WO2012041240A1 - 带气腹装置的螺旋穿刺器及其使用方法 - Google Patents

带气腹装置的螺旋穿刺器及其使用方法 Download PDF

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Publication number
WO2012041240A1
WO2012041240A1 PCT/CN2011/080329 CN2011080329W WO2012041240A1 WO 2012041240 A1 WO2012041240 A1 WO 2012041240A1 CN 2011080329 W CN2011080329 W CN 2011080329W WO 2012041240 A1 WO2012041240 A1 WO 2012041240A1
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WIPO (PCT)
Prior art keywords
sheath
core rod
pneumoperitoneum
needle
wall
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PCT/CN2011/080329
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English (en)
French (fr)
Inventor
莫易凡
林志雄
Original Assignee
Mo Yifan
Lin Zhixiong
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Publication date
Application filed by Mo Yifan, Lin Zhixiong filed Critical Mo Yifan
Publication of WO2012041240A1 publication Critical patent/WO2012041240A1/zh

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Classifications

    • 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
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3474—Insufflating needles, e.g. Veress needles
    • 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
    • A61B2017/3454—Details of tips
    • A61B2017/3458—Details of tips threaded
    • 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
    • A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
    • A61B2017/349—Trocar with thread on outside

Definitions

  • the present invention relates to a medical device, and more particularly to a spiral puncturing device with a pneumoperitoneum device and a method of using the same.
  • laparoscopic surgery usually uses a pneumoperitoneum to establish a pneumoperitoneum, and then puncture through a puncture device, so that the operation takes a long time, and it is easy to cause damage during the puncture into the abdomen.
  • the incidence of posterior peritoneal vascular injury caused by the first puncture of laparoscopic surgery was 0. 05%-0. 11%; laparoscopic cholecystectomy (LC), often complicated by vascular injury due to the use of pneumatic abdomen needles, puncture cones, etc.
  • LC laparoscopic cholecystectomy
  • the mortality rate was 0.02%, accounting for 21.9% of LC deaths; cases of abdominal puncture pneumoperitoneum, puncture damage to the omental vessels, intestinal tract, liver or other tissues and organs occurred.
  • a spiral puncture device with a pneumoperitoneum device which is composed of a sleeve sheath with a handle at the tail and a core rod with a core rod at the tail.
  • the side of the handle is provided with a vent pipe with a gas valve, and the handle cavity is provided.
  • the tail of the handle is provided with an opening coaxially communicating with the sheath sheath, and the core rod is inserted into the sheath sheath through the opening provided in the handle, and the core rod is inserted
  • the core rod is a hollow tube, and the front end is provided with a pinhole, and the inner cavity of the core rod is along the front end of the core rod to the end of the core rod
  • a pneumoperitoneum with a resetting device and an air guiding tube are arranged in turn, the needle of the pneumoperitoneum extends out of the mandrel from the needle hole, and the air guiding tube is sleeved outside the end of the pneumoperitoneum; one end of the resetting device is fixed to the core On the inner wall of the rod, the other end of the resetting device is fixed on the pneu
  • Solution 2 The method for using the spiral puncture device with a pneumoperitone device according to the first aspect is characterized in that: a small opening is cut on the surface of the abdomen skin with a scalpel, and the skin of the abdominal wall is clamped and lifted with a towel clamp, and the spiral puncture device is inserted. At the incision of the skin, the needle is squeezed into the core rod by the tissue to cause discoloration of the two-color strip; Directionally rotate the spiral puncture device to squeeze the tissue into the abdominal cavity. After the two-color strip returns to color, insert the water-filled funnel through the silica gel layer into the secondary opening to connect the lower funnel port to the upper end of the airway tube. Observe whether the water in the funnel flows into the trachea.
  • the front end of the spiral puncture device is not piercing the peritoneum, and the spiral puncture device is slowly rotated until the water flow in the funnel guides the trachea; then the funnel is removed.
  • the snorkel is inserted into the secondary opening and communicates with the upper end opening of the airway tube, so that the snorkel delivers gas to the abdominal cavity through the airway tube to establish a pneumoperitoneum; after the pneumoperitoneum is established, the spiral puncture device is continuously rotated to make the sheath sheath The front end enters the abdominal cavity, and then the core rod can be withdrawn.
