Adjustable skin flap stripping knife

Abstract

The utility model discloses an adjustable skin flap stripping knife which comprises a handle, an upper-layer cutting knife head and a lower-layer cutting knife head. One end of the upper-layer cutting tool bit is fixedly connected with the outer surface of the handle and inserted into the handle to be fixedly connected with the heat conduction plate, and a temperature control mechanism is arranged on the outer surface of the heat conduction plate to heat the upper-layer cutting tool bit. One end of the lower-layer cutting tool bit penetrates through a movable groove in the end of the handle to be connected with a power mechanism, and the power mechanism drives the lower-layer cutting tool bit to slide in the movable groove. The temperature of the upper-layer cutting tool bit is adjusted through the temperature control mechanism, the power mechanism drives the lower-layer cutting tool bit to swing left and right according to the set frequency and shear with the upper-layer sawtooth tool bit, heat of the upper-layer cutting tool bit is prevented from being conducted to a skin flap through the heat-insulation and insulation baffle, a skin flap vascular net cannot be damaged, and the skin flap vascular net cannot be damaged. Therefore, the problems that hemostasis cannot be achieved at the same time during skin flap stripping in an existing mammary gland operation, smoke is generated due to burning in the operation, blood supply damage to a small blood vessel network of the skin flap is serious, the requirement for the skin flap stripping technology is high, and the thickness is uneven are solved.

Description

Background Art

[0002] Breast cancer is the most common malignant tumor in women. Its incidence has been increasing in recent years, with about 400,000 new cases of breast cancer in my country each year. Although breast-conserving surgery for early-stage breast cancer is becoming more and more popular, mastectomy is still the most common surgical method for patients with advanced breast cancer and some early-stage patients. In my country, mastectomy still accounts for more than 70% of breast cancer patients.

[0003] The first step of breast cancer mastectomy surgery is also the step that requires relatively high surgical skills, which is to peel off the entire gland from the skin and shallow fat tissue on the surface of the breast, that is, to peel off the breast skin and part of the shallow subcutaneous tissue left to be prepared from the breast gland. This step is commonly known as flap peeling, which requires high surgical skills. Breast surgeons often need more than 3 to 5 years and more than 500 surgical practices to master this step. Because this step is closely related to the common complications and surgical effects after breast cancer surgery, it requires rich clinical experience and skills.

[0004] For breast cancer mastectomy, the ideal effect of flap dissection should meet the following two conditions: (1) The thickness of the flap (including the full-thickness skin and a small amount of superficial subcutaneous tissue) is appropriate, and it is best to operate on the plane of the superficial subcutaneous fascia layer. On the one hand, as little breast tissue as possible should be left (the thinner the less residual), which represents the thoroughness of breast tissue removal; on the other hand, the damage to the subcutaneous vascular plexus should be minimized (the thicker the flap, the less impact on blood supply), which is crucial to the vitality of the flap; (2) The thickness of the flap is uniform and consistent. The uniformity during the dissection process is very important for the aesthetic result and minimizing the risk of complications (such as flap necrosis). Flaps of uniform thickness promote uniform healing and reduce the risk of seroma formation or infection.

[0005] In actual surgery, there are some difficulties in meeting the above two conditions. First, each patient's own conditions vary greatly, and the thickness of the skin and subcutaneous tissue is different. Many patients can hardly find a clear superficial fascia layer. The degree of breast glandular fat is different, and the blood supply of the skin and subcutaneous tissue is different. Although the literature recommends a flap thickness of 5 to 10 mm, in fact, the thickness of the flap retained by different surgeons and different patients varies greatly. Secondly, due to the wide range of breast flap dissection, the dissection area mostly ranges from 200 square centimeters to 400 square centimeters. Using the existing conventional scalpel dissection method and electrosurgical dissection method, even for experienced and skilled breast surgeons, it is difficult to accurately estimate the thickness of the retained flap, and it is even more difficult to keep the thickness of the flap uniform. At present, it depends entirely on the doctor's personal experience and the precise control of hand movements during the operation.

