技术领域technical field
本发明属于医疗器械技术领域，尤其涉及一种用于结肠造口的磁性吻合装置。The invention belongs to the technical field of medical devices, in particular to a magnetic anastomosis device for colostomy.
背景技术Background technique
结肠造口是指外科医生为了治疗某些肠道疾病（如直肠癌、溃性结肠炎等）而在腹壁上所做的人为开口，并将一段肠管拉出开口外，翻转缝于腹壁，从而形成了肠造口。其作用就是代替原来的会阴部肛门行使排便功能，实际上就是粪便出口的改道，对整体的消化功能影响不大。目前随着结直肠癌的发病率持续升高，越来越多的患者需要行结肠造口手术。传统的结肠造口手术是将近端结肠直接从腹腔通过腹膜拖出腹壁造瘘，肠功能恢复时开瘘。但传统的腹膜内结肠造口术存在有明显的缺陷：需缝合结肠与侧腹壁之间的间隙，操作繁琐，术后容易发生腹内疝而致肠梗阻；造口处结肠与腹壁圆形切口缝合要确实可靠，否则术后会在此形成切口疝；大部分造口者在排便前无特殊信号，容易造成粪便污染，给病人术后的生活带来无尽的烦恼。A colostomy is an artificial opening made by a surgeon on the abdominal wall in order to treat certain intestinal diseases (such as rectal cancer, ulcerative colitis, etc.), and a section of intestinal tube is pulled out of the opening, turned over and sewed on the abdominal wall, thereby An enterostomy is formed. Its function is to replace the original perineum and anus to perform the defecation function. In fact, it is the diversion of the excrement outlet, which has little effect on the overall digestive function. As the incidence of colorectal cancer continues to rise, more and more patients need colostomy surgery. The traditional colostomy operation is to drag the proximal colon directly from the abdominal cavity through the peritoneum and open the fistula when the intestinal function is restored. However, there are obvious defects in the traditional intraperitoneal colostomy: the gap between the colon and the lateral abdominal wall needs to be sutured, which is cumbersome to operate, and intra-abdominal hernia is prone to occur after the operation, resulting in intestinal obstruction; The suture must be reliable, otherwise an incisional hernia will be formed here after the operation; most patients with a stoma have no special signal before defecation, which is likely to cause fecal contamination and bring endless troubles to the postoperative life of the patient.
国外文献报道结肠造口术后并发症发生率高达21%-71%，而国内文献报道16.3%-53.8%。肠造口的并发症主要包括造口本身的并发症，如造口缺血性坏死、造口回缩、造口处穿孔、造口脱垂；造口皮肤黏膜连接处的并发症，如出血、分离、瘘、狭窄；造口旁疝；造口周围的皮肤病，如接触性皮炎、损伤性皮炎；其他较少见的并发症还有造口静脉曲张出血等。而如此多的并发症也给护理工作带来巨大的负担。Foreign literature reports that the incidence of complications after colostomy is as high as 21%-71%, while domestic literature reports 16.3%-53.8%. Complications of enterostomy mainly include the complications of the stoma itself, such as stoma avascular necrosis, stoma retraction, stoma perforation, and stoma prolapse; complications of the stoma-mucosal junction, such as bleeding , separation, fistula, stenosis; parastomal hernia; skin diseases around the stoma, such as contact dermatitis, traumatic dermatitis; other less common complications include stoma variceal bleeding. And so many complications also bring huge burden to the nursing work.
发明内容Contents of the invention
为了克服上述现有技术的缺点，本发明的目的在于提供一种用于结肠造口的磁性吻合装置，通过磁性相吸，将结肠与腹壁皮下组织结合在一起，方法便捷可靠，采用磁性压迫吻合技术，完成造口。该装置能较好的解决造口缺血性坏死、造口回缩，造口皮肤黏膜连接处并发症及造口周围的皮肤病。In order to overcome the above-mentioned shortcomings of the prior art, the purpose of the present invention is to provide a magnetic anastomosis device for colostomy, which combines the colon and the subcutaneous tissue of the abdominal wall through magnetic mutual attraction. The method is convenient and reliable, and the magnetic compression anastomosis is adopted technology to complete the stoma. The device can better solve stoma ischemic necrosis, stoma retraction, complications of stoma skin mucous membrane junction and skin diseases around the stoma.
