CN109199524B

CN109199524B - Rib cutter under thoracoscope

Info

Publication number: CN109199524B
Application number: CN201811205913.1A
Authority: CN
Inventors: 张春敭; 赵松; 齐宇; 吴恺; 朱登彦; 刘东雷; 盛银良
Original assignee: First Affiliated Hospital of Zhengzhou University
Current assignee: First Affiliated Hospital of Zhengzhou University
Priority date: 2018-10-17
Filing date: 2018-10-17
Publication date: 2020-04-24
Anticipated expiration: 2038-10-17
Also published as: CN109199524A

Abstract

The rib cutter under the thoracoscope includes an outer sheath tube and an operating handle. The operating handle has an L-shaped structure as a whole. The operating handle is composed of a mounting sleeve and a handle. The rear end is extended downward, and the handle is provided with an installation cavity with an open bottom; in summary, the present invention can only rotate toward the side with the color-coded coating when cutting ribs, so as to avoid damage to other parts of the operation part. When the direction of the drill bit needs to be changed, the direction can be changed by drawing and other components, and the shape of the rib is irregular, so the drill bit of the present invention can be adjusted in direction, so it is suitable for ribs of various shapes; the overall structure design of the present invention is reasonable , reduce the injury of the patient, complete functions, shorten the operation time and reduce the operation risk.

Description

Rib cutter under thoracoscope

Technical Field

The invention belongs to the technical field of medical treatment, and particularly relates to a rib cutter under a thoracoscope.

Background

When rib diseases such as rib tumor and the like occur, the diseased rib needs to be cut off, the existing cutting-off mode is to cut off all tissues of skin muscles between two broken ends of the rib to be cut off, then the two ends of the rib are cut off from the gap, and the broken end rib is pulled out from the cut; the existing operation mode has the defects that the injury is large, two holes need to be drilled on the chest wall, the chest wall between the two holes needs to be cut, the number of human tissues cut in the whole operation process is large, the bleeding is more, the operation time is long, the injury to the human body is large, and the operation risk is high.

Disclosure of Invention

The invention aims to overcome the defects in the prior art and provides a thoracoscopic rib cutter which can reduce the damage caused by rib cutting, shorten the operation time and reduce bleeding.

In order to solve the technical problems, the invention adopts the following technical scheme: the thoracoscopic rib cutter comprises an outer sheath tube and an operating handle, wherein the operating handle is integrally of an L-shaped structure and consists of an installation sleeve and a handle, the central line of the installation sleeve is arranged along the front-back horizontal direction, the handle is fixedly connected to the rear end part of the installation sleeve and extends downwards, an installation cavity with an opening at the bottom is formed in the handle, a power supply is arranged in the installation cavity, and a bottom cover for plugging the installation cavity is arranged on the bottom surface of the handle; the central line of the outer sheath pipe is superposed with the central line of the mounting sleeve, the rear end part of the outer sheath pipe is assembled in the mounting sleeve, the outer sheath pipe is in running fit with the mounting sleeve, the outer diameter of the outer sheath pipe is equal to the inner diameter of the mounting sleeve, and the mounting sleeve is provided with a positioning mechanism for limiting the outer sheath pipe to rotate in the mounting sleeve;

the front end of the outer sheath tube is connected with a connecting sleeve, the connecting sleeve is made of elastic materials, a motor base is fixed at the front end of the connecting sleeve, a motor is installed in the motor base, a main shaft of the motor is horizontally arranged forwards, a drill bit is installed on the main shaft of the motor, and a direction adjusting mechanism for adjusting the bending degree of the connecting sleeve is further arranged on the outer sheath tube;

fixed cover is fixed with along length direction on the sheath pipe, fixed cover is equipped with the high frequency electrotome in the assembly, installation cover bottom still be connected with the control handle, be equipped with motor control button, high frequency electrotome control button and rheostat on the control handle, motor control button is used for controlling motor work, high frequency electrotome control button is used for controlling the high frequency electrotome, motor, rheostat, motor control button and power pass through the connection of electric lines, and all electric lines are accomodate in the sheath intraductal.

The handle is provided with anti-skid lines.

A positioning mechanism for restricting outer sheath pipe at installation cover internal rotation include the stopper, the perforation has been seted up at the top of installation cover, the top of installation cover is equipped with the mounting bracket, the stopper comprises braking portion and operating portion, the stopper articulates on the mounting bracket through the round pin axle, the braking portion extends the slope setting to the front lower place, the lower extreme of braking portion is equipped with rubber compact heap, rubber compact heap passes to hug closely after the perforation on the roof of tip behind outer sheath pipe, the operating portion extends the setting to the rear, be equipped with compression spring between the bottom surface of operating portion and the top of installation cover, under compression spring's effect, rubber compact heap roof pressure is on the roof of tip behind outer sheath pipe.

