Device for continuously and automatically expanding and exposing surgical field under closed peeping for transvaginal laparoscopic surgery

Abstract

The invention discloses a pervaginal laparoscopic surgery operation field continuous self-expanding and exposing device under closed sight, which is provided with a control sheath rod, a traction uterus lifting plate, a telescopic intestine pressing plate, a directional elastic ring, a sealed sheath bag and a balance gravity hammer, the sealed sheath bag is annularly connected with the directional elastic ring, the traction uterus lifting plate is arranged on the upper side of the directional elastic ring, and the telescopic intestine pressing plate is arranged on the lower side of the sealed sheath bag. The telescopic intestine pressing plate is installed in the flat sheath tube penetrating through the control sheath rod and is adjusted, stretched and fixed through a bolt and a nut, the directional elastic ring is rotated to the horizontal and vertical angle by pulling the sealing sheath bag, the uterus lifting plate is pulled to automatically and horizontally lift the uterus, and the telescopic intestine pressing plate adjusts and controls the interference of the intestine tube. Independent safe surgical operation areas are isolated in the pelvic cavity through automatic expansion during surgery, mutual interference is avoided, the surgical risk is reduced, and the surgical efficiency is improved.

Description

Technical Field

[0001] The invention relates to a transvaginal laparoscopic surgery auxiliary device. Background Art

[0002] Transvaginal laparoscopic surgery is a minimally invasive treatment method that inserts a sealed sheath bag through the vaginal route, observes the pelvic and abdominal cavities in a closed and inflated state, and performs cutting operations, such as removing diseased tissue or solid organs in the pelvic and abdominal cavities. Traditional PORT is performed after the surgeon uses traditional vaginal surgery to cut the vaginal vault, and even cuts and severs the sacral ligament and cardinal ligament before the expansion support ring of the PORT is inserted into the pelvic cavity. Therefore, the entire surgical process cannot be monitored by laparoscopy. This research team was the first to invent a PORT that uses laparoscopy for full monitoring (name: Transvaginal Single-port Multi-channel Laparoscopic Surgery with a Sealed Ring Active Clamp Manipulator; Patent Application No. 202223438496.X), and applied it to clinical practice. During this process, the following problems were discovered, and improvement methods were proposed.

[0003] Since there are multiple organs such as intestines, mesentery, omentum, bladder, uterus, ovaries, fallopian tubes, etc. in the pelvic and abdominal cavities, which are often piled up together, large gauze pads are used to isolate organs to form a surgical field during laparotomy to avoid interference of other organs with the surgical field of view. However, large gauze pads cannot be inserted through tiny incisions during laparoscopic surgery. Even if a larger gauze pad is inserted, there is a lack of sufficient field of view for observation and effective deployment. Blind deployment with rigid surgical instruments is forced to easily damage normal organs, and the insertion of small gauze pads is difficult to effectively prevent the intestine from entering the field of view, so it is difficult to isolate organs. Transvaginal laparoscopic surgery often uses the posterior vaginal fornix approach. When surgically treating lesions of organs such as the ovaries located in the front of the pelvic side, the surgical field is affected by the prolapse of the uterus in the front of the pelvic cavity and the interference of the colorectal intestine in the back of the pelvic cavity, which can easily damage the intestine. Particular attention should be paid to the serious impact of the "valve effect". For a retroflexed uterus, establishing pneumoperitoneum through the posterior vaginal fornix is ​​prone to a carbon dioxide pneumoperitoneum sealing effect. The uterus seals the pelvic floor, and the abdominal and pelvic air intake channels are separated, forming an air intake valve with a flap function. The pneumoperitoneum machine cannot intelligently and dynamically monitor the pneumoperitoneum pressure accurately, resulting in continuous inflation, and the pneumoperitoneum pressure continues to increase, leading to severe compartment syndrome, which can cause liver and kidney dysfunction and even endanger life. Obviously, the innovative development of a small incision through the vaginal fornix to be inserted into the pelvic and abdominal cavity, and can expand itself to isolate the uterus in front and the colorectum in the back, forming a relatively independent front and back area, can effectively avoid interference, facilitate operation, and reduce intestinal damage, which is of great significance.

