WO2013147461A1

WO2013147461A1 - Wound retractor for laparoscopic surgery

Info

Publication number: WO2013147461A1
Application number: PCT/KR2013/002377
Authority: WO
Inventors: 김철우
Original assignee: Kim Chul Woo
Priority date: 2012-03-29
Filing date: 2013-03-22
Publication date: 2013-10-03
Also published as: KR101172660B1

Abstract

The present invention relates to a wound retractor (wound protector) which is inserted into an abdominal incision site of a patient so as to circularly open an incision site for providing a maximum operating view with a minimal incision to an operator, blocks an extracted specimen from coming into contact with the incision site to prevent infection by the extracted specimen, and is covered with a cover so as to allow a tool for laparoscopic surgery to be used without internal gas leakage through a trocar port provided to the cover. Specifically, the present invention provides a wound retractor comprising: an upper body; a shape maintenance member inserted into the upper body; a trocar sleeve; and a lower body.

Description

Laparoscopic Wound Retractor

The present invention is inserted into the abdominal incision of the patient to open the incision in the circle to provide the operator with the maximum operating view (Operating View) with a minimal incision, while blocking the contact with the incision to remove the infection by the extract And a wound retractor (wound protector) that allows the use of a laparoscopic surgical instrument without a gas leak through the trocar port attached to the cover. Specifically, the present invention is the upper body; A shape maintaining member inserted into the upper body; Bushing; And it provides a sound retractor consisting of a lower body.

Recently, surgery is performed with the smallest incision in the abdomen to minimize the remaining scars.

An abdominal incision refers to a site where an abdominal incision is inserted in order to insert a surgical instrument for surgery or to extract an ejection (organ, hump, cancer tissue, etc.) generated during surgery.

However, the smaller the incision, the less space for surgery. Thus, in the related art, a surgical assistant (for example, a nurse) pulls open the incision directly, or snaps the incision into and out of the incision with a forceps, connects wires to the forceps, and pulls the instruments around to secure the abdominal surgery space by opening the incision. Surgery was performed.

In the case of the conventional retractor, the structure and shape of the conventional retractor are complicated, and the shape of the upper part of the instrument is not kept constant when it is inserted and used in the incision of the abdomen of the patient (the patient's abdomen must be kept in a circular shape. When the incision is small, the shape of the upper body is not kept constant in a circular shape due to pressure), there is a difficulty in securing a sufficient field of view and removal of the extract, and maintaining the shape of the upper body is very important.

In addition, there has always been a need for a sound retractor that does not have a complex configuration and simply inserts through the incision of the patient's abdomen and opens the incision of the patient circularly.

As a related art with respect to theound retractor, the following prior art document exists.

(Patent Document 0001) Korea Patent Application No. 10-2009-0021762 (2009.03.13)

(Patent Document 0002) Korean Patent Application No. 10-2009-0015138 (2009.07.29)

(Patent Document 0003) Korean Patent Application No. 10-2005-7016465 (2005.09.05)

(Patent Document 0004) Korean Patent Application No. 10-2008-0087450 (2008.09.04)

(Patent Document 0005) Korean Patent Application No. 10-2010-0114462 (2010.10.25)

(Patent Document 0006) Korean Patent Application No. 10-2010-0001668 (2010.01.08)

(Patent Document 0007) Korean Patent Application No. 10-2010-0008204 (2010.01.29)

The present invention has been made to solve the problems of the prior art as described above, the object of the present invention is inserted into the abdominal incision of the patient by opening the incision in a circular opening to the operator with a minimal incision to the maximum surgical field (Operating In addition to providing a view, it prevents the extract from contacting the incision and prevents infection by the extract, and the cover-mounted trocar port allows the laparoscopic surgical instruments to be used without any internal gas leaks. Is in providing.

One embodiment of the present invention to achieve the above object is provided in the incision site of the abdomen of the patient is provided with a wound retractor laparoscopic surgical instruments provide a passage for insertion or removal of the extract, such a wound retractor, An upper body having two circular ring-shaped members each consisting of a tube made of a flexible elastic body, which are tightly coupled to each other along a circumference of the circular ring and penetrate up and down; A shape retaining member inserted along each tube passage of the two circular annular members, wherein the shape retaining member is a circular annular spring and a circular annular rigid body inserted along the inner space of the spring. A shape maintaining member; A bushing formed of a soft elastic body sealingly coupled along a circumference of the lower part of the upper part at the lower part of the upper part; And a lower body formed at a distal end away from a lower portion of the upper body of the bushing, the lower body including a lower body sealingly coupled with the bushing as an annular soft elastic body, the lower body being externally The size of the ring can be reduced so that it can be inserted into the patient's abdomen through the incision site of the patient, and after insertion, it is restored by elasticity and restored to the ring shape to expand the incision site of the patient's abdomen, After the lower body was inserted into the lower annular member of the two circular annular members of the upper body, the diameter of the annular member far from the lower body was widened by an external force to extend the lower portion beyond the outer circumference of the remaining annular member. By moving it closer to the sieve, the length of the bushings is reduced, reducing the distance from the lower body to the upper body. By repeating this process, the incision portion of the patient's abdomen can be extended in a circular shape as desired. In this case, the circular shape of the upper body made of the flexible elastic body is inserted into each of the passages of the circular annular member. The circular shape can be maintained by the shape maintaining member.

