JPH09253086A - Abdominal wall traction device for operation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To smoothly progress an operation and to make constitution simpler and extremely inexpensive by extremely facilitating the traction operation of the abdominal wall of the patient's incised port at the time of operating the stomach, liver, intestines, spleen, kidney, pancreas, etc., in the abdominal cavity. SOLUTION: A traction device body 7 in which a freely rotatable winding wheel, a gear freely rotatably fixed simultaneously to one flank of this winding wheel, a spiral spring detained at one end to one side part of this case body 1 and detained at the other end to the winding wheel and a locking mechanism for locking the elastic repulsive force of this spiral spring are formed in a case body 1 and a case cover 2. A suitable pulling means 9 mounted with a traction hook 8 for pulling the abdominal wall of the patient's incised port at the front end is freely windably and withdrawably connected to the winding wheel in the traction device body 7 and the base end of a suitable supporting means 11 mounted with a holder 10 for supporting the side frames on the right and left sides of an operation table at the front end is connected to the suitable position of the case body 1 of the traction device body 7.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention mainly draws the abdominal wall of an incision of a patient during an operation on the stomach, liver, intestine, spleen, kidney, pancreas, etc. in the abdominal cavity in order to facilitate the operation easily and smoothly. The present invention relates to a surgical abdominal wall tractor suitable for placement.

[0002]

2. Description of the Related Art A conventional surgical abdominal wall retractor 60 is shown in FIG.
Two relatively large tractor bodies 61, as shown
A wire 64 having a pulling wheel 63 for pulling the abdominal wall C of the incision B of the patient A attached to the tip of the winding wheel 62.
The base end of the tractor is connected so as to be able to be wound up and down, and a handle 65 for winding the wire 64 is provided on one side surface of the tractor body 61, and the wire 64 wound by the handle 65 is appropriately positioned in the tractor body 61. It was formed in a roll-up type by the handle 65 so as to provide a lock mechanism (not shown) for locking.

[0003]

However, at the time of surgery on the stomach, liver, intestine, spleen, kidney, pancreas, etc. in the abdominal cavity, each strut is attached to the head side left and right sides of the operating table via clamps and the like. Install an arched bar E between the upper ends of D,
Fix the tractor body 61 of the two hoisting type tractors 60 with the handle 65 to the arch-shaped bar E or the like at appropriate intervals,
After pulling the pulling hooks 63 from the respective puller main bodies 61 and hooking the pulling hooks 63 on the head side abdominal wall C of the incision B of the patient A, respectively, the handle 65 is wound up to an appropriate tensioned position and pulled to the head side respectively. Then, it is locked by the lock mechanism, and one pull-up retractor 60 is pulled by a similar handle 65 to the side frame F attached to one of the left and right side portions of the operating table via a clamp or the like. The device main body 61 is fixed, and the tow hook 63 is unwound from each of the traction device main bodies 61 and hooked on the abdominal wall C on the foot side of the incision B of the patient A, and then wound up by the handle 65 to an appropriate tensioned position. I pulled it to the foot side and locked it with the lock mechanism.

That is, the abdominal wall C on one side of the incision B of the patient A
The two abdominal walls C on the other side of the incision B of the patient A are also pulled to the other side by one hoist type retractor 60. Therefore, the operation of pulling the abdominal wall C of the incision B of the patient A is troublesome, and not only the operation cannot be smoothly proceeded, but also the retractor 60 is a winding type by the handle 65, so that the configuration is complicated and expensive. There was a problem.

Therefore, the present invention was created in view of the above-mentioned viewpoints, and the stomach, the liver, the intestines, the spleen in the abdominal cavity,
During surgery on the kidney, pancreas, etc., the abdominal wall of the patient's incision can be remarkably easily pulled so that the surgery can proceed smoothly, and the configuration can be simplified to be very inexpensive. A surgical abdominal wall retractor is provided.

[0006]

In order to achieve the above-mentioned object, the present invention provides a rotatable winding wheel inside a case body and a case cover, and a side surface of the winding wheel. A gear that is fixed and rotates simultaneously with this winding wheel, a spiral spring that has one end locked to one side of the case body and the other end locked to the winding wheel, and the repulsive force of this spiral spring A locking mechanism for locking is formed to form a tractor main body, and a retracting wheel in the tractor main body is provided with a traction hook for traction of the abdominal wall of the patient's incision at the distal end thereof. And a base end of an appropriate supporting means having holders for supporting side frames on the left and right sides of the operating table attached to the distal end at an appropriate position of the case body of the tractor body. It is a thing.

[0007]

BEST MODE FOR CARRYING OUT THE INVENTION In the following, as an embodiment of the present invention, during an operation on a stomach, a liver, an intestine, a spleen, a kidney, a pancreas, etc. in an abdominal cavity, an incision of a patient is made to facilitate the operation smoothly. The state of pulling the abdominal wall will be described with reference to the drawings.