[0006] Existing flap dissection methods include: (1) scalpel flap dissection: insert the scalpel (or machete) into the superficial fascia layer under the skin first, and then slide the blade back and forth and push forward. This is an old-fashioned operation method before the widespread use of electrosurgery. It has now been abandoned by most surgeons and requires high surgical skills. Its advantages are that there is no thermal damage to the flap, and the flap dissected by a skilled doctor is relatively smooth; its disadvantages are that it is impossible to stop bleeding at the same time when dissecting the flap, and there is a lot of bleeding, especially for patients with hypertension. Moreover, if the thickness of the flap is not ideal during the dissection process, it cannot be adjusted. The direction of the blade is extremely difficult to grasp during the operation. Unskilled operators can easily cause uneven thickness of the flap or even puncture the skin; (2) electrosurgery flap dissection: This is the operation method currently used by most breast surgeons. Most of them use the electrocoagulation mode of the electrosurgery. The advantage is that it can stop bleeding while operating, with less bleeding, but it also has many disadvantages. First, since there is no real-time calibration of auxiliary equipment during the operation, it depends entirely on the experience and hand of the surgeon. The stability of the electrosurgical knife to control the movement of the electrosurgical knife can easily lead to uneven thickness of the flap. Secondly, the local high temperature generated during the operation of the electrosurgical knife will inevitably cause local tissue burns, which will significantly damage the subcutaneous small blood vessel network and easily lead to postoperative flap ischemia and necrosis and fat liquefaction. Thirdly, the operation of the electrosurgical knife will inevitably produce a large amount of burning smoke on the surface, causing serious local air pollution in the operating room, damaging the operation and causing related personnel to inhale a large amount of smoke. Fourthly, for some patients with pacemakers or heart stents in their bodies, the current in the body when using the electrosurgical knife may have adverse effects on them. (3) Ultrasonic scalpel flap peeling: Ultrasonic scalpel is rarely used for flap peeling, and is only used in a very small number of patients who cannot use the electrosurgical knife. Although the ultrasonic scalpel has the advantages of less thermal damage and thorough hemostasis, since each operation of the ultrasonic scalpel can only peel a very small piece of tissue, for extensive flap peeling surgery such as breast resection, the operation process will be extremely slow, the operation time will be extended several times, and it is not easy to peel a flap of uniform thickness.

[0007] It can be seen that the existing glass flap method has problems such as uneven flap thickness, heavy bleeding, and complicated operation. Utility Model Content

[0008] In view of the above-mentioned problems, the utility model provides an adjustable skin flap peeling knife, which can reduce the requirements on the operating techniques of breast surgeons, easily peel off a smooth and uniform skin flap, avoid the generation of a large amount of burning smoke, and can adapt to the personalized requirements of different patients.

[0009] In order to achieve the above purpose, the technical solution adopted by the utility model is:

[0010] An adjustable skin flap peeling knife comprises a handle 1, a cutting mechanism 2 is arranged at the end of the handle 1, and the cutting mechanism 2 comprises an upper cutting head 201 and a lower cutting head 202; one end of the upper cutting head 201 is fixedly connected to the outer surface of the handle 1, and is inserted into the interior of the handle 1 and fixedly connected to a heat conducting plate 5, and a temperature control mechanism 6 is arranged on the outer surface of the heat conducting plate 5 for heating the upper cutting head 201; one end of the lower cutting head 202 passes through a movable groove 11 at the end of the handle 1 and is connected to a power mechanism 7 arranged inside the handle 1, and the power mechanism 7 can drive the lower cutting head 202 to slide in the movable groove 11.

[0011] Furthermore, the cutting mechanism 2 is connected to the handle 1 in a bending manner, and the bending angle is 125 degrees to 145 degrees.

[0012] Furthermore, the upper cutting head 201 is slightly longer than the lower cutting head 202, and both are composed of cutting blades, and the two layers of cutting blades are arranged alternately.

[0013] Further, the cutting blade is in a fang shape or a shallow crescent shape.

[0014] Furthermore, the interval between the upper serrated blade head 201 and the lower serrated blade head 202 is less than 0.1 cm.

[0015] Furthermore, the power mechanism 7 includes a motor 701, the output end of the motor 701 is slidably connected to a connecting plate 702, the outer surface of the connecting plate 702 is fixedly connected to one end of the lower cutting head 202, and can drive the connecting plate 702, thereby driving the lower cutting head 202 to move.

[0016] Furthermore, the overall width of the cutting mechanism 2 is 4.5-5.5 cm, preferably 5 cm.

[0017] Furthermore, a removable heat-insulating baffle 3 is provided above the upper cutting head 201, guide strips are provided on both sides of the heat-insulating baffle 3, and two limit plates 4 are fixedly connected to the end of the handle 1, and grooves matching the guide strips are opened inside the limit plates 4.

[0018] Furthermore, the temperature control mechanism 6 includes a heating plate 601 and a thermistor temperature control chip 602. The heating plate 601 is arranged on the upper surface of the heat conducting plate 5 for heating the heat conducting plate 5; the thermistor temperature control chip 602 is arranged on the lower surface of the heat conducting plate 5 for detecting the temperature of the heat conducting plate 5.