  • the advantages of the invention are as follows: 1. The operation is simple, and the original two steps are shortened into one step, which saves the operation time. 2.
  • the passivation design at the needle can prevent the needle from entering the abdominal cavity and scratching the blood vessels or tissues, reducing unnecessary risks during the operation.
  • the outer wall of the trocar is threaded.
  • the puncturing device is fed into the abdominal cavity by continuous one-way rotation. It can control the speed and depth of the puncturing device into the abdominal cavity, avoiding the rapid entry, causing abdominal or retroperitoneal blood vessels or organs. Damage. 4, increase the set position ring, can ensure that during the operation, the surgeon will not be inserted into the deep cavity of the abdominal cavity due to the operator touching the puncture device, causing damage to blood vessels or organs.
  • Figure 1 is a schematic structural view of the present invention
  • Figure 2 is a side cross-sectional view of the present invention
  • Figure 3 is a partial enlarged view of the front end of the core rod of the present invention.
  • Figure 4 is a schematic structural view of a core rod with a core rod holder
  • Figure 5 is a schematic view showing the structure of a sheath sheath with a handle
  • Fig. 6 is a schematic view showing the structure of Fig. 4 after adding a set ring.
  • a spiral puncture device with a pneumoperitoneum device which is composed of a sleeve sheath 2 with a handle 1 at the tail and a core rod 4 with a core rod holder 3 at the tail, and the side of the handle is provided with gas.
  • the handle cavity is provided with a rubber check valve coaxial with the sheath sheath 7 (used to increase the friction between the core rod and the casing sheath with the handle and maintain airtightness);
  • the tail of the handle is provided with an opening 8 coaxially connected with the casing sheath (the opening is a core rod with a handle
  • the casing sheath is combined with the inlet of the core rod), the core rod is inserted into the casing sheath through the opening provided in the handle, and after the core rod extends into the sleeve sheath to the end, the front end of the core rod will extend out of the sleeve
  • the sheath in use, after the core rod is inserted into the sleeve sheath and the core rod is touched by the handle, the front end of the core rod will extend from a front end portion of the sheath sheath, and then the handle handle and the core rod
  • the gas entering from the snorkel can sequentially enter the abdominal cavity of the human body through the vent hole, the gap between the core rod and the airway tube, the upper port of the airway tube, and the gas is built. belly.
  • the resetting device comprises a fixing ring 21, a spring 22 and a movable ring 23 arranged in sequence, the fixing ring is fixed at one end of the spring, and the movable ring is fixed at the other end of the spring, and the pneumoperitone needle sequentially passes through the fixing ring and the spring. And the movable ring, the movable ring is close to the end of the needle of the pneumoperitoneum, the fixing ring is fixed on the inner wall of the core rod, and the movable ring is fixedly connected with the pneumoperitoneum. This ensures that during the penetration of the muscle layer of the present invention, the pneumoperitoneum contracts to the mandrel without affecting the progress of penetration. Once the pneumoperitoneum enters the abdominal cavity, the pneumoperitoneum will pop out, thereby establishing the pneumoperitoneum.
  • the pneumoperitoneum cavity is hollow, and the end of the pneumoperitoneum is connected with the guiding tube.
  • the front end of the pneumoperitoneum is provided with a pinhole 31, and the pinhole is disposed on the side wall of the needle, and the needle is a passivated needle.
  • the pinhole at the needle is placed on the side wall of the pneumoperitoneum for the purpose of passivation of the needle, which does not stab the internal organs or blood vessels and is not easily blocked.
  • the pneumoperitoneum is fixedly connected to the airway tube, and the connection state is such that when the reset device is not under pressure, the needle extends out of the pinhole.
  • the sleeve sheath is integrally transparent, and the side wall of the core rod is provided with a window hole 41 below the connection between the handle and the sheath sheath.
