Sternum rib retractor for cardiopulmonary transplantation

Abstract

The invention belongs to the technical field of cardiopulmonary transplantation, and discloses a sternum and rib retractor for cardiopulmonary transplantation, which comprises a fixing component and an adjusting component slidably mounted on the fixing component, a first distraction component is mounted on the outer wall of the fixing component, a plurality of air bags are mounted on the outer wall of the first distraction component, the air bags are in contact with the sternum of a patient during expansion, and the adjusting component is slidably mounted on the fixing component. A cushion layer is formed to prevent the sternum from being in direct contact with metal of the retractor, a fixing cavity is formed in the fixing assembly, and an extrusion plate is installed on the outer wall of the fixing cavity in a penetrating mode, so that air enters the air bag through a pipeline, and the air bag expands to conduct buffering protection on the sternum of a patient. When the sternum distraction device is used, the distraction plate is embedded into the sternum of a patient, the handle drives the fixing block and the adjusting bolt to rotate, the position of the distraction plate is adjusted, and the adjusting function is achieved. The air bag dynamically adapts to the sternum form, the retraction pressure is dispersed, compression necrosis of local tissue is avoided, and the sternum tissue of a patient is effectively protected.

Description

TECHNICAL FIELD

[0001] The present application belongs to the technical field of transplantation surgery, and particularly relates to a sternum rib retractor for heart-lung transplantation. BACKGROUND

[0002] The sternum rib retractor for heart-lung transplantation is an important surgical instrument in the field of cardiothoracic surgery, and its background technology involves multiple dimensions such as surgical needs, instrument development and material innovation. Heart-lung transplantation is the only effective means to treat end-stage heart-lung disease. The operation requires simultaneous removal of the diseased heart-lung and implantation of donor organs, involving complex anastomosis operations of the heart, lungs and large blood vessels. The surgical incision usually adopts median sternum splitting or anterolateral incision, and the key structures such as mediastinum, pericardium, pulmonary hilum and phrenic nerve need to be fully exposed. Due to the narrow operation space and the involvement of multiple organs, the stability, adjustment accuracy and tissue protection performance of the retractor are extremely high. For example, the implantation of donor heart-lung requires accurate control of the retraction angle of the sternum and ribs to avoid compression of the transplanted organs or damage to the phrenic nerve. Titanium alloy gradually replaces traditional stainless steel as the main material of the retractor due to its high strength, corrosion resistance and good biocompatibility. For example, the bidirectional rotatable sternum rib retractor is made of titanium alloy, and its four-point support structure can disperse the traction force to reduce the risk of sternum fracture, and at the same time adapt to different needs of median incision and lateral incision.

[0003] In the prior art, the heart-lung transplantation surgery time is relatively long, generally 6-8 hours, so that the retractor blade long-time presses the medial periosteum or nutrient blood vessels of the sternum, affecting the blood supply of the broken end. Excessive distraction leads to high sternum tension, local bone cell ischemia and necrosis, increasing the risk of postoperative sternum opening (splitting), infection (such as osteomyelitis), and adhesion between the retractor and the sternum when the retractor is separated from the sternum, which increases the risk of infection in patients. SUMMARY

[0004] In view of the deficiencies of the prior art, the purpose of the present application is to provide a sternum rib retractor for heart-lung transplantation, which solves the problem that the patient's sternum is easily damaged by long-time contact with the retractor in the prior art.

[0005] The purpose of the present application can be achieved by the following technical solution: a sternum rib retractor for heart-lung transplantation, comprising a fixed component and an adjusting component slidably mounted on the fixed component; A first distraction component is installed on the outer wall of the fixed component, and a plurality of air bags are installed on the outer wall of the first distraction component. When the air bags are inflated, they come into contact with the patient's sternum, forming a cushion layer to prevent direct contact between the sternum and the retractor; A fixed cavity is formed in the inside of the fixed component, and an extrusion plate is installed through the outer wall of the fixed cavity. The movement of the adjusting component synchronously drives the extrusion plate to extrude the air in the fixed cavity, so that the air enters the air bag through the pipeline, and the air bag is inflated to buffer and protect the patient's sternum.

[0006] In some of the disclosure, the fixing assembly comprises a fixing plate, a fixing rod and a gear groove, one end of the fixing plate is fixed with the fixing rod by welding or threaded connection, the outer wall of the fixing plate is provided with the gear groove, the tooth shape of which is an involute structure to enhance the engagement stability, and the inner wall of the fixing plate is provided with the inflating assembly.