As shown in FIGS. 1 to 4, the surgical abdominal wall tractor of the present invention has a rotatable winding wheel 3 inside a case body 1 and a case cover 2, and a winding wheel 3 of the winding wheel 3. A gear 4 fixed to one side surface and rotating simultaneously with the winding wheel 3, and a spiral spring 5 having one end locked to one side of the case body 1 and the other end locked to the winding wheel 3.
And a lock mechanism 6 that locks the elastic force of the spiral spring 5 are built in, and a retractor body 7 is formed. Of the abdominal wall C, a pulling hook 8 for pulling the pulling hook 9 is attached to a base end of the pulling means 9 so that the pulling means 9 can be freely pulled out, and the pulling device main body 7 is appropriately positioned on the case main body 1 and the left and right sides of the operating table are attached to the tip. It is configured such that the base ends of the supporting means 11 to which the holder 10 for supporting the side frame F of the side portion is attached are connected appropriately.

That is, as shown in FIG. 2, in the case body 1, first, a fitting portion 13 for fitting the spiral spring 5 is recessed at the outer side of the inner side surface of one end of the body plate 12 having a substantially elliptical shape. The bearing portion (not shown) of the winding wheel 3 is provided at the center of the inner surface of the fitting portion 13, and one end of the spiral spring 5 is locked at one side of the inner surface of the fitting portion 13. Locking hole 14
And a fitting portion 15 for fitting the winding wheel 3 and the gear 4 on the inner side inner surface of one end of the main body plate 12.
Is provided so as to communicate with the fitting portion 13, and the fitting portion 1
An insertion hole 16 for inserting the pulling means 9 is provided at one end of the inner surface of
And a pair of bearings 16a are provided at appropriate intervals, and a fitting portion 17 for fitting the lock mechanism 6 is formed in the inner surface of the other end of the main body plate 12 so as to communicate with the fitting portion 15. A shaft hole 18, a shaft hole 19, and a spring stop hole 20 of the lock mechanism 6 are provided at appropriate intervals in the vicinity of the fitting portion 15 on the inner surface of the fitting portion 17, and are provided on the outer surface of the other end of the body plate 12. Is provided with a connecting portion (not shown) with a pin hole 21 for connecting the base end of the holder 10, and further, four screw holes 22 for fixing the case cover 2 are provided on the inner peripheral edge of the main body plate 12. It is formed so as to be arranged at appropriate intervals.

The case cover 2 has a substantially elliptical shape which is the same as the case body 1 and has a plate thickness thinner than that of the case body 1. One end of the cover plate 23 has an inner side surface and the bearing portion 24 of the winding wheel 3 and a pair thereof. Bearings 24a are provided at appropriate intervals, the shaft hole 25 and the shaft fitting hole 26 of the lock mechanism 6 are provided at appropriate intervals at the other end of the cover plate 23, and the peripheral edge of the cover plate 23 is provided with the above-mentioned. Four screw insertion holes 27 for fixing the case body 1 are formed at appropriate intervals.

The winding wheel 3 has a long axle 29 protruding from the center of one side surface of a disc-shaped wheel plate 28 and a short axle 30 protruding from the center of the other side surface of the wheel plate 28. A winding groove 31 for winding the pulling means 9 is provided on the outer peripheral surface of the plate 28, and a stopper for connecting the base end of the pulling means 9 to be wound into the winding groove 31 is provided on one side peripheral edge of the wheel plate 28. The screw 32 is screwed in, and further, two screw holes 33 are formed in the peripheral portion of the wheel plate 28 at appropriate intervals.

The gear 4 has a shaft hole 35 formed in the center of a disk-shaped wheel plate 34, and a large number of teeth 3 are formed on the outer peripheral surface of the wheel plate 34.
6 are provided at equal intervals, and further two screw holes 37 are formed at appropriate intervals on the peripheral edge of the vehicle plate 34.

The spiral spring 5 is a spiral spring plate 38.
An outer locking piece 39 projecting from one outer end of the
An inner locking piece 40 is formed so as to project from the other inner end of the.

The locking mechanism 6 is provided with a claw 41 at the tip, a hook-like swinging portion 42 at the substantially central portion in the longitudinal direction, a shaft hole 43 near the tip, and a base end. A lock cam 45 having a spring stop hole 44, and the cam shaft 4
6, a tension coil spring 47, and a collar release shaft 48.

