Transvaginal laparoscopy with continuous self-expanding exposure device under closed view of surgical field
By combining directional elastic bands and uterine lifting boards, the isolated organs in the pelvic cavity are automatically expanded, solving the problems of visual interference and organ damage in vaginal laparoscopic surgery, and realizing safe and efficient transvaginal laparoscopic surgery.
Patent Information
- Authority / Receiving Office
- CN · China
- Patent Type
- Utility models(China)
- Current Assignee / Owner
- HEFEI HERBO MEDICAL EQUIP CO LTD
- Filing Date
- 2025-03-06
- Publication Date
- 2026-06-23
AI Technical Summary
In transvaginal laparoscopic surgery, the accumulation of pelvic organs can cause visual interference and make effective isolation difficult. Furthermore, rigid dilation support rings are difficult to insert at the vaginal opening, affecting the safety and efficiency of the surgery.
The directional elastic ring of the traction-sealed sheath bag is rotated to a horizontal-vertical angle, combined with the traction lifting plate and the telescopic pressure plate, to automatically expand the isolated organs in the pelvic cavity, forming an independent surgical area and avoiding organ interference.
It improves surgical safety and efficiency, reduces the risk of organ damage, avoids excessive pneumoperitoneum pressure and the "valve effect," and provides a stable operating tunnel.
Smart Images
Figure CN224387480U_ABST
Abstract
Description
Technical Field
[0001] This invention relates to an auxiliary device for transvaginal laparoscopic surgery. Background Technology
[0002] Transvaginal laparoscopic surgery is a minimally invasive treatment method that involves inserting a PORT (Port) consisting of a sealed sheath bag through the vaginal entrance. This allows for observation and surgical manipulation of the pelvic and abdominal cavities under a closed, inflated state. Procedures include the removal of diseased tissue or solid organs within the pelvic and abdominal cavities. Traditionally, the PORT requires the surgeon to incise the vaginal fornix using conventional vaginal surgery methods, and sometimes even to sever the sacral and cardinal ligaments, before the expansion support ring of the PORT can be inserted into the pelvic cavity. Therefore, it is not possible to use laparoscopy to monitor the entire surgical process. Our research team pioneered the invention of a PORT that allows for full laparoscopic monitoring (name: Transvaginal Single-Port Multi-Access Laparoscopic Surgery Sealed Ring Movable Holder; Patent Application No. 202223438496.X), and applied it in clinical practice. During this process, the following problems were discovered, leading to the proposed improvement method.
[0003] Because the pelvic and abdominal cavities contain multiple organs such as the intestines, mesentery, omentum, bladder, uterus, ovaries, and fallopian tubes, which are often clustered together, large gauze pads are used in open surgery to isolate these organs and create a surgical field, preventing interference from other organs. However, in laparoscopic surgery, it is impossible to insert large gauze pads through tiny incisions. Even if a relatively large gauze pad is inserted, there is insufficient field of vision for observation and effective spreading. Forcibly using rigid surgical instruments for blind spreading can easily damage normal organs. Inserting small gauze pads is also difficult to effectively prevent the intestines from entering the field of vision, making organ isolation challenging. Transvaginal laparoscopic surgery often uses an incision in the posterior vaginal fornix approach. When treating lesions of organs such as the ovaries located in the anterior pelvic region, the surgical field is affected by uterine prolapse from the anterior pelvis and interference from the colon and rectum from the posterior pelvis, making intestinal damage very easy. Particular attention must be paid to the serious impact of the "valve effect." For retroflexed uteruses, establishing pneumoperitoneum through the posterior vaginal fornix can easily lead to a carbon dioxide pneumoperitoneum closure effect. The uterus closes the pelvic floor, separating the air intake channels of the abdominal and pelvic cavities, forming a valve-like air intake. Since the pneumoperitoneum machine cannot intelligently and dynamically monitor the pneumoperitoneum pressure accurately, continuous inflation and a sustained increase in pneumoperitoneum pressure can lead to severe compartment syndrome, causing abnormal liver and kidney function and even endangering life. Clearly, the innovative development of a transvaginal fornix micro-incision for insertion into the pelvic and abdominal cavities, capable of self-expansion to isolate the uterus anteriorly and the colon and rectum posteriorly, creating relatively independent anterior and posterior regions, can effectively avoid interference, facilitate operation, and reduce intestinal damage, which is of great significance.
