JP3682703B2 - Medical retractor - Google Patents

Description

[0001]
[Technical field to which the invention belongs]
The present invention relates to a simple medical retractor that holds the wound lip open when performing surgery (hereinafter, unless otherwise specified in this specification, the term “medical retractor” is simply referred to as “retractor”). ").
[0002]
[Prior art]
There are many retractors of this type of conventional example.
For example, the retractors described in JP 2000-60861 A, JP 11-226022 A, JP 10-504743 A, etc. (hereinafter, these conventional examples are collectively referred to as “the former conventional examples”). However, none of them has a complicated structure, is not always easy to handle, and is not in a form that can be used easily.
[0003]
On the other hand, the retractor 50 (hereinafter referred to as “the latter conventional example”) that is widely used has the following structure because it can be used easily even now.
As shown in FIG. 7, the retractor body 52 is provided with a flange 54 on one side and a handle 56 is provided on the other side of the retractor body 52. The retractor 50 is made of stainless steel or the like. It was provided integrally with metal, and its length was generally about 250 to 300 mm.
[0004]
Therefore, the use or operation of the latter retractor 50 of the conventional example is exemplified as follows for an open operation of the back of the spine (vertebra).
As known for the purpose of ensuring that the surgeon observes the affected area of the human body, first, the skin of the spine portion was incised with a medical knife (not shown) to prepare for the development of the retracted part and the maintenance of the visual field. .
Then, the retractor 50 is used for the deployment of the retracted part, the buttocks 54 are inserted into the outer edge of the joint joint on the back, the skin and muscle groups are moved outward with the joint protrusion as a fulcrum, and the inside of the joint protrusion The surgical field was expanded to observe and treat the wound.
In this case, after the incision of the skin, keep the deployment state of the retracted part carefully so as not to interfere with the operation for a certain period of time until the operation is completed and while reducing the burden on the patient. This is very important for surgery.
[0005]
Therefore, in the latter conventional example, after the incision of the skin by the surgeon, in order to continuously maintain the deployed state of the wound part, the handle 56 is operated to resist the restoring action of the spine skin and muscles, A certain space or retractor was developed inside the articular process to leverage the outer edge of the joint.
[0006]
Then, after the surgeon develops the retractor, the assistant holds the handle 56 of the retractor 50 in place of the surgeon, and the deployment state of the target retractor as described above for a certain time until the operation is completed. It was done to maintain.
[0007]
[Problems to be solved by the invention]
The problem to be solved by the present invention is that the former retractor of the conventional example has a complicated structure and is not always easy to handle.
On the other hand, the retractor 50 of the latter conventional example has an advantage that it can be used easily, but it requires the skill of an assistant, and the assistant can maintain the posture of the retracted part while maintaining the posture of the body. The maintenance needs to be performed continuously, and the work is artificially performed. In particular, it has been difficult to maintain for a long time.
Further, due to the fatigue of the assistant or the like, there is a possibility that a problem occurs in the deployment state of the target retractor, and the operation intended by the surgeon may be impaired.
In addition, the presence of an assistant holding the retractor 50 beside the surgeon during the operation is troublesome, and there are many drawbacks that often impede the surgeon's operation.
As in the present invention described below, a suture is attached to one end of the latter retractor 50 on the handle 56 side so as to control the posture of the retractor 50, and the other end of the suture is attached to the patient. It is theoretically conceivable to maintain the deployed state of the wound part continuously by fixing to the skin.
However, the retractor 50 of the latter conventional example is provided integrally with the flange 54 side and the handle 56 side, and the entire length thereof is generally about 250 to 300 mm. If the retractor 50 is present in the vicinity of the retracted part, it is obvious that the retractor 50 cannot be adopted because it interferes with the delicate and free operation of the surgeon in combination with the presence of the assistant. To.
Accordingly, an object of the present invention is made to eliminate the above-described drawbacks of the conventional example.