  • the side wall corresponding to the air inlet tube and the window hole is provided with a double color strip, and the two color strip position
  • the vent hole can also realize the function of the window hole, that is, only the vent hole can be provided on the side wall of the core rod, and the two-color strip of the side wall of the air guide tube can be disposed at a position corresponding to the vent hole.
  • the end wall of the core rod is provided with a secondary opening 51 concentric with the air guiding tube, and the secondary opening passes through the silicone layer Sealed.
  • a sealing ring 52 is provided between the outer side wall of the front end of the core rod and the inner side wall of the front end of the sleeve sheath to prevent gas from leaking from the gap between the core rod and the sleeve sheath.
  • a continuous sheath thread 61 is distributed on the outer wall of the sheath sheath; the sheath thread is started from the end near the front end of the sheath sheath, and the other end is the end, and the distance between the beginning of the sheath thread and the sleeve sheath is 0-3 cm, the sheath The distance between the threaded end and the sleeve sheath and the handle is 0-3cm ;
  • a portion of the outer surface of the front end of the core rod that extends out of the sleeve sheath is further provided with a rod thread 62, and the beginning end of the rod thread is located at a horizontal distance from the front end portion of the core rod. 0 ⁇ 1. 5cm.
  • the way of the puncture of the puncture can be changed.
  • the continuous spiral puncture and abdomen method can be controlled to control the rate of entering the abdominal cavity and reduce the risk of surgery.
  • the outer wall of the sheath sheath is further provided with a positioning ring 71 which can be rotated and fixed up and down outside the sheath sheath, and the positioning ring is an annular structure with a through hole in the middle, and the through hole aperture is slightly larger than the outer wall of the sheath sheath.
