技术领域technical field
本发明属于医疗器械技术领域，具体涉及一种用于腹腔镜下保留肾单位手术中最大限度地保留残余肾脏功能的自锁型半肾套扎带。The invention belongs to the technical field of medical devices, and in particular relates to a self-locking hemi-kidney band for maximally retaining residual kidney function in laparoscopic nephron-preserving surgery.
背景技术Background technique
随着腹腔镜技术的逐渐成熟，腹腔镜下保留肾单位手术技术已逐渐被广大医师掌握并应用，其手术时间、术中出血量等指标也逐步与开放手术相同，所以腹腔镜下保留肾单位手术已日渐成为小肾癌微创手术治疗的主要手段。然而，由于腹腔镜下保留肾单位手术术中难以像传统开放手术一样，在完全阻断肾脏动、静脉血供后，采用在所要保留的部分肾脏周围添加冰屑降温的方法，致使保留肾脏组织的热缺血时间延长，从而损伤肾实质细胞，最终导致肾脏功能的不可逆损伤，进而影响术后肾功能的恢复。因此，腹腔镜下保留肾单位手术在手术视野清晰的情况下完整切除肿瘤的同时，如何更好的保护残肾功能，成为该手术的关注热点及技术难点。尤其对于孤立肾、对侧肾脏存在疾病的患者，肾功能的保护凸显得更为重要。针对腹腔镜下保留肾单位手术术中的肾功能保护，许多学者进行了深入的探索研究，希望可以通过改进相关技术来解决这一难题。从手术方法技巧方面出发，Gill等人提出了肾动脉分支阻断的技术，选择性阻断供应肿瘤区域的血管，达到保护肾功能的目的，他还提出肾髓质层关闭后，即可松开阻断恢复肾脏血管，以缩短肾脏组织热缺血时间，从而最大限度地保留肾功能。然而，该技术对术前判断、术中操作技巧等要求非常高，对术者的手术经验依赖性较大，而且并不是所有肿瘤都有特定血管供应，同时这种做法还增加了分离分支血管时导致血管破裂的可能性。Gill等人还提出通过药物诱导低血压来营造零缺血状态，但该方法对患者身体因素、血流动力学等影响较为复杂，对患者的选择性较高。另一方面，从营造低温手术环境方面出发，Landman和Crain等提出了术中输尿管插管进行冰水灌注为肾脏降温的方法。通过逆行向肾脏集合系统内进行冰水灌注，可将肾实质的核心温度降至23摄氏度左右，但该技术操作繁琐，降温效果与集合系统的表面积相关，而且长时间的高压灌注对肾脏功能的影响同样不可忽视。Janetschek采用了术中肾动脉冰水灌注的方法进行降温保护，因操作复杂同样没能进一步推广。到目前为止，尚未出现一种简单易用、可操作性强的用于最大限度的在腹腔镜下保留肾单位手术中保护残余肾脏功能的器械与方法。With the gradual maturity of laparoscopic technology, laparoscopic nephron-sparing surgery techniques have been gradually mastered and applied by the majority of physicians, and its operation time, intraoperative blood loss and other indicators are gradually the same as those of open surgery, so laparoscopic nephron-sparing surgery Surgery has increasingly become the main means of minimally invasive surgical treatment of small renal cell carcinoma. However, because laparoscopic nephron-sparing surgery is difficult like traditional open surgery, after completely blocking the renal arterial and venous blood supply, the method of adding ice chips around the part of the kidney to be preserved is used to cool down, resulting in the preservation of renal tissue. The prolonged warm ischemia time will damage the renal parenchymal cells, eventually leading to irreversible damage to renal function, which in turn affects the recovery of renal function after surgery. Therefore, in laparoscopic nephron-sparing surgery, while completely resecting the tumor with a clear surgical field of view, how to better protect the function of the residual kidney has become a focus of attention and technical difficulties in this surgery. Especially for patients with solitary kidney and contralateral kidney disease, the protection of renal function is more important. Aiming at the protection of renal function in laparoscopic nephron-sparing surgery, many scholars have carried out in-depth exploration and research, hoping to solve this problem by improving related technologies. From the perspective of surgical techniques, Gill et al. proposed the technique of blocking the branches of the renal artery to selectively block the blood vessels supplying the tumor area to achieve the purpose of protecting renal function. He also proposed that after the renal medulla is closed, it can be loosened. Open blockage to restore renal blood vessels to shorten the warm ischemia time of renal tissue, so as to preserve renal function to the greatest extent. However, this technique has very high requirements for preoperative judgment and intraoperative operation skills, and is highly dependent on the operator's surgical experience. Moreover, not all tumors have specific blood vessel supply. At the same time, this method also increases the risk of separating branch vessels. possibility of vascular rupture. Gill et al. also proposed to create a zero-ischemic state by drug-induced hypotension, but this method has more complex effects on patients' physical factors and hemodynamics, and is more selective for patients. On the other hand, from the perspective of creating a hypothermic operating environment, Landman and Crain et al proposed a method of intraoperative ureteral catheterization for ice water perfusion to cool the kidneys. The core temperature of the renal parenchyma can be reduced to about 23 degrees Celsius by retrogradely perfusing ice water into the collecting system of the kidney. The impact cannot be ignored either. Janetschek adopted the method of perfusing the renal artery with ice water for cooling protection, but it was not further promoted due to the complicated operation. So far, there has not been an easy-to-use and highly operable device and method for maximally protecting the residual renal function in laparoscopic nephron-sparing surgery.
