WO2019037505A1 - 一种手术切口牵开器 - Google Patents

一种手术切口牵开器 Download PDF

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Publication number
WO2019037505A1
WO2019037505A1 PCT/CN2018/089501 CN2018089501W WO2019037505A1 WO 2019037505 A1 WO2019037505 A1 WO 2019037505A1 CN 2018089501 W CN2018089501 W CN 2018089501W WO 2019037505 A1 WO2019037505 A1 WO 2019037505A1
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Prior art keywords
retractor
surgical incision
incision retractor
surgical
incision
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PCT/CN2018/089501
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English (en)
French (fr)
Inventor
郭思栋
王锐
王晓东
莫小慧
钟旭飘
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佛山市优特医疗科技有限公司
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Publication of WO2019037505A1 publication Critical patent/WO2019037505A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors

Definitions

  • the invention patent relates to the field of medical instruments, and in particular to a surgical incision retractor.
  • the surgeon needs to make full use of the incision to observe, check the condition inside the incision, and then perform the operation through the incision. In this process, the incision needs to be fully expanded, which is beneficial to the operation.
  • surgeons want to expand or retract a wound with the aid of an instrument.
  • the traditional incision retraction technique uses surgical forceps to dilate the incision, but the metal surgical forceps are rigid and bulky, occupying a lot of space, and are not easy to fix, affecting the surgical operation.
  • Chinese patent application CN105380688A discloses a soft tubular film eversion retractor. It is a tubular film made of a flexible material; there is a double-tube upper ring made of a flexible material at the upper opening of the tubular film; and a lower ring made of a flexible material at the lower opening of the tubular film.
  • the lower ring and the tubular membrane are first forcefully inserted into the incision, the lower ring is placed in the body, and then the double tube of the upper ring is turned over to wind the flexible tubular membrane, so that the height of the flexible cylinder is gradually reduced. Until the upper ring contacts the incision skin, the flexible membrane is tensioned within the incision.
  • a flexible membrane with tension can force the slit to expand to a diameter close to the flexible membrane barrel.
  • the main drawback is that the cross-sectional area (or circumference) of the tubular film is fixed.
  • the size of the incision during surgery is determined by the need for surgery, not just a few fixed sizes.
  • it needs to insert a large size of the lower ring into the body, which is not conducive to surgery, and clinical application is greatly limited.
  • retractors with a fixed perimeter (or cross-sectional area) that differ only in the way the retraction is made.
  • some retractors in the prior art employ a flexible band-shaped ring that is directly inserted into the slit when in use. Since the ring is of a fixed size, its flexibility must be good, otherwise it is difficult to insert the slit. However, because of its flexibility, the incision pressure forces the ring to flatten and does not expand the incision.
  • some retractors of the prior art in order to prevent the retractor from flattening under the incision pressure, some retractors use tape to pull the incision and fix it on the surrounding skin, which is troublesome to operate, and It also has the same limitations as the retractor disclosed in CN105380688A.
  • Chinese patent application CN105232097A discloses a surgical retractor which is composed of a flexible metal ring and a plurality of pulling belts.
  • a surgical retractor which is composed of a flexible metal ring and a plurality of pulling belts.
  • it is necessary to assemble a flexible metal ring into a ring insert the inner cavity of the incision, and then pull the end of the pulling belt. Fix it on the metal ring, pull the strap firmly, try to open the incision, and then fix the pulling strap on the surrounding skin.
  • This method requires a metal ring to be forcefully inserted into the incision, and the ring needs to be removed from the incision after the operation is completed, which is inconvenient to operate.
  • different slits need to be equipped with metal rings of different sizes.
  • the present invention provides a surgical incision retractor comprising a retractor body 1 having one end of the retractor body 1 provided with a locking ring 101, the other end of the retractor body 1
  • the locking ring 101 is threaded into the annular surgical retractor to adjust the circumference of the surgical incision retractor.
  • the retractor body 1 is disposed on one end surface of the lock ring 101 and is provided with a plurality of toothed protrusions 103.
  • the inner wall of the lock ring 101 is provided with a buckle 102.
  • the buckle 102 and the toothed protrusion 103 can be engaged with each other for fixing the circumference of the surgical incision retractor.
  • the size of the different surgical incisions can be adjusted by adjusting the buckle 102 and the plurality of toothed protrusions 103 disposed at different positions to adjust the circumference of the retractor, thereby adapting Surgical needs.
  • the retractor body 1 is inserted into one end surface of the lock ring 101 and is provided with a plurality of slots 106.
  • the inner wall of the lock ring 101 is provided with a buckle 102, the card The buckle 102 can be snapped into the slot 106 to secure the circumference of the surgical incision retractor.
  • the surgical incision retractor has a circumference ranging from 20 to 1000 millimeters. Those skilled in the art can determine according to different surgical needs, for example, according to the position and size of the incision.
  • the surgical incision retractor is prepared from a composite material selected from one or a combination of the following materials: polyurethane material, polyester material, polyamide material, polyethylene material, polypropylene material, silicone. Material or stainless steel.
  • the retractor body 1 has a height of 4-50 mm.
  • the height refers to the height of the retractor body 1 forming the ring in the axial direction, that is, the width of the strip-shaped or strip-shaped retractor body 1 in the unfolded state.
