Abdominal wall suspension surgical instrument assembly of air-free laparoscope

Abstract

The air-free laparoscope abdominal wall suspension surgical instrument assembly comprises a bed supporting frame, a cross rod fixing extension rod, an abdominal wall puncture outfit with a handle, a pull rope with a lock catch, a T-shaped foldable pull rod, a suspension rope and accessories of the suspension rope. The suspension rope can be quickly, simply and conveniently arranged on the abdominal wall through the abdominal wall puncture outfit with the handle, and the T-shaped foldable pull rod can directly, safely and controllably suspend the abdominal wall on the side abdominal wall; in the lock catch, a pushing and loosening pipe with a side hole pulls the side wall of a rope channel through a trapezoid body, and locking and loosening of the suspension rope and the hollow pull rod holding section are achieved by pushing a clamping strip or a clamping single ball or clamping double balls or clamping three balls. By means of the assembly, a pneumoperitoneum-free uniform intra-abdominal-cavity operation space can be rapidly, simply and safely established, the requirement of an endoscopic surgery is met, and complications related to pneumoperitoneum are avoided.

Description

Technical Field

[0001] The present invention belongs to the field of medical device technology, and develops a pneumoperitoneum and abdominal wall suspension surgical instrument assembly for laparoscopic minimally invasive surgery. Therefore, it is no longer necessary to use an inflation pump to pump CO2 gas into the abdominal cavity during minimally invasive abdominal surgery, and more importantly, it can also avoid various related complications caused by high CO2 abdominal pressure in the abdominal cavity. Specifically, it relates to a structural design and a technical method for using a pneumoperitoneum and abdominal wall suspension surgical instrument assembly for laparoscopic minimally invasive surgery. Background Art

[0002] At present, conventional laparoscopic minimally invasive surgery requires the injection of CO2 gas into the closed abdominal cavity, which raises the patient's diaphragm and affects the patient's cardiopulmonary function. It also compresses the patient's lower limb venous blood return, which is prone to deep vein thrombosis. Hypercapnia causes systemic multi-organ dysfunction and metabolic disorders in patients. Therefore, the search for pneumoperitoneum-free laparoscopic surgical instruments and the exploration of simpler, more convenient and efficient pneumoperitoneum-free surgical operation techniques have long been recognized by industry experts.

[0003] The current laparoscopic pneumoperitoneum-free surgical instruments are still immature, the operating techniques are complicated, the application of instruments is still inconvenient during use, and the total operation time is too long, indicating that this type of medical equipment for pneumoperitoneum-free abdominal wall suspension is imperfect and the technical methods are immature. Therefore, it is necessary to develop laparoscopic pneumoperitoneum-free minimally invasive surgical instruments that are quick, effective, and easy to operate, which can quickly and efficiently establish an effective operating space in the abdominal cavity. The types of surgical instruments and technical methods for laparoscopic pneumoperitoneum-free abdominal wall suspension surgery in the past include: skin negative pressure adsorption such as CN203591288U or adhesion suspension such as CN107837101A. This method is rarely used now because of insufficient adsorption or adhesion, unsatisfactory suspension for obese patients, and subcutaneous ecchymosis; skin occlusion suspension method CN208958195U, which uses occlusal forceps to lift the skin to drive the suspension of the abdominal wall. Due to the obvious occlusal tearing damage to the skin, it is less and less used in gynecological surgery; subcutaneous tissue steel needle penetration method such as CN201098106Y, which uses The steel needle pierces the skin and subcutaneous tissue and then suspends the abdominal wall, which causes obvious subcutaneous hematoma, ecchymosis and damage, and is gradually no longer used; the whole abdominal wall suspension method, such as CN109907785B, CN15881904A, etc., makes a small incision of 5-8 cm, inserts various right-angle metal suspension hooks, or inserts an incision traction protection device into the small incision, and traction The entire layer of the abdominal wall is used to establish an effective surgical operation space in the abdominal cavity. This method first requires a small incision, which does not conform to the concept of minimally invasive surgery. More importantly, it has the disadvantages and shortcomings of cumbersome instrument installation and operation, difficult and inconvenient application, and the placement of the main instrument parts easily affects the doctor's surgical operation.

[0004] Based on the current status of the prior art, the inventors of the present application intend to redesign and plan the structural design and application technical methods of existing such instruments, and provide a pneumoperitoneum-free abdominal wall suspension surgical instrument assembly, which can safely, efficiently, quickly and simply place the pneumoperitoneum-free abdominal wall suspension surgical instrument assembly, and explore new technical methods and processes for placing the pneumoperitoneum-free abdominal wall suspension instrument assembly. In particular, the most easily overlooked objective condition is that the instruments for placing the suspended abdominal wall are all performed in a state without pneumoperitoneum, which is different from conventional laparoscopic surgery in which the abdominal cavity has been inflated in advance to establish a huge intra-abdominal operating space. At this time, when the abdominal wall is in close contact with the abdominal viscera and intestinal tract, how can we see the structural relationship of various tissues and organs in the abdominal cavity, especially pay attention to the adhesion of the abdominal viscera and the inner side of the abdominal wall, avoid or even absolutely ensure that various installation operations will not cause secondary damage to the abdominal viscera. Therefore, the structural design of the pneumoperitoneum-free abdominal wall suspension instrument and the technical methods for its operation are crucial, and the structural design and use technical methods of the instrument assembly of the present invention can better achieve the above goals. Summary of the invention

[0005] The purpose of the present invention is to provide a gas-free laparoscopic abdominal wall suspension surgical instrument assembly to overcome the defects and deficiencies in the existing instrument structure design and application technology based on the current status of the existing technology and needs. The laparoscopic gas-free abdominal wall suspension surgical instrument assembly can solve the defects and shortcomings of the existing gas-free abdominal wall suspension technology in the manufacture of abdominal wall suspension equipment and the application technology method, and can efficiently, safely, quickly and simply complete the abdominal wall suspension operation without pneumoperitoneum in the abdominal cavity, and can avoid the current skin negative pressure suction abdominal wall suspension force is insufficient, the skin bite traction to tear the skin damage is obvious, the skin subcutaneous tissue steel needle penetration puncture caused excessive damage to the subcutaneous tissue, the intra-abdominal suspension needs to make a larger incision and need to place a more complex instrument system, the time-consuming and labor-saving pain points and the defects in the technical operation process and placement method. The design and application features of the gas-free laparoscopic abdominal wall suspension surgical instrument assembly of the present invention can be more conducive to the smooth implementation and smooth operation of the technical method, can effectively prevent and avoid the occurrence of abdominal wall and internal organ-related secondary injuries under gas-free conditions, and can shorten the placement time of the operation to the greatest extent.

[0006] The present invention provides a gas-free laparoscopic abdominal wall suspension surgical instrument assembly, which comprises a bed support frame 1, a crossbar fixed extension rod 2, an abdominal wall puncture device with a handle 3, a tension rope with a lock 4, a controllable T-shaped folding pull rod 5, a suspension rope 6 and an accessory 7. The invention is characterized in that the crossbar fixed extension rod 2, the abdominal wall puncture device with a handle 3, the tension rope with a lock 4, the controllable T-shaped folding pull rod 5, the suspension rope 6 and the accessory 7 constitute the characteristic main parts of the gas-free laparoscopic abdominal wall suspension traction fixation (see Figure 1 ).

