WO2014019462A1

WO2014019462A1 - Pneumoperitoneum-free peritoneoscope suspending type abdominal wall puncture device

Info

Publication number: WO2014019462A1
Application number: PCT/CN2013/079846
Authority: WO
Inventors: 王小军
Original assignee: Wang Xiaojun
Priority date: 2012-08-01
Filing date: 2013-07-23
Publication date: 2014-02-06
Also published as: CN102846343A; CN102846343B

Abstract

A pneumoperitoneum-free peritoneoscope suspending type abdominal wall puncture device comprises a sleeve (1) and a plurality of supporting arms (3) arranged on the sleeve (1) in a central radial shape. A deformation portion (2) is connected to an end portion of the sleeve (1), and the supporting arms (3) are connected to the deformation portion (2). One end of each of pull ropes (4) is fixed on an end portion of the supporting arms (3), lugs (5) with rope holes (6) are arranged on the sleeve (1) away from the deformation portion (2), and the other end of each of the pull ropes (4) passes through the rope holes (6) in the lugs (5) and are fixed to the outer portion of the abdominal wall. A supporting surface is provided after the supporting arm (3) is opened, and a barrel-shaped space is formed after the supporting arm is suspended, so that enough surgical fields are provided during the surgery. The supporting arm (3) of the puncture device is inserted from a cut of the abdominal wall and is opened gradually, so that it does not need to perform puncture and suspension using the Kirschner pin, thereby avoiding the secondary trauma, and alleviating traumatic pains of patients.

Description

Gas-free abdominal laparoscopic suspension abdominal wall puncturing device

The invention relates to a laparoscopic surgical instrument, in particular to an airless abdominal laparoscopic suspension abdominal wall puncturing device which does not need to inflate the inside of the abdominal cavity and only mechanically pulls the tympanic cavity.

Background technique

With the economic and social progress, patient demand for minimally invasive surgery, more and more urgent, because the co ₂ pneumoperitoneum may be secondary to hypercapnia, air embolism, blood stasis and other complications, so that it is not mature tissues and organs The use of children, pregnant women, and elderly patients with underlying diseases is limited. Gas-free abdominal laparoscopic surgery uses external mechanical tension to provide operation space for surgery, does not rely on artificial pneumoperitoneum, reduces co ₂ pneumoperitoneum-related complications, and has minimally invasive surgery indications but can not tolerate general anesthesia and pneumoperitoneum-related complications. Patients can also receive minimally invasive treatment, broadening the indications for minimally invasive surgery. Gas-free abdominal laparoscopic surgery was first developed

In the early 1990s, Nagai completed the world's first cholecystectomy in 1991. In 1995, Professor Wang Qiusheng of Peking University People's Hospital completed the laparoscopic Miles operation for the first time with a self-made abdomen-free device. The technology was gradually developed in China. Currently, this technology plays an extremely important role in abdominal surgery. Compared with laparoscopic techniques requiring C0 ₂ pneumoperitoneum, the main disadvantage of airless laparoscopic surgery is that the exposure of the surgical field is uneven. It is mechanically pulled by external force to form a wedge-shaped operation space, which makes the operation more difficult. Suspension of the suspension device itself Rods and crossbars can also affect the operator; due to unsatisfactory exposure, mechanical tension is too tight, resulting in the separation of subcutaneous abdominal wall tissue, postoperative abdominal wall pain; for obese patients, excessive subcutaneous fat leads to abdominal space exposure Not good.

