CN111714189B - Mouth gag for endovascular fistula operation - Google Patents
Mouth gag for endovascular fistula operation Download PDFInfo
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- CN111714189B CN111714189B CN202010619474.XA CN202010619474A CN111714189B CN 111714189 B CN111714189 B CN 111714189B CN 202010619474 A CN202010619474 A CN 202010619474A CN 111714189 B CN111714189 B CN 111714189B
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- opening
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/32053—Punch like cutting instruments, e.g. using a cylindrical or oval knife
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/285—Surgical forceps combined with cutting implements
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- A61M1/0023—
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- Ophthalmology & Optometry (AREA)
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Abstract
The invention relates to the field of intravascular fistula operation, in particular to an intravascular fistula operation mouth gag, which comprises two opening units, wherein each opening unit comprises a holding part and an opening part, the front end part of the opening part is a protruded arc-shaped knife edge, the holding part comprises a handle, and the handles in the two opening units are hinged. When the technical scheme is adopted, the fistula opening can be made in intravascular fistula operation with high quality.
Description
Technical Field
The invention relates to the field of intravascular fistula operation, in particular to an intravascular fistula operation mouth gag.
Background
Arteriovenous internal fistula is one of surgical operations and is mainly used for hemodialysis treatment. During operation, a fistula is required to be made on an artery and an adjacent vein, the artery blood vessel section and the vein blood vessel section are anastomosed and then are sutured, arterial blood flows in the anastomosed vein, and an arteriovenous internal fistula, namely a passage between the artery and the vein is formed.
Therefore, when the arteriovenous internal fistula is established, the sizes of the venous blood vessel section and the arterial section are required to be completely consistent, so that the fistula opening can be anastomosed neatly and accurately. The fabrication of the fistula mouth in the current arteriovenous internal fistula operation has the problems that the fistula mouth is not easy to control, such as inaccurate fistula mouth size, irregular fistula mouth edge, inconsistent sizes of the arterial fistula mouth and the venous fistula mouth, poor involution in anastomosis and the like.
Disclosure of Invention
The invention aims to provide an opening device for manufacturing a fistula orifice in intravascular fistula operation with high quality.
In order to achieve the purpose, the technical scheme of the invention provides an intravascular fistula surgical mouth gag which comprises two opening units, wherein each opening unit comprises a holding part and an opening part, the front end part of the opening part is a protruded arc-shaped knife edge, the holding part comprises a handle, and the handles in the two opening units are hinged.
The technical effect of the scheme is as follows: because the front end part of the opening part is the protruded arc-shaped cutting edge, the vascular wall can be accurately and tidily cut off to manufacture the fistula when the suture is occluded, so that the sizes of the arterial fistula and the venous fistula are ensured to be consistent, the involution effect is good when the suture is anastomosed, and the suture quality of the arterial blood vessel section and the venous blood vessel section is further improved; and the fistula that forms through arc cutting edge is oval moreover, for other shapes, for circular fistula, when the oval-shaped fistula was sewed up the back arterial blood and is flowed to the vein through the fistula, the impact force of blood to suture mouth and vein wall is less, and at the initial stage of sewing up, the impact force reduces and to prevent on the one hand that blood from sewing up mouthful and overflowing, and on the other hand sews up initial stage vein and need adapt to the impact of blood gradually and expand and thicken and increase vein wall thickness, and the impact force reduces and is favorable to cultivateing still immature vein to avoid vein damage.
Furthermore, one end of the handle is detachably connected with the rear end part of the opening part. The technical effect of the scheme is as follows: the opening parts with different sizes can be conveniently connected to the handle for operation.
Furthermore, one end of the handle is fixedly connected with a connector, the rear end part of the opening part is provided with a connector, and the connector is detachably connected with the connector. The technical effect of the scheme is as follows: after the connector and the connector have the same size, the same handle can be conveniently connected with different opening parts.
Furthermore, the holding part also comprises an annular finger ring which is fixedly connected with the other end of the handle. The technical effect of the scheme is as follows: the annular ring is convenient for a doctor to hold.
