Pneumoperitoneum-free endoscopic surgery abdominal wall suspension instrument assembly

Abstract

The invention provides a pneumoperitoneum-free endoscopic surgery abdominal wall suspension instrument assembly. The pneumoperitoneum-free endoscopic surgery abdominal wall suspension instrument assembly comprises a bed supporting frame, a cross rod fixing extension rod, a reverse abdominal wall puncture outfit, a pull rope with a lock catch, a controllable folding pull rod, a suspension rope and an accessory set. The reverse abdominal wall puncture outfit is matched with the accessory set and used for forming suspension holes in three different positions of the abdominal wall. The controllable folding pull rod, the suspension rope or the combination of the controllable folding pull rod and the suspension rope suspend the abdominal wall through three suspension holes in different positions and are fixed to the bed supporting frame through the pull rope with the lock catch and the transverse rod fixing and extending rod, and suspension is completed. According to the pneumoperitoneum-free endoscopic surgery abdominal wall suspension instrument assembly, the operation space in the abdominal cavity established by the suspension abdominal wall can meet the surgical operation requirement, the degree of damage to abdominal wall tissue is minimum, and operation becomes simpler, more convenient and safer.

Description

Technical Field

[0001] This application relates to the field of medical device technology, specifically to an abdominal wall suspension device assembly for laparoscopic surgery that can be performed without insufflation within the abdominal cavity. The assembly suspends the abdominal wall under pneumoperitoneum-free conditions to create an effective surgical operating space within the abdominal cavity, facilitating the smooth execution of various laparoscopic surgical procedures. Background Technology

[0002] Conventional laparoscopic surgery requires injecting CO2 gas at a pressure of 12-15 cmH2O into the closed abdominal cavity. This causes the entire anterior abdominal wall to rise in a semi-elliptical shape under the influence of anesthesia and muscle relaxants, creating sufficient surgical space for minimally invasive procedures. However, this inflated abdominal cavity also brings corresponding side effects and complications. The elevation of the diaphragm affects the patient's cardiopulmonary function, and it also compresses venous blood return in the lower limbs, increasing the risk of deep vein thrombosis. Hypercarbonate-induced metabolic disorders can further affect the recovery of multiple organs. Therefore, the search for an abdominal wall suspension device that can create an effective operating space within the abdominal cavity and meet the needs of minimally invasive surgery, instead of inflating the abdominal cavity, has long been recognized by industry experts. However, currently used gasless abdominal medical devices and technologies still have many shortcomings that cannot be overcome and urgently need improvement. For example, the suspension devices disclosed in patent publication numbers CN109907785B and CN115886904A all require a large suspension incision to be made on the abdominal wall, which causes significant damage to the abdominal wall tissue.

[0003] It is particularly important to emphasize that, unlike conventional laparoscopic surgery where the abdominal cavity is pre-inflated and a large operating space is established, the abdominal cavity is deflated under gasless surgery conditions. The abdominal wall is in close contact with abdominal organs such as the intestines, liver, and spleen. Moreover, the initial abdominal wall suspension procedure is performed without any laparoscopic forceps to be inserted into the abdominal cavity for assistance. Therefore, the structural design of the gasless abdominal wall suspension instrument and its operational procedures are crucial to ensuring the safe insertion of the suspension instrument into the abdominal cavity for abdominal wall suspension and absolutely preventing collateral damage to the abdominal organs. Summary of the Invention

[0004] The purpose of this application is to provide a gasless laparoscopic abdominal wall suspension device assembly that creates an intra-abdominal operating space that meets the requirements of surgical operation, minimizes damage to abdominal wall tissues, and makes the operation simpler, more convenient and safer.

[0005] To achieve the above objectives, this application provides the following technical solution: An abdominal wall suspension device assembly for gasless laparoscopic surgery includes: a bed support frame (1), a horizontal bar fixing extension rod (2), a reverse abdominal wall trocar (3), a locking tension rope (4), a controllable folding pull rod (5), a suspension rope (6), and an accessory group; the reverse abdominal wall trocar (3) cooperates with the accessory group to create and form suspension holes for pulling the abdominal wall in three different positions on the anterior abdominal wall, the midline of the left clavicle, and the midline of the right clavicle; the controllable folding pull rod (5), the suspension rope (6), or a combination thereof pull and suspend the abdominal wall through the suspension holes at the three different positions, and is fixed to the bed support frame (1) via the locking tension rope (4) and the horizontal bar fixing extension rod (2) to complete the suspension fixation.

[0006] In one embodiment, the reverse abdominal wall trocar (3) is an extended cannula trocar, consisting of a core, an outer cannula, an arc-shaped handle (10) with an air injection valve, and a sealing cap. The arc-shaped handle (10) with an air injection valve is located at the base of the outer cannula and is fixedly connected to the long axis of the outer cannula at an angle of 45-90 degrees. The arc-shaped handle is also provided with an air inlet pipe with an air inlet valve.

[0007] In one embodiment, the front opening of the outer sleeve is a bevel, which is elliptical and is positioned at a 25-degree angle to the axial direction of the major axis of the outer sleeve, and the bevel is positioned towards the side of the arc-shaped handle.

[0008] In one embodiment, the controllable folding lever (5) includes a long main rod (13) and a short auxiliary rod (14) pivotally connected to one end of the long main rod. The long main rod (13) includes a main body (15), a solid head (16), a control channel extending through the length of the main body, and a control structure disposed within the control channel. The solid head (16) extends forward from the midpoint of the front end of the main body (15) to one side, and has a long strip-shaped cross-section, which is part of the cross-sectional shape of the main body (15). The short auxiliary rod (14) comprises a first part (18) and a second part (19) connected by a structure. The midpoint of the first part (18) and the second part (19) is pivotally connected to the end of the solid head (16). An opening groove (12) extending through the length direction is provided on the side of the first part (18) facing the solid head (16). Below the bottom of the opening groove (12) on the side of the first part (18) of the short auxiliary rod (14), a sliding groove extending through the long axis direction of the first part is provided. The cross-sectional shape of (18) is a part of the cross-sectional shape of the second part (19). The shape of the opening groove (12) is adapted to the shape of the solid head (16), and the cross-sectional shape when the two are closed is consistent with the cross-sectional shape of the second part (19) or the main body (15). The main body (15) of the long main rod (13) has a control channel running through the long axis. The control channel is provided with a control structure, which is used to control the short auxiliary rod (14) relative to the long main rod (13). The controllable folding lever (5) has two states: in the first state, the short auxiliary lever (14) and the solid head (16) of the long main lever (15) are joined together to form a straight line, which is used to insert the short auxiliary lever (14) as the top of the long main lever (15) into the abdominal cavity; in the second state, the short auxiliary lever (14) is unfolded relative to the long main lever (16) to form a T-shaped structure, which is used to block and support the abdominal wall in the abdominal cavity, thereby realizing the suspension of the abdominal wall.