针对位于肾脏上、下两极的小肿瘤，肾动脉的完全阻断导致全肾无血液供应，肾脏全程处于缺血状态，从而导致正常肾脏组织不可逆的损伤。因此临床急需一种用于腹腔镜下保留肾单位手术中，避免了对整个肾脏血供进行阻断，最大限度地保留残余肾脏功能的医疗器械。For small tumors located at the upper and lower poles of the kidney, the complete blockage of the renal artery leads to no blood supply to the whole kidney, and the kidney is in a state of ischemia throughout the entire process, resulting in irreversible damage to normal kidney tissue. Therefore, there is an urgent clinical need for a laparoscopic nephron-sparing operation, which avoids blocking the blood supply to the entire kidney and preserves the residual renal function to the greatest extent.
发明内容Contents of the invention
本发明的目的是提供一种用于腹腔镜下保留肾单位手术中，避免了对整个肾脏血供进行阻断，最大限度地保留残余肾脏功能的自锁型半肾套扎带。The object of the present invention is to provide a self-locking hemi-renal ligature used in laparoscopic nephron-preserving surgery, which avoids blocking the blood supply of the whole kidney and preserves the residual kidney function to the greatest extent.
为解决上述技术问题，本发明设计了一种微创手术用带自锁功能的半肾套扎带，可以通过只阻断肿瘤生长端肾脏的血液供应，既保证了肿瘤切除的效果，又降低了术中失血量，更具意义的是将保留部分肾脏的缺血时间降为零；进而避免了对整个肾脏血供进行阻断，最大程度地保留了残余肾脏的功能，充分体现了腹腔镜下保留肾单位手术的意义。In order to solve the above technical problems, the present invention designs a hemi-kidney bandage with self-locking function for minimally invasive surgery, which can only block the blood supply of the kidney at the tumor growth end, which not only ensures the effect of tumor resection, but also reduces the The intraoperative blood loss is reduced, and more importantly, the ischemia time of the preserved part of the kidney is reduced to zero; thereby avoiding the blockage of the blood supply to the entire kidney, and retaining the function of the remaining kidney to the greatest extent, it fully embodies the advantages of laparoscopic surgery. Significance of nephron-sparing surgery.
本发明提供了一种自锁型半肾套扎带，由肾脏扎带、套箍、连杆手柄、套箍卡片、自锁拉片、自锁滑块、滑块卡片和活动手柄组成。The invention provides a self-locking hemi-kidney bandage, which is composed of a kidney bandage, a hoop, a connecting rod handle, a hoop card, a self-locking pull piece, a self-locking slider, a slider card and a movable handle.