A further embodiment of the present invention provides a wound retractor, which is installed at an incision site of a patient's abdomen, in which a laparoscopic surgical instrument provides a passage for insertion or removal of an extract, each of which is formed of a flexible elastomer tube Two circular annular member consisting of an upper body having a space portion which is closely coupled to each other along the circumference of the circular ring to penetrate up and down; A rigid member inserted along each tube passage of the two circular annular members, wherein the rigid member comprises two or more pieces inside each circular annular member to form an overall circular annular shape; A bushing formed of a soft elastic body sealingly coupled along a circumference of the lower part of the upper part at the lower part of the upper part; And a lower body formed at a distal end away from a lower portion of the upper body of the bushing, the lower body including a lower body sealingly coupled with the bushing as an annular soft elastic body, the lower body being externally The size of the ring can be reduced so that it can be inserted into the patient's abdomen through the incision site of the patient, and after insertion, it is restored by elasticity and restored to the ring shape to expand the incision site of the patient's abdomen, After the lower body was inserted into the lower annular member of the two circular annular members of the upper body, the diameter of the annular member far from the lower body was widened by an external force to extend the lower portion beyond the outer circumference of the remaining annular member. Moving to a position closer to the sieve reduces the length of the bushings, thereby reducing the distance from the lower body to the upper body. By repeating this process, the incision portion of the patient's abdomen can be extended in a circular shape as desired. In this case, the circular shape of the upper body made of the flexible elastic body is inserted into each of the passages of the circular annular member. The circular shape can be maintained by the rigid member.

In addition, the wound retractor according to the present invention further includes a cover that is sealingly fastened to an open upper portion of the upper body, and the cover is provided with one or more insertion holes into which the laparoscopic surgical instrument can be inserted. .

In this case, it is preferable that the rigid member which consists of two or more pieces is made so that each piece and the site | part which a piece may meet may be fastened by complementary shape with each other.

The laparoscopic wound retractor according to the present invention by the above configuration is inserted into the abdominal incision of the patient to open the incision in a circular shape to provide the operator with a maximum incision with the minimum incision (Operating View) By preventing the extract from contacting the incision to prevent infection by the extract, there is an advantage that you can use the laparoscopic surgical instruments without leaking the internal gas through the trocar port mounted on the cover.

1 is a perspective view of a wheel retractor according to one embodiment of the present invention, in which no rigid member is inserted;

Figure 2 is a perspective view of the wheel retractor according to an embodiment of the present invention, the shape retaining member is inserted

3 is an exploded view of the shape maintaining member

4 is a perspective view of a wheel retractor according to an embodiment of the present invention with a rigid member inserted therein;

Figure 5 is a perspective view of the upper body according to an embodiment of the present invention, the rigid member is inserted

6 is a perspective view of a cover according to an embodiment of the present invention;

FIG. 7 is an exploded perspective view of a state in which a wound retractor and a cover are coupled according to an embodiment of the present invention; FIG.

FIG. 8 is a cross-sectional view of a state in which the wound retractor and the cover are coupled according to an embodiment of the present invention. FIG.

The following description provides a simplified description of one or more embodiments to provide a basic understanding of embodiments of the present invention. This section is not intended to be a comprehensive overview of all possible embodiments, nor is it intended to identify key elements of all elements or to cover the scope of all embodiments. Its sole purpose is to present some concepts of one or more embodiments in a simplified form as a prelude to the more detailed description that is presented later.

1 shows a perspective view of a wheel retractor in accordance with one embodiment of the present invention without a rigid member inserted.

In the embodiment shown in FIG. 1, theound retractor includes a top body 100; Bushing 200; And a lower body 300.

2 shows a perspective view of a wheel retractor according to one embodiment of the present invention with a shape retaining member inserted therein.

In the embodiment shown in FIG. 2, theound retractor includes a top body 100; Shape maintaining

members

401 and 402 inserted into an inner space of the upper body; Bushing 200; And a lower body 300.

The upper body 100 is composed of two circular annular members (110, 120), in this case are in close contact with each other along the circumference of the circular ring. That is, two donut-shaped circular annular members are paired and completely overlapped so that the intermediate annular portions penetrate each other. This can be seen in more detail in FIG. 5.