[0007] In the present invention, the bed support frame 1 is composed of L-shaped vertically cross-arranged lifting rods, cross bars and fixings, and can also be a U-shaped bracket structure, which is firmly fixed to the bedside frames on both sides of the operating table by fixings. The height of the bed support frame 1 can be roughly adjusted by adjusting the fixings to maintain the stability and firmness of the bed support frame 1. In order not to affect the surgical operations in the upper abdomen, lower abdomen or pelvis, the bed support frame 1 is required to be placed away from the abdominal surgical area to avoid restrictions and interference on the surgical operations and arm range of motion of the operator. Therefore, the bed support frame 1 is generally required to be placed on the head side or tail side of the operating table, so that the interference effect of the L-shaped bed support frame 1 on the operator's operation will be smaller.

[0008] In the present invention, the directions of the full-thickness suspension and traction of the abdominal wall under laparoscopy without pneumoperitoneum are generally three directions. At the midline of the upper abdomen or lower abdomen, the suspension direction is vertically upward. At this time, the suspension rope 6 holds the full-thickness of the abdominal wall and supports the most solid midline white line of the abdomen, which minimizes the impact and damage on the abdominal wall tissue damage; at the midline position of the clavicles on both sides, it is necessary to suspend vertically upward in the upward left and right outer directions. Therefore, the placement and suspension direction of the suspension rope 6 need to be suspended in the area just above the surgical site and in the upward or upper outer directions on both sides of the abdominal wall to establish a more evenly distributed and widely distributed good and effective intra-abdominal operating space; in order to avoid lateral strain and compression of the full-thickness abdominal wall and skin by the suspension rope 6, it is required that the suspension rope 6 can vertically enter and exit the abdominal wall to reduce damage to the abdominal wall, and it is also required that the placement position and traction direction of the suspension rope 6 should not interfere with the operation of the operator holding the surgical instruments with both hands as much as possible.

[0009] In the present invention, the bed support frame 1 is installed on the cross bar of the operating bed. By sliding left and right along the cross bar and fixing a single or three cross bar fixed extension rods 2 at corresponding positions on the cross bar as needed, the suspension position of the suspension rope 6 above the patient's abdomen can be adjusted in the left and right directions according to the position and direction of the suspension rope 6; the extension rod 8 on the cross bar fixed extension rod 2 is vertically arranged and fixed on the cross bar, and the length of the extension rod 8 to be extended and retracted forward and backward in the direction of the navel can be adjusted by a rocker to provide the appropriate lifting position required to reach just above the operating area, and adjust the suspension position of the suspension rope 6 in front and behind the patient's abdomen; the cross bar fixed extension rod 2 is arranged on the circular cross bar of the bed support frame 1, and the cross bar fixed extension rod 2 can be rotated around the circular cross bar of the bed support frame 1 and can be fixed by tightening the fixing piece, and the traction height of the suspension rope 6 in the upper and lower directions of the patient's abdomen can be roughly adjusted up and down as needed, so that the three-dimensional direction of the cross bar fixed extension rod 2 can be adjusted to control the suspension position and traction direction of the suspension rope. The end of the extension rod 8 is intermittently provided with an annular groove 9 or a blocking protrusion 10 for selectively hanging the tension rope 4 with a lock buckle and the suspension rope 5 as needed. The annular groove 9 or the blocking protrusion 10 is provided to prevent the tension rope 4 with a lock buckle from slipping or shifting.

[0010] In the present invention, the tension rope 4 with a lock is composed of a lock 13 and a rope hook 14, a tension display 15, and a tension rope 16. The tension display 15 is placed adjacent to the rope hook 14 and is connected to the tension rope 16. The tension display 15 shows the size of the suspension pulling force of the tension rope 16 on the abdominal wall muscles when the abdominal wall muscles are relaxed under the action of muscle relaxants. It can also be divided into three segments of green, yellow and red segments for display, or directly display the tension value. The tension display 15 can find that the pulling force of the abdominal wall tension rope 16 is too large as early as possible, prevent the double damage to the abdominal wall muscle soft tissue that may be caused when the muscle relaxant effect decreases during the operation, and also be a useful real-time reminder of the reduction of the intra-abdominal operating space. The rope hook 14 can be provided with a protective buckle, and when the rope hook 14 hooks the rings 29 at both ends of the suspension rope 6, or the rope hook 14 passes around the horizontal axis or the extension rod 8 and hooks its own tension rope 16, the protective buckle can close the rope hook 14 to prevent accidental slippage.

[0011] In the present invention, in the pull rope 4 with a lock, the lock 13 is composed of a solid shell 17, left and right pull rope channels 18, a push-release tube 19, a positioning component 20, a spring 21 and a cap 22 (see Figure 2). In the cylindrical, elliptical or ∞-shaped solid shell 17, a tension rope channel 18 is provided on both sides. The main body of the tension rope channel 18 is a trapezoidal or conical channel, wherein the cap side of the tension rope channel 18 is a cylindrical structure, and the bottom of the tension rope channel 18 near the push-release tube nozzle 19-3 is a trapezoidal structure. The tension rope channel 18 is sequentially provided with a central hole cap (22), a spring (21), a push-release tube (19) and a clamping component (20) from top to bottom. The push-release tube 19 is a hollow funnel-shaped structure or a trapezoidal structure, and is arranged below the tension rope channel 18; at the bottom of the tension rope channel 18, an outlet of the push-release tube mouth 19-3 is arranged, and the slender tubular mouth 19-3 of the push-release tube partially extends out of the tension rope channel 18, and a section of the mouth 19-3 is exposed outside the solid shell 17, which is used to press the push-release tube 19; the body 19-2 of the push-release tube is a wide hollow cone-shaped structure, and the side wall of the push-release tube body 19-2 has 1-3 circular openings 23 for the insertion of the locking component 20; the body 19-2 of the push-release tube gradually widens from bottom to top, and a spring 21 is arranged above the widest push-release tube top 19-1, and a cap 22 is arranged above the spring 21, and there is a circular opening in the middle of the cap. The cap opening, the spring inner passage, the inner cavity of the funnel-shaped push-release tube and the inner cavity of the elongated tubular push-release tube mouth 19-3 are all correspondingly on the same axis. The cap opening and the inner diameter of the elongated tubular push-release tube mouth 19-3 are equal, and are both larger than the diameter of the suspension rope and the diameter of the gripping section of the hollow pull rod (31). The two push-release tubes 19 in the tension rope passages 18 on the left and right sides of the lock buckle 13 are arranged in opposite directions. The entire lock buckle 13 has a smooth and complete appearance, and only a part of the push-release tube mouth 19-3 protrudes from the tension rope passage 18 to the surface for pressing the push-release tube. The trapezoidal structure of the tension rope channel 18 is designed to provide the side wall of the tension rope channel 18 with a space-restricted and gradually increasing squeezing force on the locking component 20, such as the locking ball, and the fixed spacing between the tension rope channel 18, which has a cylindrical structure at the top of the tension rope channel 18, and the side wall of the push-release tube 19 ensures that the locking ball is placed between the circular opening (23) of the release tube body and the side wall of the tension rope channel 18. No matter how the push-release tube 19 moves up and down, and no matter whether the insertion and withdrawal of the tension rope 16 causes the locking ball to move outward, it will not cause the locking ball to fall off or slide out of control. The side wall opening (23) of the push-release tube is the point of action for controlling the locking component 20, such as the locking ball, to move up and down. The placement position of the locking ball and its active position across the side wall opening 23 of the release tube body 19 in the moving state are the structural basis for realizing the locking ball to the tension rope 16.