[0019] Furthermore, a control chip 8 and a power supply are provided inside the handle 1 for controlling the operation of electrical components; a control panel 10 is provided on the outer surface of the handle 1, which is provided with a switch, a frequency adjustment button, a temperature control adjustment button of the heating plate, and a display screen for adjusting or displaying the frequency and temperature.

[0020] Compared with the prior art, the utility model has the following beneficial effects:

[0021] In the utility model, the skin flap, the heat-insulating baffle and the blade are parallel, so that a smooth and uniform skin flap can be easily peeled off; by setting components such as the heat-insulating baffle and the temperature control mechanism, adjusting the temperature control button, the temperature control mechanism adjusts the temperature of the upper cutting knife head, so that the knife head reaches a coagulation temperature (for example, 60-80°C), and the power mechanism drives the cutting blade of the upper cutting knife head to swing left and right according to the set frequency (for example, 600-1200 times / minute), and produces shearing with the lower row of serrated knives, so as to achieve the effect of stopping bleeding and peeling the skin flap evenly. At the same time, by setting the heat-insulating baffle, the heat of the upper cutting blade is blocked from being conducted to the skin flap, and the skin flap vascular network will not be damaged, and high temperature and smoke will not be generated. The thickness of the heat-insulating baffle can be replaced at any time according to the actual situation of each patient and the thickness of the pre-reserved skin flap, so as to adapt to the individual requirements of different patients and achieve the effect of increasing applicability, thereby solving the existing problems of being unable to stop bleeding during use, causing uneven thickness of the skin flap, obvious damage to the subcutaneous small blood vessel network and slow operation.

[0022] In the utility model, by providing components such as batteries, no additional lines are required to connect to the power supply, the volume is reduced, and it is easy to use. The temperature and the operation of the motor are controlled by the cooperation of the control panel and the control chip, thereby achieving an effect of easy operation. BRIEF DESCRIPTION OF THE DRAWINGS

[0023] Figure 1 This is a schematic diagram of the overall structure of an adjustable skin flap peeling knife of the utility model;

[0024] Figure 2 It is a three-dimensional structural schematic diagram of a cutting mechanism in an adjustable skin flap peeling knife of the utility model;

[0025] Figure 3 It is a cross-sectional view of a handle of an adjustable skin flap peeling knife of the utility model;

[0026] Figure 4 It is a three-dimensional structural schematic diagram of a heat-insulating baffle in an adjustable skin flap peeling knife of the utility model;

[0027] Figure 5 The utility model is a three-dimensional structural schematic diagram of a temperature control mechanism in an adjustable skin flap peeling knife.

[0028] In the figure: 1. handle; 2. cutting mechanism; 201. upper cutting head; 202. lower cutting head; 3. heat-insulating baffle; 4. limit plate; 5. heat-conducting plate; 6. temperature control mechanism; 601. heating plate; 602. thermistor temperature control chip; 7. power mechanism; 701. motor; 702. connecting plate; 8. control chip; 9. battery; 10. control panel; 11. movable slot. DETAILED DESCRIPTION

[0029] In order to make the purpose, technical solution and advantages of the utility model more clear, the utility model is further described in detail below in conjunction with the accompanying drawings and embodiments. It should be understood that the specific embodiments described here are only used to explain the utility model, rather than to limit the utility model.

[0030] like Figure 1-5 As shown, an adjustable skin flap peeling knife includes a handle 1, a cutting mechanism 2 is provided at the end of the handle 1, and the cutting mechanism 2 is bent and connected to the handle 1 at an obtuse angle. Preferably, the bending angle is 125 degrees to 145 degrees, and more preferably, the angle is 135 degrees. The cutting mechanism 2 includes an upper cutting head 201 and a lower cutting head 202 arranged in two rows, the upper cutting head 201 is slightly longer than the lower cutting head 202, and the cutting heads are both composed of cutting blades. For example, the upper and lower cutting heads are both composed of 8 cutting blades. One end of the upper cutting blade 201 is fixedly connected to the outer surface of the handle 1, and a plurality of movable grooves 11 are provided on the inner wall of the front end of the handle 1. One end of the cutting blade of the lower cutting head 202 passes through the movable groove 11 and is connected to the power mechanism 7. The power mechanism 7 can drive the lower cutting head to slide in the movable groove 11, thereby generating relative motion with the upper cutting head and generating shear force. The number of movable grooves 11 is the same as the number of cutting blades of the lower cutting head 202. When in use, the upper serrated head 201 is fixed, and the lower serrated head 202 vibrates at a high frequency of, for example, 600-1200 times / minute (which can be adjusted according to the cutting effect during the operation) to form a shear force peeling flap with the upper serrated head 201.

