CN108143449B - Novel axillary cavity endoscope thyroid surgery retractor - Google Patents

Abstract

The invention relates to the technical field of medical devices, and discloses a novel retractor for endoscopic thyroid surgery through axillary approach. The surgical retractor includes a draw bar, a first draw hook and a second draw hook arranged on both sides of the draw bar in parallel with each other, and also includes a serrated telescopic bar and a pressure bar arranged below the second draw hook. The upper end of the telescopic rod is fixedly connected, the lower end of the serrated telescopic rod is rotatably connected with one end of the pressing rod, the other end of the pressing rod is provided with a downwardly curved hook, the pressing rod, the first pulling hook and the second pulling hook Both are located on the left side of the sawtooth telescopic rod, and the second draw hook includes a rod body, a pull tab head provided on the left end of the rod body, and a manipulation device provided on the right end of the rod body. The surgical retractor of the invention has simple adjustment and convenient operation, and the shape and size of the surgical operation space can be changed according to the needs of the surgical operation space.

Description

A new retractor for endoscopic thyroid surgery through axillary approach

technical field

The invention relates to the technical field of medical instruments, in particular to a novel axillary approach endoscopic thyroid surgery retractor that can be retracted and rotated to increase the surgical operation space and field of view.

Background technique

Traditional open thyroid surgery is often caused by horizontal incisions in the neck, and the proliferation of keloids on the neck after surgery affects the appearance and troubles the lives of patients. Surgery without keloids on the neck is gradually emerging. Laparoscopic thyroid surgery has developed by leaps and bounds in the past ten years, and various surgical methods have appeared, such as full areola approach, axillary areola approach, single-port areola approach, axillary-assisted laparoscopy, and so on. In recent years, there have been reports of single-port thyroid surgery through axillary approach. In the single-port thyroid surgery with axillary approach, a U-shaped retractor is used to pull up the epidermal tissue from the axilla to the neck.

Chinese Patent Publication No. CN205379323 discloses a thyroid retractor with anti-skid function, which includes a draw rod, a first draw hook and a second draw hook arranged at both ends of the draw rod, and the inner surfaces of the first draw hook and the second draw hook are provided with a number of bumps , the first draw hook, the second draw hook and the bump are integrally formed. During the operation, the second retractor is inserted into the surgical opening near the patient's axilla, the first retractor is lifted, and the second retractor pulls up the epidermal tissue from the patient's axilla to the neck, thus forming a surgical operation space, which is convenient for the doctor to put Surgical instruments are inserted for cutting, clipping and other surgical procedures, but the lifting height of human epidermis is limited, resulting in a narrow surgical operation space, difficult surgical operations, and prone to errors.

SUMMARY OF THE INVENTION

The invention is to overcome the problem of difficult operation caused by the narrow operation space of the axillary approach in the prior art, and provides a thyroid surgery retractor that can expand the operation space of the axillary approach and facilitate the subsequent operation of the doctor.

In order to achieve the above-mentioned purpose, the present invention adopts the following technical solutions: including a pull rod, a first pull hook and a second pull hook arranged on both sides of the pull rod in parallel to each other, and a sawtooth telescopic rod and a pressure rod arranged under the second pull hook, the pull rod The connection point with the second hook is fixedly connected with the upper end of the sawtooth telescopic rod, the lower end of the sawtooth telescopic rod is rotatably connected with one end of the pressure rod, and the other end of the pressure rod is provided with a downwardly curved hook, the pressure The rod, the first pull hook and the second pull hook are all located on the left side of the sawtooth telescopic rod, and the second pull hook includes a rod body, a pull tab head provided on the left end of the rod body, and a manipulation device provided on the right end of the rod body.

The second retractor can adjust the size of the tab head on the left end of the rod body according to the needs. Before the second retractor enters the surgical opening of the axilla, the opening area of the tab head should be adjusted to the minimum, which is convenient for the tab head to enter the surgical opening. After the second retractor enters the surgical opening of the axilla , increase the area of the pull tab head to an appropriate size according to the needs, and the contact area between the pull tab head and the epidermal tissue that is pulled up and raised increases, thereby increasing the surgical operation space and facilitating the operation of the doctor; the first retractor is used to hoist the entire retractor device. The function of the serrated telescopic rod is to reduce the tissue damage of the patient and adjust the size of the surgical operation space freely. The distance between the rods is reduced, which is convenient for the doctor to extend the second retractor and the pressure rod into the surgical opening of the patient's axilla, reducing unnecessary damage to the patient's body tissue. The space between the second retractor and the pressure rod and the field of view behind the muscle tissue under the epidermis can be adjusted freely according to the needs of the surgical operation space, so as to facilitate the doctor to carry out the operation; The rod can not only move up and down to press down the muscle tissue, but also freely rotate a certain angle according to the needs, so that a specific shape of surgical operation space and visual field space is formed between the muscle tissue and the surface tissue, which further facilitates the doctor to perform the operation; The other end is provided with a downward-directed hook to stretch the muscles at the lower part of the epidermis tissue outwards, so as to increase the surgical operation space and field of vision behind the muscle tissue.