肾脏扎带，肾脏扎带的一端为轴圈，另一端有一个扎带孔，肾脏扎带上有若干个扎带卡槽；Kidney tie, one end of the kidney tie is a shaft ring, the other end has a tie hole, and there are several tie slots on the kidney tie;
套箍，包括套箍轴、扎带通道和套箍卡片槽；肾脏扎带通过轴圈固定在套箍轴上后形成一个环形，有扎带孔的一端穿入扎带通道；The ferrule includes a ferrule shaft, a strap channel and a ferrule card slot; the kidney strap is fixed on the ferrule shaft through the collar to form a ring, and the end with the strap hole penetrates into the strap channel;
连杆手柄，包括一个连杆和连杆后端的固定手柄，所述的连杆中空内设自锁拉片槽，连杆前端与套箍接连，连杆后端固定手柄的上方有滑块滑槽；The connecting rod handle includes a connecting rod and a fixed handle at the rear end of the connecting rod. The connecting rod is hollow with a self-locking tab groove inside. The front end of the connecting rod is connected with the ferrule. groove;
自锁拉片，置于连杆的自锁拉片槽内，自锁拉片上有若干个拉片卡槽，自锁拉片前端的拉钩用于钩住扎带孔；The self-locking pull piece is placed in the self-locking pull piece groove of the connecting rod. There are several pull piece slots on the self-locking pull piece. The hook at the front end of the self-locking pull piece is used to hook the cable tie hole;
自锁滑块，包括滑块外凸轴、滑块内凸轴和滑块卡片槽；滑块外凸轴嵌入活动手柄上的外凸滑块滑槽；滑块内凸轴嵌入连杆手柄上的滑块滑槽；Self-locking slider, including the outer convex shaft of the slider, the inner convex shaft of the slider and the card slot of the slider; the outer convex shaft of the slider is embedded in the outer convex slider chute on the movable handle; the inner convex shaft of the slider is embedded in the connecting rod handle slider chute;
套箍卡片可插入套箍卡片槽；The ferrule card can be inserted into the ferrule card slot;
滑块卡片可插入滑块卡片槽。The slider card can be inserted into the slider card slot.
所述的扎带卡槽，为25-35个，间距为1.5-2.5mm。There are 25-35 cable tie slots with a spacing of 1.5-2.5mm.
所述的拉片卡槽，为25-35个，间距为1.5-2.5mm。There are 25-35 pull-tab slots with a spacing of 1.5-2.5mm.
所述的套箍，还包括定位凸槽，用于固定套箍和连杆手柄。The ferrule also includes a positioning convex groove for fixing the ferrule and the connecting rod handle.
所述的套箍卡片，由卡片手柄、卡片卡钩和卡片弹片组成；卡片卡钩卡入相应的扎带卡槽内；卡片手柄嵌入套箍卡片槽。The ferrule card is composed of a card handle, a card hook and a card shrapnel; the card hook is inserted into the corresponding cable tie slot; the card handle is inserted into the ferrule card slot.
所述的滑块卡片，也是由卡片手柄、卡片卡钩和卡片弹片组成。The slider card is also composed of a card handle, a card hook and a card shrapnel.
所述的连杆手柄，还包括手柄轴圈；所述的活动手柄，还包括手柄轴，手柄轴与手柄轴圈固定。The connecting rod handle also includes a handle shaft ring; the movable handle also includes a handle shaft, and the handle shaft is fixed to the handle shaft ring.
所述的活动手柄，还包括手柄挡块，可防止医生操作时器械掉落。The movable handle also includes a handle stopper, which can prevent the instrument from falling when the doctor operates it.
本发明的肾脏扎带的轴圈固定在套箍的套箍轴上，在肾脏扎带收紧或放松时，起到固定肾脏扎带一端的作用。肾脏扎带上有若干个扎带卡槽，当肾脏扎带收紧或放松至不同程度时，由卡片卡钩卡入相应的扎带卡槽内，以固定肾脏扎带所形成的“套扎圈”的大小。扎带孔与拉钩相作用，当操作活动手柄时，可通过由活动手柄、自锁滑块、自锁拉片组成的控制机构拉动肾脏扎带，以拉紧“套扎圈”从而调整肾脏扎带对所套扎肾脏的作用力大小。The shaft ring of the kidney tie of the present invention is fixed on the collar shaft of the collar, and plays the role of fixing one end of the kidney tie when the kidney tie is tightened or loosened. There are several tie slots on the kidney tie. When the kidney tie is tightened or loosened to different degrees, the card hooks will be inserted into the corresponding tie grooves to fix the "ligation" formed by the kidney tie. circle" size. The tie hole works with the pull hook. When the movable handle is operated, the kidney tie can be pulled through the control mechanism composed of the movable handle, self-locking slider, and self-locking pull piece to tighten the "ligating ring" to adjust the kidney tie. The force of the belt on the ligated kidney.
