CN103976767A - Automatic drag hook device for open-heart surgery - Google Patents

Automatic drag hook device for open-heart surgery Download PDF

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Publication number
CN103976767A
CN103976767A CN201410239875.7A CN201410239875A CN103976767A CN 103976767 A CN103976767 A CN 103976767A CN 201410239875 A CN201410239875 A CN 201410239875A CN 103976767 A CN103976767 A CN 103976767A
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CN
China
Prior art keywords
drag hook
fixed
slide
bar
transverse axis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CN201410239875.7A
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Chinese (zh)
Other versions
CN103976767B (en
Inventor
李芝
王俊
秦建伟
邵永丰
何志诚
戚晓通
赵胜
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Jiangsu Province Hospital First Affiliated Hospital With Nanjing Medical University
Original Assignee
Jiangsu Province Hospital First Affiliated Hospital With Nanjing Medical University
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Application filed by Jiangsu Province Hospital First Affiliated Hospital With Nanjing Medical University filed Critical Jiangsu Province Hospital First Affiliated Hospital With Nanjing Medical University
Priority to CN201410239875.7A priority Critical patent/CN103976767B/en
Publication of CN103976767A publication Critical patent/CN103976767A/en
Application granted granted Critical
Publication of CN103976767B publication Critical patent/CN103976767B/en
Expired - Fee Related legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • 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
    • A61B17/0206Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with antagonistic arms as supports for retractor elements
    • 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
    • A61B2017/0237Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for heart surgery

Abstract

The invention discloses an automatic drag hook device for an open-heart surgery. The automatic drag hook device comprises a breastbone expander and a supporting device arranged on the breastbone expander. A fixed installation strip is arranged at the upper portion of a movable arm and/or a fixed arm of the breastbone expander. The supporting device is clamped on the fixed installation strip. The supporting device comprises a fixed block, a supporting frame and a drag hook slide block, wherein the supporting frame is fixedly installed on the fixed block and provided with a sliding shaft, the drag hook slide block is arranged on the slide shaft, slides on the slide shaft and is provided with an installation hole for installing a hook and a fixed bolt hole, and the drag hook slide block and the slide shaft are connected and fixed through a locking bolt in the fixed bolt hole. After the automatic drag hook device is used, one surgical assistant can be omitted, and work efficiency is improved; influences of the assistant on surgical region exposure can be avoided, and surgical time can be shortened; the assistant can directly view the surgical operation process due to good exposure, and clinical teaching is facilitated.