[0004] The entire transvaginal laparoscopic surgery is a special PORT consisting of a sealed sheath bag inserted through the vaginal route. During the process of converting the previous patent into application, this research team found that it is difficult to use a hard expansion support ring when entering the narrow vaginal opening, and the elastic expansion support ring is prone to twisting in the vagina, affecting normal use. Summary of the invention

[0005] The present invention is to avoid the deficiencies of the above-mentioned prior art. According to the anatomical relationship of the pelvic organs with the uterus in front and the colorectum in the back, a device for continuously expanding and exposing the surgical field under closed peephole for transvaginal laparoscopy is invented. The directional elastic ring is rotated to a horizontal and vertical angle by pulling the sealed sheath bag, the uterine lifting board is pulled to automatically lift the uterus horizontally, and the telescopic intestinal compression board is adjusted to control interference with the intestinal tract and other tissues. During the operation, it automatically expands to isolate and form an independent and safe surgical operation area in the pelvic cavity, thereby avoiding mutual interference, reducing surgical risks, and improving surgical efficiency.

[0006] The present invention adopts the following technical solutions to solve the technical problems: 1. A device for continuously expanding and exposing the surgical field under closed peephole surgery for transvaginal laparoscopy, characterized in that it comprises a control sheath rod (1), a traction uterine lifting board (13), a telescopic intestinal compression board (16), a directional elastic ring (14), a sealing sheath bag (2) and a balanced gravity hammer (3), wherein the sealing sheath bag is connected to the directional elastic ring in an annular manner, the traction uterine lifting board is installed on the upper side of the directional elastic ring, and the lower side is installed in the rotating groove of the main card slot grab hook (111) at the front end of the control sheath rod, and the telescopic intestinal compression board is installed in a flat sheath tube (116) that runs through the control sheath rod, and is adjusted and retracted by a bolt (17) and a nut (12).

[0007] 2. A device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy, characterized in that the control sheath rod is composed of a control hook (11) and a directional elastic ring end face sealing cap (15), and the control hook (11) is composed of a control handle (114), a slide groove support plate (112), a main card slot grab hook (111), a flat sheath tube (116), a hook anti-drop ball (115), a sealing cap tightening and stretching groove (117) and a balanced gravity hook (118) functional structure, wherein the tightening and stretching strip (152) of the directional elastic ring end face sealing cap (15) is sleeved in the tightening and stretching groove (117) of the sealing cap at the front end of the control hook (11), the main card slot grab hook (111) passes through the directional elastic ring end face sealing cap buckle grab hook sealing groove hole (153), and then the main card slot grab hook (111) can limit the directional elastic ring to rotate from a horizontal angle to a vertical angle.

[0008] 3. A device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy, characterized in that the control hook (11) is a long strip structure, one end of which is connected to the control handle (114), the middle is a slide support plate (112), and the other end is connected to the main card slot grab hook (111), the main card slot grab hook (111) holds the main control shaft (142) of the directional elastic ring, and the middle of the slide support plate is a long strip sliding window (113) into which the bolt (17) can be inserted. The bolt can slide parallel to the sliding window. A flat sheath tube (116) is provided below the slide groove support plate. The end of the sheath tube opening facing the main slot grab hook (111) is the distal end, and the other end of the flat sheath tube is the proximal end facing the control handle (114). The connecting end of the main slot grab hook and the slide groove support plate is provided with a sealing cap tightening and stretching groove (117) for installing a sealing cap on the end face of a directional elastic ring to prevent it from falling off. The lower end of the control handle (114) is provided with an arc hook (118) and an anti-falling ball (115).

