CN211633401U - In vivo self-assembled magnetic anchoring device for stab-reducing laparoscopic cholecystectomy - Google Patents
In vivo self-assembled magnetic anchoring device for stab-reducing laparoscopic cholecystectomy Download PDFInfo
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- CN211633401U CN211633401U CN202020163375.0U CN202020163375U CN211633401U CN 211633401 U CN211633401 U CN 211633401U CN 202020163375 U CN202020163375 U CN 202020163375U CN 211633401 U CN211633401 U CN 211633401U
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Abstract
An in vivo self-assembling magnetic anchoring device for stab-resistant laparoscopic cholecystectomy, comprising: the permalloy sub-magnet group consists of N permalloy cylinders which are sequentially connected through a rotating shaft, wherein the axial direction of the rotating shaft is parallel to the axial direction of the permalloy cylinders, and hooks for clamping the laparoscopic graspers are arranged on the permalloy cylinders at the two end parts; the fishing net device consists of N-1 nylon wires and a non-magnetic ring, wherein one end of each nylon wire is connected to one rotating shaft, and the other end of each nylon wire is fixed on the ring; the traction wire group consists of three traction wires and three soft clamps, each soft clamp is linked at the front end of one traction wire, and the tail end of each traction wire penetrates through the circular ring and then penetrates out through the poking clamp; the external magnet is positioned outside the body, provides magnetic guidance for the self-assembly of the permalloy sub-magnet group, is anchored with the abdominal wall of the permalloy sub-magnet group after the self-assembly, and adjusts the gallbladder in the body to move towards different directions through manual traction outside the body.
Description
Technical Field
The invention belongs to the technical field of surgical medical instruments, and particularly relates to an in-vivo self-assembly magnetic anchoring device for stab-reducing card laparoscopic cholecystectomy.
Background
Since Mouret P of france completed the first laparoscopic cholecystectomy in 1987, laparoscopic techniques were widely used in surgical clinics and gradually replaced traditional open surgery. As a minimally invasive operation, the small-sized illuminating and photographing device and a surgical operation tool are conveyed into an abdominal cavity through an abdominal wall by using a poking card to complete the operation, and the minimally invasive operation has the characteristics of small operation wound, short time and quick postoperative recovery.
Currently, the most widely used laparoscopic three-port cholecystectomy requires 3 ports to be established in the abdominal wall for observation, main operation and auxiliary operation. In recent years, two port laparoscopic cholecystectomy and single port laparoscopic cholecystectomy have progressed rapidly, considering the need for "scar reduction" in patients, while several studies have demonstrated a corresponding reduction in the number of puncture holes to reduce surgical bleeding and complications. The puncture-reducing card laparoscope cholecystectomy refers to the operation treatment of a patient by 1-2 holes, but the number of the holes is reduced due to the limitation of the type of an operation tool in an abdominal cavity, the hole diameter is correspondingly increased, the hole diameter is increased from standard 10-12mm to 30mm, and the reduction of the wound is still limited. Meanwhile, the reduction of the number of the poking holes simultaneously means that the visibility is reduced and the difficulty of avoiding the collision of instruments in the abdominal cavity is further improved.
The magnetic anchoring navigation system refers to that magnetic equipment in a body is dragged or positioned on the abdominal wall under the action of an external magnetic field so as to complete the operation in the abdominal cavity which is difficult to carry out by the traditional method, and the application of the magnetic anchoring navigation system in laparoscopic surgery is one of the most significant innovations in minimally invasive surgery. The sub-magnet is sent into the body together with the instruments needed in the operation through a channel established by a laparoscope puncture hole, the instruments and the sub-magnet are combined through a specific method, the sub-magnet is inosculated with the external mother magnet through mutual magnetic attraction force, the mother magnet on the abdominal wall of a patient is moved, and the internal instruments can be moved in the abdominal cavity without limitation until the corresponding positions needed in the operation are positioned. The magnetic anchoring navigation system is used as an aid, so that the puncture card laparoscopic surgery is further developed, and the puncture hole diameter is reduced. However, in clinical popularization, the operation capability of the mother magnet is limited, and the use of surgical instruments (graspers and ultrasonic knives) still needs external manual control, which is also a limit that the puncture hole of the puncture reducing card laparoscope technology cannot be effectively reduced.