In the tractor main body 7, first, the base end of the traction means 9 such as a wire wound in the winding groove 31 of the winding wheel 3 formed as described above is screwed with the set screw 32. After being inserted and connected, the shaft hole 35 of the gear 4 is fitted into the axle 29 on one side of the winding wheel 3 to form the screw holes 33, 37.
After being fixed to the front end of the axle 29 on one side of the winding wheel 3 with the screw 49, the inner locking piece 40 of the spiral spring 5 is attached.
Lock. Next, the case body 1 is obtained by fixing and locking the gear 4 and the spiral spring 5 to the winding wheel 3, respectively.
The spiral spring 5 is fitted into the fitting portion 13 and the locking hole 1
4, the outer locking piece 39 is locked, and the winding wheel 3 and the gear 4 are fitted in the fitting portion 15 so that the tip end side of the pulling means 9 such as a wire is inserted through the insertion hole 16 to the outside. Set to. In addition, the shaft hole 1 of the fitting portion 17 in the case body 1
8, the shaft hole 43 of the lock cam 45 of the lock mechanism 6, in which one end of the tension coil spring 47 is supported by the screw 50,
1 is swingably supported at one end of the small diameter side of the cam shaft 46 so as to be locked to each tooth 36 on the outer peripheral surface of the gear 4, and then the tension coil spring 47 is inserted in the spring stop hole 20 of the fitting portion 17. The other end is supported by a screw 51, and one end of the collar release shaft 48 on the small diameter side is supported in the shaft hole 19 of the fitting portion 17 from the inside of the swinging portion 42. Finally, the screw insertion holes 27 of the case cover 2 are provided in the screw holes 22 of the inner surface of the case body 1 for bearings between the bearing portions 24 and the tips of the axles 29, 30 of the winding wheel 3. Each screw 53 through the ball 52 respectively
To stop. In this case, the large diameter side end of the cam shaft 46 of the lock mechanism 6 is supported in the shaft hole 25 of the case cover 2, and the lock mechanism 6 is fitted in the shaft fitting hole 26 of the case cover 2.
The other end of the collar release shaft 48 on the large diameter side is locked to the inner peripheral edge of the shaft fitting hole 26 at the flange near the other end on the large diameter side, and the other end on the large diameter side is fitted into the shaft. The shaft is supported so that it can be pushed back so that it slightly protrudes from the hole 26 to the outside of the shaft fitting hole 26, and two bearings 16a of the case body 1 and two bearings 24a of the case cover 2 are provided. The guide wheels 54 are rotatably supported so as to sandwich the pulling means 9 such as a wire inserted through the insertion hole 16 from both sides.

Further, the pulling means 9 such as a wire inserted outward from the insertion hole 16 of the case body 1 of the tractor body 7 has a pulling hook 8 for pulling the abdominal wall C of the incision B of the patient A at the tip. After mounting, the base end of the support means 11 such as a chain is attached to the connecting portion of the outer surface of the other end of the case body 1 of the tractor body 7 by a crimping metal fitting 55, and the base end of the support means 11 is a pin (not shown) in the pin hole 21. ) Is inserted and connected.

Next, the operation of the surgical abdominal wall retractor according to one embodiment of the present invention will be described. As shown in FIGS. 3 and 4, the abdominal cavity of the stomach, liver, intestine, spleen, kidney, pancreas, etc. At the time of surgery, two conventional retractable retractors fixed by attaching arched bars E to the columns D on the left and right sides of one side of the operating table are used to fix the abdominal wall on one side of the incision B of the patient A. C is pulled to one side respectively, and the puller main body 7 of the surgical abdominal wall puller of the present invention is held, and the pulling hook 8 at the tip of the pulling means 9 such as a wire is attached to the other side of the incision B of the patient A. While pulling the pulling means 9 such as a wire to an appropriate position while hooking on the abdominal wall C on the side and moving the pulling body 7 to the other side, the winding wheel 3 and the gear 4 rotate simultaneously with this. The spiral spring 5 is wound up against the repulsive force, and the bullet of the spiral spring 5 is properly positioned. Force, after locking by engaging the claw 41 of the lock cam 45 of the locking mechanism 6 each tooth 36 of the outer peripheral surface of the gear 4, the holder 10 of the support means 11 such as a chain
Is supported on one of the side frames F on the left and right side portions on the other end side of the operating table. On the other hand, after the operation on the stomach, liver, intestine, spleen, kidney, pancreas, etc. in the abdominal cavity, the other end on the large diameter side of the collar release shaft 48 of the lock mechanism 6 is pulled from the outer surface of the case cover 2 of the tractor body 7. When pressed, the large diameter portion of the collar release shaft 48 comes into contact with the inside of the hook-shaped swinging portion 42 of the lock cam 45, and the proximal end side of the lock cam 45 uses the cam shaft 46 as an axis to pull the tension coil spring 47. When the claw 41 at the tip of the lock cam 45 is disengaged from each tooth 36 on the outer peripheral surface of the gear 4 at the same time, the winding wheel 3 is rotated by the elastic force of the spiral spring 5. The pulling means 9 such as a wire is wound in the winding groove 31 of the winding wheel 3.