Furthermore, the arc length of the arc-shaped blade at the front end part of the opening part has various specifications, and the vertical distance between the highest point of the radian of the arc-shaped blade and the connecting line of the two ends of the radian is 0.8 mm. The technical effect of the scheme is as follows: the size of the width direction of the fistula opening is convenient to control.
Furthermore, the holding part is fixedly connected with the opening part, a cavity and a sealing cavity part are arranged in one opening part, and the sealing cavity part can seal the cavity or release the sealing of the cavity in the opening or closing process of the opening part. The technical effect of the scheme is as follows: be convenient for collect the vascular wall after the excision, avoid the vascular wall after the excision to drop to the health in, damage patient when effectively avoiding the secondary to take out the vascular wall after the excision.
Furthermore, a cavity and a cavity sealing part are arranged in the two opening parts. The technical effect of the scheme is as follows: any side of the two opening parts faces downwards, so that the cut blood vessel wall can be collected, and the operation is convenient.
Furthermore, the arc-shaped cutting edge is provided with a hole, the cavity and the cavity sealing part are both in an L shape, the cavity comprises a horizontal slide way and a vertical slide way, the cavity sealing part comprises a cavity sealing plate and a suction plate, the suction plate is arranged in the horizontal slide way in a sliding mode, and the cavity sealing plate can seal the vertical slide way or relieve the vertical slide way from being sealed. The technical effect of the scheme is as follows: when cutting the fistula on the vascular wall, can carry out the clamp to vascular incision position both ends and close, but the intravascular of incision position department still has blood, accomplishes the fistula preparation back at present, can clean the blood of fistula department, then sews up again, can cause the damage to blood vessel section position and other tissues of health like this, this scheme is when avoiding the vascular wall after the excision to drop to the health in, handles the blood in the vascular of incision position department, has effectively reduced the injury to the patient.
The suction device comprises a horizontal slideway, a plurality of opening units, a plurality of suction plates and a plurality of elastic pieces, wherein the horizontal slideway is provided with a side wall, the side wall of the outer pipe is provided with a channel, the suction plates are connected with the side wall of the horizontal slideway through the elastic pieces, one end of one of the traction pieces is connected with one of the suction plates, and the other end of the traction piece is connected with the free end of the outer pipe through the channel of the handle and the inner pipe; one end of another traction piece is connected with another suction plate, and the other end of the traction piece is connected with the free end of the inner tube through a channel of the handle and a channel of the side wall of the outer tube. The technical effect of the scheme is as follows: the handle drives the closed in-process of opening, change through inner tube and outer tube free end position, utilize and pull a drive suction board and remove, thereby make the inside negative pressure that forms of cavity, be favorable to inhaling the cavity with blood through the hole, utilize simultaneously to pull a drive seal chamber board and remove the shutoff to vertical slide, make the vascular wall after the excision drop to vertical slide in, after the incision is accomplished, seal chamber board resets under the effect of elastic component, thereby carry out the closing cap to the vascular wall after the excision, the vascular wall after the excision drops to the patient body when effectively avoiding the mouth gag to take out the patient body.
Furthermore, a groove is arranged on the arc-shaped cutting edge, and the cavity sealing plate can be inserted into the groove. The technical effect of the scheme is as follows: ensure that blood flows through the pores into the vertical slide.
Drawings
FIG. 1 is a three-dimensional view of an opening according to an embodiment of the present invention;
FIG. 2 is a three-dimensional schematic view of a grip portion according to an embodiment of the present invention;
FIG. 3 is a three-dimensional schematic diagram of a first embodiment of the present invention;
FIG. 4 is a schematic three-dimensional view of a second embodiment of the present invention;
FIG. 5 is a schematic half-sectional view of a second embodiment of the present invention;
FIG. 6 is an enlarged view of a portion of FIG. 5 at A;
fig. 7 is a partial enlarged view of fig. 5 at B.
