CN108852436B - Channel device for transanal minimally invasive surgery - Google Patents

The application provides a channel device for a trans-anal minimally invasive surgery, which comprises an external channel component and an internal channel component, wherein the external channel component comprises an instrument channel component and a connecting cover component, the instrument channel component comprises an instrument channel pipe body and a sealing component arranged in the instrument channel pipe body, and the instrument channel pipe body is at least provided with two; the built-in channel assembly comprises a first port, an inner channel main body and a second port, wherein the first port is arranged at one end of the inner channel main body, which is close to the connecting cover part, and the second port is arranged at one end of the inner channel main body, which is far away from the connecting cover part; the material of the inner channel main body is elastic material, and the outer diameter of the inner channel main body gradually increases from the first port to the second port. The channel device is suitable for the transanal minimally invasive surgery, the structural arrangement of the channel is suitable for narrow and longer anorectal, the injury to human bodies is reduced, the surgery operation space is increased, and the reliability of the device is ensured.

Channel device for transanal minimally invasive surgery

Technical Field

The application relates to a medical instrument, in particular to an anal canal channel component for a trans-anal minimally invasive operation, which is used for the trans-anal partial excision of rectal tumors and the trans-anal complete trans-intestinal mesentery excision operation.

Background

For benign tumors of the rectum and early rectal cancers, the traditional surgical means is to cut off the rectum tumor locally through the anus through the direct vision of the anus retractor, but the exposure of the operation field is poor, and the requirement that the tumor is close to the anus (the distance between the tumor and the anal verge is generally less than 5 cm) is the main limitation of the traditional operation method. In 1985, a german doctor, buss et al, first reported the local excision of rectal tumors using a trans-anal endoscopic microsurgical platform (TEM for short), which consists of a special proctoscope, a special surgical instrument and a scope visualization system.

The doctor Atalah et al in the United states reported first that a single-port laparoscopic tunnel was placed into the anal canal, and that after CO2 inflation, a conventional laparoscopic device was used to complete the rectal tumor partial resection, and was named TAMIS (transanal minimally invasive surgery). TAMIS surgery has made "high-grade" transanal minimally invasive surgery a reality for development in hospitals that have only conventional laparoscopic equipment. Currently commercialized single port laparoscopic channels for tami procedures are: SILS (Covidien), SSL (Ethicon), triport (Olympus), gelPOINT (Applied Medical), etc. The TAMIS platform can not only perform local excision of rectal tumors, but also has been recently reported as being used for transanal TME (taTME) surgery of advanced rectal cancer, i.e., TAMIS-TME surgery. The core component of the tami platform is a commercially available single-port laparoscopic channel.

As shown in fig. 1, a schematic diagram of a balloon type single-port laparoscopic multi-channel device with application number CN201210241381.3 in the prior art is shown, in operation, a incision is made in the abdominal wall, the channel is placed into the abdominal cavity through the incision, the inner balloon 1 is positioned on the inner side of the abdominal wall, the outer balloon 3 is positioned on the outer side of the skin, then the inner balloon is inflated through the inner balloon inlet 4, the channel is fixed so that the channel cannot slide out of the incision, then the channel balloon 2 is inflated through the channel balloon inlet 5 so that the channel balloon can be tightly combined with the incision, finally the outer balloon is inflated through the outer balloon inlet 6 so that the channel cannot slide into the abdominal cavity, and a closed system is formed.

The channel is set to be large at two ends and narrow in the middle, so that the structure can be clamped with an opening of an abdominal cavity of a human body, the channel is prevented from falling off and falling into the body cavity, the channel is made of flexible materials, and a normal channel is formed after the air bag is inflated. The current laparoscopic multi-channel devices are all similarly arranged, such a configuration is very convenient in laparoscopic surgery, but in the TAMIS operation type, since the channel needs to enter the narrow and long anorectal area, the design for preventing the channel from falling off in the operation channel assembly for the abdominal cavity is not suitable for the transanal minimally invasive surgery, and the part of the channel entering the body is formed by a plastic film, so that the anal canal is difficult to support, and thus, a channel device suitable for the transanal minimally invasive surgery is needed.

Disclosure of Invention

The present application aims to provide a passage device for a transanal minimally invasive surgery, which enables a doctor who performs the transanal minimally invasive surgery to use the passage device more conveniently and reliably, can maintain sufficient resistance inside the human body to prevent the passage from falling off, and can increase the operation space inside while ensuring that the opening is as small as possible.