  • the retractor body 1 has a thickness of no more than 5 mm, preferably no more than 3 mm, for example the retractor body 1 has a thickness of 0.2-5 mm. This thickness ensures that the surgical incision retractor does not take up too much incision space.
  • the thickness is the thickness of the retractor body 1 that does not include the buckle ring 101 and the toothed projections 103.
  • the thickness is the thickness of the retractor body 1 forming the ring in the radial direction.
  • each of the toothed projections 103 has an end adjacent to the locking ring and an end remote from the locking ring, wherein the locking ring is adjacent to the locking ring One end is low, far from the end of the lock ring.
  • the external force forces the retractor circumference to have a decreasing tendency, the high end of the dentate projection 103 of the retractor will be blocked by the buckle 102, preventing the circumference from becoming smaller and achieving the purpose of stopping.
  • a plurality of the dentations 103 may be disposed in parallel on the retractor body 1 at equal intervals.
  • the adjacent dentations 103 have a pitch of 3-20 mm and a total of 3-30 dentations 103 are provided.
  • the dentations 103 may also be disposed on the retractor body 1 at non-equal spacing.
  • the toothed projections 103 away from one end of the lock ring 101 are densely arranged, and the one end adjacent to the lock ring 101 is loosely arranged. In order to adjust the circumference of the surgical incision retractor more finely after expansion.
  • the surgical incision retractor is in a minimum circumference state before use, and after the doctor completes the incision preparation, due to the circumference adjustment function of the surgical incision retractor, the surgical incision retractor whose initial circumference is smaller than the incision circumference can be selected, It can be easily placed in the incision or placed into the incision with another simple tool.
  • the surgical incision retractor is then gradually enlarged by a manual method, or by means of a mechanical dilator, or an electronic dilator, the surgical incision retractor having the above-described device having a retracting function, the surgical incision retractor Once the circumference of the ring becomes larger, it cannot be smaller.
  • the annulus of the surgical incision retractor maintains the final expanded circumference after expansion and does not automatically rebound. Therefore, the incision field of view does not have the risk of being squeezed out during use. This eliminates the need for additional instruments to retract the incision or complicated operations and does not require additional tape fixation. After the operation is completed, the retractor can be pulled directly out of the incision and discarded.
  • the retractor body 1 of the surgical incision retractor is provided with a plurality of apertures 104 to reduce material usage and reduce contact area with the wound.
  • the total area of these openings 104 does not exceed 70%, preferably no more than 50% of the total area of the retractor body 1.
  • one end of the retractor body 1 is threaded into the locking ring 101, and the annular surgical incision retractor formed is generally circular after expansion because the circular shape is generally stable. But it can also be designed into other shapes to meet specific surgical needs, such as semi-circles, ovals, triangles, regular polygons, irregular polygons, and polygons with arc edges.
  • the portion of the retractor body 1 of the surgical incision retractor of the present invention that is not provided with the dentate projection 103 is in the retractor body 1
  • the two long sides are also provided with a convex cymbal 105, and the length of the cymbal 105 projecting outward is not less than 1 mm.
  • a flexible or elastic membrane sleeve 2 is placed over the outer surface of the surgical incision retractor to separate direct contact of the incision tissue with the surgical incision retractor.
  • the film sleeve 2 is sleeved before the surgical incision retractor is placed in the incision, or the film sleeve 2 is pre-fixed (such as by welding, heat bonding, gluing, etc.) on the outer surface of the surgical incision retractor. on.
  • the height of the membrane sleeve 2 is greater than or equal to the height of the surgical incision retractor.
  • the film sleeve 2 is a flexible or elastic film sleeve having a thickness of less than 0.5 mm, and the material thereof is selected from the group consisting of polyurethane materials, polyester materials, polyamide materials, polyethylene materials, polypropylene materials, and silicones. Materials, and combinations of the above materials.
  • the surgical incision retractor provided by the invention does not need to insert any object into the body to achieve the purpose of retraction, and also has a protective function on the incision tissue. It can be applied to surgery with different incision sizes, simplifying operation and facilitating surgery.
  • the present invention provides a method of surgically retracting an incision using the above-described surgical incision retractor with variable circumference during surgery.
  • the method includes the following steps:
  • the flexible membrane sleeve may be sleeved on the surgical incision retractor, or the flexible membrane sleeve may be previously bonded or welded to the outer side surface of the surgical incision retractor.
  • the surgical incision retractor provided by the present invention is simple in operation and is a surgical incision retractor capable of adapting to different sizes of surgical incisions.
  • the incision field of view does not have the risk of being squeezed out during use. No additional instruments are required to retract the incision or complicated operations, nor do they require additional tape fixation.
  • Figure 1 Schematic diagram of the surgically adjustable surgical incisor retractor provided in Example 1;
  • Figure 2 A side view of a surgical incision retractor containing a membrane sleeve provided in Example 2;
  • Figure 3 an enlarged view of A in Figure 2;
  • Figure 4 is a schematic view showing the structure of the surgically adjustable retractor of the circumference provided in Example 3;
  • Figure 5 is a schematic view showing the structure of the surgically adjustable retractor of the circumference provided in Example 4.
  • Figure 6 is a side elevational view of the locking collar of the surgically adjustable surgical incision retractor provided in Example 4.