[0007] In some of the disclosure, the first distraction assembly comprises an adjusting bolt mounted on the fixing rod, a connecting seat mounted at the bottom of the adjusting bolt, a U-shaped distraction plate mounted at the bottom of the connecting seat, a plurality of air bags mounted on the outer wall of the distraction plate, a connecting pipeline mounted on the outer wall of the distraction plate, a fixing block mounted at the top of the adjusting bolt, a handle penetratingly mounted on the outer wall of the fixing block, a plurality of lubricating holes opened on the outer wall of the distraction plate, the air bags are made of medical silica gel and filled with inert gas, the adjusting bolt is connected with the fixing block through threads, when the handle is rotated, the distraction plate is adhered along the surface of the sternum, the air bags are communicated with the inflating assembly through the connecting pipeline, and the outer wall of the distraction plate is provided with a plurality of lubricating holes.

[0008] In some of the disclosure, the inflating assembly comprises a sliding groove opened on the outer wall of the fixing plate, and a pushing rod mounted at the bottom of the extrusion plate, the pushing rod is located inside the sliding groove and extends out of the outer wall of the sliding groove, a first spring is mounted on the inner wall of the fixing plate, one end of the first spring is fixedly connected with the outer wall of the extrusion plate, an air outlet is mounted on the inner wall of the fixing cavity, and the pushing rod is mechanically linked with the sliding block of the adjusting assembly, when the sliding block slides, the pushing rod moves along the sliding groove, the extrusion plate compresses the volume of the fixing cavity, air enters the air bag through the air outlet, the first spring is a stainless steel spiral spring, which provides a rebound force of 5-8N to ensure the reset of the extrusion plate.

[0009] In some of the disclosure, the adjusting assembly comprises a sliding block and a moving rod, the sliding block is designed to be hollow, the inner wall size is slightly larger than the cross section of the fixing plate, allowing the sliding block to slide axially along the fixing plate, the moving rod is mounted with a second distraction assembly at the bottom, and the second distraction assembly is the same structure as the first distraction assembly but is installed in the opposite direction, so as to achieve symmetric distraction of the sternum through bidirectional adjustment, and the outer wall of the sliding block is mounted with a driving assembly.

[0010] In some of the disclosure, the driving assembly comprises a protective shell mounted on the outer wall of the sliding block, a first shaft mounted on the inner wall of the protective shell, a first gear mounted on the outer wall of the first shaft, a worm mounted at one end of the first shaft, a second shaft mounted on the inner wall of the protective shell, a worm wheel mounted on the outer wall of the second shaft, the worm wheel is in transmission connection with the worm, the worm wheel is in meshing with the gear groove, the transmission ratio is 1:30, the bottom of the worm wheel extends out of the bottom of the protective shell, and the worm is fixedly connected with the first shaft through a key.

[0011] In some of the disclosure, the outer wall of the first shaft is provided with a ratchet wheel, the top of the protective shell is provided with a screw rod, the bottom of the screw rod is provided with an arc-shaped clamping plate through a bearing, the bottom of the clamping plate is provided with a clamping groove, the clamping groove is embedded with the ratchet wheel, the embedding depth of the clamping plate and the ratchet wheel is adjusted through the screw rod, the inner wall of the clamping groove is provided with a polyurethane friction layer to increase the friction force with the tooth surface of the ratchet wheel, when the retraction position is fixed, the clamping plate is pressed down by rotating the screw rod, the clamping groove is completely embedded with the ratchet wheel, and the transmission shaft is locked.

[0012] In some of the disclosure, the outer wall of the sliding block is provided with a lubricating box, the top of the lubricating box is provided with a supplement bottle through threads, the inside of the lubricating box is provided with a lubricating cavity, the bottom of the lubricating cavity is provided with a lubricating pipe, the lubricating pipe is communicated with the lubricating hole through a pipeline, the supplement bottle is sealed through threads, the inside of the supplement bottle stores water-based lubricant containing 5% sodium hyaluronate, when the spreading plate moves, the air pump drives to inject air into the lubricating cavity through a cam, and the lubricant seeps out of the lubricating hole at a flow rate of 0.1 mL / s.

[0013] In some of the disclosure, the inner wall of the protective shell is provided with a second spring, one end of the second spring is provided with a driven plate, the inner wall of the protective shell is provided with an air pump, the driving end of the air pump is fixedly connected with the outer wall of the driven plate, the outer wall of the output shaft is provided with a cam, the driving end of the air pump is hinged with the driven plate, and the cam is installed on the outer wall of the output shaft and has a lift of 8 mm; when the motor operates at a low speed, the cam extrudes the driven plate once per revolution, the air pump generates an air pressure of 0.5 kPa to push the lubricant, the second spring is a compression spring, and the stiffness coefficient is 20 N / mm, so that the driven plate is quickly reset.

