A tension adjustment device for autologous fascial sling procedures

Abstract

The application discloses a tension adjusting device for autologous fascial sling surgery, which is provided with a tension indicator and a tension adjuster, the tension adjuster is provided with two tension ropes, the tension adjuster is used for quantitatively adjusting and locking the length of the tension ropes, and the outer ends of the two tension ropes are respectively fixedly connected with the two end portions of the autologous fascial sling. The tension indicator is used for indicating the tension of the tension ropes. The application discloses the specific structure of the tension adjuster, so that the tension in the sling surgery can be quantified and visualized, the tension can be adjusted in the surgery, the tension does not need to be repeatedly fixed, the operation is convenient, the structure is simple, and the tension adjuster is easy to disinfect.

Description

Technical Field

[0001] This invention relates to the field of medical device technology, and in particular to a sling tension adjustment auxiliary device for pelvic organ prolapse and stress urinary incontinence surgery during and after surgery. Background Technology

[0002] In surgeries for pelvic organ prolapse and stress urinary incontinence, conventional slings have drawbacks such as rejection and a high incidence of long-term complications. Consider using autologous fascia lata or hamstring tendons as sling materials to perform tension-free mid-urethral sling surgery (MUS) for stress urinary incontinence (SUI), which has advantages such as no rejection, good biocompatibility, and fewer long-term complications.

[0003] However, the following technical challenges exist in autologous fascia sling surgery:

[0004] 1. Lack of objective standards for tension control: Currently, intraoperatively, the surgeon mainly relies on touch to judge the tightness of the sling, lacking quantitative methods. "How to control the degree of suspension and how much force to use for suspension during insertion is a difficult problem in various tube-assisted treatments." Traditional SIS surgical slings also suffer from problems such as "inconvenient and difficult tension adjustment."

[0005] 2. Manual traction is inefficient and inaccurate: During the operation, the surgeon usually uses hemostatic forceps or fingers to hold the fascia strip for traction, which makes it difficult to accurately control the traction force and direction, and is easy to damage the fascia surface.

[0006] 3. Intraoperative adjustments require repeated operations: Once fixation is completed and the tension is found to be unsuitable, the sutures need to be removed and readjusted, which prolongs the operation time and increases the risk of tissue damage.

[0007] Currently, there is a lack of integrated auxiliary devices specifically designed for traction and tension adjustment during autologous fascia sling surgery in clinical practice. Summary of the Invention

[0008] The technical problem to be solved by the present invention is to provide a tension adjustment device for autologous fascia sling surgery, which can solve the problems of relying solely on subjective feelings in the above-mentioned sling surgery and autologous fascia sling surgery, resulting in large deviations in surgical effects, inability to standardize, difficulty in observing and determining tension, difficulty in quantitative control, inconvenience in traction operation, and cumbersome intraoperative adjustment.

[0009] To achieve the above objectives, the present invention adopts the following technical solution:

[0010] The tension adjustment device for autologous fascia sling surgery is characterized by: a traction device with a tension gauge, pull ropes extending from both sides of the traction device, the traction device being used to quantitatively adjust and lock the length of the pull ropes, the pull ropes on both sides being fixed to the two ends of the sling through surgical traction lines, the tension gauge being used to indicate the tension on the pull ropes; and the sling being the patient's autologous fascia.

[0011] The puller is internally enclosed by a base, a middle cylinder, and a top cover to form a sealed cavity. The base has a cylindrical groove, and the inner wall of the groove is connected to an inwardly extending stop claw. A columnar ratchet gear is movably and coaxially embedded in the groove. The stop claw is movably embedded between the ratchet teeth on the outer periphery of the ratchet gear. A rope winding post is coaxially and fixedly connected to the outer end of the ratchet gear. There is a gap between the rope winding post and the top cover. The maximum gap is not less than the thickness of the ratchet gear. The rope winding post and the middle cylinder are fixedly connected by a connector. The tension gauge is installed on the outer side of the top cover. A telescopic rod is fixedly connected to the base on the inner middle part of the top cover. The telescopic rod is installed through the ratchet gear and the rope winding post with a gap.