连杆手柄上的滑块滑槽可供滑块内凸轴相对滑动，滑块滑槽，较佳地，一端设计有向下的弯曲段，通过对活动手柄的操作可使滑块内凸轴进入该弯曲段，此时自锁滑块连带自锁拉片向下运动，可使拉钩与扎带孔脱开。The slider chute on the handle of the connecting rod can allow the inner convex shaft of the slider to slide relative to each other. Preferably, one end of the slider chute is designed with a downward bending section, and the inner convex shaft of the slider can be moved by operating the movable handle. Entering the bending section, the self-locking slider moves downward together with the self-locking pull piece, so that the drag hook can be disengaged from the cable tie hole.
手柄轴圈与手柄轴相匹配，连接连杆手柄与活动手柄，并使两者可产生相对转动。固定手柄用于操作该器械时手指抓握用，自锁拉片槽内可供自锁拉片穿过。The handle shaft ring matches the handle shaft, connects the connecting rod handle and the movable handle, and enables the two to produce relative rotation. The fixed handle is used for finger grasping when operating the device, and the self-locking pull-tab groove can pass through the self-locking pull-tab.
套箍卡片嵌于套箍卡片槽内，当需要放松肾脏扎带所形成的套扎圈时，按下卡片手柄，卡片弹簧受力向下，卡片卡钩释放扎带卡槽，使得肾脏扎带放松。卡片卡钩，较佳地，设计成楔形，当肾脏扎带收紧时，扎带卡槽逐个通过卡片卡钩从而实现了肾脏扎带只能单向通过套箍而逐渐收紧。The ferrule card is embedded in the ferrule card slot. When it is necessary to loosen the ligation ring formed by the kidney tie, press the card handle, the card spring is forced downward, and the card hook releases the tie slot, making the kidney tie Relax. The card hooks are preferably wedge-shaped. When the kidney tie is tightened, the tie grooves pass through the card hooks one by one so that the kidney tie can only pass through the hoop in one direction and gradually tightened.
拉钩，较佳地，设计为楔形，当操作活动手柄拉动自锁拉片时，拉钩通过与扎带孔的配合带动肾脏扎带收紧，当滑块内凸轴进入滑块滑槽弯曲部时，自锁拉片被带动一起向下运动，拉钩与扎带孔脱开。自锁拉片上的有若干个拉片卡槽，当操作活动手柄时，滑块卡片即可卡入相应的拉片卡槽内，其原理与套箍卡片和肾脏扎带之间的单向运动形式相同，滑块卡片与套箍卡片结构、原理完全一样，较佳地，套箍卡片的卡片手柄长度略短于滑块卡片的卡片手柄长度。The pull hook is preferably designed as a wedge. When the movable handle is operated to pull the self-locking pull piece, the pull hook will drive the kidney tie to tighten by cooperating with the tie hole. When the inner convex shaft of the slider enters the curved part of the slider chute , the self-locking pull piece is driven to move downward together, and the pull hook is disengaged from the cable tie hole. There are several pull-tab slots on the self-locking pull-tab. When the movable handle is operated, the slider card can be snapped into the corresponding pull-tab slot. The principle is the same as the one-way movement between the ferrule card and the kidney tie. The form is the same, and the structure and principle of the slider card and the ferrule card are exactly the same. Preferably, the length of the card handle of the ferrule card is slightly shorter than the length of the card handle of the slider card.
自锁滑块通过自锁滑块外凸轴与外凸滑块滑槽相配合，自锁滑块内凸轴与滑块滑槽相匹配，当自锁滑块运动时，自锁滑块内凸轴可在滑块滑槽内滑动。当操作活动手柄时，可带动自锁滑块沿滑块滑槽相对滑动。滑块卡片槽用于嵌入滑块卡片。The self-locking slider matches the outer convex shaft of the self-locking slider with the outer convex slider chute, and the inner convex shaft of the self-locking slider matches the slider chute. When the self-locking slider moves, the inside of the self-locking slider The protruding shaft can slide in the slider slide groove. When the movable handle is operated, the self-locking slider can be driven to slide relatively along the slide groove of the slider. The slider card slot is used to insert the slider card.