  • Figure 7 is a schematic view showing the structure of the surgically adjustable retractor of the circumference provided in Example 5;
  • Figure 8 is a schematic view showing the structure of the surgically adjustable retractor of the circumference provided in Example 6;
  • Figure 9 is a schematic view showing the structure of the surgically adjustable surgical retractor of the circumference provided in Example 7;
  • Figure 10 is a schematic view showing the structure of a surgically adjustable surgical incision retractor provided in Example 8.
  • Figure 1 is a surgical incision retractor whose circumference can be adjusted according to the size of the incision.
  • Figure 2 is a side view of the surgical incision retractor.
  • Figure 3 is an enlarged view of A in Figure 2.
  • the surgical incision retractor includes a retractor body 1, and one end of the retractor body 1 is provided with a locking ring 101, and the other end of the retractor body 1 is worn.
  • the locking buckle ring 101 forms an annular surgical incision retractor to adjust the circumference of the surgical incision retractor, and the other end surface of the retractor body 1 is provided with a plurality of toothed protrusions 103, and the locking ring 101
  • the inner wall is provided with a buckle 102, and the buckle 102 and the toothed protrusion 103 are engaged with each other to fix the circumference of the surgical incision retractor.
  • the circumference of the surgical incision retractor can be adjusted by sliding the other end of the retractor body 1 in the locking ring 101.
  • the surgical incision retractor In the initial state, the surgical incision retractor is maintained in a state of a small circumference, and the buckle 102 is adjusted to be engaged with the toothed protrusions 103 disposed at different positions, so as to achieve different sizes, adjustments, and fixations for different surgical incisions.
  • the circumference of the device is opened to accommodate the surgical needs.
  • each of the toothed projections 103 is low at one end near the lock ring 101 and high at an end away from the lock ring 101. This causes the buckle 102 to be retracted when the retractor is expanded, allowing the toothed projection 103 to pass, so that the toothed projection 103 can slide within the buckle 102 in the locking ring 101, that is, from the toothed convexity. The lower end of 103 slides toward the higher end to achieve the purpose of increasing the circumference.
  • the buckle 102 When a toothed protrusion 103 passes, the buckle 102 is reset by the elastic restoring force, and when the external force pressure forces the retractor circumference to have a decreasing tendency, the high end of the dentate protrusion 103 of the retractor will be The buckle 102 blocks, preventing its circumference from becoming smaller and achieving the purpose of stopping.
  • the locking ring 101 and the toothed projection 103 are provided on the inner surface of the annular surgical incision retractor.
  • the lock ring 101 and the toothed projection 103 may also be provided on the outer surface of the annular surgical incision retractor as needed.
  • the surgical incision retractor material is polyurethane.
  • the annular surgical incision retractor has an initial circumference of 60 mm and a circumference ranging from 60 to 100 mm.
  • the surgical incision retractor has a height of 30 mm and a thickness of 0.8 mm.
  • the shape of the ring is circular.
  • the initial circumference refers to the circumference of the surgical incision retractor in the unused state or in the stored state.
  • the circumference of the surgical incision retractor can be gradually increased from the initial circumference to the maximum within the range of its circumference, so the initial circumference is also the minimum within the circumference of the surgical incision retractor. .
  • the surgical incision retractor is first placed in the incision, and then the surgical incision retractor is expanded by hand or another dilating forceps, thereby expanding the surgical incision and facilitating the operation.
  • the surgical incision retractor of the above embodiment 1 may be provided with a flexible membrane sleeve 2.
  • a flexible film sleeve 2 is placed on the outer surface, or the flexible film sleeve 2 is pre-fixed (such as by welding, heat bonding, gluing, etc.) on the outer surface of the surgical incision retractor.
  • the material of the film is a polyurethane film having a height of 60 mm and a thickness of 0.05 mm. It has a circumference of 60 mm and fits just on the outer surface of the surgical incision retractor (initial circumference) of Example 1.
  • the flexible membrane sleeve 2 was placed over the outer surface of the surgical incision retractor of Example 1 prior to use. Due to the elasticity, the flexible membrane sleeve 2 also expands the circumference as the surgical incision retractor expands to the size of use. The excess portion in the height direction is folded into the retractor after the incision is enlarged, or cut off with a surgical scissors.
  • the use of the flexible membrane sleeve 2 avoids direct contact of the incision tissue with the surgical incision retractor, facilitates surgery, and is safe to operate.
  • Figure 4 is another surgical incision retractor whose circumference can be adjusted according to the size of the incision.
  • the structure is basically the same as the surgical incision retractor described in Embodiment 1.
  • the retractor body 1 is further provided with an opening 104 having an aperture of 3 mm and a spacing of 10 mm, and the area of the opening 104 occupies 7% of the area of the retractor body 1.
  • Such an opening 104 can reduce the material usage of the surgical incision retractor, reduce the cost, and can reduce the contact area of the surgical incision retractor with the wound, and reduce the irritation to the skin and tissue.
  • the surgical incision retractor material in this embodiment is a polyester.
  • the annular surgical incision retractor has an initial circumference of 90 mm and a circumference ranging from 90 to 150 mm.
  • the surgical incision retractor has a height of 30 mm and a thickness of 0.8 mm.
  • the shape of the ring is circular.
  • the surgical incision retractor is first placed into the incision, and then the surgical incision retractor is expanded by hand or another dilating forceps, and the incision is expanded by the surgical incision retractor to facilitate the operation.
  • Figure 5 is a surgical incision retractor with a circumference that can be adjusted according to the size of the incision.
  • Figure 6 is a side elevational view of the surgical ring retractor with the circumference of the incision retractor adjusted for the size of the incision.
