Depth-adjustable ventilation puncture sheath for thoracoscope thyroid surgery

Abstract

The invention belongs to minimally invasive surgical instruments, and particularly relates to a depth-adjustable ventilation puncture sheath for thoracoscope thyroid surgery, which comprises a puncture outfit tube for establishing an instrument channel, a puncture outfit core which can be pulled out after penetrating and establishing the channel, and a gas injection valve which is arranged on the puncture outfit tube and is used for introducing carbon dioxide into a cavity, the sealing cap is arranged at the near end of the puncture outfit tube and used for forming sealing when an instrument enters and exits, and the adjustable port is used for adjusting the movement angle of the surgical instrument. The adjustable port comprises a fixed base used for bearing connection, an adjusting base used for setting the offset direction and a movable port used for enabling the sheath body port to generate transverse dislocation relative to the center of the end of the puncture outfit tube so as to limit the movable range of a surgical instrument, sword collision is reduced, repeated transposition and interruption caused by poor hole positions are reduced, operation continuity is maintained, and the operation efficiency is improved. The matching efficiency of hands, eyes and instruments is improved.

Description

Technical Field

[0001] The present invention belongs to minimally invasive surgical instruments, in particular to an adjustable depth ventilation puncture sheath for laparoscopic thyroid surgery. Background Art

[0002] Traditional thyroid surgery requires an incision in the neck to completely open the view of the thyroid gland, leaving a scar on the neck after the surgery. Minimally invasive thyroid surgery is performed through an incision at a longer distance. Because the incision is hidden and small, it is not easy to detect.

[0003] The most common minimally invasive thyroid surgery is a thoraco-breast approach, in which three operation holes are usually set up at the outer edges of the bilateral areola and the center of the chest. A pneumoperitoneum needle is then used to open a subcutaneous tunnel from the three operation holes toward the thyroid gland in the neck, and normal saline containing anesthetic is injected. An operation cavity is initially established under the skin of the thyroid gland in the neck and hemostasis is performed. A puncture sheath is then inserted along the puncture needle path, and carbon dioxide is injected through the puncture sheath to stabilize the operation cavity. The knife, endoscope, and forceps are inserted through the left, middle, and right puncture sheaths respectively. An ultrasonic scalpel is used to open the gap between the platysma muscle and the anterior cervical muscle group in the middle of the upper neck of the thyroid gland to expose the thyroid gland, superior pole blood vessels, recurrent laryngeal nerve, and parathyroid gland. The knife, endoscope, and forceps cooperate to complete the lesion resection and necessary central lymph node dissection. Finally, hemostasis, flushing, drainage tube placement, and incision suture are performed in sequence.

[0004] The above-mentioned surgical process involves many operations involving the knife and forceps, especially the coordinated operations during the resection process. During the operation, the knife and forceps move in the puncture sheath and can also form a slight relative rotation between the puncture sheath. When the moving areas of the knife and forceps intersect, the two are easy to interfere with each other, affecting the surgical operation. In addition, the distance and angle from the puncture point to the thyroid gland of different patients are different. Therefore, a puncture sheath structure is needed to reduce the occurrence of interference between the knife and forceps and improve surgical efficiency. Summary of the Invention

[0005] The purpose of the present invention is to provide an adjustable depth ventilation puncture sheath for laparoscopic thyroid surgery to reduce the occurrence of knife and forceps interference and improve surgical efficiency.

[0006] An adjustable depth ventilation puncture sheath for laparoscopic thyroid surgery comprises a trocar tube for establishing an instrument channel and a trocar core for inserting and removing the trocar after establishing the channel; an insufflation valve disposed on the trocar tube for introducing carbon dioxide into the cavity; a sealing cap disposed at the proximal end of the trocar tube for forming a seal when the instrument is inserted and removed; and an adjustable port for adjusting the movement angle of the surgical instrument.

[0007] The adjustable port includes a fixed base for bearing connection, an adjustment base for setting the bias direction, and a movable port for causing the sheath port to be laterally displaced relative to the center of the puncture tube end to limit the movable range of the surgical instrument.

[0008] Furthermore, the fixed base is provided with an annular slot for accommodating the adjustment base, and the adjustment base is provided with an annular inserting portion for rotating in the annular slot to set the bias direction.

[0009] Furthermore, the movable port includes an adjusting rod for guiding translation and a sheath port for forming an inlet and an outlet with the end of the puncture tube.

