it from time to time as necessary. Furthermore, since the profile is low and the space occupied by the frame and assistive devices is minimal.

The operating possibilities afforded to the surgeon even outside the actual surgical site are enormous. The surgical aids of the present invention can be manipulated to closely conform to the shape of the entity being moved and to protect this entity from damage from air, water loss, or heat, or from being harmed by surgical tools. can. Furthermore, the surgical aid of the present invention is ideal for use, for example, during brain surgery, where the moved entity may cause acute inflammation due to conductive materials.

Rigid, unbendable instruments can cause lacerations to organs such as the liver and lungs due to careless movement by the assistant holding them.
However, the assistive device of the present invention deforms gently to avoid such lacerations. Yet again. Heart and intestinal cells that are constantly in motion can be injured by materials with high friction surfaces. Such injuries do not occur using the low friction surfaces of the assistive devices of the present invention.

[Brief explanation of drawings]

FIG. 1 is a perspective view of a surgical aid. FIG. 2 is a view showing the surgical aid of FIG. 1 being used within a surgical site, and also shows the hand plate and forearm of a person to illustrate the functional analogy; FIG. 6 is a perspective view of the chapter frame showing the clamps securing two surgical aids movable along frame members 15,16. FIG. 4 is a transparent view of the clamp attached to the frame 18 shown in the third factor. FIG. 5 is a plan view of the frame. FIG. 6 is a perspective view of the surgical site showing two different types of surgical aids in use; FIG. 7 is a surgical aid having a different heart configuration than that shown in FIG. 6; Perspective view. FIG. 8 is a perspective view of another embodiment of the surgical assistance instrument of the present invention. FIG. 9 is a diagram showing an embodiment of the surgical aids shown in FIG. 8. 1... "Main headquarters", 2... "Handle", 7...
"Hand" 9... "Hand plate", 11... "Forearm", 13.
..."Frame J, 14..."First frame All5 material J, 15...[Second frame member J, 16...
"Sixth frame member", 17... [Fourth frame member J, 19.20.21.22... "A pair of retractor hooks", 23.°° "Teeth". 24.25..."Locking member J,"33.34..."Kura agent Asamura Kōgai 2 - engraving of the famous drawing (no changes to the content) sin FIG, 6 FIG, 3 F"l also , 4 FfG, 5 FIG, 9 FIG, IOFIG, II FIG, 12FIG
, 13 FIG, 14 FIG, 15 FIG
, 16FIG, 17FIG, 18FI
G, I9 Procedural Amendment (Method) % Formula % 1. Indication of the case 1988 Patent Application No. 198826 2. Name of the invention Relationship with the case of the person making the amendment Patent S'F applicant address 4, agent 5, date of amendment order March 29, 1980 6, number of inventions increased by amendment 7, subject of amendment

Claims (1)

[Scope of Claims] +1) The clamp includes: a base portion (39);
a first jaw (40) projecting upward from 39);
and a second jaw (41) opposite to the first jaw, the lower end of the second jaw being pivotally connected to the base portion, so that the second jaw (41) is opposite to the first jaw. The first jaw is rotatable toward and away from the fixed first jaw. Further, the clamp rotates the second jaw (41) so that the second jaw (41) is in a clamping relationship with the first jaw (40) or in a releasing relationship. and a device for opening and closing the second jaw by opening and closing the second jaw. The device for opening and closing the second jaw has a knee linkage (45), the nuclear knee linkage (45) comprising an elongate member (49), which elongate member is connected to the second jaw (41). one end of the elongate member remote from the base portion (39); The elongate member is disposed substantially parallel to the base portion (39)K when the jaws (40, 41) are in the closed position, and the knee linkage is further coupled to the base portion (39)K at the second end of the elongate member. a lever (43) pivotally connected to the elongate member; an extension member (44) extending angularly from the lever pivot (48) to the second jaw;
4) is pivotally connected to said second jaw (41), whereby the second show. It is characterized by being rotatable so as to release the fastening relationship with the fixed first jaw by causing an over-center movement of the pivot of the lever (43) by driving the lever (43). Clamp above.