A transfer to mechanism for adjusting adapter sleeve crookedness include wire drawing and tractive piece, the wire drawing chamber has been seted up on the pipe wall of sheath pipe, the spout has been seted up along fore-and-aft horizontal direction on the rear end left side wall of sheath pipe, a plurality of spacing holes have been seted up to the spout downside of sheath pipe, set up side by side around a plurality of spacing holes, and every spacing hole all extends the slope setting to the below before, spacing hole link up with the spout, tractive piece sliding connection is in the spout, be connected with the driving lever on the tractive piece, the driving lever is located one of them spacing downthehole and the driving lever extends the setting left, the wire drawing is worn to establish in the wire drawing intracavity, the front end of wire drawing is connected at the anterior inner wall of adapter sleeve, the.

The left side of the front end part of the outer sheath tube is provided with a color marking coating, the color marking coating and the drawn wires are located on the same horizontal plane, and the color marking coating is used for marking the bending direction of the connecting sleeve.

By adopting the technical scheme, the invention has the following beneficial effects: when rib cutting is carried out under a thoracoscope, the connecting sleeve can only bend towards one side under the drawing action of the drawn wire, the side towards the one side is the side of the color marking coating, and the single bending direction can prevent the device from damaging lung tissues in the chest wall during rotation, and avoid lung injury and the like; when the color marking device is used, the entering direction of the outer sheath tube is firstly adjusted to ensure that the color marking coating is consistent with the intended operation direction, and the specific method for adjusting the entering direction of the outer sheath tube comprises the following steps: the operating part of the braking part is pressed, the braking part tilts upwards due to a lever principle, so that the rubber pressing block is driven to move upwards and is separated from the outer wall of the outer sheath tube, then the handle is held by hands and the outer sheath tube is rotated until the color marking coating is consistent with the direction to be operated, then the operating part is loosened, the rubber pressing block is pressed on the outer wall of the outer sheath tube again through the through hole under the action of the compression spring, and the outer sheath tube cannot rotate in the mounting sleeve due to the action of the rubber pressing block;

after the direction of the outer sheath tube is adjusted, according to preoperative examination and observation under a thoracoscope, a drill is adjusted by drawing to be placed at a position to be drilled, and the specific adjusting method comprises the following steps: pulling the deflector rod out of the limiting hole into the sliding chute, pulling the deflector rod backwards, and driving the pulling block to move backwards in the sliding chute by the deflector rod, so that the connecting sleeve is pulled by the pulling block through wire drawing, and the connecting sleeve is bent until a drill bit at the front end of the connecting sleeve is arranged at a position to be drilled; then, a motor control button is pressed, a power supply provides electric energy for the motor, the motor is started, the drill bit starts to work, and the rotating speed of the motor is changed through the rheostat, so that the rotating speed of the drill bit is changed;

when bleeding is more, press motor control button, the motor stop work, then promote high frequency electrotome forward for fixed cover front end is worn out forward to the work tip of high frequency electrotome, presses high frequency electrotome control button, can use high frequency electrotome to stanch to the position of bleeding.

In conclusion, the drill bit can only rotate towards one side with the color marking coating when the rib is cut, so that other tissues of an operation part are prevented from being damaged, when the direction of the drill bit needs to be changed, the direction can be changed through parts such as wire drawing and the like, and the shape of the rib is irregular, so that the drill bit can be adjusted in direction, and is suitable for ribs with various shapes; the invention has reasonable integral structure design, reduces the injury of patients, has complete functions, shortens the operation time and reduces the operation risk.

Drawings

FIG. 1 is a schematic structural view of the present invention;

fig. 2 is an enlarged view at H in fig. 1.

Detailed Description

As shown in fig. 1 and 2, the rib cutter under thoracoscope of the invention comprises an outer sheath tube 1 and an operating handle, the operating handle is integrally in an L-shaped structure, the operating handle is composed of an installation sleeve 2 and a handle 3, the central line of the installation sleeve 2 is arranged along the front-back horizontal direction, the handle 3 is fixedly connected with the rear end part of the installation sleeve 2 and extends downwards, an installation cavity with an opening at the bottom is arranged in the handle 3, a power supply is arranged in the installation cavity, and a bottom cover 4 for plugging the installation cavity is arranged on the bottom surface of the handle 3; the central line of the outer sheath tube 1 is coincident with the central line of the mounting sleeve 2, the rear end part of the outer sheath tube 1 is assembled in the mounting sleeve 2, the outer sheath tube 1 is in rotating fit with the mounting sleeve 2, the outer diameter of the outer sheath tube 1 is equal to the inner diameter of the mounting sleeve 2, and the mounting sleeve 2 is provided with a positioning mechanism for limiting the outer sheath tube 1 to rotate in the mounting sleeve 2;

