KR20170126604A - Traction device for laparoscopic surgery - Google Patents

Abstract

The present invention relates to a traction device for laparoscopic surgery. According to an embodiment of the present invention, the traction device for the laparoscopic surgery comprises: a needle; a housing; a traction bar; a stitching fiber; a fixing button; a probe; and an operation bar. The needle includes a front end and a back end in a longitudinal direction; and forms a slot penetrating an inside in the longitudinal direction. The housing includes a receiving unit wherein the back end of the needle is combined with one side of the receiving unit, and which is opened to the other side by connecting the slot of the needle. The traction bar is inserted into the slot of the needle to be separated through the front end of the needle. The stitching fiber is connected to the traction bar. The stitching fiber is inserted into the fixing button to be moved. The fixing button limits movement of the stitching fiber to apply tension to the stitching fiber. The probe includes one end and the other end in the longitudinal direction. The one end is inserted into the slot of the needle through the receiving unit to be adjacent to the traction bar inserted into the slot of the needle. The operation bar is combined with the other end of the probe; and is inserted into the receiving unit of the housing to push the probe of the needle to the traction bar inserted into the slot. When the operation bar is inserted into the housing by pushing the operation bar inserted into the receiving unit of the housing, the traction bar connected to the stitching fiber is separated from the needle by enabling the probe to push the traction bar in the slot. The traction bar includes one end or both ends having a sharp shape. The present invention provides a traction device for laparoscopic surgery, which is capable of fixing the location thereof in abdominal cavity and of stably performing traction of organs and tissues in the abdominal cavity without damaging organs and tissues during laparoscopic surgery.

Description

TRACTION DEVICE FOR LAPAROSCOPIC SURGERY BACKGROUND OF THE INVENTION 1. Field of the Invention [0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a laparoscopic surgical traction device capable of pulling and fixing an intra-abdominal organs or tissues during laparoscopic surgery.

Laparoscopic surgery is a minimally invasive surgical procedure that minimizes the incision of the abdomen by minimizing the incision in the abdomen, unlike traditional open surgery.

In order to perform this laparoscopic operation, it is necessary to secure an intra-abdominal operation space for inserting a laparoscope or other various surgical devices into the abdominal cavity, and to secure a field of view for the surgical site. For this purpose, a surgical device (hereinafter referred to as a "traction device") is used to pull or pull an organ in the abdominal cavity.

In this connection, Korean Patent Registration No. 10-0960436, for example, discloses an example of such a traction device. The pulling device according to the above document is provided with a tension wire at the distal end of a support holder inserted into the abdominal cavity, and the tension wire forms a lasso-like loop in the abdominal cavity to fix the organ.

However, in order to use the traction device according to the above document, the abdomen must be punctured with a trocar, so that the puncture site of the abdomen is required to be sewn after the operation. In addition, the traction device according to the above document can pull only the organs that can be tangled with the tension wire, so as to pull organs having various shapes and sizes in the abdominal cavity or to pull tissues around the organs (for example, muscle tissue, etc.) So it is difficult to use it widely. Further, when the organ is pulled by the traction device according to the above document, the tension wire is tightened over a considerable part in the organ, so that a great pressure is applied to the organ, and damage to the organ may occur.

Korean Patent Registration No. 10-0960436 U.S. Patent No. 8,382,772

With regard to the traction device used in laparoscopic surgery, a structure that can be widely used for traction of various organs and tissues in the abdominal cavity can be considered as a design factor without any structural change. In addition, a structure capable of stably tracing the organs and tissues of the abdominal cavity can be considered as a design factor.

The present invention refers to a gastric fixation kit proposed by U.S. Patent No. 8,382,772 and provides a laparoscopic surgical traction device widely used for traction of various organs and tissues in the abdominal cavity during laparoscopic surgery.

The present invention also provides a laparoscopic surgical traction device capable of stably performing traction without damaging organs or tissues of the abdominal cavity during laparoscopic surgery and fixing the intraperitoneal position.

A laparoscopic surgical traction apparatus according to an exemplary embodiment of the present invention includes a needle having a distal end and a rear end in the longitudinal direction and having a slot penetrating the inside in the longitudinal direction, A pull bar that is removably inserted into the slot of the needle through the distal end of the needle, a suture connected to the pull bar, A fixing button which is fitted in the suture thread so as to move therethrough so as to allow movement of the suture thread so as to apply tension to the suture thread and has one end portion and the other end portion in the longitudinal direction, And is inserted into the slot of the needle through the receiving port adjacent the pull bar being inserted Comprises a probe and is coupled to the other end of the probe, the operation bar to be inserted into the number of the tool housing to be pushed towards the tow bar is inserted into the slot of the needle. When the operating bar is pressed against the housing by pushing the operating bar inserted into the receiving port of the housing, the probe pushes the tow bar within the slot and the tow bar connected to the suture is released from the needle. The pull bar has one end or both ends of a sharp shape.