[0009] 4. A device for continuously expanding and exposing the surgical field under closed peephole for transvaginal laparoscopy, characterized in that the end face sealing cap (15) of the directional elastic ring is adapted with a main slot grabber sealing slot hole (153), a flat sheath hole (151), a tightening stretching strip (152) and an end face circular arc adaptation sealing slot (154), wherein the flat sheath hole (151) is isolated and sealed front and back when the telescopic intestinal compression plate (16) is inserted, and the end face circular arc adaptation sealing slot (154) and its seal are formed when the directional elastic ring is rotated to a horizontal vertical position.

[0010] 5. A device for continuous self-expansion exposure of the surgical field under closed peephole for transvaginal laparoscopy, characterized in that the telescopic intestinal compression plate (16) is a flat plate structure, the front end is provided with a circular arc upturned surface (161), the rear end is provided with a circular arc guide surface (163) for inserting a flat sheath tube and a bolt positioning layer hole groove (162), the telescopic intestinal compression plate (16) is inserted through the flat sheath hole (151) of the directional elastic ring end face sealing cap and the distal sheath opening of the flat sheath tube (116), the bolt (17) is inserted through the bolt positioning layer hole groove (162), and the bolt passes through the sliding window (113) of the supporting plate and then the nut fixes the bolt.

[0011] 6. A device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy, characterized in that the traction uterine lifting plate (13) is composed of a uterine lifting plate (131), a limit bolt plate (132) and a pulling wire (133), the front end of the uterine lifting plate is arc-shaped and provided with a bolt pulling hole (1312), the middle of the rear end is provided with an arc groove (1311), adapted to the secondary control shaft (141) of the directional elastic ring, and small ears (1315) of the limit support surface perpendicular to the directional elastic ring are provided on both sides, the lower end is provided with a slotted hole (1313) for inserting the limit bolt plate, and the middle is provided with a limit removal pressing hole (1314) for the limit bolt plate.

[0012] 7. A device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy, characterized in that the limit bolt plate (132) is in the shape of a flat pin, the proximal arc shape matches the uterine lifting plate, the lower side of the whole is provided with a T-shaped disassembly handle (1322), the upper side is provided with a limit anti-slip step (1324), and the step surface is provided with a press anti-slip strip (1323).

[0013] 8. A device for continuous self-expansion exposure of the surgical field under closed peephole for transvaginal laparoscopy, characterized in that a directional elastic ring is provided with upper and lower parallel axes, and the two sides are circular arc-shaped. It is composed of an elastic outer tube (144) and an elastic inner core (143). The periphery is cylindrical. The top is provided with a horizontal secondary control axis (141) on the upper side to hold the uterine lifting board. The bottom is provided with a horizontal main control axis (142) on the lower side. The main control axis is parallel to the secondary control axis. The main control axis is held by a main card slot hook. The elastic inner core (143) is an elastic sheet-like ring structure that runs through the elastic outer tube. The directional elastic ring is elastic and can be squeezed and deformed left and right and up and down, and is firm and can not be deformed by squeezing in the front and back directions.

[0014] 9. A device for continuous self-expansion exposure of the surgical field under closed peephole for transvaginal laparoscopy, characterized in that the sealing sheath bag is composed of a directional elastic ring (14), a channel bag body (21), an air inlet (22), a smoke extraction duct (25), large and small instrument sealing sheaths (24) and an endoscope sealing sheath (23); the channel bag body is made of a conical cylindrical flexible material, and the front end is annularly connected to the directional elastic ring. Stretching the channel bag body can cause the directional elastic ring (14) to rotate from horizontal to vertical, and at the same time, the uterine lifting board (13) is pulled back to slide and rotate to be perpendicular to the directional elastic ring.

[0015] Compared with the prior art, the beneficial effects of the present invention are as follows: The present invention automatically lifts the retroflexed uterus, thereby avoiding interference of the uterus with the surgical field and also avoiding the "valve effect" caused by the retroflexed uterus, thereby improving the safety and convenience of the operation.