Description

Automatic drag hook device for intracardiac operation under direct vision
Technical field
The present invention relates to a kind of cardiac thoracic surgery apparatus, specifically a kind of automatic drag hook device for intracardiac operation under direct vision.
Background technology
Intracardiac operation under direct vision adopts mid-sternal incision more, adds because anatomical cardiac position is dark, and complex structure, visual area is less, difficult exposure.Often need clinically the with the hands intracardiac structure of tractive of assistant, but on the one hand for a long time tractive assistant Yi Fasheng is tired, causes drag hook displacement and affect surgical exposure, repeatedly adjust drag hook and wasted again operating time; Assistant is carrying out when tractive exposes occupying space around, visual area on the other hand, thereby affects patient's operation; In addition, assistant makes when with the hands tractive exposes often cannot look at the operating process of visual area straight, is unfavorable for Operation cooperation, has both extended operating time, is also unfavorable for the progress of assistant's surgical technic, causes cardiac surgeon to grow up slowly.
Through retrieval, find, name is called the Chinese invention patent of " automatic tractor for atrium sinistrum ", application number " 87214421.6 ", this invention is connected self-retractor by " work " font nail with sternal retractor, this connection belongs to and is rigidly connected, once sternal retractor is opened in operation process, the drag hook adjusting range that is arranged on top is just very little, and in operation process, is difficult to remove or change drag hook; Due to misoperation, easily the tissue in ambition is caused to damage, for some darker operative sites, also need assistant to use drag hook to carry out manual cooperation, very inconvenience is used in operation.
Summary of the invention
Technical problem to be solved by this invention is, shortcoming for above prior art, a kind of automatic drag hook device for intracardiac operation under direct vision is proposed, can efficiently be convenient to use self-retractor by auxiliary intracardiac operation under direct vision, and drag hook position can be flexible and changeable, the impact that can avoid assistant to expose operating field, shortens operating time greatly.
In order to solve the problems of the technologies described above, the invention provides a kind of automatic drag hook device for intracardiac operation under direct vision, comprise Sternal distraction device and be located at the bracing or strutting arrangement on described Sternal distraction device, described Sternal distraction device comprises rack-plate, fixed arm and lever arm, described fixed arm and lever arm be being comprised of for the top of supporting and the bottom for strutting that is connected to the arc shaped blade shape that is outside upset of below an upper section rectangular column shape all, the one end on one end of described rack-plate and the top of described fixed arm is fixedly linked, one end socket on the top of described lever arm is arranged on described rack-plate, and form symmetrical structure with described fixed arm, the gear engagement of thumb wheel and described rack-plate is installed in the link of described lever arm and rack-plate, the rotating shaft of described thumb wheel is provided with rocking arm, by rocker arms roll, drive thumb wheel to rotate moves left and right described lever arm on described rack-plate, the upper surface on the top of described lever arm and/or fixed arm is provided with fixed installation bar, and described bracing or strutting arrangement is comprised of a fixed block, two inverted "L" shaped bracing frames, a slide-bar and at least one drag hook slide block, described fixed block is that rectangular column shape and its bottom surface are provided with the draw-in groove corresponding with described fixed installation bar, and described fixed block is connected on described fixed installation bar by its draw-in groove, described inverted "L" shaped bracing frame has vertical portion and horizontal part, the vertical portion of two inverted "L" shaped bracing frames is positioned at respectively the two ends of described fixed block and protrudes upward, and top, vertical portion is to the horizontal part that is positioned at the lever arm of one side or the direction of fixed arm and extends cantilever, between the horizontal part that described slide-bar is connected to two inverted "L" shaped bracing frames that one end away from vertical portion, described drag hook slide block is arranged on described slide-bar and slides, and has installing hole and fixed bolt hole that atrium drag hook or ventricle drag hook are installed on described drag hook slide block, by the clamping screw in described fixed bolt hole, described drag hook slide block and slide-bar is connected and fixed.
Like this, the horizontal part that extends cantilever by " L " shape bracing frame provides the installing space of atrium drag hook or ventricle drag hook, slip by drag hook slide block on slide-bar facilitates the lengthwise position of atrium drag hook or ventricle drag hook to regulate, the clamping fixing and fixed card slot and fixed installation bar of the vertical portion of prolonging by " L " shape bracing frame and fixed block realizes the fixing of bracing or strutting arrangement, by rocker arms roll, driving thumb wheel to rotate the lateral attitude that drives lever arm moving left and right on rack-plate to realize atrium drag hook or ventricle drag hook regulates, thereby the position of atrium drag hook or ventricle drag hook can be changed flexibly, and fixing operation is simple, very convenient, when the present invention uses, only the handle designs of atrium drag hook and ventricle drag hook need be become to rough cylinder, make the shank cylinder diameter of section of atrium drag hook and ventricle drag hook be less than the cavity cross section diameter of drag hook slide block drag hook installing hole, while using due to drag hook, its direction hardly may be vertical with drag hook slide block, the frictional force in its responsible drag hook handle and slide block drag hook hole can be fixed, very convenient, such fixed form also can be avoided the excessive tractive of drag hook to intracardiac structure, without increasing unnecessary fixture, kill two birds with one stone.