[0031] It is known to those skilled in the art that the wider the breast skinning knife is, the higher the efficiency is, and the peeled skin flap is more likely to have a uniform thickness. The width of a breast skin flap is about 15 to 25 cm. Considering the power supply problem, the utility model can optionally set the overall width of the cutting mechanism 2 to 4.5 to 5.5 cm, preferably 5 cm.

[0032] A heat-insulating baffle plate 3 is installed above the upper cutting blade head 201. When in use, the skin flap, the heat-insulating baffle plate 3 and the upper cutting blade head 201 are parallel, so that a smooth and uniform skin flap can be easily peeled off.

[0033] Guide strips are arranged on both sides of the heat-insulating baffle 3, and two limit plates 4 are fixedly connected to the end of the handle 1. Grooves matching the guide strips are provided inside the limit plates 4. The guide strips on both sides of the heat-insulating baffle 3 are slidably connected to the grooves inside the limit plates 4. The thickness of the heat-insulating baffle 3 is divided into three thicknesses of 2 mm, 5 mm and 8 mm. The thickness of the heat-insulating baffle 3 can be replaced at any time to meet the individual requirements of different patients, thereby achieving the effect of increasing applicability.

[0034] According to clinical experience, in one embodiment, the cutting blade is fang-shaped, 3 cm long, 0.1 cm wide at the tip, 0.3 cm wide at the root, and 0.3 cm apart; in another embodiment, the blade is shallowly crescent-shaped, which can better adapt to the shape of the skin flap.

[0035] In one embodiment, the upper serrated blade head 201 and the lower serrated blade head 202 are spaced apart by less than 0.1 cm.

[0036] It should be noted that the above numerical values ​​are only exemplary and can be adjusted by technicians in the relevant technical field as needed.

[0037] One end of the cutting blade of the upper cutting head 201 is inserted into the interior of the handle 1 and fixedly connected to the heat conducting plate 5. A temperature control mechanism 6 is provided on the outer surface of the heat conducting plate 5. The temperature control mechanism 6 includes a heating plate 601 and a thermistor temperature control chip 602. The heating plate 601 is arranged on the upper surface of the heat conducting plate 5, and the thermistor temperature control chip 602 is arranged on the lower surface of the heat conducting plate 5. The heating plate 601 is used to heat the heat conducting plate 5. The material of the heat conducting plate 5 is copper, and then the heat is transferred to the upper cutting head 201. The thermistor temperature control chip 602 detects the temperature of the heat conducting plate 5.

[0038] The power mechanism 7 is arranged inside the handle 1, and includes a motor 701. The output end of the motor 701 is slidably connected to a connecting plate 702. The outer surface of the connecting plate 702 is fixedly connected to one end of the lower cutting head 202. The output shaft of the motor 701 is an eccentric shaft, which can drive the connecting plate 702 to move repeatedly left and right, thereby driving the lower cutting head 202 to move left and right.

[0039] A control chip 8 is also provided inside the handle 1, and the control chip 8 can control the operation of all electrical components. A power source, such as a chargeable and dischargeable battery, is also provided inside the handle 1. A control panel 10 is installed on the outer surface of the handle 1. The control panel 10 is provided with switches, frequency adjustment buttons, temperature control adjustment buttons of the heating plate, and a display screen for adjusting or displaying frequency, temperature, etc. In one embodiment, the thermistor temperature control chip 602 transmits the detected temperature to the control chip 8, and the control chip 8 displays the temperature on the control panel 10 for easy adjustment.

[0040] It should be noted that in actual use of the device, the heat-insulating baffle 3 of ideal thickness is first installed on the limit plate 4 according to the patient's condition to achieve the reserved flap thickness. The heat-insulating baffle 3 can slide down on the limit plate 4, so that the heat-insulating baffle 3 can be replaced. The temperature control button is adjusted, and the temperature control mechanism 6 makes the temperature on the upper cutting head 201 reach 60-80 degrees Celsius, so that the head reaches the coagulation temperature, and the motor 701 is turned on. The lower cutting head 202 begins to swing left and right at the set frequency, and produces shearing with the upper serrated head 201.

[0041] After the scalpel cuts open the breast skin, the assistant holds the skin edge with several straight pliers, and the operator pulls down the mammary gland with one hand to create tension, and holds the skin flap peeler with the other hand to stick the heat-insulating baffle 3 to the skin flap. At this time, the heat-insulating baffle 3 is parallel to the skin flap, and the cutting mechanism 2 is pushed forward parallel to the heat-insulating baffle 3. The cutting mechanism 2 reaches the hemostasis temperature of 60 to 80 degrees Celsius, and will not generate high temperature, achieving the effect of stopping bleeding and evenly peeling the skin flap.