[0016] The present invention plays the role of automatic intestinal compression after the intestinal compression plate is pushed forward during the operation, thereby avoiding the influence of the colorectal intestinal tract on the surgical field, and there is no need for repeated operations during the operation to eliminate the interference of the intestinal tract.

[0017] The directional elastic ring is firm and squeezed in the front-to-back direction without deformation, ensuring that it will not twist or deform in the vagina. At the same time, it is elastic and can be squeezed and deformed left and right and up and down, making it easier to enter and exit the narrow vaginal opening.

[0018] The traction uterine lifting board, telescopic intestinal compression board and directional elastic ring form a physical support doorway at the posterior vaginal fornix incision under the traction of the sealing sheath bag, providing a stable operating tunnel for the surgical instruments to enter and exit. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] Figure 1Functional schematic diagram of the exposure device for continuous self-expansion of the surgical field under closed peep for transvaginal laparoscopy.

[0020] Figure 2 Schematic diagram of the sheath rod function.

[0021] Figure 3 Functional structure diagram of the control sheath rod.

[0022] Figure 4 Schematic diagram of the function of the manipulator sheath when it is flattened and enters the vagina.

[0023] Figure 5 Schematic diagram of the functional structure of the control hook.

[0024] Figure 6 Schematic diagram of the structure of the directional elastic ring end face sealing cap.

[0025] Figure 7 Schematic diagram of the palace lifting board structure.

[0026] Figure 8 Schematic diagram of the limit bolt plate structure.

[0027] Fig. 9 Schematic diagram of the directional elastic ring structure.

[0028] Fig.10 Schematic diagram of the telescopic intestine pressure plate structure. DETAILED DESCRIPTION

[0029] Take the directional elastic ring end face sealing cap (15) and put its tightening stretching strip (152) into the tightening stretching groove (117) of the front end sealing cap of the control hook (11), and pass the main slot grab hook (111) through the directional elastic ring end face sealing cap buckle grab hook sealing slot hole (153) to make it installed flat.

[0030] Holding the slide support plate (112), the horizontal main control shaft (142) of the directional elastic ring (14) is installed in the rotating groove of the main card slot hook (111) at the front end of the control sheath rod, and the telescopic pressure plate (16) is inserted through the flat sheath hole (151) of the directional elastic ring end face sealing cap and the distal sheath opening of the flat sheath tube (116), wherein the bolt positioning layer hole groove (162) is downwardly directed, and the bolt (17) is inserted through the bolt positioning layer hole groove (162). The bolt passes through the sliding window (113) of the support plate and the nut (12) fixes the bolt. The length of the telescopic pressure plate can be adjusted by adjusting the push nut as needed. The telescopic pressure plate can limit the main control shaft (142) from rotating in the water position and not falling off.

[0031] The arc groove (1311) of the uterine lifting plate (131) with the pulling line (133) is adapted to be buckled on the secondary control shaft (141) of the directional elastic ring, and the T-shaped end limit anti-detachment step (1324) of the limit bolt plate is held upward and inserted into the slotted hole (1313) until the limit anti-detachment step (1324) just enters the limit disassembly pressing hole (1314). The limit bolt plate (132) can limit the rotation of the uterine lifting plate (131) on the secondary control shaft (141) without falling off, and the small ears (1315) on the supporting surfaces on both sides of the uterine lifting plate (131) can limit the vertical angle of the directional elastic ring from collapsing.

