JPH0557854B2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention relates to medical devices, particularly surgical instruments used in reconstructive surgery, especially thoracic surgery, open heart surgery, artificial valve implantation, valve plasty, and stenosis dilation surgery. Regarding.

During cardiac surgeries such as valvuloplasty, valvular dilatation, and prosthetic valve implantation, the atrial incision must be maximally dilated so that it can be formed with minimal damage to the tissue.

Conventionally, a chest spatula consisting of a handle and a hook has been known as an instrument used in thoracic surgery to hold the chest in place during surgery.
Instruments, Apparatuses, Devices and
Equipment) Catalog Volume 2, No. 05-291).

However, such instruments cannot be used to dilate ventricular wounds during open chest surgery and other similar surgeries.

Similarly, hooks for retracting ventricular wounds have been known, consisting of a handle and a hook, whose size can be varied over a wide range (see example: "Townok").
8 pages, No. HL-5053).

During surgeries performed inside the chest, incisions are made minimally in special cases. Then,
This incision must be used at maximum enlargement to provide adequate visibility and to allow convenient access to the valves and other subvalvular structures of the heart.
Known cardiac wound expansion surgical hooks use a series of instruments of varying widths. This traumatizes the atrial tissue and unnecessarily prolongs the surgery.

Furthermore, in the prior art, two branched branches,
Surgical retractors with branched devices and curved operating parts are known (reference example: ``Taunotsu'').
(Townok) p. 8, No. HL-5042). This known retractor has the disadvantage that when the surgeon opens the edges of the wound, his hands obstruct the view of the surgical field. Furthermore, the operation must be performed inside the wound, which is difficult to handle and prolongs the surgical time.

[Problem that the invention seeks to solve]

The present invention aims to solve the above-mentioned problems, namely to provide a retractor that can smoothly and quickly keep the edges of the incision wound expanded to the maximum extent throughout the operation.

[Means for solving problems]

In order to achieve the above object, a surgical retractor according to the present invention has a plurality of branched branches characterized by a curved working part and is equipped with a spreading device,
The branch part is composed of a plurality of parts, each branch part having a fixed part and a movable actuating part attached to the fixed part by a hinge means, and the actuating parts of both plate parts move the branch part. having a common central guide for housing, bent in a curved direction, and rigidly fixed on a central rod mounted on the fixed parts of the branches, with movable rods between the fixed parts of the branches; is provided, one end of the movable rod is connected to the drive part of the dispersion device, the other end is connected to the movable actuating part of the branch, and an opening formed as a slider is fitted and guided in the central rod. It carries a scattering device.

The retractor of the present invention has the ability to expand the wound edge without any disturbance and to immediately expand the wound edge to the required size during surgery without traumatizing the wound edge.

Embodiments of the present invention will be described in detail below with reference to the accompanying drawings.

〔Example〕

The surgical retractor has two bifurcated branches 1 and 2 (FIG. 1).

Each branch 1 or 2 has a fixed part 3 and 4 and a movable actuating part 5 and 6. The fixed parts 3 and 4 are connected by hinge means 7 to the movable actuating parts 5 and 6 of the branches 1 and 2.

The ends 8 and 9 of the actuating parts 5 and 6 of the branches 1 and 2 are bent towards each other so that they can be moved into the slot 10 of the central guide 11. The central guide 11, like the ends 8 and 9 of the actuating parts 5 and 6, has a curved shape.

The central guide 11 is rigidly fixed in a central rod 12 connected to the fastening parts 3 and 4 of the branches 1 and 2. The movable rod 13 connects the fixed parts 3 and 4 of the branches 1 and 2.
It is positioned between. One end of the movable rod 13 is connected to a slider 14 movable along the central rod 12.

The recess 16 accommodates hinge means 17 provided in the side surface 15 of the slider 14. Hinge 17
are provided on the side protrusions 18 of the branched branches 1 and 2.