活动手柄的外凸滑块滑槽与自锁滑块外凸轴相连，当操作活动手柄时，可带动自锁滑块沿滑块滑槽相对滑动。The outer convex slider chute of the movable handle is connected with the outer convex shaft of the self-locking slider, and when the movable handle is operated, the self-locking slider can be driven to slide relatively along the slider chute.
本发明自锁型半肾套扎带结构简单，使用方便、成本低廉，用于腹腔镜下保留肾单位手术中，手术操作简单，阻断效果确切，避免了对整个肾脏血供进行阻断，最大限度地保留残余肾脏功能，由肾脏扎带形成的套扎圈可单独留在套扎好的肾脏上，而将器械手柄撤出工作通道，遂本发明的使用不需建立额外工作通道，减小了手术创伤，降低了感染风险，并且每个部件可拆卸清洗、灭菌并反复使用。The self-locking half-kidney bandage of the present invention is simple in structure, convenient to use and low in cost, and is used in laparoscopic nephron preservation surgery. To preserve the residual kidney function to the greatest extent, the ligation ring formed by the kidney bandage can be left alone on the ligated kidney, and the handle of the instrument is withdrawn from the working channel, so the use of the present invention does not need to establish an additional working channel, reducing The surgical trauma is small, the risk of infection is reduced, and each part can be disassembled, cleaned, sterilized and used repeatedly.
附图说明Description of drawings
图1是自锁型半肾套扎带组成结构示意图；Fig. 1 is a schematic diagram of the composition and structure of the self-locking hemi-kidney ligation;
图2是套箍结构示意图；Fig. 2 is the schematic diagram of ferrule structure;
图3是连杆手柄的手柄部分结构示意图；Fig. 3 is a schematic structural view of the handle part of the connecting rod handle;
图4是套箍卡片结构示意图；Fig. 4 is a schematic structural diagram of a ferrule card;
图5是自锁滑块右视图及剖面视图；Fig. 5 is a right view and a sectional view of the self-locking slider;
图6是活动手柄结构示意图；Fig. 6 is a schematic diagram of the structure of the movable handle;
附图中各附图标记说明：Explanation of each reference sign in the accompanying drawings:
1、肾脏扎带，1.1轴圈，1.2扎带卡槽，1.3扎带孔；1. Kidney tie, 1.1 shaft ring, 1.2 tie slot, 1.3 tie hole;
2、套箍，2.1套箍轴，2.2扎带通道，2.3套箍卡片槽，2.4定位凸槽；2. Ferrule, 2.1 Ferrule shaft, 2.2 Cable tie channel, 2.3 Ferrule card slot, 2.4 Positioning convex groove;
3、连杆手柄，3.1滑块滑槽，3.2手柄轴圈，3.3固定手柄，3.4自锁拉片槽；3. Connecting rod handle, 3.1 slider chute, 3.2 handle shaft ring, 3.3 fixed handle, 3.4 self-locking pull piece groove;
4、套箍卡片，4.1卡片手柄，4.2卡片卡钩，4.3卡片弹片；4. Ferrule card, 4.1 card handle, 4.2 card hook, 4.3 card shrapnel;
5、自锁拉片，5.1拉钩，5.2拉片卡槽；5. Self-locking pull piece, 5.1 pull hook, 5.2 pull piece card slot;
6、自锁滑块，6.1滑块外凸轴，6.2滑块内凸轴，6.3滑块卡片槽；6. Self-locking slider, 6.1 slider outer convex shaft, 6.2 slider inner convex shaft, 6.3 slider card slot;
7、滑块卡片；7. Slider card;
8、活动手柄，8.1外凸滑块滑槽，8.2手柄挡块，8.3手柄轴。8. Movable handle, 8.1 outer convex slider chute, 8.2 handle stopper, 8.3 handle shaft.
具体实施方式Detailed ways
下面结合附图和实施例对本发明作进一步详细说明，但本发明的实施不仅限于此。The present invention will be described in further detail below in conjunction with the accompanying drawings and embodiments, but the implementation of the present invention is not limited thereto.
实施例1：Example 1:
如图所示，本发明提供了一种自锁型半肾套扎带，由肾脏扎带1、套箍2、连杆手柄3、套箍卡片4、自锁拉片5、自锁滑块6、滑块卡片7和活动手柄8组成。As shown in the figure, the present invention provides a self-locking hemi-kidney tie, which consists of a kidney tie 1, a collar 2, a connecting rod handle 3, a collar card 4, a self-locking pull piece 5, and a self-locking slider. 6. The slider card 7 and the movable handle 8 are formed.
