CN103263281B - Abdominal wall supporting suspension support - Google Patents

Abstract

The invention discloses an abdominal wall supporting suspension bracket, which comprises a main branch, an auxiliary branch, a connecting branch, a suspension line and a pulling line; The center of the branch is hinged at the center of the main branch, and the two ends of the auxiliary branch are equipped with a second auxiliary branch; the two ends of the connecting branch are the hinged end and the sliding end, and the hinged end is hinged on the auxiliary branch. Sliding fit; one end of the suspension wire is fixed at the hinge of the main branch and the auxiliary branch, and the other end is suspended on the external surgical frame; it is used to drive the sliding end to slide along the positioning groove, and one end of the pulling wire is connected to the sliding end . In laparoscopic surgery where pneumoperitoneum is not suitable, the stent of the present invention is used to perform laparoscopic surgery to increase the surgical field of view, thus avoiding a series of unnecessary risks brought by laparotomy.

Description

Abdominal Wall Support Suspension Bracket

technical field

The invention relates to an instrument for laparoscopic surgery, in particular to an abdominal wall support suspension bracket.

Background technique

Laparoscopic surgery is a newly developed minimally invasive method, and it is an inevitable trend in the development of future surgical methods. With the rapid development of industrial manufacturing technology, the integration of related disciplines has laid a solid foundation for the development of new technologies and methods. Coupled with the increasingly skilled operation of doctors, many open operations in the past have now been replaced by laparoscopic surgery. Greatly increased surgical options.

Laparoscopic surgery is performed using laparoscopes and related instruments: using a cold light source to provide illumination, inserting a laparoscopic lens (3-10mm in diameter) into the abdominal cavity, and using digital camera technology to make the images captured by the laparoscopic lens pass through the light guide. The fiber is conducted to the post-stage signal processing system and displayed on a dedicated monitor in real time. Then the doctor analyzes and judges the patient's condition through the images of different angles of the patient's organs displayed on the monitor screen, and uses special laparoscopic instruments to perform the operation. Laparoscopic surgery mostly uses 2 to 4 holes. After recovery, only 1 to 3 scars of 0.5 to 1 cm are left in the abdominal cavity. It can be said that it is a small wound and painless operation. hole” surgery. The development of laparoscopic surgery reduces the pain of patients, shortens the recovery period of patients, and reduces the hospitalization costs of patients. It is a surgical method that has developed rapidly in recent years.

For surgical field exposure, although conventional _CO2 insufflation has inherent incomparable advantages, it still has certain defects, such as a high risk of gas embolism, affecting cardiopulmonary function, promoting tumor progression and spread, and aggravating the spread of inflammation. Especially for some pregnant women, patients with basic diseases such as severe cardiopulmonary insufficiency, and patients with severe diffuse peritonitis, the application of conventional CO ₂ pneumoperitoneum is more risky, and the trauma of laparotomy is relatively large so as to aggravate Risk of anesthesia, difficulties in postoperative recovery, or failure of surgery.

Contents of the invention

In order to overcome the defects of conventional _CO2 pneumoperitoneum and expand the application range of laparoscopic technology, the present invention provides an abdominal wall support suspension bracket, which can be used to pull the abdominal wall through the bracket in laparoscopic surgery in some serious disease states And support function, provide sufficient surgical field of view for the operator, avoid surgical trauma and anesthesia risks caused by laparotomy due to inability to establish pneumoperitoneum, so as to speed up post-operative recovery and improve the success rate of surgery.

An abdominal wall support suspension bracket, comprising:

The main branch, the main branch is provided with a positioning groove, and the two ends of the main branch are installed with the first auxiliary branch;

Auxiliary branch, the center of the auxiliary branch is hinged at the center of the main branch, and the two ends of the auxiliary branch are equipped with second auxiliary branches;

A connecting branch, the two ends of the connecting branch are respectively a hinged end and a sliding end, the hinged end is hinged on the auxiliary branch, and the sliding end is slidably matched with the positioning groove;

Suspension wire, one end of the suspension wire is fixed at the hinge of the main branch and the auxiliary branch, and the other end is suspended on the external surgical frame;

The pulling wire is used to drive the sliding end to slide along the positioning groove, and one end of the pulling wire is connected to the sliding end.