Disclosure of Invention
In order to overcome the defects of the prior art, the invention aims to provide an in-vivo self-assembly magnetic anchoring device for stab-resistant laparoscopic cholecystectomy, a permalloy sub-magnet group is self-assembled in vivo to form a hexagonal 'fishing net' device and is connected with a gallbladder clamp traction wire, the traction wire group is led out of the body through a stab card, and the gallbladder in the body is adjusted to move towards different directions through in-vitro manual traction.
In order to achieve the purpose, the invention adopts the technical scheme that:
an in vivo self-assembling magnetic anchoring device for stab-resistant laparoscopic cholecystectomy, comprising:
the permalloy sub-magnet group 1 consists of N permalloy cylinders which are sequentially connected through a rotating shaft, wherein the axial direction of the rotating shaft is parallel to the axial direction of the permalloy cylinders, and hooks 8 for clamping the laparoscopic graspers are arranged on the permalloy cylinders at the two end parts;
the fishing net device 2 consists of N-1 nylon threads 9 and a non-magnetic circular ring 5, one end of each nylon thread 9 is connected to one rotating shaft, and the other end of each nylon thread 9 is fixed on the circular ring 5;
the traction wire group 3 consists of three traction wires and three soft clamps 6, each soft clamp 6 is linked at the front end of one traction wire, and the tail end of each traction wire penetrates through the circular ring 5 and then penetrates out through the poking clamp;
the external magnet 4 is positioned outside the body, provides magnetic guidance for the self-assembly of the permalloy sub-magnet group 1, and is anchored with the diaphragm wall 7 of the permalloy sub-magnet group 1 after the self-assembly.
The diameter of the permalloy cylinder is 7.07mm, and the height of the permalloy cylinder is 7.07 mm.
N is 7, a first rotating shaft female shaft 111 is arranged on one side of the first permalloy cylinder 11, a second rotating shaft female shaft 121 and a second rotating shaft male shaft 122 are arranged on the side surface of the second permalloy cylinder 12, a third rotating shaft female shaft 131 and a third rotating shaft male shaft 132 are arranged on the side surface of the third permalloy cylinder 13, a fourth rotating shaft female shaft 141 and a fourth rotating shaft male shaft 142 are arranged on the side surface of the fourth permalloy cylinder 14, a fifth rotating shaft female shaft 151 and a fifth rotating shaft male shaft 152 are arranged on the side surface of the fifth permalloy cylinder 15, a sixth rotating shaft female shaft 161 and a sixth rotating shaft male shaft 162 are arranged on the side surface of the sixth permalloy cylinder 16, a seventh rotating shaft male shaft 172 is arranged on the side surface of the seventh permalloy cylinder 17, the second rotating shaft male shaft 122 is connected with the first rotating shaft female shaft 111 for rotation, and the third rotating shaft male shaft 132 is connected with the second rotating shaft female shaft 121 for rotation, the fourth rotation axis male shaft 142 is connected to the third rotation axis female shaft 131 to rotate, the fifth rotation axis male shaft 152 is connected to the fourth rotation axis female shaft 141 to rotate, the sixth rotation axis male shaft 162 is connected to the fifth rotation axis female shaft 151 to rotate, and the seventh rotation axis male shaft 172 is connected to the sixth rotation axis female shaft 161 to rotate, and a hexagonal structure is formed by self-assembly.
The first rotating shaft female shaft 111, the second rotating shaft female shaft 121, the third rotating shaft female shaft 131, the fourth rotating shaft female shaft 141 and the fifth rotating shaft female shaft 151 are identical in structure and respectively composed of two sections of coaxial end cylinders with intervals, the second rotating shaft male shaft 122, the third rotating shaft male shaft 132, the fourth rotating shaft male shaft 142, the fifth rotating shaft male shaft 152 and the sixth rotating shaft male shaft 162 are identical in structure and respectively composed of a section of middle cylinder, and the middle cylinders are clamped between the two corresponding sections of end cylinders and connected through rotating parts to realize rotation; the sixth rotating shaft female shaft 161 is an arc-shaped sleeve, the axial direction of the sixth rotating shaft female shaft is parallel to the axial direction of the sixth permalloy cylinder 16, and the seventh rotating shaft male shaft 172 is inserted into the arc-shaped sleeve to realize connection and rotates along the arc direction.
