CN110897665B - An umbrella-shaped magnetic anchoring traction device for traction exposure in magnetic anchoring laparoscopic surgery - Google Patents
An umbrella-shaped magnetic anchoring traction device for traction exposure in magnetic anchoring laparoscopic surgery Download PDFInfo
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- CN110897665B CN110897665B CN201911402659.9A CN201911402659A CN110897665B CN 110897665 B CN110897665 B CN 110897665B CN 201911402659 A CN201911402659 A CN 201911402659A CN 110897665 B CN110897665 B CN 110897665B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
- A61B17/0218—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
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Abstract
The umbrella rib consists of three identical cuboid units, symmetrical shafts are arranged on two sides of the bottom end of each cuboid unit, the two shafts of each cuboid unit are inserted into the shaft rings of the adjacent pair of the shaft bases to form a rotating shaft, a tissue clamp consists of a tissue clamp main body and a fixing arc, the fixing arc is connected with the fixing ring through wires, the umbrella cap and the umbrella rib are made of magnetic materials, the tissue clamp is made of antimagnetic materials, can be fed in through a stamp, has a large cross section and a small height, is large enough to act with an external magnet and can be used for grabbing and pulling tissues, and the visual field of the endoscopic surgery is exposed.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to an umbrella-shaped magnetic anchoring traction instrument for traction exposure of a magnetic anchoring endoscopic surgery.
Background
With the explosive development of minimally invasive surgery, traditional laparoscopic techniques have tended to be mature and widely popular, but surgeons have not stopped exploring minimally invasive techniques. Based on the high requirements of 'reduced stabbing, less pain and no mark', new minimally invasive techniques such as transumbilical single-hole laparoscopic surgery and natural cavity endoscopic surgery have also been developed. However, no matter LESS or NOTES, the single-hole laparoscope technology does not achieve an ideal minimally invasive effect, and the root cause is that a plurality of endoscopic instruments are placed from the same poking card, on one hand, the diameter of the poking card has to be increased, the diameter of the poking card of the single-hole endoscope is about 30mm, and the diameter of the poking card of the traditional endoscope is only 5-10 mm, on the other hand, the instruments are mutually interfered, so that the formation of an operation triangle is not facilitated, and the operation difficulty is high.
The magnetic surgical technique based on the principle of homopolar repulsion and heteropolar attraction of magnets and the characteristic of non-contact magnetic force in a special form is rapidly developed, and a series of subversion clinical new techniques are produced. The magnetic anchoring technology is one of core technologies of clinical application of magnetic surgery, and uses magnetic attraction force between magnets or between magnets and paramagnetic substances to enable one magnet to perform non-contact spatial anchoring on the other magnet or paramagnetic substance, wherein the magnet serving as an active part in the magnetic anchoring technology is called an anchoring magnet (or an external magnet), and the magnet or paramagnetic object serving as a passive attraction role is called a target magnet (or an internal magnet). Magnetic anchoring techniques are currently being used clinically primarily in subtractive stamping endoscopic procedures. Current magnetically anchored endoscopic instruments include magnetically anchored pulling instruments, magnetically anchored cautery instruments, and magnetically anchored video instruments. Among them, the research of magnetic anchoring traction devices is at most the most mature.
However, the internal magnet of the traditional magnetic anchoring traction apparatus has the following defects that ① is limited in size (the diameter is 10mm generally) because the internal magnet needs to be sent into the abdominal cavity through a poking card, the internal magnet possibly falls off under the action of larger traction force of the traction tissue, the smoothness of operation is affected, even medical accidents are caused, ② is small in contact cross section with the abdominal wall because the internal magnet is limited in size, when the traction tissue generates smaller traction force, the internal magnet generates larger pressure on the abdominal wall under the action of the external magnet, so that the abdominal wall is damaged, ③ is limited in cross section of the internal magnet, and a certain height is usually required to be met for achieving larger traction force as much as possible, so that the tissue cannot be effectively pulled in a narrow space (such as the traction of liver lobes of hepatectomy).
Disclosure of Invention
In order to overcome the defects of the prior art, the invention aims to provide an umbrella-shaped magnetic anchoring pulling instrument for grasping and pulling tissue in a magnetic anchoring endoscopic surgery and exposing an operation field, which can assist an endoscopic operator to perform the operation field exposure, can smoothly send the surgical instrument into an abdominal cavity through a poking card, increase the attractive force with an external magnet, increase the contact area with an abdominal wall, reduce the height of a working state, solve the contradiction between the size and the magnetic force, and improve the safety, the effectiveness and the feasibility of the operation of the magnetic anchoring stab-reduction endoscopic surgery. In addition, the instrument is made of ferromagnetic materials, and the normal work of other instruments cannot be interfered by magnetic force in endoscopic surgery, and the variable-form magnetic anchoring traction instrument which can be fed through a poking card, has a large cross section, a small height and large enough acting force with an external magnet, is used for grabbing and pulling tissues and exposing the visual field of endoscopic surgery, and can effectively solve the contradiction between the size and the magnetic force.