  • the structure is basically the same as the surgical incision retractor described in Embodiment 1, but it is not provided with a dentate projection.
  • the surgical incision retractor material in this embodiment is polyurethane, and the annular surgical incision retractor has an initial circumference of 120 mm and a circumference ranging from 120 to 200 mm.
  • the surgical incision retractor has a height of 30 mm and a thickness of 0.8 mm.
  • the shape of the ring is circular.
  • the retractor body 1 has a plurality of narrow grooves 106 in the height direction.
  • the grooves 106 have a width of 3 mm and a height of 20 mm, and the spacing between each of the two grooves 106 is 8 mm.
  • the area of the groove 106 is 25% of the area of the ring.
  • the outer surface of the surgical incision retractor can also be covered with a flexible membrane sleeve 2.
  • the material of the film sleeve 2 is a polyurethane film having a height of 60 mm and a thickness of 0.08 mm. It has a circumference of 60 mm and fits just over the outer surface of the surgical incision retractor.
  • the surgical incision retractor is first placed into the incision, and then the retractor is expanded by hand or another dilating forceps, and the incision is enlarged by the surgical incision retractor to facilitate the operation.
  • Figure 7 is a surgical incision retractor with a circumference that can be adjusted to the size of the incision.
  • the structure is basically the same as the surgical incision retractor described in Embodiment 1.
  • the two long sides of the retractor body 1 are further provided with a convex ridge 105 having a height of 5
  • the millimeter can prevent the surgical incision retractor from slipping out of the incision when in use.
  • the surgical incision retractor material in this embodiment is polyurethane, and the annular surgical incision retractor has an initial circumference of 90 mm and a circumference ranging from 90 to 120 mm.
  • the surgical incision retractor has a height of 50 mm and a thickness of 0.9 mm.
  • the surgical incision retractor is first placed into the incision, and then the surgical incision retractor is expanded by hand or another dilating forceps, and the incision is expanded by the surgical incision retractor to facilitate the operation.
  • Figure 8 is a surgical incision retractor whose circumference can be adjusted according to the size of the incision.
  • the structure is basically the same as the surgical incision retractor described in Embodiment 3.
  • the two long sides of the retractor body 1 are further provided with a convex ridge 105 having a height of 3
  • the millimeter can prevent the surgical incision retractor from slipping out of the incision when in use.
  • the surgical incision retractor is first placed into the incision, and then the surgical incision retractor is expanded by hand or another dilating forceps, and the incision is expanded by the surgical incision retractor to facilitate the operation.
  • Figure 9 is a surgical incision retractor whose circumference can be adjusted according to the size of the incision.
  • the structure is basically the same as the surgical incision retractor described in Embodiment 5.
  • the two long sides of the retractor body 1 may have a discontinuous convex ridge 105, the height of the ⁇ 105 It is 2 mm to prevent the surgical incision retractor from slipping out of the incision during use.
  • the surgical incision retractor is first placed into the incision, and then the surgical incision retractor is expanded by hand or another dilating forceps, and the incision is expanded by the surgical incision retractor to facilitate the operation.
  • Figure 10 is a retractor with a perimeter that can be adjusted to the size of the incision.
  • the structure is basically the same as the surgical incision retractor described in Embodiment 1.
  • the surgical incision retractor material in this embodiment is a polyamide.
  • the annular surgical incision retractor has an initial circumference of 180 mm and a circumference ranging from 180 to 300 mm.
  • the surgical incision retractor has a height of 50 mm and a thickness of 1.2 mm.
  • the shape of the ring is rounded and rounded, making it easier to fit the shape of the slit.
  • the surgical incision retractor is first placed into the incision, and then the surgical incision retractor is expanded by hand or another dilating forceps, and the incision is expanded by the surgical incision retractor to facilitate the operation.