The technical scheme of the application is realized as follows:

a channel device for a trans-anal minimally invasive surgery comprises an external channel component and an internal channel component,

the external channel component comprises an instrument channel component and a connecting cover component, wherein the instrument channel component comprises an instrument channel pipe body and sealing components arranged in the instrument channel pipe body, and the number of the instrument channel components is more than 2; the built-in channel assembly comprises a first port, an inner channel main body and a second port, wherein the first port is arranged at one end of the inner channel main body, which is close to the connecting cover part, and the second port is arranged at one end of the inner channel main body, which is far away from the connecting cover part; the material of the inner channel main body is elastic material, and the outer diameter of the inner channel main body gradually increases from the first port to the second port.

The inner channel body is made of elastic materials, so that the inner channel body can automatically rebound to restore to the original shape after the compressed volume enters the anorectal. The external diameter of the inner channel main body is set to be variable, so that the channel can enter the anorectum to form a conical structure to prevent falling off, the anorectum can be gradually expanded from the inlet to the inside, the size of the opening is reduced, and a larger operation space is formed in the anorectum.

Specifically, an angle formed by a plane tangent to the outer surface of the inner channel body and the central axis of the inner channel body is alpha, wherein 0 < alpha is less than or equal to 30 degrees.

Further, α is 2 ° or 3 ° or 5 ° or 10 ° or 15 ° or 20 °.

Preferably, the first port is provided with an inner channel buckle, and the inner channel buckle is provided with a sealing gasket; the connecting cover part comprises a connecting cover buckle and a sealing gasket stop block, when the external channel assembly and the internal channel assembly are connected, the connecting cover buckle is positioned below the internal channel buckle, and the sealing gasket is in an elastic deformation state and is attached to the sealing gasket stop block. This can further increase the sealability.

According to a preferred aspect of the present application, the connection cover clip is made of an elastically deformable material so that the inner channel assembly and the outer channel assembly are relatively movable in an axial direction of the inner channel body. The doctor still probably needs the angle of external passageway at the operation in-process, through the axial relative movement of external passageway subassembly and built-in passageway subassembly including the passageway main part, reducible sealing gasket and sealing gasket dog's relative pressure to reduced the frictional force between sealing gasket and the sealing gasket dog, thereby convenient rotation is released after the completion of rotating, sealing gasket and sealing gasket dog are closely laminated again, in order to realize such function, the connecting cover buckle is made by elastically deformable material, thereby but make built-in passageway subassembly and external passageway subassembly relative movement in axial direction.

According to another preferred aspect of the present application, an elastically deformable member is provided between the connection cover clip and the inner channel clip so that the inner channel assembly and the outer channel assembly are relatively movable in the direction in which the axis of the inner channel body extends. The elastically deformable member may be a spring or an elastic polymer material.

Preferably, the inner channel body is provided with an adjustable diameter and/or length. Because of the specific size of the anorectum that varies from patient to patient, the diameter and/or length of the inner channel body may vary to accommodate different patients. In particular, the variable diameter and/or length arrangement of the inner channel body may be referred to as a variable diameter or length arrangement of the tubular element in the prior art. For example by means of a segmented sleeve or threaded connection to vary the diameter and/or length of the inner channel body.

Preferably, the sealing member comprises an instrument seal and a gas seal, the instrument seal being located above the gas seal. This increases the tightness of the instrument after entry.

Preferably, the instrument sealing member is in an inverted cone shape, the instrument sealing member is made of elastic materials, the instrument sealing member is provided with reinforcing ribs, the bottom of the instrument sealing member is provided with an opening for passing instruments, and the gas sealing member is a one-way gas valve. By the arrangement, when no instrument is placed, the gas sealing element can ensure that gas can not enter and exit only through the action of the one-way gas valve, and the arrangement of the instrument sealing element can be tightly attached to the periphery of the instrument after the instrument is placed, so that the gas tightness of the device is improved under the condition that the one-way valve fails.

Preferably, the instrument channel tube body comprises a supporting seat, a sleeved outer ring and an inner pressure sleeve, and a sealing ring is arranged between the supporting seat and the gas sealing piece; the outer ring is sleeved on the periphery of the supporting seat, the outer ring is sleeved with the instrument sealing piece integrally, a clamping groove is formed in the joint of the outer ring and the instrument sealing piece, the sealing piece protecting piece is fixed through the clamping groove, and the inner pressure sleeve is arranged between the outer ring and the gas sealing piece. The arrangement ensures that all the components are mutually associated and matched, ensures the integrity and the reliability of the device, and can also prevent the condition of missing parts during assembly.