In one embodiment, the drawbar has a tubular shape. The pull bar is provided at one side thereof with a fastener for fitting the suture into the pull bar, and the pull bar is fixed to the pull bar through the fastener by inserting the suture inserted into the pull bar into the pull bar At least one depressing portion.

In one embodiment, the needle is formed in a straight or curved shape.

In one embodiment, the probe is formed as a flexible tube.

In one embodiment, the laparoscopic surgical traction device further comprises a protective cover detachably coupled to the housing to cover the needle.

In one embodiment, the laparoscopic surgical traction device further comprises a shield plate that is fitted to the suture to be covered by the pull bar separated from the needle.

In one embodiment, the shield plate has a curved shape in which an insertion hole into which the suture thread is inserted is formed at the center. At one side edge of the shield plate, a guide slit is formed for fitting the suture into the fitting hole.

In one embodiment, the guide slit includes at least one refracting portion.

In one embodiment, the shield plate is formed of a silicon material.

According to the laparoscopic surgical traction apparatus according to the embodiment of the present invention, a needlestick needle can be inserted into the abdomen directly without using the trocar to puncture the abdomen during laparoscopic surgery. It is easy to use.

In addition, the needle pierced in the abdomen can penetrate the organs or tissues of the abdominal cavity, and can be pulled out from the needle in the abdominal cavity by pulling the pull bar. The suture can be pulled out of the abdomen by being connected to the pull bar. Can be pulled widely to fix the position.

In addition, by using a pull bar having one end or both ends of a sharp shape, the organs or tissues can be directly fixed in the abdominal cavity by suturing with a suture. Therefore, depending on the status of the intraperitoneal organs or tissues and the position of the surgical site, the method of traction of organs or tissues can be different, so that the laparoscopic surgery can be performed under optimal conditions.

In addition, by using a protective plate fitted in the suture so as to cover the pull bar in the abdominal cavity, it is possible to disperse the pressure applied to the organ or tissue to be pulled, thereby preventing damage to the organ or tissue.

1 is a perspective view showing a traction device for laparoscopic surgery according to an embodiment of the present invention.
FIG. 2 is an exploded perspective view of the laparoscopic surgical traction apparatus shown in FIG. 1. FIG.
FIG. 3 is a view showing a distal end portion of a needle having a pull bar inserted therein in a laparoscopic surgical pulling apparatus according to an embodiment of the present invention. FIG.
FIG. 4 is a cross-sectional view of the laparoscopic surgical traction device shown in FIG. 1 with a protective cover removed.
5 is an enlarged view of a portion A shown in Fig.
6 is a perspective view illustrating a housing coupled with a needle of a laparoscopic surgical traction apparatus according to an embodiment of the present invention.
Fig. 7 is a perspective view of the housing shown in Fig. 6 as seen from another direction. Fig.
FIG. 8 is a perspective view of the housing shown in FIG. 6 with the safety bar rotated.
FIG. 9 is a side view of a manipulation bar coupled with a probe of a laparoscopic surgical traction apparatus according to an embodiment of the present invention.
FIG. 10 is a cross-sectional view of a traction device for laparoscopic surgery according to an embodiment of the present invention, in which a manipulation bar is pushed into a housing.
11 is an enlarged view of a portion B shown in Fig.
12 is a perspective view illustrating a pull bar of a laparoscopic surgical pull apparatus according to an embodiment of the present invention.
13 is a perspective view showing a pull bar according to another embodiment.
FIG. 14 is a perspective view illustrating a fixing button of a laparoscopic surgical pulling apparatus according to an embodiment of the present invention. FIG.
15 is a cross-sectional view of a traction device for laparoscopic surgery according to another embodiment of the present invention.
16 is a perspective view illustrating a protective plate of a laparoscopic surgical traction apparatus according to an embodiment of the present invention.
17 is a view showing an example of mounting the protection plate shown in Fig.
18 is a view showing a modified state of the protection plate shown in Fig.
FIG. 19 is a view showing a guide slit of another embodiment formed on the protective plate shown in FIG. 16; FIG.
Fig. 20 is a view showing an insertion fitting of another embodiment formed on the protection plate shown in Fig. 16;
FIGS. 21 to 24 are views for explaining an example of a method of pulling organs using a traction device for laparoscopic surgery according to an embodiment of the present invention.
FIG. 25 is a view showing an example of a organ taken by a laparoscopic surgical traction apparatus according to an embodiment of the present invention. FIG.
26 and 27 are views for explaining another example of a method for pulling organs using a laparoscopic surgical traction apparatus according to an embodiment of the present invention.

DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, an embodiment of a laparoscopic surgical traction apparatus according to the present invention will be described with reference to the accompanying drawings. In the drawings, the same reference numerals designate the same or corresponding components or parts. As used herein, 'forward', 'front', etc. direction indicators refer to the direction in which the pull bar is separated from the needle, and 'rear' and 'back' refer to the opposite direction.