The stent is a stable strip-shaped structure in the closed state. In laparoscopic surgery in some severe disease states or when pneumoperitoneum is not suitable for other factors, the abdominal wall skin is pulled up, and then about 1cm is cut on the abdominal wall. An incision is made to the full thickness of the abdominal wall to create an abdominal space, and the closed stent is implanted into the abdominal cavity through the surgical incision in the abdominal wall. Then, the pulling effect of the pulling wire drives the sliding end of the connecting branch to move along the positioning groove, thereby increasing the angle between the main branch and the auxiliary branch, gradually opening the whole support, and increasing the surgical field of view in the abdominal cavity.

Preferably, the main branch, the auxiliary branch and the connecting branch are all plate-like structures, wherein:

Main branch: length 10-24cm, width 0.5-1.5cm, thickness 0.2-0.5cm;

Auxiliary branches: length 5-10cm, width 0.4-1.5cm, thickness 0.2-0.5cm;

Connecting branch: length 3-6cm, width 0.4-1.5cm, thickness 0.2-0.5cm.

The incision on the abdominal wall is about 1 cm. In order to make the stent in the closed state easy to implant into the abdominal cavity, the size and structure of each component of the stent should be adapted to the size of the incision. The main branch, auxiliary branch and connecting branch can be made of metal or hard plastic, and all need to be elastic and have high toughness to withstand certain abdominal wall pressure.

Preferably, the length of the first auxiliary branch and the second auxiliary branch is 1-4 cm, the width is 0.2-0.8 cm, and the thickness is 0.1-0.5 cm.

After the main branch and auxiliary branch are fully propped, if the abdominal space expanded by the stent does not meet the requirements of the surgical field of view, the surgical field of view can be further increased by opening the first auxiliary branch and the second auxiliary branch. It is made of plastic and has a certain deformation ability to avoid excessive pressure on the abdominal wall by the auxiliary branch.

Further preferably, the installation method of the first auxiliary branch and the second auxiliary branch is hinged or plugged.

The auxiliary branch can be connected with the main branch or the auxiliary branch by hinge or insertion. The principle of the auxiliary branch is to increase the size of the main branch or the auxiliary branch to achieve a sufficient surgical field of view. Among them, the hinge is on the main branch or the auxiliary branch. The auxiliary branches are opened in the abdominal cavity through relevant instruments. If the connection method of the second auxiliary branch is plug-in, it must be closely matched with the auxiliary branch to prevent the second auxiliary branch from falling off and increase the risk of surgery.

Preferably, there are two positioning grooves, and the two positioning grooves are symmetrical to the center of the main branch, and the connecting branches are also two respectively matched with the two positioning grooves, and the hinge of the two connecting branches The ends are respectively hinged at both ends of the auxiliary branch.

Pulling the puller wire drives the sliding end of the connecting branch to move along the positioning groove to open the stent. If only one connecting branch is used, the puller wire needs a larger pulling force when the stent is opened, and the abdominal wall bears greater pressure at this time. Two connecting branches are arranged, and the pulling wire is pulled to drive the two connecting branches to simultaneously drive the stent to open. The pulling force on the pulling wire is small, which is easy to operate and helps to protect the patient's abdominal wall.

As a preference, the sliding end of the connecting branch is protruded with a positioning column extending into the positioning groove, the two ends of the pulling wire are respectively wound on the positioning columns of the two connecting branches, and the middle part of the pulling wire passes through the main The hinges of the branches and subbranches extend outward.

The positioning column is protruding from the sliding end. The positioning column is limited by the positioning groove. The two ends of the pulling wire are fixed on the positioning column by winding. The medical staff can pull the middle part of the pulling wire to drive the positioning column to move along the positioning groove. The opening of the support is convenient and labor-saving.

Preferably, there is a hinge shaft running through the center of the auxiliary branch and the main branch, the hinge shaft is a cylindrical structure, both ends of the hinge shaft are provided with outward flanges, and one end of the suspension line is connected to the hinge shaft At the bottom, the pulling wire extends outwards through the side wall of the hinge shaft.

The flanging edges at both ends of the hinge shaft limit the position of the auxiliary branch and the main branch to prevent them from falling off the hinge shaft. Both the suspension line and the traction line protrude from the hinge shaft. The hinge shaft is located at the center of the bracket, which is convenient for maintaining the support. balance.

Preferably, the edges and corners of the main branch, the auxiliary branch, the connecting branch, the first auxiliary branch and the second auxiliary branch are all rounded.