[0009] In one embodiment, the controllable folding pull rod (5) has a control channel inside. Depending on the control channel and the control structure located therein, there are two different structural forms of controllable folding pull rods, including a folding pull rod controlled by a traction rope and a folding pull rod controlled by a push-pull steel rod. In the folding pull rod controlled by the traction rope, the control channel is configured to include a first rope channel (20) and a second rope channel (21). The first rope channel (20) and the second rope channel (21) are located on opposite sides of the axial direction of the main body (15), and the front openings (24) of the tube walls of the first rope channel (20) and the second rope channel (21) are located on the solid head (15). 6) On both sides, corresponding to the positions of the first part (18) and the second part (19) of the short auxiliary rod (14); the control structure includes a first pull rope (22) and a second pull rope (23). One end of the first pull rope (22) and the second pull rope (23) are respectively connected to the crossbar fine opening (32) at the center of the free end of the first part (18) and the second part (19). The other end of the first pull rope (20) and the second pull rope (23) extend out from the tail end of the main body (15) through the front opening (24) of the tube wall of the main body (15) and through the first rope channel (20) and the second rope channel (21) to be fixed or connected.

[0010] In one embodiment, in the folding pull rod controlled by the push-pull steel rod, the control channel is the pull rod channel (17), located on one side of the central axis of the main body (15), with an opening at each end. The opening at the front end and the solid head (16) are located on opposite sides of the front end face of the main body (15). A control structure is installed in the control channel, that is, the control structure in the pull rod channel (17) is a push-pull steel rod (11). The head of the push-pull steel rod (11) extends forward and bulges out into a small ball. The small ball extends forward and enters the groove below the bottom of the opening groove (12) on the side of the first part (18). The short auxiliary rod (14) The bottom of the side opening groove (12) of the first part (18) is provided with a sliding groove that runs through the long axis of the first part; the push-pull steel rod (11) is pushed and pulled in the front and back direction, and the small ball at the head end of the push-pull steel rod (11) slides in the sliding groove below the bottom of the opening groove (12) of the first part (18) of the short auxiliary rod (14), which will inevitably drive the short auxiliary rod (14) to close and unfold relative to the long main rod (13); the tail section of the push-pull steel rod (11) forms a self-single-axis hinge joint at the tail end outlet of the long main rod (13): when unfolded into a straight line, it is convenient to insert into the lock (28), and when folded into a right angle, it is convenient to hold the tail section of the push-pull steel rod (11) and fix it.

[0011] In one embodiment, the suspension rope (6) has an elongated oval bundle-like structure, and each end of the suspension rope (6) is provided with a slit (25). The mating surface of the slit (25) is provided with a circular washer (26), and the inner ring of the circular washer (26) has a meshing and interlocking surface structure.

[0012] In one embodiment, the accessory group includes a straight abdominal wall puncture needle and a sigmoid puncture needle (9). The sigmoid puncture needle (9) includes an arc-shaped needle tube, an arc-shaped needle core located inside the arc-shaped needle tube, and a straight handle fixedly connected to one end of the arc-shaped needle tube. Both ends of the arc-shaped needle tube are open. The inner cavity of the arc-shaped needle tube can accommodate the suspension rope (6) through which it is inserted.

[0013] In one embodiment, the locking tension rope (4) consists of a locking buckle (28), a rope hook (29), a tension indicator, and a tension rope. The locking buckle (28) consists of a solid shell, a tension rope channel, a push-release tube (30), a locking component (31), a spring, and a cap. The tension rope channel is conical, and the push-release tube (30) is installed inside it. The locking component (31) has a structure of three locking spheres, and the locking component (31) straddles the three side holes of the push-release tube (30). As the push-release tube (30) is pulled... The force rope channel is continuously squeezed and moved downward by the upper spring. Under the synergistic squeezing of the inclined side wall of the force rope channel, the locking component (31) is forced to move inward and gradually lock onto the long main rod (15) or force rope of the controllable folding pull rod (5) passing through the push release tube (30). As the push release tube (30) mouth is pressed upward with a finger, the push release tube (30) will inevitably drive the locking component (31) into the widened force rope channel, thereby loosening the locking effect of the three locking balls on the controllable folding pull rod (5) or force rope passing through them.

[0014] Compared with the prior art, the technical solution of this application has the following beneficial effects: (1) The abdominal wall suspension surgical instrument assembly of the present invention causes minimal damage to the abdominal wall and the least tearing to the skin, leaving only the puncture needle hole of the puncture needle as the suspension hole, leaving virtually no scar; it will not cause tearing and expansion of the skin wound, nor will it cause large-scale patchy damage to the abdominal wall tissue. The present invention uses a suspension rope (6) to support the most robust full-thickness abdominal wall fibrous connective tissue at the linea alba in the middle of the abdomen. This area has the strongest suspension resistance, and because it uses full-thickness abdominal wall suspension and traction, it is more effective in establishing an intra-abdominal operating space, fully meeting the requirements of laparoscopic surgery. The suspension is also simple and easy to perform for obese patients, and the suspension effect is equally good. The instrument and technique employed in this invention cause minimal damage, requiring no incision. Abdominal wall traction and suspension are achieved solely through a puncture needle that vertically penetrates the entire abdominal wall. Simultaneously, the traction and suspension points are distributed at three points: the midline of the abdominal wall and the midline of the clavicles on both sides of the surgical area. Therefore, the traction points and range are more uniform, creating a wider effective operating space within the abdominal cavity. Furthermore, the traction force in different areas of the abdominal wall can be adjusted in real time based on the values ​​displayed on the intraoperative traction monitor. All of these features are not found in any other gasless abdominal wall suspension techniques or instruments.

[0015] (2) The first insertion of the first traction suspension device under pneumoperitoneum conditions is the most difficult because the abdominal wall and internal organs such as the stomach and intestines are closely attached under pneumoperitoneum conditions. Directly and blindly puncturing the abdominal cavity can easily cause damage to the internal organs. At the same time, it is not possible to completely avoid the situation where there is adhesion between the intestine and the abdominal wall in patients with a history of surgery. At this time, there are no additional forceps to be inserted into the abdominal cavity to protect the internal organs and assist in the safe insertion of the traction suspension device through the abdominal wall.

[0016] This invention solves the problem by using a reverse abdominal wall trocar 3, modifying the structure of the base and end of the commonly used abdominal wall trocar cannula, and installing an arc-shaped handle 10 with an air inlet valve at the end of the abdominal wall trocar cannula. This change in mechanical structure allows the thumb and palm to use sufficient force to flip the end of the reverse abdominal wall trocar 3 cannula upward and lift the abdominal wall, thus separating the abdominal wall from the intestinal viscera. It is precisely through this structural design change of installing an arc-shaped handle 10 with an air inlet valve at the end of the reverse abdominal wall trocar 3 that the goal of quickly inserting an abdominal wall suspension and traction device into the abdominal cavity, which is impossible to achieve blindly with conventional abdominal wall trocars or any abdominal wall trocar cannula, is achieved. Conventional abdominal wall trocars cannot provide such a strong force to lift the front opening of the cannula upward.

