WO2018038374A1

WO2018038374A1 - Wound retractor for laparoscopic surgery

Info

Publication number: WO2018038374A1
Application number: PCT/KR2017/006546
Authority: WO
Inventors: 전성태; 이교일
Original assignee: (주)써지코어
Priority date: 2016-08-26
Filing date: 2017-06-21
Publication date: 2018-03-01
Also published as: KR20180023525A; KR101866488B1

Abstract

The present invention relates to a wound retractor for laparoscopic surgery, which is inserted into an abdominal incision of a patient and opens an incision site in a circular shape, thereby providing a practitioner with the maximum surgical view with minimal incision and preventing a trocar from being displaced during an operation.

Description

Laparoscopic Wound Retractor

The present invention relates to a laparoscopic retractor for laparoscopic surgery that is inserted into an abdominal incision of a patient and opens the incision in a circular manner to provide the operator with a maximum surgical field with minimal incision and prevent trocar from escaping during surgery.

In general, laparoscopic surgery is a method of performing a small incision in the abdomen and inserting a video camera and various surgical instruments into the abdomen.

Laparoscopic surgery, such as the size of the incision is small because the surgical wound is cosmetic, and the pain caused by the wound is much less. In addition, it shows a fast recovery rate has a shorter hospital stay than open surgery, and has the advantage of being able to quickly return to daily life, and recently, laparoscopic surgery is performed in most diseases of almost all branches except for some cancers.

Laparoscopic surgery is generally performed by inserting only a small hole of 0.5 ~ 1.5㎝ size and inserting a surgical instrument therein.However, if necessary, surgery is performed by directly inserting the operator's hand into the abdominal cavity. It is called Hand Assisted Laparoscopic Surgery (HALS).

However, the smaller the incision, the less space for surgery. Therefore, in the related art, the surgical assistant directly opens the incision, or snaps the incision into and out of the incision with a forceps and the like, connects wires to the forceps, and pulls the instruments around to open the incision to secure the abdominal operation space.

In the case of the conventional retractor, the structure and shape of the conventional retractor is complicated, and the shape of the upper part of the instrument must be maintained in a circular shape when the insert is used in the incision of the patient. The shape of the upper body is very important because the shape of the upper body is not kept constant in a circular shape, and thus it is difficult to secure a sufficient field of view and to remove the extract.

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 patient's incision circularly.

On the other hand, the Republic of Korea Patent Publication No. 10-1523606 of the prior art is inserted into the abdominal incision of the patient to open the incision, the cylindrical tube on the upper ring in the sound retractor (Wound Retractor) to block the contact with the incision The "medical opening device" has been posted, which makes it easy to wind with little force when winding the work.

However, the "medical opening device" as described above has an advantage in the operation of rolling the cylindrical tube by the configuration such as filling the silicone oil between the rigid member and the coating member, the retractor combined with the trocar is used in laparoscopic surgery In this case, there is a problem that the coupling part of the trocar is separated from the upper part of the retractor by the force of elastic cylinder returning to the original state while the cylindrical tube is repeatedly rolled and the pressure of the gas injected into the abdomen of the patient through the trocar. .

In addition, in order to solve such a problem, when the retractor and the trocar are removed from the incision site while being tightly sealed through the fastening means, the dismantling operation of the trocar is inconvenient, and as a result, There is a problem such as a delay in time.

An object of the present invention is to provide a sound retractor that is inserted into an incision site of the abdomen of a patient and is provided with a laparoscopic surgical instrument to provide a passage for insertion or removal of an extract.

Another object of the present invention is to provide a laparoscopic surgical retractor that can prevent problems such as leakage of gas injected into a patient's abdomen by preventing trocar from escaping from the retractor during surgery. have.

Laparoscopic surgical ground retractor according to the present invention for achieving the above object is the first ring member and the second ring member formed in a ring shape coupled to each other; A lower ring inserted into the abdominal incision site of the patient to prevent detachment; A bushing connecting the upper ring and the lower ring to each other; Trocar coupled to surround the outer side of the upper ring; And a covering coupled to the outside of the trocar to fix the trocar to the upper ring and to support the upper ring.

