Subcutaneous retractor and subcutaneous cavity building method

Abstract

A subcutaneous retractor includes a penetrating pull rod and an internal lock assembly including a main housing, a lock cylinder, and a resilient element. The main shell comprises a lock body defined by a shell near end face, a shell far end face and a shell side face. A lock cavity is formed in the lock body, and the lock main hole penetrates through the near end face of the shell and communicates with the lock cavity. The lock side hole transversely extends relative to the lock main hole, penetrates through the side face of the shell and is communicated with the lock cavity. The lock cylinder comprises a lock bolt and an unlocking arm, and the lock bolt is provided with a U-shaped or fork-shaped lock mouth; the lock bolt is mounted in the lock cavity, the pull rod is inserted into the lock main hole during locking, the elastic element is mounted between the side wall of the lock cavity and the lock bolt and is in a compressed state, and the restoring force of the elastic element pushes the lock bolt to move towards the direction close to the lock main hole, so that the lock nozzle is clamped into the annular groove; the lock bolt is clamped between the near-end wall and the far-end wall of the lock cavity, and when the pull rod is pulled or pushed in the axial direction of the pull rod, the annular groove of the pull rod and the lock bolt are meshed with each other to form a meshing pair, and the pull rod is prevented from being disengaged from the inner lock assembly.

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 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 subcutaneous retractor is provided, comprising a penetrating pull rod and an inner lock assembly, wherein the inner lock assembly comprises a main shell, a lock core and an elastic element. The main shell comprises a lock body defined by a shell proximal surface, a shell distal surface and a shell side surface; a lock cavity is provided inside the lock body, a lock main hole penetrates the shell proximal surface and communicates with the lock cavity; a lock side hole extends transversely relative to the lock main hole, penetrates the shell side surface and communicates with the lock cavity. The lock core comprises a lock bolt and an unlocking arm, wherein the lock bolt is provided with a U-shaped or forked lock mouth; the lock bolt is installed in the lock cavity, and its unlocking arm is installed in the lock side hole and extends beyond the main shell. The pull rod comprises a pull rod rod with a diameter of D1 and an inclined tip, and an annular groove is provided in the vicinity of the tip, wherein the annular groove comprises an annular groove proximal end, an annular groove distal end and a lock core rod with a diameter of D2. When locking, the pull rod is inserted into the main lock hole, and the elastic element is installed between the side wall of the lock cavity and the lock bolt and is in a compressed state. Its restoring force pushes the lock bolt to move in the direction close to the main lock hole, so that the lock mouth is stuck in the annular groove; the lock bolt is clamped between the proximal wall and the distal wall of the lock cavity. When the pull rod is pulled or pushed along the axial direction of the pull rod, the annular groove of the pull rod and the lock bolt engage with each other to form an engagement pair, thereby limiting the pull rod from coming out of the inner lock assembly. When unlocking, applying external force to the unlocking arm to compress the elastic element can drive the lock bolt to move in the direction away from the main lock hole laterally, so that the lock mouth is separated from the annular groove, thereby allowing the pull rod to come out of the inner lock assembly.

[0005] In one solution, the main housing has a maximum transverse width B1, a minimum transverse width B2, and a thickness H1, wherein B1≥B2≥H1≥3×D1, wherein 0.7mm≤D1≤2.5mm. In another solution, 0.7mm≤D1≤1.5mm.

[0006] In another embodiment, when locked, the length of the unlocking arm exposed outside the main housing is L1, wherein L1>0.5×(D1-D2).

[0007] In another embodiment, the locking nozzle includes a first U-shaped locking nozzle and a second U-shaped locking nozzle, wherein the first and second U-shaped locking nozzles form a closed annular locking nozzle; the first U-shaped locking nozzle includes an arc-shaped locking nozzle with a radius of R3, 0.5×D2<R3<0.5D1. In another embodiment, the second U-shaped locking nozzle includes an arc-shaped locking nozzle with a radius of R4, wherein R4>0.5D1. The distance between the centers of the two arcs L2>0.5×(D1-D2).

[0008] In another embodiment, the lock body includes a lock cover head and a lock handle, the lock cover head has a transverse dimension B3, the lock handle has a transverse dimension B4, where B3>B4, forming an outer extension cover; the side hole for installing the unlocking arm with a lock is arranged below the outer extension cover. In another embodiment, the lock cover head has a thickness dimension H2, the lock handle has a thickness dimension H3, where H2<H3.

[0009] In another embodiment, the diameter D3 of the proximal lock hole of the lock main hole, the plane contour of the main shell along the axial projection direction of the lock main hole includes a minimum circumscribed circle D4, and the plane contour of the main shell projected in any direction perpendicular to the axial direction of the lock main hole includes a minimum circumscribed circle D5, D4>D5≥3×D3.

[0010] In another embodiment, the proximal end surface of the shell forms an angle A1 with the pull rod 10, wherein 45°≤A1≤90°.

[0011] In another embodiment, the main shell includes an extension arm with a maximum length of L3, a minimum circumscribed circle diameter of a plane contour projected along the maximum length direction of D6, and a proximal locking hole diameter of the main locking hole of D3, wherein L3≥2×D6≥6×D3, 0.8mm≤D3≤2.6mm.

[0012] In another embodiment, the lock body further comprises an approximately L-shaped or J-shaped extension hook extending toward the distal end, the extension hook comprising a hook arm and a hook head. In a preferred embodiment, the extension hook comprises a thin plate-shaped hook arm and a hook head, the maximum width of the hook head is B5, the diameter of the main lock hole is D3, and the plane profile of the main housing projected along the axial direction of the proximal lock hole comprises a minimum circumscribed circle D8, wherein B5≥2×D3, D8≥3×D3, and 0.8mm≤D3≤2.6mm.

[0013] In another embodiment, the penetration rod includes a first pull rod and a second pull rod with the same structure, the lock core includes a first lock core and a second lock core with the same structure, and the elastic element includes a first elastic element and a second elastic element. The first lock cavity and the second lock cavity are respectively provided inside the two ends of the main shell; the first main lock hole penetrates the proximal end surface of the shell and is connected to the first lock cavity, the first side lock hole extends transversely relative to the first main lock hole, penetrates the side surface of the shell and is connected to the first lock cavity; the second main lock hole penetrates the proximal end surface of the shell and is connected to the second lock cavity; the second side lock hole extends transversely relative to the main lock hole, penetrates the side surface of the shell and is connected to the second lock cavity. The first lock core is installed in the first lock cavity and its unlocking arm extends beyond the main housing through the first lock side hole; the first pull rod is inserted through the first lock main hole, the first elastic element is installed in the elastic element installation chamber of the first lock cavity and is in a compressed state, and its restoring force pushes the first lock core to move toward the direction close to the first lock main hole, so that the lock mouth of the first lock core and the ring groove of the first pull rod are engaged with each other to form a first engagement pair, thereby limiting the first pull rod from being disengaged from the inner lock assembly. The second lock core is installed in the second lock cavity and its unlocking arm extends beyond the main housing through the second lock side hole; the second pull rod is inserted through the second lock main hole, the second elastic element is installed in the elastic element installation chamber of the second lock cavity and is in a compressed state, and its restoring force pushes the second lock core to move toward the direction close to the second lock main hole, so that the lock mouth of the second lock core and the ring groove of the second pull rod are engaged with each other to form a second engagement pair, thereby limiting the second pull rod from being disengaged from the inner lock assembly.