Referring to FIGS. 1 and 5, a laparoscopic surgical traction apparatus 1000 (hereinafter referred to as a "traction apparatus") according to an embodiment is a device that can be pierced A housing 200 coupled to the needle 100 to support the needle 100 and a housing 200 coupled to the housing 200 so as to be pushed into the housing 200 by a user's pressing operation The probe 200 is coupled to and supported by the manipulation bar 300 and the manipulation bar 300 and is inserted into the needle 100 through the housing 200 as the manipulation bar 300 is pushed into the housing 200 (400). Since the pulling apparatus 1000 is used in a manner that the needle 100 is directly pushed into the abdomen 10 of the patient, it is not necessary to puncture the abdominal region 10 using a trocar needle (not shown) Even if the needle 100 pierced by the needle 100 is pulled out, it is not necessary to perform the suturing because the wound area of the abdomen 10 due to the needle 100 is small.

The apparatus 1000 according to one embodiment further includes a pull bar 500 detachably inserted into the needle 100 and a suture 600 connected to the pull bar 500. The pull bar 500 is inserted into the abdominal cavity 13 through the skin 11 and abdominal wall 12 of the abdomen 10 while being inserted into the needle 100 during laparoscopic surgery. When the needle 100 passes through the organ 20 or tissue (e.g., muscle tissue around the organ 20) of the abdominal cavity 13, the pulling bar 500 is inserted into the needle 100, (See Figs. 22 and 23). Further, the pull bar 500 is separated from the needle 100 in the abdominal cavity 13 by the pushing operation of the manipulation bar 300. This pull bar 500 is used to pull the organ 20 or tissue in the abdominal cavity 13 or to pierce the organ 20 or tissue in the abdominal cavity 13. [

The traction device 1000 according to an embodiment may be a suture device that keeps the suture 600 pulled out of the abdomen 10 in tension to pull the organ 20 or tissue in the abdominal cavity 13, And a fixed button 700 (hereinafter, referred to as a 'fixed button'). The suture 600 may be used to bind one part of the organ 20 or tissue to another part when the organ 20 or tissue in the abdominal cavity 13 is pierced with the pull bar 500, Is also used to tie these organs (20, 21) or tissues together if they are further pierced by other organs (21) or tissues. The suture 600 may be pulled within the abdominal cavity 13 to pull one portion of the organ 20 toward another or pull the organ 20 toward the other organs 21, It is possible to position the towed organs 20 by knotting. In some cases, the organ 20 or tissue, which is pierced by the pull bar 500 in the abdominal cavity 13 and bound by the suture 600, is pulled out of the abdomen 10 by pulling the suture 600, 13). In this case, the pulled organs 20 can be fixed to the fixing button 700.

In addition, the pulling apparatus 1000 according to an embodiment prevents the user from being injured due to the needle 100 having a sharp shape during storage or handling, and prevents contamination of the needle 100 due to external foreign matter And a protection cover 800 for preventing the dust from being generated. The protective cover 800 is detachably coupled to the housing 200 so as to cover the needle 100.

The needle 100 can be pierced and pushed into the abdominal region 10 and has a thin thickness so that the abdomen 10 is left with a small wound area that does not require suturing. The needle 100 has a length enough to penetrate through the abdominal region 10 of the human body and to be sufficiently inserted into the abdominal cavity 13. The needle 100 has a front end 101 directed toward the front side FD and a rear end 102 directed toward the rear side RD in the longitudinal direction thereof. In addition, the needle 100 has a slot 110 passing through the inside in the longitudinal direction, and the slot 110 is opened at the tip 101 and the rear end 102, respectively.

3 to 5, the distal end portion 100F including the distal end 101 of the needle 100 is inserted into the needle 100 when the needle 100 is inserted into the patient's abdomen 10, Is formed into a sharp shape so as to easily penetrate the skin 11, the abdominal wall 12, and the peritoneum (not shown) of the patient and enter the abdominal cavity 13. [ The needle 100 may be pierced into the patient's abdomen 10 to penetrate the organ 20 or tissue within the abdominal cavity 13. [

In one embodiment, the needle 100 is formed of a metal material that is harmless to the human body, such as stainless steel. The needle 100 may be formed by electropolishing to have a smooth surface. In one embodiment, the needle 100 may be pushed into the abdomen 10 with a small force and may have a diameter D of 1 mm such that the needle 100 may not be sutured at the site of the abdomen 10, . The needle 100 also has a length L sufficient to reach the organ 20 to be pulled in the abdominal cavity 13, for example, 10 cm to 20 cm. The diameter D and the length L of the needle 100 are not limited to the diameter and length according to the embodiment and may vary depending on the position of the surgical organs in the abdominal cavity 13, (For example, the degree of abdominal obesity), and the like.

The housing 200 is a hollow hub that supports the needle 100. The housing 200 of one embodiment has a size that allows the user to hold the finger. 6 to 8, the housing 200 is elongated in the same direction as the longitudinal direction FD / RD of the needle 100. In addition, the housing 200 has a shape in which the thickness T in the vertical direction (TD / LD) is smaller than the width W in the left and right directions (LSD / RSD) And has a shape whose cross section is substantially elliptical. In the housing of the other embodiment, the central portion of both side surfaces in the left and right direction (LSD / RSD) of the housing 200 may be concave to improve the grip feeling, and a plurality of grooves May be formed.