The covering is formed in a circular shape and is composed of a plurality of divided bodies, the body is cut so that the end of one side that meets each other and the adjacent body of the other side can be opened, the ends of the other side that meet each other bend or fold Characterized in that it can be formed.

The covering is formed in a circular shape, a circumferential portion surrounding the outside of the lower end of the trocar, and an upper flange and a lower planar portion extending from the upper and lower ends of the circumference to respectively support the upper and lower ends of the upper ring. And a fitting protrusion protruding from the inner circumferential surface of the circumference portion to enter between the first ring member and the second ring member, and extending along the circumference portion.

Laparoscopic surgical retractor according to the present invention as described above is inserted into the incision of the abdomen of the patient to provide a passage for insertion or removal of the laparoscopic surgical instruments, as well as the state of the tract retractor and trocar are mutually coupled By having a separate covering that can be firmly fixed to prevent the phenomenon of trocar is separated from the retractor during the operation, and through this has the advantage of preventing the problem of gas leaking into the abdomen of the patient.

In addition, the laparoscopic wound retractor according to the present invention has a relatively simple and easy to attach to the trocar, the cover is configured to reduce the cost for the production of the product to improve the economics and at the same time laparoscopic surgery operation is very easy Has

1 is an exploded perspective view showing a partial configuration of the laparoscopic wound retractor according to the present invention.

2 is a perspective view showing the covering shown in FIG.

3 is a perspective view showing a state of use of the covering shown in FIG. 1 and FIG.

Figure 4 is a cross-sectional view showing the use state of the laparoscopic wound retractor according to the present invention.

5 is a cross-sectional view showing a state of use of the laparoscopic wound retractor according to the present invention.

Hereinafter, with reference to the accompanying drawings will be described in detail for the laparoscopic wound retractor according to a preferred embodiment of the present invention.

1 to 5 illustrate a laparoscopic wound retractor according to the present invention. 1 to 5, the laparoscopic wound retractor according to the present invention includes an upper ring 10, a lower ring 20, a bushing 30, a trocar 40, and a covering 50. .

The upper ring 10 is formed in two circular ring shapes, and the first ring member 11 and the second ring member 12 made of a flexible elastic body are coupled to each other in a vertical direction to constitute a pair.

The first ring member 11 and the second ring member 12 are each formed with a hollow so that the surgical tool or hand can pass inward, and are formed in a paired form overlapping each other. The first ring member 11 and the second ring member 12 are coupled or integrally configured to be in close contact with each other along each circumference, that is, the edge, as shown.

In addition, although not shown in the drawings, a space portion is formed along the circumference of the first ring member 11 and the second ring member 12, and a rigid member for maintaining the shape may be separately inserted into the space portion. . In this case, the rigid member is preferably made of a material whose shape is not easily deformed by an external force.

The other ring member located below the hollow of the ring member while expanding the diameter by applying external force to any one of the first ring member 11 or the second ring member 12 located above. It is possible to repeat the operation of pushing the way upwards, that is, the way of turning upside down. This is to expand the incision site of the patient abdomen using the elastic force of the bushing 30 while gradually reducing the length of the bushing 30 to be described later.

As described above, when the first ring member 11 or the second ring member 12 is repeatedly rolled, the first ring member 11 or the second ring member 12 is not distorted by pressure. By maintaining the circular cross-sectional shape, it is easy to proceed with the operation of reducing the length of the bushing 30, thereby removing the surgical extract and insertion of the surgical tool is very convenient.

The lower ring 20 forms a circular ring shape like the first ring member 11 or the second ring member 12 and is sealingly coupled to the bushing 30 described later as a soft elastic body.

The lower ring 20 is formed of a material such as soft silicone having elasticity to reduce its size or change its shape by external force. The lower ring 20 can be easily inserted into the abdominal incision site of the patient, since the deformation of the size and shape is easy, and after insertion, the lower ring 20 is restored to the ring shape by elasticity to expand the incision site of the patient's abdomen.

Bushing 30 is sealingly coupled to each of the upper ring 10 and the lower ring 20 to connect the upper ring 10 and the lower ring 20, and extends a predetermined length up and down.

