Miniature subcutaneous locking device, transdermal traction device and subcutaneous cavity building method

Abstract

A subcutaneous locker includes a lock block, an inner core, and an elastic member. The inner core comprises a core block and a core arm. The core block comprises a core near end face, a core far end face, a first convex sliding rail and a second convex sliding rail, the lock opening penetrates through the core near end face and the core far end face. The lock block comprises a lock shell defined by a lock near end face, a lock far end face and a lock side face. A lock cavity is formed in the lock shell and comprises a cavity near end, a cavity far end, a first concave sliding rail and a second concave sliding rail, wherein the first concave sliding rail and the second concave sliding rail are arranged on the two sides. One end of the lock cavity penetrates through the lock side face to form a lock cavity inlet, and the lock side hole penetrates through the lock side face to be communicated with the lock cavity. The lock main hole penetrates through the lock near end face and the cavity near end to be communicated with the lock cavity to form a lock near end hole, and the lock main hole continues to extend to penetrate through the cavity far end to form a lock far end hole. The elastic piece is installed in the lock cavity and is in a compressed state, and restoring force of the elastic piece drives the lock opening of the inner core to move in the direction close to the lock main hole. External force is applied to the core arm to compress the elastic piece, so that the lock opening moves in the direction away from the lock main hole.

Description

Technical Field

[0001] The invention relates to a surgical instrument, and in particular to a minimally invasive surgical instrument. Background Art

[0002] Thyroidectomy, mastectomy, parotidectomy, pneumoperitoneoscopic surgery and other subcutaneous organ resection or subcutaneous tumor resection surgeries often require a large incision in the patient's skin, which is then pulled open with a retractor to expose the internal tissue and create a surgical space. This leaves patients with significant scars. A transfer incision technique is a technique that makes a small incision at an appropriate location on the patient to establish a subcutaneous channel to reach the lesion for surgery. Transfer incision surgery faces two challenges: First, how to establish a local subcutaneous cavity at the lesion to create a subcutaneous surgical space? Second, transfer incision surgery usually only opens a single channel. How to achieve video monitoring and cooperation between two or more instruments in a single channel to achieve tissue stripping and lesion exposure? Minimally invasive transfer incision surgery has been used clinically, but there is currently no supporting equipment to solve the two problems of the previous surgery. Summary of the invention

[0003] Therefore, in order to solve the problems of the prior art, various solutions have been proposed.

[0004] In one aspect of the present invention, a micro subcutaneous locker is provided. The locker comprises a lock block, an inner core and an elastic member. The inner core comprises a core block and a core arm, the core block comprises a core proximal surface, a core distal surface and a first convex slide rail and a second convex slide rail arranged on both sides; the lock opening passes through the core proximal surface and the core distal surface. The lock block comprises a lock proximal surface, a lock distal surface and a lock shell defined by a lock side surface; a lock cavity is provided in the lock shell, the lock cavity comprises a cavity proximal end, a cavity distal end and a first concave slide rail and a second concave slide rail arranged on both sides; one end of the lock cavity penetrates the lock side surface to form a lock cavity entrance, and the lock side hole penetrates the lock side surface to communicate with the lock cavity; the lock main hole penetrates the lock proximal surface and the cavity proximal end to communicate with the lock cavity to form a lock proximal end hole, and the lock main hole continues to extend through the cavity distal end to form a lock distal end hole. The inner core is installed in the lock cavity, its first convex slide rail matches the first concave slide rail, the second convex slide rail matches the second concave slide rail, the proximal end surface of the core matches the proximal end of the cavity, the distal end surface of the core matches the distal end of the cavity, and its core arm extends to the outside of the lock block through the lock side hole; the elastic member is installed in the lock cavity and is in a compressed state, and its restoring force drives the lock mouth of the inner core to move toward the direction close to the main hole of the lock.

[0005] In one embodiment, the first concave slide rail includes a first inner concave cylindrical surface, the first convex slide rail includes a first outer convex cylindrical surface, and the first inner concave cylindrical surface and the first outer convex cylindrical surface match to form a first cylindrical sliding bearing; the second concave slide rail includes a second inner concave cylindrical surface, and the second convex slide rail includes a second outer convex cylindrical surface, and the second inner concave cylindrical surface and the second outer convex cylindrical surface match to form a second cylindrical sliding bearing.

[0006] In another embodiment, the lock further comprises a lock side cover, which is embedded in the lock cavity entrance and fixed to the lock housing by interference riveting, welding or bonding. In another embodiment, an outer convex lip is provided at the intersection of the lock side and the lock cavity entrance, and after shaping and grinding, the outer convex lip can be deformed to form an inner extension arm to prevent the elastic member from falling out of the lock cavity.

[0007] In another embodiment, the diameter of the proximal end hole of the lock main hole is D1, the minimum circumscribed circle diameter of the projection plane contour of the lock block along the axis direction of the lock main hole is D2, and the minimum circumscribed circle diameter of the projection plane contour of the lock block along the direction perpendicular to the axis of the lock main hole is D3, where D2≥D3>3×D1, where 0.8≤D1≤2.6mm, 10.5mm≥D3>3×D1. In another embodiment, the maximum thickness of the lock block along the axis direction of the lock main hole is H1, and D3>H1.

[0008] In another embodiment, the lock includes a first U-shaped lock and a second U-shaped lock, the first U-shaped lock includes an arc-shaped lock with a radius of R4, and the second U-shaped lock includes an arc-shaped lock with a radius of R5, wherein R5>R4>0.5×D1.

[0009] In yet another embodiment, the locking block is made of a material cut from a metal raw material.

[0010] In another embodiment, the lock block includes a dovetail groove in the vicinity of the lock cavity entrance, the dovetail groove includes a first groove slope, a second groove slope and a groove bottom surface extending therebetween, the groove bottom surface width of the dovetail groove is greater than the opening width of the dovetail groove; the lock block also includes a lock side cover whose shape and size match the dovetail groove, the lock side cover is buckled into the dovetail groove, and the lock side cover and the dovetail groove are fully or partially interference fit to form a firm riveted fixation.