[0012] Each of the force measuring connection ends on both sides of the tension gauge is connected to a reversing ring. A guide tube is provided parallel to the axis of the rope winding column and fixedly connected to the upper cover. The upper end of the guide tube is axially aligned with the reversing ring connected to the force measuring connection end, and the lower end is axially aligned with the lower part of the rope winding column. The two tension ropes enter from the two sides of the puller, pass radially from far to near through the reversing rings of the two force measuring connection ends of the tension gauge, and then enter the upper end of the guide tube. From the lower end of the guide tube to the lower part of the rope winding column, after winding around the outer wall of the rope winding column, they are fixed to the fixed end of the upper part of the rope winding column.

[0013] The present invention has the following beneficial effects:

[0014] Sling surgery can be performed using a traction device that allows for visual quantification and standardization of stop and tension hooks.

[0015] 1. Tension is quantifiable, visualized, and recordable: Through tension sensing units and scale markings, the traditional subjective experience of "relying on touch" is transformed into objective and visible quantitative indicators. Data can be recorded, which facilitates standardized operation and significantly improves the accuracy of tension control.

[0016] 2. Single-handed operation, convenient and efficient: The operator can complete a series of operations such as traction, tension observation and locking fixation with one hand, freeing up the other hand for auxiliary operations.

[0017] 3. Adjustable during surgery, no need for repeated fixation: It can be adjusted to tighten or loosen, and is controllable in both directions. If the tension is not suitable, the traction position can be adjusted and the tension reset at any time without removing sutures, thus shortening the operation time.

[0018] 4. Postoperative external adjustment can be performed to avoid secondary surgery, reducing patient trauma and medical costs.

[0019] 5. Particularly suitable for autologous fascia slings, protecting the integrity of the autologous fascia slings: avoiding damage, twisting or slippage of the fascia slings during traction, while taking into account the flexibility and elastic recoil characteristics of autologous fascia.

[0020] 6. Simple structure and easy to disinfect: The device has a simple overall structure and all parts are detachable, making it easy to clean, disinfect and reuse.

[0021] 7. The ratchet clutch structure is integrated with the tension measurement. In particular, the friction and resistance generated by the winding of the pull rope will not cancel out the measurement of the tension gauge. It is based on the sequential movement of the pull rope through the reversing ring of the tension gauge in the pull rope path. The direction of the measured tension is determined by the position setting of the outer reversing ring, which also determines the priority order of the pull rope path.

[0022] 8. By utilizing the synchronized winding action of the pull ropes on both sides, the pull ropes on both sides are completely isolated through the double-headed spiral groove, ensuring that neither they interfere with each other and guaranteeing the long-term stable use of the puller. Attached Figure Description

[0023] Figure 1 This is a schematic diagram of the overall structure of an embodiment of the present invention.

[0024] Figure 2 yes Figure 1 A schematic diagram of the tensioner structure in the specified state.

[0025] Figure 3 This is a schematic diagram of the internal structure of the puller after the top cover has been removed.

[0026] Figure 4 yes Figure 2 A sectional view.

[0027] Figure 5 This is a top-view diagram of a single stop pawl.

[0028] Figure 6 yes Figure 5 Sectional view AA.

[0029] Figure 7 This is a schematic diagram of the rope's direction.

[0030] Figure 8 This is a partially enlarged schematic diagram of the outer wall of the rope-wrapped column.