[0014] In another embodiment, the maximum length of the main shell is L4, the minimum circumscribed circle diameter of the plane profile projected along the maximum length direction is D7, and the diameter of the pull rod is D1, where L4≥2×D6≥6×D1, and 0.7mm≤D1≤2.6mm.

[0015] In another embodiment, the main housing includes a first main housing and a second main housing, and the first main housing and the second main housing are connected by a pin shaft to form a lock body rotation pair, so that the first main housing and the second main housing can rotate relative to each other. In another embodiment, the main housing includes a first main housing and a second main housing, and a flexible connection connects the first main housing and the second main housing into one body, and its elastic deformation enables the first and second lock bodies to move and rotate relative to each other.

[0016] In another embodiment, the lock core includes a first lock core, a second lock core and a third lock core; the elastic element includes a first elastic element and a second elastic element. The first lock core includes a first lock bolt and a first lock mouth, and the lock mouth includes a first side mouth and a second side mouth; the second lock core includes a second lock bolt and a second lock mouth; the second lock mouth includes a third side mouth and a fourth side mouth; the first side mouth and the third side mouth include inclined surfaces; the third lock core includes a third lock bolt and a third lock mouth, and the third lock mouth includes a first driving inclined surface, a second driving inclined surface, a first limiting shoulder and a second limiting shoulder; the unlocking arm is integrally connected with the first and second limiting shoulders and extends laterally outward. The first lock core and the second lock core are installed in the lock cavity with lock mouths facing each other; the first elastic element is installed between the side wall of the lock cavity and the tail of the first lock core and is in a compressed state, pushing the first lock bolt to move in the direction close to the main lock hole; the second elastic element is installed between the side wall of the lock cavity and the tail of the second lock core and is in a compressed state, pushing the second lock bolt to move in the direction close to the main lock hole; the third lock core is installed between the first lock core and the second lock core, the first driving bevel is in contact with the first side mouth, the second driving bevel is in contact with the third side mouth, and its unlocking arm is installed in the lock side hole and extends to the outside of the main shell.

[0017] When locking, the pull rod is inserted from the main lock hole, and the restoring force of the first and second elastic elements pushes the first and second lock bolts to move toward the direction close to the main lock hole, so that the first lock mouth and the second lock mouth are inserted into the annular groove; and the first lock bolt and the second lock bolt are clamped between the proximal wall and the distal wall of the lock cavity. At this time, the pull rod is pulled or pushed along the axial direction of the pull rod, and the restoring force of the elastic element pushes the first and second lock bolts to make the first and second lock mouths engage with the annular groove to form an engagement pair, thereby limiting the pull rod from coming out of the inner lock assembly. When unlocking, an external force is applied to the unlocking arm to make it move toward the inside of the inner lock assembly, so that the first driving inclined surface squeezes the first side mouth to push the first lock bolt to move in the direction away from the main lock hole, thereby making the first lock mouth come out of the annular groove; at the same time, the second driving inclined surface squeezes the third side mouth to push the second lock bolt to move in the direction away from the main lock hole, thereby making the second lock mouth come out of the annular groove; then the pull rod can come out of the inner lock assembly.

[0018] In another embodiment, the main housing is divided into a proximal main housing part and a distal main housing part along the approximate middle of the lock cavity of the main housing, and the proximal main housing part and the distal main housing part are fixedly connected to form a whole by riveting with a pin. In another embodiment, the main housing is divided into a proximal main housing part and a distal main housing part along the intersection area of ​​the lock cover head and the lock handle of the main housing, and the proximal main housing part can be made of metal or non-metal with greater strength, and the distal main housing part can be made of non-metal or metal material with lower strength. The proximal main housing part and the distal main housing part are fixedly connected to form a whole by riveting with a pin or bonding. In another embodiment, a window is opened on the side of the main housing and a side cover matching the window is added, the lock core and the elastic element are assembled and inserted through the window, and then the side cover is bonded, welded or riveted to the main housing to form a whole.

[0019] In another aspect of the present invention, a method for creating a subcutaneous cavity using a retractor is provided: 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 inner locking component: Use clamps to hold the inner locking component and push it along the subcutaneous channel to the expected position of use in the lesion area; Assemble the pull rod: pierce the skin with a penetrating pull rod from the outside of the skin at the expected use position, and insert the pull rod through the main lock hole of the inner lock assembly under the guidance of the endoscope, and make the lock mouth and the ring groove bite each other to form an engagement pair; Usage: Pull the proximal end of the pull rod by hand or use an external stent to pull and fix the proximal end of the pull rod, thereby pulling the inner locking component and driving the surrounding human tissue to move, forming a local cavity; Removal: Under the guidance of an endoscope, use a clamp to enter through the subcutaneous channel and apply external force to the unlocking arm to compress the elastic element so that the lock mouth is disengaged from the ring groove, thereby pulling the pull rod out from the body, and then use a clamp to clamp the inner lock assembly and remove it through the subcutaneous channel.

