WO2009127103A1 - 经阴道内窥镜手术器械 - Google Patents

经阴道内窥镜手术器械 Download PDF

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Publication number
WO2009127103A1
WO2009127103A1 PCT/CN2008/071890 CN2008071890W WO2009127103A1 WO 2009127103 A1 WO2009127103 A1 WO 2009127103A1 CN 2008071890 W CN2008071890 W CN 2008071890W WO 2009127103 A1 WO2009127103 A1 WO 2009127103A1
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WIPO (PCT)
Prior art keywords
transvaginal
vaginal
endoscope
surgical instrument
hook
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Application number
PCT/CN2008/071890
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English (en)
French (fr)
Inventor
尧良清
Original Assignee
Yao Liangqing
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Publication date
Application filed by Yao Liangqing filed Critical Yao Liangqing
Publication of WO2009127103A1 publication Critical patent/WO2009127103A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A61B17/4241—Instruments for manoeuvring or retracting the uterus, e.g. during laparoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/303—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the vagina, i.e. vaginoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A61B2017/4216—Operations on uterus, e.g. endometrium

Definitions

  • the present invention relates to a medical device, and more particularly to a surgical instrument for use in the field of minimally invasive medicine such as obstetrics and gynecology, surgery and diagnostics.
  • minimally invasive medicine such as obstetrics and gynecology, surgery and diagnostics.
  • Transabdominal laparoscopic surgery is to perform several holes in the abdominal wall and laparoscopically through laparoscopic instruments, which is the representative of minimally invasive surgery.
  • 1 The abdominal wall still needs to be perforated, which has certain trauma and affects the appearance; 2
  • 2 The operation requires co 2 and inflated abdomen, which leads to disorder of acid-base and electrolyte balance in the patient's circulatory system; Separation, leading to obstruction of the cardiopulmonary circulation, increasing the risk of surgery.
  • Transvaginal surgery refers to the operation through the female natural tunnel, that is, the vagina. Although the surgical approach is small, it is still subject to many constraints: 1 The surgical field of view is small, which greatly restricts the scope of surgery through this route; 2 The vagina is deep, The operator's difficulty in operation also severely restricts the scope of surgery through this route. Summary of the invention
  • the technical problem of the present invention is to provide a utilization of a female vagina and to expand the operation.
  • the present invention provides a transvaginal endoscopic surgical instrument which is composed of a transvaginal endoscope, a transvaginal endoscope, a transvaginal hook, and a transvaginal electrosurgical knife.
  • Transvaginal vascular clamp, transvaginal surgical scissors, mesh smear suction device combined into a complete set of surgical instruments, said transvaginal sinus retractor combined with transvaginal endoscopic upper lobe hook, or combined transvaginal endoscope lower lobe Pull the hook, fully expose the pelvic cavity, the whole set uses vaginal curved electric knife, transvaginal vascular clamp, transvaginal surgical scissors, mesh slash suction device for gynecological surgery.
  • the transvaginal endoscope is composed of an endoscope, a fixed buckle and a lower vaginal pull hook, wherein the lower vaginal pull hook is connected with the endoscope by a fixing buckle, and forms an arc at the end of the lower vaginal pull hook. Baffle.
  • the transvaginal endoscope is composed of an endoscope, a fixed buckle and a vaginal upper leaf hook, wherein the upper vaginal pull hook is connected with the endoscope by a fixing buckle.
  • the transvaginal lag-shaped hook has a uterine structure at the front end and two wings in the middle portion, which fully exposes the pelvic cavity, and the posterior part is combined with the upper vaginal retractor or the lower vagina.
  • the transvaginal electric knife comprises an electric cutter head, an electric knife handle and an electric knife button, wherein the electric knife handle is an extended electric knife handle, a curved electric cutter head is connected to the front end, and an electric knife button is arranged at the rear end.