[0004] The entire transvaginal laparoscopic surgery involves inserting a special PORT consisting of a sealed sheath bag through the vaginal path. During the process of transforming and applying previous patents, our research team found that it was difficult to use a rigid expansion support ring when entering the narrow vaginal opening, while an elastic expansion support ring was prone to twisting inside the vagina, affecting normal use. Summary of the Invention
[0005] To overcome the shortcomings of the existing technology, this invention, based on the anatomical relationship of the uterus being anterior and the colon and rectum being posterior in the pelvic cavity, provides a device for continuous self-expansion of the surgical field under closed-loop visualization during transvaginal laparoscopy. It employs a traction-sealed sheath bag to rotate a directional elastic ring to a horizontal-vertical angle, an automatic horizontal uterine lifting plate, and a telescopic intestinal pressure plate to adjust and control interference with the intestines and other tissues. During the procedure, it automatically expands to isolate and form an independent and safe surgical operating area within the pelvic cavity, avoiding mutual interference, reducing surgical risks, and improving surgical efficiency.
[0006] The present invention adopts the following technical solution to solve the technical problem:
[0007] 1. A device for continuous self-expansion of surgical field under closed-view in transvaginal laparoscopy, characterized by comprising a control sheath rod (1), a traction lifting plate (13), a telescopic bowel pressing plate (16), a directional elastic ring (14), a sealing sheath bag (2), and a counterweight (3). The sealing sheath bag is connected to the directional elastic ring in a ring. The traction lifting plate is installed on the upper side of the directional elastic ring and installed on the lower side in the rotating groove of the main slot hook (111) at the front end of the control sheath rod. The telescopic bowel pressing plate is installed in the flat sheath tube (116) that passes through the control sheath rod and is adjusted and fixed by bolts (17) and nuts (12).
[0008] 2. A device for continuous self-expansion of surgical field under closed-view in transvaginal laparoscopic surgery, characterized in that the control sheath rod is composed of a control hook (11) and a directional elastic ring end face sealing cap (15). The control hook (11) is composed of a control handle (114), a sliding support plate (112), a main slot hook (111), a flat sheath (116), a hook anti-detachment ball (115), a sealing cap tightening and stretching groove (117), and a balance weight hook (118). The tightening and stretching strip (152) of the directional elastic ring end face sealing cap (15) is fitted inside the sealing cap tightening and stretching groove (117) at the front end of the control hook (11). The main slot hook (111) passes through the directional elastic ring end face sealing cap and hook sealing groove hole (153). Then the main slot hook (111) can limit the directional elastic ring to rotate from a horizontal angle to a vertical angle.
[0009] 3. A device for continuous self-expansion of surgical field under closed-view in transvaginal laparoscopic surgery, characterized in that the control hook (11) is a long strip structure, one end is connected to the control handle (114), the middle is a sliding support plate (112), and the other end is connected to the main slot hook (111). The main slot hook (111) holds the main control shaft (142) of the directional elastic ring. The center of the sliding support plate is a long strip sliding window (113) into which a bolt (17) can be inserted. The bolt can slide parallel inside the sliding window. There is a flat sheath (116) below the slide support plate. The end of the sheath facing the main slot hook (111) is the far end, and the other end of the flat sheath is the proximal end facing the control handle (114). The connection end of the main slot hook and the slide support plate is provided with a sealing cap tightening and stretching groove (117) for installing the sealing cap of the directional elastic ring end face to prevent detachment. The lower end of the control handle (114) is provided with an arc hook (118) and an anti-detachment ball (115).