[0012] In the present invention, the locking component 20 in the lock 13 has four structures, namely, a locking strip 24, a locking single ball 26, a locking double ball 27, or a locking triple ball 28. The locking component 20 is located in the tension rope channel 18, inserted through the opening 23 of the side wall of the funnel-shaped push-relax tube 19 body, and close to the axis of the inner cavity of the funnel-shaped push-relax tube 19. The working principle is that by pressing the push-relax tube nozzle 19-3, the opening 23 of the side wall of the push-relax tube can realize the top opening and displacement of the locking component 20 and loosen its lock on the tension rope 16; after loosening the loose tube nozzle 19-3, the spring 21 arranged above continuously pressurizes the push-relax tube 19 and continuously moves it downward, so that the opening 23 of the side wall of the push-relax tube can realize the forced extrusion of the locking component 20 such as the locking ball and lock the tension rope 16.

[0013] Further, when the locking component 20 is a locking strip 24: when the locking strip 24 is an organic material such as hard nylon, the locking strip 24 is vertically arranged on the side wall of the tension rope channel 18 and extends in the axial direction, the free end of the locking strip 24 is arranged toward the cap side, the free edge of the locking strip 24 is inserted into the opening 23 of the side wall of the push-release tube, and is close to the axial centerline of the push-release tube 19, and the free end of the locking strip has fine teeth to lock the tension rope 16 passing through; When the locking strip 24 is made of metal material such as stainless steel, the locking strip 24 is vertically arranged on the side wall of the tension rope channel 18, and the metal locking strip 24 and the side wall of the tension rope channel 18 form a flip joint connection limited to 90 degrees, and the limited flipping direction is flipping toward the cap side. At this time, the middle section of the locking strip 24 is connected to the bottom of the tension rope channel 18 by a small spring 25, and the free edge of the locking strip 24 extends to the midpoint of the axis of the funnel-shaped push-release tube 19.

[0014] In order to realize the locking operation of the lock buckle 13 on the tension rope 16, the end of the tension rope 16 is inserted from the opening of the push-release nozzle 19-3, and the tension rope 16 will push the locking strip 24 to move toward the side of the cap; when the tension rope 16 passes through the locking strip 24 and the tension rope channel 18 and passes through the lock buckle 13, due to the inherent elasticity of the organic material of the locking strip 24 or the tension of the small spring on the metal locking strip, the biased placement of the locking strip 24 and the structural characteristics of the length being greater than the radius of the tension rope channel 18, the reverse locking of the tension rope 16 by the locking strip 24 becomes As the pressure gets tighter and tighter, the free end of the locking strip 24 will lock the tension rope 16 to complete the locking action; similarly, when the locking strip 24 has already locked the tension rope 16, when the mouth 19-3 of the loose tube is continuously pressed toward the cap direction by hand, the correspondingly moved opening 23 of the loose tube body will inevitably lift the locking strip 24 and deflect it toward the cap direction. Due to the inclined placement of the organic material locking strip 24 toward the cap side and the unidirectional flipping characteristics of the vertically placed metal locking strip 24 toward the cover plate, the locking effect of the locking strip 24 on the tension rope 16 can be easily released and loosened.

[0015] Furthermore, the single locking ball (26) or the double locking balls (27) or the triple locking balls (28) in the locking component (20) are all arranged across the side wall opening (23) of the push-release tube. When the locking component 20 is the single locking ball 26: at this time, the push-release tube 19 is a circular tubular structure, and a side wall opening 23 is arranged on the body; the single locking ball 26 always crosses the side wall opening 23 of the push-release tube, and the midpoint of the single locking ball (26) is located between the side wall of the ladder-shaped tension rope channel (18) and the side wall of the push-release tube (19), and can partially cross the side wall opening 23 and move in an offset direction; the diameter of the single locking ball (26) is slightly larger than the diameter of the side wall opening (23) of the push-release tube. Due to the action of the top spring and as the side wall of the conical tension rope channel (18) continuously squeezes the locking single ball (26), the locking single ball (26) will continuously deflect into the push release tube to lock the tension rope 16, but the locking single ball (26) will not completely cross the side wall opening (23) of the push release tube or fall into the inner cavity of the push release tube; similarly, the diameter of the locking single ball (26) is greater than the distance between the side wall of the ladder-shaped tension rope channel (18) and the side wall of the push release tube (19), so that the locking single ball (26) can never get rid of the control of the side wall opening (23) of the push release tube. When the push-to-relax tube nozzle 19-3 is pressed and the tension rope 16 is inserted, the push-to-relax tube side wall opening 23 drives the locking single ball 26 to move toward the cap side of the gradually widening trapezoidal tension rope channel (18). Therefore, the locking single ball 26 has more space to shift toward the side wall of the tension rope channel 18, and the tension rope 16 can smoothly push the locking single ball 26 through the inner cavity of the push-to-relax tube 19 and pass through the small hole of the cap 22 to get out of the lock buckle 13, thereby achieving the loosening and release of the tension rope 16 by the locking single ball 26. When the squeezing of the push-pull slack tube nozzle 19-3 is released, the single ball 26 will automatically shift into the cavity through the push-pull slack tube side wall opening 23 in the gradually narrowing tension rope channel 18, and lock the tension rope 16; as the tension rope 16 is further pulled back in the direction of the push-pull slack tube nozzle 19-3, the locking force of the single ball 26 on the tension rope 16 in the gradually narrowing conical tension rope channel 18 becomes stronger and stronger, and the lock becomes more secure. Its working principle is to use the side wall opening 23 of the push-pull slack tube to realize the up and down movement of the single ball 26 in the trapezoidal and conical tension rope channel 18, thereby realizing the secure locking of the tension rope 16. Similarly, when the locking single ball 26 has achieved locking of the tension rope 16, pressing the loose tube nozzle 19-3 in the direction of the cover cap 22 and pushing the loose tube side hole 23 will inevitably lift the locking single ball 26 and shift it toward the side wall of the gradually widening tension rope channel 18, thereby unlocking the locking effect of the locking single ball 26 on the tension rope 16.

[0016] Further, when the locking component 20 is a locking double ball 27: when the locking component is a double ball, the two single balls 27 are respectively placed on both sides of the side wall opening (23) of the push-release tube, and the two openings 23 are symmetrically placed on both sides of the push-release tube body 19-2; the two single balls 26 are located between the side wall of the ladder-shaped tension rope channel (18) and the side wall opening (23) of the push-release tube, and the midpoint of each small ball is located outside the wall of the push-release tube 19; the diameter of the side wall opening (23) of the push-release tube is slightly smaller than the diameter of the locking double ball (27), and the single ball can be displaced into the cavity of the release tube 19 by a distance of nearly the radius, but the single ball will not roll into the release tube; the distance between the side wall of the tension rope channel 18 and the side wall of the push-release tube 19 is smaller than the diameter of the single ball, and when installing the two single balls, pins need to be respectively placed on the side wall of the tension rope channel 18 close to the position of the single ball for insertion and fixing.