  • the transvaginal vascular clamp is a straight-grip handle vascular clamp, which is divided into a right-angled vascular clamp and a right-angled vascular clamp, which is composed of a straight grip handle, a surgical rod and a vascular clamp head.
  • the surgical rod is integrated with the vascular clamp head and is inserted into the straight handle.
  • the transvaginal surgical scissors is a straight-grip surgical scissors, and the shape of the front scissor head is divided into two types: a straight cut and a curved cut.
  • the mesh type suction suction device is provided with a control valve at the front portion thereof, an inlet at the front end of the suction device, and an suction device outlet on one side of the control valve, and the suction end is a mesh screen structure.
  • a method of applying a transvaginal endoscopic surgical instrument comprising the following steps:
  • vaginal surgical scissors Use vaginal surgical scissors, vaginal curved electric knife, vaginal vascular clamp to perform the corresponding surgical operation, and finally rinse with a mesh squeezing suction device.
  • Figure 1 is a schematic view showing the structure of a transvaginal endoscope according to the present invention
  • Figure 2 is a schematic view showing the structure of the transvaginal endoscope of the present invention.
  • Figure 3 is a schematic view showing the structure of the palace hook of the present invention.
  • Figure 4 is a schematic view showing the structure of a transvaginal extension electrosurgical unit of the present invention.
  • Figure 5 is a schematic view showing the structure of a transvaginal vascular clamp of the present invention.
  • FIG. 5A is a schematic view showing the structure of the transvaginal vascular clamp head in the form of a straight odontome according to the present invention
  • FIG. 5B is a schematic view showing the structure of the transvaginal vascular clamp head in the form of a straight edentulous forceps
  • FIG. The vascular clamp head is a schematic diagram of a curved toothed jaw structure
  • FIG. 5D is a schematic view showing the transvaginal vascular clamp head of the present invention as a curved edentulous forceps
  • FIG. 5E is a transvaginal vascular clamp head of the present invention having a right angle shape Schematic diagram of the tooth clamp structure
  • Figure 5F is a schematic view showing the structure of the transvaginal vascular clamp head of the present invention as a right angle toothless forceps;
  • Figure 6 is a schematic view showing the structure of a transvaginal surgical scissors according to the present invention.
  • 6A is a schematic view showing the transvaginal surgical scissors head of the present invention as a direct shear structure
  • 6B is a schematic view showing a transvaginal surgical scissors head of the present invention
  • Figure 7 is a mesh screen of the present invention.
  • the invention provides a transvaginal endoscopic surgical instrument, which comprises a transvaginal endoscope, a transvaginal endoscope, a transvaginal collateral hook, a transvaginal curved electric knife, a transvaginal vascular clamp, a
  • the vaginal surgical scissors and the mesh squeezing suction device are combined into a complete surgical instrument, and the transvaginal sinusoidal retractor combined with the transvaginal endoscope upper retractor 5, or combined with the transvaginal endoscopic lower retractor 3, fully exposes the pelvic cavity
  • the whole set uses vaginal curved electric knife, transvaginal vascular clamp, transvaginal surgical scissors, mesh slash suction device for gynecological surgery.
  • the transvaginal endoscope is composed of an endoscope 1, a fixed buckle 2 and a lower vagina pull hook 3, wherein the lower vagina hook 3 is connected to the endoscope 1 by a fixed buckle 2.
  • the curved baffle 4 is formed at the extension end of the lower end of the vagina.
  • the transvaginal endoscope is composed of an endoscope 1, a fixed buckle 2 and a vaginal upper hook 5, wherein the upper vaginal pull hook 5 is fixed with a buckle 2 and an endoscope 1 Connected.
  • the transvaginal sinusoidal hook has a uterine shape 6 at the front end and a double stalk 7 in the middle, which fully exposes the pelvic cavity, and the posterior part is combined with the vaginal upper lobe 5 or the lower vagina.
  • the transvaginal electric knife includes a curved electric cutter head 8, an electric knife handle 9 and an electric knife button 10, wherein the electric knife handle 9 is an extended electric knife handle, and a front end is connected with a bend.