Abstract

一种手术切口牵开器，包括牵开器本体（1），牵开器本体（1）的一端设置有锁扣环（101），牵开器本体（1）的另一端穿入锁扣环（101），形成环状的手术切口牵开器，以调节手术切口牵开器的周长。

Description

一种手术切口牵开器 技术领域
本发明专利涉及医疗器械领域，具体涉及一种手术切口牵开器。
背景技术
外科医生在手术时需要充分利用切口观察、检查切口内的情况，然后通过切口实施手术。在这个过程中，需要切口充分扩张，有利于手术操作。一般来说外科医生都希望借助于一种器械扩大或牵开伤口。传统的切开牵开技术是用手术钳扩张切口，但是金属手术钳是刚性的而且体积大，占用空间多，不易固定，影响手术操作。
中国专利申请CN105380688A公开了一种软性筒状薄膜外翻牵开器。它是一个柔性材料制成的筒状膜；在筒状膜上部开口处有一个柔性材料制成的双管上环；在筒状膜下部开口处有一个柔性材料制成的下环。在使用时，先将下环和筒状膜用力塞入切口中，使下环置于体内，然后翻转上环的双管使之卷绕柔性筒状膜，这样柔性筒的高度就逐渐变小直至上环与切口皮肤接触，使柔性膜在切口内张紧。具有张力的柔性膜就可以迫使切口扩大到与柔性膜筒相近口径。其主要缺陷在于筒状膜的横截面积(或周长)是固定的。手术中切口大小要随着手术需要而确定，不仅仅只有几个固定的尺寸。此外，其需要把一个很大尺寸的下环塞入体内，不利于手术，临床应用受到很大的限制。
还有很多类似的周长(或横截面积)固定的牵开器，区别仅在于将切口牵开的方式不同。例如，现有技术中的一些牵开器采用柔性带状环，使用时直接将环塞入切口，由于这个环是固定尺寸的，其柔性必须很好，否则很难塞入切口。然而，因为其柔性好，切口压力就会迫使该环变扁，无法达到切口扩大的目的。在现有技术中的一些牵开器中，为了防止牵开器在切口压力下变扁，有的牵开器用胶带将切口拉来并且固定在周边皮肤上，这种牵开器操作麻烦，并且也具有与CN105380688A公开的牵开器同样的局限性。
中国专利申请CN105232097A公开了一种手术牵开器，它是由柔 性金属环和若干个牵拉带组成，使用时需要将柔性金属环组装成环，塞入切口内腔，然后把牵拉带一端固定在金属环上，用力拉牵拉带，试使切口张开，然后将牵拉带固定在周边皮肤上。这个方法需要将一个金属环用力塞入切口内，手术完成后还需要再将这个环从切口内取出，同样操作不方便。而且，不同切口需要配备不同大小的金属环。
因此，亟需提供一种操作简便，能够适应不同大小手术切口的手术切口牵开器。
上述对背景技术的陈述仅是为了方便对本发明技术方案(使用的技术手段、解决的技术问题以及产生的技术效果等方面)的深入理解，而不应当被视为承认或以任何形式暗示该信息构成已为本领域技术人员所公知的现有技术。
发明内容
本发明的目的在于提供一种手术切口牵开器，其能够良好适应不同大小的手术切口，且操作简便。
基于上述目的，本发明提供了一种手术切口牵开器，其包含牵开器本体1，所述牵开器本体1的一端设置有锁扣环101，所述牵开器本体1的另一端穿入所述锁扣环101，形成环状的所述手术切口牵开器，以调节所述手术切口牵开器的周长。
在一个具体的实施方案中，该牵开器本体1穿入所述锁扣环101的一端表面设置有多个齿状凸起103，所述锁扣环101的内壁设置有卡扣102，所述卡扣102与所述齿状凸起103可相互卡接，用以固定所述手术切口牵开器的周长。
在具体的实施方案中，可通过调节卡扣102与多个在不同位置设置的齿状凸起103的相互卡接，实现针对不同的手术切口的大小，调节牵开器的周长，从而适应手术需求。
在另一个具体的实施方案中，该牵开器本体1穿入所述锁扣环101的一端表面设置有多个槽106，所述锁扣环101的内壁设置有卡扣102，所述卡扣102可卡入所述槽106，以固定所述手术切口牵开器的周长。
在具体的实施方案中，所述手术切口牵开器的周长范围在20-1000毫米。本领域技术人员可以根据不同手术需求而确定，例如根据切口 的位置、大小来确定。
在具体的实施方案中，所述手术切口牵开器选自以下材料之一或其组合的复合材料制备：聚氨酯材料、聚酯材料、聚酰胺材料、聚乙烯材料、聚丙烯材料、聚硅酮材料或不锈钢。
在具体的实施方案中，所述牵开器本体1的高度为4-50毫米。本领域技术人员可以根据切口皮肤厚度选择其高度。这里的高度是指形成环状的牵开器本体1在轴向方向上的高度，即在展开状态下，条形的或带状的牵开器本体1的宽度。
在具体的实施方案中，所述牵开器本体1的厚度不超过5毫米，优选不超过3毫米，例如所述牵开器本体1的厚度为0.2-5毫米。这样的厚度确保了手术切口牵开器不占用过多切口空间。所述的厚度为不包括锁扣环101和齿状凸起103的牵开器本体1的厚度。所述的厚度为形成环状的牵开器本体1在径向方向上的厚度。
在具体的实施方案中，在展开状态下的所述牵开器本体1上，每个所述齿状凸起103具有靠近锁扣环的一端和远离锁扣环的一端，其中靠近锁扣环的一端低，远离锁扣环的一端高。这使得牵开器在扩张时，齿状凸起103可以在所述锁扣环101内的卡扣102内滑动，即从齿状凸起103低的一端向高的一端滑动，而达到周长增加的目的。但是当外力压迫使牵开器周长有一个减小的趋势时，牵开器的齿状凸起103高的一端将被卡扣102挡住，阻止其周长变小，达到止退的目的。