[0010] Furthermore, the adjustment base is provided with a socket for cooperating with the adjustment rod, so as to realize linear sliding of the movable port relative to the adjustment base.

[0011] Furthermore, the adjusting rod is provided with a threaded section, and the movable port is provided with an adjusting ring for cooperating with the threaded section to drive the movable port to translate.

[0012] Furthermore, the adjustment base is provided with a limiting portion, and the movable port is provided with a limited portion that cooperates with the limiting portion for stopping, so as to limit the translation stroke of the movable port.

[0013] Furthermore, the sealing cap is a cross-shaped silicone sealing valve used to form a close seal on the outer surface of the instrument when the instrument is inserted and removed to reduce gas leakage.

[0014] Furthermore, the gas injection valve is a valve component used to connect to the pneumoperitoneum machine and open or close the gas passage as needed.

[0015] Furthermore, a handheld portion is provided on the outside of the trocar tube for moving forward or backward in the subcutaneous tunnel to adjust the insertion depth.

[0016] Furthermore, the adjustable port is used to appropriately misalign the inlet and outlet axes of the two surgical instruments to reduce the degree of intersection and mutual interference in the cavity.

[0017] The beneficial effects achieved by the present invention using the above structure are as follows:

[0018] The adjustable port allows for a moderate misalignment of the entrance and exit axes of the two instruments and optimizes the angle, allowing for on-site fine-tuning of the instrument's incident direction and offset while maintaining the given skin port and hole distance. This reduces sword collisions, reduces repeated position changes and interruptions caused by poor hole positioning, maintains operational continuity, and improves the efficiency of hand-eye-instrument coordination. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] Figure 1 This is a schematic diagram of the overall structure of the puncture sheath proposed in the present invention;

[0020] Figure 2 This is a schematic diagram of the cross-sectional structure of the puncture sheath proposed in the present invention;

[0021] Figure 3This is a schematic cross-sectional view of the adjustable port of the puncture sheath proposed in the present invention;

[0022] Figure 4 This is a schematic structural diagram of the mobile port of the puncture sheath proposed in the present invention;

[0023] Figure 5 This is a schematic structural diagram of the adjustment base of the puncture sheath proposed in the present invention;

[0024] Figure 6 This is a schematic diagram of adjusting the puncture sheath proposed in the present invention.

[0025] Among them, 1. puncture tube; 2. puncture core; 3. air injection valve; 4. sealing cap; 5. adjustable port; 6. hand-held part; 5010. fixed base; 5011. annular slot; 5020. adjustment base; 5021. annular insertion part; 5022. jack; 5023. limiting part; 5030. movable port; 5031. adjusting rod; 5032. adjusting ring; 5033. sheath port; 5034. limited part. DETAILED DESCRIPTION

[0026] The technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, rather than all the embodiments; based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without making creative work are within the scope of protection of the present invention.

[0027] like Figure 1 and Figure 2 As shown;

[0028] The puncture sheath of the present invention is composed of a puncture tube 1 and a puncture core 2. During the operation, the puncture core 2 and the puncture tube 1 are first combined into one to complete the insertion;

[0029] The core body is responsible for establishing the expansion channel. After reaching the target level, the core body is pulled out, leaving only the puncture tube 1 as the instrument channel.

[0030] The retained trocar tube 1 is provided with a sealing valve at the proximal end to continuously maintain the airtightness and pressure in the cavity when the instrument enters and exits, and to reduce air leakage when changing the instrument.

[0031] Among them, the gas injection valve 3 is set on the puncture tube 1, which is used to reliably connect with the pneumoperitoneum machine, open or close the gas passage as needed through the stopcock / Luer interface, and introduce carbon dioxide into the cavity to establish and maintain a stable surgical cavity pressure;

[0032] The sealing cap 4 adopts a cross-shaped silicone sealing valve, which can form a dynamic fit with the outer surface of the instrument when the surgical instrument is inserted and removed, playing a sealing role to prevent gas from escaping;

[0033] The adjustable port 5 is used to adjust the movement angle of the surgical instrument by changing the direction of the instrument's entrance on the puncture sheath so that its incident angle is within the range desired by the surgeon, thereby limiting the instrument's active sector as needed, reducing mutual interference and improving the continuity of the operation.