The bushing 30 should be inserted into the abdominal incision site of the patient, so it is preferable that the bushing 30 is made of a soft elastic material so as to reduce its size, diameter, or outer diameter by external force, and the external force does not act on the bushing 30. In order to maintain the circular shape provides a working environment that can be easily inserted surgical instruments for the procedure.

In addition, although not shown in the drawings, the upper ring 10 is embedded or inserted into the upper end of the bushing 30, and the lower ring 20 is embedded or inserted into the lower end of the upper ring 10 and the bushing 30 and The lower ring 20 may be configured in one piece.

The trocar 40 allows the surgical tool to be inserted into the abdominal incision of the patient or to inject or remove gas into the abdomen of the patient. As shown in FIG. Insertable port portion 41 is provided to protrude a predetermined height to the center, the bi-directional gas port 42 for the injection of gas is provided on one side.

The trocar 40 as described above may be coupled to surround the upper end of the world retractor, that is, the upper ring 10. For this purpose, the trocar 40 vertically extends downward along the circumference of the lower end. An extended lower cover 43 is formed.

The covering 50 is tightly coupled along the lower end of the trocar 40, that is, the lower cover 43, to fix the trocar 40 in a coupled state to the upper ring 10.

The covering 50 is coupled to surround the lower cover 43 of the trocar 40 from the outside, where the lower cover 43 is the upper ring 10, that is, the first ring member 11 and the second ring. It is firmly supported in close contact with the member 12.

In addition, the covering 50 may be configured to be divided into a plurality of bodies. Referring to FIG. 2, the covering 50 may be divided into a pair of

bodies

50a and 50b, and the pair of

bodies

50a and 50b may be cut to form a distal end of one side where they meet each other. The other end portions which meet each other are formed to be bent or folded.

As shown, the pair of

bodies

50a and 50b are formed so that each one end portion thereof is separated from each other, and in a state where one side is in contact with each other, a pair corresponding to the shape of the lower end of the trocar 40 is formed. .

In addition, the pair of

bodies

50a and 50b are provided with a joint 51 at each other end so that each other end can be bent or folded relative to each other. The joint 51 is formed to be bent and bent in a material having a predetermined elasticity so that any one side of the pair of

bodies

50a and 50b can be opened or folded based on the portion of the joint 51.

The covering 50 may be formed of a pair of

bodies

50a and 50b and the joint part 51 integrally made of a flexible synthetic resin material or a silicon material so that the joint part 51 can be easily deflected.

In addition, the covering 50 includes a pair of

bodies

50a and 50b each including a circumferential portion 52, upper and

lower flange portions

53a and 53b, and a fitting protrusion 54.

3 and 4, the circumferential portion 52 is coupled to surround the outer side of the upper cover 43 formed at the lower end of the trocar 40 in a circular shape and may be supported along the outer side of the upper ring 10. A cross section of the pair of

bodies

50a and 50b is formed to form a vertical plane.

The circumferential portion 52 is formed to have a vertical surface or an arc shape so as to have an inner diameter wider than the outer diameter of the upper ring 10 to closely support the outer circumferential portion of the upper ring 10.

The upper and

lower flange portions

53a and 53b are configured to support the upper and lower ends of the upper ring 10, respectively, and protrude inwardly from the upper and lower ends of the circumferential portion 52, respectively. It is coupled in close contact with the wrapping form on the outside of the upper ring (10).

In addition, the covering 50 is further provided with a grip portion 53c protruding obliquely upward from the front end portion of the upper flange 53a of the upper and

lower flange portions

53a and 53b.

The grip portion 53c is disassembled of the covering 50 in a state in which the covering 50 is tightly coupled to the upper ring 10 by applying a pressure to the inside of the bushing 30 by gas filled in the abdomen of the patient. To be made easily.

The fitting protrusion 54 is to couple the covering 50 to the lower cover 43 together with the circumferential portion 52 and the upper and

lower flange portions

53a and 53b so that the inner circumferential center portion of the circumferential portion 52 is close. It protrudes along a predetermined length along.