The technical scheme that the present invention further limits is: the aforesaid automatic drag hook device for intracardiac operation under direct vision, support frame as described above comprises at least two montants and a slide-bar, described montant is inverted "L" shaped, parallel being fixedly connected on described fixed block in one end of at least two described montants, described slide-bar is fixed between the other end of at least two described montants, make described montant, slide-bar and fixed block form frame-shaped construction, adopt this structure to avoid drag hook to contact with lever arm or the fixed arm of retractor, thereby guaranteed its exposure.
The aforesaid automatic drag hook device for intracardiac operation under direct vision, one side of described montant also arranges and described slide-bar vertical horizontal slide-bar in the horizontal direction, described horizontal slide-bar comprises the first transverse axis, the second transverse axis and connecting rod, the first transverse axis and the second transverse axis stagger from beginning to end and be arranged in parallel, described connecting rod respectively with vertical being connected of end of described the first transverse axis and the second transverse axis, the end of described the first transverse axis is provided with forked joint, and by connecting bolt, described forked joint is fixed on described montant, described the second transverse axis is provided with drag hook slide block, described drag hook slide block is arranged on described the second transverse axis and slides, on described drag hook slide block, there is installing hole and fixed bolt hole that drag hook is installed, by the clamping screw in described fixed bolt hole, described drag hook slide block and the second transverse axis are connected and fixed.
The end of the first transverse axis of the horizontal slide-bar of the present invention is provided with forked joint, can snap in the bolt of bracing or strutting arrangement montant side, after screwing bolt, horizontal slide-bar can be fixed on bracing or strutting arrangement, on its other end second transverse axis, through a drag hook slide block, thereby be convenient to install drag hook, to diaphragmatic surface tractive, expose; Drag hook slide block can be free to slide along the second transverse axis, and can be along 360 degree rotations centered by the second transverse axis.Drag hook slide block cavity middle part have with cavity connect bolt hole, adjusting behind slide position can by screwing bolt, fixedly slide block be on the second transverse axis, the other end of drag hook slide block is provided with the installing hole of the cylindrical drag hook that runs through body, is convenient to install drag hook.
The aforesaid automatic drag hook device for intracardiac operation under direct vision, the circle that under the cross section of described fixed installation bar is, 1/5th height level clips, described fixed block is provided with the groove mating with described fixed installation bar, and described groove and fixed installation strip adoption matched in clearance.
The aforesaid automatic drag hook device for intracardiac operation under direct vision, described fixed block side is provided with at least two fixing and locking holes, and described fixing and locking hole and described groove connect, and in described fixing and locking hole, are provided with lock-screw.
Further, the aforesaid automatic drag hook device for intracardiac operation under direct vision, is at least provided with two drag hook slide blocks on the slide-bar of support frame as described above.
Through row relatively, the advantage having is for the present invention and prior art:
1), rational in infrastructure, powerful, the ingenious cooperation of each bracing or strutting arrangement, can guarantee the modulability of the depth and place of drag hook, thereby guarantees the exposure of operating field, can adapt to the needs of different operations and Different Individual.During the direct-view such as clinical execution mitral valve replacement, plastic surgery for mitral valve and the thrombosis removing of left room operation, with ventricle drag hook, retracting interatrial septum is fixed on slide block; And can by lobe traction before Tricuspid valve, expose with atrium drag hook while implementing ventricular septal defect repair operation; While implementing Tricusp Valvuloplasty or replacement operation, can adopt atrium drag hook to retract right atrium exposes;
2), this apparatus do not assembling bracing or strutting arrangement and laterally can use as common sternal retractor during slide-bar, its atrium or ventricle drag hook also can be done separately traction and expose;
3), can reduce by an assistant after using this device, increase work efficiency; The impact that can avoid assistant to expose operating field, shortens operating time; And good exposure can make assistant look at operative process straight, be convenient to clinical band religion, be more conducive to the growth of department of cardiac surgery junior doctor;
4), this apparatus structure is simple, cost is low, adopts the stainless steel material that meets medical standard to make, sturdy and durable, cleaning aspect can be through high-temperature sterilization, can Reusability, combination is quick, easy to adjust, uses simple to operate;
5), design ingeniously, simple in structure, convenient and practical, be all more significant intracardiac operation under direct vision self-retractors of a kind of economic benefit and social benefit, during use, can improve the comparatively ideal professional assistive device of cardiac operation quality.
Accompanying drawing explanation
Fig. 1 is structural representation of the present invention.