[0031] In the diagram: 1-traction device, 2-convex ring, 3-anti-slip teeth, 4-force gauge, 5-pull rope, 6-sling, 7-middle cylinder, 8-rope winding post, 10-ratchet, 11-stop pawl, 12-guide tube, 13-surgical traction line, 14-top cover, 15-base, 16-double-headed spiral groove, 17-telescopic rod, 18-force measuring connection end, 19-fixed end, 20-reversing ring. Detailed Implementation

[0032] The present invention will be further described below with reference to the accompanying drawings and embodiments. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

[0033] In the description of this invention, it should be noted that the terms "upper," "lower," "inner," and "outer," etc., indicate the orientation or positional relationship based on the usage state or the orientation or positional relationship shown in the accompanying drawings. They are used only for the convenience of describing the invention and for simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, or be constructed and operated in a specific orientation. Therefore, they should not be construed as limitations on the invention. Unless otherwise explicitly specified and limited, the terms "installed," "connected," and "linked" should be interpreted broadly. For example, they can refer to a fixed connection, a detachable connection, or an integral connection; they can refer to a direct connection or an indirect connection through an intermediate medium; they can refer to the internal communication between two elements. The traction device is used externally and can be made of human-safe plastic or metal materials. Those skilled in the art can understand the specific meaning of the above terms in this invention based on the specific circumstances.

[0034] like Figure 1-4 As shown, the tension adjustment device for autologous fascia sling surgery is used for adjusting the tension of the sling during and after surgery for pelvic organ prolapse and stress urinary incontinence. Traditional sling surgery relies entirely on the surgeon's experience and feel to determine the sling tension, making objective evaluation and technical transmission difficult. Furthermore, due to the complexity of adjusting and re-tensioning the sling after loosening, repeated readjustment is rarely performed during surgery. This invention changes this situation, which relies entirely on the surgeon's sense of touch, by providing a traction device that can be easily adjusted and objectively quantified.

[0035] The traction device is equipped with a force gauge 4 for objectively measuring the tension value. The force gauge 4 is installed on the outside of the upper cover 14, and the tension value indicated by the pointer of the force gauge 4 can be directly and intuitively seen from the outer surface. Pull ropes 5 extend from both sides of the traction device 1, and the outer ends of the pull ropes 5 are fixedly connected to the surgical traction lines 13 that are fixedly connected to both ends of the sling. This connection can be secured using a clamping structure or a binding structure. The primary feature of this invention is that the length of the pull ropes 5 is quantitatively adjusted and locked using the traction device 1, and the tension force on the pull ropes 5 is measured and displayed in real time using the force gauge 4. The diameter of the traction device 1 can be set to different specifications ranging from 5cm to 10cm.

[0036] The sling 6 is the patient's autologous fascia. Using autologous fascia lata or hamstring tendons as sling materials for tension-free mid-urethral sling surgery (MUS) to treat stress urinary incontinence (SUI) has advantages such as no rejection, good biocompatibility, and fewer long-term complications. Of course, this invention is also applicable to slings made of other materials.

[0037] As a simple-constructed traction device, the following structural description of the traction device is actually an embodiment of the aforementioned functions. The traction device 1 has a sealed cavity formed by a base 15, a middle cylinder 7, and a top cover 14, which can accommodate a continuous, complete cylindrical cavity. For ease of description, the order from top to bottom is agreed to be top cover 14, middle cylinder 7, and base 15. The base 15 has a cylindrical groove. A telescopic rod 17 is fixedly connected between the base 15 and the top cover 14 along the central axis of the cylindrical groove. The telescopic rod 17 can extend and retract along its length without twisting. The telescopic rod 17 can extend and retract with resistance through a sleeve structure of different diameters but with contact friction. Since extension and retraction require force and energy consumption, it will not retract after extension without force. The sleeve portions of the telescopic rod 17 in contact with each other have multiple mating convex rings and grooves. The protrusion size of the convex rings is no more than 0.5mm. The deformation generated by applying force can change the nesting of the convex rings and grooves. Alternatively, a corrugated pipe-like structure can be used to achieve resistance-based telescopic movement through rigid folded walls and energy-dissipating telescopic resistance, allowing the base 15 and the top cover 14 to telescopically extend and retract axially while remaining synchronous in the rotational direction. The telescopic rod is installed by passing through the ratchet and rope-winding post with a gap, meaning that the telescopic rod is installed through the ratchet and rope-winding post without contacting them.