[0014] In some of the disclosure, the inner wall of the protective shell is provided with a motor, the output end of the motor is provided with an output shaft, the outer wall of the output shaft is provided with a second gear, the outer wall of the second gear is provided with a moving plate through a bearing, the outer wall of the moving plate is provided with an electric telescopic rod, the inner wall of the protective shell is provided with an auxiliary plate, and one end of the electric telescopic rod is fixedly installed on the outer wall of the auxiliary plate.

[0015] The nouns, conjunctions or adjectives involved in the above technical solutions are explained as follows: Fixed connection refers to the connection of parts or components after being fixed without any relative movement; Rotary connection refers to the connection between parts that allows the parts to rotate relative to each other; Threaded connection is a kind of detachable fixed connection, which has the advantages of simple structure, reliable connection, convenient assembly and disassembly, and is widely used in mechanical engineering and connection structure fields; Sliding connection refers to the connection between parts that allows the parts to slide relative to each other.

[0016] The beneficial effects of the present application are as follows: 1. The application is used, the spread plate is embedded on the sternum of the patient, the fixed block and the adjusting bolt are driven by the handle to rotate, the position of the spread plate is adjusted, and the adjusting function is realized. The air bag dynamically adapts to the sternum shape, disperses the distraction pressure, avoids local tissue pressure necrosis, and effectively protects the sternum tissue of the patient.

[0017] 2. The application can be accurately adjusted through the cooperative design of the fixing assembly and the adjusting assembly, in combination with the worm and gear drive assembly and the bidirectional distraction assembly. The involute tooth shape meshing design of the worm and the gear groove is matched with a transmission ratio of 1:30, so that the moving speed of the sliding block is controlled within the range of 0.5mm / s, and the self-locking characteristics of the worm and gear completely solve the displacement deviation problem caused by vibration of the traditional lead screw drive.

[0018] 3. The lubrication system and the driving assembly are deeply integrated, the mechanical linkage of the cam and the inflator is realized, the dynamic matching of the lubricant flow and the distraction speed is realized, the lubricant waste is avoided, the surgical field pollution is prevented, and the strict synchronization of air pressure transmission and mechanical movement is ensured. In the event of an emergency, the safety of the operation is greatly enhanced. DETAILED DESCRIPTION

[0019] In order to more clearly illustrate the technical solutions in the embodiments of the application or the prior art, the following will briefly introduce the drawings needed to be used in the embodiment or prior art description. Obviously, for those skilled in the art, other drawings can also be obtained without creative labor on the basis of these drawings.

[0020] Figure 1 is a schematic diagram of the overall structure of the embodiment of the application; Figure 2 is a schematic diagram of the spread plate part structure of the embodiment of the application; Figure 3 is a schematic diagram of the top view of the protective shell part structure of the embodiment of the application; Figure 4 is a schematic diagram of the fixed plate part structure of the embodiment of the application; Figure 5 is a schematic diagram of the fixed cavity part structure of the embodiment of the application; Figure 6 is a schematic diagram of the lubricating box part structure of the embodiment of the application; Figure 7 is a schematic diagram of the screw rod part structure of the embodiment of the application.

[0021] In the figure: 1, fixed assembly; 10, fixed plate; 11, fixed rod; 12, gear slot; 2, first distraction assembly; 20, distraction plate; 21, connecting seat; 22, adjusting bolt; 23, fixed block; 24, handle; 25, air bag; 26, connecting pipeline; 27, lubricating hole; 3, inflation assembly; 31, sliding slot; 32, extrusion plate; 33, first spring; 34, air outlet; 35, fixed cavity; 36, push rod; 4, adjusting assembly; 40, sliding block; 41, moving rod; 42, second distraction assembly; 5, driving assembly; 50, protective shell; 51, No. 1 shaft; 52, No. 1 gear; 53, worm; 54, No. 2 shaft; 55, worm wheel; 6, motor; 61, output shaft; 62, No. 2 gear; 63, auxiliary plate; 64, moving plate; 65, electric telescopic rod; 7, ratchet wheel; 71, screw rod; 72, clamping plate; 73, clamping groove; 8, lubricating box; 81, supplementary bottle; 82, lubricating cavity; 83, lubricating pipe; 9, second spring; 91, driven plate; 92, air pump; 93, cam. DETAILED DESCRIPTION

[0022] The technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application. Obviously, the described embodiments are only part of the embodiments of the present application, rather than all the embodiments of the present application. Based on the embodiments in the present application, all other embodiments obtained by those skilled in the art without creative work fall within the scope of protection of the present application.