[0010] 4. A device for continuous self-expansion of surgical field under closed-view in transvaginal laparoscopy, characterized in that the end face sealing cap (15) of the directional elastic ring is adapted to the main groove hook sealing groove hole (153), the flat sheath hole (151), the tightening tension strip (152) and the end face arc adapting sealing groove (154), wherein the flat sheath hole (151) is isolated and sealed before and after when the telescopic pressure plate (16) is inserted, and the end face arc adapting sealing groove (154) and its seal are formed when the directional elastic ring is rotated to horizontal and vertical.
[0011] 5. A device for continuous self-expansion of surgical field under closed-view in transvaginal laparoscopy, characterized in that the telescopic pressure plate (16) is a flat plate structure with an arc-shaped upturned surface (161) at the front end and an arc-shaped guide surface (163) for inserting a flat sheath and a bolt positioning layer groove (162) at the rear end. The telescopic pressure plate (16) is inserted through the flat sheath hole (151) of the end face sealing cap of the directional elastic ring and the distal sheath opening of the flat sheath (116). The bolt (17) is inserted through the bolt positioning layer groove (162). The bolt is fixed by a nut after passing through the sliding window (113) of the supporting plate.
[0012] 6. A device for continuous self-expansion of surgical field under closed-view in transvaginal laparoscopic surgery, characterized in that the traction lifting plate (13) is composed of a lifting plate (131), a limiting plate (132) and a traction line (133). The front end of the lifting plate is flat and arc-shaped with a traction hole (1312) for the traction line. The middle of the rear end is provided with an arc groove (1311) to adapt to the secondary control shaft (141) of the directional elastic ring. Small ears (1315) with perpendicular angle limiting support surfaces to the directional elastic ring are provided on both sides. The lower end is provided with a groove-shaped hole (1313) for the insertion of the limiting plate. The middle is provided with a limiting and disassembly pressing hole (1314) for the limiting plate.
[0013] 7. A device for continuous self-expansion of surgical field under closed-view in transvaginal laparoscopic surgery, characterized in that the limiting plug plate (132) is a flat pin, with a proximal arc shape matching the lifting plate, and a T-shaped disassembly handle (1322) on the lower side of the whole, and a limiting anti-dislodgement step (1324) on the upper side, with a pressing anti-slip strip (1323) on the step surface.
[0014] 8. A device for continuous self-expansion of surgical field under closed-view in transvaginal laparoscopic surgery, characterized in that the directional elastic ring has a parallel upper and lower axis and an arc-shaped ring structure on both sides, consisting of an elastic outer tube (144) and an elastic inner core (143). The periphery is cylindrical, the top has a horizontal secondary control shaft (141) on the upper side to hold the uterine plate, and the bottom has a horizontal main control shaft (142) on the lower side. The main control shaft is parallel to the secondary control shaft and is held by the main slot hook. The elastic inner core (143) is an elastic sheet-like ring structure that runs through the elastic outer tube. The directional elastic ring is elastic and deformable in the left and right and up and down directions, and is firm and does not deform when squeezed in the front and back directions.
[0015] 9. A device for continuous self-expansion of surgical field under closed-view in transvaginal laparoscopic surgery, characterized in that the sealing sheath bag is composed of a directional elastic ring (14), a channel bag body (21), an air inlet (22), a smoke extraction channel (25), a sealing sheath for large and small instruments (24), and an endoscope sealing sheath (23). The channel bag body is made of a conical cylindrical flexible material, and its front end is connected to the directional elastic ring in a ring. Stretching the channel bag body can make the directional elastic ring (14) rotate from horizontal to vertical, and at the same time, the traction lifting plate (13) also slides and rotates backward to be perpendicular to the directional elastic ring.
[0016] Compared with existing technologies, the beneficial effects of this invention are reflected in:
[0017] This invention automatically lifts the retroflexed uterus, avoiding interference with the surgical field and the "valve effect" caused by retroflexion of the uterus, thus improving the safety and convenience of the surgery.