The included angle between the second rotating shaft female shaft 121 and the second rotating shaft male shaft 122 on the section of the second permalloy cylinder 12 is 120 °, the included angle between the third rotating shaft female shaft 131 and the third rotating shaft male shaft 132 on the section of the third permalloy cylinder 13 is 120 °, the included angle between the fourth rotating shaft female shaft 141 and the fourth rotating shaft male shaft 142 on the section of the fourth permalloy cylinder 14 is 120 °, the included angle between the fifth rotating shaft female shaft 151 and the fifth rotating shaft male shaft 152 on the section of the fifth permalloy cylinder 15 is 120 °, and the included angle between the arc midpoint of the sixth rotating shaft female shaft 161 and the sixth rotating shaft male shaft 162 on the section of the sixth permalloy cylinder 16 is 60 °.
The tissue binding surface of the soft clip 6 is made of materials such as rubber, and the tissue damage is avoided.
Compared with the prior art, the invention has the beneficial effects that:
1. realizes the external manual control of gallbladder traction in cholecystectomy under a puncture reducing card laparoscope, and freely adjusts the direction and the force in the cholecystectomy through three traction lines.
2. The difficulty of mutual interference of instruments in the operation is reduced, and the three traction lines in the traction line group are soft nylon lines and do not interfere with hard surgical instruments.
3. The diameter of the traction wire can be ignored, the card poking space is hardly occupied, and the reduction of the hole diameter of the poking hole is facilitated.
4. The self-assembly function of the sub-magnet group increases the magnetic attraction force between the sub-magnet group and the abdominal wall external mother magnet, and the stab-resistant card is really reduced on the premise of not increasing the diameter of the stab-resistant card.
5. The force application direction of the medical worker for lifting the gall bladder is changed through the circular ring structure, and the comfort level and the convenience of operation are improved.
Drawings
FIG. 1 is a schematic diagram (top view) of the self-assembled structure of a permalloy sub-magnet assembly of the present invention.
FIG. 2 is a schematic view of the structure of a first permalloy cylinder according to the invention.
FIG. 3 is a schematic structural view of a second, third, fourth and fifth permalloy cylinder according to the present invention.
FIG. 4 is a schematic view (side view) of the structure of a first permalloy cylinder joined to a second permalloy cylinder in accordance with the present invention.
FIG. 5 is a schematic view (side view) of the structure of the sixth permalloy cylinder and the seventh permalloy cylinder of the present invention after they are assembled.
FIG. 6 is a schematic view (top view) of the structure of the sixth permalloy cylinder and the seventh permalloy cylinder according to the present invention after they are assembled.
Fig. 7 is a schematic view of a manually operated hook connection.
FIG. 8 is a schematic view (side view) of the structure of the present invention after all the cylinders of the Mo alloy have been joined.
FIG. 9 is a schematic view showing a connection structure of the permalloy magnet assembly and the fishing net device according to the present invention.
FIG. 10 is a schematic view of the nylon thread attachment position of the present invention.
Fig. 11 is a schematic view of the structure of the traction wire set of the present invention.
Fig. 12 is a schematic view of the assembled operation structure of the present invention.
Detailed Description
The embodiments of the present invention will be described in detail below with reference to the drawings and examples.
The invention relates to an in-vivo self-assembly magnetic anchoring device for stab-resistant laparoscopic cholecystectomy, which realizes the reduction of stab holes through the in-vivo self-assembly of sub-magnets. In the present invention, the self-assembly means that a cylindrical (bar-shaped) sub-magnet is inserted into the abdominal cavity by a stab card, and a new frame structure is assembled in the abdominal cavity by mechanical control, thereby performing an intra-abdominal operation which was difficult to be completed before.
With particular reference to fig. 1-12, the in vivo self-assembling magnetic anchoring device of the present invention mainly comprises a permalloy sub-magnet assembly 1, a fishing net device 2, a pull wire assembly 3 and an in vitro magnet 4.