[0032] When inserting into the vagina, the traction uterine lifting board (13) and the elastic directional elastic ring (14) are rotated to be parallel to the telescopic intestinal compression board (16), and the traction wire (133) is clamped with a non-destructive instrument and inserted into the vagina. The control handle (114) is held to assist in inserting the uterine lifting board (131), and then the two sides of the directional elastic ring (14) are gently pinched to narrow it so that it is easy for the control hook (11) to enter the vagina smoothly. When the directional elastic ring enters the posterior fornix position, the traction channel bag body (21) causes the directional elastic ring (14) to rotate from horizontal to vertical. At the same time, the traction uterine lifting board (13) also slides backward and rotates to be perpendicular to the directional elastic ring, forming a continuously self-expanding exposed surgical field space. At this time, the end face sealing cap (15) and the end face of the directional elastic ring (14) are in contact and sealed.

[0033] The air inlet (22) is inflated, the sealing sheath bag (2) is expanded, and the endoscope and instruments are respectively inserted from the large and small instrument sealing sheaths (24) and the endoscope sealing sheath (23) for surgery, and the pelvic cavity is entered through the posterior vaginal fornix incision. The traction wire (133) is clamped by a non-destructive instrument along the posterior fornix incision and sent to the back of the uterus in the pelvic cavity. The nut (12) is pushed to allow the telescopic bowel compression plate (16) to enter the pelvic cavity through the posterior vaginal fornix incision, and the colorectum is pushed open. The nut (12) is locked to fix the telescopic bowel compression plate (16) to continuously expose the field of vision.

[0034] A suitable gravity balance hammer (3) is hung on the balance gravity hook (118) to make it balanced without having to hold it for a long time.

[0035] After the operation is completed, the air is exhausted and the control handle (114) is pulled outward, so that the directional elastic ring (14) and the traction uterine lifting board (13) are automatically rotated to be pulled out horizontally.

[0036] The above embodiments are only descriptions of the preferred implementation modes of the present invention, and are not intended to limit the scope of the present invention. Without departing from the spirit and essence of the design of the present invention, any equivalent changes or modifications made to the present invention should be included in the protection scope of the present invention.

Claims

1. A device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy, characterized by: The invention comprises a control sheath rod (1), a traction uterine lifting plate (13), a telescopic intestinal compression plate (16), a directional elastic ring (14), a sealing sheath bag (2) and a balanced gravity hammer (3). The sealing sheath bag is connected to the directional elastic ring in an annular manner. The traction uterine lifting plate is installed on the upper side of the directional elastic ring, and the lower side is installed in the rotation groove of the main card slot grab hook (111) at the front end of the control sheath rod. The telescopic intestinal compression plate is installed in a flat sheath tube (116) that passes through the control sheath rod and is adjusted and retracted by a bolt (17) and a nut (12).

2. The device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy according to claim 1 is characterized in that The control sheath rod is composed of a control hook (11) and a directional elastic ring end face sealing cap (15), and the control hook (11) is composed of a control handle (114), a slide groove support plate (112), a main card slot grab hook (111), a flat sheath tube (116), a hook anti-drop ball (115), a sealing cap tightening and stretching groove (117) and a balanced gravity hook (118) functional structure, wherein the tightening and stretching strip (152) of the directional elastic ring end face sealing cap (15) is sleeved in the tightening and stretching groove (117) of the sealing cap at the front end of the control hook (11), and the main card slot grab hook (111) passes through the directional elastic ring end face sealing cap buckle grab hook sealing groove hole (153), and then the main card slot grab hook (111) can limit the directional elastic ring to rotate from a horizontal angle to a vertical angle.

3. The device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy according to claim 2 is characterized in that the device can be controlled The pull hook (11) is a long strip structure, one end of which is connected to the control handle (114), the middle is a slide groove support plate (112), and the other end is connected to the main card slot grab hook (111). The main card slot grab hook (111) holds the main control shaft (142) of the directional elastic ring. The middle of the plate surface of the slide groove support plate is a long strip sliding window (113) in which a bolt (17) can be inserted. The bolt can slide parallel in the sliding window. A flat sheath tube (116) is provided below the slide groove support plate. The end of the sheath tube opening facing the main card slot grab hook (111) is the distal end, and the other end of the flat sheath tube is the proximal end facing the control handle (114). The connecting end of the main card slot grab hook and the slide groove support plate is provided with a sealing cap tightening and stretching groove (117) for installing a sealing cap on the end face of the directional elastic ring to prevent it from falling off. The lower end of the control handle (114) is provided with an arc hook (118) and an anti-falling ball (115).