[0023] Please refer to Figure 1 , Figure 2 , Figure 4 and Figure 5The utility model provides a sternum rib retractor of heart-lung transplantation, including fixed component 1 and adjusting component 4 of sliding installation on fixed component 1, the outer wall of fixed component 1 is equipped with first strutting open component 2, the outer wall of first strutting open component 2 is equipped with a plurality of air bags 25, and air bag 25 contacts the sternum of patient when inflating, the inside of fixed component 1 is equipped with fixed cavity 35, and the outer wall of fixed cavity 35 is equipped with extrusion plate 32 through installation, and adjusting component 4 moves synchronous belt drive extrusion plate 32 extruding the air in fixed cavity 35, so that air enters air bag 25 through pipeline, so that air bag 25 inflates, and the sternum of patient is buffered and protected. When adjusting component 4 moves, push rod 36 drives extrusion plate 32 to compress the air in fixed cavity 35, forces gas to enter air bag 25 through the pipeline, so that it expands preferentially to fit the sternum. Lubricant is released in a time-delayed manner, after the air bag is fully inflated, the cam 93 of the drive assembly 5 begins to press the driven plate 91, triggering the air pump 92 to inject air into the lubricating cavity 82, and the lubricant seeps out from the lubricating hole 27 through the lubricating pipe 83. After the air bag expands, a stable gap is formed between the strutting plate 20 and the sternum, the lubricating hole 27 is not directly compressed by metal, the lubricant flow channel is unobstructed, avoiding the blockage of the hole caused by insufficient initial pressure in traditional designs, and the lubricant is released only after the air bag forms a support surface, ensuring uniform coverage of the contact area. Clinical data shows that the utilization rate of lubricant has greatly improved.

[0024] It should be noted that by combining gear transmission with sliding structure, the problem of low precision in manual adjustment of traditional retractors is solved, and the two-way design reduces unilateral stress concentration and reduces the risk of sternum fracture. The air bag is composed of three layers of composite film (inner layer of silicone, middle layer of nylon net and outer layer of polyurethane), with a burst pressure of ≥50kPa and capable of withstanding 200 cycles of inflation and deflation. The existing retractor air bag is mostly single-layer structure. The present design is reinforced by layering, maintaining flexibility while avoiding accidental rupture during surgery.

[0025] Please refer to Figure 1 , Figure 2 and Figure 4 , the fixed component 1 includes a fixed plate 10, a fixed rod 11, and a gear slot 12. The fixed plate 10 has a fixed rod 11 installed at one end. The outer wall of the fixed plate 10 is equipped with a gear slot 12. The strutting open component 2 includes an adjusting bolt 22 installed on the fixed rod 11. The bottom of the adjusting bolt 22 is equipped with a connecting seat 21. The bottom of the connecting seat 21 is equipped with a U-shaped strutting plate 20. The outer wall of the strutting plate 20 is equipped with a plurality of air bags 25. The outer wall of the strutting plate 20 is equipped with a connecting pipeline 26. The top of the adjusting bolt 22 is equipped with a fixed block 23. The outer wall of the fixed block 23 is equipped with a handle 24 through installation. The outer wall of the strutting plate 20 is equipped with a plurality of lubricating holes 27. The adjusting component 4 includes a sliding block 40 slidingly installed on the fixed plate 10. The sliding block 40 is hollow, and the hollow size is slightly larger than the cross section of the fixed plate 10. The outer wall of the sliding block 40 is equipped with a moving rod 41. The bottom of the moving rod 41 is equipped with a second strutting open component 2 with the same structure but opposite direction.

[0026] It should be noted that in use, the distraction plate 20 is fitted to the sternum of the patient, and the position of the distraction plate 20 is adjusted by rotating the handle 24, the fixing block 23 and the adjusting bolt 22, to achieve the adjusting function. The air bag dynamically adapts to the shape of the sternum, disperses the distraction pressure, avoids local tissue pressure necrosis, reduces postoperative complications by 80% compared with traditional metal distraction devices, the air pressure is transmitted synchronously with the mechanical movement, the distraction force and the real-time matching of the buffer protection are realized, the problem of response delay of the pneumatic system in the prior art is solved, the first distraction assembly 2 and the second distraction assembly 42 are symmetrically installed through the moving rod 41, the adjusting bolts 22 rotate in opposite directions, and synchronous reverse movement is realized. The movement process is as follows: when the sliding block 40 moves 5mm to the right, the left distraction plate 20 expands outward by 3mm, and the right side shrinks by 3mm, so that the distraction force is balanced. Bidirectional independent adjustment avoids sternum deviation, is especially suitable for patients with asymmetric ribs, and the distraction precision reaches ±0.1mm. The fixing plate 10 is made of titanium alloy and is forged, the surface is treated by anodic oxidation, and the bending strength reaches 1200MPa. The gear groove 12 is formed by powder metallurgy process, the tooth surface hardness is HRC60, and the service life reaches 100,000 cycles. Compared with the welded guide rail in the prior art, the design realizes gapless movement through meshing transmission, and the precision is improved to 0.01mm.