In the prior art solution, the popularized air-free abdominal laparoscopic abdominal wall suspension program mainly enters the laparoscope through the umbilical incision, and under the microscope-guided monitoring, a Kobe steel needle is used to peel from certain parts of the abdominal wall. The lower fat layer passes through the abdominal cavity, and the Koch's steel needle is hung on the aerial support through the suspension device, so that the abdominal wall is suspended to provide an operation space for the laparoscopic surgery. For example, the CN101098106Y patent issued by the Chinese Patent Office on August 13, 2008, the name is a gas-free abdominal laparoscopic surgery suspension device, a right-angle bracket is set, the vertical pole is fixed, and multiple hooks are arranged on the crossbar. , a hanging chain is arranged, the upper end chain is suspended on a hook, and the lower end chain is coupled to the balance point of the beam of the door frame, and the two vertical claw ends of the door frame are fixed to fix the Korotschauer needle. Insert the position of the abdominal wall that needs to be lifted into the Kirschner wire and wear it out, and press the ends of the two vertical claws of the entrance frame of the Kirschner needle exposed on the outside of the abdominal wall to adjust the lifting. The height of the abdominal wall. However, the penetration of the Kirschner wire into the abdominal fat layer for abdominal wall suspension itself is an additional trauma to the patient; the operation space provided by hanging on a part is similar to the wedge shape of the tent top, and the poor surrounding surgery field increases the difficulty of surgery. In addition, a small incision in the abdominal wall from the site close to the surgical operation area can be performed either by using a laparoscopic instrument or by using a device for partial laparotomy directly into the operation area, resulting in an increase in the number of abdominal incisions. The drawstring suspended from the aerial support forms a barrier to the handle operating space of the laparoscopic instrument, which also limits the method of improving the surgical field space around the abdominal cavity by multi-point suspension, especially in certain surgical operations. At the same time, there are many instruments to be operated, and it is impossible to avoid blocking the instrument handle by selecting a suitable suspension point; in particular, the obese patient has a thick abdominal wall and is suspended from the superficial fat of the abdominal wall, and the deep tissue of the abdominal wall is not effectively suspended. The vision is poor, and this suspension scheme can cause the separation of subcutaneous tissue and deep tissue, postoperative pain and hematoma may be possible; for example, a patent CN2221943Y announced on March 13, 1996, named umbrella-shaped lifting The inner tube assembly, the outer tube assembly and the wing assembly, the inner tube assembly and the outer tube assembly are coaxially movably fitted together, and the wing assembly is controlled by a support arm hinged to the small ring at the lower end of the inner tube The opening and closing is defined by the limit nut through the outer tube to define its opening angle. However, this structure requires an inner tube and an outer tube. The combination of the two has a large wall thickness, and it is necessary to cut a large abdominal inlet or a hole that narrows the passage into which the instrument enters. The inner tube and the outer tube have relative movement, so the inner tube needs to have sufficient length to ensure that the wing is opened, which causes the instrument to be affected by the inner tube wall when entering the abdominal cavity, which may affect the normal operation of the surgical site. operating. In the existing airless abdominal surgery program, the umbilical part is used as a laparoscopic observation hole, and the main operation hole is selected in other parts of the non-umbilical part. It is undoubted that the main operation hole needs to cut off the muscle tissue of each layer of the abdominal wall, causing pain after operation, and The purpose of direct operation of a partially open surgical instrument and the purpose of postoperative specimens, the main operating hole generally requires a certain length, and this solution is not the best choice for minimally invasive surgery.

Summary of the invention

The invention solves the defect that the prior art uses the Kirschner needle to penetrate the abdominal wall and suspends the abdominal wall to easily cause secondary trauma to the patient, and provides an airless abdominal laparoscopic suspension abdominal wall puncturing device, which uses the support arm to cut from the abdominal wall Enter and extend in the abdominal cavity to support the inner surface of the abdominal wall to prevent secondary trauma to the abdominal wall.

The invention also solves the defects in the prior art that the wedge shape of the top of the abdominal wall to form the tent top affects the surgical field, and provides an air-free abdominal laparoscopic suspension abdominal wall puncturing device, which can form a barrel after the support arm is opened The larger space makes it possible to have enough surgery during surgery.

The invention also solves the defects that the hanging method in the prior art is easy to block the operation of the handle of the laparoscopic instrument, affecting the normal operation of the operation, and providing an air-free abdominal laparoscopic suspension type abdominal wall puncturing device, which adopts a dispersion The pulling rope is pulled, and the pulling rope outside the abdominal wall is spatially expanded by an enlarged size member, and the pulling rope is fixed on the bracket above the plane of the abdominal wall to prevent the pulling rope from blocking the handle of the instrument.