Detailed Description
The following is further detailed by way of specific embodiments:
reference numerals in the drawings of the specification include: the device comprises an opening part 1, a handle 2, a connector 3, an arc-shaped blade 4, a cavity 5, a cavity sealing part 6, a horizontal slide 7, a vertical slide 8, a cavity sealing plate 9, a suction plate 10, a pore 11, a pull wire 12, a spring 13, an outer tube 14, an inner tube 15 and a channel 16.
The first embodiment is as follows:
the first embodiment is substantially as shown in figures 1-3: the intravascular fistula surgical mouth gag shown in fig. 3 is made of medical stainless steel and comprises two opening units, wherein each opening unit comprises a holding part and an opening part 1; as shown in figure 2, the holding part comprises a handle 2 and an annular ring, the annular ring and the right end of the handle 2 are integrally formed, a connector 3 is integrally formed at the left end of the handle 2, and the handles 2 in the two opening units are hinged through a pin shaft.
As shown in fig. 1, the front end of the opening 1 is a protruded arc-shaped blade 4, that is, the arc-shaped blade 4 is arc-shaped along the length direction of the opening 1, according to the requirements of different sizes of fistula for vascular surgery, the arc length of the arc-shaped blade 4 has various specifications such as 4mm, 5mm, 6mm, 7mm and 8mm, and the vertical distance between the highest point of the arc-shaped blade 4 and the connecting line of the two ends of the arc is 0.8 mm. The rear end part of the opening part 1 is provided with a connecting port (the visual angle of figure 1 cannot be observed) in an inner cuboid shape, the size of the connecting port is matched with that of the connecting head 3, the depth of the connecting port is 2cm, the length of the inner cuboid of the connecting port is 4mm, the width of the inner cuboid is 2mm, the height of the inner cuboid is 2mm, the connecting head 3 is consistent with the inner depth of the connecting port, and the connecting port is inserted into the rear end part of the opening part 1, so that the opening part 1 is stably and accurately connected with the connecting head 3.
The specific implementation process is as follows:
when an arteriovenous internal fistula operation is carried out, a patient lies on an operating table on the back, the left upper limb is straightened and abducted, an operation area is disinfected, a towel is laid and the distal radial area of the left forearm is locally numb, a longitudinal incision with the length of about 3cm is made on the distal radial side of the left forearm, the skin is incised, a head vein is found out from the subcutaneous tissue, each branch is carefully ligated, full dissociation and release are carried out, a radial artery is dissociated and found out in the same incision, the head vein and the radial artery are separated, the radial artery is clamped and closed by a vascular clamp, an incision with the arc length of 0.5cm is cut out on the side surface of the separated radial artery by an endovascular fistula operation mouth gag, namely, the incision is cut out in the process that the arc-shaped blade 4 of the opening part 1 is closed along with the handle 2; and clamping the proximal end of the cephalic vein by using a vascular clamp, ligating and cutting off the cephalic vein at the far end, cutting an incision with the arc length of 0.5cm at the proximal end of the cephalic vein by using an intravascular fistula operation mouth gag, and suturing the incision positions of the cephalic vein and the radial artery.
Example two:
unlike the first embodiment, the grip portion and the opening portion 1 are integrally formed as shown in fig. 4 and 5, and as shown in fig. 6, a cavity 5 and a cavity 6 are provided in both the opening portions 1. The cavity 5 and the cavity sealing part 6 are both L-shaped, the cavity 5 comprises a horizontal slideway 7 and a vertical slideway 8, the cavity sealing part 6 comprises a cavity sealing plate 9 and a suction plate 10, the suction plate 10 is arranged in the horizontal slideway 7 in a sliding manner, a groove is formed in the arc-shaped cutting edge 4, the cavity sealing plate 9 can be inserted into the groove, and a plurality of holes 11 are further formed in the arc-shaped cutting edge 4.