The circular

annular members

110 and 120 are tubes made of flexible elastic bodies, respectively, and have spaces formed therein along a circumference thereof, and the

shape retaining members

401 and 402 or rigid members described later in this space. 410 and 420 may be inserted.

Meanwhile, the circular

annular members

110 and 120 are tightly coupled to each other to prevent the inflow and outflow of air. Meanwhile, the circular

annular members

110 and 120 are made of a flexible elastic body to widen the diameter by external force, thereby increasing the outer circumference of the remaining annular members. It is possible to move beyond. The circular annular members are made of a flexible elastic body, preferably made of a transparent or translucent material so that the internal space can be observed. This is because it is more preferable to be able to observe the engagement of the position of the rigid member located in the space therein and the complementary shape of the rigid member as described later.

The

shape retaining members

401 and 402 comprise a circular annular spring 401 and a circular annular rigid body 402 inserted along the inner space of the spring. The

shape retaining members

401 and 402 have a structure in which a rigid body 402 made of a spring 401 and a material which is not easily deformed is inserted into the spring (see FIG. 3), thereby forming a circular annular member. It serves to maintain the shape of the field (110, 120) in a circular shape as it is.

A rigid member may be used instead of this shape retaining member, which is shown in FIG. 4.

4 shows a perspective view of a wheel retractor according to one embodiment of the present invention with a rigid member inserted therein. As shown in FIG. 4, the circular

annular members

110 and 120 are formed of flexible elastic bodies, respectively, and a space is formed along the circumference of the circle, and the

rigid members

410 and 420 are formed therein. Will be inserted.

Such rigid members are members having high rigidity, and are made of a material whose shape is not easily deformed by external force.

The

rigid members

410 and 420 are formed of two or more pieces along the circumference of the circular ring shape to form a circular ring shape as a whole.

For example, if the rigid member consists of two pieces, it means that when two pieces are connected, they form a circle as a whole. The same is true for three or more pieces.

The reason for the need for the

shape maintaining members

401 and 402 or the

rigid members

410 and 420 is to make an incision in the abdomen of the patient and insert the lower body 300 therein. The length of the bushing 200 is reduced in order to expand the surgically. In this case, as described above, the diameter of the annular member far from the lower body of the circular annular member is increased by external force, thereby increasing the diameter of the outer annular member. The length of the bushings is reduced by moving beyond the perimeter to a position close to the underbody. By repeating this process, the length of the trocar is reduced, and the incision site of the patient's abdomen is expanded by the elastic force of the trocar.

If there is no shape retaining member or rigid member when this expansion occurs, the pressure causes the shape of the circular

annular members

110, 120 of the upper body to fail to retain a circular shape and to be distorted to enter the surgical tool or You may feel uncomfortable when observing the abdominal cavity or removing surgical extracts. However, in the present invention, the

shape retaining members

401 and 402 or the

rigid members

410 and 420 are inserted into the pipe passages of the circular

annular members

110 and 120, thereby reducing the length of the bushing. The shape can be maintained continuously. Therefore, it is very convenient to work when removing surgical implants or inserting surgical instruments.

On the other hand, the rigid members made of two or more pieces, more preferably, each piece and the portion where the pieces meet is preferably made to be fastened by a complementary shape to each other.

5 shows a perspective view of an upper body according to an embodiment of the present invention with a rigid member inserted therein.

The rigid member made of two or more pieces is made such that each piece and the portion where the pieces meet are fastened by complementary shapes to each other. This can be confirmed in FIG. 5, as shown in FIG. 5, where a piece and a piece meet each other form a complementary shape such as a male and female form. By engaging in this complementary shape, it is possible to increase the annular member by external force and then return it to its original position so that the rigid members made of pieces are engaged in the correct position and thus retain the circular shape of the annular member. Help

Bushing 200 is sealingly coupled along the circumference of the lower part of the upper part at the lower part of the upper part, and also sealingly coupled along the circumference of the lower part and the lower part. The bushing 200 should be inserted into a small hole cut into the abdomen of the patient, so that the diameter of the bushing 200 may be reduced by external force. In order to provide a working environment for the surgical instruments to be inserted for the procedure, it is preferable to be made of an elastic material that is restored to its original shape in the state where no external force is applied. Materials of such characteristics include soft silicone or natural rubber.

The lower body 300 has an annular shape and is sealingly coupled to the bushing 200. The material of the lower body 300 is preferably a soft elastic material. It is advantageous to be formed of a material such as silicone having elasticity as a soft material such as the above-described bushing 200 is inserted into a hole drilled into the abdomen of the patient and then deployed inside the abdomen of the patient.

