CN113303847B - U-shaped suspension retractor for oral and maxillofacial surgery endoscopic surgery - Google Patents

U-shaped suspension retractor for oral and maxillofacial surgery endoscopic surgery Download PDF

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Publication number
CN113303847B
CN113303847B CN202110602789.8A CN202110602789A CN113303847B CN 113303847 B CN113303847 B CN 113303847B CN 202110602789 A CN202110602789 A CN 202110602789A CN 113303847 B CN113303847 B CN 113303847B
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shaped
suspension
drag hook
nut
endoscopic surgery
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CN113303847A (en
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王勇
石亮
高涵
王克涛
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Qilu Hospital of Shandong University
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Qilu Hospital of Shandong University
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50Supports for surgical instruments, e.g. articulated arms

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention relates to a U-shaped suspension drag hook for endoscopic oral surgery, which comprises: the U-shaped drag hook is a U-shaped structure consisting of strip plates, one end of the U-shaped structure is an extending end, and the other end of the U-shaped structure is a suspending end; and the suspension structure is connected with the suspension end of the U-shaped plate. One end of the U-shaped drag hook extends into the separated tissue gap, the other end of the U-shaped drag hook passes through the suspension structure, the tissue is dragged to form a gap by adjusting the pulling of the suspension structure, and the endoscopic minimally invasive surgery is performed through the gap.

Description

U-shaped suspension retractor for oral and maxillofacial surgery endoscopic surgery
Technical Field
The invention belongs to the technical field of an ostomy device, and particularly relates to a U-shaped suspension retractor for oral and maxillofacial surgery endoscopic surgery.
Background
The information in this background section is only for enhancement of understanding of the general background of the invention and is not necessarily to be construed as an admission or any form of suggestion that this information forms the prior art that is already known to a person of ordinary skill in the art.
The traditional oral and maxillofacial surgery can leave scars on obvious parts of the face or the neck, which affects the beauty and the confidence of patients.
The endoscopic surgery can achieve the effect of minimally invasive surgery on the lesion area. Access to the focal zone for surgery is achieved through a small, hidden incision in the mouth or hairline. Because the face and the neck have no natural lacuna, in the process of endoscopic surgery, a gap needs to be opened firstly, then the cavity is built to form an effective cavity space, and then the cavity is deeply inserted into the cavity for surgery.
Disclosure of Invention
In view of the above problems in the prior art, the present invention is to provide a U-shaped suspension retractor for endoscopic oral surgery. Is convenient for treating diseases at the exposed part, cuts are made at the hidden position to make lacunae, and operations are carried out to avoid scars left at the exposed part.
In order to solve the technical problems, the technical scheme of the invention is as follows:
a U-shaped suspension retractor for endoscopic oral surgery comprises:
the U-shaped drag hook is a U-shaped structure consisting of strip-shaped plates, one end of the U-shaped structure is an extending end, and the other end of the U-shaped structure is a suspension end;
and the suspension structure is connected with the suspension end of the U-shaped plate.
One end of the U-shaped drag hook extends into the separated tissue gap, the other end of the U-shaped drag hook passes through the suspension structure, the tissue is dragged to form a gap by adjusting the pulling of the suspension structure, and the endoscopic minimally invasive surgery is performed through the gap.
The U-shaped structure of the U-shaped drag hook forms a symmetrical structure, force is conveniently applied to the other end through one end, when force is applied to the suspension end by the suspension structure, the extending end is enabled to upwarp, and then the effect of pulling tissues upwards to form gaps is achieved.
For example, the affected part is located the face, in order to avoid cutting at the face, generally need carry out the incision in the outside hair of face or the oral cavity, then, stretch into the end and stretch into in the tissue clearance that the separation is good, through the pulling of hanging structure, the tractive tissue opens the clearance through the tractive, conveniently operates on facial position, has avoided carrying out the incision in the face and has left the problem of scar.