[0017] Furthermore, when the positioning component 20 is a three-position positioning ball 28: three push-release tube body side holes 23 are evenly spaced on the same plane of the hollow funnel-shaped push-release tube body 19-2, and the three side holes are spaced 120 degrees apart and arranged on the same plane; the three positioning balls 28 are placed in the tension rope channel 18 across the tube wall of the push-release tube side hole 23, and the midpoints of the three single balls are in the push-release tube 19. Due to the limiting spacing effect of the push-release tube side hole 23, the three positioning balls 28 are limited to the same plane, and at the same time, with the help of the mutual support between the three positioning balls 28, they are limited to move up and down on the same plane of the push-release tube side wall opening 23 without scattering, and the three positioning balls 28 will not exceed and roll out of the plane defined by the push-release tube side wall opening 23 and lose control. When the tension rope 16 is inserted from the push-to-relax tube nozzle end 19-3 of the lock buckle 13, the mouth 19-3 of the push-to-relax tube is pressed with a finger, and the push-to-relax tube 19 is shifted toward the cap 22 of the continuously widening tension rope channel 18, so that the gap between the three locking balls 28 is increased. Therefore, the three locking balls 28 all move to the outside of the side wall opening 23 of the release tube, so that the tension rope 16 or the gripping section of the hollow pull rod 31 has the opportunity to pass through the gap between the locking balls 27, pass through the inner cavity of the push-to-relax tube 19 and then pass out of the lock buckle 13; when the squeezing of the push-to-relax tube nozzle 19-3 is released, due to the continuous downward squeezing of the push-to-relax tube 19 by the top spring 21, the side wall opening 23 of the push-to-relax tube drives the three locking single balls 28 to squeeze the inserted tension rope 16 with increasing force; as the side wall of the cone of the tension rope channel 18 becomes narrower and narrower, the lock buckle becomes more secure. When the three locking balls 28 have already locked the tension rope 16, when the release tube nozzle 19-3 is pressed toward the cap 22 side again, the side hole 23 of the release tube will inevitably drive the three locking balls 28 to move toward the top of the tension rope channel 18 which is gradually widening, and the gaps between the three locking balls 28 will gradually increase, thereby loosening the combined extrusion and locking effect of the three locking balls 28 on the tension rope 16.

[0018] The most important application background of the present invention is that the surgical instrument assembly must suspend and pull up the abdominal wall under the condition of pneumoperitoneum-free. At this time, the entire abdominal wall is in close contact with the abdominal viscera and the intestinal tract. Therefore, it is crucial to start inserting and placing the suspension instrument assembly under the initial condition of pneumoperitoneum-free, especially the first or second step, and how to prevent the damage to the internal organs when the instrument enters the abdominal cavity. The pneumoperitoneum-free abdominal wall suspension technical method developed by the present invention adopts a method of vertically suspending the full-thickness abdominal wall. This method requires that the suspension rope is vertically in and out of the full-thickness abdominal wall, so that the damage to the abdominal wall and skin tissue is minimized, and the compressive cutting damage to the skin and muscles during suspension is also minimized. The present invention adopts an extended cannula puncture device 3 with a handle of 10mm outer diameter (see Figure 5 ), which is composed of a tube core, an outer sleeve 11 and a handle 12. By holding the handle 12 of the extended sleeve puncture device 3 with a handle and twisting it to flip the opening of the puncture device upward, the entire layer of the abdominal wall is separated from the intestinal viscera, ensuring that the needle of the subsequent puncture needle sleeve can vertically penetrate into the outer sleeve 11 of the puncture device; at the same time, the direction of the opening bevel of the outer sleeve 11 of the puncture device 3 is consistent with the direction of the handle 12, ensuring that the opening bevel of the outer sleeve 11 is upward, and the wall of the outer sleeve 11 plays a role in protecting the inserted puncture needle from damaging the abdominal viscera. Therefore, a handle 12 is arranged at the end of the extended sleeve puncture device 3 with a handle, and the handle 12 is 45 degrees to 90 degrees with the outer sleeve 11, which is more conducive to the puncture device outer sleeve opening 11 to tilt up and push up the abdominal wall. The slight structural changes such as the arrangement of the handle 12 at the end of the puncture device 3 and the change of the opening direction of the puncture device outer sleeve 11 can achieve the effect that conventional laparoscopic puncture devices and other sleeves cannot achieve, and effectively avoid the possibility of damage to internal organs in the blind state in the abdominal cavity and without the assistance of effective auxiliary instruments.

[0019] In the present invention, in view of the fact that the currently commonly used inflatable laparoscopic abdominal wall puncture device has no handle and has an air inlet valve, the force of grasping and twisting the air inlet valve is not enough to satisfactorily lift the puncture device opening upwards, and at the same time, in order to optimize the air inlet flow, the opening directions of all current puncture devices are set to be opposite to the placement direction of the air inlet pipe. The present invention can also structurally change the currently commonly used extended laparoscopic abdominal wall puncture device, change the opening direction of the currently commonly used puncture device to a side structure facing the air inlet direction, and then use the force to hold the connection between the air inlet pipe and the air inlet valve to lift and twist the opening of the abdominal wall puncture device. The structural modification of the currently commonly used inflatable laparoscopic abdominal wall puncture device can also achieve a good lifting effect for patients with thin abdominal walls, which is conducive to the safe insertion of the puncture needle and is also within the protection of the present invention.

[0020] In the present invention, in the outer sleeve 11, under the protection of the inclined surface of the opening of the outer sleeve 11 facing the abdominal wall, or with the guidance of the endoscope light spot in the outer sleeve 11, the linear abdominal wall puncture trocar 37 or the type B abdominal wall puncture trocar 38 in the attachment is directly and vertically inserted into the opening of the outer sleeve 11 of the puncturer; further, the type B abdominal wall puncture trocar 38 is used to directly pierce the skin and vertically penetrate the entire layer of the abdominal wall into the outer sleeve 11 at one time, and the outer sleeve 11 is moved to the position where the abdominal wall is to be pierced, and the handle 40 of the type B abdominal wall puncture trocar 38 is held and twisted upward, and the needle head of the type B abdominal wall puncture trocar 38 is directly and vertically penetrated through the skin by force, and then the needle core of the type B abdominal wall puncture trocar 38 is removed. The type B abdominal wall puncture trocar 38 is configured as a circular arc-shaped cannula puncture thick needle with a handle 40, and has a circular arc-shaped puncture needle core; the circular arc of the circular arc-shaped cannula puncture needle core is 90-180 degrees, so that the puncture needle can complete the vertical puncture and vertical puncture of the entire abdominal wall layer in one operation on the same abdominal wall plane. The 90-180 degree circular arc design of the puncture needle and the tail handle 40 of the type B abdominal wall puncture trocar 38 make it easier for the puncture trocar to complete the vertical puncture through the entire abdominal wall in one operation on the same plane. The invention is convenient, simple and easy to operate, especially vertically penetrating the whole layer of the abdominal wall can minimize the trauma to the abdominal wall tissue; a handle 40 is vertically arranged at the needle tail of the type B abdominal wall puncture trocar 38 away from the center of the circle, and the direction and angle of the needle insertion can be controlled by holding the handle 40 by torque. This slight change in the structure of the abdominal wall puncture trocar 38 can achieve the operation of puncturing and penetrating the whole layer of the abdominal wall in one go in the same plane under blind vision, overcoming the operation of entering and exiting the abdominal wall that cannot be completed under the condition of pneumoperitoneum, and it is more difficult to safely pass through the whole layer of the abdominal wall at one time.