[0017] The outer cannula of the reverse abdominal wall trocar 3 is designed with its end opening facing the air inlet valve side, that is, the side facing the abdominal wall skin, and maintains the maximum area of ​​the elliptical opening. The structural design of the inclined surface of the end opening of the reverse abdominal wall trocar 3 at a 25-degree angle to the axis of the outer cannula provides both structural stability and maximizes the area of ​​the end opening. When the end of the outer cannula pushes up the abdominal wall, the elliptical opening faces the abdominal wall side, thus minimizing damage to the abdominal wall. This change in the structure of the end opening of the outer cannula of the reverse abdominal wall trocar 3 also provides a safe and protective structure for the straight abdominal wall puncture needle or the B-shaped abdominal wall puncture needle (9) to be directly inserted into the opening of the inner cavity of the outer cannula. This overcomes the defect that the end opening of all conventional abdominal wall trocars is facing away from the abdominal wall side, which cannot accommodate the puncture needle to enter the inner cavity. Through the above-mentioned changes to the structure of conventional abdominal wall trocars, the present invention successfully achieves the goal of quickly, effectively and safely placing abdominal wall suspension instruments under pneumoperitoneum conditions.

[0018] Furthermore, the curved handle of the reverse abdominal wall trocar 3 is equipped with an air injection valve. This is to temporarily inject gas into the abdominal cavity through the air injection valve in the curved handle when there are complex adhesions between the intestines and the abdominal wall. After the adhesions are loosened, the patient can return to the gas-free state to continue intra-abdominal suspension and surgical operations. The structural design of the curved handle (10) with an air inlet valve of the reverse abdominal wall trocar 3 is a temporary intra-abdominal inflation measure taken to protect the absolute safety of the patient's surgery and avoid secondary damage to the adhered intestines in special circumstances. This structural design is conducive to finding the part of the abdominal wall without intestinal adhesions, inserting the trocar, and loosening the adhesions between the intestines and the abdominal wall. This solves the bottleneck problem of not being able to continue gas-free laparoscopic minimally invasive surgery in the case of complex adhesions in the abdominal cavity.

[0019] The present invention designs the front opening of the reverse abdominal wall puncture device 3 with the bevel facing the arc-shaped handle (10) with the air injection valve. This is to ensure that the widest bevel opening at the front of the reverse abdominal wall puncture device 3 is close to the anterior abdominal wall and faces the skin. Under the torque of the arc-shaped handle, the anterior abdominal wall can be pushed upward, causing the anterior abdominal wall to move away from the contact of the intestinal tract and internal organs such as the liver and spleen in the abdominal cavity. At the same time, the upward bevel opening of the front of the reverse abdominal wall puncture device 3 also provides a maximum area for structural stability of the outer cannula opening. This provides an absolute safety guarantee for the safe and quick one-time penetration of the abdominal wall puncture needle into the inner cavity of the front of the outer cannula, preventing damage to internal organs, especially the intestinal tract. This invention achieves the clinical requirement of safely, quickly, and easily introducing a controllable foldable lever (5) or traction rope into the abdominal cavity and suspending and tractioning the anterior abdominal wall under gasless conditions by changing the structural design of the beveled opening at the front end of the conventional trocar. This is something that all current gasless abdominal wall suspension instruments and techniques cannot achieve under blind conditions.

[0020] (3) The controllable folding lever (5) provided by this invention has two different structural forms: a controllable folding lever controlled by a traction rope and a controllable folding lever controlled by a push-pull steel rod. The purpose is to realize the folding and flipping action of the short auxiliary lever (14) in the abdominal cavity by manipulating the traction rope or the push-pull steel rod (11) at the end of the long main rod (13) of the controllable folding lever (5) from outside the abdominal cavity, thereby realizing the opening and closing of the controllable folding lever (5). This application is the most minimally invasive and simplest method for inserting an abdominal wall suspension device into the abdominal cavity, overcoming the structural and operational defects of other lever structures that require the assistance of instruments such as intra-abdominal grasping forceps to achieve closing and folding.

[0021] (4) The most effective way to establish an effective intra-abdominal operating space under pneumoperitoneum-free conditions is to suspend the abdominal wall at multiple points corresponding to the surgical area. In this application, a suspension rope (6) is used to hold the entire layer of the abdominal wall to complete the suspension of a section of the abdominal wall, which minimizes the damage to the abdominal wall and can also hold a section of the abdominal wall longitudinally. The established intra-abdominal operating space is more effective and optimized. Because the force required for full-layer abdominal wall traction suspension is relatively large, there is a risk of continuous tearing of the suspension rope (6) slit (25). Therefore, the present invention provides a circular washer (26) on the mating surface of the slit (25) at both ends of the suspension rope (6) to prevent the slit (25) from being continuously pulled and torn, causing the suspension rope (6) to break. The inner ring of the circular washer (26) has a meshing and interlocking surface structure (27), so that after pinching, it is easy to restore the long oval bundle-like structure of the suspension rope (6), ensuring that the suspension rope (6) passes smoothly through the inner cavity of the straight abdominal wall puncture needle or the type B abdominal wall puncture needle (9).

[0022] (5) The structure and technique of suspending the abdominal wall in the gasless laparoscopic surgery of the present invention are applied to the three-dimensional space of the corresponding transverse and longitudinal positions of the surgical field to suspend the abdominal wall, and the intra-abdominal operating space is maximized and the effect is optimal. The type B abdominal wall puncture needle (9) of the present invention can easily and simply vertically puncture the entire layer of the abdominal wall, and can quickly insert and exit the abdominal wall at a reverse angle of more than 180 degrees, so as to achieve the suspension target of holding a section of the entire layer of the abdominal wall. This is achieved by using the straight handle on the type B abdominal wall puncture needle (9) and applying arc rotation force. The present invention achieves the defects of conventional straight puncture needles or semi-circular arc puncture needles that require repeated insertion and exit of the abdominal wall by fixing a straight handle at one end of the arc puncture needle. It simplifies the surgical operation steps and increases the safety of the operation. Attached Figure Description

[0023] To more clearly illustrate the technical solutions in the embodiments of this application, the accompanying drawings used in the description of the embodiments will be briefly introduced below. Obviously, the accompanying drawings described below are only some embodiments of this application. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort.

[0024] Figure 1 A schematic diagram of a pneumoperitoneum-free laparoscopic abdominal wall suspension device assembly provided in the first embodiment of this application; Figure 2 This is a schematic diagram of the reverse abdominal wall trocar in this application; Figure 3 This is a schematic diagram of the structure of one embodiment of the controllable folding rod in this application; Figure 4 This is a schematic diagram of another embodiment of the controllable folding rod in this application; Figure 5 This is a schematic diagram of the structure of the type B abdominal wall puncture needle in this application; Figure 6 This is a schematic diagram of the suspension rope structure in this application; Figure 7 This is a schematic diagram of the locking mechanism in this application.