[0042] By setting up a heat-insulating baffle 3, the function of guiding the direction of the blade head can be achieved, and at the same time, the heat of the upper cutting blade head 201 can be blocked from being transferred to the skin flap, which will not damage the skin flap vascular network and will not generate high temperature and smoke. The thickness of the heat-insulating baffle 3 can be replaced at any time to meet the individual requirements of different patients, thereby achieving the effect of increasing applicability.

[0043] The results show that the use of the adjustable skin flap peeling knife of the utility model can improve the uniformity of skin flap thickness by 30%, reduce the operation time by 20%, and reduce the amount of bleeding by 50%.

[0044] In actual surgery, the adjustable skin flap stripping knife of the utility model was used to perform surgery on 10 breast cancer patients. After the surgery, the thickness of the skin flap was uniform and there was no obvious complication.

[0045] The above shows and describes the basic principle and main features of the utility model and the advantages of the utility model. Those skilled in the art should understand that the utility model is not limited by the above embodiments. The above embodiments and descriptions are only for explaining the principle of the utility model. Without departing from the spirit and scope of the utility model, the utility model may have various changes and improvements, which fall within the scope of the utility model to be protected. The scope of protection claimed by the utility model is defined by the attached claims and their equivalents.

Claims

1. An adjustable skin flap peeling knife, comprising a handle (1), characterized in that: A cutting mechanism (2) is provided at the end of the handle (1), and the cutting mechanism (2) comprises an upper cutting head (201) and a lower cutting head (202); one end of the upper cutting head (201) is fixedly connected to the outer surface of the handle (1), inserted into the interior of the handle (1) and fixedly connected to a heat conducting plate (5); a temperature control mechanism (6) is provided on the outer surface of the heat conducting plate (5) for heating the upper cutting head (201); one end of the lower cutting head (202) passes through a movable groove (11) at the end of the handle (1) and is connected to a power mechanism (7) provided inside the handle (1); the power mechanism (7) can drive the lower cutting head (202) to slide in the movable groove (11).

2. The skin flap peeling knife according to claim 1, characterized in that: The cutting mechanism (2) is connected to the handle (1) in a bending manner, and the bending angle is 125 degrees to 145 degrees.

3. The skin flap peeling knife according to claim 1, characterized in that: The upper cutting blade head (201) is slightly longer than the lower cutting blade head (202), and both are composed of cutting blades, with the two layers of cutting blades being arranged in an alternating manner.

4. The skin flap peeling knife according to claim 3, characterized in that: The cutting blade is in a fang shape or a shallow crescent shape.

5. The skin flap peeling knife according to claim 3, characterized in that: The interval between the upper cutting blade head (201) and the lower cutting blade head (202) is less than 0.1 cm.

6. The skin flap peeling knife according to claim 1, characterized in that: The power mechanism (7) comprises a motor (701), the output end of the motor (701) being slidably connected to a connecting plate (702), the outer surface of the connecting plate (702) being fixedly connected to one end of the lower cutting head (202), and being capable of driving the connecting plate (702), thereby driving the lower cutting head (202) to move.

7. The skin flap peeling knife according to claim 1, characterized in that: The overall width of the cutting mechanism (2) is 4.5-5.5 cm.

8. The skin flap peeling knife according to claim 1, characterized in that: The overall width of the cutting mechanism (2) is 5 cm.

9. The skin flap peeling knife according to claim 1, characterized in that: A detachable heat-insulating baffle (3) is provided above the upper cutting blade head (201), guide strips are provided on both sides of the heat-insulating baffle (3), and two limit plates (4) are fixedly connected to the end of the handle (1), and grooves matching the guide strips are provided inside the limit plates (4).

10. The skin flap peeling knife according to claim 1, characterized in that: The temperature control mechanism (6) comprises a heating plate (601) and a thermistor temperature control chip (602); the heating plate (601) is arranged on the upper surface of the heat conducting plate (5) and is used to heat the heat conducting plate (5); the thermistor temperature control chip (602) is arranged on the lower surface of the heat conducting plate (5) and is used to detect the temperature of the heat conducting plate (5).

11. The skin flap peeling knife according to claim 1, characterized in that: The handle (1) is also provided with a control chip (8) and a power supply for controlling the operation of the electrical components; the outer surface of the handle (1) is provided with a control panel (10), which is provided with a switch, a frequency adjustment button, a temperature control adjustment button for the heating plate, and a display screen for adjusting or displaying the frequency and temperature.

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