为解决上述技术问题，本发明采用的技术方案为：In order to solve the problems of the technologies described above, the technical solution adopted in the present invention is:
一种用于结肠造口的磁性吻合装置，包括磁性底座和吻合环，磁性底座置于腹壁外侧，吻合环位于肠内，磁性底座包括座主体，座主体与吻合环相对的一侧设有凹槽，凹槽底部设有磁体，凹槽侧壁设置有胶面，磁体能吸引吻合环，凹槽底部设置有上下贯通的孔；吻合环的外径小于凹槽的直径，当吻合环落入凹槽中时，吻合环的内环与孔对接。A magnetic anastomosis device for a colostomy, comprising a magnetic base and an anastomotic ring, the magnetic base is placed outside the abdominal wall, the anastomotic ring is located in the intestine, the magnetic base includes a seat body, and a concave hole is provided on the side of the seat body opposite to the anastomotic ring Groove, the bottom of the groove is provided with a magnet, the side wall of the groove is provided with a rubber surface, the magnet can attract the anastomotic ring, and the bottom of the groove is provided with a hole through up and down; the outer diameter of the anastomotic ring is smaller than the diameter of the groove, when the anastomotic ring falls into When in the groove, the inner ring of the anastomotic ring abuts the hole.
为优化上述技术方案，采取的具体措施还包括：In order to optimize the above technical solutions, the specific measures taken also include:
上述的磁性吻合装置还包括造口袋，造口袋由金属环口及位于金属环口外周的密闭塑料袋构成，造口袋的金属环口与孔的下端连接，磁体将金属环口吸附于磁性底座上。The above-mentioned magnetic anastomosis device also includes an ostomy bag, the ostomy bag is composed of a metal ring mouth and a sealed plastic bag located on the outer periphery of the metal ring mouth, the metal ring mouth of the ostomy bag is connected with the lower end of the hole, and the magnet absorbs the metal ring mouth on the magnetic base .
上述的座主体采用的材料为生物相容性塑料。The above-mentioned base body is made of biocompatible plastic.
上述的吻合环的内环直径比孔直径略大。The diameter of the inner ring of the aforementioned anastomotic ring is slightly larger than the diameter of the hole.
上述的吻合环的外径比凹槽的直径小5-10mm。The outer diameter of the aforementioned anastomotic ring is 5-10 mm smaller than the diameter of the groove.
上述的胶面外侧面贴附可撕除的隔离纸。A removable release paper is attached to the outer side of the above-mentioned rubber surface.
上述的磁体为环状结构。The above-mentioned magnet is a ring structure.
上述的吻合环为磁环或能被磁体吸附的金属环。The aforementioned anastomotic ring is a magnetic ring or a metal ring that can be absorbed by a magnet.
本发明的用于结肠造口的磁性吻合装置，包括腹壁侧磁性底座和结肠内的吻合环，进行吻合时，将吻合环置于保留肠腔内，闭合断段，梭型切除拟定造口处腹壁皮肤，留下皮下组织，靠边缘切开皮下组织及腹壁脂肪，撑开腹壁肌肉，打开腹膜，将带有吻合环的肠壁断段拉出腹壁，保持长度大于腹壁厚度。将皮下组织覆盖于吻合环上，间断关闭皮下组织边缘。将磁性底座放置于造口处，引导吻合环，逐步靠近磁性底座的凹槽，凹槽内磁体吸引吻合环，使吻合环进入凹槽中，将肠壁及腹壁皮下组织压闭在一起。揭开磁性底座的外侧胶面的隔离纸，将磁性底座粘贴固定于腹壁皮肤上。沿磁性底座中间的孔打开皮下组织，切除环内皮下组织及肠壁，粪便通过磁性底座中间的孔引出体外。造口袋安置于磁性底座的另一侧，用于接取排泄物。由于吻合是通过慢性压榨的方式，同时粪便可以通过装置中心空孔进行排泄，其过程类似治疗肛瘘的挂线疗法，磁性装置压迫处组织最终坏死脱落，同时可取下装置。本发明的优点为：提供一种磁性吻合装置，降低手术操作难度，减少手术操作步骤，提高手术效率。该装置采用磁性压迫吻合技术，通过慢性压榨周围增生来吻合，整个操作过程中肠腔闭合，污染机会减少。同时粪便通过装置内圆孔引出，不直接接触皮肤，极大地减少肠造口的相关并发症，装置外安置金属环造口袋，通过磁性相吸固定，更换方便。The magnetic anastomotic device for colostomy of the present invention includes a magnetic base on the abdominal wall and an anastomotic ring in the colon. When performing anastomosis, the anastomotic ring is placed in the retained intestinal cavity, the segment is closed, and the planned stoma is resected by a shuttle. The skin of the abdominal wall leaves the subcutaneous tissue, cuts the subcutaneous tissue and abdominal wall fat at the edge, stretches the abdominal wall muscles, opens the peritoneum, and pulls the segment of the intestinal wall with an anastomotic ring out of the abdominal wall to keep the length greater than the thickness of the abdominal wall. Cover the subcutaneous tissue on the anastomotic ring, and close the edge of the subcutaneous tissue intermittently. Place the magnetic base on the stoma, guide the anastomotic ring, and gradually approach the groove of the magnetic base. The magnet in the groove attracts the anastomotic ring, so that the anastomotic ring enters the groove, and presses the intestinal wall and subcutaneous tissue of the abdominal