[0008]
[Means and effects for trying to solve the problems]
To achieve the above object, the invention of the medical retractor according to claim 1,
In a medical retractor with a buttocks on one side and a handle on the other side,
A retractor body provided with a collar on one side and a retractor slave provided with a handle on the other side are detachably provided,
A support hole is provided on the other side of the retractor body, and a suture thread can be attached to the support hole as a control means for controlling the posture of the retractor body.
[0009]
Since the invention of the medical retractor according to the first aspect has the above-described configuration, the following effects can be obtained.
Since the retractor body and retractor follower are detachable, the retractor follower is removed from the retractor body after the medical retractor is prepared for the patient's surgery and the retractor is held in a certain position. Can be separated.
Then, maintain a constant posture, separate the retractor follower, for example, attach a suture thread to the other support hole on the other side of the retractor body, and move away from the retractor body By fixing the end of the suture in the direction to the patient's skin, in the conventional example, it is possible to omit what the surgeon's assistant held in a certain position of the retractor by hand, so no assistant is required .
Therefore, since it is not an artificial retractor posture control by an assistant, a static certainty of the retractor posture control can be expected, so that there is no possibility of unexpected trouble during the operation.
In addition, although there is no assistant beside the surgeon and the control means is attached to the retractor body, its length is, for example, halved compared to the entire length of the retractor. Since the space can be widened, it can contribute to the improvement of the delicate and free operation of the surgeon.
Furthermore, for example, since the length of the retractor body can be reduced by half compared to the conventional example, for example, the space for the surgical operation of the medical instrument necessary for maintaining the space of the retractable part There is no protrusion.
Therefore, since there is no obstacle in the space part of the retracted part, free surgical operation is not hindered.
In addition, since the control means is a suture, the surgeon can easily use it, and one end of the suture is appropriately fixed to the other side of the retractor body, and the other end is fixed to the affected part of the patient. The posture of the retractor body can be easily controlled by suturing the skin near the side.
Since the control means is a suture, the suture can be attached to the retractor body simply by tying one suture end through the support hole of the retractor body, further improving the operability and convenience of the retractor. Is expensive.
[0010]
The invention of the medical retractor according to claim 2 is the invention of the medical retractor according to claim 1, wherein the operating member having an engaging projection corresponding to the support hole is provided through the strip. Being armed on one side of the body,
An engagement protrusion is detachably provided in the support hole.
[0011]
Since the invention of the medical retractor according to claim 2 has the above-described configuration, in addition to the effects provided by the invention of the medical retractor according to claim 1, the following effects are achieved.
Since the engaging protrusion of the retractor follower is detachable from the support hole and is provided in correspondence with the support hole, there is an advantage that both attachment and detachment operations can be performed in a very short time.
The ability to perform both attachment and detachment operations in a very short time has a great medical or technical significance, particularly in this type of retractor used for highly urgent surgery.
[0012]
A medical retractor according to a third aspect of the present invention is the medical retractor according to the first or second aspect, wherein the support hole is configured to allow the suture to be attached thereto, together with the engagement. It is characterized in that the mating protrusion is engaged.
[0013]
Since the invention of the medical retractor according to claim 3 has the above-described configuration, in addition to the effects provided by the invention of the medical retractor according to claim 1 or 2, the following effects are exhibited.
Since the support hole is configured to allow the suture to be attached and the engagement protrusion is also engaged, the support hole has an advantage that it can be used for mounting the suture and the engagement protrusion.
[0014]
The invention of the medical retractor according to claim 4 is the invention of the medical retractor according to claim 1 , 2 or 3, wherein the medical retractor is provided with a void inside and is in the longitudinal direction of the retractor slave. A casing having a guide groove facing the cavity side is attached to one side of the retractor follower, and the cavity is formed to penetrate from one side of the casing;
The guide groove leaves a part of the upper surface of the casing, is formed from one side to the other side, and the other side is opened,
An operating member is elastically mounted through a striated body from a space in the casing to an open end of the guide groove, and an engagement protrusion corresponding to a support hole provided in the retractor body is provided on one side of the operating member. It is characterized by that.