In order to achieve the above purpose, the technical scheme adopted by the invention is as follows:
An umbrella-shaped magnetic anchoring pulling instrument for use in magnetic anchoring endoscopic surgical pulling exposure, comprising:
The umbrella cap 1 is cylindrical in main body, a fixed ring 4 is arranged in the center of the bottom end of the cylinder, three pairs of rotating shaft bases 3.1 which are arranged in a 120-degree array are arranged at the edge of the top end, each pair of rotating shaft bases 3.1 consists of two flaky bodies which are connected into an L shape, and each flaky body is provided with a through hole as a shaft collar;
The umbrella rib 2 consists of three identical cuboid units, wherein two symmetrical shaft cores 3.2 are arranged on two sides of the bottom end of each cuboid unit, and the two shaft cores 3.2 of each cuboid unit are inserted into the shaft rings of the adjacent pair of shaft bases 3.1 to form a shaft 3;
the tissue clamp 5 consists of a tissue clamp main body and a fixed arc 6, and the fixed arc 6 is connected with the fixed ring 4 through a silk thread;
wherein, the umbrella cap 1 and the umbrella rib 2 are made of magnetic materials, and the tissue clip 5 is made of antimagnetic materials.
Preferably, the diameter of the umbrella cap 1 is 10mm, the thickness of the umbrella cap is different specifications according to the pulling force requirement, for example, 1.5mm and 10mm, the height of each pair of rotating shaft bases 3.1 is 2.5mm, the diameter of the shaft collar is 1mm, and the outer diameter of the fixed ring 4 is 4mm, the inner diameter is 2mm and the thickness is 1mm. Each cuboid unit is 40mm long, 5mm wide and 2mm thick.
Preferably, the sheet body is rectangular, two sheet bodies of each pair of rotating shaft bases 3.1 are vertically connected, and the through hole is formed in the center of each sheet body.
The fixing arc 6 is a circular arc structure on the tissue clamp 5 and is used for bolting the silk thread on the fixing arc.
The bottom end of each cuboid unit is contacted with the top end of the umbrella cap 1 or has a tiny gap so as to ensure that each cuboid unit rotates 90 degrees through the rotating shaft 3, thereby realizing the conversion between an imbedded state and a working state, wherein the imbedded state is a state that the cuboid unit is vertical to the umbrella cap 1, and the working state is a state that the cuboid unit is parallel to the umbrella cap 1.
Compared with the prior art, the invention has the beneficial effects that:
1. The umbrella-shaped magnetic anchoring traction instrument has two states, namely an imbedding state and a working state, wherein the imbedding state has a small cross section (10 mm) and can be smoothly imbedded into the abdominal cavity through the poking clamp, and the working state has a large cross section (914 mm 2) and can provide enough traction force for tissue traction exposure, so that the umbrella-shaped magnetic anchoring traction instrument can be used for grabbing and pulling larger tissues and reducing the falling of traction instruments;
2. The umbrella-shaped magnetic anchoring traction instrument has a large working state cross section, so that the pressure of the umbrella-shaped magnetic anchoring traction instrument on the abdominal wall is reduced, and the damage to the abdominal wall is reduced;
3. The umbrella-shaped magnetic anchoring traction instrument has small working state height (the minimum height of an internal magnet is 4 mm), and can be used for tissue traction exposure in a narrow space;
4. the umbrella-shaped magnetic anchoring traction instrument is made of ferromagnetic materials, so that the normal work of other instruments cannot be interfered by magnetic force in endoscopic surgery;
5. The umbrella cap of the umbrella-shaped magnetic anchoring traction device is adjustable in height, and when the operation space is large enough and larger traction force is needed, the height of the umbrella cap can be increased to increase the magnetic force of the inner magnet and the outer magnet, so that the traction force on tissues is increased.
Drawings
FIG. 1 is a schematic diagram of the structure of the present invention (set-in state, specification one).
Fig. 2 is a schematic structural diagram (in-place state, second specification) of the present invention.
Fig. 3 is a schematic structural view (working state) of the present invention.
FIG. 4 is a schematic view of the umbrella cap of the present invention.
FIG. 5 is a schematic view of the rib structure of the present invention.
FIG. 6 is a schematic view of the structure of the tissue gripper according to the present invention.
Detailed Description
Embodiments of the present invention will be described in detail below with reference to the accompanying drawings and examples.