[0018]

As described above, the surgical abdominal wall tractor of the present invention has the rotatable winding wheel 3 inside the case body 1 and the case cover 2 and one side surface of the winding wheel 3. Gear 4 that is fixed and rotates at the same time as this winding wheel 3
And a spiral spring 5 having one end locked to one side of the case body 1 and the other end locked to the winding wheel 3, and a lock mechanism 6 for locking the elastic force of the spiral spring 5. The retractor main body 7 is formed, and a retracting hook 9 for retracting the abdominal wall C of the incision B of the patient A is attached to the winding wheel 3 in the retractor main body 7. The ends are connected so that they can be rolled in and pulled out, and the side frames F on the left and right side portions of the operating table are attached to the tip at appropriate positions of the case body 1 of the retractor body 7.
Appropriate support means 11 to which a holder 10 for support is attached
By connecting the proximal ends of the, the arched bar E, etc. to each strut D on one side of the operating table at the time of surgery on the stomach, liver, intestine, spleen, kidney, pancreas, etc. in the abdominal cavity. With the conventional two hoisting type retractors 60 which are erected and fixed, the abdominal wall C on one side of the incision B of the patient A is towed to one side respectively, and the abdominal wall retractor for surgery of the present invention is drawn. Holding the tractor body 7 and hooking the traction hook 8 on the abdominal wall C on the other side of the incision B of the patient A, and pulling out the traction means 9 to an appropriate position while moving the tractor body 7 to the other side. Accordingly, while the winding wheel 3 and the gear 4 are simultaneously rotated, the spiral spring 5 is wound against the elastic force, and the elastic force of the spiral spring 5 is locked by the lock mechanism 6 at an appropriate position. Lock it
Since it suffices to support the holder 10 of the supporting means 11 on any one of the side frames F on the other side of the operating table, the pulling operation of the abdominal wall C of the incision B of the patient A can be performed very easily.
The surgery can proceed smoothly.

In addition, in the surgical abdominal wall tractor of the present invention, the retracting wheel 3 in the tractor main body 7 is connected with the appropriate traction means 9 with the traction hook 8, and the case main body 1 of the tractor main body 7 is connected.
The handle 65 for winding up the wire 64 is not provided on one side surface of the tractor main body 61 as in the conventional case, because the holder 10 and the appropriate supporting means 11 are simply connected to the appropriate position. And the fact that the tractor main body 7 is smaller than the conventional tractor main body 61, the
The structure can be simplified, and it can be provided at a very low cost.

[Brief description of drawings]

FIG. 1 is a front view of a surgical abdominal wall tractor of the present invention.

FIG. 2 is an exploded perspective view of the tractor body of FIG.

FIG. 3 is a plan view showing a usage state of the present invention.

FIG. 4 is a perspective view of the same.

[Explanation of symbols]

 1 Case Main Body 2 Case Cover 3 Entrainment Wheel 4 Gear 5 Swirl Spring 6 Lock Mechanism 7 Retractor Main Body 8 Traction Hook 9 Traction Means 10 Holder 11 Support Means 12 Body Plate 13 Fitting Portion 14 Locking Hole 15 Fitting Portion 16 Insertion Hole 16a Bearing 17 Fitting portion 18 Shaft hole 19 Shaft hole 20 Spring stop hole 21 Pin hole 22 Screw hole 23 Cover plate 24 Bearing portion 24a Bearing 25 Shaft hole 26 Shaft fitting hole 27 Screw insertion hole 28 Wheel plate 29 Wheel axle 30 Axle 31 winding groove 32 set screw 33 screw hole 34 car plate 35 shaft hole 36 tooth 37 screw hole 38 spring plate 39 outer side locking piece 40 inner side locking piece 41 claw 42 swing part 43 shaft hole 44 spring stop hole 45 lock cam 46 Cam shaft 47 Extension coil spring 48 Release shaft 49 Screw 50 Screw 51 Screw 52 Ball 53 Screw 5 Guide wheel 55 Caulking Metal A patient B incision C abdominal D strut E arched bar F side frame

Claims (1)

[Claims] 1. Inside the case body and the case cover,
A rotatable winding wheel, and a gear that is fixed to one side surface of the winding wheel and rotates at the same time as the winding wheel,
Forming a tractor main body having a spiral spring having one end locked to one side of the case main body and the other end locked to the winding wheel, and a lock mechanism for locking the elastic force of the spiral spring. Then, the base end of an appropriate traction means having a traction hook for traction of the abdominal wall of the patient's incision attached to the distal end of the retracting wheel in the tractor body is freely retractable and retractable. An abdominal wall tractor for surgery, characterized in that a base end of an appropriate support means having holders for supporting side frames on the left and right side portions of the operating table is attached to an appropriate position of the case body.