[0021] In the present invention, the suspension rope 6 is a long cylindrical structure, the surface of the suspension rope 6 is smooth and uniform, and can also be made of an organic material with hard texture at both ends and soft texture in the middle. The texture of the suspension rope 6 can adapt to the curvature of the puncture needle and can smoothly pass through the puncture needle tube (see Figure 4 ); there are longitudinal slits 28 at both ends of the suspension rope 6, and after the slits are opened, the two ends of the suspension rope 6 become rings 30; the rings 29 at both ends of the suspension rope 6 are pinched together to reposition and restore to a whole cylindrical suspension rope 6. Such a structural design of the suspension rope 6 makes it possible to simultaneously pass through the tiny puncture trocar lumen and suspend the abdominal wall, which becomes easy; when suspending the abdominal wall, the slits at both ends are opened to make the two ends of the suspension rope 6 become rings 30, so that the rope hook 14 of the tension rope can be hooked up for suspension.

[0022] Furthermore, after the suspension rope 6 is retracted, the suspension rope 6 will cause compression injuries to the skin and abdominal wall between the two inlets and outlets. Figure 6)'s adjustable support rod 39 is placed between the two ends of the suspension rope 6, close to or close to the skin. The length of the support rod 39 is adjusted to be equal to or close to the distance between the entry point and the exit point of the suspension rope 6 to avoid secondary damage to the skin and abdominal wall tissue caused by the contraction force of the suspension rope 6.

[0023] In the present invention, the technical method for placing the gas-free laparoscopic abdominal wall suspension surgical instrument assembly is based on the fact that the midline of the upper abdomen or lower abdomen has been suspended by the suspension rope 6 in the first step. How to further place the suspension instrument assembly in the second step is also crucial. At this time, there is no other instrument in the abdominal cavity to provide assistance: a controllable T-shaped foldable pull rod 5 is used to complete the next step of the operation. The controllable T-shaped foldable pull rod 5 is composed of a hollow pull rod 31, a movable positioning pin 32, a foldable head end cross bar 33 and a pulling wire 34 (see Figure 3 ); further, the entire hollow rod 31 has a small inner cavity extending from the gripping end to a distance approximately equal to half the distance from the end of the hollow rod 31 to the head end cross bar 33, and a small opening 35 is formed on each side wall of the hollow rod 31, which is connected to the inner cavity of the hollow rod 31; the midpoint of the foldable head end cross bar 33 is connected to the hollow rod 31 to form a movable joint, the head end cross bar on one side is a solid tubular 33-1, and the other side is a solid semi-tubular 33-2, and the head end cross bars on both sides are There are fine holes 36 at the proximal ends of 33. The semi-tubular head end pull rod 33-2 and the front section of the hollow pull rod 31 can be folded together to form a circular tube. The diameter of the folded circular tube is the same as the diameter of the solid tube 33-1 of the head end cross bar. Two pulling wires 34 pass through the fine holes 36 at the proximal ends of the foldable head end cross bar, respectively through the openings 35 on both sides of the hollow pull rod near the movable positioning pin, and enter the inner cavity of the hollow pull rod 31 and meet and connect and fix at the gripping end of the hollow pull rod 31. The gripping section of the hollow pull rod 31 has horizontal or oblique stripes. How to achieve the folding or unfolding control of the head end cross bar of the controllable T-shaped foldable pull rod 5 without the help of any auxiliary equipment in the abdominal cavity is very important and is also an important part of determining the establishment of intra-abdominal space without pneumoperitoneum. The feature of the present application is that the effective opening and closing control of the head end cross bar 33 is achieved by connecting the pulling wire 34 at the end of the hollow pull rod 31.

[0024] The results of use show that the pneumoperitoneum-free abdominal wall suspension surgical instrument assembly of the present invention can effectively establish a wider and more uniform intra-abdominal surgical operation space by suspending three corresponding areas requiring surgical operations, namely the middle of the anterior abdominal wall and the two lateral abdominal walls. With the help of muscle relaxants, the establishment of the intra-abdominal operation space is more sufficient, wider and more uniform, and the effect of the intra-abdominal free space that cannot be achieved by the area around the incision is achieved by other pneumoperitoneum-free technical methods including the small incision suspension method, which is limited to the intra-abdominal free space; compared with the traditional inflation method, the effect of the established intra-abdominal free space is the same. In addition, the pneumoperitoneum-free abdominal wall suspension surgical instrument assembly also avoids the inevitable defects of low temperature, cancer cell dissemination, lens fogging, etc. in the establishment of pneumoperitoneum by inflation method, and can avoid metabolic disorders and effects on cardiopulmonary function caused by high pressure of CO2 in the abdominal cavity, and can also prevent the fogging effect of the endoscope lens caused by airflow, so as to better enable laparoscopic surgery to run smoothly, steadily and safely.

[0025] Compared with the prior art, the pneumoperitoneum-free abdominal wall suspension surgical instrument assembly has the following advantages:

[0026] (1) Other existing pneumoperitoneum-free abdominal wall suspension technologies include the use of negative pressure adsorption or adhesive adhesion to pull the skin, grasping the skin with forceps, piercing the skin and subcutaneous tissue with metal bars to suspend, inserting instruments into the abdominal cavity through small incisions to hook and suspend the abdominal wall, etc. The purpose is to suspend the abdominal wall under pneumoperitoneum-free conditions and establish sufficient laparoscopic surgical operation space in the abdominal cavity. Negative pressure or adhesive adsorption or adhesion to pull the skin, because it relies on negative pressure or adhesive to pull the skin, it is easy to cause skin petechiae and edema, and the effect of suspending and pulling the abdominal wall is not good, especially for obese patients; while the pneumoperitoneum-free abdominal wall suspension surgical instrument assembly of the present invention has the least impact on the skin, leaving only the wound of the puncture needle hole, and basically no scars, and because it is the suspension and traction of the entire layer of the abdominal wall, the effect of establishing the intra-abdominal operation space is better, which fully meets the requirements of laparoscopic surgery.

[0027] Grasping and lifting the skin with forceps has been tried out in obstetrics and gynecology for many years, but now fewer doctors use it. Grasping and lifting the skin with three forceps, a longer time and a greater pulling force will lead to the continuous expansion of skin tears, especially when the effect of muscle relaxants decreases and the muscles contract, the skin tears are easy to tear and expand, and it is not effective for obese patients. The pneumoperitoneum-free abdominal wall suspension surgical instrument assembly of the present invention uses the suspension rope 6 to vertically enter and exit the entire layer of the abdominal wall, and the suspension rope covers the entire abdominal wall, so it will not cause tearing damage to the skin wound. The suspension of obese patients is simple and easy, and the suspension effect is equally good.

[0028] Using a metal bar to pierce through the skin and subcutaneous tissue can easily lead to subcutaneous bleeding and hematoma, causing great damage to the abdominal wall and significantly increasing the chance of infection. The pneumoperitoneum-free abdominal wall suspension surgical instrument assembly of the present invention will not cause large-scale sheet-like damage to the abdominal wall tissue, and the strongest suspension tension is the strongest fibrous connective tissue at the midline white line of the abdomen, causing minimal damage.