肾脏扎带1的一端为轴圈1.1，另一端有一个扎带孔1.3，肾脏扎带上有若干个扎带卡槽1.2；One end of the kidney tie 1 is a shaft ring 1.1, the other end has a tie hole 1.3, and there are several tie slots 1.2 on the kidney tie;
套箍2，包括套箍轴2.1、扎带通道2.2和套箍卡片槽2.3；肾脏扎带通过轴圈1.1固定在套箍轴2.1上后形成一个环形，有扎带孔的一端穿入扎带通道2.2；Ferrule 2, including ferrule shaft 2.1, strap channel 2.2 and ferrule card slot 2.3; the kidney strap is fixed on the ferrule shaft 2.1 through the shaft ring 1.1 to form a ring, and the end with the strap hole is inserted into the strap channel 2.2;
连杆手柄3，包括一个连杆和连杆后端的固定手柄3.3，所述的连杆中空内设自锁拉片槽3.4，连杆前端与套箍2接连，连杆后端固定手柄3.3的上方有滑块滑槽3.1；The connecting rod handle 3 includes a connecting rod and a fixed handle 3.3 at the rear end of the connecting rod. A self-locking tab groove 3.4 is provided in the hollow of the connecting rod. There is a slider chute 3.1 above;
自锁拉片5，置于连杆的自锁拉片槽3.4内，自锁拉片上有若干个拉片卡槽5.2，自锁拉片前端的拉钩5.1用于钩住扎带孔1.3；The self-locking pull piece 5 is placed in the self-locking pull piece groove 3.4 of the connecting rod, there are several pull piece card slots 5.2 on the self-locking pull piece, and the pull hook 5.1 at the front end of the self-locking pull piece is used to hook the cable tie hole 1.3;
自锁滑块6，包括滑块外凸轴6.1、滑块内凸轴6.2和滑块卡片槽6.3；滑块外凸轴6.1与活动手柄上的外凸滑块滑槽8.1嵌合；滑块内凸轴6.2与连杆手柄上的滑块滑槽3.1嵌合；The self-locking slider 6 includes the outer convex shaft 6.1 of the slider, the inner convex shaft 6.2 of the slider and the card groove 6.3 of the slider; the outer convex shaft 6.1 of the slider is fitted with the outer convex slider chute 8.1 on the movable handle; the slider The inner convex shaft 6.2 fits with the slider slide groove 3.1 on the connecting rod handle;
套箍卡片4可插入套箍卡片槽2.3；The ferrule card 4 can be inserted into the ferrule card slot 2.3;
滑块卡片7可插入滑块卡片槽6.3。The slider card 7 can be inserted into the slider card slot 6.3.
实施例2：Example 2:
其余同实施例1，所述的扎带卡槽，为25个，间距2mm，所述的拉片卡槽，为25个，间距2mm；The rest are the same as in Example 1, the cable tie slots are 25 with a spacing of 2 mm, and the pull tab slots are 25 with a spacing of 2 mm;
所述的套箍2，还包括定位凸槽2.4，用于固定套箍2和连杆手柄3；The ferrule 2 also includes a positioning convex groove 2.4 for fixing the ferrule 2 and the connecting rod handle 3;
所述的套箍卡片4，由卡片手柄4.1、卡片卡钩4.2和卡片弹片4.3组成；卡片卡钩4.2卡入相应的扎带卡槽1.2内；卡片手柄4.1嵌入套箍卡片槽2.3；The hoop card 4 is composed of a card handle 4.1, a card hook 4.2 and a card shrapnel 4.3; the card hook 4.2 is inserted into the corresponding cable tie slot 1.2; the card handle 4.1 is embedded in the hoop card slot 2.3;
所述的滑块卡片7，结构同套箍卡片，也是同由卡片手柄、卡片卡钩和卡片弹片组成；The slider card 7 has the same structure as the hoop card, and is also composed of a card handle, a card hook and a card shrapnel;
所述的连杆手柄3，还包括手柄轴圈3.2；所述的活动手柄8，还包括手柄轴8.3，手柄轴8.3与手柄轴圈3.2固定。The connecting rod handle 3 also includes a handle shaft ring 3.2; the movable handle 8 also includes a handle shaft 8.3, and the handle shaft 8.3 is fixed to the handle shaft ring 3.2.