  • the electric knife head 8 is provided with an electrosurgical button 10 at the rear end.
  • the transvaginal vascular clamp is a straight-grip handle vascular clamp, which is divided into a right-angled vascular clamp and a right-angled vascular clamp, which is composed of a straight handle 11 and a surgical rod. 12 is combined with a vascular clamp head, and the surgical rod 12 is integrated with the vascular clamp head, and is inserted into the straight handle 11 . According to the needs of the surgery, different vascular clamp heads are selected.
  • the vascular clamp head is a straight-shaped toothed clamp 13 structure
  • the vascular clamp head is a straight toothless forceps 14 structure
  • the vascular clamp head is a curved toothed pliers 15 structure
  • the vascular clamp head is a curved toothless clamp 16 structure
  • the vascular clamp head is a rectangular-shaped toothed pliers 17 structure
  • the vascular clamp head is a rectangular-shaped toothless forceps 18 structure
  • the transvaginal surgical scissors is a straight-grip surgical scissors, and the shape of the front scissor head is divided into two types: a straight shear 19 and a curved shear 20.
  • the surgical scissors head is a straight shear 19 structure
  • the surgical scissors head is a curved shear 20 structure
  • the mesh type suction suction device is provided with a control valve 22 at the front portion thereof, an inlet 21 at the front end of the suction device, and a suction device outlet 24 at one side of the control valve 22, and the suction end is Mesh screen structure 23.
  • Example 1 Surgery for various attachments, including ovarian cyst removal, ectopic pregnancy removal, ligation, and accessory resection.
  • transvaginal ovarian cystectomy incision of the vagina after the vaginal; transvaginal endoscopic leaves and palace-shaped hook 6 exposed pelvic; under endoscopic 1 direct vision, transvaginal vascular forceps to pull the wall; transvaginal surgery After cutting the wall of the capsule, the cyst was separated by transvaginal vascular clamp, and the ovarian cyst was removed; the root was electrocoagulated to stop bleeding; the 3 - 0 gut was sutured continuously for ovarian incision; the mesh was flushed with suction, and no active bleeding was observed; 2-0 intestinal sutures the vagina after the vagina.
  • Example 2 Uterine fibroids removal surgery.
  • Transvaginal uterine fibroids (posterior wall) stripping incision of the vagina after the vaginal canal; transvaginal endoscopic leaves and uterus-shaped hooks 6 expose the pelvic cavity; under endoscopic 1 direct vision, after injection of the pituitary between the muscle walls Ye Su; transvaginal electric knife to cut the myometrium; vaginal vascular clamp to remove fibroids from the capsule; 2 - 0 gut simple suture suture of the myometrium; 3 - 0 gut continuous suture to suture the uterus Muscle layer; mesh screen flushing device flushing, check for no active bleeding; 2-0 intestinal suture of the posterior vagina.
  • Transvaginal appendectomy incision of the vagina after the vaginal canal; transvaginal endoscopic lobe and uterus-shaped hook 6 exposed pelvic cavity; under endoscopic 1 direct vision, ultrasonic knife tangentially cut the appendix mesenteric and appendix artery; Double ligation of the root of the appendix; removal of the appendix, after the stump electrocoagulation, the 4th wire purse sutured the stump; the mesh rushed into the suction device to check for no active bleeding; 2-0 intestinal suture after the vagina.
  • Example 4 Stone surgery in the lower urinary tract.
  • Transvaginal ureteral calculi removal of the vagina after the vaginal canal; transvaginal endoscopic leaves and uterus-shaped hooks 6 exposed pelvic cavity; under the endoscope 1 direct view, longitudinally cut the wall, removed by vaginal vascular clamp Calculus; After the ureteral incision was placed into the double J tube, the 4-10 intestinal line was sutured intermittently; the mesh smear was flushed, and no active bleeding was found; 2-0 intestinal suture was sutured after the vagina.