Preferably, the seal protector bottom is provided with a plurality of resilient flaps. Thereby preventing excessive deformation of the instrument seal.

Preferably, the external channel assembly further comprises an air inlet pipeline, an air outlet pipeline and a gas filter, wherein the air inlet pipeline and the air outlet pipeline are respectively communicated with the internal channel assembly, and the air inlet pipeline is connected with the gas filter. Thereby further filtering the gas entering the human body.

The scope of the present application is not limited to the specific combination of the above technical features, but also covers other technical features formed by any combination of the above technical features or their equivalents. Such as those described above, and those disclosed in the present application (but not limited to) having similar functions, are replaced with each other.

Due to the application of the technical scheme, compared with the prior art, the application has the following advantages: the application redesigns the channel device for operation, so that the channel device is suitable for the minimally invasive operation through anus, the structural arrangement of the channel is suitable for narrow and longer anorectum, the injury to human bodies is reduced, the operation space is increased, and the safety of the channel device is ensured.

Drawings

FIG. 1 is a schematic diagram of a prior art laparoscopic multi-channel device;

FIG. 2 is a schematic perspective view of an embodiment of the present application;

FIG. 3 is a top view of an embodiment of the present application;

FIG. 4 is a cross-sectional view taken along the direction A-A in FIG. 3;

FIG. 5 is a top view of an instrument channel assembly in accordance with an embodiment of the present application;

FIG. 6 is a cross-sectional view of the instrument channel B-B of FIG. 5;

FIG. 7 is a schematic illustration of the structure of the instrument seal;

fig. 8 is a schematic view of the structure of the gas seal.

Detailed Description

The application will now be described in further detail with reference to the drawings and to specific examples.

An access device for use in a trans-anal minimally invasive procedure having an external access module 10 with multiple channels for access instruments and an internal access module 20 for insertion into the body is shown in fig. 2, which shows a top view of this embodiment. The section taken along the direction A-A gives a cross-sectional elevation view as shown in figure 4. As shown in connection with fig. 2-4, the external channel assembly 10 further includes an inlet pipe 31 and an outlet pipe 32, the inlet pipe 31 and the outlet pipe 32 being in communication with the internal channel assembly 20. The gas filter 30 is connected to the gas inlet line 31. The external channel assembly 10 comprises 4 instrument channel members 11 and a connecting cover member 12, and the internal channel assembly 20 comprises a first port 21, an internal channel body 22 and a second port 23, wherein the first port 21 is arranged at one end of the internal channel body 22 close to the connecting cover member 12, and the second port 23 is arranged at one end of the internal channel body far away from the connecting cover member 12. The material of the inner channel body 22 is an elastic material, so that the inner channel body 22 can rebound automatically after being compressed into the body cavity, and an auxiliary tool is not required to be used for expanding the inner channel body 22 in a conventional manner, thereby reducing the risk of operation and ensuring the original shape of the channel. Specifically, the material of the inner channel body 22 may be selected from elastic polymer materials including, but not limited to, natural Rubber (NR), butadiene Rubber (BR), styrene Butadiene Rubber (SBR), etc.

As can be seen from fig. 2 or 4, the inner channel body 22 is a tapered member with a narrower upper part and a wider lower part, and the outer diameter thereof gradually increases from the first port 21 to the second port 23. In particular, we define the angle of variation α as the angle formed by the plane tangential to the outer surface of the inner channel body and the central axis of the inner channel body, the angle varying in the range 0 < α.ltoreq.30°, in particular, α may be in particular 2 ° or 3 ° or 5 ° or 10 ° or 15 ° or 20 ° in particular embodiments.