When the covering 50 is coupled to the outside of the lower cover 43, the fitting protrusion 54 is inserted between the first ring member 11 and the second ring member 12 to firmly support the upper ring 10. do. That is, since the upper ring 10 is more closely coupled with the lower cover 43 of the trocar 40 by the covering 50 having the fitting protrusion 54, the leakage of gas in the abdomen of the patient may be completely blocked. At the same time to ensure that the covering 50 is not easily separated.

On the other hand, the covering 50 is provided with a fixing means 55 in a portion where the pair of body (50a, 50b) is opened, that is, a portion of the one end of the pair of the body (50a, 50b) abuts.

The fixing means 55 is configured such that the covering 50 can be easily attached to and detached from the lower cover 43 of the trocar 40. The fixing means 55 is a pair of bodies as shown in FIG. 5. One end of the body (50a) of the side (50a, 50b) of the "b" in the cross-sectional shape of the "b" in the form of a protrusion projected outwardly to the locking projection 55a and the locking projection (55a) can be caught and released by the interference fit method. And a hook 55b.

Hereinafter will be described the use method and effect of the laparoscopic wound retractor according to the present invention having the configuration as described above.

3 and 4, first, to form an incision site in the abdomen of the patient and insert the lower ring 20 therein, and then to extend the incision site to reduce the length of the bushings 30 to facilitate surgery To this end, the first ring member 11 and the second ring member 12 of any one of the ring member located on the upper side by widening the diameter by an external force to turn over the outer circumference of the ring member located on the lower portion Alternately roll the bushing (30) to work. In this case, while the length of the bushing 30 is reduced, the incision site of the patient's abdomen is easily expanded by the elastic force of the bushing 30.

Thereafter, the covering 50 is coupled to the lower cover 43 formed at the lower end of the trocar 40 in a state in which the length of the bushing 30 is reduced. This can effectively prevent the gas leakage problem, the surgical tool can be stably inserted into the abdominal cavity through the trocar 40, the upper ring 10 rolled to reduce the length of the bushing 30 is elastic This prevents the movement from being restored to its original state.

In particular, the covering 50 is the upper ring 10 by the organic coupling relationship of specific components such as the circumferential portion 52, the upper and

lower flange portions

53a, 53b, the fitting protrusion 54 and the fixing means 55 And firmly supports the lower cover 43 of the trocar 40, can be combined and disassembled very quickly.

In addition, when the user wants to loosen the upper ring 10 in a state where the surgery is completed, the user simply dismantles the covering 50 through the fixing unit 55, and then removes the lower ring 20 in the abdomen of the patient. It is very convenient and simple to use because it is easy to separate the laparoscopic wound retractor by removing it, and there is an advantage of effectively reducing the time for preparation and cleanup.

Laparoscopic surgical retractor according to the present invention described above has been described with reference to the accompanying drawings, but this is merely exemplary, and those skilled in the art have various modifications and equivalent embodiments therefrom I understand that it is possible. Therefore, the true technical protection scope of the present invention should be defined only by the technical spirit of the appended claims.

Claims

An upper ring having a first ring member and a second ring member coupled to each other formed in a ring shape;

A lower ring inserted into the abdominal incision site of the patient to prevent detachment;

A bushing connecting the upper ring and the lower ring to each other;

Trocar coupled to surround the outer side of the upper ring;

Laparoscopic surgical retractor, characterized in that it is coupled to the outer side of the trocar and the cover to fix the trocar to the upper ring and to support the upper ring.
The method of claim 1,

The covering is formed in a circular shape and consists of a plurality of divided bodies,

The body is laparoscopic surgical retractor, characterized in that the other end of the body and the other side that meets each other is cut so as to open, the end of the other side is formed to bend or fold.
The method of claim 1,

The covering

A circumference formed in a circular shape and surrounding the lower end of the trocar,

An upper flange and a lower flange portion which protrude inwardly from the upper end and the lower end of the circumference to respectively support and support the upper end and the lower end of the upper ring;

Laparoscopic surgical retractor, characterized in that it comprises a fitting protrusion protruding from the inner peripheral surface of the circumference to enter between the first ring member and the second ring member, extending along the circumference.