  • the diameter of the positioning ring is sleeved outside the sleeve sheath; the positioning ring is disposed on the outer wall of the sleeve sheath with the sheath thread, and the inner wall of the through hole is provided with an internal thread corresponding to the sheath thread.
  • the height of the positioning ring can be adjusted by rotating the positioning ring. By setting the positioning ring, the operator can prevent the operator from touching the puncture device and causing the puncture device to be inserted deep into the abdominal cavity, causing damage to the blood vessel or the organ.
  • the method of use of the invention is as follows: a small opening is cut on the surface of the abdomen skin with a scalpel, the skin of the abdominal wall is clamped and lifted with a towel clamp, and the spiral puncture device is inserted into the skin incision, and the needle is compressed by the tissue due to the passivation treatment of the needle.
  • the core rod causes discoloration of the two-color strip; the spiral puncture device is rotated in the direction of the sheath sheath of the sleeve, so that the tissue is squeezed out and enters the abdominal cavity.
  • the two-color strip returns to the color, the front end of the spiral puncture device passes through the muscle layer, and the pneumoperitoneum is reset.
  • the device affects the resetting; at this time, the funnel with water is inserted into the secondary opening through the silica gel layer, and the lower funnel port is connected with the upper end opening of the air guiding tube to observe whether the water in the funnel flows to the airway, if the air pipe is not flowed, It means that the front end of the spiral puncture device does not break through the peritoneum, and the spiral puncture device needs to be rotated slowly until the water flow in the funnel guides the trachea, indicating that the pneumoperitoneum needle completely enters the abdominal cavity. At this time, the funnel is removed and the ventilation tube is inserted into the secondary tube. Inside the opening and communicating with the upper end opening of the air guiding tube