[0027] It should be noted that the two first distraction assemblies 2 respectively fix the two sides of the sternum of the patient, the sliding block 40 slides on the fixing plate 10, so as to adjust the degree of distraction of the sternum, thereby facilitating the operation.

[0028] Please refer to Figure 1 and Figure 5 The outer wall of the fixing assembly 1 is provided with an inflation assembly 3. The inflation assembly 3 comprises a sliding groove 31 formed in the outer wall of the fixing plate 10, and the bottom of the extrusion plate 32 is provided with a push rod 36. The push rod 36 is located in the inside of the sliding groove 31 and extends out of the outer wall of the sliding groove 31. The inner wall of the fixing plate 10 is provided with a first spring 33, one end of the first spring 33 is fixedly connected with the outer wall of the extrusion plate 32, the inner wall of the fixing cavity 35 is provided with an air outlet 34, and the first spring 33 can conveniently reset the extrusion plate 32.

[0029] It should be noted that the push rod 36 is driven by the adjusting assembly 4, the push rod 36 drives the extrusion plate 32 to extrude the air in the fixing cavity 35, the air enters the air bag 25 through the air outlet 34 and the connecting pipeline 26, so as to protect the sternum of the patient while adjusting the distraction position of the sternum.

[0030] Please refer to Figure 1 and Figure 3A drive assembly 5 is installed on the outer wall of the slider 40. The drive assembly 5 includes a protective shell 50 installed on the outer wall of the slider 40. A first shaft 51 is installed on the inner wall of the protective shell 50. A first gear 52 is installed on the outer wall of the first shaft 51. A worm gear 53 is installed at one end of the first shaft 51. A second shaft 54 ​​is installed on the inner wall of the protective shell 50. A worm wheel 55 is installed on the outer wall of the second shaft 54. The worm wheel 55 is connected to the worm gear 53 and meshes with the gear groove 12. The bottom of the worm wheel 55 extends out of the bottom of the protective shell 50. A motor 6 is installed on the inner wall of the protective shell 50. An output shaft 61 is installed at the output end of the motor 6. A second gear 62 is installed on the outer wall of the output shaft 61. A movable plate 64 is installed on the outer wall of the second gear 62 through a bearing. An electric telescopic rod 65 is installed on the outer wall of the movable plate 64. An auxiliary plate 63 is installed on the inner wall of the protective shell 50. One end of the electric telescopic rod 65 is fixedly installed on the outer wall of the auxiliary plate 63.

[0031] It should be noted that shaft 51 drives the worm gear 53 and worm wheel 55 to rotate. The worm wheel 55 meshes with the gear groove 12, thereby driving the protective shell 50 and the slider 40 to move on the fixed plate 10, thus realizing the function of adjusting the retraction distance. The self-locking characteristic of the worm gear ensures the stability of the retraction position, reducing the risk of loosening by 50% compared with traditional lead screw transmission, making it suitable for long-term surgery.

[0032] It should be noted that the operation of motor 6 drives output shaft 61 and gear 62 to rotate. Gear 62 meshes with gear 52, thereby causing shaft 51 to rotate, which in turn adjusts the pulling distance of the puller.

[0033] It should be noted that when the slider 40 moves at a speed greater than 1 mm / s, the motor 6 drives the output shaft 61 to rotate at high speed. The cam 93 presses the driven plate 91 with an 8 mm lift per revolution. The air pump 92 generates a high pressure of 0.5 kPa, and the lubricant is released at a high flow rate of 0.3 mL / s, quickly covering the opening surface. After the retraction is completed, the motor 6 operates at a low speed, the pressing frequency of the cam 93 decreases, and the lubricant flow rate automatically drops to 0.05 mL / s, maintaining only basic lubrication. The flow rate is strictly synchronized with the retraction speed, which avoids insufficient lubrication during rapid retraction and prevents excessive lubricant from flowing into the chest cavity during the fixation stage. The purely mechanical linkage design, with cam + spring reset, requires no sensors or circuit control, improving reliability and meeting the requirements of the sterile environment of the operating room.

[0034] Please see Figure 1 , Figure 3 and Figure 7 A ratchet 7 is installed on the outer wall of shaft 51, a screw 71 is installed on the top of protective shell 50, and an arc-shaped retaining plate 72 is installed on the bottom of screw 71 through a bearing. A retaining groove 73 is opened on the bottom of retaining plate 72, and the retaining groove 73 is engaged with ratchet 7.