[0015]
Since the invention of the medical retractor according to claim 4 has the above-described configuration, in addition to the effects provided by the invention of the medical retractor according to claim 1, 2, or 3, the following effects are exhibited.
The other side of the operating member is directed upward due to the elastic force of the striated body, while one side of the operating member is directed downward in the opposite direction.
Is engaged with the support hole.
On the other hand, when the engaged state of both is released and the retractor body is used independently, the retractor body is pushed down against the elastic force of the operating member, and the retracting protrusion is pulled out of the support hole, thereby retracting the retractor. The connection between the main body and the retractor follower is quickly released.
[0016]
The invention of the medical retractor according to claim 5 is the invention of the medical retractor according to claim 4, wherein the operating member is elastically mounted in the casing with the other side facing upward and one side facing downward. It is characterized by this.
[0018]
DETAILED DESCRIPTION OF THE INVENTION
A medical retractor according to an embodiment of the present invention will be described with reference to the drawings.
The present invention is not limited to the following embodiments, and various modifications can be made within the scope of the gist of the invention.
FIG. 1 is an exploded perspective view showing a state before the retractor body and retractor slave of the medical retractor according to the embodiment of the present invention are mounted, and FIG. 2 is the mounting of the retractor body and retractor slave. FIG. 3 is a longitudinal sectional view of the main part, and is an enlarged vertical sectional view showing a state after the retractor body and the retractor slave are mounted. FIG. 4 is a longitudinal sectional view of the main part. FIG. 5 is an enlarged longitudinal sectional view showing a state before the retractor body and the retractor slave are attached, FIG. 5 is a side view showing the use state of the retractor, and FIG. 6 is a front view showing the use state of the retractor body. FIG. 7 is a perspective view showing a conventional medical retractor.
[0019]
In the medical retractor 10 according to the embodiment of the present invention, a retractor body 10a having a collar 12 on one side and a retractor slave 10b having a handle 14 on the other side are detachably provided. This is a basic configuration (see FIGS. 1 and 2). The length of the retractor body 10a is 110 mm, the length of the retractor slave 10b is 120 mm, and the total length of both the 10a and 10b is 230 mm. A medical retractor 10 having a main body 10a thickness of 3 mm was employed.
The inventor tried a long one in which the length of the retractor follower 10b is constant (120 mm) so that it can be shared as described above, and the length of the retractor body 10a is 130 mm in accordance with the purpose of the operation.
The inventor tried to manufacture the retractor 10 from stainless steel, but the material of the retractor 10 is not limited.
Any kind of material such as hard plastics and tempered glass can be used as long as it can be used for the purpose of use of the retractor 10.
[0020]
In order to detachably install the retractor body 10a and the retractor slave 10b, a relatively small support hole 16 is provided on the other side of the retractor body 10a (the right side in the drawing of FIG. 1).
Although the details will be described later, the support hole 16 is provided with a function capable of attaching a control means such as a suture thread 18 for the purpose of controlling the posture of the retractor body 10a when used. (See FIGS. 1 and 6).
[0021]
On the other hand, a casing 24 having a rectangular cross section provided with a void 20 on the inner side and having a guide groove 22 facing the void 20 in the longitudinal direction of the retractor slave 10b is one of the retractor slaves 10b. It is mounted on the side (left side in the drawing of FIG. 1).
The structure of the casing 24 will be described in more detail. The space 20 is formed so as to penetrate from one side of the casing 24.
Further, the guide groove 22 facing the void 20 is formed from one side to the other side so as to cut out most of the other side while leaving one side of the upper surface of the casing 24 in the drawing. The side is open.
[0022]
Then, an operating member 28 is elastically mounted from a space 20 of the casing 24 to an open end of the guide groove 22 via a strip 26 such as a leaf spring (see FIGS. 3 and 4).