One or more technical schemes of the invention have the following beneficial effects:
the invention relates to a U-shaped suspension retractor for endoscopic surgery in the mouth, which is convenient for endoscopic surgery on the face or the neck, is convenient for making a cavity on a lesion part of the face or the neck and avoids scars from being left at the exposed position of the face and the neck.
According to the invention, through the U-shaped suspension draw hook, the internal tissue gap can be conveniently drawn, an endoscope minimally invasive operation can be conveniently carried out, a doctor can conveniently see the internal condition, the burden of an assistant is reduced, and the stability of the stoma is improved.
Through the arrangement of the flushing suction tube, the problem that the sight line is influenced by smoke generated by the ultrasonic knife when the electric knife is used in endoscopic surgery is solved. The operation field is clearer through the normal saline flushing.
Through the setting of supporter, can realize the supporting role to the endoscope, liberation hand labor, stability in the operation process is better to can avoid the influence to the operation sight.
Drawings
The accompanying drawings, which are incorporated in and constitute a part of this specification, are included to provide a further understanding of the invention, and are incorporated in and constitute a part of this specification, illustrate exemplary embodiments of the invention and together with the description serve to explain the invention and not to limit the invention.
FIG. 1 is a structural view of a U-shaped suspension retractor for oral endoscopic surgery;
FIG. 2 is a view showing the structure of the U-shaped retractor;
FIG. 3 is a view showing the structure of the irrigation suction tube;
FIG. 4 is a block diagram of a long tube support form;
FIG. 5 is a block diagram of a spool support form;
FIG. 6 is a side view of the support of FIG. 5;
the device comprises a U-shaped drag hook 1, a U-shaped drag hook 2, an extending end 3, a hanging end 4, a rotating plate 5, a rotating shaft 6, a screw rod 7, a nut 8, a rotating baffle 9, a hanging ring 10, a gasket 11, a suction pipe 12 and a support body.
Detailed Description
It is to be understood that the following detailed description is exemplary and is intended to provide further explanation of the invention as claimed. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs.
It is noted that the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of example embodiments according to the present disclosure. As used herein, the singular forms "a", "an" and "the" are intended to include the plural forms as well, and it should be understood that when the terms "comprises" and/or "comprising" are used in this specification, they specify the presence of stated features, steps, operations, devices, components, and/or combinations thereof, unless the context clearly indicates otherwise.
An endoscopic oral surgery U-shaped suspends drag hook in midair includes:
the U-shaped drag hook is a U-shaped structure consisting of strip-shaped plates, one end of the U-shaped structure is an extending end, and the other end of the U-shaped structure is a suspending end;
and the suspension structure is connected with the suspension end of the U-shaped plate.
As further technical scheme, the U-shaped drag hook still includes the rotor plate, and the parallel arrangement is hugged closely with stretching into the end slat to the rotor plate, and the rotor plate passes through the rotation axis with stretching into the end slat and is connected.
As a further technical scheme, the rotating plate comprises a fixed end and a movable end, the fixed end is connected with the end-extending lath through a rotating shaft, and the movable end is close to the end-extending of the U-shaped drag hook.
As a further technical scheme, the edge of the movable end of the rotating plate exceeds the extending end of the U-shaped drag hook.
Furthermore, the lath at the extending end covered by the rotating plate is provided with a slot.
Furthermore, the extending end and the end of the rotating plate form a bending structure, and the direction of the bending structure points to the suspension end.
As a further technical scheme, a suspension opening is arranged at the suspension end of the U-shaped drag hook.
As a further technical scheme, the suspension structure comprises a screw and nuts, the screw penetrates through the suspension opening, and the nuts are located on two sides of the suspension opening and connected with the screw.
Further, the screw rod is provided with an external thread.
Further, the nut is a round nut, a ring nut, a disc nut, a hexagon nut, a fastening nut or a square nut.
Furthermore, a rotary blocking body is arranged on the nut, the rotary blocking body is an inclined rotary rod, and one end of the rotary rod is connected with the nut.
Further, the top of the screw rod is provided with a hanging ring.