In order to realize the connection between the external channel assembly 10 and the internal channel assembly 20, the first port 21 is provided with an internal channel buckle 24, and a sealing gasket 25 is arranged on the internal channel buckle 24 for further increasing the air tightness, and the connecting cover part 12 comprises a connecting cover buckle 13 and a sealing gasket stop block 14; as shown in fig. 4, when the external channel assembly 10 and the internal channel assembly 20 are connected, the connecting cover buckle 13 is located below the internal channel buckle 24, the gasket 25 is in an elastically deformed state and is attached to the gasket stop 14, and a sufficient friction force is generated between the gasket 25 and the gasket stop 14 due to the deformed attachment of the gasket 25, so that the external channel assembly 10 can be prevented from relatively rotating relative to the internal channel assembly 20. In addition, when the doctor needs to adjust the angle of the external channel assembly 20 during the operation, the doctor needs to further adjust the relative angle of the external channel assembly 10 and the internal channel assembly 20, so that the friction force between the gasket 25 and the gasket stop 14 needs to be reduced, when the external channel assembly 10 and the internal channel assembly 20 are relatively far away in the axial direction of the internal channel main body 22, the elastic deformation of the gasket 25 can be reduced, so that the friction force between the gasket 25 and the gasket stop 14 can be reduced, the external channel assembly 10 and the internal channel assembly 20 can easily rotate relatively, and in order to realize the axial relative displacement of the external channel assembly 10 and the internal channel assembly 20, in this embodiment, the connecting cover buckle 13 is made of a deformable elastic material, and in particular, a deformable material such as a polymer elastic material or a steel sheet can be restored under the condition that no external force is applied. In addition, in addition to the arrangement of the present embodiment, the present application may also use an elastic member made of an elastic material between the connecting cover buckle 13 and the inner channel buckle 24 to achieve this function, and the specific elastic material may be, but is not limited to, a spring and a rubber pad. In addition, in order to facilitate the manual operation to realize the relative displacement, a pressing member 26 is further provided on the inner channel body 22 to facilitate the pressing displacement by the operator.

Because the specific anorectal dimensions vary from patient to patient, the diameter and/or length of the inner channel body 22 may vary to accommodate different patients. In particular, the variable diameter and/or length arrangement of the inner channel body 22 may be referred to as a variable diameter or length arrangement of tubular elements in the prior art. Such as by way of a segmented sleeve or threaded connection or any other deformable means to alter the diameter and/or length of the inner channel body 22. In this embodiment, the inner channel body 22 material may be selected to be an electroactive polymer to achieve a variable diameter and/or length of the inner channel body 22.

Fig. 5 is a top view of the instrument channel assembly 11, and fig. 6 is a cross-sectional view of fig. 5 taken in the direction B-B. As seen in fig. 6, the instrument channel assembly 11 includes an instrument channel tube and a sealing member. Specifically, the sealing components include an instrument seal 15 and a gas seal 16, with the instrument seal 15 being located above the gas seal 16. As shown in fig. 7, the instrument sealing member is in an inverted cone shape, the instrument sealing member 15 is made of elastic materials, the surface is provided with reinforcing ribs, the bottom is provided with an opening for passing the instrument, and the instrument can be tightened to prevent air leakage after being inserted; as shown in fig. 8, the gas seal 16 is a one-way gas valve, so that when no instrument is placed, the gas seal 16 can prevent gas from entering and exiting only through the action of the one-way gas valve, and the arrangement of the instrument seal 15 can be tightly attached to the periphery of the instrument after the instrument is placed, and the gas tightness of the device is increased under the condition that the one-way valve fails.

Further, the instrument channel tube body comprises a supporting seat 111, a sleeved outer ring 112 and an inner pressure sleeve 113, and a sealing ring 17 is arranged between the supporting seat 111 and the gas sealing piece 16; the outer sleeve ring 112 is sleeved on the periphery of the supporting seat 111, the outer sleeve ring 112 and the instrument sealing member 15 are integrally arranged, a clamping groove is formed at the joint of the outer sleeve ring 112 and the instrument sealing member 15, the sealing member protection member 18 is fixed through the clamping groove, and the inner pressure sleeve 113 is arranged between the outer sleeve ring 112 and the gas sealing member 16. The application ensures the structural stability of the inside of the instrument channel parts by tightly connecting the parts, ensures the air tightness of the whole channel device by mutually matching the parts, and can not be assembled if a certain part is carelessly omitted during assembly, thereby preventing the missing of the parts and improving the reliability of assembly. The provision of a plurality of resilient tabs at the bottom of the seal protector 18 helps to reset the instrument seal 15 in the event of excessive deflection of the instrument seal 15.

As described above, we have fully described the gist of the present application, but the present application is not limited to the above-described embodiments and implementation methods. A practitioner of the related art may make various changes and implementations within the scope of the technical idea of the present application.