Although the operation member 28 is not restricted by the material thereof, in this embodiment, the operation member 28 is provided by an elongated metal piece, and the width thereof is slightly narrower than the width of the guide groove 22 described above.
[0023]
An engagement protrusion 30 corresponding to the support hole 16 provided in the retractor body 10a is provided on one side of the operation member 28, that is, below the retractor body 10a side.
In the normal state, the engagement protrusion 30 is engaged with the support hole 16 by being controlled by the stress of the elastic force of the ridge 26, and the retractor body 10a and the retractor slave 10b are coupled.
[0024]
This point will be described in more detail. The operation member 28 is elastically mounted by the elongated body 26 from below the other side of the space 20 of the casing 24 to below the open side of the space 20.
In this case, when the operation member 28 is in a normal state, the other side, that is, the handle 14 side is set upward, and one side of the operation member 28, that is, the retractor body 10a side is set downward.
[0025]
The operation member 28 has a taper-like upwardly inclined state in the drawing, and in order to make the operation member 28 in such an inclined state, a strip 26 is mounted below the other side of the operation member 28. Yes.
The other side of the elongated body 26 is fixed by a support member 32, and one side thereof is supported by the inner surface 20 a of the space 20 of the casing 24.
In this way, the other side of the operation member 28 is directed upward while the other side of the operation member 28 is directed downward in the opposite direction due to the resilient force of the splaying body 26, so that the engagement protrusion of the operation member 28 described above is normal. 30 is engaged with the support hole 16 of the retractor main body 10a.
[0026]
On the other hand, when the engagement state between the two members is released and the retractor body 10a is used independently as described later, it is pushed down against the elastic force of the elongated member 26 of the operation member 28 to engage the retractor body 10a. By causing the protrusion 30 to come out of the support hole 16, the connection between the retractor body 10a and the retractor slave 10b is quickly released.
[0027]
In the drawing, two circular holes 34 are formed on the other side of the retractor follower 10b, but this is merely a reduction in weight.
[0028]
Next, the case where the affected part of a patient's spine is operated with the retractor 10 according to the embodiment of the present invention will be described with reference to FIGS. 5 and 6.
First, the surgeon cuts the skin near the spine with a medical blade (not shown).
Next, the incision is opened using a skin retractor (not shown), the retractor 10 is subsequently inserted into the opened incision, and the buttocks 12 are brought into contact with the outside of the joint projection Sa of the spine S, As shown by a symbol “arrow” in FIG. 5, the outside of the joint projection Sa is used as a fulcrum to cause the skin and muscle groups to be caused outward.
Thus, the retracting portion is developed inside the joint projection Sa.
The size of the retracted portion varies depending on the purpose of the operation, but generally has a depth of 50 to 70 mm and a diameter of about 25 mm in preparation for an operation under a microscope (see FIG. 6).
Accordingly, the length of the retractor main body 10a is preferably at least 50 to 70 mm or more, corresponding to the depth from the skin to the fulcrum of the joint projection Sa in order to keep the skin and muscle layers outward.
[0029]
By the way, it is important to continuously maintain the retracted part as a constant space for a certain period of time until the operation is completed, but in the present invention, in order to continuously maintain the retracted part as a constant space, Do as follows.
[0030]
After the retracting portion is deployed, the operating member 28 is pushed downward against the elastic force of the strip 26 (see FIGS. 3 and 4) in order to detach the retractor follower 10b from the retractor body 10a. .
Thus, for example, when one end of the suture thread 18 is not attached in advance in a state where the retracted portion is maintained as a constant space by the retractor body 10a having a half length, the suture thread 18 is supported by the support hole 16. The other end of the suture thread 18 is sutured to the patient's skin while maintaining the posture of the retractor body 10a while maintaining the retractable portion as a constant space.
[0031]
Thus, since the posture of the retractor body 10a is continuously controlled to be constant without using artificial means, the retracted part developed by the collar 12 of the retractor body 10a is continuously provided as a constant space. Maintained.