In the housing 200, a rear end portion 100R (see FIG. 4) including the rear end 102 of the needle 100 is coupled to the side wall 201 facing the front FD. Specifically, the rear end 100R of the needle 100 is coupled to penetrate the side wall 201 of the housing 200 having a predetermined thickness. A receiving port 210 for receiving at least a part of the operating bar 300 in the longitudinal direction is formed in the housing 200 and a receiving port 210 is formed at a rear end RD of the housing 200 Lt; / RTI > The operation bar 300 is inserted into the receiving port 210 from the rear RD of the housing 200. The slot 110 opened at the rear end 102 of the needle 100 communicates with the receiving port 210. Accordingly, the probe 400 can be inserted into the slot 110 of the needle 100 through the receiving port 210 of the housing 200. In one embodiment, the housing 200 is formed of a synthetic resin material. The housing 200 may be formed integrally with the needle 100 through insert molding.

The housing 200 includes upper and lower opposing upper and lower walls 202 and 203 for positioning the operation bar 300 inserted into the receiving port 210 of the housing 200 in the housing 200. [ (Not shown). The pair of latching openings 220 are formed through the upper wall 202 and the lower wall 203, respectively, and are spaced apart from each other in the longitudinal direction of the housing 200. The operation bar 300 is provided at two positions where the stopper 220 is engaged, for example, at the first position and the second position in the longitudinal direction of the housing 200, (Not shown).

In addition, the housing 200 includes a safety bar 230 that can be folded upward (TD) against the rear edge portion 202A of the top wall 202. [ In one embodiment, the safety bar 230 includes a first portion bar 231 that is foldably attached to the rear edge portion 202A of the top wall 202, And a second portion bar 232 bent perpendicularly. The second part bar 232 is bent such that a part opposite to the part connected to the first part bar 231 is parallel to the first part bar 231, (For example, the index finger) while pressing the safety bar 230 with another finger (e.g., a index finger). The safety bar 230 is formed to have a substantially L shape when viewed from the side of the housing 200. In the direction of the width W of the housing 200 adjacent to the portion of the safety bar 230 where the first part bar 231 and the second part bar 232 are in contact with each other, that is, the rear edge of the first part bar 231 And a pair of protrusions 233 protruding in a direction opposite to the direction in which the second partial bar 232 is bent are provided on both sides. In a state in which the safety bar 230 is folded in the housing 200 or the first part bar 231 is positioned parallel to the upper wall 202 of the housing 200, The entry of the manipulation bar 300 into the housing 210 can not be blocked by the pair of projections 233 and the manipulation bar 300 can not be pushed into the housing 200. That is, the operation bar 300 is prevented from being pushed into the housing 200 arbitrarily. In the state where the safety bar 230 is folded in the housing 200 or the first part bar 231 is positioned to be perpendicular to the upper wall 202 of the housing 200, The operating bar 300 can be inserted into the receiving port 210 and the operating bar 300 can be pushed into the housing 200. In this case, .

A securing clip 240 for securing the suture 600 is protruded from the lower wall 203 of the housing 200. The suture 600 is inserted into the fixing clip 240 and is prevented from being entangled in a portion extending and connected to the pull bar 500 inserted in the needle 100, for example. In order to allow the suture 600 to be easily inserted into the abdomen 10 along the needle 100 when the needle 100 is pierced into the abdomen 10, It is preferable to insert the needle 100 into the abdominal region 10. When the suture 600 is pulled to pull the organ 20 or tissue of the abdominal cavity 13 after the needle 100 is pushed into the abdomen 10, the suture 600 is separated from the securing clip 240 It can be pulled easily.

On both sides in the left and right direction (LSD / RSD) of the housing 200, the rear edge portions 250 of both side surfaces protrude from other portions. 2) of the protective cover 800 covered with the needle 100 is attached to the rear edge portion 250 of both sides so that the protective cover 800 is optionally peeled off .