wall together. Uncover the release paper on the outer plastic surface of the magnetic base, and paste and fix the magnetic base on the abdominal wall skin. The subcutaneous tissue is opened along the hole in the middle of the magnetic base, the subcutaneous tissue and the intestinal wall are excised, and the feces are drawn out of the body through the hole in the middle of the magnetic base. The ostomy bag is placed on the other side of the magnetic base to receive excrement. Since the anastomosis is performed through chronic compression, and feces can be excreted through the central hole of the device, the process is similar to the hanging thread therapy for the treatment of anal fistula, and the tissue at the compression part of the magnetic device will eventually necrosis and fall off, and the device can be removed at the same time. The invention has the advantages of providing a magnetic anastomosis device, reducing the difficulty of operation, reducing operation steps and improving operation efficiency. The device adopts magnetic compression anastomosis technology, and anastomoses through chronic compression of surrounding hyperplasia. During the entire operation, the intestinal cavity is closed and the chance of contamination is reduced. At the same time, feces are drawn out through the inner round hole of the device without direct contact with the skin, which greatly reduces the complications related to enterostomy. A metal ring ostomy bag is placed outside the device, which is fixed by magnetic attraction and is easy to replace.
附图说明Description of drawings
图1是本发明磁性底座的结构示意图；Fig. 1 is the structural representation of magnetic base of the present invention;
图2是图1的剖面图；Fig. 2 is a sectional view of Fig. 1;
图3是本发明吻合环的结构示意图；Fig. 3 is a structural schematic diagram of an anastomotic ring of the present invention;
图4是图3的剖面图；Fig. 4 is the sectional view of Fig. 3;
图5是本发明实际应用的示意简图；Fig. 5 is a schematic diagram of the practical application of the present invention;
图6是吻合环尚未进入磁性底座的示意图；Fig. 6 is a schematic diagram of the anastomotic ring not yet entering the magnetic base;
图7是吻合环进入磁性底座的示意图；Fig. 7 is a schematic diagram of an anastomotic ring entering a magnetic base;
图8是沿磁性底座中间的孔切除环内皮下组织及肠壁的示意图；Fig. 8 is a schematic diagram of excision of ring endothelial subthelial tissue and intestinal wall along the hole in the middle of the magnetic base;
图9是造口袋的示意图。Fig. 9 is a schematic diagram of an ostomy bag.
其中的附图标记为：磁性底座1、座主体11、凹槽12、磁体13、孔14、吻合环2、胶面3、造口袋4、肠壁A、皮下组织B。The reference signs therein are: magnetic base 1, seat main body 11, groove 12, magnet 13, hole 14, anastomotic ring 2, rubber surface 3, ostomy bag 4, intestinal wall A, subcutaneous tissue B.
具体实施方式detailed description
下面结合附图对本发明的技术方案作详细说明。The technical scheme of the present invention will be described in detail below in conjunction with the accompanying drawings.
本发明的一种用于结肠造口的磁性吻合装置，包括磁性底座1和吻合环2，磁性底座1置于腹壁外侧，吻合环2位于肠内，磁性底座1包括座主体11，座主体11与吻合环2相对的一侧设有凹槽12，凹槽12底部设有磁体13，凹槽12边缘设置有胶面3，磁体13能吸引吻合环2，凹槽12底部设置有上下贯通的孔14；吻合环2的外径小于凹槽12的直径，当吻合环2落入凹槽12中时，吻合环2的内环与孔14对接。A magnetic anastomotic device for colostomy of the present invention, comprising a magnetic base 1 and an anastomotic ring 2, the magnetic base 1 is placed outside the abdominal wall, the anastomotic ring 2 is located in the intestine, the magnetic base 1 includes a seat main body 11, and the seat main body 11 The side opposite to the anastomotic ring 2 is provided with a groove 12, the bottom of the groove 12 is provided with a magnet 13, the edge of the groove 12 is provided with a rubber surface 3, the magnet 13 can attract the anastomotic ring 2, and the bottom of the groove 12 is provided with an up and down through The hole 14 ; the outer diameter of the anastomotic ring 2 is smaller than the diameter of the groove 12 , when the anastomotic ring 2 falls into the groove 12 , the inner ring of the anastomotic ring 2 is docked with the hole 14 .