The edges and corners of each component on the bracket are rounded to prevent the sharp edges and corners from scratching the abdominal organs and peritoneum during the use of the bracket, reducing the risk of surgery.

The beneficial effect of the present invention is that in the laparoscopic surgery where pneumoperitoneum is not suitable, the laparoscopic surgery can be performed by using the bracket to increase the surgical field of view, thereby avoiding a series of unnecessary risks brought by laparotomy, and the operation The operation process is basically similar to the operation process under the pneumoperitoneum state, the operation is convenient, and both doctors and patients can accept it.

Description of drawings

Fig. 1 is a schematic structural view of the main branch in the present invention.

Fig. 2 is a schematic diagram of the structure of the auxiliary branch in the present invention.

Fig. 3 is a cross-sectional view of the abdominal wall support suspension bracket of the present invention.

Fig. 4 is an assembly diagram of the abdominal wall support suspension bracket in the present invention.

Fig. 5 is another assembly diagram of the abdominal wall support suspension bracket in the present invention.

Detailed ways

The inventive abdominal wall support and suspension bracket will be described in further detail below in conjunction with the accompanying drawings.

The abdominal wall support and suspension bracket of the technical solution mainly includes five parts: a main branch 1, an auxiliary branch 2, a connecting branch 3, a suspension line 4 and a pulling line 5.

As shown in Figure 1, the main branch 1 is a plate-shaped structure, with rounded transitions at the edges and corners, and a smooth surface. The material is metal or hard plastic, with elasticity and high toughness. The structural size is: length 10~ 24cm, width 0.5-1.5cm, thickness 0.2-0.5cm, in addition, auxiliary branches 13 are installed at both ends of the main branch 1. The center of the main branch 1 has a central hole 11 with a diameter of 0.3 to 0.4 cm, and is provided with two positioning grooves 12 arranged symmetrically relative to the central hole 11. The positioning grooves 12 are located at a distance of 4 cm from the central hole and along the length of the main branch 1. direction, the positioning groove 12 has a length of about 4cm and a width of about 0.4mm. 1 end about 1.5cm.

As shown in Figure 2, the auxiliary branch 2 is also a plate-shaped structure, with rounded transitions at the corners and smooth surface, made of metal or hard plastic, with elasticity and high toughness, and its structural size is: length 5 ～12cm, width 0.4～1.5cm, thickness 0.2～0.5cm. The center of the auxiliary branch 2 is hinged at the center of the main branch 1, the rotation angle between the auxiliary branch 2 and the main branch 1 is 0°～90°, and the center of the auxiliary branch 2 is also provided with a center hole 21, the center hole 21 corresponds to the position of the center hole 11 of the main branch 1, and is provided with a hinge shaft 6 passing through the center holes of the main branch 1 and the auxiliary branch 2. As shown in Figure 3, the hinge shaft 6 is a cylindrical structure, and both ends of the hinge shaft 6 are provided with outward flanges acting on the main branch 1 or the auxiliary branch 2 to fix the position of the main branch 1 or the auxiliary branch 2. Prevent the two from falling off from the hinge shaft 6. At the same time, auxiliary branches 22 are also installed at both ends of the auxiliary branch 2 .

As shown in Figure 4 and Figure 5, the connecting branch 3 is two that cooperate with the two positioning grooves 12, and the structural characteristics are similar to the main branch 1 and the auxiliary branch 2, the length is 3-6 cm, and the width is 0.4-1.5 cm. The thickness is 0.2-0.5cm. The two ends of the connecting branch 3 are respectively a hinged end and a sliding end, the hinged end is hinged on the auxiliary branch 2 , and the sliding end is slidably matched with the positioning groove 12 . As shown in Figure 3, the sliding end is provided with a positioning column 24 extending into the positioning groove 12. The diameter of the positioning column 24 should be smaller than the width of the positioning groove 12. One end of the positioning column 24 is tightly fitted in the connecting support 3, and the other end There is an outer flanging matched with the positioning groove 12 . A fixed post is protruded from the center of the auxiliary branch 2 at 3 cm, and the fixed post runs through the connecting branch 3, and the connecting branch 3 can rotate around the fixed post.

As shown in Figure 3, the suspension wire 4 can be selected from steel wire or high-toughness wire, which can withstand a pull of 4-5kg, and its thickness is smaller than the inner diameter of the hinge shaft 6. The other end of the wire 4 is fixed on the external surgical support.