[0011] In another embodiment, the width of the lock side cover is smaller than the transverse width of the lock cavity, thereby forming a ventilation groove between the lock side cover and the lock housing, and the ventilation groove is conducive to cleaning and sterilizing the parts in the lock cavity.

[0012] In another embodiment, the inner core includes a first inner core, a second inner core and a third inner core; the elastic member includes a first elastic member and a second elastic member; the first inner core includes a first core block and a first U-shaped lock, and the first U-shaped lock is provided with a first side lip and a second side lip on both sides; the second inner core includes a second core block and a second U-shaped lock, and the second U-shaped lock is provided with a third side lip and a fourth side lip on both sides; the first side lip and the third side lip include an inclined surface; the third inner core includes a third core block, a third lock and a core arm, and the third lock includes a first driving inclined surface and a second driving inclined surface. The first inner core and the second inner core are installed in the lock cavity in a manner that the locks are opposite; the first elastic member is installed at the tail of the first inner core and is in a compressed state, pushing the first core block to move toward the direction close to the lock main hole; the second elastic member is installed at the tail of the second inner core and is in a compressed state, pushing the second core block to move toward the direction close to the lock main hole. The third inner core is installed between the first inner core and the second inner core, wherein the first driving bevel contacts the first side lip, the second driving bevel contacts the third side lip, and its core arm is installed in the lock side hole and extends to the outside of the main shell; when external force is applied to the core arm to move it toward the direction close to the lock main hole, the first driving bevel squeezes the first side lip to push the first core block to move away from the lock main hole; at the same time, the second driving bevel squeezes the third side lip to push the second core block to move away from the lock main hole; after removing the external force, the restoring force of the first and second elastic members moves the first inner core and the second inner core toward the direction close to the lock main hole, thereby pushing the third lock core to move away from the lock main hole.

[0013] In another embodiment, the intersection area between the lock side surface and the first lock side hole further includes an outer convex lip, which can be deformed after shaping and polishing to form an inner extension arm to limit the third inner core from escaping from the lock cavity.

[0014] In another embodiment, the lock further includes a first lock side cover and a second lock side cover, wherein the first lock side cover is embedded in the entrance of the first cavity, and the second lock side cover is embedded in the entrance of the second cavity, and the first and second lock side covers are interference riveted, welded or bonded to the lock housing.

[0015] Another aspect of the present invention provides a subcutaneous retractor, comprising any of the aforementioned locking devices, and further comprising a penetrating pull rod, wherein the pull rod comprises an inclined pull rod tip and a pull rod handle and a pull rod rod with a diameter of D6 extending therebetween, and a pull rod annular groove is provided in the vicinity of the pull rod tip, wherein the annular groove comprises a proximal end of the annular groove, a distal end of the annular groove and a core rod with a diameter of D7. When locked, the restoring force of the elastic member drives the lock opening of the inner core to move toward the direction approaching the main lock hole, so that the first U-shaped lock opening is stuck in the annular groove, and the restoring force of the elastic member keeps the first U-shaped lock opening and the annular groove in mutual engagement to form an engagement pair, thereby limiting the pull rod rod from coming out of the lock device. When unlocked, an external force is applied to the core arm to compress the elastic member, pushing the core block to move in a direction away from the main lock hole, so that the first U-shaped lock opening is completely separated from the annular groove, thereby allowing the pull rod rod to come out of the lock device. In one solution, the length of the core arm exposed outside the lock block when locked is L3, wherein L3>0.5×(D6-D7).

[0016] Another aspect of the present invention provides a method for using the retractor to perform subcutaneous pneumoperitoneum cavity construction: Channel establishment: an incision is made at an appropriate location on the patient's epidermis, and under endoscopic guidance, an energy device is used to separate tissues to establish a subcutaneous channel to the area adjacent to the lesion; Insert the locking device: Use clamps to hold the locking device and push it along the subcutaneous channel to the expected position of use in the lesion area; Assemble the pull rod: From the outside of the skin at the expected use position, pierce the skin with a penetrating pull rod, and under the guidance of an endoscope, insert the pull rod through the main lock hole of the locker, and make the lock mouth and the ring groove engage with each other to form an engagement pair; Usage: Pull the proximal end of the rod by hand or use an in vitro stent to pull and fix the proximal end of the rod, thereby pulling the lock and driving the surrounding human tissue to move, forming a local cavity; Removal: Under the guidance of endoscope, use clamps to enter through the subcutaneous channel and apply external force to the core arm to compress the elastic part so that the lock mouth is out of the ring groove, thereby pulling out the pull rod from the body, and then use clamps to clamp the lock and remove it through the subcutaneous channel. BRIEF DESCRIPTION OF THE DRAWINGS