Fig. 2 is support device structure schematic diagram of the present invention.
Fig. 3 is the horizontal slide-bar structural representation of the present invention.
The specific embodiment
Below the present invention is described in further detail:
embodiment 1
A kind of automatic drag hook device for intracardiac operation under direct vision that the present embodiment provides, structure as depicted in figs. 1 and 2, comprise Sternal distraction device and be located at the bracing or strutting arrangement on Sternal distraction device, Sternal distraction device comprises rack-plate 4, fixed arm 5 and lever arm 6, the arc that the bottom of fixed arm 5 and lever arm 6 has outside upset struts blade 7, one end of rack-plate 4 and fixed arm 5 are fixedly linked, lever arm 6 installation end sockets are arranged on the other end of rack-plate 4, and form symmetrical structure with fixed arm 5, the gear engagement of thumb wheel and rack-plate is installed in the link of lever arm 6 and rack-plate 4, the rotating shaft of thumb wheel is provided with rocking arm 8, by rocker arms roll, drive thumb wheel to rotate moves left and right lever arm on rack-plate 4, bracing or strutting arrangement comprises fixed block 3, bracing frame and drag hook slide block 10, bracing frame comprises two inverted "L" shaped montants 1 and a slide-bar 2, parallel being fixedly connected on fixed block 3 in one end of two montants, between the horizontal part that slide-bar is connected to two inverted "L" shaped bracing frames that one end away from vertical portion, make montant, slide-bar and fixed block form frame-shaped construction, the top of lever arm and fixed arm is provided with fixed installation bar 9, the circle that under the cross section of fixed installation bar 9 is, 1/5th height level clips, fixed block is that rectangular column shape and its bottom surface are provided with the groove corresponding with fixedly mounting bar 11, and groove and fixed installation strip adoption matched in clearance, fixed block 3 sides are provided with two fixing and locking holes, fixing and locking hole and groove connect, in fixing and locking hole, be provided with lock-screw.Bracing or strutting arrangement is connected on fixed installation bar 9, bracing frame is fixedly mounted on fixed block, and on bracing frame, there is slide-bar 2, two drag hook slide blocks 10 are set on slide-bar, drag hook slide block 10 can 360 ° of rotations on slide-bar, on drag hook slide block, there is installing hole and fixed bolt hole that drag hook is installed, by the clamping screw in fixed bolt hole, drag hook slide block and slide-bar are connected and fixed.
In the present embodiment, in a side of montant, also arrange and slide-bar vertical horizontal slide-bar in the horizontal direction, structure as shown in Figure 3, laterally slide-bar comprises the first transverse axis 12, the second transverse axis 13 and connecting rod 14, the first transverse axis and the second transverse axis stagger from beginning to end and be arranged in parallel, connecting rod respectively with vertical being connected of end of the first transverse axis and the second transverse axis, the end of the first transverse axis is provided with forked joint 15, and by connecting bolt, forked joint is fixed on montant, the second transverse axis is provided with drag hook slide block 10 ', drag hook slide block 10 ' is arranged on the second transverse axis and slides, on drag hook slide block, there is installing hole and fixed bolt hole that drag hook is installed, by the clamping screw in fixed bolt hole, drag hook slide block and the second transverse axis are connected and fixed.
The thumb wheel of the Sternal distraction device of the present embodiment is installed on lever arm, and the lower end of thumb wheel is provided with the thumb wheel core that the teeth that can stir on rack-plate move sliding shoe, and its upper end is connected with the rocking handle that thumb wheel is rotated.The bottom of lever arm 3 and fixed arm 2 is that arc struts blade, and arc struts blade and acts on the breastbone cutting, and plays exposed chest otch.Bracing or strutting arrangement is sleeved on the fixed installation bar of lever arm or fixed arm by the groove at the fixed block place of its bottom, groove Cross-section is chimeric each other with the moulding of fixed installation bar pole section, fixed block middle part has two places to penetrate the fixing and locking hole of groove cavities, by screwing lock-screw fixed support device on Sternal distraction device.Fixed block two ends are connected with montant, and a bolt is respectively arranged at the top of two montants, for fixed lateral slide-bar.Two montant tops connect smooth cylindrical slide-bar, on slide-bar, through two drag hook slide blocks, so that drag hook is installed, to tractive above or below side, expose.
Laterally slide-bar tail end is forked, can snap in the bolt 11 of bracing or strutting arrangement side, after screwing bolt, horizontal slide-bar can be fixed on bracing or strutting arrangement, its other end is also smooth cylinder the second transverse axis, on its other end second transverse axis, through a drag hook slide block, thereby be convenient to install drag hook, to diaphragmatic surface tractive, expose; Drag hook slide block can be free to slide along the second transverse axis, and can be along 360 degree rotations centered by the second transverse axis.Drag hook slide block cavity middle part have with cavity connect bolt hole, adjusting behind slide position can by screwing bolt, fixedly slide block be on the second transverse axis, the other end of drag hook slide block is provided with the installing hole of the cylindrical drag hook that runs through body, is convenient to install drag hook.
Above embodiment only, for explanation technological thought of the present invention, can not limit protection scope of the present invention with this, every technological thought proposing according to the present invention, and any change of doing on technical scheme basis, within all falling into protection domain of the present invention.