The embodiment also comprises two traction parts and an elastic part, wherein the traction part is a traction wire 12, and the elastic part is a spring 13. As shown in fig. 7, one of the two opening units 2 is welded with an arc-shaped outer tube 14, the other handle 2 is welded with an arc-shaped inner tube 15, the inner tube 15 is slidably disposed in the outer tube 14, and channels 16 are respectively formed in the handle 2 and the side wall of the outer tube 14.
As shown in fig. 6, the suction plate 10 is connected to the right side wall of the horizontal sliding way 7 through a spring 13, that is, the left end of the spring 13 is welded to the suction plate 10, the right end of the spring 13 is welded to the right side wall of the sliding way, and the number of the springs 13 connected to each suction plate 10 is two. One end of one of the traction wires 12 is connected with one of the suction plates 10 through a knot, the traction wire 12 is positioned between two springs 13, and the other end of the traction wire 12 passes through a channel 16 of the handle 2 and an inner tube 15 and then is connected with the side wall of the free end of an outer tube 14 shown in fig. 7; one end of another pulling wire 12 is connected to another suction plate 10 as shown in fig. 6, and the other end of the pulling wire 12 is connected to the side wall of the free end of the inner tube 15 after passing through a passage 16 of the handle 2 and a passage 16 of the side wall of the outer tube 14 as shown in fig. 7.
When cutting the fistula on the vascular wall, can adopt the vascular clamp to carry out the pinches closure to vascular incision position both ends, but the intravascular of incision position department still has blood, accomplishes the fistula preparation back at present, can wipe the blood of fistula department, then sews up again, can cause the damage to blood vessel section position and other tissues of health like this.
In the process that the handle 2 drives the opening part 1 to be closed, the free ends of the inner tube 15 and the outer tube 14 move in opposite directions as shown in fig. 7, so that the traction wire 12 is driven to move, and the suction plate 10 and the cavity sealing plate 9 shown in fig. 6 are driven to move rightwards through the traction wire 12. The two openings 1 contact and cut off the vessel wall to form an inward notch during the rightward movement of the suction plate 10; meanwhile, in the process that the suction plate 10 moves rightwards, negative pressure is formed inside the cavity 5, so that blood is sucked into the cavity 5 through the pores 11, and the damage to tissues caused by wiping the blood at the fistula is effectively avoided; simultaneously seal chamber board 9 and move the vascular wall of excision back of removal and drop to vertical slide 8 in, after the incision is accomplished, two handles 2 open, seal chamber board 9 and reset under spring 13's effect to carry out the closing cap to the vascular wall after the excision, effectively avoid the mouth gag to take out the vascular wall after the excision when patient's health and drop to patient's body in, effectively avoided the injury to the patient.
The foregoing is merely an example of the present invention and common general knowledge of known specific structures and features of the embodiments is not described herein in any greater detail. It should be noted that, for those skilled in the art, without departing from the structure of the present invention, several changes and modifications can be made, which should also be regarded as the protection scope of the present invention, and these will not affect the effect of the implementation of the present invention and the practicability of the patent.
Claims (9)
1. Endovascular fistula operation mouth gag which characterized in that: the cutting tool comprises two opening units, wherein each opening unit comprises a holding part and an opening part, the front end part of each opening part is a protruding arc-shaped blade, each holding part comprises a handle, and the handles in the two opening units are hinged; a cavity and a cavity sealing part are arranged in one opening part, a hole is formed in the arc-shaped cutting edge, the cavity and the cavity sealing part are both L-shaped, the cavity comprises a horizontal slide way and a vertical slide way, the cavity sealing part comprises a cavity sealing plate and a suction plate, the suction plate is arranged in the horizontal slide way in a sliding mode, and the cavity sealing plate can seal the vertical slide way or relieve the vertical slide way from being sealed.
2. The endovascular fistula surgical opener of claim 1, wherein: one end of the handle is detachably connected with the rear end part of the opening part.
3. The endovascular fistula surgical opener of claim 2, wherein: one end of the handle is fixedly connected with a connector, the rear end part of the opening part is provided with a connector, and the connector is detachably connected with the connector.