the front end of the outer sheath tube 1 is connected with a connecting sleeve 5, the connecting sleeve 5 is made of elastic materials, a motor base 6 is fixed at the front end of the connecting sleeve 5, a motor is installed in the motor base 6, a main shaft of the motor is horizontally arranged forwards, a drill bit 7 is installed on the main shaft of the motor, and a direction adjusting mechanism for adjusting the bending degree of the connecting sleeve 5 is further arranged on the outer sheath tube 1;

outer sheath pipe 1 is gone up and is fixed with fixed cover 8 along length direction, is equipped with high frequency electrotome 9 in the fixed cover 8, 2 bottoms of installation cover still be connected with the control handle 10, be equipped with motor control button 11, high frequency electrotome control button 12 and rheostat 13 on the control handle 10, motor control button 11 is used for the work of control motor, high frequency electrotome control button 12 is used for controlling high frequency electrotome 9, motor, rheostat 13, motor control button 11 and power pass through the connection of electric lines, and all electric wires are accomodate in outer sheath pipe 1.

The handle 3 is provided with anti-skid threads 14.

A positioning mechanism for restricting outer sheath pipe 1 at the installation cover 2 internal rotation include the braking piece, the perforation has been seted up at the top of installation cover 2, the top of installation cover 2 is equipped with mounting bracket 14, the braking piece comprises braking portion 15 and operating portion 16, the braking piece articulates on mounting bracket 14 through round pin axle 17, braking portion 15 extends the slope setting to the front below, the lower extreme of braking portion 15 is equipped with rubber compact heap 18, rubber compact heap 18 passes to hug closely after the perforation on the roof of outer sheath pipe 1 rear end portion, operating portion 16 extends the setting to the rear, be equipped with compression spring 19 between the bottom surface of operating portion 16 and the top of installation cover 2, under compression spring 19's effect, 18 roof pressures of rubber compact heap are on the roof of outer sheath pipe 1 rear end portion.

The direction adjusting mechanism for adjusting the curvature of the connecting sleeve 5 comprises a wire drawing 20 and a pulling block 21, a wire drawing cavity is formed in the wall of the outer sheath tube 1, a sliding groove 22 is formed in the left side wall of the rear end portion of the outer sheath tube 1 along the front-back horizontal direction, a plurality of limiting holes 23 are formed in the lower side of the sliding groove 22 of the outer sheath tube 1, the limiting holes 23 are arranged side by side front and back, each limiting hole 23 is obliquely arranged towards the front lower side in an extending mode, the limiting holes 23 are communicated with the sliding groove 22, the pulling block 21 is slidably connected in the sliding groove 22, a pulling rod 24 is connected to the pulling block 21, the pulling rod 24 is located in one of the limiting holes 23 and extends leftwards, the wire drawing 20 penetrates through the wire drawing cavity, the front end of the wire drawing 20 is connected to the front inner wall of the connecting.

The left side of the front end part of the outer sheath tube 1 is provided with a color marking coating 25, the color marking coating 25 and the drawing wire 20 are positioned on the same horizontal plane, and the color marking coating 25 is used for marking the bending direction of the connecting sleeve 5.

When rib cutting is carried out under a thoracoscope, the connecting sleeve 5 can only bend towards one side under the drawing action of the wire drawing 20, the side towards the one side is the side of the color marking coating 25, and the single bending direction can avoid the device from damaging lung tissues in the chest wall during rotation, avoiding lung injury and the like; when in use, the entering direction of the sheath tube 1 is firstly adjusted, so that the color marking coating 25 is consistent with the intended operation direction, and the method for specifically adjusting the entering direction of the sheath tube 1 comprises the following steps: the operating part 16 of the brake is pressed, the brake part 15 tilts upwards due to the lever principle, so that the rubber pressing block 18 is driven to move upwards and is separated from the outer wall of the outer sheath tube 1, then the handle 3 is held by hand and the outer sheath tube 1 is rotated until the color marking coating 25 is consistent with the direction to be operated, then the operating part 16 is loosened, the rubber pressing block 18 is pressed on the outer wall of the outer sheath tube 1 again through the perforation under the action of the compression spring 19, and the outer sheath tube 1 cannot rotate in the mounting sleeve 2 due to the action of the rubber pressing block 18;

after the sheath tube 1 enters the direction adjustment, the drill bit 7 is adjusted by the wire drawing 20 to be placed at the position to be drilled according to the preoperative examination and the observation under the thoracoscope, and the specific adjusting method comprises the following steps: the shifting rod 24 is shifted out of the limiting hole 23 into the sliding groove 22, then the shifting rod 24 is pulled backwards, the shifting rod 24 drives the pulling block 21 to move backwards in the sliding groove 22, so that the connecting sleeve 5 is pulled by the pulling block 21 through the wire drawing 20, and the connecting sleeve 5 is bent until the drill bit 7 at the front end of the connecting sleeve 5 is placed at a position to be drilled; then, a motor control button 11 is pressed, a power supply provides electric energy for the motor, the motor is started, the drill bit 7 starts to work, and the rotating speed of the motor is changed through a rheostat 13, so that the rotating speed of the drill bit 7 is changed;

when bleeding is more, the motor control button 11 is pressed, the motor stops working, then the high-frequency electrotome 9 is pushed forwards, the working end part of the high-frequency electrotome 9 penetrates out of the front end of the fixed sleeve 8 forwards, and the high-frequency electrotome control button 12 is pressed, so that the bleeding position can be stopped by using the high-frequency electrotome 9.