[0025] Reference numerals: 1. Bed support frame; 2. Crossbar fixed extension rod; 3. Reverse abdominal wall puncture device; 4. Pull rope with lock; 5. Controllable folding pull rod; 6. Suspension rope; 9. Z-shaped abdominal wall puncture needle; 10. Arc-shaped handle with air inlet valve; 11. Push-pull steel rod; 12. Opening groove; 13. Long main rod; 14. Short auxiliary rod; 15. Main body; 16. Solid head; 17. Pull rod channel; 18. First part; 19. Second part; 20. First rope channel; 21. Second rope channel; 22. First traction rope; 23. Second traction rope; 24. Front opening of tube wall; 25. Slit; 26. Circular washer; 27. Engaging surface; 28. Lock; 29. ​​Rope hook; 30. Push-release tube; 31. Locking component; 32. Crossbar fine opening; 33. Slide groove. Detailed Implementation

[0026] To better understand this invention, two different practical examples will be provided below.

[0027] Application Example 1 The first embodiment of this application provides a gasless laparoscopic abdominal wall suspension device assembly (hereinafter referred to as the suspension assembly) and its suspension technique for upper abdominal surgeries such as partial gastrectomy.

[0028] Conventional laparoscopic minimally invasive surgery first requires a 10mm incision at the umbilicus to insert an abdominal wall trocar. The purpose of this trocar is to inflate the abdominal cavity with air and insert a laparoscope through it, creating effective operating space within the abdominal cavity and allowing observation of abdominal organs, tissues, and adhesions. This embodiment uses a reverse abdominal wall trocar 3. Its purpose is not only to insert a laparoscope through this trocar to observe abdominal organs, tissues, and adhesions, but also to lift the abdominal wall upwards, away from the abdominal organs, and provide a safe and reliable protective structure for abdominal wall puncture. It also allows for the safe and easy insertion and suspension of abdominal wall devices into the abdominal cavity without pneumoperitoneum. The reverse abdominal wall trocar 3 of this invention is characterized by its arc-shaped handle 10 with an air inlet valve and an opening structure design that is opposite in direction to the conventional abdominal wall trocar, yet it achieves functions that conventional abdominal wall trocars cannot.

[0029] In the first embodiment of this invention, at the start of the upper abdominal laparoscopic surgery, a 10mm incision is made at the umbilicus under direct vision, and a reverse abdominal wall trocar 3 is inserted. The core is removed, but the outer cannula of the reverse abdominal wall trocar 3 is left in place. The laparoscope lens is inserted to observe whether there are any intestinal adhesions or the condition of the internal organs in the abdominal wall. If there are no adhesions, the arc-shaped handle 10 with an air inlet valve at the end of the reverse abdominal wall trocar 3 is grasped and flipped. Using the arc-shaped handle 10 with an air inlet valve, the oblique opening at the front end of the outer cannula of the reverse abdominal wall trocar 3 is pushed upward and flipped upward. This requires a relatively large wrist force to achieve. Regardless of the patient's size, the oblique opening at the front end of the outer cannula of the reverse abdominal wall trocar 3 can be felt on the surface of the skin that has been pushed up, and the light of the laparoscope lens inside the outer cannula of the reverse abdominal wall trocar 3 can be seen.

[0030] The reverse abdominal wall trocar 3 of the present invention has an arc-shaped handle and an outer tube fixed at a 45-90 degree angle to the longitudinal axis. This fixed angle is conducive to using the strength of the palm and thumb to twist the front opening of the outer tube of the reverse abdominal wall trocar 3 inserted into the abdominal cavity upward and lift the abdominal wall. In this way, the entire layer of the abdominal wall is lifted away from contact with the intestines and other internal organs in the abdominal cavity, thus protecting the safety of the internal organs. Conventional abdominal wall trocars cannot provide the upward lifting force at the front opening of the outer tube, which is at the same level as the air inlet valve.

[0031] Conventional abdominal wall trocars typically have the beveled opening at the front of the outer cannula facing away from the air inlet valve. This is because the air inlet valve is located at the top, and the structure of the outer cannula's front end is designed with the opening facing downwards to allow for direct and rapid injection of gas into the abdominal cavity. If the front opening of the outer cannula were designed to face the air inlet valve, the injected airflow would inevitably blow towards the anterior abdominal wall, significantly slowing down the injection speed, easily creating turbulence, and also blurring the lens. This invention designs the beveled opening at the front of the outer cannula of the reverse abdominal wall trocar 3 to face the direction of the arc-shaped handle 10 with the air inlet valve, with the beveled opening at a 25-degree angle. This structure ensures that when holding the reverse abdominal wall trocar 3, the beveled opening at the front of the outer cannula faces the abdominal wall, allowing the anterior abdominal wall to be lifted upwards and away from internal organs when the front of the reverse abdominal wall trocar 3 is flipped. Simultaneously, the upward-facing beveled opening provides a safe protective structure for the direct insertion of the linear abdominal wall trocar needle or the sigmoid abdominal wall trocar needle 9 in the accessory assembly to form a suspension hole. The 25-degree bevel design provides a maximum elliptical front opening space while ensuring the robustness of the outer tube's front opening and the reliability of the structure that creates the maximum protective space.

[0032] Furthermore, the outer cannula of the reverse abdominal wall trocar 3 is equipped with an arc-shaped handle 10 with an air inlet valve. The arc-shaped handle also contains an air inlet pipe with an air inlet valve. This is to address situations where, under extreme conditions, there is significant adhesion between the anterior abdominal wall and the intestines, making it difficult to find a suitable location for abdominal wall puncture and suspension, especially for patients with a history of repeat or multiple surgeries. By placing the air inlet pipe within the arc-shaped handle 10 with the air inlet valve, temporary inflator can be introduced into the abdominal cavity to assess the adhesions in the inner layer of the anterior abdominal wall. After the adhesions between the intestines and the abdominal wall are loosened, the gas is released, and the abdominal wall suspension and laparoscopic surgery can continue under pneumoperitoneum-free conditions. This structural design serves as a temporary backup plan for special intestinal adhesions and other situations. This new structure of the invention utilizes a similar original structure to achieve emergency functions and address the needs of handling special circumstances, resolving complex adhesions between the intestines and the anterior abdominal wall, better preventing and reducing intraoperative collateral damage and surgical complications, and is more in line with medical ethics.

[0033] The difficulty of the gasless laparoscopic abdominal wall suspension technique of this invention lies in the fact that before the gasless laparoscopic abdominal wall suspension surgical instrument assembly is placed, the anterior abdominal wall and the organs such as the intestines in the abdominal cavity are in a state of close contact. Without gas, and without any auxiliary instruments to be inserted into the abdominal cavity, this invention, relying on its uniquely designed gasless laparoscopic abdominal wall suspension surgical instrument assembly and novel operating techniques, can safely, effectively, quickly, and easily suspend the abdominal wall along the midline and the midclavicular lines on both sides to establish an effective intra-abdominal surgical operating space. This is the most crucial step in successfully establishing an intra-abdominal surgical operating space under gasless conditions. One of the most important structural features of this application is the design of the front opening of the outer cannula of the reverse abdominal wall trocar 3 and the arc-shaped handle 10 with an air inlet valve. The technique of using the extended outer cannula of the reverse abdominal wall trocar 3 to lift the abdominal wall allows the abdominal wall suspension instrument to safely and quickly enter the abdominal cavity to complete the suspension and traction of the anterior abdominal wall under gasless conditions.