[0029] A small incision of 5-8 cm is required to insert the suspension instrument through a small incision to hook up the entire layer of the abdominal wall. The instrument is inserted through the incision to hook up the surrounding abdominal wall to achieve the suspension of the abdominal wall. The suspension range is small, and the effective surgical operation space established in the abdominal cavity is relatively small. In addition, the excessive suspension only around the navel causes the defect of a wider contact surface between the abdominal walls on both sides and the intestinal tract. The pneumoperitoneum-free abdominal wall suspension surgical instrument assembly of the present invention does not require an incision, achieving a truly non-invasive incision. All operations are completed by placing a puncture needle that vertically penetrates the entire layer of the abdominal wall, without any damage to the abdominal wall tissue. The damage is reduced to a minimum. At the same time, the traction suspension points are located at three points, namely the midline of the abdominal wall and the midlines of the clavicles on both sides in the surgical area. Therefore, the traction points and traction ranges of the abdominal wall are more evenly dispersed, and a wider and more uniform operating space is established in the abdominal cavity. The traction force in different areas of the abdominal wall can also be monitored and adjusted according to surgical needs, so as to fully achieve the purpose of establishing a uniform and sufficient intra-abdominal operating space, which is not available in other pneumoperitoneum-free abdominal wall suspension technologies and instruments and cannot be achieved. The effect of a uniform and consistent intra-abdominal operating space established by sufficient inflation is fully achieved.

[0030] (2) The whole process of placing the abdominal wall suspension surgical instrument assembly without pneumoperitoneum of the present invention causes minimal damage to the abdominal wall. During the traction process, since there is a tension display 15 on the tension rope 4 with a lock buckle that plays a traction role, the magnitude of the tension on the abdominal wall can be displayed to prevent excessive traction injury to the abdominal wall. In particular, when the efficacy of anesthetic muscle relaxants decreases, the entire abdominal wall muscles will involuntarily contract and cause iatrogenic traction injury to the abdominal wall. This can remind the anesthesiologist to add muscle relaxants to prevent secondary damage to the abdominal tissue. Therefore, the traction and suspension force of the abdominal wall can be dynamically monitored and the risk value can be predicted.

[0031] (3) The first insertion of the first abdominal wall suspension is the most difficult operation. This is because the abdominal wall and gastrointestinal viscera are in close contact in the pneumoperitoneum-free state, and direct puncture is likely to cause visceral damage. At the same time, it is also impossible to completely avoid adhesions between the intestine and the abdominal wall in patients with a history of surgery. These factors are the main reasons that limit the current development of pneumoperitoneum-free abdominal wall suspension technology. The elongated cannula puncture instrument 3 with a handle used in the pneumoperitoneum-free abdominal wall suspension surgical instrument assembly of the present invention can clearly see the abdominal wall inside the abdominal cavity under the guidance of an endoscope; a handle 12 is arranged at the end of the cannula puncture instrument 11, which can effectively lift the opening of the outer cannula puncture instrument 11 upward, avoiding contact and damage with the abdominal organs, and can also protect the puncture cannula needle 37 from safely and quickly entering and leading out of the full layer of the abdominal wall to complete the suspension operation; the structural design of the head end of the outer cannula 11 facing the direction of the handle 12 provides an absolute safety guarantee for the one-time penetration of the cannula puncture needle 11 through the abdominal wall and preventing damage to the internal organs, especially the intestinal tract, which is also the reason why all current pneumoperitoneum-free abdominal wall suspension technologies must first make a small abdominal incision and need to clearly see the adhesion situation in the abdominal cavity before operating. The present invention achieves the clinical operation needs of smoothly and safely realizing abdominal wall puncture suspension under pneumoperitoneum-free conditions by changing the structural design of the puncture instrument, which is also the simplest and safest technical method to operate among all current pneumoperitoneum-free abdominal wall suspension technologies.

[0032] (4) The controllable T-shaped foldable pull rod 5 inserted into the second abdominal wall suspension surgical instrument assembly for pneumoperitoneum-free operation of the present invention is also required to be able to independently realize the controllable closing and folding operation of the foldable head end cross bar 33 in the abdominal cavity without the help of any auxiliary instruments. At this time, the abdominal wall only has the first suspension rope at the midline of the abdomen, and the umbilical Trocar can be used for the insertion and lighting of the laparoscope lens. No surgical instrument is inserted into the abdominal cavity to help the T-shaped foldable pull rod 5 complete the controllable flipping of the foldable head end cross bar 33, and the I-shaped hollow pull rod is placed in the abdominal cavity. 31 becomes a T-shape. The present invention arranges pulling wires 34 at both ends of the head end cross bar 33 of the T-shaped foldable pull rod 5, thereby realizing abdominal wall puncture, controllable flipping, pulling and suspension at any position of the abdominal wall. The opening and folding of the head end cross bar 33 of the T-shaped foldable pull rod 5 can be controlled by the pulling wire 34, and the opening and folding of the controllable T-shaped foldable pull rod 5 after insertion through the abdominal wall and the operation of pulling out the abdominal wall become the simplest and fastest, which is impossible to achieve with other pneumoperitoneum-free abdominal wall suspension technologies and is also the most minimally invasive and simplest technical method for abdominal wall suspension.

[0033] (5) The pneumoperitoneum-free abdominal wall suspension surgical instrument assembly has three abdominal wall suspension areas, namely the midline of the abdominal wall and the left and right abdominal walls. With the assistance of muscle relaxants, the free space created in the abdominal cavity is wider and more uniform, meeting the needs of laparoscopic surgery and avoiding the defects of other pneumoperitoneum-free suspension technologies, such as insufficient suspension or only satisfactory suspension of the small incision area but insufficient establishment of other free abdominal cavities.

[0034] (6) The pneumoperitoneum-free abdominal wall suspension surgical instrument assembly can control the left and right movement of the three suspension ropes 6 in the entire abdominal wall traction position by the left and right movement of the cross-bar fixed extension rod 2 on the cross-bar; the cross-bar fixed extension rod 2 can be adjusted to extend or retract toward the navel direction, which can control the front and back movement of the suspension rope 6 in the entire abdominal wall traction position; the rotation fixation of the cross-bar fixed extension rod 2 on the cross-bar can control the up and down movement of the suspension rope 6 in the entire abdominal wall traction height. This initial adjustment of the three-dimensional traction direction is not available in other pneumoperitoneum-free abdominal wall suspension technologies. Through this pre-adjustment plus the fine adjustment of the lock buckle, the three traction suspensions of the abdominal wall can be adjusted on demand in real time.

[0035] (7) Compared with the skin negative pressure adsorption or adhesion method, the skin occlusion suspension method, and the subcutaneous steel needle penetration method, the whole abdominal wall suspension method of the present application causes the least damage to the abdominal wall tissue; among the whole abdominal wall suspension methods, the trocar skin puncture method of the present application causes the least damage to the abdominal wall tissue, and the minimally invasive method leaves almost no scars, thus avoiding the impact of small incisions on the integrity of the abdominal cavity; the free abdominal cavity space established by the suspension of the three areas of the abdominal wall in the present application is more uniform and sufficient, thus avoiding the conventional whole abdominal wall suspension method of only suspending one point on the midline of the abdominal wall; in these four aspects, the combined instrument design and technical method of the present application is the simplest, most time-saving, safe and convenient, and significantly exceeds all the current pneumoperitoneum-free abdominal wall suspension instruments and technical methods. BRIEF DESCRIPTION OF THE DRAWINGS

[0036] Figure 1 The pneumoperitoneum-free abdominal wall suspension surgical instrument assembly of the present invention;

[0037] Figure 2 Schematic diagram of the lock structure of the present invention, (a) the locking component is a locking strip, (b) the locking component is a locking single ball, (c) the locking component is a locking double ball, (d) the locking component is a locking triple ball;

[0038] Figure 3 Schematic diagram of the controllable T-shaped folding pull rod structure of the present invention

[0039] Figure 4 This is a schematic diagram of the suspension rope structure of the present invention;

[0040] Figure 5Schematic diagram of the structure of the abdominal wall puncture device with a handle according to the present invention, (a) an outer sleeve of the abdominal wall puncture device with a handle, (b) the abdominal wall puncture device with a handle;

[0041] Figure 6 Schematic diagram of the structure of (1) a linear abdominal wall puncture trocar, (2) a S-shaped abdominal wall puncture trocar and (3) an adjustable support rod in the accessories described in the present invention.