Preferably, the pull tab head includes a first elongated pull tab, a second elongated pull tab, a first support rod and a second support rod, and one end of the first elongated pull tab extends longitudinally with a first pull tab A handle, one end of the second long pull-tab is longitudinally extended with a second pull-tab handle, and the connection point of the first long-strip pull-tab and the first pull-tab handle is hinged to the second long-strip pull-tab and the second pull-tab The connection point of the handle, a spring is arranged between the first handle and the second handle, the other end of the first handle is hinged with one end of the first support rod, and the other end of the second handle is hinged. One end is hinged with one end of the second support rod, the left end of the rod body is provided with a fixed shaft perpendicular to the plane direction where the pull-tab head is located, and the other end of the first support rod is hinged with the other end of the second support rod through the fixed shaft, The plane on which the pull tab head is located is perpendicular to the pull rod.

A hinge is formed between the first elongated pull-tab and the second elongated pull-tab, and the size of the angle between the first elongated pull-tab and the second elongated pull-tab is adjusted according to the operation space required during the operation. , thereby changing the open area of the pull tab.

Preferably, the rod body includes an inner rod body and an outer rod body sleeved on the outside of the inner rod body and slidably matched with it, the manipulation device includes a screw rod, a casing and an elastic rod, and the screw rod is sleeved on the right end of the outer rod body and is integrated with it forming, the thread of the screw is provided on the outer wall of the screw, the outer wall of the screw is provided with a nut matched with the thread, the right end of the screw is fixed with a first elastic rod in the direction perpendicular to the screw, the shell The body is sleeved on the outside of the screw rod and slidably matched with it, the nut is located at the left end of the housing and prevents the housing from sliding to the left, the fixing shaft is set at the left end of the inner rod body, and the right end of the inner rod body is fixed through the screw rod. The right end of the casing and the left end of the casing are fixedly provided with a second elastic rod corresponding to the first elastic rod, and a spring group is arranged between the first elastic rod and the second elastic rod.

The fixed shaft is set at the left end of the inner rod body, the other end of the first support rod is hinged with the second support rod through the fixed shaft, and the outer rod body is sleeved on the outside of the inner rod body and slides with it. When there is an angle between the two long pull tabs, slide the outer rod body to the left relative to the inner rod body, the other end of the first support rod and the second support rod tend to overlap each other and gradually enter the inside of the outer rod body, so that the first support rod and the second support rod tend to overlap each other. The angle between the other end of the support rod and the second support rod becomes smaller, thereby driving the first long pull tab and the second long pull tab to rotate, so that the space between the first long pull tab and the second long pull tab is When the angle between the first pull tab and the second pull tab needs to be increased, slide the outer rod body relative to the inner rod body to the right, because the first pull tab handle and the second pull tab A spring is arranged between the handle, and the first handle and the second handle are stretched by the elastic force to stretch the first handle and the second handle, so that the first long handle and the second long handle are pulled apart. The angle between the slices increases. The operating device can control the sliding between the inner rod body and the outer rod body. When the nut is turned clockwise, the nut moves to the right on the screw rod. Due to the blocking effect of the casing, the outer rod body gradually moves to the left relative to the inner rod body. When the nut is rotated, the nut moves to the left on the screw rod, and the outer rod body gradually moves to the right relative to the inner rod body due to the elastic force of the spring group between the first elastic rod and the second elastic rod. The size of the included angle between the first elongated pull tab and the second elongated pull tab is adjusted by rotating the nut, and the operation is simple and convenient.

Preferably, the serrated telescopic rod includes a serrated rod and a sleeve rod sleeved on the outside of the serrated rod, the outer wall of the serrated rod is provided with serrations in the longitudinal direction, and the outer side of the sleeve rod is provided with a screw hole that matches the screw hole, The screw passes through the screw hole and is clamped to the serrations on the serrated rod.