Furthermore, the suspension structure also comprises a gasket, and the gasket is arranged at the top of the suspension end of the nut and the U-shaped draw hook.
As a further technical scheme, the suspension structure comprises a fixed block, and the fixed block is fixedly connected with the suspension end.
As a further technical scheme, the device also comprises a flushing suction tube which is arranged at the bottom of the extending end of the U-shaped drag hook and is connected with the bottom of the extending end.
As a further technical scheme, the device also comprises a support body, the support body is connected with the bottom of the extending end of the U-shaped draw hook, and the support body is of a ring body or a pipe body structure.
Furthermore, the supporting body is arranged at one side of the flushing and sucking pipe or sleeved on the flushing and sucking pipe.
In the traditional operation, the lesion tissue is exposed at the lesion position by an operation, a wound is left on the face and the neck, and a scar is generated after healing. The endoscope operation is performed at a hidden position, so that the condition that the face and neck part is exposed to generate a wound and a scar is avoided. For example, when a tumor is present in a facial region and an operation is required, an incision may be made in the hairline of the head around the face or in the oral mucosa, and the tumor may be removed by penetrating the incision into the facial region. Therefore, the distance is long, and a special instrument is needed to pull open the tissue gap, so that the endoscope and the instrument can enter the tissue gap conveniently, the internal tumor can be exposed more conveniently, and important nerve vessels can be protected.
The invention relates to a U-shaped suspension retractor for oral and maxillofacial surgery endoscopic surgery, which comprises: the U-shaped drag hook 1 is a U-shaped structure consisting of strip-shaped plates, one end of the U-shaped structure is an extending end 2, and the other end of the U-shaped structure is a suspension end 3; and the suspension structure is connected with the suspension end of the U-shaped plate.
Have the mount on the edge of operation table, at the operation in-process, the end of stretching into of U type drag hook 1 is stretched into and is operated in the gap, then suspends the end in midair and fixes through the mount, has saved and has utilized artifical chamber of making unstability, leads to the inside problem of surgeon can not see. Has the function of making the cavity stable. The operation time can reach 1-2h, and if the cavity is not stable, the fatigue of a doctor can be caused, and the accuracy of the operation of the doctor is influenced. The U-shaped suspension draw hook can better play the stability of the ostomy cavity.
Because the U-shaped drag hook 1 is a strip-shaped plate, the strip-shaped plate is attached to the gap, and the gap is favorably formed by dragging the tissue of the gap.
The U-shaped structure of the U-shaped drag hook 1 has the advantages that after the stretching end stretches into the gap, when the suspension end has an acting force to the outside, the U-shaped structure keeps the shape, and through the force conduction, the stretching end has an obvious stretching force in the same direction, so that the U-shaped drag hook is favorable for the position of an operation to be subjected to cavity creation, and the condition that an operator sees the inside is favorable. The atress of U type structure is special, for example when putting U type structure upright, U type opening sets up to left or right direction, and the heavy object is placed to the one end of U type, and the upper end is upwards drawn, and the lower extreme can drive the heavy object and upwards mention. For another example, when the U-shaped structure is placed upright with the U-shaped opening facing left or right, one hand is placed at the lower end and the upper end is lifted upward, and the hand is pressed downward with force, a significant upward pulling force is felt. Therefore, the U-shaped structure is arranged, and the extending end has the function of pulling the gap open under the action of force.
Moreover, the U-shaped retractor has stability compared with other structures, such as using a straight plate, if the extending end is controlled to be lifted by the suspension end of the straight plate, the first straight plate needs a fulcrum, so the straight plate cannot directly pull the tissue upwards in a suspension mode, the extending end can press downwards, if the extending end wants to press downwards, the suspension end needs to provide a fulcrum, such as providing a fulcrum by hand; second, if the straight plate is engaged through the fulcrum, it is only possible to pull open the internal space of the tissue, and the physician is outside and not good for observing the internal conditions. Due to the structure of the U-shaped structure, the extending end can pull up tissues upwards to generate gaps through the synergistic effect of the two ends, so that the operation of a doctor is facilitated.