实施例中，磁性吻合装置还包括造口袋4，造口袋4由金属环口及位于金属环口外周的密闭塑料袋构成，造口袋4的金属环口与孔14的下端连接，磁体13将金属环口吸附于磁性底座1上。In the embodiment, the magnetic anastomosis device also includes an ostomy bag 4, the ostomy bag 4 is composed of a metal ring mouth and an airtight plastic bag located on the outer periphery of the metal ring mouth, the metal ring mouth of the ostomy bag 4 is connected with the lower end of the hole 14, and the magnet 13 connects the metal The ring mouth is adsorbed on the magnetic base 1 .
实施例中，座主体11采用的材料为生物相容性塑料。In an embodiment, the material used for the base body 11 is biocompatible plastic.
实施例中，吻合环2的内环直径比孔14直径略大。In the embodiment, the diameter of the inner ring of the anastomotic ring 2 is slightly larger than the diameter of the hole 14 .
实施例中，吻合环2的外径比凹槽12的直径小5-10mm。In an embodiment, the outer diameter of the anastomotic ring 2 is 5-10 mm smaller than the diameter of the groove 12 .
实施例中，胶面3外侧面贴附可撕除的隔离纸。In the embodiment, a removable release paper is attached to the outer surface of the rubber surface 3 .
实施例中，磁体13为环状结构。In the embodiment, the magnet 13 is a ring structure.
实施例中，吻合环2为磁环或能被磁体吸附的金属环。In the embodiment, the anastomotic ring 2 is a magnetic ring or a metal ring that can be attracted by a magnet.
参照图1、图2，磁性底座1为带有凹槽12的装置，由生物相容性塑料座主体11及凹槽12内圆环状磁体13组成，中心为孔14，边缘为胶面3。Referring to Figures 1 and 2, the magnetic base 1 is a device with a groove 12, which is composed of a biocompatible plastic base body 11 and a circular magnet 13 in the groove 12, with a hole 14 in the center and a rubber surface 3 on the edge .
参照图3、图4，吻合环2为圆环体结构，其内径略大于磁性底座1的凹槽12内径，其外径比磁性底座1的凹槽12外径小5-10mm。Referring to Fig. 3 and Fig. 4, the anastomotic ring 2 is a torus structure, its inner diameter is slightly larger than the inner diameter of the groove 12 of the magnetic base 1, and its outer diameter is 5-10mm smaller than the outer diameter of the groove 12 of the magnetic base 1.
参照图9，金属环造口袋7由中间的金属环及外周的密闭塑料袋构成。Referring to Fig. 9, the metal ring ostomy bag 7 is composed of a metal ring in the middle and an airtight plastic bag on the periphery.
本发明的工作原理是：The working principle of the present invention is:
参照图5至图8，进行吻合时，将吻合环2置于肠腔内，闭合断段，梭型切除拟定造口处腹壁皮肤，留下皮下组织，靠边缘切开皮下组织及腹壁脂肪，撑开腹壁肌肉，打开腹膜，将带有吻合环2的肠壁断段拉出腹壁，保持长度大于腹壁厚度。将皮下组织覆盖于吻合环2上，间断关闭皮下组织边缘。将磁性底座1放置于造口处，引导吻合环2，逐步靠近磁性底座1的凹槽，如图6所示。通过凹槽12内磁体13的作用，将肠壁及腹壁皮下组织压闭在一起，如图7所示。揭开磁性底座1的外侧胶面3的隔离纸，将磁性底座1粘贴固定于腹壁皮肤。沿磁性底座1的孔14打开皮下组织，切除环内皮下组织及肠壁，粪便通过孔14引出体外，如图8所示。金属环造口袋4安置于磁性底座1的另一侧，用于接取排泄物。Referring to Figures 5 to 8, when performing anastomosis, place the anastomotic ring 2 in the intestinal cavity, close the section, and resect the abdominal wall skin at the planned stoma with a shuttle, leaving the subcutaneous tissue, and cut the subcutaneous tissue and abdominal wall fat along the edge, Stretch the abdominal wall muscles, open the peritoneum, and pull the intestinal wall segment with anastomotic ring 2 out of the abdominal wall, keeping the length greater than the thickness of the abdominal wall. Cover the subcutaneous tissue on the anastomotic ring 2, and close the edge of the subcutaneous tissue intermittently. Place the magnetic base 1 on the stoma, guide the anastomotic ring 2, and gradually approach the groove of the magnetic base 1, as shown in Figure 6. Through the action of the magnet 13 in the groove 12, the intestinal wall and the subcutaneous tissue of the abdominal wall are pressed together, as shown in FIG. 7 . Uncover the release paper on the outer rubber surface 3 of the magnetic base 1, and paste and fix the magnetic base 1 on the skin of the abdominal wall. The subcutaneous tissue is opened along the hole 14 of the magnetic base 1, the subcutaneous tissue and the intestinal wall are excised, and the feces are drawn out of the body through the hole 14, as shown in FIG. 8 . A metal ring ostomy bag 4 is placed on the other side of the magnetic base 1 for receiving excrement.