[0020] In another aspect of the present invention, a method for pneumoperitoneum cavity creation using a retractor is provided: Channel establishment: Establish a puncture channel through the patient's skin and muscle tissue; Insert the inner locking assembly: clamp the inner locking assembly with a clamp and push it along the puncture channel to the intended use position; Assemble the pull rod: From the outside of the skin at the expected use position, pierce the skin with a penetration pull rod, and under the guidance of the endoscope video, insert the pull rod through the main lock hole of the inner lock assembly, and make the lock mouth and the ring groove bite each other to form a bite pair; Usage: Pull the proximal end of the pull rod by hand or use an external stent to pull and fix the proximal end of the pull rod, thereby pulling the inner locking component and driving the surrounding human tissue to move, forming a local cavity; Removal: Under the guidance of endoscope, use clamps to enter through the puncture channel and apply external force to the unlocking arm to compress the elastic element, so that the lock mouth is disengaged from the ring groove, thereby pulling out the pull rod from the body, and use clamps to clamp the inner lock assembly and remove the inner lock assembly through the puncture channel. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] 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 a 3D schematic diagram of the retractor 1; Figure 2 is an exploded schematic diagram of the retractor 1; Figure 3 is a 3D schematic diagram of the inner lock assembly 20 (with the main housing 21 partially cut away); Figure 4 is a 3D schematic diagram of the lock cylinder 25; Figure 5 is a schematic side projection diagram of the retractor 1 in a locked state; Figure 6 yes Figure 5 6-6 sectional view; Figure 7 yes Figure 5 7-7 sectional view; Figure 8 is a 3D schematic diagram of the retractor 1 in a locked state (the main housing 21 is partially cut away); Fig. 9 is a schematic side projection diagram of the retractor 1 in an unlocked state; Fig.10 yes Fig. 9 10-10 cross-sectional view; Fig.11 yes Fig. 9 11-11 sectional view; Fig.12 is a 3D schematic diagram of the retractor 1 in the unlocked state (the main housing 21 is partially cut away); Fig.13 This is a clinical scenario diagram of using a retractor 1 to create a subcutaneous cavity; Fig.14 This is a clinical scenario diagram of using a retractor 1 to perform pneumoperitoneum cavity creation; Fig.15 is a projection schematic diagram of the lock cylinder 35; Fig.16 yes Fig.15 16-16 sectional view; Fig.17 is a 3D schematic diagram of the main housing 31; Fig.18 is a side projection view of the main housing 31; Fig.19is a projection view of the main housing 31 from the proximal end to the distal end; Fig. 20 yes Fig.19 20-20 sectional view; Fig.21 is a 3D schematic diagram of the retractor 1a in a locked state (the main housing 31 is partially cut away); Fig. 22 is a 3D schematic diagram of the retractor 1a in the unlocked state (the main housing 31 is partially cut away); Fig.23 is a 3D schematic diagram of the first lock cylinder 45 (second lock cylinder 46); Fig.24 is a 3D schematic diagram of the third lock cylinder 47; Fig.25 is a projection diagram of the main housing 41 from the proximal end to the distal end; Fig.26 yes Fig.25 26-26 sectional view; Fig. 27 yes Fig.25 27-27 sectional view; Fig.28 is a 3D schematic diagram of the main housing 41; Fig.29 is a side projection view of the retractor 1b in a locked state; Fig.30 yes Fig.29 30-30 sectional view; Fig.31 is a side projection view of the retractor 1b in the unlocked state; Fig.32 yes Fig.31 32-32 sectional view; Fig.33 is a 3D schematic diagram of the retractor 1c; Fig.34 is a side projection view of the retractor 1c; Fig.35 is a 3D schematic diagram of the retractor 1d; Fig.36 is a side projection view of the retractor 1d; Fig.37 is a projection view of the retractor 1c from the proximal end to the distal end; Fig.38 is a projection view of the retractor 1c along the maximum length direction; Fig.39 is a 3D schematic diagram of the retractor 1e; Fig.40 is a projection view of the retractor 1e from the proximal end to the distal end; Fig.41 yes Fig.40 41-41 sectional view; Fig.42 is a projection view of the retractor 1e along the maximum length direction; Fig.43 is a 3D schematic diagram of the retractor 1f; Fig.44 is an exploded schematic diagram of the retractor 1f; Fig.45 is a 3D schematic diagram of the retractor 1g; Fig.46 is a lateral projection view of the retractor 1h; Fig.47 yes Fig.46 47-47 sectional view; Fig.48 It is a projection view of retractor 1h from the proximal end to the distal end; Fig.49 is a 3D schematic diagram of the retractor 1h; Fig.50 , Fig.51 and Fig.52 is a schematic diagram of the manufacturing process of the main housing 31; Throughout the several views, the same reference numerals designate identical parts or components. DETAILED DESCRIPTION

[0022] 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.

[0023] Figure 1-Figure 2 A subcutaneous retractor 1 is depicted, comprising a penetrating pull rod 10 and an inner locking assembly 20. The pull rod 10 comprises a pull rod rod 11 with a diameter of D1 and an inclined tip 19, wherein an annular groove 18 is provided in the vicinity of the tip 19, and the annular groove 18 comprises an annular groove proximal end 15, an annular groove distal end 16 and a locking core rod 17 with a diameter of D2.

[0024] like Figure 2-Figure 3 The inner lock assembly 20 includes a main housing 21 , a lock core 25 and an elastic element 29 .

[0025] like Figure 3The main housing 21 includes a lock body 214 defined by a housing proximal surface 211, a housing distal surface 212 and a housing side surface 213. A lock cavity 220 is provided inside the lock body 214, and the lock cavity 220 includes a cavity proximal end 221 and a cavity distal end 222. A main lock hole 225 extends from the housing proximal surface 211 through the cavity proximal end 221, and is connected with the lock cavity 220 to form a proximal lock hole 224; the main lock hole 225 penetrates the cavity distal end 222 and extends to the vicinity of the housing distal surface 212 or penetrates the housing distal surface 212 to form a distal lock hole 226. The side lock hole 215 extends transversely relative to the main lock hole 225, penetrates the housing side surface 213 and is connected with the lock cavity 220.

[0026] like Figure 4 The lock core 25 includes a lock bolt 251 and an unlocking arm 252 , and the lock bolt 251 is provided with a U-shaped (or fork-shaped) lock mouth 253 . Figure 5-8 The schematic diagram of the retractor 1 in the locked state is depicted. The lock core 25 is installed inside the main housing 21, wherein the lock bolt 251 is installed in the lock cavity 220, and the unlocking arm 252 is installed in the lock side hole 215 and extends beyond the outside of the main housing 21. The elastic element 29 is installed between the side wall of the lock cavity 220 and the lock bolt 251 and is in a compressed state, and its restoring force pushes the lock bolt 251 to move toward the direction close to the lock main hole 225. The pull rod 11 is inserted through the proximal lock hole 224, wherein the inclined tip 19 squeezes the lock mouth 253, forcing the elastic element 29 to be further compressed, pushing the lock bolt 251 to move in a direction away from the lock main hole 225; when the annular groove 18 completely enters the lock cavity 220, the spring restoring force pushes the lock bolt 251 to move in a direction close to the lock main hole 225, so that the lock mouth 253 is inserted into the annular groove 18; and the lock bolt 251 is clamped between the proximal end 221 and the distal end 222 of the lock cavity 220. At this time, the pull rod 10 is pulled or pushed axially, and the restoring force of the elastic element pushes the lock bolt 251 to make the lock mouth 253 and the annular groove 18 engage with each other to form an engagement pair, thereby limiting the pull rod 11 from coming out of the inner lock assembly 20.

[0027] refer to Figure 9-12 To understand the coordination diagram when the retractor 1 is in the unlocked state, an external force is applied to the unlocking arm 252 to compress the elastic element 29, pushing the locking bolt 251 to move in a direction away from the main lock hole 225, so that the locking mouth 253 disengages from the annular groove 18, thereby allowing the pull rod 11 to disengage from the inner lock assembly 20.

[0028] Fig.13 A clinical scenario diagram of using a retractor 1 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. Under the guidance of the endoscope 3, an energy device is used to separate the tissue to establish a subcutaneous channel to the area adjacent to the lesion (Note: Fig.13The middle grid represents the skin, and the dotted area represents the established subcutaneous channel); Insert the inner locking assembly: use the clamp 3 to hold the inner locking assembly 20 and push it along the subcutaneous channel to the expected use position of 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 10 (or pierce with the aid of an instrument), and under the guidance of the video of the endoscope, insert the pull rod 11 through the proximal lock hole of the inner lock assembly, and make 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 10 by hand or use an external stent to pull and fix the proximal end of the pull rod 10, thereby pulling the inner locking component and driving the surrounding human tissue to move, forming a local cavity (local surgical working cavity); Removal: Under the guidance of an endoscope, use the clamp 3 to enter through the subcutaneous channel and apply external force to the unlocking arm 252 to compress the elastic element 29, so that the locking mouth 253 disengages from the annular groove 18, thereby pulling the pull rod 10 out of the body, and then use the clamp 3 to clamp the inner locking assembly and remove the inner locking assembly through the subcutaneous channel.