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Description

经阴道内窥镜手术器械 技术领域
本发明涉及一种医疗器械， 特别涉及一种用于妇产科、外科及诊 断学等微创医学领域的手术器械。 背景技术 说
目前， 女性盆腹腔内手术途径包括三种： 开腹手术、 经腹打孔腹 腔镜手术及经阴道手术。 书
其中， 开腹手术为传统手术途径， 随着社会进歩和经济发展， 已 显现诸多弊端： ①开腹导致创伤； ②术后疼痛明显； ③术后肠道及各 项生命体征恢复慢； ④住院时间长； ⑤术后疤痕明显， 影响美观， 给 病人带来很大的痛苦， 尤其是对女性而言。 因此， 开腹手术已不能适 应现代患者的要求， 有必要寻找其他微创或无创手术。
经腹打孔腹腔镜手术是， 在腹壁打若干个孔， 在腹腔镜下通过腹 腔镜器械， 是目前微创手术的代表。 但是， 该手术存在着缺点： ①腹 壁仍需打孔， 具有一定的创伤， 影响美观； ②手术需用 co2等充气腹， 导致患者循环系统中酸碱、 电解质平衡紊乱； ③气腹压迫横隔， 导致 心肺循环受阻， 增加手术风险。
经阴道手术是指通过女性天然孔道， 即阴道进行的手术， 该手术 途径虽然创伤小， 但是仍受到很多制约： ①手术视野小， 极大地制约 通过该途径进行手术的范围； ②阴道比较深， 术者操作困难， 也严重 制约通过该途径进行手术的范围。 发明内容
本发明的技术问题是要提供一种利用女性阴道、并且扩大了手术 者的手指操作范围， 真正达到无创手术的经阴道内窥镜手术器械。 为了解决以上的技术问题，本发明提供了一种经阴道内窥镜手术 器械，其由经阴道内窥镜上叶、经阴道内窥镜下叶、经阴道宫形拉钩、 经阴道弯电刀、 经阴道血管钳、 经阴道手术剪、 网筛式冲吸引器组合 成整套手术器械， 所述的经阴道宫形拉钩联合经阴道内窥镜上叶拉 钩， 或联合经阴道内窥镜下叶拉钩， 充分暴露盆腔， 整套使用经阴道 弯电刀、经阴道血管钳、经阴道手术剪、网筛式冲吸引器于妇科手术。
所述的经阴道内窥镜下叶， 由内窥镜、 固定扣和阴道下叶拉钩组 成， 其中阴道下叶拉钩用固定扣与内窥镜连接， 在阴道下叶拉钩末端 延长段形成弧形挡板。
所述的经阴道内窥镜上叶， 由内窥镜、 固定扣和阴道上叶拉钩组 成， 其中， 阴道上叶拉钩用固定扣与内窥镜连接而成。
所述的经阴道宫形拉钩， 其前端为宫形结构， 中部形成两翼， 充 分暴露盆腔， 后部联合阴道上叶拉钩或阴道下叶拉钩。
所述的经阴道弯电刀， 包括电刀头、 电刀柄和电刀按钮， 其中电 刀柄为一延长电刀柄， 其前端连接有一弯形电刀头， 后端装有电刀按 钮。
所述的经阴道血管钳， 为一种直握式手柄血管钳， 分为直角形有 齿血管钳和直角形无齿血管钳两种， 由直握手柄、手术杆和血管钳头 部组合而成， 手术杆与血管钳头部联为一体， 与直握手柄插接。
所述的经阴道手术剪， 为一种直握式手术剪， 其前部剪刀头形状 分为直剪和弯剪两种。
所述的网筛式冲吸引器， 其前部装有一控制阀， 吸引器前端有一 入口，在控制阀的一侧装有一吸引器出口，吸引器末端为网筛式结构。
一种经阴道内窥镜手术器械的应用方法， 该方法包括以下的歩 骤：