[0034] After completing surface positioning, preliminary subcutaneous tunnel establishment and hemostasis, the puncture cores 2 of the three puncture sheaths are assembled with the puncture tube 1, inserted through three incisions, and advanced parallel to the subcutaneous tunnel to the working level in front of the sternum / under the platysma muscle. Once in place, the puncture cores 2 are removed, leaving only the puncture tube 1 as a closed channel;

[0035] A hand-held portion 6 is provided on the outside of the trocar tube 1. During the operation, the upper and lower inclined surfaces of the hand-held portion 6 can be respectively supported by the hand as needed;

[0036] When pushing inward, the puncture sheath is advanced along the existing subcutaneous tunnel; when pulling outward, it is moderately retreated along the original channel;

[0037] By operating the handheld portion 6, a subtle and controllable forward or backward movement can be achieved while holding it stably, thereby conveniently adjusting the insertion depth of the puncture sheath in the subcutaneous tunnel and improving the accuracy of positioning and the continuity of operation.

[0038] After the depth is determined, the puncture tube 1 is first fixed to the incision with sutures or tape to prevent slipping during operation and reduce bypass leakage.

[0039] The pneumoperitoneum machine is then connected to trocar tube 1 and started, and low-pressure carbon dioxide is used to maintain the working cavity: the areola approach is usually set at 5–6 mmHg, and can be temporarily adjusted to 6–8 mmHg when the visual field needs to be improved. It always operates within the low-pressure range to take into account both exposure and safety.

[0040] A laparoscope is placed in the middle puncture tube 1 to verify the layer, hemostasis and cavity pressure stability; under the scope, operating instruments are placed in the puncture tubes 1 on both sides respectively, and the tissue is continued to be separated along the existing subcutaneous tunnel until a clear and sustainable surgical space is obtained.

[0041] After the space is formed, the directions and offsets of the left and right adjustable ports 5 are adjusted respectively so that the inlet / outlet axes of the two surgical instruments are appropriately misaligned, thereby reducing the overlapping area of ​​operations, reducing mutual interference, and improving collaborative efficiency.

[0042] Please refer to Figure 3 、 Figure 4 and Figure 5 , the adjustable port 5 of the puncture sheath provided by the present invention includes a fixed base 5010, an adjustment base 5020 and a movable port 5030;

[0043] The fixed base 5010 serves as a bearing member and is provided with an annular slot 5011 for accommodating and constraining the annular inserting portion 5021 of the adjustment base 5020 to achieve connection between the port and the sheath.

[0044] The annular insert portion 5021 of the adjustment base 5020 can rotate circumferentially within the annular slot 5011 to set the direction of the bias.

[0045] The moving port can move in parallel and directly act on the surgical instrument to limit its moving range and complete quantitative offset.

[0046] The adjusting base 5020 is provided on the fixed base 5010 , and the fixed base 5010 is provided with an annular slot 5011 for inserting the fixed base 5010 , and the adjusting base 5020 is provided with an annular inserting portion 5021 ;

[0047] The annular insert 5021 can rotate in the annular slot 5011 to adjust the adjustment direction of the adjustable port 5;

[0048] The mobile port 5030 includes an adjustment rod 5031 , an adjustment ring 5032 and a sheath port 5033 ;

[0049] The adjustment rods 5031 are located below the movable port 5030 . There are two adjustment rods 5031 , and the two adjustment rods 5031 are parallel to each other.

[0050] The adjustment rod 5031 passes through the insertion hole 5022 on the adjustment base 5020 and can slide in the insertion hole 5022, so that the adjustment base 5020 and the movable port 5030 can form a translational motion, thereby misaligning the adjustable port 5 and the center of the end of the puncture tube 1, thereby limiting the movable range of the surgical instrument;

[0051] The section of the adjusting rod 5031 passing through the insertion hole 5022 is a threaded section, and the adjusting ring 5032 is located on the threaded section of the adjusting rod 5031. Rotating the adjusting ring 5032 can make the movable port 5030 translate toward one side of the puncture sheath, thereby changing the axis of the inlet and outlet of the surgical instrument on the puncture sheath.

[0052] Please refer to, Figure 2 、 Figure 3 and Figure 6 When adjusting the moving range of the surgical instrument, first insert the surgical instruments in the left and right puncture sheaths respectively; then let the two instruments cross at the target area in the cavity as a starting reference.

[0053] The adjusting ring 5032 is rotated slowly to drive the movable port 5030 to translate along a predetermined direction, so that the inlet and outlet axes of the puncture sheath are misaligned.

[0054] As the translation amount gradually increases, the distance between the ends of the two instruments in the cavity increases accordingly, and the original degree of intersection can be seen to decrease step by step under the microscope.