Therefore, the surgeon can concentrate on the operation without worrying about troubles in the wounded part.
[0032]
In order to achieve the object of the present invention, the inventor has also planned a retractable form of the retractor body 10a and the retractor slave 10b.
However, when the retractor body 10a and the retractor body 10b are folded in half, the thickness is expected to be twice as large as the thickness (3 mm) of the retractor body 10a of the above-described form.
Therefore, there is a possibility that the visual field of the retracted part may be hindered.
Therefore, when the retractor body 10a and the retractor slave 10b are folded in two, it is necessary to consider the material and the like so as to reduce the thickness while considering the strength.
Similarly to the above-described embodiment, it is also the same that the retractor body 10a is provided with a control means such as a suture thread for controlling the posture of the retractor body 10a.
Control means such as a suture is provided on the other side of the retractor body 10a, and is also planned to be provided on one side of the back surface that becomes the front surface when the retractor slave 10b is folded.
Further, although illustration is omitted at the boundary between the two 10a and 10b, it is also planned to control the horizontal state of both the 10a and 10b and the suppression of the reluctance during folding by providing a rotating shaft and a stopper.
[Brief description of the drawings]
FIG. 1 is an exploded perspective view showing a state before mounting a retractor body and a retractor slave of a medical retractor according to an embodiment of the present invention.
FIG. 2 is a perspective view showing a state after attachment of the retractor body and retractor slave of the medical retractor according to the embodiment of the present invention.
FIG. 3 is a longitudinal sectional view of a main part of the medical retractor according to the embodiment of the present invention, and is an enlarged longitudinal sectional view showing a state after the retractor body and the retractor slave are mounted.
FIG. 4 is a longitudinal sectional view of a main part of the medical retractor according to the embodiment of the present invention, and is an enlarged longitudinal sectional view showing a state before the retractor body and the retractor slave are mounted.
FIG. 5 is a side view showing a use state of the medical retractor according to the embodiment of the present invention.
FIG. 6 is a front view showing a use state of the medical retractor according to the embodiment of the present invention.
FIG. 7 is a perspective view showing a conventional medical retractor.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 10 Medical retractor 10a The retractor main body 10b provided with the collar part The retractor slave 12 provided with the handle 12 The collar part 14 The handle 16 The support hole 18 The suture thread 20 The void 22 The guide groove 24 The casing 26 The striation body 28 The operation member 30 Joint protrusion 32 Support member 34 Circular hole 50 The latter conventional medical retractor 52 The latter conventional retractor body 54 The latter conventional collar 56 The latter conventional handle S Spine Sa Joint

Claims (5)

In a medical retractor with a buttocks on one side and a handle on the other side,
A retractor body with a collar on one side and a retractor slave with a handle on the other side are detachably provided,
A medical retractor, wherein a support hole is provided on the other side of the retractor body, and a suture can be attached to the support hole as a control means for controlling the posture of the retractor body. An operating member provided with an engaging projection corresponding to the support hole is elastically mounted on one side of the retractor slave through a strip.
The medical retractor according to claim 1, wherein an engagement protrusion is detachably provided in the support hole . 3. The medical retractor according to claim 1 or 2, wherein the support hole is configured to allow the suture to be attached, and the engagement protrusion is engaged with the support hole . A casing having a cavity on the inside and having a guide groove facing the cavity side in the longitudinal direction of the retractor slave is mounted on one side of the retractor slave, and the cavity Is formed through from one side of the casing,
The guide groove leaves a part of the upper surface of the casing, is formed from one side to the other side, and the other side is opened,
An operating member is elastically mounted through a striated body from a space in the casing to an open end of the guide groove, and an engagement protrusion corresponding to a support hole provided in the retractor body is provided on one side of the operating member. The medical retractor according to claim 1, 2 or 3. The operating member has the other side facing upward and one side facing downward
The medical retractor according to claim 4 , wherein the medical retractor is mounted in a casing .

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