The lower body 300 can reduce the size of the ring by external force and can be inserted into the patient's abdomen through the incision site of the patient. After insertion, the lower body 300 is restored by the elastic property to restore the ring shape. The incision is enlarged.

On the other hand, the lower body 300 may be formed extending from the lower end of the bushing 200. In addition, the above-described upper body 100, the bushing 200 and the lower body 300 may be integrally formed.

Laparoscopic surgery injects gas into the abdomen through the trocar to secure a surgical space, which minimizes the outflow of this gas (gas injected and gas discharged from the abdomen) to reduce the time or cost of surgery. According to one embodiment of the invention, the trocar may further include a lid 500. Figure 6 shows a perspective view of the cover according to an embodiment of the present invention, Figure 7 shows an exploded perspective view of the trocar and the cover is coupled according to an embodiment of the present invention, Figure 8 is a view of the present invention According to an embodiment there is shown a cross-sectional view of the trocar and the cover combined.

The cover has an opening 510 in the center thereof through which the surgical instruments can be inserted, while the peripheral portion 530 surrounding the opening 510 is made of a soft elastic material. As a result, the surgical tool is inserted and moved freely when moving up, down, left, right, etc., and is made of an elastic material, and thus returns to its original state after the end of the movement.

In addition, the lower portion of the cover forms a circular ring, and the edge portion 520 protrudes inward along the inner circumference of the circular ring portion. As shown in FIG. 6 by this rim 520, the lid 500 is inserted into the space 130 between the two

annular members

110, 120 of the upper body when the lid 500 is fitted to the upper body 100. It can be fitted in an interference fit and sealed. The cover 500 may be inserted into the upper body 100 and separated again by the edge portion 520.

On the other hand, although not shown, the upper body; Bushing; Lower body; And the portions to which the lids are respectively connected are completely sealed by a sealing member.

In addition, the sealing member 540 formed around the opening of the lid may be formed inward along the circumference of the opening 510 of the lid 500. This sealing member 540 becomes narrower from the opening 510 to the actual opening 550. The sealing member 540 is made of a soft elastic body, whereby it is possible to fit snugly to the opening 550 when the surgical tool is inserted, thereby effectively preventing the gas from leaking out. Since the sealing member 540 is made of a soft elastic body, even when the diameter of the surgical tool is larger than the opening 550, the size of the opening 550 is increased to enable the insertion of the tool.

The description of the presented embodiments is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these embodiments will be apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the scope of the invention. Thus, the present invention should not be limited to the embodiments set forth herein but should be construed in the broadest scope consistent with the principles and novel features set forth herein.

The present invention having the configuration as described above is a useful invention that provides the operator with the maximum operating view (Operating View) with a minimal incision to prevent infection by the extract, and can use a laparoscopic surgical instrument without internal gas leakage. .

Claims

A ound retractor installed at an incision site of a patient and providing a passage through which a laparoscopic surgical instrument is inserted,

An upper body having two circular ring-shaped members each consisting of a tube made of a flexible elastic body, which are tightly coupled to each other along a circumference of the circular ring and penetrate up and down;

A shape retaining member inserted along each tube passage of the two circular annular members, wherein the shape retaining member is a circular annular spring and a circular annular rigid body inserted along the inner space of the spring. A shape maintaining member;

A bushing formed of a soft elastic body sealingly coupled along a circumference of the lower part of the upper part at the lower part of the upper part; And

A lower body formed at a distal end from a lower portion of the upper body of the bushing, the lower body including a lower body, sealingly coupled to the bushing as a ring-shaped soft elastic body,

The lower body can reduce the size of the ring by external force and can be inserted into the patient's abdomen through the incision site of the patient. After insertion, the lower body is restored by the elastic property to restore the ring shape. To expand,

After the lower body was inserted into the abdomen of the patient, the outer annular member of the two circular annular members of the upper body was widened by an external force to extend the diameter of the outer annular member. By moving it closer to the position from the lower body to reduce the length of the trocar to reduce the distance from the lower body to the upper body, and repeat this process to expand the incision area of the patient's abdomen as desired,

In this case, the circular shape of the upper body made of the flexible elastic body may be maintained in the circular shape by the circular annular springs and the circular annular rigid bodies respectively inserted into the through passages of the circular annular members. there is,

A laparoscopic surgical retractor, which is installed at an incision site of a patient and provides a passage through which a laparoscopic surgical instrument is inserted or a surgical extract is removed.
The method of claim 1,

Further comprising a cover that is sealingly fastened to the open upper portion of the upper body, wherein the cover is provided with one or more insertion holes into which the laparoscopic surgical instruments can be inserted,

A laparoscopic surgical retractor, which is installed at an incision site of a patient and provides a passage through which a laparoscopic surgical instrument is inserted or a surgical extract is removed.