[0042] Figure numerals: 1, bed support frame, 2, horizontal bar fixing extension rod, 3, abdominal wall puncture device with handle, 4, tension rope with lock, 5, controllable T-shaped folding pull rod, 6, suspension rope, 7, accessories, 8, extension rod, 9, annular groove, 10, blocking protrusion, 11, outer sleeve of abdominal wall puncture device, 12, handle, 13, lock, 14, rope hook, 15, tension display, 16, tension rope, 17 solid shell, 18, left and right tension rope channels, 19, push-release tube, 19-1, top of push-release tube, 19-2, push-release tube body, 19-3, push-release tube mouth, 20, clamping part Parts, 21. Spring, 22. Cover cap, 23. Opening on the side wall of the push-loose tube, 24. Positioning strip, 25. Small spring, 26. Positioning single ball, 27. Positioning double balls, 28. Positioning three balls, 29. Longitudinal slit, 30. Ring, 31. Hollow pull rod, 32. Movable positioning pin, 33. Foldable head end cross bar, 33-1. Solid tubular structure, 33-2. Solid semi-tubular structure, 34. Pull line, 35. Hole in the wall of the hollow pull rod, 36. Thin hole near the end of the head end cross bar, 37. Straight abdominal wall puncture trocar, 38. S-shaped abdominal wall puncture trocar, 39. Adjustable support rod, 40. Holding handle. DETAILED DESCRIPTION

[0043] Example:

[0044] A fixed bed support frame 1 is placed near the head of the operating table, and the height of the crossbar is adjusted. The crossbar fixing extension rod 2 is shifted to the middle of the crossbar, which is equivalent to the horizontal fixation of the patient's upper abdominal midline. After a 1 cm small incision is made next to the umbilicus and the abdomen is entered under direct vision, an abdominal wall puncture device 3 with a handle is inserted under direct vision, the tube core is removed and the outer sleeve 11 is retained, and the laparoscope lens is inserted to observe whether there is intestinal adhesion on the inner surface of the abdominal wall. If there is no adhesion, the handle 12 at the end of the puncture device is grasped and twisted upward, and the opening of the outer sleeve 11 is turned upward with the help of the handle 12. At this time, the inclined surface of the opening of the outer sleeve 11 will therefore push up the abdominal wall. At this time, regardless of the patient's fatness or thinness, the opening of the elliptical outer sleeve 11 can be palpated on the skin surface, and the light of the laparoscope lens of the lens can be seen. The linear abdominal wall puncture trocar 37 needs to be inserted in two steps: under the protection of the outer sleeve 11, move to the intended insertion point of the first suspension rope 6, such as the midline of the upper abdominal wall (the upper third of the line connecting the umbilicus and the xiphoid process) as the insertion point, and use the linear abdominal wall puncture trocar 37 to directly and vertically penetrate the abdominal wall into the inner cavity of the outer sleeve 11. Due to the protection of the outer sleeve wall, there will be no risk of damage to surrounding tissues and organs, and the outer sleeve 11 will be led out of the skin from the umbilicus incision; remove the needle core of the linear puncture trocar 37, insert the suspension rope 6 into the inner cavity of the puncture trocar 37, lead it out of the skin from the small umbilicus incision, and pull out the outer sleeve of the puncture trocar 37; then select the midline of the upper abdomen 2 cm away from the umbilicus as the second puncture point, reinsert the outer sleeve 11 of the abdominal wall puncture device 3 with a handle through the umbilicus, with the tip bevel facing the second puncture point, and use the linear abdominal wall puncture trocar 37 to vertically puncture the abdominal wall Enter the puncture device outer sleeve 11, as the puncture device 11 is led out from the umbilical incision again, one end of the suspension rope 6 led out from the aforementioned umbilical incision is inserted from the needle tip direction of the abdominal wall puncture cannula needle 37 at the second puncture point, and led out of the skin from the needle seat direction, and the cannula of the abdominal wall puncture cannula needle 37 is removed, so that the suspension ropes 6 on both sides are pulled and tightened to complete the placement of the first suspension rope on the midline of the upper abdomen; the adjustable support rod 39 can be placed close to the skin between the suspension ropes 6 to prevent the suspension ropes 6 from being closed and causing secondary damage to the skin and abdominal wall; the longitudinal slits 29 at both ends of the suspension rope 6 are opened to form a circular ring 30, and the rope hook of the tension rope 4 with a lock buckle is taken to hook the ring 30 of the suspension rope 6, and the tension rope 4 passes through the tension rope channel 18 on one side of the lock buckle 13, bypasses the annular groove 9 at the end of the cross bar fixed extension rod 2, and then passes through the tension rope channel 18 on the other side. The push-release nozzle capillary 19-3 in the pressing lock 13 realizes precise control of the suspension height of the tension rope 6 and can be adjusted in real time as needed.

[0045] The puncture point is at the midpoint between the umbilicus and the xiphoid process on the left upper abdomen midclavicular line. Under the guidance of the laparoscope lens, use the linear abdominal wall trocar 37 to puncture the entire abdominal wall and enter the abdominal cavity; if there is intestinal coverage, the extended abdominal wall puncture device outer sleeve 11 with a handle can be used to reach the intended puncture point, and the linear abdominal wall trocar 37 is used to vertically puncture the entire abdominal wall and enter the outer sleeve 11 of the abdominal wall puncture device 3 with a handle, and the puncture needle core is pulled out, and the type I controllable foldable pull rod 5 is inserted. After the abdominal wall puncture device outer sleeve 11 is pulled out, the solid tubular structure 33 of the foldable head end cross bar 33 is pulled and controlled at the gripping end of the hollow pull rod 31. -1 pulling line 34, so that the foldable head end pull rod 33 and the hollow pull rod 31 are turned into a T shape; pull the hollow pull rod 31, and insert its gripping section into the lock 13 of the pull rope 4 with a lock, to complete the second suspension traction; the pull rope of the pull rope 4 with a lock passes around the annular groove 9 at the end of the cross bar fixed extension rod 2 and is hooked by its own rope hook, and the gripping end of the hollow pull rod 31 is inserted into the push-release tube mouth 19-3 of the lock 13, and the mouth thin tube 19-3 is pressed to achieve precise control of the suspension height of the pull rope 6. Finally, two Trocars are placed 2cm below the costal arch on the anterior axillary line and at the level of the umbilicus according to routine. At the end of the operation, the pulling wire 34 of the solid semi-tubular structure 32-2 of the foldable head end cross bar 32 is pulled at the end of the hollow pulling rod 31, so that the T-shaped foldable pulling rod 5 is folded into an I-shaped foldable pulling rod 5, and the I-shaped foldable pulling rod 5 can be directly pulled out from the abdominal wall.