Description

带气腹装置的螺旋穿刺器及其使用方法 技术领域
本发明涉及一种医疗器械， 特别是一种带气腹装置的螺旋穿刺器及其使用 方法。
背景技术 说
目前腹腔镜手术， 一般都先采用气腹针建立气腹， 之后再通过穿刺器进行 穿刺， 这样进行手术的时间较长， 而且在穿刺进腹的过程中， 容易造成损伤。 腹腔镜手术第一穿刺导致的后腹膜大血管损伤发生率在 0. 05%-0. 11%；腹腔镜胆 囊切除术 (LC)，由于使用气腹针、 穿刺锥等器械而常并发血管损伤， 血管损伤病 书
死率为 0. 02%，占 LC死亡数的 21. 9%; 腹腔穿刺气腹针、 穿刺器损伤网膜血管， 肠管， 肝脏或其他组织器官的案例时有发生。
发明内容
本发明的目的在于提供一种操作简便、 使用安全的带气腹装置的螺旋穿刺 器及其使用方法。
本发明技术方案由以下两部分构成：
方案一： 一种带气腹装置的螺旋穿刺器， 它由尾部带手柄的套管鞘以及尾 部带芯杆座的芯杆构成， 手柄的侧面设有带气阀的通气管， 手柄内腔设有与套 管鞘同轴的橡胶单向阀； 手柄尾部设有与套管鞘同轴并联通的开口， 所述的芯 杆通过手柄上设有的开口插入套管鞘内， 芯杆伸入套管鞘至尽头后， 芯杆的前 端将延伸出套管鞘； 其特征在于： 所述的芯杆为空心管， 前端设有出针孔， 芯 杆内腔沿芯杆前端至芯杆末端依次设有带复位装置的气腹针和导气管， 气腹针 的针头从出针孔延伸出芯杆外， 导气管套设于气腹针末端外； 所述的复位装置 的一端固定于芯杆内壁上， 复位装置的另一端固定于气腹针上； 当带手柄的套 管鞘与带芯杆座的芯杆组合且芯杆前端完全延伸出套管鞘时， 位于橡胶单向阀 下方的芯杆侧壁上设有通气孔， 导气管的上端开口与芯杆座内壁不接壤。
方案二： 方案一所述的带气腹装置的螺旋穿刺器的使用方法， 其特征在于: 用手术刀在腹部皮肤表面切开小口， 腹壁皮肤用巾钳夹住并提起， 将螺旋穿刺 器插入皮肤切口处， 针头受组织挤压缩入芯杆导致双色条变色； 顺套管鞘螺紋 方向定向旋转螺旋穿刺器， 使其挤开组织并进入腹腔， 当双色条恢复颜色后， 将装有水的漏斗穿过硅胶层插入次级开口内， 使漏斗下端口与导气管的上端开 口连通， 观察漏斗内的水是否流向导气管， 如果未流向导气管， 则说明螺旋穿 刺器前端未穿破腹膜， 还需缓慢旋转螺旋穿刺器， 直至漏斗内的水流向导气管; 之后移开漏斗， 将通气管插入次级开口内并与导气管的上端开口连通，， 使通气 管通过导气管输送气体至腹腔， 建立气腹； 气腹建立完成后， 继续将螺旋穿刺 器缓慢旋转， 使套管鞘前端进入腹腔， 之后抽出芯杆即可。
本发明的优点为： 1、 操作简便， 由原来的两个步骤缩短为一个步骤， 节约 了手术时间。 2、 针头处采用钝化设计， 可以避免针头进入腹腔体内划伤血管或 组织， 减少了手术过程中不必要的风险。 3、 穿刺器外壁采用螺紋式设计， 通过 持续单向旋转的方式将穿刺器送入腹腔内， 能够控制穿刺器进入腹腔的速度以 及深度， 避免因快速进入， 造成腹腔或腹膜后血管或脏器的损伤。 4、 增设定位 环， 可以保证在手术过程中， 不会因为术者触碰穿刺器导致穿刺器插入腹腔深 处， 造成血管或脏器的损伤。
附图说明
图 1为本发明的结构示意图；
图 2为本发明的侧剖图；
图 3为本发明芯杆前端的局部放大图；
图 4为带芯杆座的芯杆的结构示意图；
图 5为带手柄的套管鞘的结构示意图；
图 6为图 4增设定位环后的结构示意图。
标号说明：
1手柄、 2套管鞘、 3芯杆座、 4芯杆、 5气阀、 6通气管、 7橡胶单向阀、 8 开口；
11出针孔、 12气腹针、 13导气管、 14通气孔、 21固定环、 22弹簧、 23活 动环、 31针孔、 41视窗孔、 51次级开口、 52密封圈、 61鞘螺紋、 62杆螺紋、 71定位环。
具体实施方式