The operation bar 300 is a hub for supporting the probe 400 and has a shape complementary to the receiving port 210 so as to be inserted into the receiving port 210 of the housing 200 And includes a resiliently deformable portion 310 and a pressing portion 320 integrally formed at a rear end of the resiliently deformable portion 310. The elastic deforming portion 310 includes a pair of free ends 311 that are elastically deformed by being pushed up and down by the upper wall 202 and the lower wall 203 of the housing 200 when inserted into the receiving port 210, And a fixed end 312 connecting the free ends 311 of the pair. A locking protrusion 313 protruding upward (TD) and downward (LD) is formed at the tip of each of the pair of free ends 311, respectively. The pair of latching protrusions 313 formed on the elastic deforming portion 310 are fitted to the latching protrusions 220 formed on the housing 200 by snap fitting. Specifically, when the manipulation bar 300 is inserted into the receiving port 210 of the housing 200, a pair of locking projections 313 are inserted into the upper wall 202 and the lower wall 203 of the housing 200, The operation bar 300 is fixed to the housing 200 so as to have a position before the pressing operation, that is, the first position (see FIG. 4). When the operation bar 300 is pushed into the housing 200 as long as a pair of locking protrusions 313 are formed on the front side of the upper wall 202 and the lower wall 203 of the housing 200 So that the operation bar 300 is fixed to the housing 200 so as to have a position after the pressing operation, that is, the second position (see FIG. 10). According to one embodiment, the operating bar 300 is movable only in the housing 200 from the first position to the second position by the shape of the locking projection 313, To the first position. Therefore, it is difficult to arbitrarily separate the operation bar 300 from the housing 200, so that the operation of the traction device 1000 operated by pushing the operation bar 300 into the housing 200, for example, the reuse of the used traction device 100 it's difficult. The manipulation bar 300 of one embodiment is formed of a synthetic resin material. The operation bar 300 may be formed to have a color different from that of the housing 200 so that the user can visually confirm the operation state of the operation bar 300.

The probe 400 is a tube having a thickness capable of being inserted into the slot 110 of the needle 100 or a tube with a part of the inside thereof clogged and has one end 401 (see FIG. 2) and the other end 402 (see Fig. 9). The probe 400 is inserted into the slot 110 through the receiving port 210 of the housing 200 so that one end portion 401 is adjacent to the draw bar 500 inserted into the slot 110 of the needle 100 . The probe 400 keeps the slot 110 in a hermetic state with the probe 100 inserted into the slot 110 of the needle 100. The other end 402 of the probe 400 is coupled to a portion of the manipulation bar 300 facing the front (FD). Specifically, the other end 402 of the probe 400 is coupled to the fixed end 312 facing the front (FD) through a pair of free ends 311 of the resiliently deformable portion 310 ).

The pull bar 500 is inserted into the slot 110 through the tip 101 of the needle 100 and positioned within the tip portion 100F of the needle 100. [ 10 and 11, the pull bar 500 can be separated from the needle 100 and placed in the abdominal cavity 13. [

Referring to FIGS. 12 and 13, the pull bar 500 of the embodiment has a bar shape which is thick enough to be inserted into the slot 110 of the needle 100 and penetrates the inside in the longitudinal direction. The pull bar 500 has a fixture 510 that passes through one side of the suture 600 so that the suture 600 can be inserted therein. In one embodiment, when the pull bar 500 is detached from the needle 100 within the abdominal cavity 13 and is engaged with the suture 600, the pull bars 500 and the suture 600 and the 'T' Thereby making it easier to hold the laparoscopic surgical apparatus by the device 32 (see FIG. 27) with the forceps. For this purpose, the fastener 510 is formed on one side of the central portion in the longitudinal direction of the drawbar 500. The pull bar 500 has at least one push portion 520 which is deformed by pressing a part of the pull bar 500 so that the suture 600 inserted into the pull bar 500 is not pulled out through the fastener 510.

The pull bar 500 is separated from the needle 100 passing through the organ 20 or tissue in the abdominal cavity 13 during laparoscopic surgery and is pulled by the suture 600 pulled from the outside of the abdomen 10, So that the organ 20 or tissue is pulled in the direction of pulling the suture 600 about. The pull bar 500 of one embodiment is formed such that one end in the longitudinal direction has a sharp shape. The pull bar 500 is detached from the needle 100 in the abdominal cavity 13 even when the needle 100 does not penetrate the organ 20 or tissue in the abdominal cavity 13 and is pulled out of the needle 100 by the suture 600 It can be used to pierce organs (20) or tissues so that the organ (20) or tissue can be directly bound and pulled. That is, the pull bar 500 can be used in the abdominal cavity 13 as a needle that can entangled the organ 20 or tissue with the suture 600.

The organ 20 or tissue bound by the suture bar 500 by the pull bar 500 is pulled toward the abdominal wall 12 in the abdominal cavity 13 by the suture 600 pulled out of the abdomen 10 and pulled . The traction bar 500 can also be used to further pierce other organs 21 or tissue so that the organs 20 or tissue within the abdominal cavity 13 can be tied to other organs 21 or tissue and pulled through the suture 600 ) Can be knotted and fixed in position. A laparoscopic surgical apparatus inserted into the abdominal cavity 13 together with the traction device 1000 is used to puncture the organ 20 or tissue in the abdominal cavity 13 with the pull bar 500. [

The pull bar 500 is formed so that one end in the longitudinal direction has a sharp shape, but is not limited thereto. That is, as in the pull bar 500 'of the other embodiment shown in FIG. 13, both end portions in the longitudinal direction thereof are all at a sharp angle so that they can be used for easily piercing the organ 20 or tissue in the abdominal cavity 13 Shape.