The other end of the rod 13 reaches a knob 19 of a drive mechanism (not shown) for moving the slider 14 of the spreader having the branches 1 and 2. The drive mechanism is, for example, a kinematic pair, such as a screw set.

Branches 1 and 2 have a common handle 20.

[Effect]

For example, during open heart surgery such as prosthetic heart valves, implantation, valvuloplasty, stenotic valve dilatation, etc., surgical retractors (Figure 1) for diffusing the edges of the ventricular wound are used as follows: Manipulate.

The retractor together with actuating parts 5 and 6 is introduced into an incision made in the atrial wall (not shown). In this position, the ends 8 and 9 of the actuating parts 5 and 6 of the branched branches 1 and 2 are pushed completely into the slot 10 of the central guide 11. The width of the working parts 5 and 6 introduced into the incision in the atrial wall is at its minimum width. The central rod 12 with the branches 1 and 2 and the central guide 11 fixed thereon is curved like a hook (FIG. 3) so that the retractor can be inserted into the wound incision and thereby close the edges of the wound. After retracting the hook, operate it in the same way as a conventional hook. In that way, the surgeon can take his hands off the surgical field and hold the retractor at the handle. The surgeon can operate it freely. This also improves the visual control conditions of the surgical field. After the actuating parts 5 and 6 of the bifurcated branches 1 and 2 of the retractor have been inserted into the incisions in the atrial wall, the knob 19 of the movable rod 13 is rotated to move the slider 14 along the central rod 12. Movement of the slider 14 allows movement of the branches 1 and 2 on the hinge means 17. Branches 1 and 2
The actuating parts 5 and 6 of the traction device are connected to the fixed parts 3 of the branches 1 and 2 of the retractor.
and 4 around the hinge means 7 attached thereto. Actuating parts 5 and 6 of branches 1 and 2 move smoothly to dilate the edges of the atrial wound to the desired size.

〔Effect of the invention〕

The above configuration ensures that a retractor formed in accordance with the present invention serves to continuously and immediately expand the surgical wound to the desired size with minimal trauma to the surrounding tissue. This improves the operating conditions for the surgeon. That is, it guarantees manual freedom and provides a wide field of view of the surgical field. The time required for surgery is shortened and the post-surgery recovery period is shortened with good results.

[Brief explanation of the drawing]

FIG. 1 is a schematic overall view of the surgical retractor according to the present invention, FIG. 2 is an enlarged view of the main parts of the surgical retractor according to the present invention, and FIG. 3 is a curved branch of the surgical retractor according to the present invention. FIG. 2 is a diagram schematically showing a movable operating section. 1, 2... branch part, 3, 4... fixed part, 5, 6...
... Actuating part, 7... Hinge means, 8, 9... End of actuating part, 10... Slot, 11... Central guide, 12... Central rod, 13... Movable rod,
14...Slider, 15...Slider side, 1
6... Recess, 17... Hinge means, 18... Side protrusion of the operating portion, 19... Knob, 20... Handle.

Claims (1)

[Claims] 1 A surgical retractor consisting of two branched branches 1 and 2 having curved operating parts 5 and 6 and a spreading device, in which the branches 1 and 2 are formed from a plurality of parts, and each The branches are fixed parts 3, 4 and fixed parts 3, 4
an actuating part 5 attached by hinge means to;
6, the ends 8 and 9 of the actuating parts 5 and 6 of the two branches 1 and 2 are connected by one central guide 11 bent in the direction of curvature of the actuating parts 5 and 6 of the branches 1 and 2. The central guide is housed in the fixed parts 3, 4 of the branches 1, 2.
firmly fixed on the central rod 12 fixed to the
A movable rod 13 is arranged between the fixed parts 3 and 4,
One end of the movable rod is connected to the driving part of the dispersion device, and the other end is attached to the actuating parts 5, 6 of the branches 1, 2 by hinge means, and is fitted and slidable on the central rod 12. A surgical retractor characterized in that it is connected to a dispersion device formed as a slider 14.