Claims (5)

1. the automatic drag hook device for intracardiac operation under direct vision, comprise Sternal distraction device and be located at the bracing or strutting arrangement on described Sternal distraction device, described Sternal distraction device comprises rack-plate, fixed arm and lever arm, described fixed arm and lever arm be being comprised of for the top of supporting and the bottom for strutting that is connected to the arc shaped blade shape that is outside upset of below an upper section rectangular column shape all, the one end on one end of described rack-plate and the top of described fixed arm is fixedly linked, one end socket on the top of described lever arm is arranged on described rack-plate, and form symmetrical structure with described fixed arm, the gear engagement of thumb wheel and described rack-plate is installed in the link of described lever arm and rack-plate, the rotating shaft of described thumb wheel is provided with rocking arm, by rocker arms roll, drive thumb wheel to rotate moves left and right described lever arm on described rack-plate, it is characterized in that: the upper surface on the top of described lever arm and/or fixed arm is provided with fixed installation bar, described bracing or strutting arrangement is comprised of a fixed block, two inverted "L" shaped bracing frames, a slide-bar and at least one drag hook slide block, described fixed block is that rectangular column shape and its bottom surface are provided with the draw-in groove corresponding with described fixed installation bar, and described fixed block is connected on described fixed installation bar by its draw-in groove, described inverted "L" shaped bracing frame has vertical portion and horizontal part, the vertical portion of two inverted "L" shaped bracing frames is positioned at respectively the two ends of described fixed block and protrudes upward, and top, vertical portion is to the horizontal part that is positioned at the lever arm of one side or the direction of fixed arm and extends cantilever, between the horizontal part that described slide-bar is connected to two inverted "L" shaped bracing frames that one end away from vertical portion, described drag hook slide block is arranged on described slide-bar and slides, and has installing hole and fixed bolt hole that atrium drag hook or ventricle drag hook are installed on described drag hook slide block, by the clamping screw in described fixed bolt hole, described drag hook slide block and slide-bar is connected and fixed.
2. the automatic drag hook device for intracardiac operation under direct vision according to claim 1, it is characterized in that: a side of described montant also arranges and described slide-bar vertical horizontal slide-bar in the horizontal direction, described horizontal slide-bar comprises the first transverse axis, the second transverse axis and connecting rod, the first transverse axis and the second transverse axis stagger from beginning to end and be arranged in parallel, described connecting rod respectively with vertical being connected of end of described the first transverse axis and the second transverse axis, the end of described the first transverse axis is provided with forked joint, and by connecting bolt, described forked joint is fixed on described montant, described the second transverse axis is provided with drag hook slide block, described drag hook slide block is arranged on described the second transverse axis and slides, on described drag hook slide block, there is installing hole and fixed bolt hole that drag hook is installed, by the clamping screw in described fixed bolt hole, described drag hook slide block and the second transverse axis are connected and fixed.
3. the automatic drag hook device for intracardiac operation under direct vision according to claim 1, it is characterized in that: the circle that under the cross section of described fixed installation bar is, 1/5th height level clips, described fixed block is provided with the groove mating with described fixed installation bar, and described groove and fixed installation strip adoption matched in clearance.
4. the automatic drag hook device for intracardiac operation under direct vision according to claim 4, it is characterized in that: described fixed block side is provided with at least two fixing and locking holes, described fixing and locking hole and described groove connect, and in described fixing and locking hole, are provided with lock-screw.
5. the automatic drag hook device for intracardiac operation under direct vision according to claim 1, is characterized in that: on the slide-bar of support frame as described above, be at least provided with two drag hook slide blocks.
CN201410239875.7A 2014-05-30 2014-05-30 For the automatic drag hook device of intracardiac operation under direct vision Expired - Fee Related CN103976767B (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109044430A (en) * 2018-09-05 2018-12-21 鹿文峰 A kind of automatic drag hook device for intracardiac operation under direct vision
CN109431559A (en) * 2018-12-04 2019-03-08 先健科技(深圳)有限公司 Expander
CN109528255A (en) * 2018-11-19 2019-03-29 北京大学深圳医院 A kind of Sternal distraction device

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN87214421U (en) * 1987-10-20 1988-06-01 北京心肺血管医疗研究中心-安贞医院 Automatic tractor for atrium sinistrum
US5984867A (en) * 1997-05-02 1999-11-16 Heartport, Inc. Surgical retractor and method of retracting
CN2489727Y (en) * 2001-06-13 2002-05-08 郑国强 Reversable infantile sternum, rib retractor
US20070179345A1 (en) * 2006-01-27 2007-08-02 Santilli Albert N Retraction of the Left Atrial Appendage

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN87214421U (en) * 1987-10-20 1988-06-01 北京心肺血管医疗研究中心-安贞医院 Automatic tractor for atrium sinistrum
US5984867A (en) * 1997-05-02 1999-11-16 Heartport, Inc. Surgical retractor and method of retracting
CN2489727Y (en) * 2001-06-13 2002-05-08 郑国强 Reversable infantile sternum, rib retractor
US20070179345A1 (en) * 2006-01-27 2007-08-02 Santilli Albert N Retraction of the Left Atrial Appendage

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109044430A (en) * 2018-09-05 2018-12-21 鹿文峰 A kind of automatic drag hook device for intracardiac operation under direct vision
CN109528255A (en) * 2018-11-19 2019-03-29 北京大学深圳医院 A kind of Sternal distraction device
CN109431559A (en) * 2018-12-04 2019-03-08 先健科技(深圳)有限公司 Expander

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