如图 1-5所示： 一种带气腹装置的螺旋穿刺器， 它由尾部带手柄 1 的套管 鞘 2以及尾部带芯杆座 3的芯杆 4构成， 手柄的侧面设有带气阀 5的通气管 6 (用于通入气体， 保持气腹的存在）， 手柄内腔设有与套管鞘同轴的橡胶单向阀 7 (用来增加芯杆与带手柄的套管鞘之间的摩擦力并保持气密性）； 手柄尾部设 有与套管鞘同轴并联通的开口 8 (该开口为芯杆与带手柄的套管鞘组合时芯杆的 入口）， 所述的芯杆通过手柄上设有的开口插入套管鞘内， 芯杆伸入套管鞘至尽 头后， 芯杆的前端将延伸出套管鞘 （使用时， 将芯杆伸入套管鞘并使芯杆座与 手柄触碰后， 芯杆前端将从套管鞘前端延伸出部分区域， 之后手握手柄以及芯 杆座将本发明所述的螺旋穿刺器持续单向旋转至腹腔内）； 其特征在于： 所述的 芯杆为空心管， 前端设有出针孔 11， 芯杆内腔沿芯杆前端至芯杆末端依次设有 带复位装置的气腹针 12和导气管 13， 气腹针的针头从出针孔延伸出芯杆外， 导 气管套设于气腹针末端外； 所述的复位装置的一端固定于芯杆内壁上， 复位装 置的另一端固定于气腹针上； 当带手柄的套管鞘与带芯杆座的芯杆组合且芯杆 前端完全延伸出套管鞘时， 位于橡胶单向阀下方的芯杆侧壁上设有通气孔 14， 导气管的上端开口与芯杆座内壁不接壤。 一旦本发明的气腹针端头进入人体腹 腔后， 从通气管进入的气体能依次通过通气孔、 芯杆与导气管之间的空隙、 导 气管上端口、 气腹针进入人体腹腔， 建造气腹。
所述的复位装置包括依次排列的固定环 21、 弹簧 22和活动环 23， 所述的 固定环固定在弹簧一端， 活动环固定在弹簧另一端， 所述气腹针依次穿过固定 环、 弹簧和活动环， 活动环靠近气腹针的针头一端， 固定环固定在芯杆内壁上， 活动环与气腹针固定连接。 这样可以确保在本发明穿透肌肉层的过程中， 气腹 针收缩至芯杆， 不影响穿透进度， 一旦气腹针进入腹腔， 气腹针将弹出， 从而 进行建立气腹的工作。
所述的气腹针内腔为中空， 气腹针末端与导流管联通， 气腹针前端设有针 孔 31， 且针孔设置在针头侧壁上， 针头为钝化针头。 针头处的针孔设置在气腹 针侧壁上的目的在于针头钝化， 不会刺伤内脏器官或血管， 并且不易堵塞。
气腹针与导气管固定连接， 且连接状态为当复位装置未受到压力时， 针头 延伸出针孔。 所述的套管鞘整体透明， 芯杆侧壁开设有位于手柄与套管鞘连接 处下方的视窗孔 41， 导气管与视窗孔对应的侧壁上设有双色条， 所述的双色条 位置为： 当气腹针伸出针孔状态时， 导气管从视窗孔中显示一种颜色； 当气腹 针受到挤压收缩时带动导气管移动后， 导气管从视窗孔中显示另一种颜色。 其 中调整通气孔的位置， 也可以使通气孔实现视窗孔的功能， 即在芯杆侧壁只需 设置通气孔即可， 导气管侧壁的双色条设置在与通气孔相应的位置即可。
芯杆座末端壁上设有与导气管同轴心的次级开口 51， 次级开口通过硅胶层 密封。 当气腹针弹出， 色标改变时， 采用漏斗插入硅胶层， 并延伸入导气管内， 看看漏斗内的水是否会流出， 如果会， 说明气腹针穿破腹膜， 拔出漏斗， 即可 进行充气； 反之， 则让穿刺器继续螺旋前行， 直至漏斗内的水流出。 采用硅胶， 是因为硅胶能够在漏斗抽出时回复原样， 在充气过程中， 可以防止气体从次级 开口泄露， 影响气腹的形成。
在芯杆前端未延伸出套管鞘部分的外侧壁与套管鞘前端内侧壁之间设有密 封圈 52， 防止气体从芯杆与套管鞘之间的缝隙泄露。
套管鞘外壁上分布有连续的鞘螺紋 61 ; 鞘螺紋以靠近套管鞘前端管口的一 端为始端， 另一端为终端， 鞘螺紋始端与套管鞘管口的距离为 0-3cm， 鞘螺紋终 端与套管鞘和手柄交界处的距离为 0-3cm;
芯杆伸入套管鞘至芯杆座与手柄接触后、 芯杆的前端将延伸出套管鞘的部 分外表面还设有杆螺紋 62， 杆螺紋始端位于距芯杆前端端部水平距离为 0~1. 5cm。
通过设置螺紋， 可以改变穿刺器的进腹方式， 由传统的扭动挤压式进腹法 或垂直压力进腹法变为持续螺旋穿刺进腹法， 能够控制进入腹腔的速率， 减少 手术风险。
如图 6 所示： 套管鞘外壁还设有可以在套管鞘外上下旋转移动并固定的定 位环 71， 定位环为中间设有通孔的环形结构， 通孔孔径略大于套管鞘外壁直径， 定位环套设在套管鞘外； 定位环设置在套管鞘外壁设有鞘螺紋的区间上， 通孔 内壁设有与鞘螺紋对应的内螺紋。 定位环的高低可以通过旋转定位环进行调节， 通过设置定位环可以防止术者触碰穿刺器导致穿刺器插入腹腔深处， 造成血管 或脏器损伤的情况。
本发明的使用方法如下： 用手术刀在腹部皮肤表面切开小口， 将腹壁皮肤 用巾钳夹住并提起， 将螺旋穿刺器插入皮肤切口处， 由于针头钝化处理， 针头 受组织挤压缩入芯杆导致双色条变色； 顺套管鞘螺紋方向定向旋转螺旋穿刺器， 使其挤开组织并进入腹腔， 当双色条恢复颜色后， 说明螺旋穿刺器前端穿过肌 肉层， 气腹针受到复位装置影响复位； 此时将装有水的漏斗穿过硅胶层插入次 级开口内， 使漏斗下端口与导气管的上端开口连通， 观察漏斗内的水是否流向 导气管， 如果未流向导气管， 则说明螺旋穿刺器前端未穿破腹膜， 还需缓慢旋 转螺旋穿刺器， 直至漏斗内的水流向导气管， 则说明气腹针针头完全进入腹腔， 此时， 移开漏斗， 将通气管插入次级开口内并与导气管的上端开口连通， 使通