[0018] The present invention automatically compresses the intestine after the intestinal compression plate is advanced during the operation, avoiding the influence of the colorectal intestinal tract on the surgical field and eliminating the need for repeated intraoperative operations to remove interference from the intestinal tract.
[0019] The directional elastic band is firm and does not deform when squeezed in the front and back directions, ensuring that it will not twist or deform inside the vagina. At the same time, it is also elastic and can be squeezed and deformed in the left and right and up and down directions, making it easier to enter and exit the narrow vaginal opening.
[0020] The traction lifting plate, telescopic bowel pressure plate, and directional elastic ring, under the traction of the sealed sheath bag, form a physical support channel at the posterior fornix incision of the vagina, providing a stable operating tunnel for the entry and exit of surgical instruments. Attached Figure Description
[0021] Figure 1 Schematic diagram of the functional principle of the device for continuous self-expansion of the surgical field under closed-view visualization in transvaginal laparoscopy.
[0022] Figure 2 Schematic diagram of the control sheath lever function.
[0023] Figure 3 Functional structure diagram of the control sheath lever.
[0024] Figure 4 A schematic diagram illustrating the function of the control sheath when it is flattened and inserted into the vagina.
[0025] Figure 5 Schematic diagram of the control hook function.
[0026] Figure 6 Schematic diagram of the end face sealing cap structure of the directional elastic ring.
[0027] Figure 7 Schematic diagram of the uterine board structure.
[0028] Figure 8 Schematic diagram of the limit bolt plate structure.
[0029] Figure 9 Schematic diagram of a directional elastic ring structure.
[0030] Figure 10 Schematic diagram of the telescopic intestinal press plate structure. Detailed Implementation
[0031] Take the end face sealing cap (15) of the directional elastic ring and put its tightening strip (152) into the tightening groove (117) of the front end sealing cap of the control hook (11). The main slot grab hook (111) passes through the buckle hook sealing groove hole (153) of the end face sealing cap of the directional elastic ring to make it flat.
[0032] Hold the slide support plate (112), install the horizontal main control shaft (142) of the directional elastic ring (14) in the rotating groove of the main slot hook (111) at the front end of the control sheath rod, and insert the telescopic pressure plate (16) through the flat sheath hole (151) of the end face sealing cap of the directional elastic ring and the far end sheath opening of the flat sheath tube (116). The bolt positioning layer hole groove (162) is oriented downward, and the bolt (17) is inserted through the bolt positioning layer hole groove (162). After the bolt passes through the sliding window (113) of the support plate, the nut (12) fixes the bolt. The length of the telescopic pressure plate can be adjusted by adjusting the push nut as needed. The telescopic pressure plate can restrict the main control shaft (142) from rotating in the water position and prevent it from falling off.
[0033] The arc groove (1311) of the lifting plate (131) with the pull line (133) is fitted and snapped onto the secondary control shaft (141) of the directional elastic ring. The T-shaped end of the limiting bolt plate is held upward and inserted into the slot hole (1313) until the limiting bolt plate (1324) just enters the limiting disassembly pressing hole (1314). The limiting bolt plate (132) can restrict the lifting plate (131) from rotating on the secondary control shaft (141) and prevent it from falling off. The small ears (1315) on both sides of the supporting surface of the lifting plate (131) can restrict the vertical angle of the directional elastic ring from collapsing.
[0034] When inserting into the vagina, rotate the traction lifting plate (13) and the elastic directional elastic ring (14) until they are parallel to the telescopic rectal pressure plate (16). Use a non-destructive instrument to hold the traction line (133) and insert it into the vagina. Hold the control handle (114) to assist in inserting the lifting plate (131). Then, gently pinch the sides of the directional elastic ring (14) to narrow it so that it can be smoothly inserted into the vagina with the control hook (11). When the directional elastic ring enters the posterior fornix position, pull the channel bag (21) to make the directional elastic ring (14) turn from horizontal to vertical. At the same time, the traction lifting plate (13) also slides back and rotates to be perpendicular to the directional elastic ring, forming a continuously self-expanding surgical field space. At this time, the end face sealing cap (15) and the end face of the directional elastic ring (14) are in contact and sealed.