[0034] In this embodiment, the present invention uses a straight abdominal wall puncture needle to insert a first suspension rope 6 at the midline of the upper abdomen to complete the traction and suspension of the first abdominal wall position: First, the point two finger-widths below the xiphoid process on the anterior midline of the upper abdominal wall is selected as the needle entry point. The oblique opening at the front end of the outer cannula of the reverse abdominal wall puncture device 3 is used to lift the anterior midline of the abdominal wall upward. The straight abdominal wall puncture needle from the accessory group punctures the abdominal wall from the needle entry point and enters the inner cavity of the outer cannula of the reverse abdominal wall puncture device 3. The straight abdominal wall puncture needle is then withdrawn from the body through a small incision at the umbilicus along with the reverse abdominal wall puncture device 3. The needle core is removed, the suspension rope 6 is inserted into the straight abdominal wall puncture needle tube, and the straight abdominal wall puncture needle tube is then withdrawn. At this time, the suspension rope 6 is in a state where it enters from the insertion point and exits through the umbilical incision, remaining inside the abdominal wall; further, the reverse abdominal wall puncture device 3 is used to lift the anterior abdominal wall exit point one finger-width above the umbilicus, and a straight abdominal wall puncture needle is used to pierce the abdominal wall from the skin outside the exit point and directly enter the inner cavity of the outer cannula of the reverse abdominal wall puncture device 3, and is led out through the small incision at the umbilicus. The needle core is removed, and the front end of the suspension rope 6 led out from the small incision at the umbilicus is inserted backward into the inner cavity of the straight abdominal wall puncture needle tube and led out through the skin from the exit point; the slits 25 at both ends of the suspension rope 6 are opened, and the slits 25 become circular rings; the rope hooks 29 on the tension rope 4 are used to hook the circular rings at both ends of the suspension rope 6, completing the full-layer suspension of the abdominal wall at the anterior midline of the lower abdominal wall.

[0035] The first accessory in the accessory group, the straight abdominal wall puncture needle, is used in conjunction with the reverse abdominal wall puncture device 3 to form a first suspension hole on the abdominal wall to suspend a section of the abdominal wall. This process requires multiple steps to complete the suspension of the abdominal wall segment at the midline of the upper abdomen.

[0036] The inventors discovered in clinical practice that if upper abdominal surgery is performed with suspension at only one point on the upper abdominal wall, such as the midline of the upper abdomen, the surgical operating space inside the abdominal cavity will form a pointed tent-like shape, with the middle raised and the sides contracted. This cannot meet the needs of laparoscopic surgery, and the effective operating space within the abdominal cavity is relatively small, which significantly affects the smooth operation of the surgery. Therefore, in order to establish a sufficient and effective operating space within the abdominal cavity under gas-free conditions, it is necessary to select three points on the left and right upper abdominal walls, namely the midclavicular line on the left and right upper abdominal walls, respectively, for lifting and suspension. Suspension at these three points together creates a larger operating space within the abdominal cavity.

[0037] In laparoscopic gasless abdominal wall suspension, there are three horizontal suspension points in the surgical area. The traction directions are: vertically upward from the midline of the abdomen, upward and outward from the left midclavicular line, and upward and outward from the right midclavicular line. The midline is suspended directly upward through a controllable foldable lever 5 or suspension rope 6. At this point, the controllable foldable lever 5 or suspension rope 6 supports the entire abdominal wall and provides the most stable support along the midline of the abdomen, minimizing the impact and degree of damage to the abdominal wall tissues. The subsequent suspension point is located at the first lateral abdominal wall midclavicular line. Only controllable foldable traction rods 5 can be used to suspend and pull the entire abdominal wall upward and outward, followed by the insertion of a surgical trocar. Finally, for the suspension of the other side of the abdominal wall, with the assistance of surgical forceps, either controllable foldable traction rods 5 or suspension ropes 6 can be used to suspend and pull the entire abdominal wall upward and outward. Therefore, by using the placement and suspension of three controllable foldable traction rods 5 or suspension ropes 6 in different directions, a uniformly distributed intra-abdominal operating space that meets the requirements of laparoscopic surgery can be established directly above and on both sides of the surgical site.

[0038] The present invention provides the controllable folding pull rod 5, which has two different structural forms depending on the different internal traction channels and control structures: a folding pull rod controlled by a traction rope and a folding pull rod controlled by a push-pull steel rod. The control structure also has two different structures: a push-pull steel rod or a traction rope.

[0039] The aforementioned suspension point on the first lateral abdominal wall can only be suspended using a controllable folding lever 5. Since there are no laparoscopic surgical instruments available to insert into the abdominal cavity to assist in placing the suspension rope 6 with a straight abdominal wall puncture needle or a sigmoid abdominal wall puncture needle 9, this step can only utilize a controllable folding T-shaped lever 5 to achieve the opening and closing folding action of the short auxiliary lever 14, thereby suspending and pulling the lateral abdominal wall suspension point. The controllable folding T-shaped lever 5 has two states: folded and open. In the first state, the short auxiliary lever 14 and the solid head 16 of the long main lever 13 are folded into a straight line. At this time, the side wall opening groove 12 of the first part 18 of the short auxiliary lever 14 and the solid head 16 are folded into a straight line. The diameter after folding is equal to the diameter of the second part 19 and the long main lever 13. Pulling the tail of the push-pull steel rod 11 placed in the lever channel 17 outwards will inevitably cause the front end of the solid head 16 to expand. The small ball slides in the groove below the bottom of the first part 18 opening groove 12, causing the short auxiliary rod 14 and the long main rod 13 to fold together into a straight line, which is used to directly insert this end of the short auxiliary rod 14 into the abdominal cavity or pull it out of the abdominal wall; in the second state, after pushing and pulling the steel rod 11, the short auxiliary rod 14 flips and opens relative to the long main rod 13, so that the controllable foldable T-shaped pull rod 5 is T-shaped, which is used to open and block the abdominal wall in the abdominal cavity and pull the abdominal wall, thereby realizing the suspension of the abdominal wall. The opening or folding of the short auxiliary rod 14 at the front end of the controllable foldable T-shaped pull rod 5 of the present invention is controlled by remotely controlling the push and pull steel rod 11 or the pull rope at the tail end of the long main rod 13 to control the flipping and folding of the short auxiliary rod 14 in the abdominal cavity.

[0040] Furthermore, after the controllable foldable pull rod 5 unfolds into a T-shape within the abdominal cavity to pull the abdominal wall, the tail end of the long main rod 13 of the controllable foldable pull rod 5 is inserted into the tension rope channel of the lock 28. Pressing and pushing the mouth of the release tube 30 causes the locking component 31 in the tension rope channel of the lock 28 to move upward to adjust the tension. Releasing the pressing and locking component locks the controllable foldable pull rod 5, thereby achieving the suspension and traction force on the suspension points of the left upper abdomen and right upper abdomen; or the rope hook 29 of the tension rope 4 with lock hooks the loops at both ends of the suspension rope 6 and is suspended on the horizontal bar fixed extension rod 2 of the bed support frame 1. The position of the horizontal bar fixed extension rod 2 in the left-right and front-back directions of the abdominal wall can be manually adjusted.