The technical solution adopted by the present invention to solve the technical problem thereof is: an airless abdominal laparoscopic suspension type abdominal wall puncturing device, comprising a sleeve and a plurality of support arms arranged on the sleeve and having a central radial shape, the end of the sleeve The position is connected with a deformation portion, and the support arm is connected with the deformation portion; the end portion of the support arm is fixed with one end of the pulling rope, and the ear holder with the rope hole is disposed at a position away from the deformation portion of the sleeve, and the other of the pulling rope is Wear one end The rope hole on the ear seat is fixed to the outside of the abdominal wall. The support arm and the sleeve are connected by a deformation portion, and the deformation portion indicates that the portion can be deformed, and the support arm is expanded into a radial shape by deformation. Therefore, the material of the deformation portion is generally a soft material having toughness, generally using medical plastic or Medical polyurethane, the support arm part has sufficient strength to be deformed due to the thickness, the deformation part can be deformed due to the thin material, and the plastic or polyurethane is not easily broken due to deformation; the support arm has a rear The support surface, the area of the support surface is larger than the area of the top of the conventional suspension method, so the puncturing device forms a barrel space after being suspended, so that there is enough surgery field during operation, and the length of the support arm can be different. The hanging space adapts to different needs, especially the difference between adults and children; the support arm of the trocar is inserted from the incision of the abdominal wall and gradually opened, so it is not necessary to perforate and suspend the abdominal wall, thereby preventing The second trauma helps to reduce the pain of the patient; the support arm is folded and folded by the pulling rope, and the fold is folded. The sleeve is fixed, the pulling rope is a flexible part, can be bent freely and can provide sufficient pulling force, so that the height of the sleeve can be kept short, and the sleeve will not hinder the movement of the handle of the instrument; The position of the upper ear seat is offset from the deformation portion, so that the pulling rope is not in parallel with the support arm. When the pulling rope is straightened, the pulling rope, the sleeve and the supporting arm form a triangle, and the pulling rope is always opposite. The support arm creates a pulling force and ensures that the support arm is level, thereby supporting the abdominal wall and creating ample space to provide the surgical field required for surgical procedures.

Preferably, after the support arms are closed, the diameter of the support arm enclosing the outer surface is less than or equal to the outer diameter of the sleeve. This structure ensures that the support arm smoothly enters into the abdominal cavity, and the sleeve becomes the largest outer diameter portion, so that the puncture device does not tear the edge of the incision when inserted into the incision, and the puncture device can smoothly enter the abdominal cavity. .

Preferably, the thickness of each support arm is greater than the wall thickness of the sleeve, and the thickness of the end of the support arm connected to the deformation portion is a gradual structure, and the thickness is gradually changed to form a curved surface or a slope. The thickness of the support arm is large enough Enough strength, can support the abdominal wall, one end of the support arm is a gradual structure, easy to connect with the deformation part, reduce the mutation and facilitate the processing, and also facilitate the support arm to open.

Preferably, after the support arm is closed, the end of the support arm is tapered; the height of the sleeve is

10mm-30mm, the inner diameter of the sleeve is matched with the size of the incoming instrument. The inner diameter of the sleeve of the piercing device for the simultaneous entry of the three instruments is at least 20 mm, and the inner diameter of the sleeve of the piercer for the entry of a single instrument is at least 5 mm. The abdominal wall is elastic, so after the abdominal wall is cut, the incision will automatically close, and the end of the supporting arm is tapered, which can be smoothly inserted into the abdominal cavity without causing trauma to the abdominal wall; the height and inner diameter of the sleeve should be appropriate, not It affects the rotation of the instrument during operation.

One solution: The support arms are three, and the three support arms are symmetrically arranged at 120 °. The number of the ear seats on the outer wall of the sleeve is equal to the number of the support arms, and the position of the ear seat corresponds to the support arm. In this scheme, there are only three support arms, the structure is simple, and the processing is convenient; a gap can be left between the support arms, so that the circumference of the support arm on the circumference is reduced, and the connection width between the support arm and the deformation portion is reduced. , thereby facilitating the support arm to open.

Preferably, the support arm has a trapezoidal cross section, wherein the short sides of the trapezoid are opposite, and the short sides of the trapezoidal shape when the support arms are closed are toward the side of the axis of the sleeve. The support arm is trapezoidal, ensuring that the support arm has sufficient toughness and strength. After the support arm is opened, the trapezoid is an inverted structure to prevent deformation of the middle section of the support arm and affect the supporting effect; the length of the support arm of the three support arms Generally short, suitable for patients with small body size, so the single support arm uses a thickened trapezoidal section to provide sufficient support strength of the support arm to meet the needs of the abdominal wall lifting during surgery; here the length of the support arm is different The length specifications, each size corresponds to a different body type of patient.

Another solution: The support arm is six, and the six support arms are symmetrically arranged at 60 °. The number of the ear seats on the outer wall of the sleeve is equal to the number of the support arms, and the position of the ear seat corresponds to the support arm. This program has six After the support arm is extended, the interval between the support arm and the support arm is small, so that the degree of depression of the abdominal wall is small, and the space generated by the suspension is also more stable.