[0035] Inflate the airway (22), expand the sealing sheath (2), and perform surgery on the endoscope and instruments through the large and small instrument sealing sheaths (24) and the endoscope sealing sheath (23), respectively. Enter the pelvic cavity through the posterior fornix of the vagina, and use a non-invasive instrument to clamp the traction line (133) along the posterior fornix incision and insert it into the posterior part of the uterus in the pelvic cavity. Push the nut (12) to make the telescopic pressure plate (16) enter the pelvic cavity through the posterior fornix incision, push open the colon and rectum, and lock the nut (12) to fix the telescopic pressure plate (16) and continuously expose the field of vision.
[0036] Hang a suitable gravity balance weight (3) on the gravity balance hook (118) to balance it so that it does not need to be held for a long time.
[0037] After the surgery, the air is released, and the control handle (114) is pulled outward. The directional elastic ring (14) and the traction lifting plate (13) automatically rotate to the horizontal position and are pulled out.
[0038] The above embodiments are merely descriptions of preferred embodiments of the present invention and are not intended to limit the scope of the present invention. Any equivalent transformations or modifications made to the present invention without departing from the spirit and essence of the present invention should be covered within the protection scope of the present invention.
Claims
1. A device for continuously expanding the surgical field under closed-view visualization during transvaginal laparoscopic surgery, characterized by: It consists of a control sheath rod (1), a traction lifting plate (13), a telescopic intestinal pressing plate (16), a directional elastic ring (14), a sealing sheath bag (2), and a counterweight (3). The sealing sheath bag is connected to the directional elastic ring in a ring. The traction lifting plate is installed on the upper side of the directional elastic ring and installed in the rotating groove of the main slot hook (111) at the front end of the control sheath rod on the lower side. The telescopic intestinal pressing plate is installed in the flat sheath tube (116) that passes through the control sheath rod and is adjusted and fixed by bolts (17) and nuts (12).
2. The device for continuous self-expansion of the surgical field under closed-loop visualization in transvaginal laparoscopy according to claim 1, characterized in that: The control sheath rod consists of a control hook (11) and a directional elastic ring end face sealing cap (15). The control hook (11) consists of a control handle (114), a slide support plate (112), a main slot hook (111), a flat sheath tube (116), a hook anti-detachment ball (115), a sealing cap tightening and stretching groove (117), and a balance gravity hook (118). The tightening and stretching strip (152) of the directional elastic ring end face sealing cap (15) is fitted inside the sealing cap tightening and stretching groove (117) at the front end of the control hook (11). The main slot hook (111) passes through the directional elastic ring end face sealing cap snaps the hook sealing groove hole (153). Then the main slot hook (111) can limit the directional elastic ring to rotate from a horizontal angle to a vertical angle.
3. The device for continuous self-expansion of the surgical field under closed-view visualization in transvaginal laparoscopy according to claim 2, characterized in that it allows for control of... The hook (11) is a long strip structure. One end is connected to the control handle (114), the middle is the slide support plate (112), and the other end is connected to the main slot hook (111). The main slot hook (111) holds the main control shaft (142) of the directional elastic ring. The center of the slide support plate is a long strip sliding window (113) into which a bolt (17) can be inserted. The bolt can slide parallel inside the sliding window. Below the slide support plate is a flat sheath (116). The end of the sheath facing the main slot hook (111) is the far end, and the other end of the flat sheath is the near end facing the control handle (114). The connection end between the main slot hook and the slide support plate is provided with a sealing cap tightening and stretching groove (117) for installing the sealing cap of the directional elastic ring end face to prevent detachment. The lower end of the control handle (114) is provided with an arc hook (118) and an anti-detachment ball (115).