实施例3：Example 3:
其余同实施例1，所述的扎带卡槽，为35个，间距1.5mm；All the other are the same as in Example 1, the number of the cable tie slots is 35 with a spacing of 1.5mm;
所述的拉片卡槽，为35个，间距1.5mm；There are 35 pull-tab slots with a spacing of 1.5mm;
所述的活动手柄8，还包括手柄挡块8.2，可防止医生操作时器械掉落。The movable handle 8 also includes a handle stopper 8.2, which can prevent the instrument from falling when the doctor operates it.
实施例4：Example 4:
临床使用时，将肾脏扎带1套于肾脏一极。肾脏扎带1的轴圈1.1固定在套箍2的套箍轴2.1上，在肾脏扎带1收紧或放松时，起到固定肾脏扎带1一端的作用。肾脏扎带1上有多个扎带卡槽1.2，当肾脏扎带1收紧或放松至不同程度时，由卡片卡钩4.2卡入相应的扎带卡槽1.2内，以固定肾脏扎带1所形成的套扎圈的大小。卡片卡钩4.2设计成楔形，当肾脏扎带1收紧时，扎带卡槽1.2逐个通过卡片卡钩4.2从而使得肾脏扎带只能单向通过套箍而逐渐收紧。In clinical use, put 1 set of kidney tie on one pole of the kidney. The shaft ring 1.1 of the kidney tie 1 is fixed on the collar shaft 2.1 of the collar 2, and plays a role of fixing one end of the kidney tie 1 when the kidney tie 1 is tightened or loosened. There are multiple tie slots 1.2 on the kidney tie 1. When the kidney tie 1 is tightened or loosened to different degrees, the card hook 4.2 is inserted into the corresponding tie groove 1.2 to fix the kidney tie 1. The size of the ligation loop formed. The card hook 4.2 is designed in a wedge shape. When the kidney tie 1 is tightened, the tie slots 1.2 pass through the card hook 4.2 one by one so that the kidney tie can only pass through the hoop in one direction and gradually tightened.
随即操作活动手柄8，进而可通过由活动手柄8、自锁滑块6、自锁拉片5组成的控制机构逐渐收紧肾脏扎带1并调节其作用力。活动手柄8的外凸滑块滑槽8.1与自锁滑块外凸轴6.1相连，自锁滑块内凸轴6.2与滑块滑槽3.1相匹配，滑块卡片槽6.3用于嵌入滑块卡片7。当操作活动手柄8时，可带动自锁滑块6沿滑块滑槽3.1相对滑动。手柄挡块8.2可防止医生操作时器械掉落。手柄轴8.3与手柄轴圈3.2相连接，并使两者可产生相对转动。固定手柄3.3用于操作该器械时手指抓握用，自锁拉片槽3.4内可供自锁拉片5穿过。自锁拉片5位于连杆手柄3内部。拉钩5.1设计为楔形，当操作活动手柄8拉动自锁拉片5时，拉钩5.1通过与扎带孔1.3的配合带动肾脏扎带1收紧。自锁拉片5上的有多个拉片卡槽5.2，当操作活动手柄8时，滑块卡片7即可卡入相应的拉片卡槽5.2内，其原理与套箍卡片4和肾脏扎带1之间的单向运动形式相同。Then the movable handle 8 is operated, and then the kidney tie 1 can be gradually tightened and its active force can be adjusted by the control mechanism composed of the movable handle 8, the self-locking slider 6, and the self-locking pull piece 5. The outer convex slider chute 8.1 of the movable handle 8 is connected with the outer convex shaft 6.1 of the self-locking slider, the inner convex shaft 6.2 of the self-locking slider matches the slider chute 3.1, and the slider card slot 6.3 is used for inserting the slider card 7. When the movable handle 8 is operated, the self-locking slider 6 can be driven to slide relatively along the slider chute 3.1. The handle stopper 8.2 can prevent the instrument from falling when the doctor operates. The handle shaft 8.3 is connected with the handle shaft ring 3.2, and the two can produce relative rotation. The fixed handle 3.3 is used for grasping by fingers when operating the device, and the self-locking pull piece 5 can pass through in the self-locking pull piece groove 3.4. The self-locking pull tab 5 is located inside the link handle 3 . The drag hook 5.1 is designed to be wedge-shaped. When the movable handle 8 is operated to pull the self-locking pull piece 5, the drag hook 5.1 drives the kidney strap 1 to tighten by cooperating with the strap hole 1.3. There are multiple pull-tab slots 5.2 on the self-locking pull-tab 5. When the movable handle 8 is operated, the slider card 7 can be snapped into the corresponding pull-tab slot 5.2. The unidirectional motion form between belt 1 is the same.