在具体的实施方案中，多个所述齿状凸起103可以两两等间距平行设置于所述牵开器本体1上。在具体的实施方案中，相邻的齿状凸起103的间距为3-20mm，总共设置有3-30个齿状凸起103。
在其他实施方案中，齿状凸起103也可以非等间距的设置于所述牵开器本体1上。在展开状态下的所述牵开器本体1上，远离锁扣环101的一端的齿状凸起103排列较为密集，而靠近锁扣环101的一端排列较为松散。以便在扩张后更为精细的调节手术切口牵开器的周长。
手术切口牵开器在使用之前处于周长最小状态，在医生完成切口制备后，由于手术切口牵开器的周长调节功能，可以选择初始周长小于切口周长的手术切口牵开器，因此可以轻松地放入切口内，或利用另外一个简单工具将其置入切口内。然后用手工的方法，或借助一个 机械扩张器，或电子扩张器将手术切口牵开器周长逐渐扩大，由于本发明手术切口牵开器有上述具有止退功能的装置，手术切口牵开器的环周长变大后即不能再变小。即使在切口压力下，所述的手术切口牵开器的环状在扩张后仍然维持最后扩张的周长，而无法自动回弹。因此，在使用过程中切口视野不存在被挤压缩小风险。从而不需要其他器械牵开切口或复杂操作，也不需要另外的胶带固定。手术完成后，可以将牵开器直接从切口中拔出，弃置。
在具体的实施方案中，手术切口牵开器的牵开器本体1上设置有多个开孔104，以减少材料的使用，并且减少与伤口的接触面积。这些开孔104的总面积不超过牵开器本体1的总面积的70％，优选不超过50％。
在具体的实施方案中，所述牵开器本体1的一端穿入所述锁扣环101，形成的环状的手术切口牵开器在扩张后一般是圆形，因为圆形一般稳定。但也可以设计成其他形状，以满足具体手术需要，如半圆形，椭圆形，三角形，规则多边形，不规则多边形和带有弧边的多边形。
在具体的实施方案中，为了防止手术切口牵开器滑出切口，本发明手术切口牵开器的牵开器本体1的未设置有齿状凸起103的部分，在牵开器本体1的两长边上还设置有外凸的楞105，楞105向外伸出的长度不小于1毫米。
在具体的实施方案中，为了方便手术和安全，在所述手术切口牵开器外表面套有一个柔性的或弹性的膜套2，以隔开切口组织与手术切口牵开器的直接接触。所述膜套2在将手术切口牵开器放入切口前套上去，或者将所述膜套2预先固定(如用焊接、热粘、胶粘等方法)在手术切口牵开器的外表面上。膜套2的高度大于或等于手术切口牵开器的高度。
在具体的实施方案中，上述膜套2是厚度在0.5毫米以下的柔性或弹性薄膜套，其材料选自聚氨酯材料、聚酯材料、聚酰胺材料、聚乙烯材料、聚丙烯材料和聚硅酮材料，以及上述材料的组合。
本发明提供的手术切口牵开器，不需要将任何物体塞入体内以达到牵开的目的，也会对切口组织具有保护功能。可以适用于切口大小不同的手术，简化操作，方便手术。
在另一方面，本发明提供了一种在手术中使用可变周长的上述手术切口牵开器为手术牵开切口的方法。该方法包括以下步骤：
1)制备切口；
2)将手术切口牵开器放置在切口内；
3)用人工、机械或电子方式将手术切口牵开器扩张，使其周长扩大到充分与切口密切接触并带有适当张力或压力；
4)完成手术；
5)将手术切口牵开器拔出，弃置。
任选地，上述步骤2前可以先将柔性的膜套套在手术切口牵开器上，也可以是预先将柔性的膜套粘结或焊接在手术切口牵开器的外侧面上。
可见，本发明提供的手术切口牵开器操作简便，是能够适应不同大小手术切口的手术切口牵开器。在使用过程中切口视野不存在被挤压缩小风险。不需要其他器械牵开切口或复杂操作，也不需要另外的胶带固定。
附图说明
图1：实施例1中提供的周长可调节的手术切口牵开器的结构示意图；
图2：实施例2中提供的含有膜套的手术切口牵开器的侧视图；
图3：图2中A处的放大图；
图4：实施例3中提供的周长可调节的手术切口牵开器的结构示意图；
图5：实施例4中提供的周长可调节的手术切口牵开器的结构示意图；
图6：实施例4中提供的周长可调节的手术切口牵开器的锁扣环处的侧视图；
图7：实施例5中提供的周长可调节的手术切口牵开器的结构示意图；
图8：实施例6中提供的周长可调节的手术切口牵开器的结构示意图；
图9：实施例7中提供的周长可调节的手术切口牵开器的结构示意图；
图10：实施例8中提供的周长可调节的手术切口牵开器的结构示意图。
具体实施方式
为使本发明的目的、技术方案和优点更加清楚明白，以下结合具体实施例，并参照附图，对本发明进一步详细说明。
应当了解，所附附图并非按比例地绘制，而仅是为了说明本发明的基本原理的各种特征的适当简化的画法。本文所公开的本发明的具体设计特征包括例如具体尺寸、方向、位置和外形将部分地由具体所要应用和使用的环境来确定。
实施例1
图1为一种周长可按切口大小调节的手术切口牵开器。图2为手术切口牵开器的侧视图。图3为图2中A处的放大图。如图1至图3所示，在本实施例中，手术切口牵开器包含牵开器本体1，牵开器本体1的一端设置有锁扣环101，牵开器本体1的另一端穿入锁扣环101形成环状的手术切口牵开器，以调节手术切口牵开器的周长，该牵开器本体1的另一端表面设置有多个齿状凸起103，锁扣环101内壁设置有卡扣102，卡扣102与齿状凸起103相互卡接，以固定手术切口牵开器的周长。