Suture 600 is a suture for laparoscopic or endoscopic surgery. Such a suture 600 includes a biodegradable suture thread that dissolves and disappears within the human body after a predetermined period of time has elapsed. The suture 600 may be inserted into the abdominal cavity 13 by being pulled by the pulling bar 500 or may have a fiber property (e.g., strength) that can be retained without pulling when pulled to pull the organ 20 or tissue in the abdominal cavity 13. [ And Shingo).

The fixation button 700 is used to fix the organs 20 or tissues that are pulled up to secure a view of the medical staff to the operation space and the surgical site during the laparoscopic surgery at a fixed position in the abdominal cavity 13, And holds the suture 600 in a taut state. 14, the stationary button 700 according to one embodiment includes a stationary button body 710 and a pressing pin 720 that is rotatably coupled to the stationary button body 710 do. The suture 600 is inserted to pass through a path 701 formed in a central portion of the securing button 700. The path 701 of the securing button 700 is opened while the pushing pin 720 is erected with respect to the securing button body 710. In this state, the suture 600 is moved freely (See FIG. 4). That is, the suture 600 can be pulled out while the fixing button 700 is in close contact with the skin 11. The path 701 of the fixing button 700 is closed when the pressing pin 720 is rotated downward (R) toward the fixing button body 710. In this state, 700). That is, the suture 600 can no longer be pulled out of the fixing button 700 which is in close contact with the skin 11. The fixing button 700 is provided with a cover (not shown) which is formed of a soft silicone material so as to prevent the skin 11 from being damaged when the skin 11 is brought into close contact with the skin 11, . An adhesive harmless to the human body can be applied to the surface of the cover which is in close contact with the skin 11. [ The fixing button 700 is formed of a synthetic resin material that is easy to process and has excellent durability. In one embodiment, the securing button 700 is formed in a button shape, but the shape of the securing button 700 is not limited thereto.

Although the traction device 1000 according to one embodiment includes a straight shape of a needle 100, the traction device 1000 'according to another embodiment as shown in FIG. 15 has a curved shape, Of the needle 100 '. Such a traction device 1000 'may be used to traverse organs or tissues located within the abdominal cavity 13 to avoid other organs or tissues (e.g., diaphragm) therein.

In one embodiment, the probe 400 is formed as a flexible pipe that can flex and bend freely so that it can be movably inserted into the straight needle 100 and the curved needle 100 '. The probe 400 may be formed of a synthetic resin material, an elastomer, or the like. However, the probe 400 is not limited thereto, and may be formed of various materials that can be bent and bent freely. Further, in the case of the probe 400 to be transferred to the straight needle 100, it may be formed of a metal material harmless to the human body such as the needle 100, for example, stainless steel.

The tow apparatus 1000, 1000 'according to embodiments further includes a shield plate 900 that is a shelter of the tow bars 500, 500'.

16 and 17, the shield plate 900 according to one embodiment is formed by the contact of the pull bars 500 and 500 'having a small thickness when the organ 20 or tissue is pulled, Thereby preventing a large pressure from being exerted. The protective plate 900 is formed to have a size enough to cover the pull bars 500 and 500 'having one end or both ends in a sharp shape, And has a curved plate shape. The shield plate 900 disperses the pressure applied to the organ 20 or tissue for traction to prevent damage to the organ 20 or tissue.

The shield plate 900 of one embodiment is formed of a silicone material for medical use, in particular, a soft silicon material, so that when a force F is applied so that the convex portion is pressed (for example, , The protective plate 900 is elastically deformed so that the convex portion becomes gentle. The shield plate 900 is not limited to the silicon material according to the embodiment, and may be formed of a material having characteristics corresponding thereto, for example, various materials harmless to the human body and capable of elastic deformation.

In the shield plate 900 of the embodiment, a fitting hole 910 is formed in a central portion so that the suture 600 can be inserted. A guide slit 920 extending from one side edge to the insertion hole 910 is formed in the protection plate 900. The suture 600 can be easily inserted into the insertion hole 910 through the guide slit 920. [ The guiding slit 920 is formed in the protective plate 900 of the embodiment, but is not limited thereto. For example, as shown in FIG. 19, a guide slit 920 'including at least one refracting portion 921 may be formed in the shield plate 900 so that the suture 600 inserted into the insertion hole 910 is inserted into the insertion hole 920' (910). 20, a protrusion 911 protruding inward is formed in the fitting hole 910 to prevent the suture 600 inserted into the fitting hole 910 from being arbitrarily disengaged from the fitting hole 910 You may.

In one embodiment, the insertion hole 910 and the guide slit 920 are formed in the shield plate 900 so as to insert the suture 600, but the present invention is not limited thereto. That is, in another embodiment, the fitting plate 910 and the guide slit 920 may not be formed in the shield plate. The suture 600 may be inserted into the shield plate by punching directly with the pull bars 500 and 500 '. Even in the case where the fitting hole 910 and the guide slit 920 are formed in the protection plate 900, it is possible to prevent a part of the long-term contact portion The suture 600 may be inserted by directly piercing the other part of the shield 900 with the pull bars 500 and 500 '.