[0017] In order to more fully understand the essence of the present invention, a detailed description will be given below in conjunction with the accompanying drawings, in which: Figure 1 is an exploded schematic diagram of the lock 1; Figure 2 is a 3D schematic diagram of the inner core 3; Figure 3 It is a projection view of the inner core 3 from the proximal end to the distal end; Figure 4 It is a projection view of the locking block 2 from the proximal end to the distal end; Figure 5 It is a side projection schematic diagram of the locking block 2; Figure 6 yes Figure 4 6-6 sectional view; Figure 7 It is a 3D schematic diagram of the lock block 2; Figure 8 is a 3D schematic diagram of the lock 1 (the lock block 2 is partially cut away); Fig. 9 is an exploded schematic diagram of a lock side cover 25 of the lock 1; Fig.10 It is a schematic diagram of fixing the lock side cover 25 of the lock 1; Fig.11 is a side projection view of the tie rod 6; Fig.12 is a 3D schematic diagram of the retractor 7; Fig.13 is a partial side projection view of the distal end of the retractor 7 in the locked state; Fig.14 yes Fig.13 14-14 sectional view; Fig.15 yes Fig.13 15-15 sectional view; Fig.16 is a partial side projection view of the distal end of the retractor 7 in the unlocked state; Fig.17 yes Fig.16 17-17 sectional view; Fig.18 yes Fig.16 18-18 sectional view; Fig.19 It is a clinical scene diagram of subcutaneous cavity creation using a retractor 7; Fig. 20 This is a clinical scene diagram of using a retractor 7 to perform pneumoperitoneum cavity creation; Fig.21 is a 3D schematic diagram of the first inner core 3a (second inner core 3b); Fig. 22 is a 3D schematic diagram of the third inner core 3c; Fig.23 is a 3D schematic diagram of the locking block 2a; Fig.24 is an end projection view of the locking block 2a; Fig.25 is a side projection view of the locking block 2a; Fig.26 yes Fig.25 26-26 sectional view; Fig. 27 is a partial 3D view of the distal end of the retractor 7a in the locked state; Fig.28is a partial side projection view of the distal end of the retractor 7a in the locked state; Fig.29 yes Fig.28 29-29 sectional view; Fig.30 yes Fig.29 Schematic diagram of component movement changes in unlocked state; Fig.31 is a partial end projection view of the distal end of the retractor 7b in the locked state; Fig.32 is a partial side projection view of the distal end of the retractor 7b in the locked state; Fig.33 yes Fig.32 33-33 sectional view; Fig.34 It is a schematic diagram of the explosion of the lock side cover of the lock block 2c; Fig.35 is a side projection view of the locking block 2c; Fig.36 yes Fig.35 36-36 sectional view; Fig.37 It is a schematic diagram of the explosion of the lock side cover of the lock block 2d; Fig.38 is a side projection view of the locking block 2d; Fig.39 yes Fig.38 39-39 sectional view; Throughout the several views, the same reference numerals designate identical parts or components. DETAILED DESCRIPTION

[0018] Embodiments of the present invention are disclosed herein, however, it should be understood that the disclosed embodiments are merely examples of the present invention, and the present invention can be implemented in different ways. Therefore, the contents disclosed herein are not to be construed as limiting, but only as a basis for the claims and as a basis for teaching those skilled in the art how to use the present invention. For ease of description, the side close to the operator is defined as the proximal end, and the side away from the operator is defined as the distal end.

[0019] Figure 1 A micro subcutaneous locking device 1 is depicted, comprising a locking block 2, an inner core 3 and an elastic member 4.

[0020] like Figure 2-Figure 3The inner core 3 comprises a core block 31 and a core arm 32 connected thereto and extending outward. The core block 31 comprises a core proximal surface 311, a core distal surface 312, and a first convex slide rail 313 and a second convex slide rail 314 arranged on both sides. The lock 33 penetrates the surface 311 and the surface 312. The lock 33 comprises a first U-shaped lock 331 and a second U-shaped lock 332, wherein the first and second U-shaped locks constitute a closed special-shaped ring lock. The proximal end of the lock 33 comprises an inclined guide lip 333.

[0021] like Figure 4-Figure 7 The lock block 2 includes a lock housing 21 defined by a lock proximal end face 211, a lock distal end face 212 and a lock side face 213. A lock cavity 22 is provided in the lock housing 21, and the lock cavity 22 includes a cavity proximal end 221, a cavity distal end 222 and a first concave slide rail 223 and a second concave slide rail 224 arranged on both sides. One end of the lock cavity 22 penetrates the lock side face 213 to form a lock cavity entrance 225, and the other end thereof extends transversely to the cavity bottom face 226 inside the lock housing, and a lock side hole 227 penetrates the lock side face 213 and the lock cavity bottom face 226 and communicates with the lock cavity 22. The lock main hole 23 penetrates the lock proximal end face 211 and the cavity proximal end 221 and communicates with the lock cavity 22 to form a lock proximal end hole 231, and the lock proximal end hole 231 includes a proximal end guide hole 232. The lock main hole 23 continues to extend through the cavity distal end 222 and the lock distal end face 212 to form a lock distal end hole 233.

[0022] In one design, the lock cavity 22 further includes a drive chamber 228 disposed at the lock cavity entrance 225, and the maximum dimension of the chamber 228 along the axial direction of the lock main hole 23 is greater than or equal to the distance between the cavity proximal end 221 and the cavity distal end 222. This arrangement is conducive to the precise positioning of the elastic member, thereby precisely controlling the direction of the elastic force.

[0023] like Figure 7 In one embodiment, the junction area between the lock side surface 213 and the lock cavity entrance 225 also includes an outer lip 241. After shaping and polishing, the outer lip 241 can be deformed to form an inner extension arm 242 to prevent the elastic member from escaping from the lock cavity 22.

[0024] like Figure 8 The inner core 3 is installed in the lock cavity 22, and its first convex slide rail 313 matches the first concave slide rail 223, the second convex slide rail 314 matches the second concave slide rail 224, the core proximal end surface 311 matches the cavity proximal end 221, and the core distal end surface 312 matches the cavity distal end 222. Its core arm 32 extends to the outside of the lock block 2 through the lock side hole 227. The elastic member 4 is installed between the lock core 3 and the cavity inner extension arm 242 and is in a compressed state. Its restoring force drives the first U-shaped lock opening 331 of the inner core 3 to move toward the direction close to the lock main hole. In order to intuitively and vividly demonstrate its matching relationship, Figure 8 The lock block 2 in the Figure 2~ 8 Understand their coordination relationship.

[0025] like Figure 9-10 In one embodiment, the lock 1 further comprises a lock side cover 25, which is installed at the lock cavity entrance 225 and fixed to the lock block 2. Interference riveting, welding, bonding and other processes may be used. It is easy for those skilled in the art to understand that when the lock side cover is used to fix the elastic member, the lock block 2 may or may not include the inner extension arm 242.