可见，可通过牵开器本体1的另一端在锁扣环101中的滑动而调节手术切口牵开器的周长。初始状态下，手术切口牵开器保持在较小周长状态，调节卡扣102与在不同位置设置的齿状凸起103的相互卡接，实现针对不同的手术切口的大小，调节、固定牵开器的周长，从而适应手术需求。
具体地，在展开状态下的牵开器本体1上，每个齿状凸起103在靠近锁扣环101的一端低，远离锁扣环101的一端高。这使得牵开器在扩张时，卡扣102受力回缩允许齿状凸起103通过，因此，齿状凸起103可以在锁扣环101内的卡扣102内滑动，即从齿状凸起103低 的一端向高的一端滑动，而达到周长增加的目的。当一个齿状凸起103通过后，卡扣102受弹性回复力复位，当外力压迫使牵开器周长有一个减小的趋势时，牵开器的齿状凸起103高的一端将被卡扣102挡住，阻止其周长变小，达到止退的目的。
在本实施例中，锁扣环101、齿状凸起103设置在环状的手术切口牵开器的内表面。根据需要，也可以将锁扣环101及齿状凸起103设置在环状的手术切口牵开器的外表面。
在本实施例中，手术切口牵开器材料为聚氨酯。环状的手术切口牵开器的初始周长为60毫米，周长范围为60-100毫米。手术切口牵开器的高度为30毫米，厚度0.8毫米。环的形状为圆形。
其中，在本说明书中，初始周长是指在未使用状态下，或保存状态下的手术切口牵开器的周长。从以上所述可知，手术切口牵开器的周长可从初始周长逐渐增加至其周长范围内的最大值，因此初始周长也即手术切口牵开器的周长范围内的最小值。
在使用时，先将上述手术切口牵开器置入切口处，然后用手或另外一个扩张钳将手术切口牵开器扩张，从而使手术切口扩大，方便手术。
实施例2
图2所示，上述实施例1中的手术切口牵开器还可设置有一个柔性的膜套2。例如，在实际使用时在外表面再套一个柔性的膜套2，或者在手术切口牵开器外表面预先固定(如用焊接、热粘、胶粘等方法)柔性的膜套2。
在本实施例中，膜的材料是聚氨酯薄膜，高度60毫米，厚度0.05毫米。其周长60毫米，刚好套在实施例1的手术切口牵开器(初始周长)外表面。柔性的膜套2是在使用前套在实施例1的手术切口牵开器外表面的。由于有弹性，在手术切口牵开器扩张到使用尺寸时，这个柔性的膜套2也会随之扩大周长。其高度方向多余的部分在切口扩大后叠入牵开器内部，或用手术剪刀剪掉。该柔性的膜套2的使用避免了切口组织与手术切口牵开器的直接接触，方便手术，且操作安全。
实施例3
图4为另一种周长可按切口大小调节的手术切口牵开器。其结构基本如实施例1所述的手术切口牵开器。在本实施例中，牵开器本体1上还设置有开孔104，开孔104的孔径3毫米，间距10毫米，开孔104的面积占牵开器本体1的面积7％。这样的开孔104可以减少手术切口牵开器的材料使用，降低成本，并且可以减少手术切口牵开器与伤口的接触面积，降低对皮肤、组织的刺激。
在本实施例中的手术切口牵开器材料为聚酯。环状的手术切口牵开器的初始周长为90毫米，周长范围为90-150毫米。手术切口牵开器的高度为30毫米，厚度0.8毫米。环的形状为圆形。
在使用时，先将上述手术切口牵开器置入切口，然后用手或另外一个扩张钳将手术切口牵开器扩张，用手术切口牵开器将切口扩大，方便手术。
实施例4
图5为一种周长可按切口大小调节的手术切口牵开器。图6为该周长可按切口大小调节的手术切口牵开器的锁扣环处的侧视图。其结构基本如实施例1所述的手术切口牵开器，但其未设置有齿状凸起。
参见图5和图6，在本实施例中的手术切口牵开器材料为聚氨酯，环状的手术切口牵开器的初始周长为120毫米，周长范围为120-200毫米。手术切口牵开器的高度为30毫米，厚度0.8毫米。环的形状为圆形。牵开器本体1上沿高度方向开有多个窄的槽106，槽106的宽度3毫米，高度20毫米，每两个槽106之间的间距8毫米。槽106的面积占环体面积25％。这些槽106既可以减少手术切口牵开器的材料使用，降低成本，也可以作为止退装置的卡槽，与锁扣环101上的卡扣102配合实现止退功能。
该手术切口牵开器外表面还可以套一个柔性的膜套2。膜套2的材料是聚氨酯薄膜，高度60毫米，厚度0.08毫米。其周长60毫米，刚好可以套在手术切口牵开器的外表面。
在使用时，先将上述手术切口牵开器置入切口，然后用手或另外一个扩张钳将牵开器扩张，用手术切口牵开器将切口扩大，方便手术。
实施例5
图7为一种周长可按切口大小调节的手术切口牵开器。其结构基本如实施例1所述的手术切口牵开器。但在手术切口牵开器的牵开器本体1的未设置有齿状凸起103的部分，牵开器本体1的两长边上还设置有外凸的楞105，楞105的高度为5毫米，可以防止使用时手术切口牵开器滑出切口。
在本实施例中的手术切口牵开器材料为聚氨酯，环状的手术切口牵开器的初始周长为90毫米，周长范围为90-120毫米。手术切口牵开器的高度为50毫米，厚度0.9毫米。
在使用时，先将手术切口牵开器置入切口，然后用手或另外一个扩张钳将手术切口牵开器扩张，用手术切口牵开器将切口扩大，方便手术。