As shown in fig. 1,2 and 3, an umbrella-shaped magnetic anchoring pulling instrument for pulling exposure in a magnetic anchoring endoscopic surgery, comprising:
The umbrella cap 1 is made of ferromagnetic materials, referring to fig. 4, the main body is a cylinder with the diameter of 10mm and the thickness of the cylinder being adjustable (different specifications are needed according to the pulling force, for example, 1.5mm and 10mm are respectively referred to fig. 1 and 2), the center of the bottom end of the cylinder is provided with a fixing ring 4, the fixing ring 4 is made of ferromagnetic materials, the base part of the fixing ring 4 is connected with the center of the bottom of the umbrella cap 1, and the center of the fixing ring is provided with a circular hole. The outer diameter of the steel is 4mm, the inner diameter is 2mm, and the thickness is 1mm. The cylindrical top edge is provided with three pairs of rotating shaft bases 3.1 which are arranged in a 120-degree array, each pair of rotating shaft bases 3.1 is 2.5mm high and consists of two platy bodies which are connected into an L shape, each platy body is rectangular, the two platy bodies of each pair of rotating shaft bases 3.1 are vertically connected, and a through hole with the diameter of 1mm is formed in the central position of each platy body and is used as a shaft collar.
The rib 2 is made of ferromagnetic material, and referring to fig. 5, is composed of three identical rectangular units, each rectangular unit being 40mm long, 5mm wide and 2mm thick. The two sides of the bottom end of each cuboid unit are provided with a pair of symmetrical shaft cores 3.2, the shaft cores 3.2 are made of ferromagnetic materials, and the two shaft cores 3.2 of each cuboid unit are inserted into the shaft rings of the adjacent pair of shaft bases 3.1 to form a shaft 3. The bottom end of each cuboid unit is contacted with the top end of the umbrella cap 1 or has a tiny gap so as to ensure that each cuboid unit rotates 90 degrees through the rotating shaft 3, thereby realizing the conversion of the umbrella-shaped magnetic anchoring traction instrument between the placement state and the working state.
The tissue clip 5 is made of antimagnetic material to prevent the tissue clip from interfering with the magnetized umbrella cap 1 or the umbrella rib 2 under the action of the external magnet. Referring to fig. 6, which is composed of a tissue clip body and a fixing arc 6, the fixing arc 6 is connected to the fixing ring 4 by a wire. The fixing arc 6 refers to a circular arc-shaped structure on the tissue clamp 5 for bolting the wire thereto, the fixing arc 6 being part of the tissue clamp 5.
The placing state is a state that the cuboid unit is vertical to the umbrella cap 1, the working state is a state that the cuboid unit is parallel to the umbrella cap 1, and referring to fig. 1 and 2, in the placing state, the whole device presents a cylindrical shape with the diameter of 10mm, and can be placed into an abdominal cavity (or a pelvic cavity) through a 10mm poking card. Referring to fig. 3, in the working state, the whole device is in a divergent shape, the bottom area of the whole device can reach 900mm 2, so that the riveting force and the pulling force are increased, and the height of the whole device can be reduced to 4mm at the minimum, so that the whole device can be suitable for tissue pulling exposure in a narrow space. The fixing ring 4 is connected with the tissue clamp 5 through a silk thread and is used for grabbing and pulling tissues, and after the umbrella-shaped magnetic anchoring retractor is placed into the abdominal cavity, the retractor is taken through a laparoscopic instrument clamp to carry out operations such as moving and adjusting on the retractor.
The specific implementation process is as follows:
(1) The tissue clamp 5 is fixed on the fixed ring 4 through a silk thread, and the length of the silk thread is determined by different clinical application scenes;
(2) Placing the device in an imbedded state, and introducing the device into the abdominal cavity (or pelvic cavity, etc.) through a stamping card;
(3) Grasping tissue to be exposed by a tissue clamp through the endoscopic instrument;
(4) Placing the device in a working state through the endoscopic instrument;
(5) The endoscope instrument is used for grabbing the device fixing ring 4, and the device in the working state is attached to the target position of the abdominal wall through the endoscope instrument;
(6) The position of the outer magnet is adjusted so that the outer magnet and the umbrella-shaped magnetic anchoring traction device are fixed through magnetic force.
Umbrella-shaped magnetic-anchored pulling instruments with large caps can be used if space permits where the small caps cannot provide more sufficient pulling exposure to tissue.