The pulling wire 5 is a thin steel wire or a wire with higher toughness, and the two ends of the pulling wire 5 are wound on the positioning posts 24 of the two connecting supports 3, and are used to drive the sliding ends of the connecting supports 3 to move along the positioning groove 12, and pull The pull wire 5 extends outward through the side wall of the hinge shaft 6, and the medical personnel pull the middle part of the pull wire 5 to drive the two connecting branches 3 to move at the same time.

After the main branch 1 and the auxiliary branch 2 are fully opened, if the patient’s intra-abdominal surgical field of view still fails to meet the requirements of the surgical operation, the auxiliary branch on the main branch 1 or auxiliary branch 2 can be opened to further expand the opening scale of the entire stent , to expand the surgical field of view and avoid unnecessary surgical risks.

In order to adapt to various situations that may occur during the operation, the auxiliary branches in this technical solution have three structures, namely auxiliary branch A, auxiliary branch B and auxiliary branch C. The three types of auxiliary branches can be used alone or combined with Use one or a combination of the other two.

The auxiliary branch A is the auxiliary branch 13 on the main branch 1 in Figure 1. It is a plate-shaped structure, made of plastic, with rounded edges and a certain deformation ability. Its length is 1-4cm, width 0.2-0.8cm, thickness 0.1～0.5cm. The auxiliary branch A is hinged at the end of the main branch 1 or the auxiliary branch 2. The auxiliary branch A can rotate within 0-90 degrees relative to the main branch 1 or the auxiliary branch 2. After the auxiliary branch A is fully opened, it moves along the main branch or the auxiliary branch. Its length extends outwards and acts on the abdominal wall to expand the surgical field of view.

The auxiliary branch B is composed of two auxiliary branches A. The structural characteristics are shown in the auxiliary branch 22 on the auxiliary branch 2 in Figure 2. The two auxiliary branches A are hinged side by side at the end of the main branch 1 or the auxiliary branch 2. According to the actual situation of the operation, The two auxiliary branches A can be deployed in parallel or at a certain angle. Compared with the auxiliary branch A, the auxiliary branch B has better flexibility and selectivity.

The auxiliary branch C is an assembly 23 inserted at both ends of the auxiliary branch 2 . The assembly 23 includes a socket 231 sheathed on the end of the auxiliary branch 2 , and an insert 232 inserted on the socket 231 . The socket 231 and the auxiliary branch 2, as well as the plug-in 232 and the socket 231 are tightly fitted to prevent the socket 231 and the plug-in 232 from falling off during the operation. The end of the socket 231 is a semicircle, and the inserts 232 are evenly inserted in the end. The length of the inserts 232 is controlled at 2.5 to 7.5 cm, the width is 0.2 to 0.8 cm, and the thickness is 0.1 to 0.5 cm. The number of inserts 232 is 2 to 5, the length of each plug-in 232 can be the same, or according to the actual situation, the length of the plug-ins 232 can also be uneven.

During the operation, the insertion, opening and application of the above-mentioned abdominal wall support and suspension bracket require the cooperation of 2 to 3 people. The process is as follows:

1. On the basis of conventional surgery, according to the size and shape of the selected stent, make an incision about 1 cm long on the abdominal wall at a suitable position in front of the site to be operated on;

2. Pull the abdominal skin on both sides of the incision with two towel forceps (the method is the same as that of conventional laparoscopic surgery to insert a laparoscopic probe or Veress needle), or use a retractor to open the incision, and one person uses a trocar or directly puts one end of the closed bracket slowly into the abdominal cavity;

3. With the skin on both sides lifted, pull back the suspension line to make it consistent with the incision position;

4. Pull the pulling wire to open the auxiliary branch;

5. Put down the skin on both sides to pull, tighten the suspension line, and fix the suspension line and pull line at the appropriate position;

6. Place other trocars and start other routine operations of the operation;

7. If necessary during the operation, according to the exposure requirements of the surgical field of view, the auxiliary hand (one-handed auxiliary method) or laparoscopic instruments can be used to open the auxiliary branches on both sides of the main branch and the auxiliary branch respectively. They can be opened at the same time or separately. Used to expand the field of view.