[0038] A stop pawl 11 is connected to the inner wall of the cylindrical groove. The stop pawl 11 can be directly fixed to the inner wall of the cylindrical groove, or multiple stop pawls 11 can be formed into one piece by being evenly distributed around the circumference of an annular belt and locked at the bottom of the cylindrical groove. The even distribution of multiple stop pawls 11 around the circumference makes the ratchet 10 uniformly stressed and stable in movement.

[0039] like Figure 3 , 4 As shown, a cylindrical ratchet 10 is housed in a cylindrical groove. The outer wall of the ratchet 10 has a ring of ratchet teeth. The ratchet teeth cooperate with the stop pawl 11. The stop pawl 11 is movably embedded in the radial groove between the ratchet teeth. The ratchet teeth are all biased in one direction, so that the ratchet 10 can only rotate in one direction and cannot rotate in the opposite direction.

[0040] A rope-winding post 8 is coaxially fixedly connected to the outer end of the ratchet 10. The outer contour of the rope-winding post 8 is similar to a cylinder, and there is a gap between the rope-winding post 8 and the upper cover 14, which is greater than the thickness of the ratchet 10. Therefore, the base 15, the upper cover 14, and the stop pawl 11 are connected as a first integral unit, and the ratchet 10, the rope-winding post 8, and the middle cylinder 7 are connected as a second integral unit. The first integral unit and the second integral unit can rotate or move axially relative to each other in one direction. The adjacent parts of the side walls of the base 15, the middle cylinder 7, and the upper cover 14 overlap, so even if they are stretched relative to each other, the internal cavity will not be exposed.

[0041] The end or side wall near the end of the rope winding post 8 is fixedly connected to the middle cylinder 7 by a connector. Rotating the middle cylinder 7 will drive the rope winding post 8 and the ratchet 10 to rotate. Anti-slip teeth 3 are provided on the outer side wall of the middle cylinder 7, and a protruding ring 2 is also integrally provided on the outer side wall of the middle cylinder 7. The vertical cross-sectional shape of the ring 2 is rectangular, or the outer corner below the vertical cross-section of the ring 2 is an acute angle, to facilitate lifting operation. A gap of 0.7-1.7cm is provided between the ring 2 and the radially protruding base 15, so that the ring 2 can be lifted with fingers during one-handed operation. A gap of 1cm is recommended, which can easily separate the ratchet 10 from the stop pawl 11 axially. When axially engaging the ratchet 10 and the stop pawl 11, simply press down directly towards the base 15 on the tension gauge 4 part of the outer end face. After the ratchet 10 is separated from the stop pawl 11, the ratchet 10 and the stop pawl 11 can rotate in opposite directions. After the ratchet 10 and the stop pawl 11 are engaged, the ratchet 10 and the stop pawl 11 can only rotate in the forward direction. When the middle cylinder 7 rotates, the tension gauge 4 will not rotate with it to maintain the visual stability of the tension gauge 4 for the human eye.

[0042] To ensure a smooth engagement between the ratchet 10 and the stop pawl 11, the following embodiment can greatly simplify the design structure: (e.g.) Figure 5 , 6 As shown, the outer contour of the stop pawl 11 in the radially overlapping area with the ratchet smoothly widens from top to bottom. That is, the stop pawl 11 is narrow on the side facing the ratchet, making it easier to cut into the groove between the ratchet teeth. The smooth widening of the lower part of the stop pawl 11 ensures the strength and stopping stability of the stop pawl 11.