1 ) 经阴道内窥镜下叶、 或经阴道内窥镜上叶与宫形拉钩联合， 暴露 盆腔；
2 ) 在经阴道内窥镜直视下进行微创手术；
3 ) 用阴道手术剪、 阴道弯电刀、 阴道血管钳进行相应手术操作， 最 后用网筛式冲吸引器冲洗。
本发明的优越功效在于：
1 ) 利用经阴道内窥镜， 放大了手术视野， 充分暴露女性盆腹腔， 可对相应疾病进行的手术；
2 ) 本发明整套器械， 延长了手术者的手指操作范围， 可在女性盆 腹腔内进行各种精细手术， 利用女性阴道这一天然孔道， 真正 达到无创， 同时又避免了由腹腔镜充气腹所带来的种种弊端。 附图说明
图 1为本发明的经阴道内窥镜下叶结构示意图；
图 2为本发明的经阴道内窥镜上叶结构示意图；
图 3为本发明的宫形拉钩结构示意图；
图 4为本发明的经阴道延长电刀结构示意图；
图 5为本发明的经阴道血管钳结构示意图；
图 5A为本发明的经阴道血管钳头部为直形有齿钳结构示意图； 图 5B为本发明的经阴道血管钳头部为直形无齿钳结构示意图； 图 5C为本发明的经阴道血管钳头部为弯形有齿钳结构示意图； 图 5D为本发明的经阴道血管钳头部为弯形无齿钳结构示意图； 图 5E 为本发明的经阴道血管钳头部为直角形有齿钳结构示意 图；
图 5F 为本发明的经阴道血管钳头部为直角形无齿钳结构示意 图；
图 6为本发明的经阴道手术剪结构示意图；
图 6A为本发明的经阴道手术剪头部为直剪结构示意图； 图 6B为本发明的经阴道手术剪头部为弯剪结构示意图;
图 7为本发明的网筛 一. v
3 冲吸引器结构;、 ·*ι *、 l^，
图中标号说明
1一内窥镜； 2- -固定扣；
3—阴道下叶拉钩； 4- -挡板；
5—阴道上叶拉钩； 6- -宫形拉钩；
7—宫形拉钩翼； 8- -弯形电刀头；
9一电刀柄； 10-一电刀按钮；
11一直握手柄； 12-一手术杆；
13—直形有齿钳； 14-一直形无齿钳；
15—弯形有齿钳； 16-一弯形无齿钳；
17—直角形有齿钳； 18-一直角形无齿钳;
19一直形剪刀； 20-一弯形剪刀；
21—吸引器入口； 22-一控制阀；
23—网筛式末端； 24-一吸引器出口。 具体实施方式
请参阅附图所示， 对本发明作进一歩的描述。
本发明提供了一种经阴道内窥镜手术器械，其由经阴道内窥镜上 叶、 经阴道内窥镜下叶、 经阴道宫形拉钩、 经阴道弯电刀、 经阴道血 管钳、 经阴道手术剪、 网筛式冲吸引器组合成整套手术器械， 所述的 经阴道宫形拉钩联合经阴道内窥镜上叶拉钩 5， 或联合经阴道内窥镜 下叶拉钩 3， 充分暴露盆腔， 整套使用经阴道弯电刀、经阴道血管钳、 经阴道手术剪、 网筛式冲吸引器于妇科手术。
如图 1所示， 所述的经阴道内窥镜下叶， 由内窥镜 1、 固定扣 2 和阴道下叶拉钩 3组成， 其中阴道下叶拉钩 3用固定扣 2与内窥镜 1 连接， 在阴道下叶拉钩 3末端延长段形成弧形挡板 4。 如图 2所示， 所述的经阴道内窥镜上叶， 由内窥镜 1、 固定扣 2 和阴道上叶拉钩 5组成， 其中， 阴道上叶拉钩 5用固定扣 2与内窥镜 1连接而成。
如图 3所示， 所述的经阴道宫形拉钩， 其前端为宫形 6结构， 中 部形成两翼 7， 充分暴露盆腔， 后部联合阴道上叶拉钩 5或阴道下叶 拉钩 3。