The U-shaped drag hook 1 is in a shape which is convenient for operations at deeper positions, and because the endoscopic operations on the face need to be performed from the surrounding positions, after a gap is formed, the position of an internal affected part is actually far away from the position of the slit, if a common cavity-making device is used, the internal affected part cannot extend into the deeper position, even if the internal affected part can extend into the deeper position, the visual line of a doctor can be blocked. The length of the U-shaped drag hook 1 can be changed according to the operation condition, such as a deeper position and a relatively longer length.
Furthermore, the width of the strip-shaped plate of the U-shaped drag hook 1 is 10-30 mm. The width of the strip-shaped plate of the U-shaped drag hook 1 is narrow, and the U-shaped drag hook is conveniently used for stretching into and fitting a gap and dragging tissues.
Further, U type drag hook 1 still includes rotor plate 4, and parallel arrangement is hugged closely with 2 slats of the end of stretching into to rotor plate 4, and the rotor plate passes through rotation axis 5 with 2 slats of the end of stretching into to be connected. The rotating plate is parallel to the strip plate of the extending end, and the extending end can rotate relative to the extending end through the rotating shaft, so that the rotating plate forms a certain angle distance relative to the strip plate of the extending end. The device has the function of widening the gap, widens the visual field of doctors, and is convenient to see the surrounding conditions inside.
Furthermore, the rotor plate includes stiff end and expansion end, and the stiff end passes through rotation axis 5 with stretching into the end slat and is connected, and the expansion end is close to the end of stretching into of U type drag hook. The rotating plate is staggered at the part extending into the tissue gap, which is beneficial to forming the gap for pulling open and is convenient for performing endoscopic minimally invasive surgery.
Furthermore, the edge of the movable end of the rotating plate exceeds the extending end of the U-shaped drag hook. Furthermore, the excess gap is 2-3mm, so that the rotating plate and the end strip plate extending into the rotating plate are stressed differently, and the dislocation is conveniently generated.
Furthermore, the rotating plate sets up two, is connected with the upper and lower face of the end that stretches into of U type drag hook respectively. Compare in only setting up 1 rotor plate, set up the rotor plate from top to bottom simultaneously, can further improve the effect of widening the gap, it is more stable.
Furthermore, the lath of the U-shaped drag hook opposite to the rotating plate is of a plate-shaped structure or is provided with a groove-shaped opening. The groove-shaped opening is formed, so that the friction force between the U-shaped drag hook and the tissue can be improved, the anti-skidding effect is achieved, the effect of clamping the tissue to a certain degree is achieved, and the stable effect is improved.
Furthermore, the extending end and the end of the rotating plate form a bending structure, and the direction of the bending structure points to the suspension end. The structure of the upward tilting is formed, so that the anti-skid function is achieved, and the stability of the extending end is improved.
Furthermore, a suspension opening is arranged at the suspension end of the U-shaped drag hook 1. Through setting up the opening of hanging in midair, conveniently be connected with hanging in midair.
Further, the suspension structure comprises a screw 6 and nuts 7, the screw 6 passes through the suspension opening, and the nuts 7 are located on two sides of the suspension opening and connected with the screw 6. The screw 6 and the nut 7 are connected with the suspension opening, so that the U-shaped drag hook can be conveniently pulled.
Further, the screw 6 is provided with an external thread. The screw 6 is connected with the nut 7 through threads, and the suspension structure is controlled to be connected and fastened with the U-shaped drag hook through adjustment of the nut.
Further, the nut 7 is a round nut, a ring nut, a disk nut, a hexagonal nut, a clinch nut, or a square nut. The shape of the nut may be changed to form a rotational tightening force.
Furthermore, a rotation blocking body 8 is arranged on the nut 7, the rotation blocking body 8 is an inclined rotating rod, and one end of the rotating rod is connected with the nut. The rotary blocking body is arranged, so that the rotary fixing is convenient.