[0035] It should be noted that when adjusted to the appropriate position, rotating screw 71 moves the clamping plate 72 to the position of ratchet 7, and the clamping groove 73 engages with ratchet 7, thereby preventing the first shaft 51 from rotating, and thus preventing the worm gear 55 from moving with the gear groove 12, keeping the position of the retractor fixed. The double mechanical locking, worm gear self-locking + ratchet fixing, ensures zero displacement error of the retractor, which is suitable for delicate operation under the condition of heartbeat.

[0036] Please see Figure 1 and Figure 6 A lubrication box 8 is installed on the outer wall of the slider 40. A replenishment bottle 81 is threaded onto the top of the lubrication box 8. A lubrication cavity 82 is opened inside the lubrication box 8. A lubrication pipe 83 is installed at the bottom of the lubrication cavity 82. The lubrication pipe 83 is connected to the lubrication hole 27 through a pipe. A second spring 9 is installed on the inner wall of the protective shell 50. A driven plate 91 is installed at one end of the second spring 9. An air pump 92 is installed on the inner wall of the protective shell 50. The driving end of the air pump 92 is fixedly connected to the outer wall of the driven plate 91. A cam 93 is installed on the outer wall of the output shaft 61.

[0037] Specifically, the top of the lubrication box is connected to a replenishment bottle via a thread, which stores lubricant inside. The threaded interface uses a medical-grade silicone gasket to prevent leakage. After the airbag inflates, it fits tightly against the sternum at a pressure of 20-30 kPa, forming a physical isolation layer that prevents the lubricant from diffusing into the pleural cavity. The lubricant flows only unidirectionally along the lubrication tube and lubrication hole. Combined with the isolation effect of the airbag, the incidence of lubricant accidentally entering the pleural cavity during surgery is greatly reduced. The modular lubrication box 8 can be replaced every 30 seconds during surgery without disassembling the retractor body, ensuring the continuity of the operation.

[0038] It should be noted that the replenishment bottle 81 is filled with a water-based lubricant, which is harmless to the human body and does not damage human tissue. When the patient's sternum is retracted, the lubricant flows out through the lubrication cavity 82, lubrication tube 83, and lubrication hole 27, lubricating the spacer plate 20 with the patient's sternum, thereby protecting the patient's sternum and preventing damage from the spacer plate 20. The lubricant continuously covers the contact surface of the spacer plate, reducing the coefficient of friction to below 0.02. Compared with traditional manual application, this reduces tissue scratches. The lubricant dosage is dynamically matched with the retraction speed, providing high-flow lubrication during the rapid retraction phase and maintaining low flow during the fixation phase, optimizing resource utilization. The modular structure allows for quick replacement of faulty parts, reducing surgical preparation time by 40% and meeting aseptic operation requirements.

[0039] It should be noted that when the retractor is adjusted to the appropriate position, the first gear 52 is in a fixed state, the electric telescopic rod 65 retracts, driving the moving plate 64 and the second gear 62 to move. Then the second gear 62 separates from the first gear 52. Then the motor 6 rotates at a low speed. During the rotation of the cam 93, it squeezes the driven plate 91. The driven plate 91 drives the air pump 92 to pump air. The air enters the lubrication chamber 82 through the pipe, thereby pushing the lubricant to continue to flow out. The second spring 9 facilitates the reset of the driven plate 91. It should be noted that during the initial adjustment of the retractor, the lubricant flows out quickly to prevent damage to the patient's sternum from excessive speed during retraction. After the retraction position is fixed, it is only necessary to maintain the lubrication state to provide maximum protection for the patient's sternum. It should be noted that after the heart and lung transplant surgery is completed, the motor 6 rotates to the angle at which the first gear 52 and the second gear 62 separate. At this time, the electric telescopic rod 65 extends and drives the second gear 62 to move back to its original position. At the same time, the screw 71 rotates in the opposite direction, so that the slider 40 can return to its original position, completing the traction process.

[0040] Use Case 1: Complex Congenital Heart Disease Transplant Surgery The patient was a 12-year-old child with sternal malformation, making traditional retractors unsuitable. This retractor was used during the procedure, with the bidirectional retraction component 2 adjusting the left and right retraction plates to asymmetrical positions (15mm expansion on the left and 10mm on the right). The air bladder 25 adaptively inflated according to the rib arch shape, maintaining a stable pressure of 25 kPa. The lubrication system continuously released lubricant, resulting in no abrasions on the sternal surface after the procedure. Postoperative CT showed a rib alignment accuracy of 0.2mm, shortening the procedure time by 30 minutes compared to traditional surgery.

[0041] Use Case 2: Emergency Aortic Dissection Repair The patient suddenly developed type A aortic dissection, requiring rapid thoracotomy. This retractor, driven by motor 6, achieved a retraction distance of 80mm within 5 seconds, while air pump 92 simultaneously activated high-pressure lubrication mode (0.3mL / s) to prevent rapid retraction from causing vascular tearing. After locking with ratchet 7 during the operation, the retractor maintained zero displacement despite blood pressure fluctuations, successfully completing the artificial vascular replacement.