[0026] like Figure 4-Figure 5 In an optimized design of the lock block 2, the diameter of the proximal end hole 231 of the lock main hole 23 is D1, the minimum circumscribed circle diameter of the projection plane contour of the lock block 2 along the axis direction of the lock main hole 23 is D2, the minimum circumscribed circle diameter of the projection plane contour of the lock block 2 along the direction perpendicular to the axis of the lock main hole 23 is D3, and the maximum thickness of the lock block 2 along the axis direction of the lock main hole is H1, wherein D2≥D3>3×D1, D3>H1. In a specific solution, 0.8≤D1≤2.6mm, 10.5mm≥D3>3×D1, this size design is conducive to the locker entering and exiting the patient's body through the subcutaneous channel or puncture channel, and is also conducive to the locker pulling and exposing the surrounding tissues, thereby constructing a local working cavity.

[0027] Fig.11 The structure and composition of the penetration rod 6 are depicted. The rod 6 comprises an inclined rod tip 61 and a rod handle 69 and a rod rod 62 with a diameter of D6 extending therebetween, and a rod annular groove 63 is provided in the vicinity of the rod tip 61, and the annular groove 63 comprises an annular groove proximal end 64, an annular groove distal end 66 and a core rod 65 with a diameter of D7.

[0028] Figure 12-Figure 18 The structure and assembly relationship of the subcutaneous retractor 7 are depicted. The retractor 7 comprises a locker 2 and a penetration rod 6. Figure 13-15 The retractor 7 in the locked state is depicted. The pull rod 62 is inserted through the main lock hole 23, wherein the inclined tip 61 squeezes the lock opening 33, forcing the elastic member 4 to be further compressed, pushing the core block 31 to move in the direction away from the main lock hole 23; when the annular groove 63 completely enters the lock cavity 22, the spring restoring force pushes the core block 31 to move in the direction close to the main lock hole 23, so that the first U-shaped lock opening 331 is stuck in the annular groove 63; and the core block 251 is clamped between the proximal end 221 and the distal end 222 of the cavity. At this time, the pull rod 6 is pulled or pushed axially, and the restoring force of the elastic member pushes the core block 251 so that the first U-shaped lock opening 331 and the annular groove 63 remain in mutual engagement to form an engagement pair, thereby limiting the pull rod 62 from coming out of the lock 20.

[0029] Figure 16-Figure 18The retractor 7 is depicted in the unlocked state. Applying external force to the core arm 32 compresses the elastic member 4, pushing the core block 31 to move away from the main lock hole 23, so that the first U-shaped lock opening 331 is completely separated from the annular groove 63, thereby allowing the pull rod 62 to be disengaged from the lock 20.

[0030] Fig.19 A clinical scenario diagram of using a retractor 7 to create a subcutaneous cavity is depicted, and the application method is generally as follows: Channel establishment: An incision is made at an appropriate location on the patient's epidermis, and under the guidance of the endoscope 1000, an energy device is used to separate the tissue to establish a subcutaneous channel to the area adjacent to the lesion (Note: Fig.19 The middle grid represents the skin, and the dotted area represents the established subcutaneous channel); Insert the locking device: Use the clamp 2000 to hold the locking device 1 and push it along the subcutaneous channel to the expected position of use in the lesion area; Assemble the pull rod: From the outside of the skin at the intended use position, pierce the skin with the penetration pull rod 6 (or pierce with the aid of an instrument), and under the guidance of the video of the endoscope, insert the pull rod 62 through the proximal lock hole of the locker, so that the lock mouth and the ring groove engage with each other to form an engagement pair; Use: Pull the proximal end of the pull rod 6 by hand or use an external stent to pull and fix the proximal end of the pull rod 6, thereby pulling the lock and driving the surrounding human tissue to move, forming a local cavity (local surgical working cavity); Removal: Under the guidance of an endoscope, use clamp 2000 to enter through the subcutaneous channel and apply external force to the core arm to compress the elastic part, so that the lock mouth is disengaged from the ring groove, and the pull rod is pulled out from the body. Then use the clamp to clamp the lock and remove the lock through the subcutaneous channel.

[0031] Fig. 20 A clinical scenario diagram of using a retractor 7 to create a pneumoperitoneum cavity without using a pneumoperitoneum is depicted, and the application method is generally as follows: Channel establishment: Establish a puncture channel of 3000 through the patient's skin and muscle tissue (Note: Fig. 20 The grid area represents the skin); Insert the locking device: clamp the locking device 20 with the clamp 2000 and push it along the puncture channel to the expected use position; Assembling the pull rod: from the outside of the skin at the intended use position, pierce the skin with the penetration pull rod 6 (or pierce with the aid of an instrument), and under the guidance of the video of the endoscope, insert the pull rod 62 through the proximal lock hole of the locker, and make the lock mouth and the ring groove bite each other to form an occlusal pair; Use: Pull the proximal end of the pull rod 6 by hand or use an external stent to pull and fix the proximal end of the pull rod, thereby pulling the lock and driving the surrounding human tissue to move, forming a local cavity (local surgical working cavity); Removal: Under the guidance of an endoscope, use a clamp to enter through the puncture channel and apply external force to the core arm to compress the elastic part, so that the lock mouth is disengaged from the ring groove, and the pull rod is pulled out from the body. Then use the clamp to clamp the lock and remove the lock through the puncture channel.

[0032] Those skilled in the art should understand that Fig.19 Schematic diagram depicting the clinical scenario of a typical single-incision transfer incision. Fig. 20 A typical clinical scenario schematic diagram of pneumoperitoneum-free multi-hole minimally invasive surgery is depicted, and the endoscope and its corresponding puncture channel, as well as other surgical instruments and their puncture channels are not shown in the figure. The clamp 2000 can be a surgical clamp commonly used in minimally invasive surgery, such as the surgical instrument disclosed in Chinese invention application 202411443156.7. It can also be a slender forceps.