以上仅是本发明的优选实施方式，本发明的保护范围并不仅局限于上述实施例，凡属于本发明思路下的技术方案均属于本发明的保护范围。应当指出，对于本技术领域的普通技术人员来说，在不脱离本发明原理前提下的若干改进和润饰，应视为本发明的保护范围。The above are only preferred implementations of the present invention, and the protection scope of the present invention is not limited to the above-mentioned embodiments, and all technical solutions under the idea of the present invention belong to the protection scope of the present invention. It should be pointed out that for those skilled in the art, some improvements and modifications without departing from the principle of the present invention should be regarded as the protection scope of the present invention.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201511012713.0ACN105496484A (en) | 2015-12-31 | 2015-12-31 | Magnetic anastomosis device used for colostomy |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201511012713.0ACN105496484A (en) | 2015-12-31 | 2015-12-31 | Magnetic anastomosis device used for colostomy |
| Publication Number | Publication Date |
|---|---|
| CN105496484Atrue CN105496484A (en) | 2016-04-20 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201511012713.0APendingCN105496484A (en) | 2015-12-31 | 2015-12-31 | Magnetic anastomosis device used for colostomy |
| Country | Link |
|---|---|
| CN (1) | CN105496484A (en) |
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|---|---|---|---|---|
| CN109381236A (en)* | 2018-12-09 | 2019-02-26 | 江苏凯尔特医疗科技有限公司 | Pre- identical pressure magnetic inductive tube type anastomat |
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| CN2536206Y (en)* | 2001-12-29 | 2003-02-19 | 赵俊谋 | Magnetic adhering stomy device |
| US20080114384A1 (en)* | 2006-11-10 | 2008-05-15 | Wilson-Cook Medical Inc. | Ring magnets for surgical procedures |
| US8142454B2 (en)* | 2004-09-29 | 2012-03-27 | The Regents Of The University Of California, San Francisco | Apparatus and method for magnetic alteration of anatomical features |
| CN104619269A (en)* | 2012-09-07 | 2015-05-13 | 伊西康内外科公司 | Magnetic compression anastomosis device |
| CN205458860U (en)* | 2015-12-31 | 2016-08-17 | 南京大学医学院附属鼓楼医院 | A magnetism device that coincide for mouth is made to colon |
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN2536206Y (en)* | 2001-12-29 | 2003-02-19 | 赵俊谋 | Magnetic adhering stomy device |
| US8142454B2 (en)* | 2004-09-29 | 2012-03-27 | The Regents Of The University Of California, San Francisco | Apparatus and method for magnetic alteration of anatomical features |
| US20080114384A1 (en)* | 2006-11-10 | 2008-05-15 | Wilson-Cook Medical Inc. | Ring magnets for surgical procedures |
| CN104619269A (en)* | 2012-09-07 | 2015-05-13 | 伊西康内外科公司 | Magnetic compression anastomosis device |
| CN205458860U (en)* | 2015-12-31 | 2016-08-17 | 南京大学医学院附属鼓楼医院 | A magnetism device that coincide for mouth is made to colon |
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN109381236A (en)* | 2018-12-09 | 2019-02-26 | 江苏凯尔特医疗科技有限公司 | Pre- identical pressure magnetic inductive tube type anastomat |
| CN109381236B (en)* | 2018-12-09 | 2024-01-30 | 江苏凯尔特医疗科技有限公司 | Pre-anastomosis pressure magnetic induction tubular anastomat |
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| Date | Code | Title | Description |
|---|---|---|---|
| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| RJ01 | Rejection of invention patent application after publication | ||
| RJ01 | Rejection of invention patent application after publication | Application publication date:20160420 |