When it is necessary to extend the serrated telescopic rod, after loosening the screws on the outside of the sleeve rod, stretch the serrated rod and the sleeve rod to make the serrated telescopic rod extend to a suitable length, and then tighten the screw so that the screw and the serrations on the serrated rod are in contact with each other. It can be clamped to fix the telescopic sawtooth rod. The length of the serrated telescopic rod can be freely adjusted by the mutual cooperation and sliding of the stretched serrated rod and the sleeve rod, the distance between the second retractor and the pressing rod can be increased, and the surgical operation and visual field space can be enlarged.

Preferably, the pressure rod is a telescopic pressure rod, including a first telescopic rod and a second telescopic rod. The right end of the telescopic rod is connected with the lower end of the sawtooth telescopic rod, and the hook is arranged on the left end of the first telescopic rod.

The length of the telescopic pressure rod is freely controlled by the mutual cooperation and sliding of the first telescopic rod and the second telescopic rod, which facilitates the outward stretching of the muscle tissue and increases the surgical operation space and field of view.

Preferably, the inner surface of the hook is provided with point-like protrusions.

The function of the point-like protrusions is to increase the friction between the hook and the muscle tissue, and the hook and the muscle tissue are not easy to slide relative to each other.

Preferably, the included angle α between the first elongated pull-tab and the second elongated pull-tab is 0° to 120°.

When the angle α between the first elongated pull-tab and the second elongated pull-tab is 0-120°, the area of the upper epidermis tissue supported by the pull-tab head is reasonably controlled to construct a more favorable operating space for surgery.

Preferably, a smoking pipe parallel to the second draw hook is provided between the second draw hook and the pressing rod.

The smoking pipe is used to suck out the surgical smoke and make the surgical field clear.

Therefore, the present invention has the following beneficial effects: (1) Enlarging the operation space and field of view; (2) The shape and size of the operation space can be changed according to the needs of the operation space; (3) The operation retractor is easy to adjust and easy to operate.

Description of drawings

FIG. 1 is a schematic structural diagram of the present invention.

Figure 2 is a schematic diagram of the structure of the hook.

Figure 3 is a schematic diagram of the structure of the sawtooth telescopic rod.

Figure 4 is a schematic diagram of the structure of the hook.

reference number

Pull rod 1, first pull hook 2, second pull hook 3, sawtooth telescopic rod 4, pressure rod 5, smoking pipe 6, hook 51, rod body 31, pull tab head 32, operating device 33, first long pull tab 321, No. Two long pull tabs 322, first support rod 323, second support rod 324, first pull tab handle 325, second pull tab handle 326, spring 327, fixed shaft 313, inner rod body 311, outer rod body 312, screw 331 , shell 332, elastic rod 333, nut 334, spring group 337, serrated rod 41, sleeve rod 42, serration 43, screw hole 44, screw 45, first telescopic rod 52, second telescopic rod 53, point-shaped protrusions 54.

Detailed ways

The technical solutions of the present invention will be further described below through specific embodiments.