Removal of the stand:

After the operation, close the stent and restore the pre-implantation state. When taking out the resected specimen, if the incision needs to be enlarged, such as partial liver resection, intestinal resection and anastomosis, etc., the incision can be enlarged, and then the stent can be taken out, and then other Trocar, and other surgical operations; if there is no need to expand the incision, such as abdominal exploration, cholecystectomy, etc., it is necessary to remove the specimen and remove the stent through the original incision under direct vision of the laparoscope;

step:

1. Use occlusal forceps to pull up the stent as far as possible and insert it into the skin on both sides of the incision, close the stent under direct vision of the laparoscope, and restore the state before insertion;

2. Use a laparoscopic instrument or an auxiliary hand to bring one end of the stent close to the incision, and with the assistance of the laparoscope, use a vascular forceps or other auxiliary instruments to slowly pull out the stent;

3. According to the surgical operation, take out other instruments in turn, put down the skin and stretch;

4. Perform other operations.

The stent of the present invention is used in laparoscopic surgery where pneumoperitoneum is not suitable, and the stent is used for laparoscopic surgery to increase the surgical field of view, thereby avoiding a series of unnecessary risks brought by laparotomy, and the operation process is basically It is similar to the operation process under pneumoperitoneum state, the operation is convenient, and both doctors and patients can accept it.

Claims (8)

1. stomach wall supports a pipe-hanging hook, it is characterized in that, comprising:

Main (1), main (1) offers locating slot (12), and the two ends of main (1) are provided with first auxiliary (13);

Secondary (2), the center hinge of secondary (2) is connected on the center position of main (1), and the two ends of secondary (2) are provided with second auxiliary (22);

Connect (3), the two ends connecting (3) are respectively hinged end and sliding end, and hinged end is hinged on secondary (2), and sliding end and locating slot (12) are slidably matched;

Suspension line (4), one end of suspension line (4) is fixed on the hinged place of main (1) and secondary (2), and the other end is suspended on surgical frame;

Drag wire (5), for driving sliding end to slide along locating slot (12), one end of this drag wire (5) is connected to described sliding end.

2. stomach wall as claimed in claim 1 supports pipe-hanging hook, it is characterized in that, described master props up (1), secondary (2) and is connected (3) and is platy structure, wherein:

Main (1): length 10 ~ 24cm, width 0.5 ~ 1.5cm, thickness 0.2 ~ 0.5cm;

Secondary (2): length 5 ~ 10cm, width 0.4 ~ 1.5cm, thickness 0.2 ~ 0.5cm;

Connect (3): length 3 ~ 6cm, width 0.4 ~ 1.5cm, thickness 0.2 ~ 0.5cm.

3. stomach wall as claimed in claim 2 supports pipe-hanging hook, it is characterized in that, the length 1 ~ 4cm of described first auxiliary (13) and second auxiliary (22), width 0.2 ~ 0.8cm, thickness 0.1 ~ 0.5cm.

4. stomach wall as claimed in claim 3 supports pipe-hanging hook, and it is characterized in that, the mounting means of described first auxiliary (13) and second auxiliary (22) is hinged or grafting.

5. stomach wall as claimed in claim 1 supports pipe-hanging hook, it is characterized in that, described locating slot (12) is two, two relatively described masters of locating slot (12) prop up the centrosymmetry of (1), described connection is propped up (3) and is also two that coordinate with two locating slots (12) respectively, and two hinged ends connecting (3) are hinged on secondary two ends of propping up (2) respectively.

6. stomach wall as claimed in claim 5 supports pipe-hanging hook, it is characterized in that, the sliding end that (3) are propped up in described connection is convexly equipped with the locating dowel (24) stretched in locating slot (12), the two ends of described drag wire (5) are wrapped in two connections respectively and prop up in the locating dowel (24) of (3), and the middle part of drag wire (5) stretches out through main (1) and secondary hinged place of propping up (2).

7. stomach wall as claimed in claim 6 supports pipe-hanging hook, it is characterized in that, be provided with and run through the jointed shaft (6) that described pair props up (2) and main (1) center, described jointed shaft (6) is tubular structure, the two ends of jointed shaft (6) are equipped with flanging, one end of suspension line (4) is connected to jointed shaft (6) bottom, and described drag wire (5) stretches out through the sidewall of jointed shaft (6).

8. stomach wall as claimed in claim 1 supports pipe-hanging hook, it is characterized in that, described master props up (1), pair props up (2), connection (3), the edges and corners of first auxiliary (13) and second auxiliary (22) are fillet.