实施例6
图8为一种周长可按切口大小调节的手术切口牵开器。其结构基本如实施例3所述的手术切口牵开器。但在手术切口牵开器的牵开器本体1的未设置有齿状凸起103的部分，牵开器本体1的两长边上还设置有外凸的楞105，楞105的高度为3毫米，可以防止使用时手术切口牵开器滑出切口。
在使用时，先将手术切口牵开器置入切口，然后用手或另外一个扩张钳将手术切口牵开器扩张，用手术切口牵开器将切口扩大，方便手术。
实施例7
图9为一种周长可按切口大小调节的手术切口牵开器。其结构基本如实施例5所述的手术切口牵开器。但在手术切口牵开器的牵开器本体1的未设置有齿状凸起103的部分，牵开器本体1的两长边上可以有不连续的外凸的楞105，楞105的高度为2毫米，可以防止使用时手术切口牵开器滑出切口。
在使用时，先将手术切口牵开器置入切口，然后用手或另外一个 扩张钳将手术切口牵开器扩张，用手术切口牵开器将切口扩大，方便手术。
实施例8
图10为一种周长可按切口大小调节的牵开器。其结构基本如实施例1所述的手术切口牵开器。
在本实施例中的手术切口牵开器材料为聚酰胺。环状的手术切口牵开器的初始周长为180毫米，周长范围为180-300毫米。手术切口牵开器的高度为50毫米，厚度1.2毫米。环的形状为腰圆形，更便于与切口形状配合。
在使用时，先将手术切口牵开器置入切口，然后用手或另外一个扩张钳将手术切口牵开器扩张，用手术切口牵开器将切口扩大，方便手术。
以上示例性实施方式所呈现的描述仅用以说明本发明的技术方案，并不想要成为毫无遗漏的，也不想要把本发明限制为所描述的精确形式。显然，本领域的普通技术人员根据上述教导作出很多改变和变化都是可能的。选择示例性实施方式并进行描述是为了解释本发明的特定原理及其实际应用，从而使得本领域的其它技术人员便于理解、实现并利用本发明的各种示例性实施方式及其各种选择形式和修改形式。本发明的保护范围意在由所附权利要求书及其等效形式所限定。

Claims (13)

  1. 一种手术切口牵开器，其特征在于包含牵开器本体(1)，所述牵开器本体(1)的一端设置有锁扣环(101)，所述牵开器本体(1)的另一端穿入所述锁扣环(101)，形成环状的所述手术切口牵开器，以调节所述手术切口牵开器的周长。
  2. 根据权利要求1所述的手术切口牵开器，其特征在于该牵开器本体(1)穿入所述锁扣环(101)的一端的表面设置有多个齿状凸起(103)，所述锁扣环(101)的内壁设置有卡扣(102)，所述卡扣(102)与所述齿状凸起(103)可相互卡接，用以固定所述手术切口牵开器的周长。
  3. 根据权利要求1所述的手术切口牵开器，其特征在于该牵开器本体(1)穿入所述锁扣环(101)的一端的表面设置有多个槽(106)，所述锁扣环(101)的内壁设置有卡扣(102)，所述卡扣(102)可卡入所述槽(106)，以固定所述手术切口牵开器的周长。
  4. 根据权利要求1所述的手术切口牵开器，其特征在于，所述手术切口牵开器的周长范围在20-1000毫米。
  5. 根据权利要求1所述的手术切口牵开器，其特征在于，所述牵开器本体(1)的厚度为0.2-5毫米，高度为4-50毫米。
  6. 根据权利要求1所述的手术切口牵开器，其特征在于，该手术切口牵开器的环状外形选自圆形、半圆形、椭圆形、三角形、规则多边形、不规则多边形和带有弧边的多边形。
  7. 根据权利要求2所述的手术切口牵开器，其特征在于，在展开状态下的所述牵开器本体(1)上，每个所述齿状凸起(103)具有靠近锁扣环的一端和远离锁扣环的一端，所述靠近锁扣环的一端低，所述远离锁扣环的一端高。
  8. 根据权利要求7所述的手术切口牵开器，其特征在于，相邻的所述齿状凸起(103)的间距为3-20mm，总共设置有3-30个所述齿状凸起(103)。
  9. 根据权利要求1-8中任一项所述的手术切口牵开器，其特征在于，该手术切口牵开器是由选自以下材料之一或其组合的复合材料制备：聚氨酯材料、聚酯材料、聚酰胺材料、聚乙烯材料、聚丙烯材料、聚硅酮材料或不锈钢。
  10. 根据权利要求1所述的手术切口牵开器，其特征在于所述牵开器本体(1)上还设置有多个开孔(104)，所述开孔(104)的总面积不超过所述牵开器本体(1)总面积的70％，优选不超过所述牵开器本体(1)总面积的50％。
  11. 根据权利要求2所述的手术切口牵开器，其特征在于，所述牵开器本体(1)的未设置有齿状凸起(103)的部分，在所述牵开器本体(1)的两长边上设置有外凸的楞(105)，以防止所述手术切口牵开器滑出切口。
  12. 根据权利要求1所述的手术切口牵开器，其特征在于，该手术切口牵开器外表面还设置有一个柔性的膜套(2)，所述膜套(2)的厚度小于0.5毫米。
  13. 根据权利要求12所述的手术切口牵开器，其特征在于，所述膜套(2)是由选自以下的材料之一或其组合制备：聚氨酯材料、聚酯材料、或聚酰胺材料、聚乙烯材料、聚丙烯材料或聚硅酮材料。
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