[0042] Use Case 3: Minimally Invasive Mitral Valve Repair A retractor is implanted through a small incision (8cm), and the compact design of the protective shell 50 (only 45mm wide) avoids interference with thoracoscopic procedures. The micro-lubrication mode (0.05mL / s) of the lubrication box 8 reduces surgical field contamination, and the postoperative pain score of patients is reduced from the usual 6 points to 2 points, and the hospital stay is shortened to 4 days.

[0043] In the description of this specification, references to terms such as "an embodiment," "example," "specific example," etc., indicate that a specific feature, structure, material, or characteristic described in connection with that embodiment or example is included in at least one embodiment or example of the invention. In this specification, illustrative expressions of the above terms do not necessarily refer to the same embodiment or example. Furthermore, the specific features, structures, materials, or characteristics described may be combined in any suitable manner in one or more embodiments or examples.

[0044] The foregoing has shown and described the basic principles, main features, and advantages of the present invention. Those skilled in the art should understand that the present invention is not limited to the above embodiments. The embodiments and descriptions in the specification are merely illustrative of the principles of the invention. Various changes and modifications can be made to the present invention without departing from its spirit and scope, and all such changes and modifications fall within the scope of the claimed invention.

Claims

1. A sternal rib retractor for heart-lung transplantation, characterized by The fixed assembly (1) and the adjusting assembly (4) are slidably mounted on the fixed assembly (1); The outer wall of the fixed assembly (1) is provided with a first distraction assembly (2), and the outer wall of the first distraction assembly (2) is provided with a plurality of air bags (25). When the air bags (25) are inflated, they are in contact with the sternum of the patient, forming a cushion to prevent direct contact between the sternum and the metal retractor; The inside of the fixed assembly (1) is provided with a fixed cavity (35), and the outer wall of the fixed cavity (35) is provided with an extrusion plate (32). The movement of the adjusting assembly (4) synchronously drives the extrusion plate (32) to extrude the air in the fixed cavity (35), so that the air enters the air bag (25) through the pipeline, and the air bag (25) is inflated to protect the sternum of the patient.

2. The sternal rib retractor for heart-lung transplantation according to claim 1, wherein The fixed assembly (1) comprises a fixed plate (10), a fixed rod (11) and a gear groove (12). One end of the fixed plate (10) is fixed to the fixed rod (11) by welding or screw connection. The outer wall of the fixed plate (10) is provided with a gear groove (12). The tooth profile is an involute structure to enhance the engagement stability. The inner wall of the fixed plate (10) is provided with an inflation assembly (3).

3. The sternal rib retractor for heart-lung transplantation according to claim 1, wherein The first distraction assembly (2) comprises an adjusting bolt (22) mounted on the fixed rod (11). The bottom of the adjusting bolt (22) is provided with a connecting seat (21). The bottom of the connecting seat (21) is provided with a U-shaped distraction plate (20). The outer wall of the distraction plate (20) is provided with a plurality of air bags (25). The outer wall of the distraction plate (20) is provided with a connecting pipeline (26). The top of the adjusting bolt (22) is provided with a fixed block (23). The outer wall of the fixed block (23) is provided with a handle (24). The outer wall of the distraction plate (20) is provided with a plurality of lubrication holes (27). The material of the air bag (25) is medical silica gel, and the inside is filled with inert gas. The adjusting bolt (22) is connected with the fixed block (23) by screw thread. When the handle (24) is rotated, the distraction plate (20) is attached to the surface of the sternum. The air bag (25) is communicated with the inflation assembly (3) through the connecting pipeline (26). The outer wall of the distraction plate (20) is provided with a plurality of lubrication holes (27).

4. The sternal rib retractor for heart-lung transplantation according to claim 2, wherein The inflation assembly (3) comprises a sliding groove (31) formed in the outer wall of the fixed plate (10). The bottom of the extrusion plate (32) is provided with a push rod (36). The push rod (36) is located in the inside of the sliding groove (31) and extends out of the outer wall of the sliding groove (31). The inner wall of the fixed plate (10) is provided with a first spring (33). One end of the first spring (33) is fixedly connected with the outer wall of the extrusion plate (32). The inner wall of the fixed cavity (35) is provided with an air outlet (34). The push rod (36) is mechanically linked with the sliding block (40) of the adjusting assembly (4). When the sliding block (40) slides, the push rod (36) moves along the sliding groove (31). The extrusion plate (32) compresses the volume of the fixed cavity (35). The air enters the air bag (25) through the air outlet (34). The first spring (33) is a stainless steel spiral spring, which provides a rebound force of 5-8 N to ensure the reset of the extrusion plate (32).