[0033] Those skilled in the art should understand that, so far, the trocars used in laparoscopic minimally invasive surgery mainly include 3, 5, 8, 10, 11, 12, and 15 mm series. The numbers represent the nominal inner diameter of the trocar, not the outer diameter of the trocar. The inner diameter of the 3mm trocar is about 3.5~3.9mm, and its outer diameter is about 5.5~6.0mm; the inner diameter of the 5mm trocar is about 5.5~5.9mm, and its outer diameter is about 7.5~8.0mm. Studies have shown that wounds of 5mm and above will form significant scars on the patient's body surface.

[0034] refer to Figure 3 , Fig.11 , Fig.13 and Fig.14 In one design, the diameter of the pull rod 62 is D6, where 0.7mm≤D6≤2.5mm, and the length of the pull rod L1≥100mm. This size design is conducive to the pull rod penetrating the patient's skin after the operation without leaving a significant scar, while ensuring that the pull rod and the inner core are firmly matched. In another preferred design, 0.7mm≤D6≤1.5mm, and this design is more traumatic. In another design, the first U-shaped lock 331 includes an arc-shaped lock with a radius of R4, where 0.5×D6<R4<0.5×D7. The second U-shaped lock 332 includes an arc-shaped lock with a radius of R5, where R5>0.5×D6. The distance between the centers of the two arcs L2>0.5×(D6-D7). The length of the core arm 32 exposed outside the locking block 2 is L3, where L3>0.5×(D6-D7).

[0035] like Figure 6 , Figure 8 and Fig.13In another design, the lock housing 21 includes a lock cover head 21a and a lock handle 21b, wherein the lock cover head 21a has a transverse dimension B1, and the lock handle 21b has a transverse dimension B2, wherein B1>B2, forming an outer extension cover 21c. The lock side hole 227 for installing the core arm is arranged below the outer extension cover 21c. In another design, the lock cover head 21a has a thickness dimension H2, and the lock handle 21b has a thickness dimension H3, wherein H2<H3. This design can simplify the structure and facilitate the main housing to enter and exit the patient's body through the subcutaneous channel or the puncture channel.

[0036] Figure 21-28 Another locking device 1 a is depicted, comprising a locking block 2 a , a first inner core 3 a , a second inner core 3 b , a third inner core 3 c , a first elastic member 4 a and a second elastic member 4 b .

[0037] Fig.21 The structure and composition of the first (second) inner core are described. The first inner core 3a includes a core proximal face 311a, a core distal face 312a, a core block 31a defined by a first convex slide 313a and a second convex slide 314a. The inner core 3a also includes a first lock 32a, and the first lock 32a includes a first side lip 321a and a second side lip 322a. The second inner core 3a includes a core proximal face 311b, a core distal face 312b, a core block 31b defined by a third convex slide 313b and a fourth convex slide 314b. The inner core 3b also includes a second lock 32b, and the second lock 32b includes a third side lip 321b and a fourth side lip 322b. In one solution, the first side lip 321a and the third side lip 321b include inclined surfaces. In another design solution, the first, second, third, and fourth side lips include inclined surfaces with the same angle. The first and second inner cores may be identical or unequal. To simplify the description, the schematic diagram of this embodiment uses completely identical first and second inner cores.

[0038] Fig. 22 The structure and composition of the third inner core are described. The third inner core 3c includes a core proximal surface 311c, a core distal surface 312c, a core block 31c defined by a first convex slide 313c and a second convex slide 314c. The inner core 3c also includes a third lock 32c, and the third lock 32c includes a first driving inclined surface 321c and a second driving inclined surface 322c. The inner core 3c includes a core arm 33c extending outward from the opposite side of the third lock, and the cross-sectional size of the core arm 33c is smaller than that of the core block 31c, and the junction between the core block 31c and the core arm 33c forms a limiting shoulder 34c.

[0039] Figure 23-26The structure and composition of the lock block 2a are described. The lock block 2 includes a lock housing 21a defined by a lock proximal end face 211a, a lock distal end face 212a and a lock side face 213a. A lock cavity 22a is provided in the lock housing 21a, and the lock cavity 22a includes a cavity proximal end 221a, a cavity distal end 222a and a first concave slide rail 223a and a second concave slide rail 224a arranged on both sides. The lock cavity 22a penetrates the lock side face 213a to form a first cavity entrance 225a and a second cavity entrance 226a. The first lock side hole 227a penetrates the lock side face 213a and communicates with the lock cavity 22a; the second lock side hole 228a penetrates the lock side face 213a and communicates with the lock cavity 22a; the first lock side hole 227a and the second lock side hole 228a are respectively arranged on both sides of the lock cavity 22a and intersect the first and second concave slide rails substantially perpendicularly.

[0040] The main lock hole 23a penetrates the lock proximal surface 211a and the cavity proximal end 221a and communicates with the lock cavity 22a to form a lock proximal hole 231a, and the lock proximal hole 231a includes a proximal guide hole 232a. The main lock hole 23a continues to extend through the cavity distal end 222a and the lock distal surface 212a to form a lock distal hole 233a.

[0041] In one design, the lock cavity entrance 225a is provided with a first drive chamber 241a; the lock cavity entrance 226a is provided with a second drive chamber 242a. The maximum dimension of the drive chamber 251a (252a) along the axial direction of the lock main hole 23 is greater than or equal to the distance between the cavity proximal end 221 and the cavity distal end 222. This arrangement is conducive to the precise positioning of the elastic member, thereby precisely controlling the direction of the elastic force.

[0042] In one design, the first lock side hole 227a and the lock side surface 213a are connected with a first outer lip 251a, which can be deformed to form an inner extension arm 253a (not shown in the figure) after shaping and polishing. Similarly, the second lock side hole 228a and the lock side surface 213a are connected with a second outer lip 252a, which can be deformed to form an inner extension arm 254a (not shown in the figure) after shaping and polishing.