[0055] When it is observed that the mutual interference between the two instruments at the target surgical site is significantly reduced and the operating channel is smooth, the adjustment is stopped and the position is maintained.

[0056] Through the above steps, without changing the incision and hole distance, the overlapping range of the two instruments can be reduced, sword collision and congestion can be alleviated, which is conducive to forming a more convenient two-handed coordination and visual exposure.

[0057] In addition, the present invention further includes a limiting portion 5023 disposed on the adjustment base 5020 and a limited portion 5034 disposed on the movable port 5030 .

[0058] The two form a physical stop interface during the adjustment process. When the movable port 5030 is translated to the preset limit along a predetermined direction, the limiting portion 5034 is reliably blocked by the limiting portion 5023, thereby preventing excessive translation and avoiding the surgical instrument losing the necessary rotation space at the sheath opening due to excessive port offset, resulting in an undesirable state where it is almost impossible to swing or difficult to align, thereby reducing the risk of jamming and misoperation.

[0059] The present invention and its embodiments are described above. This description is not restrictive. The drawings show only one embodiment of the present invention, and the actual structure is not limited thereto. In short, if a person skilled in the art is inspired by this and, without departing from the purpose of the present invention, designs structures and embodiments similar to this technical solution without inventiveness, they shall fall within the scope of protection of the present invention.

Claims

1. A puncture sheath with adjustable depth of ventilation for thoracoscopic thyroid surgery, comprising a puncture tube for establishing an instrument channel and a puncture core for inserting and removing the puncture core after establishing the channel, an insufflation valve provided on the puncture tube for introducing carbon dioxide into the cavity, and a sealing cap provided at the proximal end of the puncture tube for forming a seal when the instrument is inserted and removed, characterized in that: It also includes an adjustable port for adjusting the movement angle of the surgical instrument; the adjustable port includes a fixed base for supporting the connection, an adjustment base for setting the bias direction, and a movable port for causing the sheath port to be laterally displaced relative to the center of the puncture tube end to limit the movable range of the surgical instrument.

2. The adjustable depth ventilation puncture sheath for thoracoscopic thyroid surgery according to claim 1, characterized in that: The fixed base is provided with an annular slot for accommodating the adjustment base, and the adjustment base is provided with an annular inserting portion for rotating in the annular slot to set the bias direction.

3. The adjustable depth ventilation puncture sheath for thoracoscopic thyroid surgery according to claim 1, characterized in that: The movable port comprises an adjusting rod for guiding translation and a sheath port for forming an inlet and an outlet with the end of the puncture tube.

4. The adjustable depth ventilation puncture sheath for thoracoscopic thyroid surgery according to claim 3, characterized in that: The adjustment base is provided with a socket for cooperating with the adjustment rod, so as to realize linear sliding of the movable port relative to the adjustment base.

5. The adjustable depth ventilation puncture sheath for thoracoscopic thyroid surgery according to claim 3, characterized in that: The adjusting rod is provided with a threaded section, and the moving port is provided with an adjusting ring for cooperating with the threaded section to drive the moving port to translate.

6. The adjustable depth ventilation puncture sheath for thoracoscopic thyroid surgery according to claim 1, characterized in that: The adjustment base is provided with a limiting portion, and the movable port is provided with a limited portion that cooperates with the limiting portion for stopping, so as to limit the translation stroke of the movable port.

7. The adjustable depth ventilation puncture sheath for thoracoscopic thyroid surgery according to claim 1, characterized in that: The sealing cap is a cross-shaped silicone sealing valve used to form a close seal on the outer surface of the instrument when the instrument is inserted and removed to reduce gas leakage.

8. The adjustable depth ventilation puncture sheath for thoracoscopic thyroid surgery according to claim 1, characterized in that: The gas injection valve is a valve component used to connect to the pneumoperitoneum machine and open or close the gas passage as needed.

9. The adjustable depth ventilation puncture sheath for thoracoscopic thyroid surgery according to claim 1, characterized in that: A handheld portion is provided on the outside of the trocar tube for moving forward or backward in the subcutaneous tunnel to adjust the insertion depth.

10. The adjustable depth ventilation puncture sheath for thoracoscopic thyroid surgery according to claim 1, characterized in that: The adjustable port is used to appropriately misalign the inlet and outlet axes of the two surgical instruments to reduce the degree of intersection and mutual interference in the cavity.

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