4. The endovascular fistula surgical opener of claim 3, wherein: the holding part also comprises an annular finger ring which is fixedly connected with the other end of the handle.
5. The endovascular fistula surgical opener of claim 4, wherein: the arc length of the arc-shaped cutting edge at the front end part of the opening part has various specifications, and the vertical distance between the highest point of the radian of the arc-shaped cutting edge and the connecting line of the two ends of the radian is 0.8 mm.
6. The endovascular fistula surgical opener of claim 1, wherein: the holding part is fixedly connected with the opening part, and the cavity can be blocked or unblocked by the cavity blocking part in the opening or closing process of the opening part.
7. The endovascular fistula surgical opener of claim 6, wherein: the two opening parts are respectively provided with a cavity and a cavity sealing part.
8. The endovascular fistula surgical opener of claim 1, wherein: the suction device is characterized by further comprising two traction pieces and an elastic piece, wherein one handle of the two opening units is fixedly connected with an arc-shaped outer pipe, the other handle of the two opening units is fixedly connected with an arc-shaped inner pipe, the inner pipe is arranged in the outer pipe in a sliding mode, channels are arranged in the side walls of the inner handle and the outer pipe, the suction plates are connected with the side wall of the horizontal slideway through the elastic piece, one end of one traction piece is connected with one suction plate, and the other end of the traction piece is connected with the free end of the outer pipe through the channel of the handle and the inner pipe; one end of another traction piece is connected with another suction plate, and the other end of the traction piece is connected with the free end of the inner tube through a channel of the handle and a channel of the side wall of the outer tube.
9. The endovascular fistula surgical opener of claim 8, wherein: the arc-shaped cutting edge is provided with a groove, and the cavity sealing plate can be inserted into the groove.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010619474.XA CN111714189B (en) | 2020-06-30 | 2020-06-30 | Mouth gag for endovascular fistula operation |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010619474.XA CN111714189B (en) | 2020-06-30 | 2020-06-30 | Mouth gag for endovascular fistula operation |
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| Publication Number | Publication Date |
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| CN111714189A CN111714189A (en) | 2020-09-29 |
| CN111714189B true CN111714189B (en) | 2022-08-12 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN202010619474.XA Active CN111714189B (en) | 2020-06-30 | 2020-06-30 | Mouth gag for endovascular fistula operation |
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Family Cites Families (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP4315557B2 (en) * | 2000-01-12 | 2009-08-19 | オリンパス株式会社 | Medical treatment tool |
| DE102004011012B4 (en) * | 2004-03-02 | 2006-03-09 | Klaus Kabella | Surgical claw cutting tool |
| US7758573B2 (en) * | 2005-10-27 | 2010-07-20 | Terumo Kabushiki Kaisha | Blood vessel treatment method using multi-degree-of-freedom forceps |
| RU2351291C1 (en) * | 2007-10-04 | 2009-04-10 | Рубик Ашотович Власян | Surgical scissors for bloodless section of tissues (versions) |
| US20110184504A1 (en) * | 2010-01-22 | 2011-07-28 | Medtronic Vascular, Inc. | Methods and Apparatus for Providing an Arteriovenous Fistula |
| CN201782799U (en) * | 2010-02-10 | 2011-04-06 | 王廷 | Vein cutter |
| AU2013296428B2 (en) * | 2012-08-01 | 2017-05-25 | Avenu Medical, Inc. | Systems and methods for percutaneous intravascular access for arteriovenous fistula |
| JP2015532152A (en) * | 2012-10-11 | 2015-11-09 | ティーブイエー メディカル， インコーポレイテッド | Apparatus and method for fistula formation |
| CN109512490A (en) * | 2017-09-20 | 2019-03-26 | 付记乐 | Anti-slip micro- scissors |
| CN109512489A (en) * | 2017-09-20 | 2019-03-26 | 付记乐 | The micro- scissors of one-pass molding |
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2020
- 2020-06-30 CN CN202010619474.XA patent/CN111714189B/en active Active
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