[0029] Fig.14 A clinical scenario diagram of using a retractor 1 to create a pneumoperitoneum cavity without using a pneumoperitoneum is depicted, and the application method is generally as follows: Channel establishment: establish puncture channel 4 through the patient's skin and muscle tissue (Note: Fig.14 The middle grid area represents the skin); Insert the inner locking assembly: clamp the inner locking assembly 20 with the clamp 3 and push it along the puncture channel 4 to the expected use position; Assemble the pull rod: From the outside of the skin at the intended use position, pierce the skin with the penetration pull rod 10 (or pierce with the aid of an instrument), and under the guidance of the video of the endoscope, insert the pull rod 11 through the proximal lock hole of the inner lock assembly, and make 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 10 by hand or use an external stent to pull and fix the proximal end of the pull rod 10, thereby pulling the inner locking component and driving the surrounding human tissue to move, forming a local cavity (local surgical working cavity); Removal: Under the guidance of an endoscope, use the clamp 3 to enter through the puncture channel and apply external force to the unlocking arm 252 to compress the elastic element 29, so that the locking mouth 253 disengages from the annular groove 18, thereby pulling the pull rod 10 out of the body, and then use the clamp 3 to clamp the inner locking assembly and remove the inner locking assembly through the puncture channel.

[0030] Those skilled in the art should understand that Fig.13 Schematic diagram depicting the clinical scenario of a typical single-incision transfer incision. Fig.14A 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 3 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.

[0031] 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.

[0032] like Figure 5-Figure 8 In one design, the diameter of the pull rod 11 is D1, where 0.7mm≤D1≤2.5mm, and the length of the pull rod L≥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 lock core fit firmly. In another preferred design, 0.7mm≤D1≤1.5mm, this design is more traumatic. In another scheme, the main shell has a maximum lateral width B1, a minimum lateral width B2, and a thickness dimension H1, where B1≥B2≥H1≥3×D1. This size design is conducive to the inner lock component entering and exiting the patient's body through the subcutaneous channel or the puncture channel, and is also conducive to the inner lock component pulling and exposing the surrounding tissue, thereby constructing a local working cavity. In another embodiment, the diameter of the pull rod 11 is D1, the diameter of the lock core rod 17 is D2, and in the locked state, the length of the unlocking arm 252 exposed outside the main housing 21 is L1, where L1>0.5×(D1-D2). This arrangement is conducive to achieving intracavitary unlocking under endoscopy.

[0033] Figure 15-Figure 22 Another retractor 1a is depicted, comprising a penetration rod 10 and an inner locking assembly 30. The inner locking assembly 30 comprises a main housing 31, a lock core 35 and an elastic element 29. Figure 15-16Another lock core 35 is depicted to include a lock bolt 351 and an unlocking arm 352, wherein the lock bolt 351 is provided with a lock mouth 353. The lock mouth 353 includes a first U-shaped lock mouth 353a and a second U-shaped lock mouth 353b, wherein the first and second U-shaped lock mouths constitute a closed annular lock mouth. In one design scheme, the proximal end of the lock mouth 353 includes an inclined guide lip 354. In another design scheme, the first U-shaped lock mouth 353a includes an arc-shaped lock mouth with a radius of R3, wherein 0.5×D2<R3<0.5D1. The second U-shaped lock mouth 353b includes an arc-shaped lock mouth with a radius of R4, wherein R4>0.5D1. The distance between the centers of the two arcs L2>0.5×(D1-D2).

[0034] Figure 17-Figure 20 Another main housing 31 is depicted. The main housing 31 includes a lock body 314 defined by a housing proximal surface 311, a housing distal surface 312 and a housing side surface 313. A lock cavity 320 is provided inside the lock body 314, and the lock cavity 320 includes a cavity proximal end 321 and a cavity distal end 322. A main lock hole 325 extends from the housing proximal surface 311 through the cavity proximal end 321, and is connected with the lock cavity 320 to form a proximal lock hole 324; an inclined guide lock hole 327 is provided at the intersection of the proximal lock hole 324 and the proximal surface. The main lock hole 325 penetrates the cavity distal end 322 and extends to the vicinity of the housing distal surface 312 to form a distal lock hole 326. The side lock hole 315 extends transversely relative to the main lock hole 325, penetrates the housing side surface 313 and is connected with the lock cavity 320. The lock cavity 320 also includes an elastic element mounting compartment 316.

[0035] In one design, the lock body 314 includes a lock cover head 314a and a lock handle 314b, wherein the lock cover head 314a has a transverse dimension B3, and the lock handle 314b has a transverse dimension B4, wherein B3>B4, forming an outer extension cover 314c. A side hole 315 for installing the unlocking arm with a lock is arranged below the outer extension cover 314c. In another design, the lock cover head 314a has a thickness dimension H2, and the lock handle 314b has a thickness dimension H3, wherein H2<H3. This design can simplify the structure and facilitate the main shell to enter and exit the patient's body through a subcutaneous channel or a puncture channel.

[0036] In another design, the diameter D3 of the proximal locking hole 324, the plane profile of the main housing 31 in the axial projection direction of the hole 324 includes a minimum circumscribed circle D4, where D4 ≥ 3 × D3, 0.8 mm ≤ D3 ≤ 2.6 mm. In another preferred design, 0.8 mm ≤ D3 ≤ 1.6 mm. In another design, the plane profile of the main housing 31 projected in any direction perpendicular to the axial direction of the hole 324 includes a minimum circumscribed circle D5, where D4 > D5 ≥ 3 × D3.

[0037] like Fig.21The lock core 35 is installed inside the main housing 31, wherein the lock bolt 351 is installed in the lock cavity 320, and the unlocking arm 352 is installed in the lock side hole 315 and extends beyond the outside of the main housing 31. The elastic element 29 is installed between the side wall of the lock cavity 320 and the lock bolt 351 and is in a compressed state, and its restoring force pushes the lock bolt 351 to move toward the direction close to the proximal lock hole 324.

[0038] Fig.21 The retractor 1a in the locked state is depicted. The pull rod 11 is inserted through the proximal lock hole 324, wherein the inclined tip 19 squeezes the lock mouth 353, forcing the elastic element 29 to be further compressed, pushing the lock bolt 351 to move in the direction away from the lock main hole 325; when the annular groove 18 completely enters the lock cavity 320, the spring restoring force pushes the lock bolt 351 to move in the direction close to the lock main hole 325, so that the first U-shaped lock mouth 353a is inserted into the annular groove 18; and the lock bolt 351 is clamped between the proximal end 321 and the distal end 322 of the lock cavity 320. At this time, the pull rod 10 is pulled or pushed axially, and the restoring force of the elastic element pushes the lock bolt 351 to make the first U-shaped lock mouth 353a and the annular groove 18 interlock with each other to form an interlocking pair, thereby limiting the pull rod 11 from coming out of the inner lock assembly 20.

[0039] Fig. 22 The retractor 1a is depicted in the unlocked state. Applying external force to the unlocking arm 352 compresses the elastic element 29, pushing the locking bolt 351 to move away from the proximal locking hole 324, so that the first U-shaped locking mouth 353a is disengaged from the annular groove 18, and the second U-shaped locking mouth 353b is aligned with the pull rod 11, thereby allowing the pull rod 11 to be disengaged from the inner lock assembly 30.