[0041] Further clinical practice by the inventors revealed that although the intra-abdominal operating space is relatively large when suspension is performed at the three transverse positions of the anterior abdominal wall corresponding to the surgical field, the effective intra-abdominal operating space becomes even larger when a segment of the abdominal wall is suspended longitudinally in the abdominal cavity. Therefore, by using suspension rope 6 to suspend a segment of the abdominal wall at the midline of the abdomen, and by using suspension rope 6 to lift and suspend a segment of the abdominal wall longitudinally at the midclavicular line of the left or right upper abdominal wall, the effective intra-abdominal operating space becomes even larger, fully meeting the needs of laparoscopic surgery.

[0042] Application Example 2 Pneumoperitoneum-free abdominal wall suspension technique for lower abdominal surgery As per usual procedure, a 10mm incision is made at the umbilicus to insert the reverse abdominal wall trocar 3. Through the reverse abdominal wall trocar 3, the endoscope is inserted for exploration and observation. Preliminary exploration revealed that the intestines were severely adhered to the lower abdominal wall. It was necessary to loosen the adhesions from the abdominal wall before the gasless laparoscopic surgery could continue.

[0043] The present invention sets the arc-shaped handle of the reverse abdominal wall trocar 3 as an arc-shaped handle 10 with an air inlet valve. One of the main purposes is to deal with the situation where there is extensive adhesion between the intestinal tract and the anterior abdominal wall. By using the arc-shaped handle 10 with the air inlet valve, the abdominal cavity can be temporarily and transiently inflated to establish pneumoperitoneum. This allows for a clear view of the adhesion, location and extent of the abdominal wall adhesion. The trocar can then be placed in a non-adhesive area to facilitate further adhesion detachment operations and peel the adhered intestinal tract away from the abdominal wall.

[0044] After placing the reverse abdominal wall trocar 3, inflate the abdominal cavity through the arc-shaped handle 10 with an air inlet valve. If complete adhesions are found in the lower abdomen, place two trocars in the upper abdominal wall where there are no adhesions for the use of forceps and scissors to loosen the adhesions. After loosening and dissecting the severely adhered intestinal segments in the lower abdomen under the guidance of the laparoscope, close the air inlet valve of the arc-shaped handle 10 with an air inlet valve on the reverse abdominal wall trocar 3, release the gas in the abdominal cavity, and return to the pneumoperitoneum state. Continue to place the pneumoperitoneum abdominal wall suspension device assembly at the expected position in the lower abdominal wall. The present invention designs the structure of the reverse abdominal wall trocar 3 as an arc-shaped handle 10 with an air inlet valve. In addition to the advantage of using the arc-shaped handle to lift the front end of the outer tube of the reverse abdominal wall trocar 3 and push the anterior abdominal wall upward under pneumoperitoneal conditions, the arc-shaped handle 10 with air inlet valve can also solve the predicament of severe intestinal adhesions in the anterior abdominal wall that prevent the laparoscopic surgery from continuing under special and complex conditions, effectively avoiding the occurrence of related surgical complications.

[0045] Using a sigmoid abdominal wall puncture needle 9, the insertion point is selected three finger-widths away from the pubic symphysis along the anterior midline of the lower abdominal wall. The entire abdominal wall at the insertion point in the lower midline is lifted upwards using a reverse abdominal wall trocar 3. The oval opening at the front end of the reverse abdominal wall trocar 3 is clearly visible. Under the guidance of the bright illumination from the laminar flow of the reverse abdominal wall trocar 3 and the protection of the upward-lifted outer cannula, the sigmoid abdominal wall puncture needle 9 directly pierces the entire abdominal wall and enters the inner cavity of the outer cannula opening of the reverse abdominal wall trocar 3. At this point, the handle of the sigmoid abdominal wall puncture needle 9 is held, and the needle is guided along the reverse abdominal wall trocar... 3. Move the outer tube to the intended needle exit point, which is a finger-width below the navel on the midline of the abdomen. While removing the outer tube of the reverse abdominal wall trocar 3, forcefully flip the straight handle of the S-shaped abdominal wall trocar needle 9. In one step, the S-shaped abdominal wall trocar needle 9 is directly pierced out of the abdominal wall from the needle exit point. Pull out the arc-shaped needle core, insert the suspension rope 6 into the arc-shaped needle tube of the S-shaped abdominal wall trocar needle 9, then withdraw the arc-shaped needle tube and leave the suspension rope 6 to hold the abdominal wall along the midline of the abdomen. Finally, use the rope hook 29 on the tension rope 4 with a lock to hook the loops at both ends of the suspension rope 6 and suspend it on the horizontal bar fixed extension rod 2 of the bed support frame 1.

[0046] Similar to the straight abdominal wall puncture needle, the curved needle tube structure alone cannot achieve a one-step entry and exit from the abdominal wall at the same skin plane. Therefore, to complete the entry and exit of the abdominal wall segment in one step, this invention fixes a straight handle at one end of the curved needle tube of the B-shaped abdominal wall puncture needle 9. With the help of wrist strength, the curved needle tube can be continuously inserted and withdrawn in a direction exceeding 180 degrees on the abdominal wall skin surface. This is an essential step for the present invention to more smoothly realize the abdominal wall suspension technique. By placing a straight handle at one end of the curved needle tube, this simple structural modification enables the difficult operation of continuous insertion and withdrawal of the needle in the abdominal wall on the same plane. It also overcomes the multi-step operation of abdominal wall insertion and withdrawal required by the straight abdominal wall puncture needle as shown in Embodiment 1, making the suspension of the abdominal wall segment easier, simpler, and safer.

[0047] Next, to achieve suspension of the first lateral abdominal wall of the lower abdomen, a controllable folding pull rod 5 is the only option. In this embodiment, a folding T-shaped pull rod 5 controlled by a traction rope is used to suspend the left lower abdominal wall. The preferred suspension position is the abdominal wall suspension segment at the midclavicular line of the left lower abdomen. After selecting the puncture point in the left lower abdomen, a straight abdominal wall puncture needle from the accessory set is used. With the assistance of the inclined opening of the outer tube of the reverse abdominal wall puncture device 3, which lifts the abdominal wall puncture point, the needle directly punctures the abdominal wall and enters the outer tube of the reverse abdominal wall puncture device 3. A folding T-shaped pull rod controlled by a traction rope is inserted. At the end of the long main rod 13, the first traction rope 22 and the second traction rope 23 are used to control the traction. They pass through the first rope channel 20 and the second rope channel 21, respectively. The opening 24 of the traction rope before exiting the tube wall is connected to the crossbar openings 32 on both sides of the short auxiliary rod 14 to control the folding and flipping of the short auxiliary rod 14. This makes the operation of controlling the opening and folding of the short auxiliary rod 14 more reliable and requires less force.