4. The device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy according to claim 2 is characterized by a directional The elastic ring end face sealing cap (15) is adapted with a main slot grab hook sealing slot hole (153), a flat sheath hole (151), a tightening stretching strip (152) and an end face circular arc adaptation sealing groove (154), wherein the flat sheath hole (151) is isolated and sealed front and back when the telescopic pressure plate (16) is inserted, and the end face circular arc adaptation sealing groove (154) and its seal are formed when the directional elastic ring is rotated to a horizontal vertical position.

5. The device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy according to claim 1, characterized in that The telescopic intestinal compression plate (16) is a flat plate-shaped structure, with a front end provided with an arc upturned surface (161), a rear end provided with an arc guide surface (163) for inserting a flat sheath tube and a bolt positioning layer hole groove (162), the telescopic intestinal compression plate (16) is inserted through the flat sheath hole (151) of the directional elastic ring end face sealing cap and the distal sheath opening of the flat sheath tube (116), and the bolt (17) is inserted through the bolt positioning layer hole groove (162), and the bolt passes through the sliding window (113) of the supporting plate and then the nut fixes the bolt.

6. The device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy according to claim 1, characterized in that The traction uterine lifting board (13) is composed of a uterine lifting board (131), a limit bolt plate (132) and a pulling wire (133). The front end of the uterine lifting board is flat and has an arc shape and a bolt wire pulling hole (1312). The middle of the rear end is provided with an arc groove (1311) adapted to the secondary control shaft (141) of the directional elastic ring. Small ears (1315) of the limit support surface perpendicular to the directional elastic ring are provided on both sides. A slotted hole (1313) for inserting the limit bolt plate is provided at the lower end, and a limit removal pressing hole (1314) for the limit bolt plate is provided in the middle.

7. The device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy according to claim 6 is characterized by: The limit bolt plate (132) is in the shape of a flat pin, and the arc shape of the proximal end matches the uterine lifting plate. A T-shaped disassembly handle (1322) is provided on the lower side of the whole, and a limit anti-slip step (1324) is provided on the upper side. The step surface is provided with a pressing anti-slip strip (1323).

8. The device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy according to claim 1 is characterized by a directional The elastic ring is provided with upper and lower parallel axes, and has an annular structure with arc-shaped sides, which is composed of an elastic outer tube (144) and an elastic inner core (143). The periphery is cylindrical, and the top is provided with a horizontal secondary control shaft (141) on the upper side to hold the uterine lifting plate, and the bottom is provided with a horizontal main control shaft (142) on the lower side. The main control shaft is parallel to the secondary control shaft, and the main control shaft is held by the main clamping slot hook. The elastic inner core (143) is an elastic sheet-like annular structure that runs through the elastic outer tube, wherein the directional elastic ring has elasticity between the left and right and the top and bottom to be squeezed and deformed, and is firm and not deformed in the front and back directions.

9. The device for continuous self-expansion exposure of the surgical field under closed peep for transvaginal laparoscopy according to claim 1, characterized in that The sealing sheath bag is composed of a directional elastic ring (14), a channel bag body (21), an air inlet (22), a smoke extraction duct (25), a large and small instrument sealing sheath (24) and an endoscope sealing sheath (23). The channel bag body is made of a conical cylindrical flexible material, and the front end is annularly connected to the directional elastic ring. Stretching the channel bag body can cause the directional elastic ring (14) to rotate from horizontal to vertical, and at the same time, the uterine lifting board (13) is also pulled back to slide and rotate to be perpendicular to the directional elastic ring.

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