[0043] Figure 27-Figure 28The composition and assembly relationship of the lock 1a are depicted. The first inner core 3a and the second inner core 3b are installed in the lock cavity 22a in a manner that the lock openings are opposite to each other; the first convex slide rail 313a matches the first concave slide rail 223a, and the second convex slide rail 314a matches the second concave slide rail 224a; the third convex slide rail 313b matches the first concave slide rail 223a, and the fourth convex slide rail 314b matches the second concave slide rail 224a. The first elastic member 4a is installed between the first drive magazine 241a and the tail of the first inner core 3a and is in a compressed state, pushing the first core block 31a to move toward the direction close to the main lock hole 23a; the second elastic member 4b is installed between the second drive magazine 242a and the tail of the second inner core 3b and is in a compressed state, pushing the second core block 31b to move toward the direction close to the main lock hole 23a; the third inner core 3c is installed between the first inner core 3a and the second inner core 3b, wherein the first drive bevel 321c contacts the first side lip 321a, and the second drive bevel 322c contacts the third side lip 321b, and its core arm 33c is installed in the first lock side hole 227a and extends to the outside of the lock shell 21a.

[0044] Figure 27-Figure 29 The components and assembly relationship of the retractor 7a in the locked state are depicted. The pull rod 62 of the pull rod 6 is inserted through the proximal lock hole 231a, wherein the inclined tip 61 squeezes the first lock opening 32a, forcing the first elastic member 4a to be further compressed, pushing the first core block 31a to move away from the main lock hole 23a; at the same time, the inclined tip 61 squeezes the second lock opening 32b, forcing the second elastic member 4b to be further compressed, pushing the second core block 31b to move away from the main lock hole 23a; when the annular groove 63 completely enters the lock cavity 22a, the elastic member 4a is pushed into the lock cavity 22a, and the elastic member 4a is pushed into the lock cavity 22a. The restoring force of the spring pushes the core block 31a and the core block 31b to move toward the direction close to the main lock hole 23a, so that the first lock opening 32a and the second lock opening 32b are inserted into the annular groove 63; and the first core block 31a and the second core block 31b are clamped between the proximal end 221a and the distal end 222a of the lock cavity, and the restoring force of the elastic member pushes the first and second core blocks so that their first and second lock openings and the annular groove remain in mutual engagement to form an engagement pair, thereby limiting the pull rod 62 from escaping from the lock 1a.

[0045] Fig.30 The puller 7a in the unlocked state is depicted. Apply external force to the core arm 33c to move it toward the inside of the lock 1a, so that the first driving inclined surface 321c squeezes the first side lip 321a to push the first core block 31a to move away from the main lock hole 23a, and then the first lock opening 32a is disengaged from the annular groove 63; at the same time, the second driving inclined surface 322c squeezes the third side lip 321b to push the second core block 31b to move away from the main lock hole 23a, and then the second lock opening 32b is disengaged from the annular groove 63; then the pull rod 11 can be disengaged from the lock 1a.

[0046] Those skilled in the art can imagine that the first inner core and the second inner core can be asymmetric structures of different shapes. To simplify the description and processing technology, the first and second inner cores in this example are the same symmetric structure. To increase the stability of unlocking, a fourth inner core with a shape and structure similar to the third inner core can be added. The working principle is similar, and the locking and unlocking principle will not be repeated here.

[0047] In one solution, the intersection of the lock side surface 213a and the first lock side hole 227a further comprises an outer convex lip 251a, which can be deformed to form an inner extension arm 251b (not shown in the figure) after shaping and polishing. The intersection of the lock side surface 213a and the second lock side hole 228a further comprises an outer convex lip 252a, which can be deformed to form an inner extension arm 252b (not shown in the figure) after shaping and polishing. The inner extension arms 251b, 252b can prevent the third inner core 3c from slipping out of the lock cavity 22a.

[0048] Similarly, the intersection area between the lock side surface 213a and the first cavity entrance 225a also includes an outer lip, which can be deformed to form an inner extension arm; the intersection area between the lock side surface 213a and the second cavity entrance 226a also includes an outer lip, which can be deformed to form an inner extension arm, and the inner extension arm can prevent the first and second elastic members from escaping from the lock cavity 22a.

[0049] In another embodiment, the lock 1a further includes a first lock side cover and a second lock side cover, wherein the first lock side cover is embedded in the entrance of the first cavity and is fixed to the lock shell by interference riveting, welding or bonding; the second lock side cover is embedded in the entrance of the second cavity and is fixed to the lock shell by interference riveting, welding or bonding.

[0050] Figure 31-Figure 33 Another retractor 7b is depicted. The retractor 7b includes a pull rod 6 and a locker 1b. The locker 1b includes a lock block 2b, a first inner core 3a, a second inner core 3b, a third inner core 3c, a first elastic member 4a and a second elastic member 4b. The lock block 2b includes a lock housing 21b and a lock cavity 22b, wherein the lock cavity 22b penetrates the lock side surface to form a first cavity entrance 225a; the lock cavity 22b extends into the lock housing 21b to form a blind cavity surface 226b. The first lock side hole 227a and the second lock side hole 228a penetrate the lock side surface 213a and communicate with the lock cavity 22b; the first lock side hole 227a and the second lock side hole 228a are respectively arranged on both sides of the lock cavity 22b and intersect the first and second concave slide rails approximately perpendicularly. The lock main hole 23a penetrates the lock housing 21b and communicates with the lock cavity 22a to form a lock proximal hole 231a and a lock distal hole 233a.

[0051] The structure of the locking block 2b is similar to that of the locking block 2a. The locking cavity, locking side hole, and locking main hole of the two are basically the same. The main difference is that the locking block 2b includes an extended locking body 25b. The maximum length of the extended locking body is L4, the minimum circumscribed circle diameter of the plane profile projected along the maximum length direction is D8, and the diameter of the proximal locking hole is D1. In one design scheme, L4≥2×D8≥6×D1, where 0.8mm≤D1≤2.6mm. This setting is conducive to opening the subcutaneous local cavity, hooking the tissue or organ, and better exposing the lesion.