[0040] The unlocking method of the retractor 1 is to pull out the unlocking arm to the outside of the inner lock assembly, while the unlocking method of the retractor 1a is to compress the unlocking arm to the inside of the inner lock assembly. When the retractor 1a is working, the proximal end surface 311 of the main shell 31 of the retractor 1a interacts with human tissue, and the unlocking arm 352 is arranged on the lower side of the outer extension cover 314c, which can prevent accidental unlocking due to squeezing of human tissue, and is conducive to the use of instruments to complete unlocking under the observation of the endoscope. Those skilled in the art can imagine that by changing the position of the elastic element in the retractor 1a, it can be changed to a mode of unlocking by pulling out the unlocking arm to the outside of the inner lock assembly.

[0041] Figures 23 to 32 Another retractor 1b is depicted, comprising a penetration rod 10 and an inner lock assembly 40. The inner lock assembly 40 comprises a main housing 41, a first lock cylinder 45, a second lock cylinder 46, a third lock cylinder 47, a first elastic element 29a and a second elastic element 29b. Fig.23, the first lock core 45 includes a first lock bolt 451 and a first lock mouth 453. The lock mouth 453 includes a first side mouth 455 and a second side mouth 456. The second lock core 46 includes a second lock bolt 461 and a second lock mouth 463. The lock mouth 463 includes a third side mouth 465 and a fourth side mouth 466. In one embodiment, the first side mouth 455 and the third side mouth 465 include inclined surfaces. In another design, the first, second, third and fourth side mouths include inclined surfaces with the same angle. In another embodiment, the tail of the lock bolt 451 also includes a first notch 452; the tail of the lock bolt 461 also includes a second notch 462. The first and second lock cores may be equivalent or unequal. To simplify the description, the schematic diagram of this embodiment uses completely identical first and second lock cores. As Fig.24 The third lock core 47 comprises a third lock bolt 471 and a third lock mouth 473. The third lock mouth 473 comprises a first driving inclined surface 473, a second driving inclined surface 474, a first limiting shoulder 475 and a second limiting shoulder 476; the unlocking arm 472 is integrally connected with the first and second limiting shoulders and extends outward laterally.

[0042] Figure 25-28 The structure and composition of another main shell 41 are described. The main shell 41 includes a lock body 414 defined by a shell proximal surface 411, a shell distal surface 412 and a shell side surface 413. A lock cavity 420 is provided inside the lock body 414, and the lock cavity 430 includes a cavity proximal end 421 and a cavity distal end 422. The main lock hole 425 passes through the proximal end 421 of the shell proximal surface 411, and is connected with the lock cavity 420 to form a proximal lock hole 424; an inclined guide lock hole 427 is provided at the intersection of the proximal lock hole 424 and the proximal surface. The main lock hole 425 penetrates the cavity distal end 422 and extends to the area adjacent to the shell distal surface 412 to form a distal lock hole 426. The side lock hole 415 extends transversely relative to the main lock hole 425, passes through the shell side surface 413 and is connected with the lock cavity 420. In one design, the lock side hole 415 includes a first lock side hole 415a and a second lock side hole 415b, and the first and second lock side holes are respectively arranged on both sides of the lock cavity 420. The lock cavity 420 also includes a first bin seat 416a and a second bin seat 416b for installing the elastic element. In one design, the lock body 414 includes a lock cover head 414a and a lock handle 414b, and the lateral dimension of the lock cover head 414a is greater than the lateral dimension of the lock handle 414b, forming an external extension cover. The lock side hole 415 for installing the unlocking arm is arranged below the external extension cover.

[0043] Figure 29-Figure 30The assembly relationship of the retractor 1b is depicted. The first lock core 45 and the second lock core 46 are installed in the lock cavity 420 in a manner that the lock mouths are opposite to each other; the first elastic element 29a is installed between the first storage seat 416a and the tail of the first lock core 45 and is in a compressed state, pushing the first lock bolt 451 to move toward the direction close to the proximal lock hole 424; the second elastic element 29b is installed between the second storage seat 416b and the tail of the second lock core 46 and is in a compressed state, pushing the second lock bolt 461 to move toward the direction close to the proximal lock hole 424; the third lock core 47 is installed between the first lock core 45 and the second lock core 46, wherein the first driving inclined surface 473 contacts the first side mouth 455, the second driving inclined surface 474 contacts the third side mouth 465, and its unlocking arm 472 is installed in the lock side hole 415 and extends to the outside of the main housing 41.

[0044] Figure 29-Figure 30 The retractor 1b is depicted in a locked state. The pull rod 11 is inserted through the proximal locking hole 424, wherein the inclined tip 19 squeezes the first locking mouth 453, forcing the first elastic element 29a to be further compressed, pushing the first locking bolt 451 to move in a direction away from the proximal locking hole 424; at the same time, the inclined tip 19 squeezes the second locking mouth 463, forcing the second elastic element 29b to be further compressed, pushing the second locking bolt 461 to move in a direction away from the proximal locking hole 424; when the annular groove 18 completely enters the lock cavity 420, the spring restoring force pushes the locking bolt 451 and the locking bolt 461 to move in a direction close to the proximal locking hole 424, so that the first locking mouth 453 and the second locking mouth 463 are inserted into the annular groove 18; and the first locking bolt 451 and the second locking bolt 461 are clamped between the proximal end 421 and the distal end 422 of the lock cavity 420. At this time, the pull rod 10 is pulled or pushed axially, and the restoring force of the elastic element pushes the first and second locking bolts so that the first and second locking mouths and the annular groove 18 engage with each other to form an engagement pair, thereby limiting the pull rod 11 from escaping from the inner locking assembly 40.

[0045] Figure 31-Figure 32 The retractor 1b is depicted in the unlocked state. External force is applied to the unlocking arm 472 to move it toward the inside of the inner lock assembly 40, so that the first driving inclined surface 473 squeezes the first side mouth 455, thereby pushing the first locking bolt 451 to move in a direction away from the proximal locking hole 424, thereby causing the first locking mouth 453 to escape from the annular groove 18; at the same time, the second driving inclined surface 474 squeezes the third side mouth 465, thereby pushing the second locking bolt 461 to move in a direction away from the proximal locking hole 424, thereby causing the second locking mouth 463 to escape from the annular groove 18; then the pull rod 11 can escape from the inner lock assembly 40.

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

[0047] Figure 33-Figure 34 Another retractor 1c is depicted, comprising a penetrating pull rod 10 and an inner locking assembly 30a. The inner locking assembly 30a comprises a main housing 31a, a lock core 35 and an elastic element 29. The main housing 31a is substantially identical to the main housing 31, the main difference being that the proximal end surface 311 of the main housing 31 forms a right angle with the pull rod 10, while the proximal end surface 311 of the main housing 31 forms an angle A1 with the pull rod 10, wherein 45°≤A1≤90°. The matching relationship and the functional relationship of the various parts of the retractor 1c and the retractor 1a in the locked state and the unlocked state are substantially identical, and will not be described in detail here. The retractor 1c is used for fixed-angle traction and special cavity space traction in specific clinical scenarios.