[0046] The puncture entry point is 2 cm below the costal arch in the midclavicular line of the right upper abdomen. Under the guidance of the laparoscope lens, a type B abdominal wall puncture trocar 38 is used to puncture the entire abdominal wall vertically into the abdominal cavity. The midclavicular line of the right upper abdomen near the umbilicus is used as the puncture exit point. Relying on the torque generated by the gripping handle 40 on the type B abdominal wall puncture trocar 38, the entire abdominal wall is vertically pierced. After the needle core is pulled out, the suspension rope 6 is inserted to complete the placement of the right upper abdomen suspension rope. At this time, if the intestinal tract covers and blocks the puncture point, the small intestine can be easily pushed away with the help of the established left Trocar surgical forceps; the suspension rope 6 is suspended and pulled in the same way, and finally two Trocars are placed 2 cm below the costal arch in the anterior axillary line and at the umbilicus.

[0047] It is common knowledge in the technical field of the present invention. An electrocoagulation device can be added without departing from the spirit and scope of the present invention. The operating tube is wrapped with insulating material and can be connected to the electrocoagulation device, which is also within the protection of the present invention. Various changes and adjustments are also within the protection of the present invention.

[0048] The above description is only a specific implementation mode of the present invention, but the protection scope of the present invention is not limited thereto. Any changes or substitutions that can be easily thought of by any technician familiar with the technical field within the technical scope disclosed in the present invention should be covered within the protection scope of the present invention.

Claims

1. An instrument assembly for gas-free laparoscopic abdominal wall suspension surgery, comprising a bed support frame (1), a crossbar fixing extension rod (2), an abdominal wall puncture device with a handle (3), a tension rope with a lock (4), a controllable T-shaped foldable pull rod (5), a suspension rope (6) and its accessories (7), It is characterized in that The crossbar fixing extension rod (2), the abdominal wall puncture device with a handle (3), the tension rope with a lock (4), the controllable T-shaped foldable pull rod (5), the suspension rope (6) and the accessories (7) constitute the main parts of the pneumoperitoneum-free abdominal wall suspension traction.

2. According to the gas-free laparoscopic abdominal wall suspension surgical instrument assembly of claim 1, the abdominal wall puncture device (3) with a handle is an extended cannula puncture device with an inner diameter of 10 mm, which is composed of a core tube, an outer cannula and a handle. It is characterized in that A handle (12) is arranged at the end of the outer sleeve (11), the inclined surface of the head end of the outer sleeve (11) faces the side direction of the handle (12), and the handle (12) and the outer sleeve (11) form an angle of 45 degrees to 90 degrees.

3. According to the gas-free laparoscopic abdominal wall suspension surgical instrument assembly of claim 1, the tension rope (4) with a lock is composed of a lock (13), a rope hook (14), a tension indicator (15), and a tension rope (16). It is characterized in that The lock buckle (13) is composed of a solid shell (17), left and right tension rope channels (18), a push-release tube (19), a locking component (20), a spring (21) and a cover cap (22).

4. The lock (13) according to claim 4, It is characterized in that The tension rope channel (18) in the lock buckle (13) is a trapezoidal channel, and is provided with a cap (22) with a central hole, a spring (21), a push-release tube (19) and a locking component (20) in sequence from top to bottom.

5. The push-release tube (19) according to claim 4, It is characterized in that The push-release tube (19) in the lock buckle (13) is in the shape of a hollow funnel or a circular tube; the top (19-1) of the push-release tube close to the spring side is the widest, the push-release tube body (19-2) gradually narrows to form a conical trapezoidal structure, the side wall of the push-release tube body (19-2) has 1-3 circular openings (23), the push-release tube mouth (19-3) is in the shape of a slender tube, and part of the mouth (19-3) protrudes from the bottom opening of the tension rope channel (18) to the surface of the solid shell (17).

6. The locking element (20) according to claim 4, It is characterized in that The locking component (20) in the lock buckle (13) is composed of a locking strip (24) and a small spring (25), or a locking single ball (26), or a locking double ball (27), or a locking triple ball (28). The locking component (20) is arranged across the side wall opening (23) of the push-release tube (19).

7. The locking element (20) according to claim 7, It is characterized in that The single locking ball (26) or double locking balls (27) or triple locking balls (28) in the locking component (20) are all arranged across the side wall opening (23) of the push-release tube; when the single locking ball (26) is a single ball, the diameter of the single locking ball (26) is slightly larger than the diameter of the side wall opening (23) of the push-release tube, and the center of the single locking ball (26) is located between the side wall of the trapezoidal tension rope channel (18) and the side wall of the push-release tube (19); when the locking component is a double ball, the side wall opening (23) of the push-release tube is symmetrically arranged on the side wall of the push-release tube body (19-2), and the double locking balls (27) are arranged straight The diameter of the locking ball (26) is slightly smaller than the diameter of the opening (23) on the side wall of the push-relax tube, the centers of the locking double balls (27) are located inside the opening (23) on the side wall of the push-relax tube and they are supported against each other on the same plane; when the locking component is three balls, the three openings (23) on the side wall of the push-relax tube are evenly spaced and arranged on the side wall of the push-relax tube body (19-2), the diameter of the locking single ball (26) is slightly smaller than the diameter of the opening (23) on the side wall of the push-relax tube, the center of the locking single ball (26) is located inside the wall of the push-relax tube (19), and the three balls respectively span the three openings (23) on the side wall of the push-relax tube and are supported against each other on the same plane.

8. The gas-free laparoscopic abdominal wall suspension surgery instrument assembly according to claim 1, It is characterized in that The two ends of the suspension rope (6) are provided with longitudinal slits (29). After the slits are opened, the two ends of the suspension rope become circular rings (30), and after being pinched and reset, they return to cylindrical suspension ropes (6).

9. According to the gas-free laparoscopic abdominal wall suspension surgical instrument assembly of claim 1, the controllable T-shaped foldable pull rod (5) is composed of a hollow pull rod (31), a movable positioning pin (32), a foldable head end cross bar (33) and a pulling wire (34), It is characterized in that The hollow pull rod (30) near the end of the movable positioning pin (31) has an opening (35) on both sides thereof, which is communicated with the inner cavity of the hollow pull rod (31); the foldable head end cross bar (33) takes the movable positioning pin (32) as the midpoint, and has a solid tubular structure (33-1) and a solid semi-tubular structure (33-2) on both sides, respectively, and a fine hole (36) is provided near the end of the head end cross bars on both sides; two pulling wires (34) pass through the fine holes (36) near the end of the head end cross bars, respectively, through the openings (35) on both sides of the hollow pull rod (31) near the movable positioning pin end, enter the inner cavity of the hollow pull rod (31), and meet at the gripping end of the hollow pull rod (31) and are connected and fixed.

10. According to the laparoscopic abdominal wall suspension surgical instrument assembly of claim 1, the accessory (7) comprises a linear abdominal wall puncture trocar (37), a S-shaped abdominal wall puncture trocar (38) and an adjustable support rod (39), It is characterized in that The type B abdominal wall puncture trocar (38) is a thick circular arc trocar puncture needle with a gripping handle (40). The arc of the circular arc trocar puncture needle is 90-180 degrees, and the gripping handle (40) is vertically arranged at the needle tail away from the center of the circle.

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