[0043] When the base 15 is fixed relative to the patient's body, the ratchet 10 connected to the middle cylinder 7 can be easily separated from or engaged with the stop pawl 11 on the side wall of the base 15 with one hand. When engaged, the ratchet 10, together with the rope winding post 8, can only rotate in one direction, wrapping the pull rope 5 around the rope winding post 8, shortening the length of the pull rope 5. When the hand is released and no force is applied, it will automatically stop and not reverse, locking the length of the pull rope 5. When it is necessary to loosen the pull rope 5, simply lift the middle cylinder 7, the ratchet 10 will separate from the stop pawl 11, and the rope winding post 8 can be rotated in the opposite direction to loosen the pull rope 5.

[0044] The pull rope 5 is the target for adjusting the traction force. It needs to simultaneously play an important role in transmitting traction force, adjusting the length of the pull rope, measuring the traction force, and executing the operation. In this invention, the pull rope 5 can be surgical grade 0 non-absorbable suture, metal wire, or nylon thread. To reduce the influence of frictional resistance on the traction force, the following structure is adopted in conjunction with the pull rope direction. For easy viewing, see the diagram below. Figure 7 The diagram shows the direction of rope 5 on one side; the direction of rope 5 on the other side follows the same logic.

[0045] The tension gauge 4 has a force measuring connection end 18 extending from each of its two sides. Two guide tubes 12 are fixedly connected to the upper cover 14. The guide tubes 12 are parallel to the central axis of the rope winding column 8. The two guide tubes 12 are respectively on one side of the two force measuring connection ends 18. One end of the guide tube 12 is radially flush with the force measuring connection end 18, and the other end extends to be radially flush with the lower part of the rope winding column 8. Reversing rings 20 are fixedly connected or hinged at the two force-measuring connection ends 18, both ends of the guide tube 12, and the entrance of the pull rope. The two pull ropes 5 enter from both sides of the puller 1 through the reversing rings 20, and pass radially from far to near through the reversing rings of the two force-measuring connection ends 18 of the force gauge. Then they run radially from near to far, pass through the reversing ring at the near end of the guide tube 12 at the far end, and then pass along the guide tube 12 through the reversing ring at the lower end of the guide tube to the rope winding post 8. After winding around the outer wall of the rope winding post 8, they are fixed to the fixed end 19 at the upper part of the rope winding post.

[0046] Furthermore, to ensure that the ropes do not tangle or knot during the winding process, thus preventing additional tensile resistance and affecting the accuracy of the tension measurement, a double-headed spiral groove 16 is provided on the outer surface of the rope winding post 8, see [reference]. Figure 8 A schematic diagram of the surface of the rope winding column shows that the double-headed spiral groove 16 has two complete and independent spiral grooves. The upper starting points of the double-headed spiral groove 16 are two fixed ends 19. The inner end of the pull rope 5 is fixed to the fixed end 19. The two fixed ends 19 are sealed inside the rope winding column, and the outer surface is smooth. Then, each pull rope 5 is individually isolated in the spiral groove on the outer wall of the rope winding column 8. This ensures that the pull rope 5 passes through the winding part independently without interference. If the winding length is short, only a small part of the pull rope 5 will pass through the spiral groove, and then it will be directly pulled to the guide tube 12. The part of the rope winding column 8 is blocked by the groove wall of the double-headed spiral groove and kept in the double-headed spiral groove. After passing the reversing ring of the force measuring connection end 18, it passes through the reversing rings 20 on both sides of the puller 1 to the outside of the puller 1 and is connected to the sling 6.

[0047] Since the two sections of rope 5 are simultaneously wound or unwound under the action of tension, the speed of winding on the rope post 8 is consistent, and the winding direction is also consistent. Therefore, they will not interfere with each other in the double-headed spiral groove 16.

[0048] Since the pull rope 5 passes radially from far to near through the reversing ring of the two force measuring connection ends 18 of the tension gauge, and then radially from near to far through the reversing ring of the near end of the guide tube 12, and then through the guide tube and the winding rope post 8, the tension is preferentially reflected on the tension gauge pointer through the tension gauge 4. The direction of the pull rope is consistent with the direction of force measurement, and the winding friction on the rope post does not directly affect the measurement of the tension value.