A method of using the traction device 1000 according to the above-described embodiment in laparoscopic surgery will be described with reference to the accompanying drawings. Although the drawing shows the towing device 1000 according to one embodiment, the towing device 1000 'according to another embodiment can be used as well.

An example of a method of using the traction device 1000 during laparoscopic surgery will be described with reference to FIGS. 21 to 24. FIG. Referring to FIG. 21, the position of an object to be operated, such as the organ 20, in the abdominal cavity 13 for laparoscopic surgery is confirmed by an ultrasonic diagnostic apparatus or the like. Thereafter, the abdomen 10 of the patient is punctured at a plurality of sites (usually three to four sites) using a trocar, and the laparoscopic surgical apparatus is inserted through the holes formed by perforation. Here, the laparoscopic surgery apparatus includes a laparoscope 31 including a device capable of photographing the abdominal cavity 13, a device 32 with a forceps, and the like. Before insertion of the laparoscopic surgical device, the abdominal cavity 13 of the patient is inflated with gas (carbon dioxide) injected through the trocar.

The traction device 1000 according to one embodiment can be pierced directly into the abdomen 10 of the patient without using a trocar, unlike the laparoscopic surgery device. When the traction device 1000 is pierced into the abdomen 10 and inserted into the abdominal cavity 13, the position of the traction device 1000 passing through the skin 11 and abdominal wall 12 with the laparoscope 31 (The position of the tip portion 100F of the body 100). When the needle 100 is inserted into the abdominal cavity 13, the needle 100 is inserted into the organ 20 through the device 32 with the forceps so that the needle 100 can smoothly penetrate the organ 20 or tissue to be pulled. You can get an organization. The objects that can be trained during laparoscopic surgery using the traction device 1000 include a heart, a cardiac, a spleen, a kidney, a bladder, a stomach, a pancreas, a lung, a small intestine, a large intestine, And abdominal organs. In addition to the above-described organs, an object which can be traced during laparoscopic surgery using the traction device 1000 includes tissue inside the abdomen (such as muscular tissue around the organ).

23, when the needle 100 of the traction device 1000 is passed through an object to be trained, such as the organ 20, as shown in FIG. 22, the outer circumference of the housing 200 The pull bar 500 is pulled out of the needle 100 by the probe 400 by pushing the operation bar 300 against the needle 100. As a result, At this time, the pull bar 500 separated from the needle 100 is connected to the suture 600 passing through the organ 20 by being pulled by the needle 100, so that the pull bar 500 is suspended from the suture 600 in the abdominal cavity 13 do.

24, when the pull bar 500 is detached from the needle 100, the protecting plate 900 is inserted through the hole formed by the perforation in the abdominal region 10, and the device 32 The shield plate 900 is inserted into the suture 600 such that the shield plate 900 is positioned above the pull bar 500. In the case where the insertion hole 910 and the guide slit 920 for inserting the suture 600 are not formed in the protection plate 900, the suture 600 can be inserted through the protection plate by the pulling bar 500 have. The needle 100 pierced in the abdomen 10 is then withdrawn from the abdomen 10 and the suture 600 is pulled out of the abdomen 10 to pull the organ 20 toward the abdominal wall 12.

For reference, FIG. 25 shows a liver 1 pulled by a traction device 1000 in a manner as described above. In Fig. 25, the left lobe 1a of the liver 1 is penetrated and supported by the traction device 1000. In Fig. The lobes 1a of the liver 1 are inserted into the pull bars 500 and pulled up by the protective plate 900 against the left lobe 1a of the liver 1 to lift the liver 1 without damaging the liver, The biliary tract 3 and the gastrointestinal tract 4 located below the left lobe 1a of the stomach 4 can be secured.

When the lancing of the organ 20 is confirmed by the laparoscope 31, that is, when the visual confirmation of the operation space and the surgical site is confirmed, the fixation button 700 is brought into close contact with the skin 11 of the patient, The fixing button 700 is operated so as to maintain the tight state.

The suture 600 is cut while the pull bar 500 is being held by the clamping device 32 and the pull bar 500 is pulled out of the abdomen 10 . According to the method of using the traction device 1000 according to this embodiment, the organ 20 can be pulled easily and quickly without putting on a surgical assistant to hold the traction device 1000 during laparoscopic surgery, The time and cost of laparoscopic surgery can be reduced.

Another method of using the traction device 1000 will be described with reference to Figs. 26 and 27. Fig. The same content regarding the preparation and initiation of laparoscopic surgery in the above-described method of use is omitted. As shown in Fig. 26, the traction device 1000 is immediately inserted into the abdominal region 10 of the patient. At this time, the needle 100 does not penetrate the organ 20 in the abdominal cavity 13, but is located outside the organ 20. In this state, the operating bar 300 is pressed against the housing 200 from the outside of the abdomen 10 to separate the pull bar 500 from the needle 100.