Claims (2)
1. An umbrella-shaped magnetically anchored pulling instrument for use in pulling an exposed magnetic anchored endoscopic procedure, comprising:
The umbrella cap (1) is cylindrical, the center of the bottom end of the cylinder is provided with a fixed ring (4), the edge of the top end of the umbrella cap is provided with three pairs of rotating shaft bases (3.1) which are arrayed at 120 degrees, each pair of rotating shaft bases (3.1) consists of two flaky bodies which are connected into an L shape, and each flaky body is provided with a through hole as a collar;
The umbrella rib (2) consists of three identical cuboid units, two symmetrical shaft cores (3.2) are arranged on two sides of the bottom end of each cuboid unit, and the two shaft cores (3.2) of each cuboid unit are inserted into the shaft rings of the adjacent pair of rotating shaft bases (3.1) to form a rotating shaft (3);
The tissue clamp (5) consists of a tissue clamp main body and a fixing arc (6), and the fixing arc (6) is connected with the fixing ring (4) through a silk thread;
wherein, the umbrella cap (1) and the umbrella rib (2) are made of magnetic materials, and the tissue clamp (5) is made of antimagnetic materials;
The diameter of the umbrella cap (1) is 10mm, the thickness of the umbrella cap is different specifications according to the pulling force requirement, the height of each pair of rotating shaft bases (3.1) is 2.5mm, the diameter of the shaft collar is 1mm, the outer diameter of the fixing ring (4) is 4mm, the inner diameter of the fixing ring is 2mm, and the thickness of the fixing ring is 1mm, and the length of each cuboid unit is 40mm, the width of each cuboid unit is 5mm, and the thickness of each cuboid unit is 2mm;
the fixing arc (6) is of a circular arc structure on the tissue clamp (5) and is used for bolting silk threads on the fixing arc;
The bottom of each cuboid unit is contacted with the top end of the umbrella cap (1) or has a tiny gap so as to ensure that each cuboid unit rotates 90 degrees through the rotating shaft (3), thereby realizing the conversion between an imbedded state and a working state, wherein the imbedded state is a state that the cuboid unit is vertical to the umbrella cap (1), and the working state is a state that the cuboid unit is parallel to the umbrella cap (1).
2. An umbrella-shaped magnetic anchoring pulling instrument for magnetic anchoring endoscopic surgery pulling exposure according to claim 1, wherein the sheet-shaped body is rectangular, two sheet-shaped bodies of each pair of spindle bases (3.1) are vertically connected, and a through hole is opened at the center position of each sheet-shaped body.
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| CN201911402659.9A CN110897665B (en) | 2019-12-31 | 2019-12-31 | An umbrella-shaped magnetic anchoring traction device for traction exposure in magnetic anchoring laparoscopic surgery |
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| CN201911402659.9A CN110897665B (en) | 2019-12-31 | 2019-12-31 | An umbrella-shaped magnetic anchoring traction device for traction exposure in magnetic anchoring laparoscopic surgery |
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| CN211433071U (en) * | 2019-12-31 | 2020-09-08 | 西安交通大学医学院第一附属医院 | Umbrella-shaped magnetic anchoring traction instrument for magnetic anchoring endoscopic surgery traction exposure |
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| US7042184B2 (en) * | 2003-07-08 | 2006-05-09 | Board Of Regents Of The University Of Nebraska | Microrobot for surgical applications |
| GB201012336D0 (en) * | 2010-07-23 | 2010-09-08 | Univ Leeds | Surgical device and procedure |
| CN102178560B (en) * | 2011-04-11 | 2012-07-04 | 西安交通大学 | Magnetic auxiliary tensioning device for single-pore laparoscope |
| ITFI20110114A1 (en) * | 2011-05-31 | 2012-12-01 | Scuola Superiore Di Studi Universit Arie Di Perfe | ROBOTIC PLATFORM FOR MINING-INVASIVE SURGERY |
| CN105286929A (en) * | 2014-07-10 | 2016-02-03 | 张自雄 | Device for creating cavities during endoscopic surgery |
| CN104490431B (en) * | 2014-12-03 | 2017-01-04 | 杭州康基医疗器械有限公司 | Exempt from pneumoperitoneum dilator |
| ES2897754T3 (en) * | 2015-04-13 | 2022-03-02 | Levita Magnetics Int Corp | retraction devices |
| CN206350739U (en) * | 2016-08-31 | 2017-07-25 | 张强 | Auxiliary pulling device under arthroscope |
| CN107468296B (en) * | 2017-09-13 | 2023-10-03 | 济南君道信医疗器械有限公司 | Traction type abdominal cavity wall spreader |
| CN208910345U (en) * | 2018-07-05 | 2019-05-31 | 泗洪县正心医疗技术有限公司 | One kind exempting from pneumoperitoneum hanger |
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| CN211433071U (en) * | 2019-12-31 | 2020-09-08 | 西安交通大学医学院第一附属医院 | Umbrella-shaped magnetic anchoring traction instrument for magnetic anchoring endoscopic surgery traction exposure |
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