Furthermore, a hanging ring 9 is arranged at the top of the screw rod. The lifting ring can be conveniently connected with the power mechanism. The screw rod is pulled by a power mechanism, and the power mechanism is a fine displacement adjusting structure, such as a precise electric angular displacement adjusting platform. Or the distance is preset and a position for hanging the hanging ring is arranged. Or manually adjusted.
Furthermore, the suspension structure further comprises a gasket 10, and the gasket is arranged on the top of the suspension end of the nut and the U-shaped draw hook. The gasket can improve the tightness of the nut and the U-shaped draw hook.
Further, the suspension structure comprises a fixed block, and the fixed block is fixedly connected with the suspension end. The fixing block is square or round, and is welded or integrally connected with the top of the suspension end, when in use, the fixing frame on the operating table is connected with the fixing block, and the top of the fixing block can be provided with a pull ring.
As shown in fig. 3, further, the utility model also comprises a suction pipe 11, wherein the suction pipe 11 is arranged at the bottom of the extending end of the U-shaped draw hook and is connected with the bottom of the extending end. When the electrotome is used, smoke is generated, an assistant needs to smoke with an aspirator, or the sight line of a doctor is influenced; in some cases, the tissue bleeds, and the tissue is not clearly visible through the endoscope, and the tissue can be washed by flushing physiological saline through the flushing and sucking tube. In the existing operation, an assistant uses a needle tube to inject physiological saline, which can affect the operation of a doctor.
The bottom cooperation setting of dash straw and U type drag hook enters into the affected part position from the bottom of U type drag hook and the clearance of tissue, can conveniently discharge the smog direct switch-on of affected part position on the dash straw, avoids the flue gas to escape on other positions.
As shown in fig. 3, 4 and 5, the retractor further includes a support 12, the support 12 is connected to the bottom of the extending end of the U-shaped retractor, and the support 12 is a ring or a tube structure. Because the endoscope is required to be placed all the time in the operation process, the diameter of an endoscope tube is various, namely 4mm, 5mm,10mm and the like, in the whole operation, an assistant is generally required to hold the endoscope all the time, the assistant holds the endoscope unstably for a long time, and the lens of the endoscope is easy to touch tissues and touch tissues or bloody water, so that the lens is blurred. Through setting up the supporter, the body of endoscope can pass the supporter, plays the effect of supporting the endoscope, if the supporter is the ring body, and the endoscope pipe passes the ring body, and the ring body is as the fulcrum, can relax the left hand to can conveniently adjust the angle of endoscope. If the supporting body is a tube body, the tube body is a long tube body or a short tube body, and the length of the long tube body is longer than that of the short tube body, as shown in fig. 5 and 6, the short tube body has the advantages of conveniently adjusting the angle of the endoscope, preventing other instruments from interfering or being capable of observing different positions.
The support body is combined with the bottom of the U-shaped drag hook, the top end of the support body is connected with the U-shaped drag hook, and the bottom end of the support body falls on the tissue or is suspended above the tissue. The endoscope has the length of 26cm-33cm, the diameter of 4mm, 5mm,10mm and the like, can directly penetrate through the support body and enter an affected part, the position of the U-shaped drag hook is fixed, and the support body can stably work. The end part of the endoscope is a lens, the middle part of the endoscope is contacted with the supporting body to provide support, and the end part of the endoscope can be used as a fulcrum to adjust the position of the lens. The supporting body and the U-shaped drag hook are matched, so that the problem that the endoscope is long in holding time in the operation process is solved, when an assistant is tired, the lens can be in contact with tissues or bloody water, manpower is liberated, and the accuracy of the operation is improved.
The dual-purpose arrangement of the flushing and suction pipe 11 can be realized by connecting a three-way pipe at the end part of the outer side.
Further, the support body 12 is provided on one side of the washing and suction pipe 11 or around the suction pipe. The position relationship between the support body and the suction pipe can be arranged by sleeving the suction pipe if the support body is a ring body.