[0049] In use, pressing the tension gauge 4 engages the pull rope control. Rotating the middle cylinder 7 clockwise winds the pull rope 5 around the rope winding post 8, shortening the pull rope 5 and increasing the pulling force on the sling 6. When the middle cylinder 7 is not rotated, the pull rope 5 is self-locked. The tension gauge 4 displays the magnitude of the pulling force on the pull rope 5 at this time, which can be read and recorded. When it is necessary to loosen the pull rope 5, pull up the protruding ring 2 relative to the base 15 to disengage the ratchet 10 from the stop pawl 11. At this time, the pull rope 5 can be pulled out to loosen the pulling force. Pressing the tension gauge 4 again engages the pull rope control again to perform tightening or locking operations.

[0050] The main procedures of this invention using an autologous fascia sling surgery example are as follows: A sterilized traction device 1 with a pull rope 5 is prepared. The traction device 1 is pre-attached and fixed to the skin of the lower abdomen.

[0051] Autologous fascia harvesting: Open the sartorius tendon membrane, cut a semitendinosus tendon approximately 18cm long and 1.5cm wide, and ligate both ends of the tendon with 0 non-absorbable sutures as surgical traction sutures 13 through sutures for later use, leaving the tail end for traction, and mark the midpoint with sutures.

[0052] The right lower extremity incision was covered with a dressing. The patient was repositioned to the lithotomy position, and the area was re-disinfected and draped. A urinary catheter was inserted and placed in the indwelling catheter. The cervix was clamped and retracted with tissue forceps. Saline was injected into the space between the vaginal mucosa and the bladder about 1.0 cm above the anterior lip of the cervix to form a water cushion. A portion of the anterior vaginal wall mucosa was removed in a fusiform shape. The paravaginal space was bluntly and sharply dissected to fully expose the bulging bladder. The bulging bladder and bladder fascia were sutured with synthetic sutures in a purse-string suture twice to repair the bulging bladder.

[0053] The vaginal wall mucosa is sutured transversely with synthetic sutures. A 1.0 cm incision is made 1 cm above the external urethral orifice at the crease of the right groin. A 20 ml water pad is injected submucosally into the anterior vaginal wall between the external urethral orifice and the bladder neck, 1.5 cm below the urethral orifice. The vaginal-urethral space is slightly freed using dissecting scissors, which are then adjusted to be parallel to the coronal plane of the body and dissected towards the descending pubic ramus anterior to the obturator foramen. Two surgical traction sutures 13 are pulled along one side of the long tendon using a right-side curved puncture needle, exiting through the right incision close to the inferior pubic ramus. The opposite side is punctured in the same manner. The surgical traction sutures 13 are secured to the outer end of the pull rope 5 of the traction device 1. The remaining length of the surgical traction suture is estimated based on the length of the sling, traction suture, and pull rope, ensuring that the excess length does not exceed 5 cm. The sling tension is adjusted using the traction device 1 to a suitable reading, which is corrected based on empirical values ​​and population statistics. The right fascia strip was fixed with absorbable suture 13, and the incisional mucosa below the urethral orifice was continuously sutured with absorbable 0 suture. The exposed autologous sling was then embedded. The skin at the puncture site in the groin was incised to expose the fascia. The fascia strip was sutured to the subcutaneous tissue, the subcutaneous fat layer was sutured, and the incision was closed intradermally. Surgical traction 13 on the left side was left outside the groin incision for future sling adjustments. The skin at both puncture sites was sutured externally with absorbable suture. After suturing, the mucosa was examined and found to be intact and undamaged. No active bleeding was observed at the wound site. The patient was returned to the ward after anesthesia recovery. With good postoperative recovery, the traction device and external surgical traction sutures can be removed in 2-7 days.