[0048] Furthermore, by pulling the other end of the first pull rope 22 located at the end of the long main rod 13 (sometimes with the second pull rope 23 being loosened appropriately at the same time), the short auxiliary rod 14 can be pulled to rotate around the pivot, thereby causing the solid head 16 of the first part 18 and the main body 15 to fold together into a straight line; in addition, by pulling the other end of the second pull rope 23 located at the end of the long main rod 13 (sometimes with the first pull rope 22 being loosened appropriately at the same time), the short auxiliary rod 14 can be pulled to rotate around the pivot, thereby causing the short auxiliary rod 14 to open and form a T-shaped structure with the long main rod 13. By coordinating the pulling of the first pulling rope 22 and the second pulling rope 23, the folding and opening of the folding T-shaped pull rod 5 controlled by the pulling rope is realized remotely outside the abdominal wall; then the long main rod 13 of the folding T-shaped pull rod 5 controlled by the pulling rope is inserted into the push-relaxation tube 30 of the lock 28, and the long main rod 13 is pushed to an appropriate height to complete the locking of the long main rod 13 of the folding T-shaped pull rod 5 controlled by the pulling rope by the lock 28.

[0049] Furthermore, the suspension of the right lower abdominal wall can also be accomplished using a reverse abdominal wall trocar 3 in conjunction with a sigmoid abdominal wall trocar 9. A suspension rope 6 is attached to the sigmoid abdominal wall trocar 9 to suspend the abdominal wall segment. After selecting the entry and exit points for the suspended abdominal wall segment at the midclavicular line of the right lower abdominal wall, and with the extended reverse abdominal wall trocar 3 supporting the abdominal wall and its inner cannula, the sigmoid abdominal wall trocar 9 is vertically pierced through the abdominal wall into the outer cannula of the reverse abdominal wall trocar 3, and then moved to the exit point on the inner layer of the abdominal wall. Using the twisting force of the straight handle of the sigmoid abdominal wall trocar 9, the sigmoid abdominal wall trocar 9 is lifted and directly pierced through the entire layer of the abdominal wall from the exit point. The needle core of the sigmoid abdominal wall trocar 9 is then removed. Insert the suspension rope 6, open the slit 25 of the suspension rope 6, and the meshing surface 27 of the slit 25 becomes a ring. Use the rope hook 29 on the tension rope 4 with a lock to hook the rings at both ends of the suspension rope 6 and suspend it on the horizontal bar fixed extension rod 2 of the bed support frame 1. The inner ring of the slit 25 is provided with a circular washer 26 to prevent it from being torn by the pulling force. Adjust the suspension force of the lock 28 to complete the suspension and traction of the third abdominal wall segment. The structural design of the S-shaped abdominal wall puncture needle 9 makes the suspension operation the simplest and easiest.

[0050] The suspension rope 6 used in this invention is pulled around the abdominal wall by hooking the loop of the suspension rope 6 with a locking buckle 4 and inserting the locking rope into the push-release tube 30 of the locking buckle 28 to complete the locking action. Finally, it is suspended on the horizontal bar extension rod 2 that extends forward from the bed support frame 1. The controllable foldable T-shaped pull rod is used by inserting its long main rod 13 into the push-release tube 30 of the locking buckle 28 to complete the locking function.

[0051] The locking tension rope 4 consists of a locking buckle 28, a rope hook 29, a tension indicator, and a tension rope. The rope hook 29 has a protective buckle. When the rope hook 29 is hooked into the loops at both ends of the suspension rope 6, or when the rope hook 29 passes around the crossbar to fix the extension rod 2 and hooks its own tension rope, the protective buckle must be locked to prevent accidental slippage.

[0052] The latch 28 consists of a solid outer shell, a tension rope channel, a push-release tube 30, a locking component 31, a spring, and a cap. The tension rope channel has two sections, left and right, and is funnel-shaped. The locking component 31 can be a locking three-ball. As the push-release tube 30 is compressed downwards by the spring above within the tension rope channel, it forces the locking component 31 to continuously shift inwards and gradually lock onto the long main rod 13 or tension rope of the controllable folding pull rod 5 passing through. When the tip of the push-release tube 30 is pressed upwards with a finger, the locking component 31, like a locking three-ball, enters the widened tension rope channel, thereby releasing the locking effect of the locking three-ball on the controllable folding pull rod 5 or tension rope.

[0053] The bed support frame 1 adjusts the position of the horizontal bar fixed extension rod 2 vertically fixed on the horizontal bar of the bed support frame 1 by moving left and right according to the required suspension position and traction direction of the suspension rope 6. The length of the horizontal bar extension rod extending towards the navel can be adjusted by the rocker wheel, so as to provide the required lifting position to reach the surgical area directly above. The three-dimensional adjustment of the horizontal bar fixed extension rod 2 controls the suspension position and traction direction of the suspension rope 6.

[0054] The suspension of the lower abdominal wall at three transverse points—the midline of the lower abdomen, the midline of the left lower abdomen clavicle, and the midline of the right lower abdomen clavicle—along with the longitudinal suspension segments along the midline of the lower abdomen and the right lower abdomen, creates the largest possible three-dimensional intra-abdominal operating space, fully meeting the spatial requirements of laparoscopic surgery.

[0055] The above description is merely a specific embodiment of this application, but the scope of protection of this application is not limited thereto. Any variations or substitutions that can be easily conceived by those skilled in the art within the technical scope disclosed in this application should be included within the scope of protection of this application. Therefore, the scope of protection of this application should be determined by the scope of protection of the claims. Furthermore, specific examples have been used in the specification to illustrate the principles and implementation methods of this application. The description of the above embodiments is only for the purpose of helping to understand the method and core ideas of this application, and the content of this specification should not be construed as a limitation of this application.

Claims

1. A gasless laparoscopic abdominal wall suspension device assembly, characterized in that, The abdominal wall suspension device assembly for gasless laparoscopic surgery includes: a bed support frame (1), a horizontal bar fixing extension rod (2), a reverse abdominal wall trocar (3), a locking tension rope (4), a controllable folding pull rod (5), a suspension rope (6), and an accessory group; the reverse abdominal wall trocar (3) cooperates with the accessory group to form suspension holes at three different positions on the anterior abdominal wall: the midline of the abdomen, the left midclavicular line, and the right midclavicular line; the controllable folding pull rod (5), the suspension rope (6), or a combination thereof, pull and suspend the abdominal wall through the suspension holes at the three different positions, and is fixed to the bed support frame (1) via the locking tension rope (4) and the horizontal bar fixing extension rod (2) to complete the suspension.

2. The abdominal wall suspension device assembly for gasless laparoscopic surgery according to claim 1, characterized in that, The reverse abdominal wall trocar (3) is an extended cannula trocar, consisting of a core, an outer cannula, an arc-shaped handle (10) with an air injection valve, and a sealing cap. The arc-shaped handle (10) with an air injection valve is located at the base of the outer cannula and is fixedly connected to the outer cannula at an angle of 45-90 degrees. The arc-shaped handle (10) with an air injection valve also has an air inlet pipe with an air inlet valve inside.