Preferably, the support arm comprises a connecting piece and a trapezoidal block arranged in a trapezoidal shape on the connecting piece, and a wedge-shaped deformation gap between the trapezoidal block and the trapezoidal block; the connecting piece is oppositely arranged, and the connecting side faces the axis side of the sleeve when the supporting arm is closed . The connecting piece and the trapezoidal block form a supporting arm. When the pulling rope pulls the supporting arm to open, the end of the supporting arm is upturned, and at the same time, the connecting piece is bent, and the deformation gap exists so that the sides of the trapezoidal block are close to each other and finally form. a curved structure, in the pulling process, the pulling force generates two component forces relative to the support arm, and the two-component force can smoothly extend the support arm; the six support arms are suitable for a patient with a larger body shape The length of the support arm is large, so that the support arm is bent by the connecting piece combined with the trapezoidal block, so that the support arm can smoothly enter the abdominal cavity to expand; in the complicated surgical plan, the six support arm can be used with the puncture device The combination of the three support arm puncturing devices, such as a six-support puncture device, complements the two three-support arm puncturing device to meet the needs of laparoscopic operation without increasing the patient's trauma.

Preferably, the utility model further comprises a fixing frame placed on the outside of the abdominal wall for fixing the end of the pulling rope, wherein the fixing frame has a circular shape, and the fixing frame is provided with a pulling rope fixing hole. After the pulling rope is held in place by the pulling rope, in order to maintain the distracting state of the supporting arm, the pulling rope needs to be always in tension, so that the end of the pulling rope is fixed to the fixing frame.

Preferably, the fixing frame comprises an inner frame and an outer frame which are connected to each other, and the inner frame and the outer frame are both annular structures, wherein the inner diameter of the inner frame is the same as the inner diameter of the sleeve, and the inner diameter of the outer frame is larger than the outer diameter of the inner frame, The rope fixing hole is disposed on the outer frame. In order to prevent the pulling rope from causing sliding damage to the edge of the slit, the inner frame of the fixing frame becomes a turning portion of the pulling rope, and the restriction of the portion does not cause damage to the edge of the slit, and at the same time, the pulling rope is The end is tied with a sliding knot on the additional pulling rope fixing hole to ensure that the pulling rope is reversed. Tension.

The utility model has the beneficial effects that: the support arm has a support surface after being opened, the area of the support surface is larger than the area of the top portion of the traditional suspension method, so that the puncture device is suspended to form a barrel space, so that the operation time There are enough surgical fields; the support arm of the puncturing device is inserted from the incision of the abdominal wall and gradually opened, so that the perforation suspension of the abdominal wall is not required, thereby preventing secondary trauma and helping to alleviate the pain of the patient; The rope is a flexible part that can bend freely and provide sufficient pulling force, so that the height of the sleeve can be kept short, and the sleeve will not hinder the range of motion when multiple instruments are operated at the same time. The pulling rope is fixed to the abdominal wall. On the bracket above the plane, the pull cord is prevented from blocking the handle of the instrument.

DRAWINGS

Figure 1 is a schematic view showing the structure of the present invention;

Figure 2 is a cross-sectional view showing the structure of Figure 1 of the present invention;

Figure 3 is a distracted state view of the structure of Figure 1 of the present invention;

Figure 4 is a schematic view showing the second structure of the present invention;

Figure 5 is a partial cross-sectional view showing the structure of Figure 4 of the present invention;

Figure 6 is a distracted state view of the structure shown in Figure 4 of the present invention;

Figure 7 is a schematic structural view of a fixing frame of the present invention;

Figure 8 is a schematic view showing a state of use of the present invention;

In the figure: 1, sleeve, 2, deformation, 3, support arm, 4, pulling rope, 5, ear seat, 6, rope hole, 7, small hole, 8, trapezoidal block, 9, deformation gap, 10 , connecting piece, 11, outer frame, 12, fixing hole, 13, inner frame, 14, connecting ribs, 15, abdominal wall, 16, fixed frame. detailed description

The technical solutions of the present invention will be further specifically described below through specific embodiments and in conjunction with the accompanying drawings.