Example 1

Figure 1 is a schematic diagram of the structure of the present invention, a new type of retractor for endoscopic thyroid surgery through axillary approach, comprising a drawbar 1 and a first drawbar 2 and a second drawbar 3 arranged on both sides of the drawbar in parallel to each other, the drawbar, the first drawbar The pull hook and the second pull hook form a U shape. The second pull hook includes a rod body 31, a pull tab head 32 located at the left end of the rod body, and a manipulation device 33 located at the right end of the rod body. Two long pull tabs 322, a first support rod 323 and a second support rod 324, one end of the first long pull tab is longitudinally extended with a first pull tab handle 325, and one end of the second long pull tab extends longitudinally A second pull-tab handle 326 is provided, and the connection point between the first elongated pull-tab and the first pull-tab handle is hinged to the connection point between the second elongated pull-tab and the second pull-tab handle, and the first pull-tab A spring 327 is arranged between the handle and the second handle, the other end of the first handle is hinged with one end of the first support rod, the other end of the second handle is hinged with one end of the second support rod, The angle α between the first elongated pull-tab and the second elongated pull-tab is 0°, and the rod body includes an inner rod body 311 and an outer rod body 312 sleeved on the outside of the inner rod body and slidably matched with it. The operating device includes a screw 331, a casing 332 and an elastic rod 333. The screw is sleeved on the right end of the outer rod body and is integrally formed with it. The screw thread is arranged on the outer wall of the screw. The matching nut 334 is fixed with a first elastic rod 335 on the right end of the screw rod perpendicular to the direction of the screw rod. The left end of the inner rod body is provided with a fixed shaft that is perpendicular to the plane where the pull-tab head is located, and the other end of the first support rod and the other end of the second support rod are hinged through the fixed shaft, and the pull-tab head is located. The plane is perpendicular to the pull rod, the right end of the inner rod body is fixed on the right end of the casing through the screw rod, and the left end of the casing is fixed with a second elastic rod 336 corresponding to the first elastic rod. The first elastic rod A spring group 337 is arranged between the second elastic rod; the thyroid surgery retractor also includes a serrated telescopic rod 4 and a pressure rod 5 arranged under the second retractor, and the serrated telescopic rod includes a serrated rod 41 and is sleeved on the sawtooth. A sleeve rod 42 on the outside of the rod, the outer wall of the serrated rod is provided with serrations 43 in the longitudinal direction, the outer side of the sleeve rod is provided with a screw hole 44 and a screw 45 matching the screw hole, the screw is clamped to the serrated rod through the screw hole The connecting point of the pull rod and the second pull hook is fixedly connected to the upper end of the sleeve rod, the lower end of the sawtooth rod is rotatably connected to one end of the pressure rod, and the pressure rod is a telescopic pressure rod, including the first telescopic rod 52 and The second telescopic rod 53, the second telescopic rod is sleeved on the outside of the first telescopic rod and slidably matched with it, the right end of the second telescopic rod is connected with the lower end of the sawtooth telescopic rod, the left end of the first telescopic rod There is a downwardly curved hook 51, and the inner surface of the hook is provided with a point-shaped protrusion 54. The pressure rod, the first pull hook and the second pull hook are all located on the left side of the sawtooth telescopic rod. There is a suction parallel to the second hook between the rods Smoke pipe 6.

Before using the retractor of the invention for surgery, first shorten the length of the serrated telescopic rod to the shortest and turn the nut clockwise to facilitate the shortening of the serrated telescopic rod and the second retractor into the surgical opening, and turn the nut clockwise to move the nut to the right on the screw. The blocking effect of the outer rod body gradually moves the outer rod body to the left relative to the inner rod body, the other end of the first support rod and the second support rod tend to overlap each other and gradually enter the interior of the outer rod body, so that the other end of the first support rod and The included angle between the second support rods becomes smaller, thereby driving the first elongated pull tab and the second elongated pull tab to rotate, making the included angle between the first elongated pull tab and the second elongated pull tab smaller , the first long pull tab and the second long pull tab overlap each other, in addition, shorten the length of the sawtooth telescopic rod to the shortest, so as to minimize the distance between the second pull hook and the pressure rod that are parallel to each other, so that the second pull hook and the pressure rod are minimized. The rod can be extended from the small surgical opening of the patient. After the second retractor and the pressure rod enter the surgical opening to an appropriate depth, the serrated telescopic rod can be used to adjust the distance between the epidermal tissue and the muscle below the epidermal tissue, increasing the operation of the operation. Space; Use the second hook to adjust the area of the first and second long pull-tabs to pull up the epidermal tissue, turn the nut counterclockwise, the nut moves left on the screw, because the first elastic rod and the second elastic rod The elastic force of the spring group in between makes the outer rod body gradually move to the right relative to the inner rod body, and the outer rod body slides to the right relative to the inner rod body. The pull-tab handle and the second pull-tab handle are under the action of the elastic force to stretch the first pull-tab handle and the second pull-tab, so that the angle between the first long pull-tab and the second long pull-tab increases, so that the The area of the first long pull tab and the second long pull tab to pull up the epidermal tissue increases, increasing the operating space for the operation; the pressure bar can pull the muscle tissue outward through the retractor, so that the field of view behind the muscle tissue is expanded, which is convenient for doctors to implement Operation;

The angle between the serrated telescopic rod and the pressure rod can be adjusted, which is very suitable for surgical operations. The angle of the pressure rod to press the muscle and pull the muscle can be adjusted, so that the area that is difficult to observe during the operation is exposed, which is convenient for the doctor to perform the operation.

Example 2

The difference between Example 2 and Example 1 is that the included angle α between the first elongated pull-tab and the second elongated pull-tab is 60°.

Example 3

The difference between Embodiment 3 and Embodiments 1 and 2 is that the included angle α between the first elongated pull-tab and the second elongated pull-tab is 120°.

The above are only preferred embodiments of the present invention, and do not limit the present invention in any form. Although the present invention has been disclosed above with preferred embodiments, it is not intended to limit the present invention. The technical personnel, within the scope of the technical solution of the present invention, can make some changes or modifications by using the technical content disclosed above to be equivalent embodiments of equivalent changes, provided that they do not depart from the technical solution content of the present invention, according to the technical solution of the present invention. Any simple modifications, equivalent changes and modifications made to the above embodiments still fall within the scope of the technical solutions of the present invention.