The permalloy sub-magnet group 1 is composed of N permalloy cylinders which are sequentially connected through rotating shafts, the diameter of each permalloy cylinder is 7.07mm, the height of each permalloy cylinder is 7.07mm, and the axial direction of each rotating shaft is parallel to the axial direction of each permalloy cylinder.
In this embodiment, when N is 7, referring to fig. 1, fig. 2, fig. 3, fig. 4, fig. 5, fig. 6, fig. 7, and fig. 8, the first permalloy cylinder 11 has a first rotation axis female shaft 111 on one side, the second permalloy cylinder 12, the third permalloy cylinder 13, the fourth permalloy cylinder 14, and the fifth permalloy cylinder 15 have the same structure and parameters, the second permalloy cylinder 12 has a second rotation axis female shaft 121 and a second rotation axis male shaft 122 on a side, the third permalloy cylinder 13 has a third rotation axis female shaft 131 and a third rotation axis male shaft 132 on a side, the fourth permalloy cylinder 14 has a fourth rotation axis female shaft 141 and a fourth rotation axis male shaft 142 on a side, and the fifth permalloy cylinder 15 has a fifth rotation axis female shaft 151 and a fifth rotation axis male shaft 152 on a side. The sixth permalloy cylinder 16 has a sixth rotation axis female shaft 161 and a sixth rotation axis male shaft 162 on the side surface, and the seventh permalloy cylinder 17 has a seventh rotation axis male shaft 172 on the side surface.
The first rotating shaft female shaft 111, the second rotating shaft female shaft 121, the third rotating shaft female shaft 131, the fourth rotating shaft female shaft 141 and the fifth rotating shaft female shaft 151 are respectively composed of two sections of end cylinders which are coaxial and have intervals, the second rotating shaft male shaft 122, the third rotating shaft male shaft 132, the fourth rotating shaft male shaft 142, the fifth rotating shaft male shaft 152 and the sixth rotating shaft male shaft 162 are identical in structure and are respectively a section of middle cylinder, and the middle cylinders are clamped between the corresponding two sections of end cylinders to be connected in a rotating mode. The sixth rotating shaft female shaft 161 is an arc-shaped sleeve, the axial direction of the sixth rotating shaft female shaft is parallel to the axial direction of the sixth permalloy cylinder 16, and the seventh rotating shaft male shaft 172 is inserted into the arc-shaped sleeve to realize connection and can rotate along the arc direction.
Also in the present embodiment, the angle between the second rotating shaft female shaft 121 and the second rotating shaft male shaft 122 on the cross section of the second permalloy cylinder 12 is 120 °, the angle between the third rotating shaft female shaft 131 and the third rotating shaft male shaft 132 on the cross section of the third permalloy cylinder 13 is 120 °, the angle between the fourth rotating shaft female shaft 141 and the fourth rotating shaft male shaft 142 on the cross section of the fourth permalloy cylinder 14 is 120 °, the angle between the fifth rotating shaft female shaft 151 and the fifth rotating shaft male shaft 152 on the cross section of the fifth permalloy cylinder 15 is 120 °, and the angle between the midpoint of the arc line of the sixth rotating shaft female shaft 161 and the sixth rotating shaft male shaft 162 on the cross section of the sixth permalloy cylinder 16 is 60 °.
Thus, the second rotation axis male shaft 122 is connected to the first rotation axis female shaft 111 for rotation, the third rotation axis male shaft 132 is connected to the second rotation axis female shaft 121 for rotation, the fourth rotation axis male shaft 142 is connected to the third rotation axis female shaft 131 for rotation, the fifth rotation axis male shaft 152 is connected to the fourth rotation axis female shaft 141 for rotation, the sixth rotation axis male shaft 162 is connected to the fifth rotation axis female shaft 151 for rotation, and the seventh rotation axis male shaft 172 is connected to the sixth rotation axis female shaft 161 for rotation, and a hexagonal structure can be formed by self-assembly.