手术操作时可将由肾脏扎带1和套箍2组成的套扎圈套扎在距预计的肿瘤切缘近端2－3cm处，通过对连杆手柄8的操作，逐渐收紧肾脏扎带1至肿瘤侧血流完全阻断。连杆手柄3上的滑块滑槽3.1可供滑块内凸轴6.2相对滑动，滑块滑槽3.1一端具有向下弯曲段，通过对活动手柄8的操作可使滑块内凸轴6.2进入该弯曲段，此时自锁滑块6连带自锁拉片5向下运动，可使拉钩5.1与扎带孔1.3脱开，由肾脏扎带1和套箍2组成的套扎圈可与连杆手柄3脱开而留在肾脏上，再将脱开的手柄部分从腹腔镜工作通道内移出体外，此时可开始进行肿瘤切除操作，待肿瘤切除干净，并肾脏创面缝合完毕后，可借助腹腔镜抓钳等常用腹腔镜器械，按动嵌于套箍卡片槽2.3内的套箍卡片4的卡片手柄4.1，卡片弹簧4.3受力向下，卡片卡钩4.2释放扎带卡槽1.2，使得肾脏扎带1放松，从而恢复肾脏创面端的血流供应。During the operation, the ligation ring consisting of the kidney tie 1 and the ferrule 2 can be ligated at a distance of 2-3 cm from the proximal end of the expected tumor resection margin, and the kidney tie 1 can be gradually tightened by operating the connecting rod handle 8 to Blood flow to the tumor side was completely blocked. The slider chute 3.1 on the connecting rod handle 3 can be used for the relative sliding of the inner convex shaft 6.2 of the slider, and one end of the slider chute 3.1 has a downward bending section, and the inner convex shaft 6.2 of the slider can enter through the operation of the movable handle 8 In this bending section, the self-locking slider 6 moves downward together with the self-locking pull piece 5, so that the pull hook 5.1 can be disengaged from the tie hole 1.3, and the tie ring composed of the kidney tie 1 and the hoop 2 can be connected with the connecting tie. The rod handle 3 is disengaged and left on the kidney, and then the disengaged handle part is removed from the working channel of the laparoscope. At this time, the tumor resection operation can be started. Commonly used laparoscopic instruments such as laparoscopic grasping forceps, press the card handle 4.1 of the ferrule card 4 embedded in the ferrule card slot 2.3, the card spring 4.3 is forced downward, and the card hook 4.2 releases the tie card slot 1.2, so that The kidney tie 1 is loosened, thereby restoring the blood flow supply at the wounded end of the kidney.
以上已对本发明创造的较佳实施例进行了具体说明，但本发明创造并不限于所述实施例，熟悉本领域的技术人员在不违背本发明创造精神的前提下还可作出种种的等同的变型或替换，这些等同的变型或替换均包含在本申请权利要求所限定的范围内。The preferred embodiments of the present invention have been specifically described above, but the present invention is not limited to the described embodiments, and those skilled in the art can also make various equivalents without violating the spirit of the present invention. Modifications or replacements, these equivalent modifications or replacements are all included within the scope defined by the claims of the present application.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310473858.5ACN103519861B (en) | 2013-10-12 | 2013-10-12 | Minimally Invasive Surgery self-locking type half kidney cover band |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310473858.5ACN103519861B (en) | 2013-10-12 | 2013-10-12 | Minimally Invasive Surgery self-locking type half kidney cover band |
| Publication Number | Publication Date |
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| CN103519861A CN103519861A (en) | 2014-01-22 |
| CN103519861Btrue CN103519861B (en) | 2015-08-05 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201310473858.5AExpired - Fee RelatedCN103519861B (en) | 2013-10-12 | 2013-10-12 | Minimally Invasive Surgery self-locking type half kidney cover band |
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| CN (1) | CN103519861B (en) |
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