4. The device for continuous self-expansion of the surgical field under closed-view visualization in transvaginal laparoscopy according to claim 2, characterized in that it is directional. The end face sealing cap (15) of the elastic ring is equipped with a main slot hook sealing groove hole (153), a flat sheath hole (151), a tightening tension strip (152) and an end face arc fitting sealing groove (154). The flat sheath hole (151) is isolated and sealed when the telescopic pressure plate (16) is inserted. When the directional elastic ring is rotated to horizontal and vertical, the end face arc fitting sealing groove (154) and its seal are formed.
5. The device for continuous self-expansion of the surgical field under closed visualization in transvaginal laparoscopy according to claim 1, characterized in that: The telescopic pressure plate (16) is a flat plate structure with an arc-shaped upturned surface (161) at the front end and an arc-shaped guide surface (163) for inserting a flat sheath tube and a bolt positioning layer groove (162) at the rear end. The telescopic pressure plate (16) is inserted through the flat sheath hole (151) of the end face sealing cap of the directional elastic ring and the distal sheath opening of the flat sheath tube (116). The bolt (17) is inserted through the bolt positioning layer groove (162). The bolt is fixed by a nut after passing through the sliding window (113) of the supporting plate.
6. The device for continuous self-expansion of the surgical field under closed visualization in transvaginal laparoscopy according to claim 1, characterized in that: The traction lifting plate (13) consists of a lifting plate (131), a limiting bolt plate (132), and a traction line (133). The front end of the lifting plate is flat and arc-shaped with a traction hole (1312) for the traction line. The middle of the rear end has an arc groove (1311) to fit the secondary control shaft (141) of the directional elastic ring. The sides have small ears (1315) that are perpendicular to the directional elastic ring and have a limiting support surface. The lower end has a slot-shaped hole (1313) for the insertion of the limiting bolt plate. The middle has a limiting and disassembly pressing hole (1314) for the limiting bolt plate.
7. The device for continuous self-expansion of the surgical field under closed-view visualization in transvaginal laparoscopy according to claim 6, characterized in that: The limiting bolt plate (132) is a flat pin-shaped plate with a rounded end that matches the lifting plate. The lower side of the plate is provided with a T-shaped disassembly handle (1322), and the upper side is provided with a limiting anti-dislodgement step (1324). The step surface is provided with a pressing anti-slip strip (1323).
8. The device for continuous self-expansion of the surgical field under closed-view visualization in transvaginal laparoscopy according to claim 1, characterized in that it is directional. The elastic ring has a parallel upper and lower axis and an arc-shaped ring structure on both sides. It consists of an elastic outer tube (144) and an elastic inner core (143). The periphery is cylindrical. The top has a horizontal secondary control shaft (141) on the upper side to hold the lifting plate. The bottom has a horizontal main control shaft (142) on the lower side. The main control shaft is parallel to the secondary control shaft. The main control shaft is held by the main slot hook. The elastic inner core (143) is an elastic sheet-like ring structure that runs through the elastic outer tube. The directional elastic ring is elastic and can be squeezed and deformed in the left and right and up and down directions, and is firm and does not deform when squeezed in the front and back directions.
9. The device for continuous self-expansion of the surgical field under closed visualization in transvaginal laparoscopy according to claim 1, characterized in that: The sealing sheath bag consists of a directional elastic ring (14), a channel bag body (21), an air inlet (22), a smoke extraction duct (25), a sealing sheath for large and small instruments (24), and an endoscope sealing sheath (23). The channel bag body is made of a conical cylindrical flexible material, with its front end connected to the directional elastic ring in a ring. Stretching the channel bag body can cause the directional elastic ring (14) to rotate from horizontal to vertical, while the traction lifting plate (13) also slides backward and rotates to be perpendicular to the directional elastic ring.