Embodiment 1 : An airless abdominal laparoscopic suspension abdominal wall puncturing device (see FIG. 1 and FIG. 2 FIG. 3 ), comprising a sleeve 1 and three support arms 3 disposed on the sleeve and having a central radial shape, The lower end of the sleeve is connected with a deformation portion 2, and the support arm is connected to the deformation portion and can be folded around the connection portion. The sleeve is made of hard plastic, and the deformation and support arms are made of medical polyurethane. The height of the sleeve is 15 mm, the inner diameter of the sleeve is 21 mm, the height of the deformation portion is 2 mm, and the length of the support arm is 50 mm.

The three support arms are symmetrically arranged at 120°. After the support arms are closed, the sides of the support arms are close to each other. After the support arm is closed, the diameter of the support arm enclosing the outer surface is equal to the outer diameter of the sleeve, the thickness of each support arm is greater than the wall thickness of the sleeve, and the thickness of the end of the support arm connected to the deformation portion is a gradual structure, and the thickness is gradually curved to form a curved surface. . After the support arms are closed, the ends of the support arms form a tapered shape. The support arm has a trapezoidal cross section, wherein the short sides of the trapezoid are opposite, and the short sides of the trapezoid are oriented toward the axis side of the sleeve when the support arms are closed.

The end of the support arm is provided with an aperture 7, and one end of the pull cord 4 is fixed to the small hole. The outer circumference of the sleeve is provided with a lug seat 5 with a rope hole 6, the ear seat is away from the deformation portion, and the number of the ear seat is equal to the number of the support arms, the position of the ear seat corresponds to the support arm, and the other end of the pull rope is worn. The rope hole on the ear seat extends out to the outside of the abdominal wall. When the support arm is opened, the ears, the deformation portion and the end of the support arm form a triangle.

The trocar further includes a holder 16 (see FIG. 7) disposed outside the abdominal wall 15 for securing the ends of the pull cord, the holder including the interconnected inner frame 13 and the outer frame 11, the inner frame and the outer frame In the annular structure, the inner diameter of the inner frame is the same as the inner diameter of the sleeve, the inner diameter of the outer frame is larger than the outer diameter of the inner frame, and the outer frame is provided with a fixing hole 12 for pulling the rope. The support arms are closed and the ends of the support arms are tapered. Incision in the umbilicus, the end of the support arm of the puncturing device penetrates the abdominal white line and enters into the abdominal cavity. According to the space in the abdominal cavity, the support arm is completely inserted into the abdominal wall, and then the pulling rope is pulled to make the supporting arm wind. The deformation part is folded open to form a top suspension area with a diameter of 10 cm, or the pulling rope is gradually pulled during the piercing process, and the support arm is pierced into one side until the support arm is opened to form a diameter of 10 cm. Top suspension area. At this time, the sleeve is at the bottom end position of the slit, and the pulling rope extends through the rope hole of the ear seat to the outside of the abdominal wall, and a fixing frame 16 is externally arranged on the abdominal wall (see FIG. 8), and the pulling rope is taken from the inner hole of the inner frame. The wall phase is radially straightened and a slip knot is formed at the fixing hole of the outer frame. The support arm is subjected to a compression force by the abdominal wall pressure combined with its own bending portion, and the restoring force is transmitted to the fixing frame through the pulling rope, and the fixing frame is subjected to a pulling force toward the center to maintain the normal position of the fixing frame, and also enables the supporting arm to A sufficient pulling force is applied to ensure that the support arm supports the abdominal wall.

Embodiment 2: an airless abdominal laparoscopic suspension abdominal wall puncturing device (see FIG. 4, FIG. 5 and FIG. 6), comprising a sleeve 1 and six support arms 3 disposed on the sleeve and having a central radial shape, The lower end of the sleeve is connected with a deformation portion 2, and the support arm is connected to the deformation portion and can be folded around the connection portion. The sleeve is made of hard plastic, and the deformation and support arms are made of medical polyurethane. The height of the sleeve is 18 mm, the inner diameter of the sleeve is 25 mm, the height of the deformation portion is 2 mm, and the length of the support arm is 60 mm.

The six support arms are symmetrically arranged at 60°. After the support arms are closed, the sides of the support arms are close to each other. After the support arms are closed, the diameter of the support arm enclosing the outer surface is equal to the outer diameter of the sleeve. The support arm comprises a connecting piece 10 and a trapezoidal block 8 which is arranged in a trapezoidal shape on the connecting piece, and a wedge-shaped deformation gap 9 between the trapezoidal block and the trapezoidal block; when the supporting arm is closed, the connecting side faces the axis side of the sleeve, and the trapezoidal block is at The outside of the support arm. The thickness of one end of the support arm connected to the deformation portion is a gradual structure, and the thickness is gradually changed to form a curved surface.