[0054] The biggest problem with traditional sling surgery is the inability to adjust postoperative tension. Once adjusted intraoperatively, the tension is fixed; if urinary difficulty or retention occurs postoperatively, a second surgery to loosen the sling is necessary, resulting in significant trauma and high risk. Literature reports a substantial incidence of postoperative urinary retention after sling surgery; one study showed that 1 in 9 patients required intermittent catheterization for 12 days. This invention solves this technical problem. Sling tension can still be non-invasively adjusted postoperatively, allowing for adjustment of sling tension based on actual conditions and automatic locking. Adjustment can be made 1 to 7 days postoperatively, while the traction device is still in place, through a small external incision without anesthesia, eliminating the need for re-entry into the operating room.

[0055] Finally, it should be noted that the above description is only an embodiment or preferred solution of the present invention. The embodiments may be applied in combination and are not intended to limit the present invention. Although the present invention has been described in detail with reference to the foregoing embodiments, those skilled in the art can still modify the technical solutions described in the foregoing embodiments or make equivalent substitutions for some of the technical features. Any modifications, equivalent substitutions, improvements, etc., made within the spirit and principles of the present invention should be included within the protection scope of the present invention.

Claims

1. A tension adjustment device for autologous fascia sling surgery, characterized in that: A traction device (1) with a tension gauge (4) is provided. Pull ropes (5) extend from both sides of the traction device (1). The traction device (1) is used to quantitatively adjust and lock the length of the pull ropes (5). The pull ropes (5) on both sides are fixed to the two ends of the sling (6) through surgical traction lines (13). The tension gauge (4) is used to indicate the tension on the pull ropes (5). The sling (6) is the patient's autologous fascia. The puller (1) is enclosed by a base (15), a middle cylinder (7) and a top cover (14) to form a sealed cavity. The base (15) has a cylindrical groove, and the inner wall of the groove is connected to an inwardly extending stop claw (11). A columnar ratchet (10) is movably and coaxially embedded in the groove. The stop claw (11) is movably embedded between the ratchet teeth on the outer periphery of the ratchet (10). The outer end of the ratchet (10) is coaxially and fixedly connected to a rope winding post (8). There is a gap between the rope winding post (8) and the top cover (14). The maximum gap is not less than the thickness of the ratchet (10). The rope winding post (8) and the middle cylinder (7) are fixedly connected by a connector. The outer side of the top cover (14) is equipped with the tension gauge (4). The inner middle part of the top cover (14) is fixedly connected to the base (15) with a telescopic rod (17). The telescopic rod (17) is installed through the ratchet (10) and the rope winding post (8) with a gap.

2. The tension adjustment device for autologous fascia sling surgery according to claim 1, characterized in that: The force measuring connection end (18) on both sides of the tension gauge (4) is connected to a reversing ring (20). A guide tube (12) is provided parallel to the axis of the rope winding column (8) and fixedly connected to the upper cover (14). The upper end of the guide tube (12) is axially aligned with the reversing ring (20) connected to the force measuring connection end (18), and the lower end is axially aligned with the lower part of the rope winding column (8). The two pull ropes (5) enter from the two sides of the puller (1) respectively, and pass radially from far to near through the reversing rings of the two force measuring connection ends (18) of the tension gauge, and then enter the upper end of the guide tube. From the lower end of the guide tube to the lower part of the rope winding column (8), after winding around the outer wall of the rope winding column (8), they are fixed to the fixed end (19) at the upper part of the rope winding column.

3. The tension adjustment device for autologous fascia sling surgery according to claim 1, characterized in that: A double-headed spiral groove is provided on the outer surface of the rope-winding column (8). The upper starting points of the double-headed spiral groove are two fixed ends (19). The part of the rope (5) wrapped around the outer wall of the rope-winding column (8) is movably embedded in the spiral groove.

4. The tension adjustment device for autologous fascia sling surgery according to claim 1, characterized in that: The stop claw (11) has multiple claws evenly distributed on the inner sidewall of the groove. The outer side profile of the stop claw (11) and the ratchet in the radially overlapping area smoothly widens from top to bottom.

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