5. The sternal rib retractor for heart-lung transplantation according to claim 1, wherein The adjusting assembly (4) comprises a sliding block (40) and a moving rod (41), the sliding block (40) is hollow designed, the inner wall size is slightly larger than the cross section of the fixed plate (10), allowing the sliding block (40) to slide along the fixed plate (10) in the axial direction, the moving rod (41) is provided with a second distraction assembly (42) at the bottom, and the second distraction assembly (42) is the same structure as the first distraction assembly (2) but the installation direction is opposite, so that the sternum is symmetrically distracted by bidirectional adjustment, and the outer wall of the sliding block (40) is provided with a driving assembly (5).

6. The sternal rib retractor for heart-lung transplantation according to claim 5, wherein The driving assembly (5) comprises a protective shell (50) mounted on the outer wall of the sliding block (40), a first shaft (51) mounted on the inner wall of the protective shell (50), a first gear (52) mounted on the outer wall of the first shaft (51), a worm (53) mounted at one end of the first shaft (51), a second shaft (54) mounted on the inner wall of the protective shell (50), a worm wheel (55) mounted on the outer wall of the second shaft (54), and the worm wheel (55) is in transmission connection with the worm (53), the worm wheel (55) is in meshing with the gear groove (12), the transmission ratio is 1:30, the bottom of the worm wheel (55) extends out of the bottom of the protective shell (50), and the worm (53) and the first shaft (51) are fixedly connected through a key.

7. The sternal rib retractor for heart-lung transplantation according to claim 6, wherein The outer wall of the first shaft (51) is provided with a ratchet wheel (7), the top of the protective shell (50) is provided with a screw rod (71), the bottom of the screw rod (71) is provided with an arc-shaped clamping plate (72) through a bearing, the bottom of the clamping plate (72) is provided with a clamping groove (73), and the clamping groove (73) is embedded with the ratchet wheel (7), the clamping plate (72) adjusts the embedding depth of the ratchet wheel (7) through the screw rod (71), the inner wall of the clamping groove (73) is provided with a polyurethane friction layer, the friction force of the tooth surface of the ratchet wheel (7) is increased, when the distraction position is fixed, the clamping groove (73) and the ratchet wheel (7) are completely embedded by rotating the screw rod (71) to make the clamping plate (72) press down, and the transmission shaft is locked.

8. The sternal rib retractor for heart-lung transplantation according to claim 5, wherein The outer wall of the sliding block (40) is provided with a lubricating box (8), the top of the lubricating box (8) is provided with a supplement bottle (81) through threads, the inside of the lubricating box (8) is provided with a lubricating cavity (82), the bottom of the lubricating cavity (82) is provided with a lubricating pipe (83), and the lubricating pipe (83) is in communication with the lubricating hole (27) through a pipeline, the supplement bottle (81) is sealed through thread connection, and the inside stores water-based lubricant containing 5% sodium hyaluronate, when the distraction plate (20) moves, the air pump (92) drives to inject air into the lubricating cavity (82) through the cam (93), and the lubricant seeps out through the lubricating hole (27) at a flow rate of 0.1ml / s.

9. The sternal rib retractor for heart-lung transplantation according to claim 6, wherein The inner wall of the protective shell (50) is provided with a second spring (9), one end of the second spring (9) is provided with a driven plate (91), the inner wall of the protective shell (50) is provided with a pump (92), and the driving end of the pump (92) is fixedly connected with the outer wall of the driven plate (91). The outer wall of the output shaft (61) is provided with a cam (93), the driving end of the pump (92) is hinged to the driven plate (91), the cam (93) is installed on the outer wall of the output shaft (61), the lift of the cam (93) is 8mm, when the motor (6) is running at low speed, the cam (93) is pressed once per week to extrude the driven plate (91), the pump (92) generates 0.5kPa air pressure to push the lubricant, the second spring (9) is a compression spring, the stiffness coefficient is 20N / mm, and the driven plate (91) is quickly reset.

10. The sternal rib retractor for heart-lung transplantation according to claim 6, wherein The inner wall of the protective shell (50) is provided with a motor (6), the output end of the motor (6) is provided with an output shaft (61), the outer wall of the output shaft (61) is provided with a second gear (62), the outer wall of the second gear (62) is provided with a moving plate (64) through a bearing, the outer wall of the moving plate (64) is provided with an electric telescopic rod (65), the inner wall of the protective shell (50) is provided with an auxiliary plate (63), and one end of the electric telescopic rod (65) is fixedly installed on the outer wall of the auxiliary plate (63).

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