[0048] Figure 35-Figure 38 Another retractor 1d is depicted, comprising a penetration rod 10 and an inner lock assembly 30d. The inner lock assembly 30d comprises a main housing 31d, a lock core 35 and an elastic element 29 (not shown in the figure). The main housing 31d has a similar structure to the main housing 31: the main housing 31d comprises a lock body 314d defined by a housing proximal surface 311d, a housing distal surface 312d and a housing side surface 313d. The interior of the lock body 314d is provided with a lock cavity 320, a cavity proximal end 321, a cavity distal end 322 and an elastic element mounting chamber 316. The main lock hole 325 comprises a guide lock hole 327, a proximal lock hole 32 and a distal lock hole 326. The lock side hole 315 extends transversely relative to the main lock hole 325, penetrates the housing side surface 313d and communicates with the lock cavity 320. The lock body 314d comprises a lock cover head 314a, a lock handle 314b and an extension arm 317d. The main housing 31d and the main housing 31 are used to install the lock cylinder 35, the elastic element 29 and the pull rod 10, and the structure and size are the same, refer to Figure 15-22 The matching relationship and functional relationship of the parts of the retractor 1d and the retractor 1a in the locked state and the unlocked state are basically the same, and will not be described in detail here.

[0049] The main difference between the main housing 31d and the main housing 31 is that the main housing 31d includes an extension arm 317d, the maximum length of the main housing 31d is L3, the minimum circumscribed circle diameter of the plane profile projected along the maximum length direction is D6, and the diameter D3 of the proximal locking hole 324 is, in one design, L3≥2×D6≥6×D3, where 0.8mm≤D3≤2.6mm. This setting is conducive to opening the subcutaneous local cavity, hooking the tissue or organ, and better exposing the lesion.

[0050] Figure 39-Figure 42 Another retractor 1e is depicted, comprising a first pull rod 10e1, a second pull rod 10e2 and an inner lock assembly 30e. The first pull rod 10e1, the second pull rod 10e2 and the pull rod 10 have substantially the same structure. The inner lock assembly 30e comprises a main housing 31e, a first lock core 35e1, a second lock core 35e2, a first elastic element 29e1 and a second elastic element 29e2. The first lock core 35e1, the second lock core 35e2 and the lock core 35 have substantially the same structure; the first elastic element 29e1, the second elastic element 29e2 and the elastic element 29 have substantially the same structure.

[0051] The main housing 31e has a similar structure to the main housing 31: the main housing 31e includes a lock body 314e defined by a housing proximal surface 311e, a housing distal surface 312e and a housing side surface 313e. The interior of the lock body 314e at both ends is provided with a first lock cavity 320e1 and a second lock cavity 320e2, respectively. The lock cavity 320e1, the lock cavity 320e2 and the lock cavity 320 have the same structure, including a cavity proximal end, a cavity distal end and an elastic element installation compartment.

[0052] The first main lock hole 325e1 is connected to the first lock cavity 320e1 through the proximal end of the cavity by the proximal end surface 311e of the shell, and the second main lock hole 325e2 is connected to the second lock cavity 320e2 through the proximal end of the cavity by the proximal end surface 311e of the shell. The structures of the first main lock hole 325e1, the second main lock hole 325e2 and the main lock hole 325 are the same, including a guide lock hole, a proximal lock hole and a distal lock hole. The first lock side hole 315e1 extends transversely relative to the main lock hole, penetrates the shell side 313e and connects to the first lock cavity 320e1; the second lock side hole 315e2 extends transversely relative to the main lock hole, penetrates the shell side 313e and connects to the second lock cavity 320e2.

[0053] Fig.41The assembly relationship of the retractor 1e is described in detail. The first lock core 35e1 is installed in the first lock cavity 320e1 and its unlocking arm extends beyond the outside of the main housing through the first lock side hole 315e1; the first pull rod 10e1 is inserted through the first lock main hole 325e1; the first elastic element 29e1 is installed in the elastic element installation compartment of the first lock cavity and is in a compressed state, and its restoring force pushes the first lock core to move toward the direction close to the first lock main hole, so that the lock mouth of the first lock core and the annular groove of the first pull rod engage with each other to form a first engagement pair, thereby limiting the first pull rod from coming out of the inner lock assembly 30e. Similarly, the second lock core 35e2 is installed in the second lock cavity 320e2 and its unlocking arm extends beyond the outside of the main shell through the second lock side hole 315e2; the second pull rod 10e2 is inserted through the second lock main hole 325e2; the second elastic element 29e2 is installed in the elastic element installation compartment of the second lock cavity and is in a compressed state, and its restoring force pushes the second lock core to move in the direction close to the second lock main hole, so that the lock mouth of the second lock core and the annular groove of the second pull rod engage with each other to form a second engagement pair, thereby limiting the second pull rod from escaping from the inner lock assembly 30e.

[0054] The matching relationship and the functional relationship of the parts of the retractor 1e and the retractor 1a in the locked state and the unlocked state are basically the same, and will not be described in detail here.

[0055] In one design, the maximum length of the main shell 31e is L4, the minimum circumscribed circle diameter of the plane profile projected along the maximum length direction is D7, and the diameter of the pull rod is D1, where L4≥2×D6≥6×D1, where 0.7mm≤D1≤2.6mm. Compared with the retractor 1d, the retractor 1e can provide greater pulling force. It can be used for abdominal wall traction to create a pneumoperitoneum, or local narrow and long cavity creation, or deep traction to create a cavity, or liver diversion and other clinical scenarios.

[0056] Figure 43-Figure 44 Another retractor 1f is depicted. It includes a first pull rod 10e1, a second pull rod 10e2 and an inner lock assembly 30f. The inner lock assembly 30f includes a main housing 31f, a first lock core 35e1, a second lock core 35e2, a first elastic element 29e1 and a second elastic element 29e2. The main housing 31f has a similar structure to the main housing 31e: the main housing 31f includes a first main housing 31f1 and a second main housing 31f2. The first main housing 31f1 includes a first lock cavity 320e1, a first lock main hole 325e1 and a first lock side hole 315e1 that are identical to those of the main housing 31e. The second main housing 31f2 includes a second lock cavity 320e2, a second lock main hole 325e2 and a second lock side hole 315e2 that are identical to those of the main housing 31e.

[0057] In one design, the first main housing 31f1 includes a lock body shaft 33f1, and the second main housing 31f2 includes a lock body shaft hole 33f2. The lock body shaft 33f1 and the lock body shaft hole 33f2 form a lock body rotation pair 33f, so that the first main housing and the second main housing can rotate relative to each other. In another design, the first main housing 31f1 includes a first lock body shaft hole, and the second main housing 31f2 includes a second lock body shaft hole. A lock body shaft pin connects the first lock body shaft hole and the second lock body shaft hole together to form a lock body rotation pair 33f.

[0058] The assembly relationship, locking state and unlocking state of the first pull rod 10e1, the second pull rod 10e2, the first lock core 35e1, the second lock core 35e2, the first elastic element 29e1 and the second elastic element 29e2 of the retractor 1f are the same as those of the retractor 1e, and will not be repeated here. The main difference is that the first main housing and the second main housing of the retractor 1f can rotate relative to each other. It is easy for those skilled in the art to think that the main housing 31f can be divided into more parts to form a second lock body rotation pair, a third lock body rotation pair, a fourth lock body rotation pair, etc., to form a hinged main housing. The rotation direction of each rotation pair can be the same or different.