Furthermore, the support 12 is a ring body, and the top of the ring body is rotatably connected with the bottom of the U-shaped draw hook. The ring body passes through the fixed plate with U type drag hook and is connected, and the ring body passes the fixed plate, and the ring body is cliied by the fixed plate, can be at the fixed plate internal rotation, like this when need not support the endoscope, can upwards rotate the ring body to influence the sight.
The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims (10)

1. The utility model provides a drag hook is suspended in midair to oral cavity mirror operation U-shaped which characterized in that: the method comprises the following steps:
the U-shaped drag hook is a U-shaped structure consisting of strip-shaped plates, one end of the U-shaped structure is an extending end, and the other end of the U-shaped structure is a suspension end;
suspension structure, be connected with the end that suspends in midair of U type structure, the U-shaped drag hook still includes the rotor plate, parallel arrangement is hugged closely with stretching into end strip shaped plate to the rotor plate, the rotor plate passes through the rotation axis with stretching into end strip shaped plate and is connected, the edge of the expansion end of rotor plate surpasss the end that stretches into of U-shaped drag hook, the clearance that exceeds is 2-3mm, the strip shaped plate of the U-shaped drag hook relative with the rotor plate is platelike structure or sets up the cell type opening, the tip that stretches into end and rotor plate forms bending structure, bending structure's the directional end that suspends in midair of direction, form the structure of perk that makes progress.
2. The oral endoscopic surgery U-shaped suspension retractor according to claim 1, characterized in that: the rotor plate includes stiff end and expansion end, and the stiff end passes through the rotation axis with stretching into the end bar and is connected, and the expansion end is close to the end that stretches into of U-shaped drag hook.
3. The oral endoscopic surgery U-shaped suspension retractor according to claim 1, characterized in that: the two rotating plates are respectively connected with the upper and lower plate surfaces of the extending end of the U-shaped drag hook.
4. The oral endoscopic surgery U-shaped suspension retractor according to claim 3, characterized in that: the suspension end of the U-shaped drag hook is provided with a suspension opening.
5. The oral endoscopic surgery U-shaped suspension retractor according to claim 4, characterized in that: the suspension structure comprises a screw and nuts, the screw penetrates through the suspension opening, and the nuts are located on two sides of the suspension opening and connected with the screw.
6. The oral endoscopic surgery U-shaped suspension retractor according to claim 5, characterized in that: the nut is a round nut, a ring nut, a disc-shaped nut, a hexagonal nut, a fastening nut or a square nut.
7. The oral endoscopic surgery U-shaped suspension retractor according to claim 6, characterized in that: the nut is provided with a rotary blocking body which is an inclined rotary rod, and one end of the rotary rod is connected with the nut.
8. The oral endoscopic surgery U-shaped suspension retractor according to claim 1, characterized in that: the suction pipe is arranged at the bottom of the extending end of the U-shaped drag hook and is connected with the bottom of the extending end.
9. The oral endoscopic surgery U-shaped suspension retractor according to claim 8, characterized in that: the support body is connected with the bottom of the extending end of the U-shaped drag hook, and the support body is of a ring body or pipe body structure.
10. The oral endoscopic surgery U-shaped suspension retractor according to claim 9, characterized in that: the supporting body is arranged at one side of the flushing and sucking pipe or sleeved on the flushing and sucking pipe.
CN202110602789.8A 2021-05-31 2021-05-31 U-shaped suspension retractor for oral and maxillofacial surgery endoscopic surgery Active CN113303847B (en)

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CN115429351B (en) * 2022-10-31 2023-05-23 成都五义医疗设备有限公司 Surgical retractor system

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WO2019091286A1 (en) * 2017-11-08 2019-05-16 南京畅丰生物科技有限公司 Intrabuccal temporomandibular joint retractor
CN111839624A (en) * 2020-07-31 2020-10-30 王立山 Jaw rises and props up inboard drag hook special use of jaw face surgery

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