The hook 8 for clamping the laparoscopic grasper is arranged on the sixth permalloy cylinder 16 and the seventh permalloy cylinder 17, the hanging ring matched with the hook 8 is arranged on the first permalloy cylinder 11 and the second permalloy cylinder 12, and the hook 8 is hung on the hanging ring, so that the simple locking of the hexagonal structure can be realized.
Referring to fig. 9 and 10, the fishing net device 2 is mainly composed of 6 nylon threads 9 and a non-magnetic ring 5, one end of each nylon thread 9 is connected to a rotating shaft, the other end is fixed to the ring 5, and the ring 5 is made of non-magnetic stainless steel and the like.
Referring to fig. 11, the traction wire group 3 mainly comprises three traction wires and three soft clips 6, each soft clip 6 is linked at the front end of one traction wire, the tail end of each traction wire penetrates through the circular ring 5 and then penetrates out through the poking card, the direction in the cholecystectomy can be adjusted by combining and drawing the three traction wires, the number of the traction wires can be adjusted as required, and the tissue binding surface of each soft clip 6 is made of materials such as rubber, so that tissue damage is avoided.
Referring to fig. 12, the in vitro magnet 4 is positioned in vitro to provide magnetic guidance for the self-assembly of the permalloy sub-magnet assembly 1 and is anchored to the septal wall 7 of the permalloy sub-magnet assembly 1 after self-assembly.
Because the permalloy is not magnetic before being magnetized by the external magnet 4 and has smaller size, the permalloy can conveniently enter the abdominal cavity through poking cards, and then self-assembly is realized under the magnetic guidance of the external magnet 4 and the assistance of surgical forceps, so that a hexagonal structure is formed, and the magnetic contact area is increased.
Therefore, the operating principle of the invention is that before the gall bladder resection by the poking card, the soft clip 6 is fixed in the left, right and front directions of the gall bladder by the surgical forceps through the poking card, and the tail end of the external traction wire passes through the circular ring 5. After the sub-magnet group 1 is sent into the abdominal cavity by a poking card, the sixth permalloy cylinder and the seventh permalloy cylinder are respectively connected with the first permalloy cylinder and the second permalloy cylinder through the hook connection under the magnetic guidance of the external magnet 4 and the assistance of an operating forceps, so that the self-assembly is realized, the hexagonal structure is formed, and the hexagonal structure is anchored with the external magnet 4 through the abdominal wall 7. The hexagonal structure increases the force bearing area for the external magnet 4 and avoids falling in the operation. Meanwhile, the fishing net device 2 completes three-dimensional transformation, the circular ring 5 is positioned on the central axis of the hexagonal structure, and the traction force is uniformly dispersed in the permalloy sub-magnet group while the direction of the traction wire group 3 is changed. The traction line group 3 penetrates out through the poking card, and an operator freely adjusts the deformation direction and amplitude of the gallbladder in vitro by adjusting the traction force and the traction line combination mode. After the gallbladder is cut off, the external magnet 4 is removed and the hook connection is removed, so that the sub-magnet group 1 can recover the strip structure and is withdrawn out of the body through the poking card.
Claims (6)
1. An in vivo self-assembling magnetic anchoring device for stab-resistant laparoscopic cholecystectomy, comprising:
the permalloy sub-magnet group (1) consists of N permalloy cylinders which are sequentially connected through a rotating shaft, wherein the axial direction of the rotating shaft is parallel to the axial direction of the permalloy cylinders, and hooks (8) for clamping the laparoscopic graspers are arranged on the permalloy cylinders at the two ends;
the fishing net device (2) consists of N-1 nylon threads (9) and a non-magnetic ring (5), one end of each nylon thread (9) is connected to one rotating shaft, and the other end of each nylon thread is fixed on the ring (5);
the traction wire group (3) consists of three traction wires and three soft clamps (6), each soft clamp (6) is linked at the front end of one traction wire, and the tail end of each traction wire penetrates through the circular ring (5) and then penetrates out through the poking clamp;
the external magnet (4) is positioned outside the body, provides magnetic guidance for the self-assembly of the permalloy sub-magnet group (1), and is anchored with the diaphragm wall (7) of the permalloy sub-magnet group (1) after the self-assembly.