如图 4所示， 所述的经阴道弯电刀， 包括弯形电刀头 8、 电刀柄 9和电刀按钮 10， 其中电刀柄 9为一延长电刀柄， 其前端连接有一弯 形电刀头 8， 后端装有电刀按钮 10。
如图 5所示， 所述的经阴道血管钳， 为一种直握式手柄血管钳， 分为直角形有齿血管钳和直角形无齿血管钳两种， 由直握手柄 11、 手术杆 12和血管钳头部组合而成，手术杆 12与血管钳头部联为一体， 与直握手柄 11插接。 根据手术的需要， 选取不同的血管钳头部。
如图 5A所示， 血管钳头部为直形有齿钳 13结构；
图 5B所示， 血管钳头部为直形无齿钳 14结构；
图 5C所示， 血管钳头部为弯形有齿钳 15结构；
图 5D所示， 血管钳头部为弯形无齿钳 16结构；
图 5E所示， 血管钳头部为直角形有齿钳 17结构；
图 5F所示， 血管钳头部为直角形无齿钳 18结构；
如图 6所示 ， 所述的经阴道手术剪， 为一种直握式手术剪， 其 前部剪刀头形状分为直剪 19和弯剪 20两种。
图 6A所示， 手术剪头部为直剪 19结构；
图 6B所示， 手术剪头部为弯剪 20结构；
如图 7所示， 所述的网筛式冲吸引器， 其前部装有一控制阀 22， 吸引器前端有一入口 21， 在控制阀 22的一侧装有一吸引器出口 24， 吸引器末端为网筛式结构 23。
通过下面的四个实施例进一歩阐明本发明的实质性特点，但本发 明绝非仅限于实施例。
实施例 1 : 各种附件手术， 包括卵巢各类囊肿剥除、 宫外孕切除、 结 扎、 及附件切除等手术。
如经阴道卵巢囊肿剥除术： 切开阴道后穹隆； 经阴道内窥镜下叶 及宫形拉钩 6暴露盆腔；在内窥镜 1直视下，经阴道血管钳牵引囊壁; 经阴道手术剪剪开囊壁后，用经阴道血管钳分离囊肿，剥除卵巢囊肿； 根部电凝止血； 3— 0肠线连续缝合卵巢切口； 网筛式冲吸引器冲洗， 查无活动性出血后； 2— 0肠线缝合阴道后穹隆。
实例 2 : 子宫肌瘤剥除手术。
经阴道子宫肌瘤（后壁）剥除术： 切开阴道后穹隆； 经阴道内窥 镜下叶及宫形拉钩 6暴露盆腔； 在内窥镜 1直视下， 在肌壁间注射垂 体后叶素； 经阴道弯电刀切开子宫肌层； 经阴道血管钳将肌瘤从包膜 中剥除； 2— 0肠线单纯间断缝合子宫肌层； 3— 0肠线连续扣锁缝合 子宫浆肌层； 网筛式冲吸引器冲洗， 查无活动性出血后； 2— 0 肠线 缝合阴道后穹隆。
实施例 3 : 阑尾切除手术。
经阴道阑尾切除手术： 切开阴道后穹隆； 经阴道内窥镜下叶及宫 形拉钩 6暴露盆腔； 在内窥镜 1直视下， 超声刀凝切阑尾系膜及阑尾 动脉； 7 号丝线双重结扎阑尾根部； 切除阑尾， 残端电凝消毒后， 4 号丝线荷包缝合包埋残端；网筛式冲吸引器冲洗，查无活动性出血后； 2— 0肠线缝合阴道后穹隆。
实施例 4: 尿管下段结石取石手术。
经阴道输尿管下段结石取石术： 切开阴道后穹隆； 经阴道内窥镜 下叶及宫形拉钩 6暴露盆腔； 在内窥镜 1直视下， 纵形切开管壁， 经 阴道血管钳取出结石； 自输尿管切口置入双 J管后， 4一 0肠线间断 缝合切口；； 网筛式冲吸引器冲洗， 查无活动性出血后； 2— 0肠线缝 合阴道后穹隆。