Claims (6)

1. A novel axillary cavity endoscope thyroid surgery retractor comprises a pull rod (1), and a first retractor (2) and a second retractor (3) which are arranged on two sides of the pull rod and are parallel to each other, and is characterized in that the first retractor is used for lifting the whole surgery retractor; the surgical retractor further comprises a sawtooth telescopic rod (4) and a pressing rod (5) which are arranged below the second retractor, the connecting point of the pulling rod and the second retractor is fixedly connected with the upper end of the sawtooth telescopic rod, the lower end of the sawtooth telescopic rod is rotatably connected with one end of the pressing rod, the other end of the pressing rod is provided with a hook (51) which bends downwards, the pressing rod, the first retractor and the second retractor are all positioned on the left side of the sawtooth telescopic rod, and the second retractor comprises a rod body (31), a pull piece head (32) arranged at the left end of the rod body and an operating device (33) arranged at the right end of the rod body;

the pull piece head comprises a first strip pull piece (321), a second strip pull piece (322), a first supporting rod (323) and a second supporting rod (324), wherein one end of the first strip pull piece longitudinally extends to form a first pull piece handle (325), one end of the second strip pull piece longitudinally extends to form a second pull piece handle (326), a connecting point of the first strip pull piece and the first pull piece handle is hinged to a connecting point of the second strip pull piece and the second pull piece handle, a spring (327) is arranged between the first pull piece handle and the second pull piece handle, the other end of the first pull piece handle is hinged to one end of the first supporting rod, the other end of the second pull piece handle is hinged to one end of the second supporting rod, a fixed shaft (313) is arranged in the plane direction where the left end of the rod body is perpendicular to the pull piece head, the other end of the first supporting rod is hinged to the other end of the second supporting rod through the fixed, the plane where the pulling sheet head is located is perpendicular to the pulling rod;

the rod body comprises an inner rod body (311) and an outer rod body (312) which is sleeved outside the inner rod body and is in sliding fit with the inner rod body, the operating device comprises a screw rod (331), a shell (332) and an elastic rod (333), the screw rod is sleeved at the right end of the outer rod body and is integrally formed with the outer rod body, the screw thread of the screw rod is arranged on the outer wall of the screw rod, a nut (334) matched with the thread is arranged on the outer wall of the screw rod, a first elastic rod (335) is fixedly arranged at the right end of the screw rod in the direction vertical to the screw rod, the shell is sleeved outside the screw rod and is in sliding fit with the screw rod, the nut is positioned at the left end of the shell and blocks the shell from sliding leftwards, the fixed shaft is arranged at the left end of the inner rod body, the right end of the inner rod body passes through the screw rod and is fixed at the right end of the shell, a second elastic rod (336) corresponding to the first elastic rod is fixedly arranged at the left end of the shell, and a spring group (337) is arranged between the first elastic rod and the second elastic rod.

2. The novel endoscopic axillary cavity thyroid surgery retractor according to claim 1, wherein the sawtooth expansion link comprises a sawtooth rod (41) and a sleeve rod (42) sleeved outside the sawtooth rod, the sawtooth (43) is arranged on the outer wall of the sawtooth rod in the longitudinal direction, a screw hole (44) and a screw (45) matched with the screw hole are arranged on the outer side of the sleeve rod, and the screw penetrates through the sawtooth hole and is clamped on the sawtooth rod.

3. The novel axillary cavity endoscope thyroid surgery retractor according to claim 1, wherein the pressure rod is a telescopic pressure rod, and comprises a first telescopic rod (52) and a second telescopic rod (53), the second telescopic rod is sleeved outside the first telescopic rod and is in sliding fit with the first telescopic rod, the right end of the second telescopic rod is connected with the lower end of the sawtooth telescopic rod, and the hook is arranged at the left end of the first telescopic rod.

4. A novel endoscopic axillary access thyroid surgery retractor according to any one of claims 1, wherein the inner surface of said hook is provided with punctiform protrusions (54).

5. The novel endoscopic axillary cavity surgery thyroid surgery retractor according to claim 1, wherein the included angle α between the first and second elongated pull tabs is 0-120 °.

6. A novel axillary endoscopic thyroid surgery retractor according to any one of claims 1, wherein a smoking pipe (6) parallel to the second retractor is arranged between the second retractor and the pressure bar.

Images