2. The in vivo self-assembling magnetic anchoring device for stab-reducing laparoscopic cholecystectomy of claim 1, wherein said permalloy cylinder is 7.07mm in diameter and 7.07mm high.
3. The in vivo self-assembled magnetic anchoring device for the stab-reducing laparoscopic cholecystectomy according to claim 1 or 2, wherein N is 7, the first permalloy cylinder (11) has a first rotation axis female shaft (111) on one side, the second permalloy cylinder (12) has a second rotation axis female shaft (121) and a second rotation axis male shaft (122) on a side, the third permalloy cylinder (13) has a third rotation axis female shaft (131) and a third rotation axis male shaft (132) on a side, the fourth permalloy cylinder (14) has a fourth rotation axis female shaft (141) and a fourth rotation axis male shaft (142) on a side, the fifth permalloy cylinder (15) has a fifth rotation axis female shaft (151) and a fifth rotation axis male shaft (152) on a side, the sixth permalloy cylinder (16) has a sixth rotation axis female shaft (161) and a sixth rotation axis male shaft (162) on a side, the side of the seventh permalloy cylinder (17) is provided with a seventh rotating shaft male shaft (172), the second rotating shaft male shaft (122) is connected with the first rotating shaft female shaft (111) to realize rotation, the third rotating shaft male shaft (132) is connected with the second rotating shaft female shaft (121) to realize rotation, the fourth rotating shaft male shaft (142) is connected with the third rotating shaft female shaft (131) to realize rotation, the fifth rotating shaft male shaft (152) is connected with the fourth rotating shaft female shaft (141) to realize rotation, the sixth rotating shaft male shaft (162) is connected with the fifth rotating shaft female shaft (151) to realize rotation, the seventh rotating shaft male shaft (172) is connected with the sixth rotating shaft female shaft (161) to realize rotation, and a six-sided structure is formed by self-assembly.
4. The in vivo self-assembly magnetic anchoring device for the stab-reducing card laparoscopic cholecystectomy, according to claim 3, wherein the first rotating shaft female shaft (111), the second rotating shaft female shaft (121), the third rotating shaft female shaft (131), the fourth rotating shaft female shaft (141), and the fifth rotating shaft female shaft (151) have the same structure, and are each composed of two sections of coaxial end cylinders with intervals, the second rotating shaft male shaft (122), the third rotating shaft male shaft (132), the fourth rotating shaft male shaft (142), the fifth rotating shaft male shaft (152), and the sixth rotating shaft male shaft (162) have the same structure, and are each a section of middle cylinder, and the middle cylinder is clamped between the two corresponding sections of end cylinders and connected by a rotating piece to realize rotation; the sixth rotating shaft female shaft (161) is an arc-shaped sleeve, the axial direction of the sixth rotating shaft female shaft is parallel to the axial direction of the sixth permalloy cylinder (16), and the seventh rotating shaft male shaft (172) is inserted into the arc-shaped sleeve to realize connection and rotates along the arc direction.
5. The in vivo self-assembling magnetic anchoring device for destlatable laparoscopic cholecystectomy of claim 4, characterized in that the included angle between the second rotating shaft female shaft (121) and the second rotating shaft male shaft (122) on the section of the second permalloy cylinder (12) is 120 degrees, the included angle between the third rotating shaft female shaft (131) and the third rotating shaft male shaft (132) on the section of the third permalloy cylinder (13) is 120 degrees, the included angle between the fourth rotating shaft female shaft (141) and the fourth rotating shaft male shaft (142) on the section of the fourth permalloy cylinder (14) is 120 degrees, the included angle between the fifth rotating shaft female shaft (151) and the fifth rotating shaft male shaft (152) on the section of the fifth permalloy cylinder (15) is 120 degrees, the included angle between the middle point of an arc line of the sixth rotating shaft female shaft (161) and the sixth rotating shaft male shaft (162) on the section of the sixth permalloy cylinder (16) is 60 degrees.
6. An in vivo self-assembling magnetic anchoring device for the laparoscopic cholecystectomy with a puncture reducing card according to claim 1, characterized in that the tissue abutment surface of the soft clip (6) is made of rubber or the like material, avoiding tissue damages.
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