3. The abdominal wall suspension device assembly for gasless laparoscopic surgery according to claim 2, characterized in that, The front opening of the outer tube of the reverse abdominal wall trocar (3) is an elliptical bevel, which forms a 25-degree angle with the axial direction of the outer tube, and the bevel is positioned toward the side of the arc-shaped handle (10) with the air injection valve.

4. The abdominal wall suspension device assembly for gasless laparoscopic surgery according to claim 1, characterized in that, The controllable folding lever (5) includes a long main rod (13) and a short auxiliary rod (14) pivotally connected to one end of the long main rod. The long main rod (13) includes a main body (15), a solid head (16), a control channel running through the length of the main body (15), and a control structure disposed within the control channel. The solid head (16) extends forward from the midpoint of the front end of the main body (15) to one side, and has a long strip-shaped cross-section, which is part of the cross-sectional shape of the main body (15). The short auxiliary rod (14) comprises a first part (18) and a second part (19) connected by a structure. The midpoint of the first part (18) and the second part (19) is pivotally connected to the end of the solid head (16). An opening groove (12) extending through the length direction is provided on the side of the first part (18) facing the solid head (16). Below the bottom of the opening groove (12) on the side of the first part (18) of the short auxiliary rod (14), a sliding groove (33) extending through the long axis direction of the first part is provided. The cross-sectional shape of the first part (18) is a part of the cross-sectional shape of the second part (19). The shape of the opening groove (12) is adapted to the shape of the solid head (16), and the cross-sectional shape when the two are closed is consistent with the cross-sectional shape of the second part (19) or the main body (15). The main body (15) of the long main rod (13) has a control channel extending through the long axis direction. A control structure is provided in the control channel. The control structure is used to control the short auxiliary rod (14) relative to the long axis direction. The long main rod (13) performs closing and unfolding activities; the controllable folding pull rod (5) has two states: in the first state, the short auxiliary rod (14) and the long main rod (13) are closed so that they are in a straight line, and the short auxiliary rod (14) is inserted into the abdominal cavity as the top of the long main rod (13); in the second state, the short auxiliary rod (14) is unfolded relative to the long main rod (13) so that they are in a T shape, and the short auxiliary rod (14) is used to block and support the abdominal wall in the abdominal cavity, thereby achieving the suspension of the abdominal wall.

5. The abdominal wall suspension device assembly for gasless laparoscopic surgery according to claim 4, characterized in that, The controllable folding pull rod (5) has a control channel inside. Depending on the control channel and the control structure located inside it, there are two different structural forms of controllable folding pull rods (5), including a folding pull rod controlled by a pull rope and a folding pull rod controlled by a push-pull steel rod. In the folding pull rod controlled by the pull rope, the control channel is configured to include a first rope channel (20) and a second rope channel (21). The first rope channel (20) and the second rope channel (21) are located on opposite sides of the axial direction of the main body (15), and the front openings (24) of the tube walls of the first rope channel (20) and the second rope channel (21) are located in the solid head (16). On both sides, corresponding to the positions of the first part (18) and the second part (19) of the short auxiliary rod (19); the control structure includes a first pull rope (22) and a second pull rope (23). One end of the first pull rope (22) and the second pull rope (23) are respectively connected to the crossbar fine opening (32) at the center of the free end of the first part (18) and the second part (19). The other end of the first pull rope (22) and the second pull rope (23) respectively extend from the tail end of the main body (15) through the opening (24) at the front end of the tube wall of the main body (15) and through the first rope channel (20) and the second rope channel (21) to be fixed or connected.

6. The abdominal wall suspension device assembly for gasless laparoscopic surgery according to claim 5, characterized in that, In the folding pull rod controlled by the push-pull steel rod (11), the control channel is the pull rod channel (17), located on one side of the central axis of the main body (15), with an opening at each end. The opening at the front end and the solid head (16) are located on opposite sides of the front end face of the main body (15). A control structure is installed in the pull rod channel (17), which is a push-pull steel rod (11). The head of the push-pull steel rod (11) extends forward and bulges out into a small ball. The small ball extends forward and enters the sliding groove (33) below the bottom of the side opening groove (12) of the first part (18). The short auxiliary rod (14) is located on the side of the first part (18). The bottom of the opening groove (12) is provided with a sliding groove (33) that runs through the long axis of the first part (18); the push-pull steel rod (11) is pushed and pulled in the front and back direction, and the small ball at the head end of the push-pull steel rod (11) slides in the sliding groove (33) below the bottom of the opening groove (12) of the first part (18) of the short auxiliary rod (14), which will inevitably drive the short auxiliary rod (14) to close and unfold relative to the long main rod (13); the tail section of the push-pull steel rod (11) forms a self-single-axis hinge joint at the tail end outlet of the long main rod (13). When unfolded into a straight line, it is convenient to insert into the buckle (28) of the tension rope (4) with a lock. When folded into a right angle, it is convenient to hold the tail section of the push-pull steel rod (11) and fix it.

7. The abdominal wall suspension device assembly for gasless laparoscopic surgery according to claim 1, characterized in that, The suspension rope (6) has an elongated oval bundle-like structure. Each end of the suspension rope (6) has a slit (25). The mating surface of the slit (25) is provided with a circular washer (26). The inner ring of the circular washer (26) has a meshing and interlocking surface structure.

8. The abdominal wall suspension device assembly for gasless laparoscopic surgery according to claim 1, characterized in that, The accessory set includes a straight abdominal wall puncture needle and a sigmoid puncture needle (9). The sigmoid puncture needle (9) includes an arc-shaped needle tube, an arc-shaped needle core located inside the arc-shaped needle tube, and a straight handle fixedly connected to the outside of one end of the arc-shaped needle tube. Both ends of the arc-shaped needle tube are open. The inner cavity of the arc-shaped needle tube can accommodate the suspension rope (6) through which it is inserted.

9. The abdominal wall suspension device assembly for gasless laparoscopic surgery according to claim 1, characterized in that, The locking tension rope (4) consists of a locking buckle (28), a rope hook (29), a tension indicator, and a tension rope. The locking buckle consists of a solid shell, a tension rope channel, a push-release tube (30), a locking component (31), a spring, and a cap. The tension rope channel is conical, and the push-release tube (30) is installed inside it. The locking component (31) has a structure of three locking spheres, which straddle the three side holes of the push-release tube (30). As the push-release tube (30) moves through the tension rope channel... The inner part is continuously squeezed downward by the upper spring, and under the coordinated squeezing of the inclined side wall of the tension rope channel, the locking component (31) is forced to move inward continuously and gradually lock onto the controllable folding pull rod (5) or tension rope passing through the push release tube (30); as the finger presses upward on the mouth of the push release tube (30), the push release tube (30) will inevitably drive the locking component (31) into the widened tension rope channel, thereby loosening the locking effect of the locking component (31) on the controllable folding pull rod (5) or tension rope passing through it.

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