Claims

权 利 要 求 书
1、 一种经阴道内窥镜手术器械， 其特征在于：
所述的经阴道内窥镜手术器械， 由经阴道内窥镜上叶、经阴道内 窥镜下叶、 经阴道宫形拉钩、 经阴道弯电刀、 经阴道血管钳、 经阴道 手术剪、 网筛式冲吸引器组合成整套手术器械， 所述的经阴道宫形拉 钩联合经阴道内窥镜上叶拉钩， 或联合经阴道内窥镜下叶拉钩， 充分 暴露盆腔， 整套使用经阴道弯电刀、 经阴道血管钳、 经阴道手术剪、 网筛式冲吸引器于妇科手术。
2、根据权利要求 1所述的经阴道内窥镜手术器械， 其特征在于: 所述的经阴道内窥镜下叶， 由内窥镜、 固定扣和阴道下叶拉钩组 成， 其中阴道下叶拉钩用固定扣与内窥镜连接， 在阴道下叶拉钩末端 延长段形成弧形挡板。
3、根据权利要求 1所述的经阴道内窥镜手术器械， 其特征在于: 所述的经阴道内窥镜上叶， 由内窥镜、 固定扣和阴道上叶拉钩组 成， 其中， 阴道上叶拉钩用固定扣与内窥镜连接而成。
4、根据权利要求 1所述的经阴道内窥镜手术器械， 其特征在于: 所述的经阴道宫形拉钩， 其前端为宫形结构， 中部形成两翼， 充 分暴露盆腔， 后部联合阴道上叶拉钩或阴道下叶拉钩。
5、根据权利要求 1所述的经阴道内窥镜手术器械， 其特征在于: 所述的经阴道弯电刀， 包括电刀头、 电刀柄和电刀按钮， 其中电 刀柄为一延长电刀柄， 其前端连接有一弯形电刀头， 后端装有电刀按 钮。
6、根据权利要求 1所述的经阴道内窥镜手术器械， 其特征在于: 所述的经阴道血管钳， 为一种直握式手柄血管钳， 分为直角形有 齿血管钳和直角形无齿血管钳两种， 由直握手柄、手术杆和血管钳头 部组合而成， 手术杆与血管钳头部联为一体， 与直握手柄插接。
7、根据权利要求 1所述的经阴道内窥镜手术器械， 其特征在于: 所述的经阴道手术剪， 为一种直握式手术剪， 其前部剪刀头形状 分为直剪和弯剪两种。
8、根据权利要求 1所述的经阴道内窥镜手术器械， 其特征在于： 所述的网筛式冲吸引器， 其前部装有一控制阀， 吸引器前端有一 入口，在控制阀的一侧装有一吸引器出口，吸引器末端为网筛式结构。
9、 如权利要求 1所述的经阴道内窥镜手术器械的应用方法， 该 方法包括以下的歩骤：
1 ) 经阴道内窥镜下叶、 或经阴道内窥镜上叶与宫形拉钩联合， 暴露 盆腔；
2) 在经阴道内窥镜直视下进行微创手术；
3) 用阴道手术剪、 阴道弯电刀、 阴道血管钳进行相应手术操作， 最 后用网筛式冲吸引器冲洗。
PCT/CN2008/071890 2008-04-17 2008-08-06 经阴道内窥镜手术器械 WO2009127103A1 (zh)

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CN104783850A (zh) * 2015-05-22 2015-07-22 刘仙 组合式多功能阴道盆腔拉钩
CN108338834B (zh) * 2018-04-24 2023-12-26 上海交通大学医学院附属第九人民医院 一种内窥镜微创手术器械

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