[0052] Figure 31-Figure 33 The structure of the lock cavity 22b is not marked in detail, and the lock cavity 22b is substantially the same as the lock cavity 22a. Figure 23-26 The installation relationship of the parts of the retractor 7b and the retractor 7a, the matching relationship of the parts in the locked state and the unlocked state, and the working principle are basically the same, which will not be repeated here.

[0053] Figure 34-Figure 36 Another locking block 2c is depicted. The locking block 2c is substantially identical to the locking block 2. The locking block 2c comprises a lock housing 21 defined by a lock proximal end face 211, a lock distal end face 212 and a lock side face 213, and the lock housing 21 comprises a lock cavity 22. The lock cavity 22 comprises a cavity proximal end 221, a cavity distal end 222, a first concave slide rail 223, a second concave slide rail 224, a lock cavity entrance 225, a cavity bottom face 226 and a lock side hole 227. The lock main hole 23 comprises a proximal end hole 231, a guide hole 232 and a lock distal end hole 233.

[0054] In one solution, the locking block 2c is made of stainless steel, titanium alloy, aluminum alloy and other metal raw materials by turning, milling, wire cutting and other material removal machining to ensure the matching accuracy and matching strength required by the micro subcutaneous locking device.

[0055] like Fig.34 In another embodiment, the lock block 2c includes a dovetail groove 270 in the vicinity of the lock cavity entrance 225. The dovetail groove 270 includes a first groove slope 271, a second groove slope 273, and a groove bottom surface 272 extending therebetween. The width of the groove bottom surface of the dovetail groove is greater than the width of the opening of the dovetail groove. In this embodiment, the dovetail groove 270 is formed by cutting off the material of the lock cavity entrance 225 vicinity from the distal end to the proximal end. The lock block 2c also includes a lock side cover 280 with a shape and size matching the dovetail groove 270. The lock side cover 280 includes a first cover slope 281, a second cover slope 283, and a cover plate 282 extending therebetween. Figure 35-36The lock side cover 280 is buckled into the dovetail groove 270, the first groove bevel 271 matches the first cover bevel 281; the second groove bevel 273 matches the second cover bevel 283; the lock side cover 280 and the dovetail groove 270 are fully or partially interference fit to form a firm riveted fixation.

[0056] like Figure 35-Figure 36 In one design, the width of the lock side cover 280 is smaller than the lateral width of the lock cavity 22, so that a ventilation groove 291 and a ventilation groove 292 are reserved between the lock side cover 280 and the lock housing 21. The ventilation groove 291 and the ventilation groove 292 are conducive to cleaning the parts in the lock cavity and sterilizing the parts in the lock cavity.

[0057] Figure 37-Figure 39 Another locking block 2d is depicted. The locking block 2d is substantially identical to the locking block 2c. The locking block 2d comprises a lock housing 21 defined by a lock proximal end face 211, a lock distal end face 212 and a lock side face 213, wherein the lock housing 21 comprises a lock cavity 22. The lock cavity 22 comprises a cavity proximal end 221, a cavity distal end 222, a first concave slide rail 223, a second concave slide rail 224, a lock cavity entrance 225, a cavity bottom face 226 and a lock side hole 227. The lock main hole 23 comprises a proximal end hole 231, a guide hole 232 and a lock distal end hole 233. The lock cavity entrance 225 of the locking block 2d comprises a dovetail groove 270d in the vicinity thereof, wherein the dovetail groove 270d comprises a first groove inclined surface 271d, a second groove inclined surface 273d and a groove bottom face 272d extending therebetween, wherein the groove bottom face width of the dovetail groove is greater than the opening width of the dovetail groove. The locking block 2d further comprises a locking side cover 280d having a shape and size matching the dovetail groove 270d, and the locking side cover 280d comprises a first cover inclined surface 281d, a second cover inclined surface 283d and a cover plate 282d extending therebetween. Figure 35-36 The lock side cover 280d is buckled into the dovetail groove 270d, the first groove slope 271d matches the first cover slope 281d; the second groove slope 273d matches the second cover slope 283d; the lock side cover 280d and the dovetail groove 270d are fully or partially interference fit, forming a firm riveted fixation. The main difference between the lock block 2c and the lock block 2d is that the dovetail groove is set in a different direction.

[0058] In the multiple embodiments described in the present invention, each embodiment focuses on different features and their beneficial effects, and these features can be replaced and combined with each other. Many evolution schemes have been shown, and more schemes are also conceivable, which are not exhaustive here. Those skilled in the art should understand that the first, second, etc. are not in a strict order, but are only for the simplicity and accuracy of the description and for easy understanding.

Claims

1. A subcutaneous locking device, characterized in that: 1) It includes a locking block, an inner core and an elastic part; 2) The inner core comprises a core block and a core arm, wherein the core block comprises a core proximal end surface, a core distal end surface, and a first convex slide rail and a second convex slide rail arranged on both sides; and the lock passes through the core proximal end surface and the core distal end surface; 3) The lock block includes a lock shell defined by a lock proximal end surface, a lock distal end surface and a lock side surface; a lock cavity is provided in the lock shell, and the lock cavity includes a cavity proximal end, a cavity distal end and a first concave slide rail and a second concave slide rail arranged on both sides; one end of the lock cavity penetrates the lock side surface to form a lock cavity entrance, and the lock side hole penetrates the lock side surface and is connected to the lock cavity; the lock main hole penetrates the lock proximal end surface and the cavity proximal end and is connected to the lock cavity to form a lock proximal end hole, and the lock main hole continues to extend through the cavity distal end to form a lock distal hole; 4) The inner core is installed in the lock cavity, and its first convex slide rail matches the first concave slide rail, the second convex slide rail matches the second concave slide rail, the proximal end surface of the core matches the proximal end of the cavity, and the distal end surface of the core matches the distal end of the cavity, and its core arm extends to the outside of the lock block through the lock side hole; the elastic member is installed in the lock cavity and is in a compressed state, and its restoring force drives the lock mouth of the inner core to move toward the direction approaching the main lock hole; applying external force to the core arm to compress the elastic member can make the lock mouth move in the direction away from the main lock hole.