Claims

1. 一种带气腹装置的螺旋穿刺器， 它由尾部带手柄 （1 ) 的套管鞘 （2 ) 以 及尾部带芯杆座 （3 ) 的芯杆 （4 ) 构成， 手柄的侧面设有带气阀 （5 ) 的通气管
(6 ) ， 手柄内腔设有与套管鞘同轴的橡胶单向阀 （7 ) ； 手柄尾部设有与套管 鞘同轴并联通的开口 （8 ) ， 所述的芯杆通过手柄上设有的开口插入套管鞘内， 芯杆伸入套管鞘至尽头后， 芯杆的前端将延伸出套管鞘； 其特征在于： 所述的 权
芯杆为空心管， 前端设有出针孔 （11 ) ， 芯杆内腔沿芯杆前端至芯杆末端依次 设有带复位装置的气腹针 （12 ) 和导气管 （13 ) ， 气腹针的针头从出针孔延伸 出芯杆外， 导气管套设于气腹针末端外； 所述的复位装置的一端固定于芯杆内 壁上， 复位装置的另一端固定于气腹针上； 当带手柄的套管鞘与带芯杆座的芯 杆组合且芯杆前端完全延伸出套管鞘时， 位于橡胶单向阀下方的芯杆侧壁上设 有通气孔 （14) ， 导气管的上端开口与芯杆座内壁书不接壤。
2. 根据权利要求 1所述的带气腹装置的螺旋穿刺器， 其特征在于： 所述的 复位装置包括依次排列的固定环 （21 ) 、 弹簧 (22)和活动环 (23)， 所述的固定 环固定在弹簧一端， 活动环固定在弹簧另一端， 所述气腹针依次穿过固定环、 弹簧和活动环， 活动环靠近气腹针的针头一端， 固定环固定在芯杆内壁上， 活 动环与气腹针固定连接。
3. 根据权利要求 1所述的带气腹装置的螺旋穿刺器， 其特征在于： 所述的 气腹针内腔为中空， 气腹针末端与导气管联通， 气腹针前端设有针孔 (31)， 且 针孔设置在针头侧壁上， 针头为钝化针头。
4. 根据权利要求 3所述的带气腹装置的螺旋穿刺器， 其特征在于： 气腹针 与导气管固定连接， 且连接状态为当复位装置未受到压力时， 针头延伸出针孔; 套管鞘整体透明， 芯杆侧壁开设有位于手柄与套管鞘连接处下方的视窗孔 (41)， 导气管与视窗孔对应的侧壁上设有双色条， 所述的双色条位置为： 当气腹针伸 出针孔状态时， 导气管从视窗孔中显示一种颜色； 当气腹针受到挤压收缩时带 动导气管移动后， 导气管从视窗孔中显示另一种颜色。
5. 根据权利要求 1所述的带气腹装置的螺旋穿刺器， 其特征在于： 芯杆座 末端壁上设有与导气管同轴心的次级开口（51)， 次级开口通过硅胶层密封。
6. 根据权利要求 1所述的带气腹装置的螺旋穿刺器， 其特征在于： 在芯杆 前端未延伸出套管鞘部分的外侧壁与套管鞘前端内侧壁之间设有密封圈（52)。
7.根据权利要求 1所述的带气腹装置的螺旋穿刺器， 其特征在于： 套管鞘 外壁上分布有连续的鞘螺紋 (61)； 鞘螺紋以靠近套管鞘前端管口的一端为始端， 另一端为终端， 鞘螺紋始端与套管鞘管口的距离为 0-3cm， 鞘螺紋终端与套管鞘 和手柄交界处的距离为 0-3cm;
芯杆伸入套管鞘至芯杆座与手柄接触后、 芯杆的前端将延伸出套管鞘的部 分外表面还设有杆螺紋 (62)， 杆螺紋始端位于距芯杆前端端部水平距离为 0-1. 5cm, 末端延伸至套管鞘始端内。
8.根据权利要求 7所述的带气腹装置的螺旋穿刺器， 其特征在于： 套管鞘 外壁还设有可以在套管鞘外上下旋转移动并固定的定位环（71)， 定位环为中间 设有通孔的环形结构， 通孔孔径略大于套管鞘外壁直径， 定位环套设在套管鞘 外； 定位环设置在套管鞘外壁设有鞘螺紋的区间上， 通孔内壁设有与鞘螺紋对 应的内螺紋。
9.根据权利要求 1-8中任一项所述的带气腹装置的螺旋穿刺器的使用方法， 其特征在于： 用手术刀在腹部皮肤表面切开小口， 腹壁皮肤用巾钳夹住并提起， 将螺旋穿刺器插入皮肤切口处， 针头受组织挤压缩入芯杆导致双色条变色； 顺 套管鞘螺紋方向定向旋转螺旋穿刺器， 使其挤开组织并进入腹腔， 当双色条恢 复颜色后， 将装有水的漏斗穿过硅胶层插入次级开口内， 使漏斗下端口与导气 管的上端开口连通， 观察漏斗内的水是否流向导气管， 如果未流向导气管， 则 说明螺旋穿刺器前端未穿破腹膜， 还需缓慢旋转螺旋穿刺器， 直至漏斗内的水 流向导气管； 之后移开漏斗， 将通气管插入次级开口内并与导气管的上端开口 连通， 使通气管通过导气管输送气体至腹腔， 建立气腹； 气腹建立完成后， 继 续将螺旋穿刺器缓慢旋转， 使套管鞘前端进入腹腔， 之后抽出芯杆即可。
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