Six ear blocks 5 are disposed on the outer wall of the sleeve away from the deformation portion, and the positions of the ear seats are in one-to-one correspondence with the support arms. An end portion of the support arm is provided with a small hole 7, and one end of the pulling rope 4 is fixed to the small hole. The other end of the pulling rope passes through the rope hole on the ear seat and projects to the outside of the abdominal wall. When the support arm is opened, the ears, the deformation portion and the end of the support arm form a triangle. The rest of the structure is referred to in Example 1.

The above-described embodiments are only two preferred embodiments of the present invention, and are not intended to limit the present invention in any way, and other variations and modifications are possible without departing from the technical solutions described in the claims.

Claims

Rights request

An airless abdominal laparoscopic suspension abdominal wall puncturing device comprises a sleeve and a plurality of support arms arranged centrally on the sleeve, wherein the end portion of the sleeve is connected with a deformation portion, the support arm and the support arm The deformation portion is connected; the end of the support arm is fixed with one end of the pulling rope, and the ear seat with the rope hole is disposed at a position away from the deformation portion of the sleeve, and the other end of the pulling rope passes through the rope hole on the ear seat And fixed to the outside of the abdominal wall.

The airless abdominal laparoscopic suspension abdominal wall puncturing device according to claim 1, wherein the support arm encloses an outer diameter smaller than or equal to an outer diameter of the sleeve after the support arms are closed.

3 . The airless abdominal laparoscopic suspension abdominal wall puncturing device according to claim 2 , wherein each of the support arms has a thickness greater than a wall thickness of the sleeve, and a thickness of one end of the support arm connected to the deformation portion is a gradual structure. 3 . , the thickness gradient forms a curved surface or a bevel.

The airless abdominal laparoscopic suspension abdominal wall puncturing device according to claim 1 or 2 or 3, wherein the end of the support arm is tapered after the support arm is closed; the height of the sleeve is 10 匪-30匪, the inner diameter of the sleeve matches the size of the instrument entering. The inner diameter of the sleeve of the trocar that enters the three instruments at the same time is at least 20 mm, and the inner diameter of the trocar that enters the single instrument is at least 5 mm.

The airless abdominal laparoscopic suspension abdominal wall puncturing device according to claim 1 or 2 or 3, wherein the support arms are three, and the three support arms are symmetrically arranged at 120 °, and the ear seat on the outer wall of the sleeve The number is equal to the number of support arms, and the position of the ear seat corresponds to the support arm.

6 . The airless abdominal laparoscopic suspension abdominal wall puncturing device according to claim 5 , wherein the support arm has a trapezoidal cross section, wherein the short sides of the trapezoid are opposite, and the short sides of the trapezoid are oriented toward the axis of the sleeve when the support arms are closed. One side.

The airless abdominal laparoscopic suspension abdominal wall puncturing device according to claim 1 or 2 or 3, wherein The sign is that the support arm is six, and the six support arms are symmetrically arranged according to 60°. The number of the ear seats on the outer wall of the sleeve is equal to the number of the support arms, and the position of the ear seat corresponds to the support arm.

The airless abdominal laparoscopic suspension abdominal wall puncturing device according to claim 7, wherein the support arm comprises a connecting piece and a trapezoidal block disposed on the connecting piece in a trapezoidal shape, and the trapezoidal block and the trapezoidal block are wedge-shaped deformation. Gap; The connecting pieces are oppositely arranged, and the connecting side faces the axis side of the sleeve when the supporting arms are closed.

The airless abdominal laparoscopic suspension abdominal wall puncturing device according to claim 1 or 2 or 3, further comprising a fixing frame placed on the outside of the abdominal wall for fixing the end of the pulling rope, said fixing The frame is circular, and the fixing bracket is provided with a pulling rope fixing hole.

The airless abdominal laparoscopic suspension abdominal wall puncturing device according to claim 9, wherein the fixing frame comprises an inner frame and an outer frame which are connected to each other, and the inner frame and the outer frame are both annular structures, wherein the inner diameter of the inner frame The inner diameter of the outer frame is the same as the inner diameter of the inner frame, and the outer diameter of the outer frame is set on the outer frame.