[0059] Fig.45 Another retractor 1g is depicted. It includes a first pull rod 10e1, a second pull rod 10e2 and an inner lock assembly 30g. The inner lock assembly 30g includes a main housing 31g, a first lock core 35e1, a second lock core 35e2, a first elastic element 29e1 and a second elastic element 29e2. The main housing 31g has a similar structure to the main housing 31e: the main housing 31g includes a first main housing 31g1 and a second main housing 31g2. The first main housing 31g1 includes a first lock cavity 320e1, a first lock main hole 325e1 and a first lock side hole 315e1 that are identical to those of the main housing 31e. The second main housing 31g2 includes a second lock cavity 320e2, a second lock main hole 325e2 and a second lock side hole 315e2 that are identical to those of the main housing 31e. The flexible connection 33g connects the first main housing 31g1 and the second main housing 31g2 into one body, and its elastic deformation enables the first and second lock bodies to move and rotate relative to each other. Fig.45 The flexible belt structure shown in the figure achieves a flexible connection effect, which still does not deviate from the spirit of the present invention. The assembly relationship, locking state and unlocking state of the first pull rod 10e1, the second pull rod 10e2, the first lock core 35e1, the second lock core 35e2, the first elastic element 29e1 and the second elastic element 29e2 of the retractor 1g are the same as those of the retractor 1f, and will not be repeated here.

[0060] Figure 46-Figure 49 Another retractor 1h is depicted, comprising a penetrating pull rod 10 and an inner lock assembly 30h. The inner lock assembly 30h comprises a main housing 31h, a lock core 35 and an elastic element 29. The main housing 31h comprises a lock body 314h defined by a housing proximal surface 311, a housing distal surface 312 and a housing side surface 313. The lock body 314h is provided with a lock cavity 320 inside, and the lock cavity 320 comprises a cavity proximal end 321 and a cavity distal end 322. The main hole 325 passes through the cavity proximal end 321 from the housing proximal surface 311 and is connected with the lock cavity 320 to form a proximal lock hole 324; an inclined guide lock hole 327 is provided at the intersection of the proximal lock hole 324 and the proximal surface. The main lock hole 325 passes through the cavity distal end 322 and extends to the vicinity of the housing distal surface 312 to form a distal lock hole 326. The lock side hole 315 extends transversely relative to the lock main hole 325, penetrates the shell side 313 and is connected to the lock cavity 320. The lock cavity 320 also includes an elastic element installation compartment 316. The same reference numerals represent substantially identical structures. Figures 47-49 The above equivalent structures are not marked in detail, please refer to Figure 15-Figure 22 understand.

[0061] The main housing 31h is similar in structure to the main housing 31, and the main difference is that the lock body 314h of the main housing 31h also includes an approximately L-shaped or approximately J-shaped extension hook 33h extending toward the distal end. The extension hook 33h shown includes a hook arm 33h1 and a hook head 33h2. The matching relationship and functional relationship of the various parts of the retractor 1h and the retractor 1a in the locked state and the unlocked state are basically the same, and will not be repeated here. The retractor 1h shown is conducive to strongly pulling blood vessels, ligaments, or subcutaneous muscle incisions and subcutaneous tissue incisions in a local cavity under the skin.

[0062] In a preferred embodiment, the extended hook 33h includes a thin plate-shaped hook arm 33h1 and a hook head 33h2, the maximum width of the hook head 33h2 is B5, the diameter of the proximal locking hole is D3, and the plane contour of the main shell 31h projected along the axial direction of the proximal locking hole includes a minimum circumscribed circle D8, wherein B5≥2×D3, D8≥3×D3, and 0.8mm≤D3≤2.6mm.

[0063] In order to briefly explain the concept of the present invention, Figure 1-Figure 49 The main housing 21, main housing 31, main housing 41, main housing 31a, main housing 31d, main housing 31e, main housing 31f, main housing 31g, and main housing 31h depicted in the drawings are not detailed in terms of assembly and manufacturing. It should be easy for a person skilled in the art to understand that, in order to facilitate parts manufacturing and product assembly, the aforementioned main housing can be decomposed into two or more parts, and after the inner lock assembly is assembled, the various parts of the main housing are fixed into a whole by processes such as glue bonding, pin riveting, thread riveting, metal welding or ultrasonic welding.

[0064] Take the main housing 31 as an example: Fig.50 It is depicted that the lock cavity of the main housing is divided into a proximal main housing portion and a distal main housing portion along the approximate middle of the lock cavity, and the proximal main housing portion and the distal main housing portion are fixedly connected into a whole by pin riveting. Fig.51 The main housing is divided into a proximal main housing part and a distal main housing part along the intersection area of ​​the lock cover head and the lock handle. The proximal main housing part can be made of metal or non-metal with greater strength, and the distal main housing part can be made of non-metal or metal with lower strength. The proximal main housing part and the distal main housing part are connected as a whole by pin riveting or bonding. Fig.52 The invention describes a method in which a window is opened on the side of the main housing and a side cover is added to match the window, the lock core and the elastic element are assembled and inserted through the window, and then the side cover is bonded, welded or riveted to the main housing to form a whole. Three schemes for convenient manufacturing and assembly have been listed. Those skilled in the art can make adaptive modifications in manufacturing and assembly based on the above-listed embodiments without departing from the spirit of the invention.

[0065] 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 retractor, characterized in that: 1) comprising a penetration rod and an inner lock assembly, wherein the inner lock assembly comprises a main housing, a lock core and an elastic element; 2) The main housing comprises a lock body defined by a housing proximal surface, a housing distal surface and a housing side surface; a lock cavity is provided inside the lock body, a main lock hole penetrates through the housing proximal surface and communicates with the lock cavity; a side lock hole extends transversely relative to the main lock hole, penetrates through the housing side surface and communicates with the lock cavity; 3) The lock core comprises a lock bolt and an unlocking arm, wherein the lock bolt is provided with a U-shaped or forked lock mouth; the lock bolt is installed in the lock cavity, and the unlocking arm is installed in the lock side hole and extends beyond the main housing; 4) The pull rod comprises a pull rod rod with a diameter of D1 and an inclined tip, a ring groove is provided in the vicinity of the tip, and the ring groove comprises a proximal end of the ring groove, a distal end of the ring groove and a lock core rod with a diameter of D2; 5) When locking, the pull rod is inserted into the main lock hole, the elastic element is installed between the side wall of the lock cavity and the lock bolt and is in a compressed state, and its restoring force pushes the lock bolt to move toward the direction close to the main lock hole, so that the lock mouth is stuck in the annular groove; the lock bolt is clamped between the proximal wall and the distal wall of the lock cavity, and when the pull rod is pulled or pushed along the axial direction of the pull rod, the annular groove of the pull rod and the lock bolt engage with each other to form an engagement pair, thereby limiting the pull rod from coming out of the inner lock assembly; 6) When unlocking, applying external force to the unlocking arm to compress the elastic element can drive the lock bolt to move laterally away from the lock main hole, so that the lock mouth is disengaged from the ring groove, thereby allowing the pull rod to disengage from the inner lock assembly.