2. The locker as claimed in claim 1, wherein the first concave slide rail includes a first inner concave cylindrical surface, the first convex slide rail includes a first outer convex cylindrical surface, and the first inner concave cylindrical surface and the first outer convex cylindrical surface match to form a first cylindrical sliding bearing; the second concave slide rail includes a second inner concave cylindrical surface, the second convex slide rail includes a second outer convex cylindrical surface, and the second inner concave cylindrical surface and the second outer convex cylindrical surface match to form a second cylindrical sliding bearing.

3. The lock according to claim 2, characterized in that The utility model also comprises a lock side cover, which is embedded in the entrance of the lock cavity and fixed with the lock shell by interference riveting, welding or bonding.

4. The lock according to claim 3, characterized in that The lock block includes a dovetail groove in the vicinity of the lock cavity entrance, and the dovetail groove includes a first groove slope, a second groove slope and a groove bottom surface extending therebetween, and the width of the groove bottom surface of the dovetail groove is greater than the opening width of the dovetail groove; the lock block also includes a lock side cover whose shape and size match the dovetail groove, and the lock side cover is buckled into the dovetail groove, and the lock side cover and the dovetail groove are fully or partially interference fit to form a firm riveted fixation.

5. The lock according to claim 1, characterized in that The diameter of the proximal end hole of the lock main hole is D1, the minimum circumscribed circle diameter D2 of the projected plane contour of the lock block along the axis direction of the lock main hole, and the minimum circumscribed circle diameter D3 of the projected plane contour of the lock block along the direction perpendicular to the axis direction of the lock main hole satisfy the relationship D2≥D3>3×D1, where 0.8≤D1≤2.6mm, 10.5mm≥D3>3×D1.

6. The lock according to claim 5, characterized in that The locking opening includes a first U-shaped locking opening and a second U-shaped locking opening, wherein the first U-shaped locking opening includes an arc-shaped locking opening with a radius of R4, and the second U-shaped locking opening includes an arc-shaped locking opening with a radius of R5, and R5>R4>0.5×D1.

7. The lock according to claim 1, characterized in that: 1) The inner core comprises a first inner core, a second inner core and a third inner core; the elastic member comprises a first elastic member and a second elastic member; the first inner core comprises a first core block and a first U-shaped lock, and the first U-shaped lock is provided with a first side lip and a second side lip on both sides; the second inner core comprises a second core block and a second U-shaped lock, and the second U-shaped lock is provided with a third side lip and a fourth side lip on both sides; the first side lip and the third side lip comprise inclined surfaces; the third inner core comprises a third core block, a third lock and a core arm, and the third lock comprises a first driving inclined surface and a second driving inclined surface; 2) The first inner core and the second inner core are installed in the lock cavity with the lock opening facing each other; the first elastic member is installed at the tail of the first inner core and is in a compressed state, pushing the first core block to move toward the direction close to the lock main hole; the second elastic member is installed at the tail of the second inner core and is in a compressed state, pushing the second core block to move toward the direction close to the lock main hole; 3) The third inner core is installed between the first inner core and the second inner core, wherein the first driving inclined surface contacts the first side lip, the second driving inclined surface contacts the third side lip, and the core arm is installed in the lock side hole and extends to the outside of the main shell; when an external force is applied to the core arm to move it toward the direction close to the lock main hole, the first driving inclined surface squeezes the first side lip to push the first core block to move away from the lock main hole; at the same time, the second driving inclined surface squeezes the third side lip to push the second core block to move away from the lock main hole; After the external force is removed, the restoring forces of the first and second elastic members cause the first inner core and the second inner core to move toward a direction approaching the main lock hole, thereby pushing the third lock core to move toward a direction away from the main lock hole.

8. A subcutaneous retractor, comprising any locking device as claimed in claims 1 to 7, characterized in that: 1) It also comprises a penetrating rod, the rod comprising an inclined rod tip and a rod handle and a rod rod with a diameter of D6 extending therebetween, a rod ring groove is provided in the vicinity of the rod tip, the ring groove comprises a proximal end of the ring groove, a distal end of the ring groove and a core rod with a diameter of D7; 2) When locking, the restoring force of the elastic member drives the lock opening of the inner core to move toward the direction close to the main lock hole, so that the first U-shaped lock opening is inserted into the ring groove. The restoring force of the elastic member keeps the first U-shaped lock opening and the ring groove engaged with each other to form an engaging pair, thereby preventing the pull rod from coming out of the locker; 2) When unlocking, external force is applied to the core arm to compress the elastic member, pushing the core block to move in a direction away from the main lock hole, so that the first U-shaped lock mouth is completely separated from the annular groove, thereby allowing the pull rod to escape from the lock.

9. The retractor according to claim 8, characterized in that: When locked, the length of the core arm exposed outside the locking block is L3, wherein L3>0.5×(D6-D7).

10. A method for creating a subcutaneous pneumoperitoneum cavity using the retractor as claimed in claim 8: Channel establishment: an incision is made at an appropriate location on the patient's epidermis, and under endoscopic guidance, an energy device is used to separate tissues to establish a subcutaneous channel to the area adjacent to the lesion; Insert the locking device: Use clamps to hold the locking device and push it along the subcutaneous channel to the expected position of use in the lesion area; Assemble the pull rod: From the outside of the skin at the expected use position, pierce the skin with a penetrating pull rod, and under the guidance of an endoscope, insert the pull rod through the main lock hole of the locker, and make the lock mouth and the ring groove engage with each other to form an engagement pair; Usage: Pull the proximal end of the rod by hand or use an in vitro stent to pull and fix the proximal end of the rod, thereby pulling the lock and driving the surrounding human tissue to move, forming a local cavity; Removal: Under the guidance of endoscope, use clamps to enter through the subcutaneous channel and apply external force to the core arm to compress the elastic part so that the lock mouth is out of the ring groove, thereby pulling out the pull rod from the body, and then use clamps to clamp the lock and remove it through the subcutaneous channel.

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