The present embodiment is not intended to limit the shape, material, structure, etc. of the present invention in any way, and any simple modification, equivalent change and modification made to the above embodiments according to the technical spirit of the present invention are within the scope of the technical solution of the present invention.

Claims

1. rib cutter under thoracoscopic, it is characterized in that: comprise outer sheath tube and operating handle, operating handle is L-shaped structure as a whole, operating handle is made up of installation sleeve and handle, the center line of installation sleeve is arranged along the front and rear horizontal direction, handle The handle is fixedly connected to the rear end of the installation sleeve and extends downward. The handle is provided with an installation cavity with an open bottom, the installation cavity is provided with a power supply, and the bottom surface of the handle is provided with a bottom cover for sealing the installation cavity; the outer sheath The center line of the tube coincides with the center line of the installation sleeve, the rear end of the outer sheath is assembled in the installation sleeve, and the outer sheath and the installation sleeve are rotated together, the outer diameter of the outer sheath is equal to the inner diameter of the installation sleeve, and the installation sleeve There is a positioning mechanism for restricting the rotation of the outer sheath in the installation sleeve;

The front end of the outer sheath is connected with a connecting sleeve, the connecting sleeve is made of elastic material, the front end of the connecting sleeve is fixed with a motor seat, a motor is installed in the motor seat, the main shaft of the motor is set horizontally forward, and a drill bit is installed on the main shaft of the motor, The outer sheath is also provided with a direction adjusting mechanism for adjusting the curvature of the connecting sleeve;

A fixing sleeve is fixed on the outer sheath along the length direction, the fixing sleeve is equipped with a high-frequency electric knife, the bottom of the installation sleeve is also connected with a control handle, and the control handle is provided with a motor control button, a high-frequency electric knife control button and a high-frequency electric knife. The rheostat, the motor control button is used to control the motor work, the high frequency electric knife control button is used to control the high frequency electric knife, the motor, the varistor, the motor control button and the power supply are connected by wires, and all the wires are stored in the outer sheath.

2 . The rib cutter under thoracoscope according to claim 1 , wherein the handle is provided with anti-skid patterns. 3 .

3. The rib cutter under thoracoscope according to claim 1, wherein the positioning mechanism for restricting the rotation of the outer sheath tube in the installation sleeve comprises a stopper, and the top of the installation sleeve is provided with a perforation, The top of the mounting sleeve is provided with a mounting frame, the braking part is composed of a braking part and an operating part, the braking part is hinged on the mounting frame through a pin shaft, the braking part extends forward and downward and is inclined and arranged, and the lower end of the braking part is provided with The rubber pressing block, after passing through the perforation, is closely attached to the top wall of the rear end of the outer sheath tube, the operating part is extended to the rear, and a compression spring is arranged between the bottom surface of the operating part and the top of the mounting sleeve. Under the action of the compression spring, the rubber pressing block is pressed against the top wall of the rear end of the outer sheath tube.

4. The rib cutter under thoracoscope according to claim 1, characterized in that: the direction adjusting mechanism for adjusting the curvature of the connecting sleeve comprises a wire drawing and a pulling block, and the tube wall of the outer sheath is provided with The wire drawing cavity, the left side wall of the rear end of the outer sheath tube is provided with a chute along the front and rear horizontal directions, the lower side of the chute of the outer sheath tube is provided with a number of limit holes, the limit holes are arranged side by side in front and back, and each limit The position holes are all extended and inclined forward and downward, the limit holes are connected with the chute, the pulling block is slidably connected in the chute, the pulling block is connected with a lever, the lever is located in one of the limit holes and the lever is in the direction of the slider. The left extension is arranged, the drawing wire is passed through the drawing cavity, the front end of the drawing wire is connected to the inner wall of the front part of the connecting sleeve, and the rear end of the drawing wire is connected to the pulling block.

5. rib cutter under thoracoscope according to claim 4, is characterized in that: the left side of the front end of the outer sheath is provided with a color-marked coating, and the color-marked coating is located on the same horizontal plane as the wire drawing, and the color-marked coating Used to mark the bending direction of the connecting sleeve.