2. The retractor according to claim 1, characterized in that The main shell has a maximum lateral width B1, a minimum lateral width B2, and a thickness dimension H1, wherein B1≥B2≥H1≥3×D1, wherein 0.7mm≤D1≤2.5mm.

3. The retractor according to claim 1, characterized in that The locking mouth comprises a first U-shaped locking mouth and a second U-shaped locking mouth, wherein the first and second U-shaped locking mouths constitute a closed annular locking mouth; the first U-shaped locking mouth comprises an arc-shaped locking mouth with a radius of R3, and 0.5×D2<R3<0.5D1.

4. The retractor according to claim 1, characterized in that When locked, the length of the unlocking arm exposed outside the main housing is L1, wherein L1>0.5×(D1-D2).

5. The retractor according to claim 4, characterized in that The lock body comprises a lock cover head and a lock handle, wherein the lock cover head has a transverse dimension B3, and the lock handle has a transverse dimension B4, wherein B3>B4, forming an outer extension cover; a lock side hole for installing an unlocking arm is arranged below the outer extension cover.

6. The retractor according to claim 4, characterized in that The proximal lock hole of the lock main hole has a diameter D3, and the plane contour of the main shell along the axial projection direction of the lock main hole includes a minimum circumscribed circle D4. The plane contour of the main shell projected in any direction perpendicular to the axial direction of the lock main hole includes a minimum circumscribed circle D5, and D4>D5≥3×D3.

7. The retractor according to claim 1, characterized in that The lock body also includes an approximately L-shaped or J-shaped extension hook extending toward the distal end, the extension hook includes a hook arm and a hook head, the extension hook includes a thin plate-shaped hook arm and a hook head, the maximum width of the hook head is B5, the diameter of the main lock hole is D3, and the plane contour of the main shell projected along the axial direction of the proximal lock hole includes a minimum circumscribed circle D8, wherein B5≥2×D3, D8≥3×D3, and 0.8mm≤D3≤2.6mm.

8. The retractor according to claim 1, characterized in that: 1) The penetration rod comprises a first rod and a second rod with the same structure, the lock core comprises a first lock core and a second lock core with the same structure, and the elastic element comprises a first elastic element and a second elastic element; 2) The first lock cavity and the second lock cavity are respectively provided inside the two ends of the main shell; the first lock main hole penetrates the proximal end surface of the shell and is connected to the first lock cavity, the first lock side hole extends transversely relative to the first lock main hole, penetrates the side surface of the shell and is connected to the first lock cavity; the second lock main hole penetrates the proximal end surface of the shell and is connected to the second lock cavity; The second lock side hole extends transversely relative to the lock main hole, penetrates the shell side surface and is connected to the second lock cavity; 3) The first lock cylinder is installed in the first lock cavity and its unlocking arm extends beyond the outside of the main housing through the first lock side hole; The first pull rod is inserted through the first lock main hole, the first elastic element is installed in the elastic element installation compartment of the first lock cavity and is in a compressed state, and its restoring force pushes the first lock core to move toward the direction close to the first lock main hole, so that the lock mouth of the first lock core and the annular groove of the first pull rod are engaged with each other to form a first engagement pair; 4) The second lock core is installed in the second lock cavity and its unlocking arm extends beyond the outside of the main shell through the second lock side hole, the second pull rod is inserted through the second lock main hole, and the second elastic element is installed in the elastic element installation compartment of the second lock cavity and is in a compressed state. Its restoring force pushes the second lock core to move in the direction close to the second lock main hole, so that the lock mouth of the second lock core and the annular groove of the second pull rod engage with each other to form a second engagement pair.

9. The retractor according to claim 1, characterized in that: 1) The lock core includes a first lock core, a second lock core and a third lock core; the elastic element includes a first elastic element and a second elastic element; 2) The first lock core includes a first lock bolt and a first lock mouth, and the lock mouth includes a first side mouth and a second side mouth; the second lock core includes a second lock bolt and a second lock mouth; the second lock mouth includes a third side mouth and a fourth side mouth; the first side mouth and the third side mouth include inclined surfaces; the third lock core includes a third lock bolt and a third lock mouth, and the third lock mouth includes a first driving inclined surface, a second driving inclined surface, a first limiting shoulder and a second limiting shoulder, and the unlocking arm is integrally connected with the first and second limiting shoulders and extends laterally outward; 3) The first lock core and the second lock core are installed in the lock cavity with the lock mouths facing each other; the first elastic element is installed between the side wall of the lock cavity and the tail of the first lock core and is in a compressed state, pushing the first lock bolt to move in a direction close to the lock main hole; the second elastic element is installed between the side wall of the lock cavity and the tail of the second lock core and is in a compressed state, pushing the second lock bolt to move in a direction close to the lock main hole; the third lock core is installed between the first lock core and the second lock core, the first driving inclined surface contacts the first side mouth, the second driving inclined surface contacts the third side mouth, and its unlocking arm is installed in the lock side hole and extends to the outside of the main housing; 4) When locking, the pull rod is inserted into the main lock hole, and the restoring force of the first and second elastic elements pushes the first and second lock bolts to move toward the main lock hole, so that the first and second lock mouths are inserted into the annular groove; and the first and second lock bolts are clamped between the proximal wall and the distal wall of the lock cavity. At this time, the pull rod is pulled or pushed along the axial direction, and the restoring force of the elastic element pushes the first and second lock bolts so that the first and second lock mouths and the annular groove engage with each other to form an engagement pair, thereby limiting the pull rod from coming out of the inner lock assembly; 5) When unlocking, external force is applied to the unlocking arm to make it move toward the inside of the inner lock assembly, so that the first driving inclined surface squeezes the first side mouth, thereby pushing the first lock bolt to move in the direction away from the main lock hole, and then the first lock mouth is disengaged from the annular groove; at the same time, the second driving inclined surface squeezes the third side mouth, thereby pushing the second lock bolt to move in the direction away from the main lock hole, and then the second lock mouth is disengaged from the annular groove; then the pull rod can be disengaged from the inner lock assembly.

10. A method for creating a subcutaneous pneumoperitoneum cavity using the retractor as claimed in claim 1: 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 inner locking component: Use clamps to hold the inner locking component and push it along the subcutaneous channel to the expected position of use in the lesion area; Assemble the pull rod: pierce the skin with a penetrating pull rod from the outside of the skin at the expected use position, and under the guidance of the endoscope, insert the pull rod through the main lock hole of the inner lock assembly, and make the lock mouth and the ring groove bite each other to form an engagement pair; Usage: Pull the proximal end of the pull rod by hand or use an external stent to pull and fix the proximal end of the pull rod, thereby pulling the inner locking component and driving the surrounding human tissue to move, forming a local cavity; Removal: Under the guidance of an endoscope, use a clamp to enter through the subcutaneous channel and apply external force to the unlocking arm to compress the elastic element so that the lock mouth is disengaged from the ring groove, thereby pulling out the pull rod from the body, and then use a clamp to clamp the inner lock assembly and remove it through the subcutaneous channel.

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