Thereafter, as shown in FIG. 27, the pull bars 500 and 500 'having one ends or both ends thereof are formed into a sharp shape by the device 32 with the pullers and the pull bars 500 , 500 ') and the organ (20) or tissue can be pierced with the suture (600). Thereafter, the organ 20 or the suture 600 bound to the tissue can be pulled from the outside of the abdomen 10 to pull the organ 20 or tissue, and the position can be fixed by operating the fixing button 700. When at least one shield plate 900 is inserted into the suture 600 to be in contact with the organ 20 or the tissue when the organ 20 or tissue is bound with the suture 600, the pull bars 500, 500 ' It is possible to prevent the organs 20 and the tissue from being damaged by dispersing the pressure applied to the organ 20 or tissue by the contact of the organ 600. [

The other organs 21 or tissue in the abdominal cavity 13 may be additionally pierced by the pull bars 500 and 500 'to bundle the organs 20 and 21 with the suture 600, . For example, the suture 600 may be pulled to pull the organ 20 toward the other organ 21, and a knot may be formed on the suture 600 in this state, The position can be fixed. At least one shielding plate 900 is inserted into the suture 600 before the plurality of organs 20 and 21 are tied to each other with the suture 600, (900) can be interposed. In addition, at least one shield plate 900 is inserted into the suture 600 so that the shield plate 900 is brought into contact with the plurality of organs 20, 21 or tissue in place of the suture 600, It is possible to disperse the pressure applied to the tissue to prevent damage to the organ (20, 21) or tissue.

The pull bars 500 and 500 'used to pierce the organs 20 and 21 in the abdominal cavity 13 are used to deliver the suture 600 when the suture 600 is knotted, 32 can be removed from the abdominal region 10. If the traction and position fixation of the organs 20 or tissue in the abdominal cavity 13 is confirmed by the laparoscope 31, that is, if confirmation of securing of the operation space and the surgical site in the abdominal cavity 13 is confirmed, Or surgery. When the test or surgery is completed, the suture 600 which is holding the organ 20, 21 or tissue is cut off and released from the fixed state.

As such, the traction device 1000 according to one embodiment can directly orbit organs or tissues in the abdominal cavity 13 with the pull bars 500 and 500 ', and can be bundled with the suture 600, It is possible to respond promptly even in emergencies.

The pulling apparatuses 1000 and 1000 'according to the above-described embodiments may further include forceps that can pull the suture 600 out of the abdomen 10 more easily.

The traction devices 1000 and 1000 'according to the above-described embodiments can be used for thoracoscopic surgery in addition to laparoscopic surgery.

The present invention described above is not limited to the above-described embodiments and the accompanying drawings. It will be apparent to those skilled in the art that various substitutions, alterations, and changes may be made without departing from the scope of the present invention.

100: needle 110: slot
200: housing 210: receiving means
300: Operation bar 310: Elastic deformation part
320: pushing part 400: probe
500: pull bar 510: fastener
600: Suture 700: Lock button
800: protective cover 900: shield plate
910: fitting 920: guide slit
1000: Towing device

Claims (9)

A needle having a front end portion and a rear end portion in the longitudinal direction and formed with a slot penetrating the inside in the longitudinal direction,
A housing having the rear end of the needle coupled to one side thereof and having a receiving port communicating with the slot of the needle and opening to the other side,
A pull bar detachably inserted into the slot of the needle through the distal end of the needle,
A suture connected to the pull bar,
A stationary button fitted to the suture so as to move therethrough and capable of restricting movement of the suture so as to apply a tension to the suture;
A probe having one end and the other end in the longitudinal direction and inserted into the slot of the needle through the receiving port such that the one end is adjacent to the drawbar inserted into the slot of the needle;
And an operation bar coupled to the other end of the probe and inserted into the receiving port of the housing so as to be pushed toward the pull bar inserted in the slot of the needle,
Wherein the push bar pushes the pull bar in the slot so that the pull bar connected to the suture is detached from the needle when the push button is pressed against the housing by pushing the push bar against the housing,
The pull bar may have one or both ends of a sharp shape
Laparoscopic surgical traction device. The method according to claim 1,
The pull bar has a tubular shape,
The pull bar is provided at one side thereof with a fastener for fitting the suture into the pull bar,
Wherein the pull bar has at least one pushing portion for securing the suture inserted into the pull bar through the fastener to the pull bar. The method according to claim 1,
Wherein the needle is formed in a straight or curved shape. The method of claim 3,
Wherein the probe is formed as a flexible tube. The method according to claim 1,
Further comprising a protective cover detachably coupled to the housing to cover the needle. 6. The method according to any one of claims 1 to 5,
Further comprising a shield plate that is fitted to the suture so as to be covered by the pull bar separated from the needle. The method according to claim 6,
Wherein the shield plate has a curved shape in which a sphere through which the suture thread is inserted is formed at the center thereof,
And a guide slit is formed at one side edge of the shield plate to insert the suture into the fitting hole. 8. The method of claim 7,
Wherein the guide slit includes at least one refractive portion. The method according to claim 6,
Wherein the shroud is formed of a silicone material.

Images